Prediction for recurrence following antithyroid drug therapy for Graves' hyperthyroidism

ABSTRACT Objective: A common problem with antithyroid drugs (ATD) treatment in patients with Graves' disease (GD) is the high recurrence rate after drug withdrawal. Identifying risk factors for recurrence is crucial in clinical practice. We hereby prospectively analyze risk factors for the recurrence of GD in patients treated with ATD in southern China. Subjects and methods: Patients who were newly diagnosed with GD and aged > 18 years were treated with ATD for 18 months and followed up for 1 year after ATD withdrawal. Recurrence of GD during follow-up was assessed. All data were analyzed by Cox regression with P values < 0.05 considered statistically significant. Results: A total of 127 Graves' hyperthyroidism patients were included. During an average follow-up of 25.7 (standard deviation = 8.7) months, 55 (43%) had a recurrence within 1 year after withdraw of anti-thyroid drugs. After adjustment for potential confounding factors, the significant association remained for the presence of insomnia (hazard ratio (HR) 2.94, 95% confidence interval (CI) 1.47-5.88), greater goiter size (HR 3.34, 95% CI 1.11-10.07), higher thyrotrophin receptor antibody (TRAb) titer (HR 2.66, 95% CI 1.12-6.31) and a higher maintenance dose of methimazole (MMI) (HR 2.14, 95% CI 1.14-4.00). Conclusions: Besides conventional risk factors (i.e., goiter size, TRAb and maintenance MMI dose) for recurrent GD after ATD withdraw, insomnia was associated with a 3-fold risk of recurrence. Further clinical trials investigating the beneficial effect of improving sleep quality on prognosis of GD are warranted.

Effect of Different Modes of Exercise on Sarcopenia in Older Adults: A Meta-analysis / 中国康复理论与实践

Objective:To evaluate the effectiveness of single modal and multimodal exercise interventions on sarcopenia in the elderly. Methods:Randomized controlled trials about the effects of single modal and multimodal exercises on the improvement of sarcopenia in the elderly were retrieved from seven databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP and Wanfang data) from the establishment of the databases to July, 2021. Two researchers selected the literatures independently, and evaluated the quality of methodology. The meta-analysis was performed with RevMan 5.3. Results:A total of 15 studies were incorporated, including 816 cases of sarcopenia. Compared to the blank control group, the skeletal muscle mass index improved little with single (MD = -0.05, 95%CI -0.14 to 0.04, P > 0.05) and multiple (MD = 0.15, 95%CI -0.01 to 0.31, P > 0.05) exercises. The maximum grip force improved with both single (MD = 2.06, 95%CI 0.25 to 3.87, P < 0.05) and multiple (MD = 2.36, 95%CI 1.10 to 3.63, P < 0.001) exercises. The knee extensors strength (SMD = 0.49, 95%CI 0.26 to 0.73, P < 0.001) and the walking speed (MD = 0.24, 95% CI 0.19 to 0.29, P < 0.001) improved with multimodal exercises. Conclusion:Single modal exercise may improve maximal grip strength in the elderly with sarcopenia, and multimodal exercise may be effective on maximal grip strength, knee extensors strength and walking speed.

Preimplantation Genetic Diagnosis of α/β Complex Thalassemia by Next Generation Sequencing / 中国实验血液学杂志

