Performances of Prognostic Models in Stratifying Patients with Advanced Gastric Cancer Receiving First-line Chemotherapy: a Validation Study in a Chinese Cohort

Purpose@#While several prognostic models for the stratification of death risk have been developed for patients with advanced gastric cancer receiving first-line chemotherapy, they have seldom been tested in the Chinese population. This study investigated the performance of these models and identified the optimal tools for Chinese patients. @*Materials and Methods@#Patients diagnosed with metastatic or recurrent gastric adenocarcinoma who received first-line chemotherapy were eligible for inclusion in the validation cohort. Their clinical data and survival outcomes were retrieved and documented. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the predictive ability of the models. Kaplan-Meier curves were plotted for patients in different risk groups divided by 7 published stratification tools. Log-rank tests with pairwise comparisons were used to compare survival differences. @*Results@#The analysis included a total of 346 patients with metastatic or recurrent disease.The median overall survival time was 11.9 months. The patients were different into different risk groups according to the prognostic stratification models, which showed variability in distinguishing mortality risk in these patients. The model proposed by Kim et al. showed relative higher predicting abilities compared to the other models, with the highest χ 2 (25.8) value in log-rank tests across subgroups, and areas under the curve values at 6, 12, and 24 months of 0.65 (95% confidence interval [CI]: 0.59–0.72), 0.60 (0.54–0.65), and 0.63 (0.56–0.69), respectively. @*Conclusions@#Among existing prognostic tools, the models constructed by Kim et al., which incorporated performance status score, neutrophil-to-lymphocyte ratio, alkaline phosphatase, albumin, and tumor differentiation, were more effective in stratifying Chinese patients with gastric cancer receiving first-line chemotherapy.

High Preoperative Fibrinogen and Systemic Inflammation Response Index (F-SIRI) Predict Unfavorable Survival of Resectable Gastric Cancer Patients

Purpose@#This study was to investigate the prognostic significance of the preoperative fibrinogen and systemic inflammation response index (F-SIRI) in a Chinese cohort of resectable gastric cancer. @*Materials and Methods@#Baseline characteristics, preoperative fibrinogen levels and peripheral neutrophil, monocyte, and lymphocyte counts were retrospectively reviewed in 240 patients who underwent radical gastrectomy. The optimal cut-off values for fibrinogen and SIRI were defined as 4.0 g/L and 1.2. Then patients with hyperfibrinogenemia (≥4.0 g/L) and high SIRI (≥1.2) were assigned with an F-SIRI of 2 (both of these hematological abnormalities), 1 (one of these abnormalities), and 0 (neither abnormality), respectively. The prognostic value was examined by univariate and multivariate survival analysis. @*Results@#Preoperative F-SIRI was significantly correlated with tumor size, fibrinogen level, and adjuvant chemotherapy. Whereas there was no significant difference in age, gender, tumor location or other characteristics between groups. In addition, high preoperative F-SIRI was significantly associated with worse disease-free survival (DFS) (hazard ratio [HR], 2.299; 95% confidence interval [CI], 1.482–3.566; P<0.001) and overall survival (OS) (HR, 2.461; 95% CI, 1.584–3.824; P<0.001) by univariate survival analysis. Moreover, it remained an independent predictor for impaired DFS (HR, 2.023; 95% CI, 1.273–3.215; P=0.003) and OS (HR, 2.341; 95% CI, 1.480–3.705; P<0.001) in multivariate Cox regression analysis. @*Conclusions@#Preoperative F-SIRI could serve as a significantly prognostic marker for long-term survival in Chinese patients who underwent radical gastrectomy.

