[Expression of type 1 and type 2 cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis at earlier stage].

Objectives: To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied. Methods: A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1ß, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged. Results: The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1ß, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1ß, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52. Conclusion: There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.

Reverse sural flap with an adipofascial extension for reconstruction of soft tissue defects with dead spaces in the heel and ankle.

INTRODUCTION: The reconstruction of soft tissue defects with dead spaces in the heel and ankle is challenging. This article describes our experience in the reconstruction of such defects using the reverse sural flap with an adipofascial extension. METHOD: Reverse sural flaps with an adipofascial extension were used in 26 patients with soft tissue defects in the heel (n = 24) or ankle (n = 2). Extended adipofascial tissue was utilized to fill the dead space. The sizes of the adipofascial extensions varied from 2.0 to 5.0 cm in length and 4.0 to 12.5 cm in width. RESULT: Twenty-three flaps survived completely, and lateral marginal necrosis occurred in three flaps. All the recipient-site wounds healed without any signs of infection. The reconstruction outcomes were excellent in 20 patients and good in 6 patients according to the criteria of Boyden et al. CONCLUSION: The extended adipofascial tissue of the reverse sural flap improves closure of the dead spaces in soft tissue defects of the heel and ankle and thus provides beneficial conditions for the treatment of infection and reconstruction of both the function and contour of the soft tissue defects with dead spaces in the heel and ankle.

Deep inferior epigastric vessel-pedicled, muscle-sparing rectus abdominis myocutaneous (RAM) flap for reconstruction of soft tissue defects in pelvic area.

Large soft tissue reconstruction in pelvic area is rare but remains challenging. Between August of 2000 and March of 2014, five patients underwent soft tissue reconstruction in pelvic area using deep inferior epigastric vessel-pedicled, muscle-sparing RAM flap. The soft tissue defects located in anterior iliac spine in three cases, lower buttock in one case, contralateral lower buttock and perineal region in one case. The size of the flaps ranged from 13 × 7 cm to 25 × 9 cm. All flaps were harvested in muscle-sparing form. Lateral two-thirds of rectus abdominis muscle and anterior sheath of the rectus abdominis muscle were harvested with the flap in disc or bar shape. All five flaps survived uneventfully. During the follow-up, no ventral hernias occurred in donor sites.

Artificial permeability and antibonding magnetic resonance in a copper-structured metamaterial with symmetry-broken ring-plate resonators.

We numerically investigate the antibonding magnetic resonance in a metamaterial composed of rings and plates, with a particular attention to the influence of broken structural symmetry on the Fano-type transmission spectrum as well as the resonant artificial permeability. From the simulation results, it is obvious that the antibonding magnetic resonance with strong magnetic-dipole coupling is responsible for the Fano-type profile, since an increase of the structural asymmetry extent to reduce the magnetic field confinement in one of the gaps will form, in contrary, a Lorentzian resonance dip. The dual excitation pathways, i.e., electric and magnetic resonances, at destructive interference are the underlying reason of the Fano-type transmission response. Additionally, the structural-asymmetry dependence of the artificial permeability shows that the broken symmetry can strongly modify the effective permeability due to the altering magnetic-dipole interactions. It is found that an anti-resonant curve of permeability versus frequency will be resulted in if significant symmetry-broken structure is introduced.

One-staged reconstruction of Achilles tendon and overlying skin defects with suppuration: using peroneus brevis tendon transfer and reversed sural neurofasciocutaneous flap.

The combined loss of the Achilles tendon and the overlying soft tissue with suppuration has been treated with many single- or multi-staged procedures, most of which are technically complex. The ideal single-stage procedures are needed. Ten patients with combined loss of the Achilles tendon and the overlying soft tissue underwent reconstruction using peroneus brevis tendon transfer and reversed sural neurofasciocutaneous flap. Follow-up was 8-48 months. Of the 10 flaps, 9 survived uneventfully except for 1 flap that had distal marginal necrosis; the flap healed following a dressing change. The flaps were wear-resistant and cosmetically acceptable. All the patients were able to perform heel lift with the operated limb and resumed walking. No Achilles tendon re-rupture or misbalance of ankle joints occurred as of date. The Arner-Lindholm evaluation standard was taken to evaluate the curative effect; the results were excellent in seven cases and good in three cases. As a one-stage procedure, the peroneus brevis tendon transfer and reversed sural neurofasciocutaneous flap is an ideal option to reconstruct the combined loss of the Achilles tendon and the overlying soft tissue.

Up-regulation of HLA-G expression in cervical premalignant and malignant lesions.