OBJECTIVE@#To explore the application value of next generation sequencing (NGS) in preimplantation genetic diagnosis of α/β complex thalassemia couple.@*METHODS@#The coding regions of α-globin genes (HBA1, HBA2) and β-globin gene (HBB) were selected as the target regions. The high-density and closely linked single nucleotide polymorphism (SNP) sites were selected as the genetic linkage markers in the upstream and downstream 2M regions of the gene. After NGS, the effective SNP sites were selected to construct the haplotype of the couple, and the risk chromosome of the mutation carried by the couple was determined. The NGS technology was used to sequence the variations of HBA1, HBA2 and HBB directly and construct haplotype linkage analysis for preimplantation genetic diagnosis.@*RESULTS@#Direct sequencing and haplotype linkage analysis of HBA1, HBA2 and HBB showed that two of the six blastocysts were α/β complex thalassemia, one was β-thalassemia heterozygote, two were α-thalassemias heterozygotes, and one was intermediate α-thalassemia. A well-developed embryo underwent preimplantation genetic diagnosis was implanted into the mother's uterus, and a healthy infant was born at term.@*CONCLUSION@#Preimplantation genetic diagnosis can be carried out by NGS technology in α/β complex thalassemia couples, and abortion caused by aneuploid embryo selection can be avoided.

A double-blind, randomized, placebo- and positive-controlled phase III trial of 1% benvitimod cream in mild-to-moderate plaque psoriasis / 中华医学杂志(英文版)

BACKGROUND@#Benvitimod cream, a novel synthetic small molecule, was effective in treating mild-to-moderate plaque psoriasis. We conducted a phase III clinical trial to assess the efficacy and safety of benvitimod cream in patients with mild-to-moderate plaque psoriasis.@*METHODS@#We randomly assigned 686 patients (2:1:1) to receive 1% benvitimod cream, 0.005% calcipotriol ointment or placebo twice a day for 12 weeks. The primary efficacy end points were the percentage of patients with a 75% or greater reduction from baseline in the psoriasis area and severity index (PASI 75) score and with a score of 0 or 1 in static physician's global assessment (sPGA) at week 12.@*RESULTS@#The results showed that 50.4% of patients in the benvitimod group achieved PASI 75, which was significantly higher than that in the calcipotriol (38.5%, P < 0.05) and placebo (13.9%, P < 0.05) groups. The proportion of patients achieving an sPGA score 0 or 1 was 66.3% in the benvitimod group and 63.9% in the calcipotriol group, which were both significantly higher than that in the placebo group (34%, P < 0.05). In the long-term follow-up study, 50.8% of patients experienced recurrence. After retreatment with 1% benvitimod, 73.3% of patients achieved an sPGA score of 0 or 1 again at week 52. Adverse events included application site irritation, follicular papules, and contact dermatitis. No systemic adverse reactions were reported.@*CONCLUSION@#During this 12-week study, benvitimod cream was demonstrated with high effectiveness and safety in patients with mild-to-moderate plaque psoriasis.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry (ChiCTR), ChiCTR-TRC-13003259; http://www.chictr.org.cn/showprojen.aspx?proj=6300.

Interpretation of expert consensus on diagnosis and treatment of eosinophilic granulomatous polyvasculitis in 2018 / 中国实用内科杂志

According to the different organs involved in patients, the concept of localized Eosinophilic granulomatous polyvasculitis(EGPA) was first proposed by consensus in 2018, which provides a basis for the early diagnosis and treatment of EGPA. The prognosis of patients with EGPA is related to the initial treatment. The treatment of EGPA depends on the severity of the disease, the organs involved and whether the disease is active or not. The overall treatment plan is divided into two stages: induction remission and maintenance therapy. Induced remission therapy mainly includes hormones and/or immunosuppressive agents(e.g. cyclophosphamide). After remission, azathioprine or methotrexate is recommended for maintenance therapy. In 2015, the global consensus of EGPA diagnostic and therapeutic experts recommended that the duration of treatment should be at least 24 months after remission. In combination with the latest international progress, the first Expert Consensus on Diagnosis and Treatment of EGPA in China 2018 consensus introduced the application of Bio-Targeting drugs in EGPA.

