[Child with sitosterolemia initially presenting with hemolytic anemia and thrombocytopenia: a case repore and literrature review].

This article focuses on a case study of sitosterolemia in a child who initially presented with hemolytic anemia and thrombocytopenia. Sitosterolemia is a rare autosomal recessive lipid metabolism disorder, difficult to diagnose due to its non-typical clinical manifestations. The 8-year-old patient was initially misdiagnosed with pyruvate kinase deficiency. Comprehensive biochemical and molecular biology analyses, including gene sequencing, eventually led to the correct diagnosis of sitosterolemia. This case highlights the complexity and diagnostic challenges of sitosterolemia, emphasizing the need for increased awareness and accurate diagnosis in patients presenting with similar symptoms.

Healthcare-associated carbapenem-resistant Klebsiella pneumoniae infections are associated with higher mortality compared to carbapenem-susceptible K. pneumoniae infections in the intensive care unit: a retrospective cohort study.

BACKGROUND: Klebsiella pneumoniae (KP) is an opportunistic pathogen causing severe pneumonia and sepsis. Carbapenem-resistant KP (CRKP) has become a major pathogen in many centres. AIM: To investigate the association between carbapenem resistance and the mortality rate, length of stay, and hospital cost in patients with Klebsiella pneumoniae infection. METHODS: The retrospective cohort study was conducted in the intensive care units of a large teaching tertiary hospital in southwest China between January 1st, 2020 and December 31st, 2022. To examine the impact of carbapenem resistance on mortality rates and economic burden, multivariate Cox regression and generalized linear models were constructed. FINDINGS: The study included 282 adult patients with KP infection (135 CSKP; 147 CRKP). CRKP-infected patients demonstrated higher mortality risk (unadjusted hazard ratio (aHR): 1.980; 95% confidence interval (CI): 1.206-3.248; P = 0.007; aHR: 1.767; 95% CI: 1.038-3.005; P = 0.036) compared to CSKP-infected patients. Stratified analysis, according to type of KP infection, revealed that patients with healthcare-associated CRKP infection had a significantly higher mortality risk compared to those with CSKP infection (log-rank P = 0.015). Patients with CRKP infection had longer hospital stays than those infected with CSKP (adjusted mean: 38.74 vs 29.71 days; P = 0.003), and hospital-related expenses were notably higher among CRKP patients than CSKP patients (adjusted cost: £40,126.73 vs 25,713.74; P < 0.001). CONCLUSION: CRKP infections increase mortality rates, prolong hospital stays, and raise healthcare costs. Healthcare facilities should adopt targeted strategies, including curtailing pre-infection hospitalization periods and managing medications more judiciously.

[Effect evaluation of the primary screening strategy for liver cancer in rural areas of China].

Objective: To estimate the effectiveness of the primary screening strategy for liver cancer in rural areas to provide basic information for the optimization and perfection of the technical program for the early detection and treatment of liver cancer. Methods: Residents including males aged 35-64 and females aged 45-64 from 9 counties in rural China between 2013 and 2015 were selected as the target population. The participant was classified into a high-risk and non-high-risk group based on the standardized questionnaire or HBsAg, and the Chi-squared test was applied to compare differences between the two groups. The Cox proportional hazard regression models were applied to assess hazard ratio (HR) and its 95% confidence interval (CI). Results: 358 348 participants were recruited from 2013 to 2015. 1 196 individuals were identified with liver cancer until December 31, 2021, with an incidence density of 52.0/10(5) person-years. Of the participants, 54 650 were assessed as high risk (15.3%) based on the questionnaire and the status of HBsAg. The high-risk population had a higher incidence density (168.3/10(5) person-years vs 31.5/10(5) person-years) and higher risk of developing liver cancer (HR=2.98, 95% CI=2.64-3.35), compared to the non-high-risk group. Based on the questionnaire-based high-risk assessment system, 47 884 (13.4%) individuals were identified as high risk, who showed statistical differences in terms of incidence density and incidence risk, in comparison to the low-risk population (all P<0.05). HBsAg can screen out a higher proportion of high-risk individuals who are women, non-smokers, non-drinkers, and individuals without a family history of liver cancer (all P<0.05). The sensitivity analysis of the effectiveness of the whole primary screening method is stable, and high-risk individuals still had a higher risk of liver cancer. Conclusions: The primary screening method of the questionnaire-based risk assessment system and HBsAg can achieve satisfactory effectiveness. The questionnaire-based risk assessment system could identify high-risk individuals to some extent, however, it still needs to be improved to meet the actual requirements.