The human leukocyte antigen G (HLA-G) molecule, a non-classical major histocompatibility complex class I antigen, exhibits highly limited tissue distribution and gene variation. Recent studies indicate strong immunoinhibitory properties in tumor cells that may favor their escape from anti-tumor immune responses. However, the role of HLA-G in cervical premalignant and malignant lesions has not been defined clearly. In our study, HLA-G expression was studied in cervical tissue from 119 patients with lesions and 22 normal cervical tissue specimens by immunohistochemistry. HLA-G was expressed in 45% (54/119) of cervical lesion-containing tissues while it was rarely detectable (0/22) in the control specimens (P = 0.000). ROC curve analysis showed that HLA-G has an area under the curve (AUC) of 0.694. Furthermore, we investigated soluble HLA-G expression in the plasma of 172 patients with cervical lesions and 20 healthy controls. Significant increases were also observed in soluble HLA-G levels (median, 191.4 vs 45.18 U/ml, P < 0.001). The relative operating characteristic (ROC) curves for soluble HLA-G (sHLA-G), squamous cell carcinoma (SCC), and carbohydrate antigen 125 (CA125) show an AUC of 0.710, 0.634, and 0.588, respectively. At the cut-off values of 108.20 U/ml for sHLA-G, 1.5 ng/ml for SCC, and 35 U/ml for CA125, the sensitivity was 73.30%, 47.83%, and 44.83%, respectively. The detection of soluble HLA-G in plasma may have significance in the early detection of cervical malignant lesions.

Metamaterial of rod pairs standing on gold plate and its negative refraction property in the far-infrared frequency regime.

A new kind of metamaterial, an array of periodic gold rod pairs standing on gold substrate, is introduced in this paper. A commercial electromagnetic mode solver, the High-Frequency Structure Simulator, is employed to explore the propagation property of electromagnetic waves in this system. When an S -polarized electromagnetic (EM) wave propagates along the substrate surface, strong magnetic resonance is produced in the far-infrared regime. Based on the simulated S parameters, effective refraction index is retrieved and negative value is obtained over the wavelength range from 49.2 microm to 66.7 microm. A wedge made of this metamaterial with an inclined angle 26.6 degrees is designed. An observable negative refraction behavior of EM wave is attained in this structure at wavelength 61.2 microm. The refractive index is calculated by Snell's law and it is consistent with the retrieved results quite well. This provides direct evidence for the negative refraction property.

Coupling effect of magnetic polariton in perforated metal/dielectric layered metamaterials and its influence on negative refraction transmission.

The optical propagation properties and magnetic polariton behaviors in perforated metal/dielectric layered structures are numerically investigated at near-IR region. A developed three-metal-layer (TML) structure is specially inspected as a simple case. Strong coupling effect of magnetic polariton is discovered in this system, which explains why TML structure reveals better negative-refraction property than the reported double-metal-layer (DML) structure. A clear LC-circuit model is presented to describe the physical mechanism of this coupling effect of magnetic polaritons. Detailed results show that the thickness of metal layer influences the transmission greatly and an optimum value is found.

Numerical simulations of negative-index refraction in wedge-shaped metamaterials.

A wedge-shaped structure made of split-ring resonators (SRR) and wires is numerically simulated to evaluate its refraction behavior. Four frequency bands, namely, the stop band, left-handed band, ultralow-index band, and positive-index band, are distinguished according to the refracted field distributions. Negative phase velocity inside the wedge is demonstrated in the left-handed band and the Snell's Law is conformed in terms of its refraction behaviors in different frequency bands. Our results confirmed that negative index of refraction indeed exists in such a composite metamaterial and also provided a convincing support to the results of previous Snell's Law experiments.

Factors predictive of recurrent gestational diabetes diagnosed before 24 weeks' gestation.