Establishment of three-dimensional measurement methods of nasolabial soft tissue for patients with maxillary protrusion / 北京大学学报(医学版)

OBJECTIVE@#To establish a series of three-dimensional measurement methods of nasolabial soft tissue for maxillary protrusion patients by using 3dMD camera, and to evaluate preoperative and postoperative changes of the nasolabial soft tissue.@*METHODS@#Three-dimensional facial photos of 30 female patients with maxillary protrusion [average age, (27.33±2.54) years] were taken by 3dMD camera preoperatively and at the end of postoperative 6 months or more. Then, 3dMD patient software was used to locate the selected landmarks at nasolabial region on the three-dimensional photos. Ten measurements, including soft tissue line distance, angle, curve distance and postoperative three-dimensional volume changes were measured twice with one week interval by 3 investigators, respectively. A standard consistency test calculated by the correlation coefficients (ICC) was performed between two sets of data (including all of the 10 measurements) for each investigator and among the three investigators to verify the repeatability.@*RESULTS@#The average maxillary incisor retraction distance of the 30 subjects was (5.13±0.99) mm, and the average follow-up time was (11.07±5.11) months. The standard consistency test was performed between the two sets of data for each investigator, and the correlation coefficients (ICC) of the 10 measurements were all over 0.8 for each investigator (P>0.05). The standard consistency test was performed among the three surveyors, with the result that the ICC of the width of the bilateral inner canthus, the height of the nose, the height of nasal tip, nasolabial angle, philtrum length, the curve height of upper vermilion and the height of upper lip were greater than 0.8 (P>0.05), and the ICC of the distance between SbalSbal, length of nasal dorsum and three-dimensional volume change of upper lip were 0.680, 0.627 and 0.528, respectively (P>0.05).@*CONCLUSION@#3dMD camera and 3dMD patient software can be used to measure and analyze the three-dimensional morphology of the nasolabial soft tissue for patients with maxillary protrusion preoperatively and postoperatively, and it is relatively accurate and reliable. However, the repeatability of three-dimensional positioning of the nasal tip point and the Sbal is slightly worse resulting in the lower value of the ICC of the distance between SbalSbal and length of nasal dorsum, as well as the upper lip three-dimensional volume change after the operation.

A non-surgical rat model of foreign body-associated urinary tract infection with ESBLs-producing E.coli injection / 医学研究生学报

Objective At present, the traditional model of urinary tract infection is not only complex in operation process but also easy to be infected, and the model with simple transurethral bacterial injection is not stable enough. This study established a rat model of foreign body-associated urinary tract infection. A spiral polyethylene tube (PT) was placed transurethrally into the bladder by transurethral inoculation with extended-spectrum β-lactamases-producing Escherichia coli (ESBLs E.coli).Methods SD female rats were randomly divided into blank control group, no foreign body groups at 7d and 14d, foreign body groups at 7d and 14d. ESBLs E.coli was injected transurethrally by foreign body into the bladder in foreign body groups. The same volumes of ESBLs E.coli and sterile saline were injected respectively in no foreign body and blank groups. Examination was made on bilateral renal gravity index, the numbers of white blood cells and neutrophils, the bacteriological and pathological changes in urine and kidney.Results The bilateral renal gravity index, the percentage of neutrophils and and the positive rates of renal and urine bacteria culture in foreign body groups at 7d and 14d were significantly higher than those in blank control group and no foreign body groups(P＜0.05). The number of white blood cells in foreign body group at 7d was significantly higher than those of blank control and no foreign body group(P＜0.05). The positive rates of renal and urine bacteria culture were 100% in the foreign body groups at 7d and 14d. The positive rate of urine bacteria culture in no foreign body at 7d was 33.3%. Under the light microscope, there were inflammatory changes in the kidney and bladder tissues of the rats in foreign body groups, and a few fibrous tissues were formed around glomeruli in foreign body group at 14d.Conclusion The establishment of a highly successful and stable rat model of urinary tract infection can be successfully achieved by injection of ESBLS E.coli through transurethral foreign body placed in bladder.