Python-assisted biological knowledge acquisition method to trigger design inspiration.

Design inspiration comes from the continuous stimulation of external information and the continuous accumulation of knowledge. In order to obtain an ideal design inspiration from nature, researchers have proposed a large number of biological information retrieval and knowledge acquisition methods. But how to purposefully acquire valuable biological knowledge in order to effectively stimulate design inspiration and produce the novel and feasible designs idea is still an urgent problem to be solved. This paper proposes a method for acquiring valuable biological knowledge to efficiently stimulate inspiration and quickly conceive solutions in engineering design. First, keywords, such as the functional requirements and key components of design objects, are selected as the engineering terminologies. Next, biological keywords related to the engineering terminologies are searched from the biological dictionary and biology websites. Then in order to retrieve enough biological knowledge, these biological keywords are expanded manually and automatically respectively based on Thesaurus Webpage and WordNet database, and expanded keywords are filtered according to repeated words and different forms of the same words. Finally, in the biological knowledge base, biological keywords that had been filtered are used to obtain biological knowledge with Python web crawler programming. Through an example of application for ship equipment, the effectiveness of the method is verified.

[Analysis on the relationship between smoking status and the onset age of onset and the direct medical expenditure expenses of gastric cancer patients].

Objective: To investigate the relationship between smoking status and the onset age of stomach cancer patients and estimate the patients' direct medical cost burden of stomach cancer due to smoking in Anhui province. Methods: The information about the primary stomach cancer patients and their direct treatment expenditures in 10 cancer-registered areas in Anhui were collected in 2017. The association between smoking status and the age of onset of stomach cancer patients was analyzed by univariate regression and multivariate logistic regression models. The median and smoking-attributed risk method was used to describe the direct treatment expenditure of stomach cancer patients in Anhui due to smoking. Results: A total of 736 patients with stomach cancer were analyzed in this study. Univariate regression analysis showed that rural household registration (t=2.091, P=0.037), smoking (t=-2.357, P=0.001 9) and alcohol consumption (t=-2.036, P=0.042) were related to the age of onset of stomach cancer. After adjusting for gender, alcohol consumption, body mass index and household registration type, the risk of early stomach cancer in people who quitted smoking cessation was lower than that in smokers (OR=0.36, 95%CI: 0.17-0.75). The total direct medical cost burden of 736 newly diagnosed stomach cancer patients was 6.939 6 million RMB. The direct medical expenditure in stomach cancer patients who had smoking behavior was higher than that in stomach cancer patients who quitted smoking and never smoked. Conclusions: Smoking is one of the risk factors for the earlier onset of stomach cancer in Anhui. It is necessary to strengthen tobacco control to reduce the economic burden of patients with stomach cancer.

[Clinical features and imaging analysis of primary bone lymphoma of the jaw].

Objective: To investigate the clinical characteristics and imaging manifestations of primary bone lymphoma (PBL) located in the jaw. Methods: Clinical data of 14 PBL patients admitted to The First Affiliated Hospital of Zhengzhou University from January 2014 to April 2019 were retrospectively analyzed, which including age, gender, location, chief complaint, laboratory test, imaging manifestations and so on. Results: Among the 14 PBL patients, 10 were male and 4 were female. Age range from 4 to 79 years, median age was 56 years old. There were 6 cases involved maxillary, 7 cases involved mandible and 1 case involved mandible and maxillary simultaneously. Twelve patients were admitted with local mass as the chief complaint, 3 had a history of toothache, 4 had loosen tooth and 2 had numbness of lips and cheeks. Two cases of oral mass with mucosal surface ulcer or abscess formation. One case complained of fever, night sweats and other systemic symptoms. The imaging findings showed 8 cases of osteolytic lesions, 1 case of sclerosis, 4 cases of mixed lesions and 1 case of cystic lesions. One case had periosteum reaction. In 12 cases, there was an obvious mass, which was characterized by the large soft-tissue mass and marrow changes were associated with surprisingly little cortical destruction. Conclusions: PBL is more common in middle aged male. The upper and lower jaw bones can be involved. Clinical and imaging manifestations lack characteristics, and common dental or periodontal symptoms such as toothache, tooth loosening, and paresthesia may occur. However, the imaging characteristics of large soft tissue masses with small degree of bone destruction can be used as an important basis for the differential diagnosis of osteomyelitis, squamous cell carcinoma, osteosarcoma and other diseases.