The purpose of this study was to determine which patient and pregnancy characteristics in the first pregnancy complicated by gestational diabetes mellitus (GDM) were associated with the diagnosis of GDM before 24 weeks' gestation in a subsequent pregnancy--early recurrent GDM. The case notes of 180 women who previously had GDM diagnosed and who had glucose tolerance tests performed before 24 weeks' gestation in their next ongoing pregnancy were reviewed. Factors examined included severity of GDM, insulin requirement, racial origin, macrosomia, obesity, age, family history of diabetes, preeclampsia, and parity. Multivariate analysis showed that women with early recurrent GDM were more likely, in their first pregnancy with GDM, to have needed insulin (odds ratio [OR] 11.26; 95% confidence interval [CI] 2.02 to 62.65), to be more often of non-Northern European origin (OR, 5.53; 95% CI, 2.46 to 12.44), to have had a macrosomic infant (OR, 4.01; 95% CI, 1.40 to 11.49) or severe GDM (OR, 3.52; 95% CI, 1.60 to 7.76), and were more often 30 years or more of age (OR, 2.27; 95% CI, 1.05 to 4.90). Obesity, family history, fasting plasma glucose levels, and parity were not significant risk factors. However, even without any of the significant risk factors, logistic regression modeling suggested that a woman who has had GDM in a previous pregnancy has a 5.1% (95% CI, 2.2 to 11.6%) chance of having early recurrent GDM. We therefore continue to recommend that all women who have had GDM diagnosed previously should have glucose tolerance testing performed early (before 24 weeks' gestation) in any future pregnancies.

Value of early glucose tolerance testing in women who had gestational diabetes in their previous pregnancy.

The patterns of glucose tolerance, clinical characteristics, and follow-up results of 1,027 pregnant women who had gestational diabetes diagnosed in their previous pregnancy, were analyzed. Glucose tolerance testing was performed before 24 weeks (mean 16.6 +/- 4.5 weeks) in 180 women (group 1); when the result was normal the test was repeated at 26-30 weeks' gestation. In this group the incidence of recurrent gestational diabetes was 49.4%, and early testing diagnosed 61.8% of cases. Group 2 consisted of 685 women in whom glucose tolerance was tested only at 26-30 weeks' gestation. In this group the incidence of recurrent gestational diabetes was 34.0%. Group 3 consisted of 162 women in whom glucose tolerance was not tested in the subsequent pregnancy. Perinatal mortality rates in Groups 1 to 3 were 2.2%, 0.6% and 3.1% respectively in the pregnancy subsequent to that in which gestational diabetes was first diagnosed. The risk of emerging diabetes mellitus on follow-up was greater in women in whom gestational diabetes was diagnosed early than in those diagnosed at the usual time (33.3% versus 12.5%, p < 0.05). Analysis of the 13 perinatal deaths in Groups 1-3 revealed 5 that were potentially avoidable; none of the 3 women with recurrent gestational diabetes in the early tested group who had perinatal deaths received insulin in their subsequent pregnancies. Although perinatal deaths are unavoidable in some high-risk pregnancies associated with gestational diabetes, this study suggests that early diagnosis of gestational diabetes may allow further reduction of perinatal mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

[Oral glucose tolerance test in late pregnancy women].

A total of 514 pregnant women had oral glucose tolerance test (OGTT) with 75g glucose load performed between 24 and 37 weeks of gestation. They were divided into 2 groups. Group I (n = 350) was normal pregnant controls. Group II (n = 164) was at high risk of DM group. With pooled data the results of OGTT from group I, a statistically derived criterion (based on 97.5 percentile approximated to the nearest 5) was devised. This criterion defines the lower limits of abnormal values for venous plasma glucose in Chinese pregnant women during an OGTT with a 75g glucose load as follows: fasting 5.5 mmol/L, 1 hour 10.2 mmol/L, 2 hours 8.2 mmol/L, 3 hours 6.6 mmol/L. These values are lower than those recommended for pregnant women by NDDG and WHO. It is a question whether the criterion derived from data in caucasian population are fit for the population in developing countries. Serum insulin release test were performed in 81 of 350 pregnant women in group I. The results showed that serum insulin release levels after a glucose load in late pregnancy were more active than those in the non-pregnant state. OGTT in women of group II with high risk of GDM showed to be more intolerant compared with those women in group I.

Hydrolysis of carcinogen--DNA adducts by three classes of deoxyribonucleosidase to their corresponding bases.

We have investigated three different enzymes, each of which splits the glycosidic bonds of normal deoxyribonucleosides, for their ability to cleave acid-sensitive carcinogen-DNA adducts: Leishmania donovani purine deoxyribonucleosidase; Lactobacillus helveticus trans-N-deoxyribosylase; and purine nucleoside phosphorylase. Twenty-eight substrates were assayed using one or more of the enzymes, monitoring free base formation by reverse-phase HPLC and a diode array detector. Products were characterized by their retention times and UV spectra. The deoxyribonucleosidase showed the broadest specificity: substrates cleaved by either the trans-N-deoxyribosylase or the phosphorylase were hydrolyzed by the deoxyribonucleosidase. O6- and N2-alkyldeoxyguanosine, N6-alkyl deoxyadenosine and several cyclic adducts were all hydrolyzed by the deoxyribonucleosidase. None of these enzymes cleaved three bulkier adducts; N2-, N6- and C-8 derivatives of benzo[a]pyrene, benzo[c]phenanthrene and N-acetoxy-2-acetylaminofluorene, respectively. Only the deoxyribonucleosidase hydrolyzed O6-methyldeoxyguanosine while both the deoxyribonucleosidase and trans-N-deoxyribosylase cleaved N6-methyl deoxyadenosine. These enzymes, especially the deoxyribonucleosidase, provide mild ways to release the carcinogen-modified base from deoxyribose and will be useful in DNA adducts analysis.