A New Modified FOLFIRINOX(mFOLFIRINOX)Regimen as First-Line Chemotherapy for Patient with Metastatic Pancreatic Adenocarcinoma(MPC) / 中山大学学报(医学科学版)

[Objective]To investigate efficacy and toxicity of a new modified FOLFIRINOX regimen(mFOLFIRI-NOX)as first-line chemotherapy for the patients with metastatic pancreatic adenocarcinoma(MPC).[Methods]20 patients with metastatic pancreatic adenocarcinoma(MPC)accepted mFOLFIRINOX arm(oxaliplatin 60 mg/m2,irinotecan 150 mg/m2,bolus of 5-FU 400 mg/m2,continuous infusion of 5-FU 2 400 mg/m2)first-line treatment and evaluated the curative effect and side effect after 3 cycles by imaging and laboratory at Sun Yat-sen Memorial Hospital from December 2012 to December 2016.The primary endpoint was overall survival(OS).The second endpoint was response rate(ORR) and toxicity.[Results]Four patients were excluded according to exclusion criteria. A total of 16 patients were enrolled including 7 males and 9 females.The median age is 55 years(ranging from 43 to 67 years).The median cycle of chemo-therapy was 4.5(3-15). The ORR was 31.3% including 5 patients with partial response,9 patients with stable disease and 2 patients with progression disease.The median follow-up duration was 14.1(2.7-24.5)months.The median OS was 16.6 months(95%CI,11.36-21.84). Overall survival rates at 6,12months were 80%and 55.6%,respectively. Three patients were presented grade 3-4 adverse events.[Conclusion]The new mFOLFIRINOX regimen improved survival of patients with MPC with tolerated toxicity as first line treatment.

Possible effect of N-acetyl-leu-leu-norleucinal, an inhibitor of Calpain, on H2O2-induced damage in 661W cells / 中国药理学通报

Aim To investigate the possible effect of N-acetyl-leu-leu-norleucinal (ALLN),an inhibitor of Calpain,on H2O2-induced damage in 661W cells.Methods The cellular survival of 661W treated with different doses of H2O2 without or with ALLN for 24 h was measured by MTT assay.The protein level of Calpain 1 and Calpain 2 was assessed by Western blot.Results Upon the H2O2 treatment at the concentrations of 50,100,500,1 000 μmol · L-1,the survival rate of 661W significantly decreased in a dose-dependent manner compared to that of the control group.Furthermore,the protein level of Calpain 1 and Calpain 2 showed an obviously time-dependent increase in 661W cells treated with 100 μmol · L-1 H2O2 for 12,18,24 h.Finally,the survival rate of 661W treated with ALLN and H2O2 was higher than that treated only with H2O2,and there was no difference in survival rate between ALLN groups (at the concentrations of 25,50,100,200 μmol · L-1) and control group.Conclusions Calpain is involved in the damage induced by H2O2.ALLN,the inhibitor of Calpain,attenuates the oxidative damage,which plays a promising protective role in photo-receptor cells under oxidative stress.

Early rehabilitation intervention reduces the incidence of extrauterine growth retardation in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effect of early rehabilitation intervention on the incidences of extrauterine growth retardation (EUGR) and early diseases in preterm infants.</p><p><b>METHODS</b>The appropriate-for-gestational-age preterm infants with a gestational age of <34 weeks and a birth weight of 1 000 to <2 000 g who were admitted to the neonatal intensive care unit (NICU) within 24 hours after birth were enrolled in a prospective randomized controlled trial. These infants were randomly divided into rehabilitation intervention group and control group. The infants in the rehabilitation intervention group were given early rehabilitation after their vital signs became stable, including oral sensory and muscle strength training and pressure touching of the head, chest, abdomen, extremities, hands, and feet. The primary outcome measures were the time to independent oral feeding, length of hospital stay, and incidence rate of EUGR. The secondary outcome measures were the incidence rates of related diseases in preterm infants, such as apnea, feeding intolerance, and sepsis.</p><p><b>RESULTS</b>A total of 97 preterm infants who met the inclusion criteria and had complete data were enrolled, with 48 in the control group and 49 in the rehabilitation intervention group. The rehabilitation intervention group had a shorter time to independent oral feeding than the control group (P<0.05). Compared with the control group, the rehabilitation intervention group had a shorter length of hospital stay and a lower corrected gestational age at discharge (P<0.05), as well as a lower incidence rate of EUGR (P<0.05). The rehabilitation intervention group ONCLUSIONS: Early rehabilitation intervention for preterm infants in the NICU may reduce the incidence rates of apnea, feeding intolerance, and EUGR and help them to achieve independent oral feeding early.</p>