Suberoylanilide hydroxamic acid overcomes erlotinib-acquired resistance via phosphatase and tensin homolog deleted on chromosome 10-mediated apoptosis in non-small cell lung cancer / 中华医学杂志(英文版)

BACKGROUND@#Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), such as erlotinib and gefitinib, are widely used to treat non-small cell lung cancer (NSCLC). However, acquired resistance is unavoidable, impairing the anti-tumor effects of EGFR-TKIs. It is reported that histone deacetylase (HDAC) inhibitors could enhance the anti-tumor effects of other antineoplastic agents and radiotherapy. However, whether the HDAC inhibitor suberoylanilide hydroxamic acid (SAHA) can overcome erlotinib-acquired resistance is not fully clear.@*METHODS@#An erlotinib-resistant PC-9/ER cell line was established through cell maintenance in a series of erlotinib-containing cultures. NSCLC cells were co-cultured with SAHA, erlotinib, or their combination, and then the viability of cells was measured by the 3-(4,5-Dimethyl thiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay and apoptosis was determined by flow cytometry and western blotting. Finally, the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) was assessed by western blotting.@*RESULTS@#The half-maximal inhibitory concentration of parental PC-9 cells was significantly lower than the established erlotinib-acquired resistant PC-9/ER cell line. PC-9/ER cells demonstrated reduced expression of PTEN compared with PC-9 and H1975 cells, and the combination of SAHA and erlotinib significantly inhibited cell growth and increased apoptosis in both PC-9/ER and H1975 cells. Furthermore, treating PC-9/ER cells with SAHA or SAHA combined with erlotinib significantly upregulated the expression of PTEN mRNA and protein compared with erlotinib treatment alone.@*CONCLUSIONS@#PTEN deletion is closely related to acquired resistance to EGFR-TKIs, and treatment with the combination of SAHA and erlotinib showed a greater inhibitory effect on NSCLC cells than single-drug therapy. SAHA enhances the suppressive effects of erlotinib in lung cancer cells, increasing cellular apoptosis and PTEN expression. SAHA can be a potential adjuvant to erlotinib treatment, and thus, can improve the efficacy of NSCLC therapy.

Imaging measurement and clinical significance of occipitocervical angle in healthy people at different ages / 中国骨伤

<p><b>OBJECTIVE</b>To measure imaging data of occipitocervical angle in healthy people at different ages by X-ray.</p><p><b>METHODS</b>One hundred and fifty asymptomatic volunteers(75 males and 75 females) aged from 20 and 70 years old with an average of(44.83±13.88) years old were divided into 5 groups according to different ages(20 to 29 years old, 30 to 39 years old, 40 to 49 years old, 50 to 59 years old and 60 to 70 years old), and 30 people in each group. All people underwent lateral radiography of neck on neutral position. McGregor line (the lowest connection line between upper margin of hard palate and occipital scales of plating), occipitocervical angle(OCA) formed by edge of C2 vertebral body, takami's occipitocervical angle formed between connection line of posterior marginal of C2 vertebral body and parallel lines of hard palate were collected. The data were performed statistical analysis according to gender and different ages, and analyzed correlation between OCA and TOCA.</p><p><b>RESULTS</b>OCA of 75 males at different ages were (14.71±3.09)° and(14.22±4.27)° in 75 females. TOCA of 75 males at different ages were (90.50±4.63)° and (90.57±6.67) ° in 75 females. There were no statistical difference in OCA and TOCA in people at different ages(<0.05). There were no significant meaning among 5 groups at different ages in OCA and TOCA(>0.05). The relation analysis results showed positive correlation between OCA and TOCA(=0.454, <0.01).</p><p><b>CONCLUSIONS</b>The paper provided normal values for occipitocervical angle in population of southwestern China between 20 and 70 years old, and results may be useful for posterior occipitocervical fixation and fusion.</p>

Modified incision to prevent the postoperative spinal lateral angulation in surgery via anterior approach for lumbar fracture / 中国骨伤