[Practice guideline for patients with ankylosing spondylitis/spondyloarthritis].

In recent years, the clinical experts consensuses or guidelines of ankylosing spondylitis (AS)/spondyloarthritis (SpA) have been constantly updated, but to better understand and practice, patient self-participation management is one of the key points to improve the level of diagnosis and treatment. Through questionnaire survey of these patients, we screened out the most concerned issues, and established the AS/SpA patient practice guideline working group with multidisciplinary physicians and patients. Fifteen opinions, as the AS/SpA patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process.

MicroRNA-588 regulates migration capacity and invasiveness of renal cancer cells by targeting EIF5A2.

OBJECTIVE: To investigate whether microRNA-588 was involved in the development and progression of renal cancer, and to explore its possible regulatory mechanisms. PATIENTS AND METHODS: Tumor tissues excised from renal carcinoma and adjacent normal tissues were selected for the experiment. Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was performed to analyze the expression level of microRNA-588 in tissue specimens. The relationship between the expression of microRNA-588 and the prognosis of patients with renal cell carcinoma was also evaluated. Subsequently, two renal cancer cell lines, including769-P and 786-O, were selected for functional experiments in vitro. Eukaryotic initiation factor 5A2 (pcDNA-EIF5A2) or microRNA-588 mimics was transfected into 769-P cells, respectively. Meanwhile, si-EIF5A2 or microRNA-588 inhibitor was transfected into 786-O cells. After that, the mRNA expression level of EIF5A2 was detected by qRT-PCR. The invasiveness and metastasis abilities of the two cell lines were evaluated via transwell assay. Furthermore, the levels of EIF5A2 and epithelial-mesenchymal transition (EMT)-related proteins were analyzed using Western blot. Luciferase reporter gene assay was used to confirm that microRNA-588 could directly regulate EIF5A2 expression. QRT-PCR and Western blot were performed to explore the mRNA and protein expressions of EIF5A2 in patients with highly or lowly-expressed microRNA-588. The correlation between the two molecules was evaluated using linear analysis. Through the above experiments, it was verified whether microRNA-588 could enhance the invasiveness and metastasis of renal cancer by targeting EIF5A2. RESULTS: MicroRNA-588 expression in tumor tissues of patients with renal carcinoma was significantly decreased with the increase of tumor diameter and stage. A higher level of microRNA-588 indicated significantly longer overall survival of patients. This suggested that microRNA-588 expression was negatively correlated with the prognosis of patients. Overexpression of microRNA-588 remarkably reduced the invasion and metastasis abilities of 769-P cells, as well as the expressions of EMT-related proteins. However, opposite results were observed in 786-O cells after knockdown of microRNA-588. Reporter gene assay confirmed that microRNA-588 could target bind to EIF5A2. In 769-P cells, up-regulated microRNA-588 significantly inhibited the mRNA and protein expressions of EIF5A2. However, down-regulated microRNA-588 in 786-O cells significantly enhanced the expressions of EIF5A2 at both mRNA and protein levels. Linear analysis verified that microRNA-588 was negatively correlated with EIF5A2 at the mRNA level. Additionally, the up-regulation of EIF5A2 in 769-P cells enhanced the malignancy of cancer cells and the expressions of EMT-related proteins. However, in 786-O cells, opposite results were observed after knockdown of EIF5A2. CONCLUSIONS: MicroRNA-588 was lowly expressed in renal cancer tissues and cell lines. This might lead to an increase in the protein level of EIF5A2, eventually promoting tumor invasion and metastasis.