A 5-year retrospective clinical study of perinatal cytomegalovirus infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence, clinical features, and treatment of perinatal cytomegalovirus (CMV) infection, as well as the factors affecting the therapeutic effect of ganciclovir.</p><p><b>METHODS</b>The clinical data of 237 infants who were hospitalized and diagnosed with perinatal CMV infection from 2008 to 2012 were retrospectively analyzed.</p><p><b>RESULTS</b>The clinical features of infants with perinatal CMV infection and the proportion of such infants in all hospitalized infants showed no significant differences across the five years. In most infants, two or more systems were involved, and CMV hepatitis plus CMV pneumonia was most common (43.1%). The results of pathogen detection showed that the percentage of the infants with positive blood CMV-IgM and blood/urine CMV-DNA was 3.8%, while 90.3% of all infants had positive blood CMV-IgM alone and 5.9% had positive blood/urine CMV-DNA alone. A total of 197 infants were treated with ganciclovir, and the cure rate was 88.3%. An abnormal history of pregnancy (OR=6.191, 95% CI: 1.597-24.002) and liver involvement before medication (OR=3.705, 95% CI: 1.537-8.931) were the independent risk factors affecting the therapeutic effect of ganciclovir in infants with perinatal CMV infection.</p><p><b>CONCLUSIONS</b>The epidemiological characteristics of perinatal CMV infection have remained generally stable for the last 5 years. CMV often involves several organs or systems, especially the liver and lung. Ganciclovir has a significant efficacy in the treatment of perinatal CMV infection, and an abnormal history of pregnancy and liver involvement before medication can increase the risk of ganciclovir resistance in infants with perinatal CMV infection.</p>

Value of Analyzing Hemoglobin Aby ROC Curve for Screening Thalassemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the value of hemoglobin A(HbA) for screening thalassemia.</p><p><b>METHODS</b>A total of 2 000 adults' peripheral blood samples from Guangdong Women and Children Hospital from June 2013 to January 2014 were collected. The hemoglobin A(HbA) level was analyzed by the full automatic capillary electrophoresis technique, and the genotypes of thalassemia were detected.</p><p><b>RESULTS</b>The optimal cutoff values of HbAfor screening silent α-thalassemia, α-thalassemia trait, intermedia α-thalassemia and β-thalassemia trait were 2.85%, 2.65%, 2.25% and 3.45%, respectively; the areas under receiver operator characteristic (ROC) curve were 0.709, 0.839, 0.979 and 0.997 respectively; the sensitivities were 0.481, 0.721, 0.953 and 0.994, and the specificities were 0.846, 0.837, 0.929 and 0.969 respectively.</p><p><b>CONCLUSION</b>The optimal cutoff values of HbAfor screening different type of thalassemia based on our laboratory data are established by using ROC curve. According to the area under ROC curve, a satisfactory accuracy for screening intermedia α-thalassemia and β-thalassemia trait can be achieved by detecting hemoglobin Alevel.</p>

Gas transmitters in female reproductive system / 生理学报

Nitric oxide, carbon monoxide and hydrogen sulfide synthesized endogenously in living organisms produce an array of disparate biological effects, so as to be considered as gas transmitters. These three gaseous molecules play important roles in many physiological and pathological processes in the bodies, such as the regulation of vascular tone and inflammatory responses as well as reproductive function. This review mainly focuses on the distribution and biological functions of these three gas transmitters in female reproductive tissues.