OBJECTIVE@#To explore a method of modified incision to prevent the postoperative spinal lateral angulation via anterior approach for lumbar fracture.@*METHODS@#A total 40 patients with lumbar fracture from January 2016 to Jun 2017 were internalized in the study. Including 28 males and 12 females, aged from 27 to 68 years with an average of (39.5±14.9) years. Among them, 28 cases caused by high fall, 9 cases by heavy injury, 3 cases by traffic accidents; and 35 fractures were located at L₁,4 at L₂,1 at L₃. All the fractures were type A based on AO classification. According to Frankel classify of spinal cord injury, 5 cases were grade A, 1 case was B, 10 cases were C, 15 cases were D, 9 cases were E. The patients were divided randomly into modified incision groups and routine incision groups. All patients were treated with decompression, internal fixation and titanium mesh supported bone graft fusion via anterior approach. All the internal fixation materials were ANTERIOR (Medtronic Inc). Incision direction and incision plane were improved in modified incision groups. The coronal Cobb angle and the angle between the vertebral screw and the corresponding endplate were analyzed before and after operation.@*RESULTS@#Pre-and post-operative coronal Cobb angles were (1.20±3.26) °, ( 2.16±3.55)° in modified incision groups and(1.22±4.42)°, (3.91±3.78)° in routine incision groups respectively. And there was no statistical difference before operation, and there was statistical difference after operation between two groups(=0.017). There was no lateral angulation of more than 5 degrees in modified incision group, but there was lateral angulation of 5 to 10 degrees in routine incision group in 6 cases. The incidence of lateral angulation about 5 degrees after operation was significantly different between two groups (=0.010). There was significant difference in the angle between the proximal two vertebral screws and the corresponding endplate between two groups (0.05).@*CONCLUSIONS@#The improvement of incision direction and plane can effectively prevent the postoperative spinal lateral angulation via anterior approach for lumbar fracture.

Analysis of clinical effects of absorbable hemostatic fluid gelatin and absorbable gelatin sponge on the hemostasis during operation of unilateral open-door cervical expansive laminoplasty / 中国骨伤

<p><b>OBJECTIVE</b>To compare the hemostatic effect between absorbable hemostatic fluid gelatin (HFG) and absorbable gelatin sponge(GS) during operation of unilateral open-door cervical expansive laminoplasty.</p><p><b>METHODS</b>The clinical data of 83 patients underwent unilateral open-door cervical expansive laminoplasty from February 2014 to May 2016 were retrospectively analyzed. According to the used hemostatic materials, patients were divided into two groups. In HFG group, there were 30 males and 11 females, ranging in age from 29 to 81 years, with an average of(55.6±11.6)years; 14 cases were simple cervical spinal stenosis, 9 were cervical spinal stenosis and ossification of posterior longitudinal ligament, and 18 were cervical spinal stenosis complicated with multiple cervical disc herniation. And in GS group, there were 32 males and 10 females, ranging in age from 36 to 78 years, with an average of (55.4±11.1) years; 12 cases were simple cervical spinal stenosis, 10 were cervical spinal stenosis complicated with ossification of posterior longitudinal ligament, and 20 were cervical spinal stenosis complicated with multiple cervical disc herniation. There was no significant difference in the age, gender, and disease categories of patients between two groups (>0.05). The operative time, intraoperative bleeding, postoperative drainage, and postoperative complications were compared between two groups.</p><p><b>RESULTS</b>The average operative time, intraoperative bleeding, and postoperative drainage in HFG group were(137.2±30.0) min, (156.1±74.6) ml, and (212.1±67.6) ml, respectively; and in GS group were (154.8±33.5) min, (242.9±120.7) ml, and(303.3±115.5) ml, respectively. There were significantly differences in above items between two groups(<0.05). No acute heamatoma or related complications was found postoperatively.</p><p><b>CONCLUSIONS</b>Compared with GS, HFG can obviously decrease operative time, intraoperative bleeding, and postoperative drainage. It is a safe and effective hemostatic material for the operation of unilateral open-door cervical expansive laminoplasty.</p>

Influence of clinical results of early low frequency training for acute Achilles tendon rupture after anchors repair / 中国基层医药

Objective To investigate the influence of clinical results of early low frequency training for acute Achilles tendon rupture after anchors repair.Methods A total of 35 patients with acute Achilles tendon rupture were treated with early low frequency training after anchors repair,including 28 males and 7 females.Aged 18 to 37 years, mean 26 years old.Duration 2h to 5d from injury to therapy.All patients palpated the discontinuity of Achilles tendon, limitative activity of ankle plantar flexion,Thompson test was positive,and MRI examination was taken.Results 35 patients were followed up for 12 to 18 months,with an average follow -up of 14.5 months.According to the Amer-Lindholm score,excellent in 30 cases,good in 5 cases,the good rate was 100%.All the wounds were healed, without infection,dehiscence,sural nerve injury and re -rupture occurred.Conclusion Early low frequency training after anchors repair for acute Achilles tendon rupture is safe and reliable,patients can receive a better functional outcome.