MiR-34a affects hepatocyte proliferation during hepatocyte regeneration through regulating Notch/HIF-1α signaling pathway.

OBJECTIVE: To explore the influences of micro ribonucleic acid (miR)-34a on liver function and hepatocyte proliferation during hepatocyte regeneration in rats and its mechanism. MATERIALS AND METHODS: A total of 80 Sprague-Dawley rats were randomly divided into 4 groups: Sham-2 d group (2 days after hepatectomy), Sham-10 d group (10 days after hepatectomy), miR-34a siRNA-2d group (miR-34a knockdown + 2 days after hepatectomy) and miR-34a siRNA-10 d group (miR-34a knockdown + 10 days after hepatectomy), with 20 rats in each group. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were detected at 2 d and 10 d after the operation. The rat liver was harvested for calculating the liver/body weight ratio. In addition, the deoxyribonucleic acid (DNA) content in rat hepatocytes was detected via Feulgen staining. The pathological changes in rat liver were detected via hematoxylin-eosin (H&E) staining. Moreover, the hepatocyte apoptosis in each group was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. Expression levels of proliferating cell nuclear antigen (PCNA), Notch1 intracellular domain (NICD), and hypoxia-inducible factor-1α (HIF-1α) in liver tissues of each group were detected via immunohistochemistry and Western blotting. RESULTS: No significant differences in the liver/body weight ratio, serum levels of ALT, AST, LDH, pathological structure of the liver, hepatocyte apoptosis level, and PCNA expression in hepatocytes were found between miR-34a siRNA-2 d group and Sham-2 d group. However, the expression levels of NICD and HIF-1α in the liver significantly increased in miR-34a siRNA-2 d group compared with those in Sham-2 d group (p<0.05). On the contrary, compared with those in Sham-10 d group, the liver function and hepatocyte regeneration level significantly increased in miR-34a siRNA-10 d group. Increased liver/body weight ratio, remarkable decline in serum levels of ALT, AST, and LDH, significant alleviation of pathological injury of liver tissues, decreased the apoptosis level and upregulated PCNA protein were observed in miR-34a siRNA-10 d group than those of Sham-10 d group. The Notch/HIF-1α signaling pathway was also significantly activated. CONCLUSIONS: MiR-34a knockdown can significantly enhance the liver function and hepatocyte regeneration ability in rats at 10 d after hepatectomy through activating the Notch/HIF-1α signaling pathway.

[Effects of retroperitoneal laparoscopic ureterolithotomy and flexible-ureteroscopic holmium laser lithotripsy for complex upper ureteral calculi].

Objective: To explore the clinical effects of retroperitoneal laparoscopic ureterolithotomy (RPLU) and flexible-ureteroscopic holmium laser lithotripsy (f-UHLL) for complicated upper ureteral calculi. Methods: A total of 45 cases of complicated upper ureteral calculi between March 2014 and January 2016 in Department of Urology, Affiliated Jiangyin Hospital of Southeast University Medical College were retrospectively analyzed, there were 32 males and 13 females, ranging from 27 to 45 years with an average age of (34.1±9.5) years. Of the 45 patients, 28 had ureteral distortion and 17 had concurrent ureteral stones in the lower or middle ipsilateral ureter. In those patients, 20 cases underwent f-UHLL, and 25 cases received RPLU. The stone size, operation time, hospital stay, stone clearance rates and postoperative fever rates between the two groups were compared with t test and χ(2)test. Results: The operation was successfully performed in all patients, no complications with leakage of urine or ureteral perforation occurred, and no significant difference in renal function between the two methods were founded in postoperative period. There was no significant difference in operation time((78.4±8.5) minuetes vs.(73.3±11.3) minuetes, t=0.61, P=0.67), time of double J tube removed ((33.8±3.4)days vs. (37.6±8.9) d, t=2.37, P=0.08) and ipsilateral renal glomerular filtration rates ((41.3±7.6)ml/minuetes vs.(40.5±7.1) ml/min, t=0.78, P=1.27) between the two groups. However, the hospitalization time ((5.9±1.7)days vs. (4.2±1.6) days, t=1.92, P=0.04), postoperative fever rates (4% vs.30%, χ(2)=5.72, P=0.03) and calculus clearance rates (100% vs. 75%, χ(2)=7.03, P=0.01) in RPLU were significantly higher than f-UHLL. Besides, 5 patients in the f-UHLL group had postoperative stone residue and were treated with extracorpore shock wave lithotripsy. Conclusions: Both RPLU and f-UHLL are safety and validity for complex upper ureteral calculi. RPLU can improve the rate of calculus removal and reduce the rate of postoperative fever.