Risk factors for extrauterine growth restriction in preterm infants with gestational age less than 34 weeks / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the correlated factors contributed to extrauterine growth restriction (EUGR) in preterm infants with the gestational age less than 34 weeks.</p><p><b>METHODS</b>A total of 694 preterm infants with the gestational ages less than 34 weeks were enrolled. They were classified into EUGR and non-EUGR groups by weight on discharge. The perinatal data, growth data, nutritional information and morbidities during hospitalization were compared between the two groups.</p><p><b>RESULTS</b>EUGR on discharge occurred in 284 (40.9%) out of the 694 infants. The incidence of EUGR in intrauterine growth restriction (IUGR) infants was significantly higher than in non-IUGR infants (P<0.01). The very low birth weight (VLBW) infants had a higher incidence of EUGR than non-VLBW infants (P<0.01). The incidence of EUGR increased with the decreases of gestational age at birth and birth weight (P<0.01). Compared with the non-EUGR group, the fasting time, the duration of parenteral nutrition, the time beginning to feed and the age to achieve full enteral feeds were significantly greater in the EUGR group (P<0.01). The cumulative protein deficit and cumulative caloric deficit in the first week of life in the EUGR group were higher than in the non-EUGR group (P<0.05). The incidences of respiratory distress syndrome, apnea, necrotizing enterocolitis and septicemia in the EUGR group were higher than in the non-EUGR group (P<0.05). The logistic regression analysis showed that birth weight, gestational age at birth and IUGR were the independent risk factors for EUGR.</p><p><b>CONCLUSIONS</b>The incidence of EUGR in infants with gestational age less than 34 weeks is high, especially in IUGR or VLBW infants. Early and aggressive nutritional strategy and prevention of apnea and septicemia may facilitate to reduce the occurrence of EUGR.</p>

Comparison of liver resection and transplantation for Child-pugh A cirrhotic patient with very early hepatocellular carcinoma and portal hypertension

Objective: The aim of this study was to compare the outcomes of liver transplantation and resection for very early hepatocellular carcinoma [HCC, < 2 cm] patients with Child-pugh A liver function and portal hypertension

Methods: From 2008 to 2013, 38 patients with Child-pugh class A liver function and portal hypertension were diagnosed as very early HCC, of whom 13 patients who received liver transplantation and 25 patients underwent liver resection. We compared the preoperative characteristics, recurrence-free survival [RFS] and overall survival [OS] rates of two group

Results: The baseline characteristics of two groups were similar. No perioperative mortality and liver failure were observed in both groups. The 1-, 3- and 5-year RFS rates of patients received liver resection and liver transplantation were 92.3%, 92.3% 92.3% and 92.0%, 71.7% and 64.5% respectively [P=0.140]

The 1-, 3- and 5-year OS rates of two groups were also similar [100%, 91.7% and 91.7% for group T versus 100%, 93.3% and 93.3% for group R, P=0.695]

Conclusion: Liver resection can offer satisfactory outcomes for very early HCC patients with well liver function and portal hypertension and should be considered as the first line choice for selected patients

Acute lung injury induced by H9N2 virus in mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>H9N2 avian influenza viruses (AIVs) have repeatedly caused infections in mammals even humans in many countries. The purpose of our study was to evaluate the acute lung injury (ALI) caused by H9N2 viral infection in mice.</p><p><b>METHODS</b>Six- to eight- week-old female SPF C57BL/6 mice were infected intranasally with 1 × 10(4) MID50 of A/HONG KONG/2108/2003 [H9N2 (HK)] virus. Clinical signs, pathological changes, virus titration in tissues of mice, arterial blood gas, and cytokines in bronchoalveolar lavage fluid (BALF) and serum were observed at different time points after AIV infection.</p><p><b>RESULTS</b>H9N2-AIV-infected mice exhibited severe respiratory syndrome, with a mortality rate of 50%. Lung histopathological changes in infected mice included diffuse pneumonia, alveolar damage, inflammatory cellular infiltration, interstitial and alveolar edema, and hemorrhage. In addition, H9N2 viral infection resulted in severe progressive hypoxemia, lymphopenia, and a significant increase in interleukin 1, interleukin 6, tumor necrosis factor, and interferon in BALF and serum.</p><p><b>CONCLUSIONS</b>The results suggest that H9N2 viral infection induces a typical ALI in mice that resembles the common features of ALI. Our data may facilitate the future studies of potential avian H9N2 disease in humans.</p>