Cognitive impairment and spontaneous epilepsy in rats with malformations of cortical development.

PURPOSE: To examine the cognition, spontaneous epilepsy, and electroencephalography (EEG) characteristics of rats with malformations of cortical development (MCD) and their use as an animal model for investigating the pathogenesis of intractable epilepsy and screening novel antiepileptic drugs. METHODS: An epileptic rat model of MCD was established with the F1 generation of pregnant rats after X-irradiation with 175 cGy (Group L), 195 cGy (Group M), or 215 cGy (Group H). Long-term video-EEG monitoring was used to record the seizures in the rats with MCD. Cognition was assessed with the Morris water maze. The EEGs were recorded and analyzed in the frontal and parietal lobes and hippocampi of adult rats. Finally, the brain tissues were processed for Nissl staining. RESULTS: The model groups exhibited markedly prolonged escape latencies and distinct decrements in the percent distance traveled in the target quadrant and platform-crossing frequency. These findings were dose-dependent. Frequent interictal epileptiform discharges were observed in the frontal and parietal lobes and hippocampi of adult rats, and their incidences were markedly higher in the model groups compared with that in the normal controls, with Group M having the highest incidence. Spontaneous seizures were observed in the model groups (mean incidence, 46.7%). The daily mean frequency of seizures and the incidence of spontaneous seizures were highest in Group M. Nissl staining revealed a dose-dependent pattern of hippocampal abnormalities, cortical and subcortical nodular heterotopia, and callosal agenesis in the model groups. CONCLUSION: The 195 cGy dose was most appropriate for establishing an epileptic model of MCD with X-irradiation.

ERKl/2 signaling pathway mediates heme oxygenase-1 up-regulation by minocycline in PC12 cells exposed to oxygen glucose deprivation / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of minocycline in promoting the survival of pheochromocytoma (PCI2) cells exposed to oxygen glucose deprivation (OGD) and explore the underlying mechanisms.</p><p><b>METHODS</b>An in vitro cell model of cerebral ischemia was established by OGD for 6 h in PCI2 cells with pretreatment with minocycline or an ERK1/2 inhibitor. At 24 h after OGD injury, the cells were evaluated for cell viability by MTT assay and expressions of heme oxygenase-I (HO-I) and phospholylated extracellular signal-regulated protein kinase 1/2 (ERK1/2) by Western blotting.</p><p><b>RESULTS</b>The cell viability decreased dramatically following OGD. Pretreatment with minocycline (O.I-IO JJ.mol/L) induced a significant increase in the cell viability after OGD and caused up-regulation of HO-I protein and enhanced ERK1/2 phospholylation, and the effects were especially obvious with 1 JJ.mol/L minocycline and were abolished by inhibition of ERK1/2 activity with UOI26 (IO JJ.mol/L).</p><p><b>CONCLUSION</b>Minocycline can protect PCI2 cells against OGD-induced toxicity by up-regulating HO-I protein expression through ERKl/2 signaling pathways.</p>

Prevention of postoperative cerebrospinal fluid leakage with absorbable hemostatic fluid gelatin / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effectiveness of absorbable hemostatic fluid gelatin in preventing postoperative cerebrospinal fluid leakage.</p><p><b>METHODS</b>The clinical data of 17 patients with dura mater tear were retrospectively analyzed from March to September in 2003. There were 16 males and 1 female, aged from 16 to 67 years old with an average of (39.6 ± 15.4) years. The injury site was at cervical vertebrae in 1 case, thoracic vertebrae in 9 cases, thoracolumbar junction in 4 cases, lumbar vertebrae in 3 cases. There were burst fracture in 4 cases and fracture-dislocation in 13 cases. According to ASIA grade, 12 cases were grade A, 2 cases were grade B, 2 cases were grade D, 1 case were grade E. Two cases caused by traffic accident, 10 by high falling, 4 by heavy parts crash, 1 by stairs fell during the earthquake. Absorbable hemostatic fluid gelatins were used to plug the dura mater tear,in order to prevent postoperative cerebrospinal fluid leakage. Postoperative drainage were recorded every day.</p><p><b>RESULTS</b>Of 17 patients, 15 cases did not develop with cerebrospinal fluid leakage. Two cases develop with cerebrospinal fluid leakage after operation and their drainage were removed at 6 to 7 days after operation. In all cases, no complications related with cerebrospinal fluid leakage occurred, such as headache, dizzy, fever,neck resistance, rash, incision disunion, incision infection, hematoma, neurologic symptoms aggravation. No abnormal phenomena was found on incision surrounding at follow-up of 9 months.</p><p><b>CONCLUSION</b>Using absorbable hemostatic fluid gelatin to plug the dura mater tear during operation is an effective method in preventing postoperative cerebrospinal fluid leakage.</p>