[The comparation of fusion targeting biopsy and systematic biopsy in the clinical diagnosis of prostate cancer: a meta-analysis].

Objective: To systematically compare the differences in the detection rate of prostate cancer with fusion targeting biopsy and systemic biopsy. Methods: A computer-based search of PubMed, Medline, China Biomedical Literature Database and Wanfang database (from the beginning of establishment of library to October 2016) on the detection rate of prostate cancer by fusion targeting biopsy and systemic biopsy was performed manually.The inclusion and exclusion criteria were formulated by 2 reviewers, and the data were extracted and evaluated respectively. RevMan5.3 software was used to analyze the detection rate of prostate cancer by two biopsy methods. Results: A total of 15 related clinical studies were included, 5 337 cases were enrolled in the study, including 2 667 cases of targeted fusion biopsy and 2 670 cases of routine systemic biopsy. The results showed that the overall detection rate of prostate cancer in targeting fusion biopsy was significantly higher than that of conventional systemic biopsy (OR=1.16, 95% CI 1.04-1.30, P=0.007). The detection rates of prostate cancer with different risk grades by two biopsy methods were conducted. We found that targeted fusion biopsy had a significant advantage compared with conventional system biopsy (OR=1.37, 95% CI 1.19-1.58, P<0.05) in middle and high risk prostate cancer with Gleason ≥ 7 points. In low-risk prostate cancer patients with Gleason score <7, the detection rate of prostate cancer by targeted fusion biopsy was lower (OR=0.76, 95% CI 0.65-0.89, P<0.05) than that of conventional systemic biopsy. Conclusions: Targeted fusion biopsy was significantly better than systemic biopsy in the overall detection rate of prostate cancer and the detection rate of the middle and high risk prostate cancer with Gleason ≥7 points. However, systemic biopsy performed better in patients with Gleason<7 points of low-risk prostate cancer.

Attenuation of subchondral bone abnormal changes in osteoarthritis by inhibition of SDF-1 signaling.

BACKGROUND: Current conservative treatments for osteoarthritis (OA) are largely symptoms control therapies. Further understanding on the pathological mechanisms of OA is crucial for new pharmacological intervention. OBJECTIVE: In this study, we investigated the role of Stromal cell-derived factor-1(SDF-1) in regulating subchondral bone changes during the progression of OA. METHODS: Clinical samples of different stages of OA severity were analyzed by histology staining, micro-CT, enzyme-linked immunosorbent assay (ELISA) and western blotting, to compare SDF-1 level in subchondral bone. The effects of SDF-1 on human mesenchymal stem cells (MSCs) osteogenic differentiation were evaluated. In vivo assessment was performed in an anterior cruciate ligament transaction plus medial meniscus resection in the SD rats. The OA rats received continuous infusion of AMD3100 (SDF-1 receptor blocker) in osmotic mini-pump implanted subcutaneously for 6 weeks. These rats were then terminated and subjected to the same in vitro assessments as human OA samples. RESULTS: SDF-1 level was significantly elevated in the subchondral bone of human OA samples. In the cell studies, the results showed SDF-1 plays an important role in osteogenic differentiation of MSCs. In the OA animal studies, there were less cartilage damage in the AMD3100-treated group; microCT results showed that the subchondral bone formation was significantly reduced and so did the number of positive Nestin or Osterix cells in the subchondral bone region. CONCLUSIONS: Higher level of SDF-1 may induce the subchondral bone abnormal changes in OA and inhibition of SDF-1 signaling could be a potential therapeutic approach for OA.

[Application of systematic etiological analysis in final and differential diagnosis of hereditary hemolytic anemia].