Complete genomic analysis of a novel infectious bronchitis virus isolate / 病毒学报

The genome of CK/CH/SD09/005, an isolate of infectious bronchitis virus (IBV), was characterized to enable the further understanding of the epidemiology and evolution of IBV in China. Twenty-five pairs of primers were designed to amplify the full-length genome of CK/CH/SD09/005. The nucleotide sequence of CK/CH/SD09/005 was compared with reference IBV strains retrieved from GenBank. The phylogenic relationship between CK/CH/SD09/005 and the reference strains was analyzed based on S1 gene sequences. The complete genome of CK/CH/SD09/005 consisted of 27691 nucleotides (nt), excluding the 5' cap and 3' poly A tail. The whole-genome of CK/CH/SD09/005 shared 97 - 99% nucleotide sequence homology with the GX-NN09032 strain, which was the only complete genome that was closely related to CK/CH/SD09/005. When compared with all reference strains except GX-NN09032, CK/CH/SD09/005 showed the highest similarity to ck/CH/LDL/091022 and SDIB821/2012 (QX-like) in the replicase gene (Gene 1) and 3'UTR, with a sequence identity rate of 97% and 98%, respectively. However, CK/CH/SD09/005 exhibited lower levels of similarity with ck/CH/LDL/091022 and SDIB821/2012 in S-3a-3b-3c/ E-M-5a-5b-N with a sequence identity of 72% - 90%. CK/CH/SD09/005 showed the highest level of nucleotide identity with Korean strain 1011, and Chinese strains CK/CH/LXJ/02I, DK/CH/HN/ZZ2004 and YX10, in ORF 3c/E (97%), 5a (96%), 5b (99%) and N (96%), respectively. ORFs 3a, 3b and M of CK/CH/SD09/005 exhibited no more than 90% homology with the reference strains, excluding GX-NN09032. The phylogenic analysis based on the S1 gene revealed that CK/CH/SD09/005 and 39 published strains were classified into seven clades (genotypes). CK/CH/SD09/005 was distributed in clade IV with several isolates collected between 2007 and 2012. CK/CH/SD09/005 showed 66% - 69% and 72% - 81% nucleotide identities with the IBV strains of other six clades in the S1 and S2 subunits, respectively. More over, multiple substitutions were found throughout the entire S gene of CK/CH/SD09/005, while insertions and deletions were located within the S1 gene. These results indicated that CK/CH/SD09/005 is a novel variant that may be derived from the QX-like strains that are prevalent in China. Multiple genetic mechanisms, including recombinations, mutations, insertions and deletions, are likely to have contributed to the emergence of this IBV strain.

The role of HIF-1α, β-catenin, IMP3 and PCNA in proliferation of gastric cancer SGC-7901 cells / 肿瘤