Comparison of screw' inserting angle through the 11th and 12th rib anterior approaches for L1 burst fracture / 中国骨伤

<p><b>OBJECTIVE</b>To compare screw's inserting angle through the 11th and 12th rib in treating L1 burst fracture, explore effects on inserting screw and postoperative angle.</p><p><b>METHODS</b>From October 2007 to October 2010, 108 patients with L1 brust fracture treated through anterior approach were analyzed,including 68 males and 40 females, aged from 21 to 64 years (mean 38.22 years). All patients were divided into the 11th (A, 51 cases) and 12th (B, 57 cases) approach. The data of operation time,blood loss, duration of incision pain, JOA score, Oswestry score, VAS score, quality of life (SF-36), recovery of nervous function, coronal Cobb angle, included angle between screw and plate were observed.</p><p><b>RESULTS</b>All patients were followed up for 9 to 37 months, mean 23 months. The operation time, blood loss, duration of incision pain, in group A were lower than group B (P<0.05), JOA score, Oswestry score, VAS score, SF-36, recovery of nervous function had no significant differences (P>0.05). There were no differences in Cobb angle before operation, but had significance after operation (P=0.000). There were statistically significance between two group in angle between screw and plate (P=0.000, P=0.003).</p><p><b>CONCLUSION</b>The 11th rib approach for the treatment of L1 burst fracture has less effects on screw, less trauma and less angle between screw and plate.</p>

Comparison of whole genome sequences and replication ability in cell cultures between two avian leukosis viruses of subgroup B / 病毒学报

The purpose of this study was to compare the whole genome sequences and replication dynamics in cell cultures of two Avian leukosis viruses of subgroup B (ALV) isolates, SDAU09E3 and SDAU09C2. Comparison of the amino acid sequences indicated that the gp85 identity of these two subgroup B isolates was 95.4%, the identity with other three ALV-B reference strains was 91.0%-94.9%, and less than 87.9% with ALV subgroup A, C, D, E and J. Comparison of the nucleotide sequence of gag and pol genes indicated that homologies of gag gene and pol gene of these two ALV-B isolates with all compared reference strains of different subgroups were above 93%. Homologies of LTR sequence of these two ALV-B isolates with other exogenous ALVs subgroups A, B, C, D and J were 72.6%-88.3%, but only 51.5% when compared with endogenous ALV subgroup E. The identity of LTR between these two ALV-B strains was only 74.8%, which was far lower than the identity of other genes. The identity of U3 region of LTR between these two ALV-B isolates was only 68.8% and there were obvious differences in the number CAAT Boxes. Replication dynamics in DF-1 cell indicated that the value of TCID50 was similar between 2 isolates but the concentration of nucleocapsid protein p27 antigen of SDAU09E3 was significantly higher than SDAU09C2 in cell culture supernatant, which indicated there was no parallel relationship between p27 antigen concentration and infectious virus particles. Whether such difference was resulted from the diversity of U3 region of LTR, further studies with their recombinant infectious clones is necessary.

The preventive efficacy of methylcobalamin on rat peripheral neuropathy influenced by diabetes via neural IGF-1 levels.