Secondary postpartum haemorrhage.

Eighty-three cases of secondary postpartum haemorrhage managed in this teaching unit over a 3-year period are described. Bleeding occurred most frequently between the 8th and 14th day of the puerperium; 73% of the patients had already been discharged from hospital and required readmission. Suction evacuation was performed in 72 patients and was successful in arresting haemorrhage whether retained placental tissue could be demonstrated on histology or not. There was histological confirmation of retained gestational products in only 30 (42%) of the patients treated surgically. No predictive factors for secondary postpartum haemorrhage could be identified in the obstetric profiles or antenatal course of most of these patients. Patients with retained gestational products could not be distinguished from those without on the basis of history or examination alone apart from 4 patients noted to have incomplete membranes at delivery.

Mechanism of induction of cytochrome P-450ac (P-450j) in chemically induced and spontaneously diabetic rats.

Previous studies demonstrated that a microsomal high-affinity N-nitrosodimethylamine demethylase activity and cytochrome P-450ac (an acetone/ethanol-inducible form) were induced by streptozotocin-induced diabetes in rats. In the present work, the induction was studied in detail in two chemically induced (by streptozotocin and alloxan) diabetic rat models and one spontaneously (BB/Wor) diabetic rat model. All the diabetic conditions caused increases in three parameters: (a) microsomal N-nitrosodimethylamine demethylase activity which is known to be a good indicator of the level of P-450ac; (b) the levels of P-450ac as determined by immunoblot analysis; and (c) the levels of mRNA of P-450ac as determined by hybridization assays with a cDNA probe for this enzyme. These increases were abolished by treatment of the diabetic rats with insulin. The results suggest that the pathophysiological condition of diabetes is responsible for the induction of P-450ac and elevation of mRNA is involved in all of the three diabetic models investigated.

Regulation of N-nitrosodimethylamine demethylase in rat liver and kidney.

In previous work, the low Km form of N-nitrosodimethylamine (NDMA) demethylase has been demonstrated to be due to a specific form of cytochrome P-450 (designated as P-450ac) and to be the enzyme required for the metabolic activation of NDMA. The present work deals with the regulation of P-450ac in rat liver during development as well as the mechanism of induction of P-450ac in rat liver and kidney by inducers. NDMA demethylase activity was almost undetectable in the liver of newborn rats, increased after day 4, and remained elevated throughout the first 17 days of the neonatal period. The enhancement of NDMA demethylase activity during development was accompanied by corresponding increases of P-450ac content and P-450ac mRNA levels as determined by Western and slot blot analyses, respectively. No sex differences with respect to this enzyme were observed in the developing rats. Acetone treatment on late-term pregnant rats for 2 days resulted in transplacental inductions of P-450ac and P-450ac mRNA in the newborn rats. Pretreatment of young male rats and adult female rats with acetone or isopropyl alcohol caused increases of NDMA demethylase activity and P-450ac content in the liver but no significant change in the P-450ac mRNA level. These facts suggest the possible existence of a posttranscription regulatory mechanism under these induction conditions. The presence of P-450ac in rat kidney was demonstrated by Western and Northern blot analyses. The renal form of P-450ac seemed to be regulated in a fashion similar to the hepatic P-450ac regarding its response to inducing factors such as fasting and acetone treatment.

Induction of mutagenesis and transformation by the extract of Alternaria alternata isolated from grains in Linxian, China.

Alternaria alternata is commonly found in the grain in areas of high incidence of oesophageal cancer and is a suspected cancer-causing factor in Linxian, China. In this study, this fungus was isolated from corn in Linxian and cultured. The extract of this fungus was shown to induce 6-thioguanine-resistant mutants in V79 cells and cause transformation of NIH/3T3 mouse fibroblast cells. Metabolic activation does not seem to be required for these activities. The mutagenic and transforming activities of the extract of A. alternata suggest that this fungus may be a factor in the etiology of oesophageal cancer in Linxian.