Objective: To explore the effects of HIF-1α (hypoxia-inducible factor-1α), β-catenin, IMP3 (insulin-like growth factor II mRNA-binding protein 3) and PCNA (proliferating cell nuclear antigen) on proliferation of gastric cancer SGC-7901 cells. Methods: The pcDNA™ 6.2-GW/EmGFP-miR- β-catenin plasmid was transfected into SGC-7901 cells to establish stably transfected cell line miR- β-catenin-7901. In this experiment, four groups were designed: control group (SGC-7901 cells were cultured under normoxic conditions), hypoxia group (SGC-7901 cells were cultured under hypoxic conditions), transfection group (miR-β-catenin-7901 cells were cultured under normoxic conditions), and combination of transfection and hypoxia group (miR-β-catenin-7901 cells were cultured under hypoxic conditions). The proliferation of SGC-7901 cells in four groups was detected by colony formation assay and cell doubling time assay. The expression levels of HIF-1α, β-catenin, IMP3 and PCNA proteins of SGC-7901 cells in four groups were detected by Western blotting. Results: As compared with the control group, the number of colonies was increased and the cell doubling time was shortened in hypoxia group (P < 0.05). As compared with the hypoxia group, the number of colonies was reduced and the cell doubling time was prolonged in the combination of transfection and hypoxia group (P < 0.05). The expression levels of HIF-1α, β-catenin, IMP3 and PCNA proteins in hypoxia group were higher than those in the control group (P < 0.05). The expression levels of HIF-1α, β-catenin, IMP3 and PCNA proteins in the transfection group were lower than those in the control group (P < 0.05). The expression levels of HIF-1α, β-catenin, IMP3 and PCNA proteins in the combination of transfection and hypoxia group were lower than those in the hypoxia group (P < 0.05). Conclusion: The proliferation of gastric cancer SGC-7901 cells may be related to the interaction of HIF-1α and β-catenin, which resulted in the increased expression levels of IMP3 and PCNA. Copyright © 2013 by TUMOR.

Removal of a broken guide wire entrapped in a fractured femoral neck / 中华创伤杂志(英文版)

Guide wire plays an important role in the fixation of femoral neck fracture with dynamic hip screw (DHS). Breakage of a guide wire during operation is a very rare condition. We met such a dilemma in DHS fixation of a 54-year-old male patient who sustained Garden type IV fracture of the right femoral neck. The distal end of the guide wire broke and was entrapped in the fractured femoral neck. We tried to get the broken part out by a cannulated drill. Reaming was started with the cannulated drill slowly rotating around the guide K-wire until the reamer fully contained the target under fluoroscope. A bone curette was used to get the broken wire out but failed, so we had to use the cannuated drill to dredge this bone tunnel. Finally the broken wire end was taken out, mixed with blood and bone fragments. Through the existing drilling channel, DHS fixation was easily finished. The patient had an uneventful recovery without avascular necrosis of femoral head or non-union of the fracture at one year's follow-up. A few methods can be adopted to deal with the broken guide wire. The way used in our case is less invasive but technically challenging. When the guide wire is properly positioned, this method is very practical and useful.

Comparison of blood loss during total knee arthroplasty between haemophilic arthropathy and osteoarthritis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the amount of blood loss and the efficacy of clotting factor in controlling blood loss during total knee arthroplasty.</p><p><b>METHODS</b>The medical documents of 18 patients with haemophilic arthritis (HA) secondary to haemophilia A and 19 patients with osteoarthritis (OA) were retrospectively reviewed. Demographic data,functional and hematological test results,the amount of blood loss and transfusion,and complications were analyzed.</p><p><b>RESULTS</b>The median amounts of total and external blood loss were 2240 ml(1892-3415 ml) and 1326 ml(934-2256 ml)in the HA group, which were significant higher than those in the OA group [1746 ml(1259-2246 ml)and 846 ml (504-1217 ml), respectively]. The median amounts of external blood loss in the two groups were 680 ml(370-1330 ml)and 730 ml(200-1190 ml)and there was no significant difference(p=0.620). Moreover, more patients in the HA group required blood transfusion (84.2% vs. 47.4%), and more red cells were transfused per patient in the HA group (2.3 U vs. 0 U).</p><p><b>CONCLUSIONS</b>The total blood loss and hidden blood loss are higher in the HA patients than in OA patients during total knee arthroplasty, although the external blood loss is basically the same. Management with more clotting factor may decrease the blood loss in HA patients.</p>