We investigated the preventive efficacy of exogenous methylcobalamin on sciatic nerve IGF-1 expression down-regulation and peripheral nerve deficit under different conditions (hyperglycemia and duration) of experimental diabetes in rats. Hyperglycemia was induced with streptozotocin, and stratified by exogenous insulin into mild and severe conditions. Duration of diabetes was ranged from 2-12 weeks. A single dose of methylcobalamin was intramuscularly administrated. Three groups of rats were compared in this study: (i) control group (NC, n = 30); (ii) saline-treated control diabetic group (n = 30); and (iii) methylcobalamin-treated diabetic group (n = 30). The study demonstrated a progressive decrease of sciatic nerve IGF-1 mRNA and peptide contents, and peripheral nerve dysfunction in the saline-treated diabetics over 12 weeks in contrast to the normal control non-diabetics (P < 0.01-0.0025). The IGF-1 reduction was delayed, which was consistent with retardation in nerve velocity conduction and structural impairment, in the methylcobalamin-treated diabetics, especially with mild hyperglycemia and shorter duration as compared with the saline-treated diabetics (P < 0.05-0.01). No effect of methylcobalamin on blood glucose was shown in the treated groups. It is concluded that exogenous methylcobalamin delayed onset of diabetic peripheral neuropathy via up-regulation of neural IGF-1 gene expression, and a better neuroprotective effect could be achieved in the presence of good control of hyperglycemia, especially at early stage of diabetes.

Analysis of drug resistance and risk factors of Enterobacteriaceae in burn units / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the risk factors of infection of extended-spectrum beta-lactamases (ESBL)-producing strains and drug resistance of Enterobacteriaceae that infected burn patients.</p><p><b>METHODS</b>A retrospective study was performed on clinical information of 92 patients with Enterobacteriaceae infection in our burn unit from January 2001 to December 2008. The distribution and drug resistance of Enterobacteriaceae, and the detection rate, drug resistance of ESBL-producing strains, and its risk factors of nosocomial infection were analyzed. Data were processed with Chi-square test.</p><p><b>RESULTS</b>One hundred and nine strains of Enterobacteriaceae were isolated, with 38 (34.9%) strains of Enterobacter cloacae, 25 (22.9%) strains of Escherichia coli, 22 (20.2%) strains of Klebsiella pneumoniae, 13 (11.9%) strains of Proteus mirabilis, and 11 (10.1%) other strains of Enterobacteriaceae. Enterobacteriaceae were moderately or highly resistant to antibiotics except imipenem, resistance rate of which was less than 8.0%. ESBL-producing strains accounted for 44.0% in Escherichia coli, and 77.3% in Klebsiella pneumoniae. Drug-resistance rate of ESBL-producing strains to antibiotics was obviously higher than that of non ESBL-producing strains. Length of hospital stay longer than 20 days, and use of the third-generation cephalosporin longer than 5 days, quinolone antibiotics longer than 7 days, and topical antibiotics longer than 5 days were the risk factors of nosocomial infection caused by ESBL-producing strains, comparing with non ESBL-producing strains, the difference was statistically significant (with chi2 value respectively 5.491, 4.441, 15.186, 4.938, P values all below 0.05).</p><p><b>CONCLUSIONS</b>Enterobacteriaceae strains in burn unit of our hospital are highly drug resistant, with high lactamase-producing rates, calling for intense monitor to control the risk factors that predispose the infection of ESBL-producing strains in order to lower the infection rate.</p>

Relationship between adipocyte fatty acid-binding protein and metabolic syndrome / 中华内分泌代谢杂志

Serum adipocyte fatty acid-binding protein (A-FABP) was raised in metabolic syndrome (MS)patients (n= 121) as compared with age-matched healthy subjects [n = 120, (14.7±4.8 vs 6.8 ±3. 0) μg/L,P<0.001]. It reached higher level in MS subjects with visceral obesity [(15.7±4.2 vs 12.6±5.1) μg/L, P<0.001]. Serum A-FABP concentration was positively correlated with body mass index, waist circumference, waist-tohip ratio, fasting insulin, homeostasis assessment for insulin resistance (HOMA-IR), fasting glucose, triglycerides,total cholesterol,and mean arterial blood pressure, whereas negatively correlated with HDL-C (r =-0. 448, P< 0.001).

Polyethylene wear and osteolysis in H/G cementless total hip arthroplasty / 中华外科杂志

<p><b>OBJECTIVES</b>To measure the linear polyethylene wear with use of a computer-assisted two-dimensional method, and to evaluate the relationship between wear and long-term clinic-radiological findings.</p><p><b>METHODS</b>Between December 1991 and December 1995, the senior author performed 40 primary total hip arthroplasties with use of H/G porous-coated acetabular component. Radiographs of 40 H/G cementless total hip arthroplasties were examined for osteolysis, radiolucent line, cup migration and so on. To measure the linear polyethylene wear, migration in the femoral head center relative to the cup shell center was calculated on digitized consecutive radiographs with special computer software program.</p><p><b>RESULTS</b>The minimum follow-up was 10 years. Total linear wear was 2-8 mm, the mean rate of linear polyethylene wear was (0.32+/-0.31) mm/year. Twelve acetabular components (30%) were revised at an average follow-up point of 12 years. Three types of polyethylene liner failure were identified: wear-through of the polyethylene liner with resultant metallosis (5 hips), excessive wear necessitating revision (5 hips), and polyethylene liner dissociation without gross evidence of wear (2 hips).</p><p><b>CONCLUSIONS</b>High wear rates and femoral and acetabular osteolysis have been and still are the main problems in uncemented total hip replacement. There is clear relationship between wear and acetabular osteolysis or loosening of the prostheses. The poor long-term results with these uncemented total hip arthroplasties illustrate the necessity of regular radiographic evaluation in order to detect osteolysis and liner failure, which are both generally asymptomatic until catastrophic failure appears.</p>

Cytotoxicity of trichloroethylene in keratinocytes involving alterations of mitochondrial function and ultrastructure / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore mechanism of dermal toxicity of trichloroethylene(TCE).</p><p><b>METHODS</b>Normal human keratinocytes (KC) were isolated from foreskins of healthy donors undergoing circumcision by two-step trypsin digestion and cultured in serum-free medium. Cells were treated with medium, 1% acetone (volume fraction) 0.125, 0.500 or 2.000 mmol/L TCE for different time (4, 8, 12 or 24) hours. After treatment, MTT assay and ATPase activity detected, inhibition ratio of mitochondrial enzyme was calculated according to optical density (A) value of MTT assay. Mitochondrial membrane potential (MMP) was detected by flow cytometry FCM after being stained with Rhodamine123 (Rh123). Morphological changes were also observed through transmission electron microscope (TEM).</p><p><b>RESULTS</b>Cellular viability and ATPase activity declined with dose of TCE, while inhibition ratio of mitochondrial enzyme increased with dose of TCE. FCM results showed that after treatment with 2.000 mmol/L TCE, fluorescence density of Rh123 decreased quickly from 18.73 +/- 0.45(0 h) to 8.20 +/- 0.66(8 h) (P < 0.01). After 8 h, fluorescence density maintained at the level equal to that of 8 h (fluorescence density of Rh123 were 8.20 +/- 0.36 and 8.20 +/- 0.40 for 12 and 24 h respectively, compared with that for 8 h group, P > 0.05). The results also showed that MMP diminished with dose of TCE. Under TEM, mitochondria in TCE-treated group appeared extensive swelling and vacuolar degeneration with less matrix and obscure or vanished mitochondria cristae but in control group, mitochondrial structure was integrated, with uniform matrix and visible mitochondria cristae.</p><p><b>CONCLUSIONS</b>TCE could inhibit mitochondrial metabolic enzyme, reduce ATP production, diminish MMP, and destroy ultrastructure of mitochondria in KC, all these contributing to the cytotoxicity of TCE.</p>

Study of trichloroethylene-induced apoptosis in normal human epidermis keratinocytes in vitro / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the apoptosis-inducing effect of trichloroethylene (TCE) on cultured normal human epidermis keratinocytes (NHEK) in vitro.</p><p><b>METHODS</b>NR(50) values (the concentration of neutral red absorbed is reduced to 50%) of TCE on NHEK were assayed by neutral red uptake (NRU), and the administered dose of TCE was determined. Lipid peroxidation (LPO) and oxidative stress were assessed by measurement of malondialdehyde (MDA) contens and superoxide dismutase (SOD) activity. Transmission electron microscope (TEM) were used to observe morphologic changes, flow cytometer (FCM) was used to measure DNA contents and calculate cell apoptosis rate and proliferation index (PI).</p><p><b>RESULTS</b>NR(50) values of TCE on NHEK was found to be 4.53 mmol/L (95% CI: 3.92-5.13 mmol/L). The increase in MDA content and inhibition of SOD activity in a concentration-dependent manner were shown after NHEK was treated with a series of dose of TCE 4 h later, and typical morphologic changes of apoptosis were also observed by TEM examination. FCM analysis revealed a sub-G(1) peak in the apoptotic cells. The apoptotic rate in TCE 0.125, 0.500, 2.000 mmol/L exposed groups (31.83%, 38.63%, 44.35%, respectively) were significantly higher than that in blank control (18.42%), while PI in TCE 0.125, 0.500, 2.000 mmol/L group (3.26%, 2.48%, 2.07%, respectively) were significantly lower than that in blank control (4.99%).</p><p><b>CONCLUSION</b>TCE may induce apoptosis of cultured NHEK in vitro, and inhibit cell proliferation through lipid peroxidation and oxidative stress.</p>

Effects of large dose of Astragalus membranaceus on the dendritic cell induction of peripheral mononuclear cell and antigen presenting ability of dendritic cells in children with acute leukemia / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effects of large dose of Astragalus membranaceus (Astragalus) on the dentritic cell (DC) induction in vitro and augumentation by peripheral mononuclear cell (MNC) and on antigen presenting ability of DC in children with acute leukemia.</p><p><b>METHODS</b>Forty-four children with acute leukemia in complete remission stage were divided into two groups. Twenty patients in the Astragalus (90 g daily) group were treated with large dose of Astragalus (90 g daily) based on conventional chemotherapy for one month, while 24 patients in the control group received chemotherapy alone. MNC were extracted from peripheral blood by wall-sticking method and cultured with such cell factors as interleukin-4, gramulocyte macrophage colony stimulating factor, tumor necrosis factor-alpha for 7-8 days. Phenotype of DC was assayed by flow cytometry and antigen presenting ability of them was assayed by mixed lymphocyte reaction.</p><p><b>RESULTS</b>There was no morphological difference in MNC induced DC between the two groups. The average number of DC in Astragalus group and control group was 4.4 x 10(6) / 2.5 x 10(6) MNC and 2.6 x 10(6) / 2.5 x 10(6) MNC, respectively, showing significant difference (P < 0.001). DC in Astragalus group could stimulate the proliferation of allogeneic lymphocytes strongly, showing significant difference when compared with that in the control group (P < 0.001). Conclusion Large dose of Astragalus could increase the DC induction of MNC and enhance the antigen presenting ability of DC in acute leukemia patients.</p>

Effects of iodine supplementation during pregnancy on child growth and development at school age.

Growth and development of 207 children (49% males; mean age 5.4 years [SD 0.2], range 4 to 7.3 years whose mothers received iodine during pregnancy, and children who received iodine first in their 2nd year, were examined in 1996; 192 children (49% males; mean age 6.5 years [SD 0.2], range 5.8 to 6.9 years) whose mothers received iodine while pregnant were seen in 1998. Children were from the southern part of China's Xinjiang Province which has the lowest levels of iodine in water and soil ever recorded. Head circumference but not height was improved for those who received iodine during pregnancy (compared with those receiving iodine at age 2) and for those supplemented before the end of the 2nd trimester (relative to those supplemented during the 3rd trimester). Iodine before the 3rd trimester predicted higher psychomotor test scores for children relative to those provided iodine later in pregnancy or at 2 years. Results from the test for cognitive development resulted in trend only differences between those children supplemented during pregnancy versus later. The results address the question of when maternal iodine supplements should begin in public health programs world wide. Findings may be relevant to the treatment of maternal and newborn thyroid deficiency in industrialized countries, particularly for those infants delivered before the end of the second trimester.