OBJECTIVE: Study on the application of the systematic analysis strategies of etiology in final and differential diagnosis of hereditary hemolytic anemia (HHA). METHODS: Analysis of 1 506 patients with suspected hemolytic anemia (HA) in systematic hemolytic etiological analysis. RESULTS: ①1 413(94%) of the total 1 506 patients [male 799, female 707, median age 22-year-old (4 days to 86-year-old) ]were caused by membranopathy, hemoglobinopathy and enzymopathy, documented the three major causes of HHA. 369 cases (26%) of the 1 413 patients showed complex type of HA, which had the coexistence of two or more hereditary defects concerning HA in red cells, the other 1 044 cases (74%) were HA with single hemolytic cause. ②In 1 044 cases of single HA, hemoglobinopathy, membranopathy and enzymopathy was 22%, 63% and 15%, respectively. When single HA plused complex HA, the hemoglobinopathy, membranopathy and enzymopathy was 29%, 57% and 14% respectively. The difference was not statistically significant (P >0.05). ③ The most common double heterozygosis with different genetic defects was hemoglobinopathy complicated with membranopathy (50%, 184/369). The complex HA was also found in patients with the enzymopathy complicated with membranopathy (18%, 66/369) and with hemoglobinopathy (4%, 13/369). Some of complex HA patients had the same kinds of genetic defects which means double hemoglobinopathies (29 cases, 8% ), membranopathies (57 cases, 15% ) and enzymopathies (9 cases, 2%). Other kinds (11 cases, 3%) of complex HA, anemia and jaundice were seen in HAA patients accompanied with acquired and secondary defects or other system abnormalities. CONCLUSION: The parallel etiologic examination of three major genetic hemolytic diseases can be 94% of patients for classification. The results showed that the first cause of HAA was membranopathy, second hemoglobinopathy and then enzymopathy. Complex hemolysis is not uncommon and single factor analysis alone is not enough to provide scientific basis for diagnosis.

KDM2B/FBXL10 targets c-Fos for ubiquitylation and degradation in response to mitogenic stimulation.

KDM2B (also known as FBXL10) controls stem cell self-renewal, somatic cell reprogramming and senescence, and tumorigenesis. KDM2B contains multiple functional domains, including a JmjC domain that catalyzes H3K36 demethylation and a CxxC zinc-finger that recognizes CpG islands and recruits the polycomb repressive complex 1. Here, we report that KDM2B, via its F-box domain, functions as a subunit of the CUL1-RING ubiquitin ligase (CRL1/SCF(KDM2B)) complex. KDM2B targets c-Fos for polyubiquitylation and regulates c-Fos protein levels. Unlike the phosphorylation of other SCF (SKP1-CUL1-F-box)/CRL1 substrates that promotes substrates binding to F-box, epidermal growth factor (EGF)-induced c-Fos S374 phosphorylation dissociates c-Fos from KDM2B and stabilizes c-Fos protein. Non-phosphorylatable and phosphomimetic mutations at S374 result in c-Fos protein which cannot be induced by EGF or accumulates constitutively and lead to decreased or increased cell proliferation, respectively. Multiple tumor-derived KDM2B mutations impaired the function of KDM2B to target c-Fos degradation and to suppress cell proliferation. These results reveal a novel function of KDM2B in the negative regulation of cell proliferation by assembling an E3 ligase to targeting c-Fos protein degradation that is antagonized by mitogenic stimulations.

Lipid-mediated protein functionalization of electrospun polycaprolactone fibers.

In this study, electrospun polycaprolactone (PCL) fibers are plasma-treated and chemically conjugated with cholesteryl succinyl silane (CSS). In addition to Raman spectroscopy, an immobilization study of DiO as a fluorescent probe of lipid membranes provides evidence supporting the CSS coating of plasma-treated PCL fibers. Further, anti-CD20 antibodies are used as a model protein to evaluate the potential of lipid-mediated protein immobilization as a mechanism to functionalize the CSS-PCL fiber scaffolds. Upon anti-CD20 functionalization, the CSS-PCL fiber scaffolds capture Granta-22 cells 2.4 times more than the PCL control does, although the two fiber scaffolds immobilize a comparable amount of anti-CD20. Taken together, results from the present study demonstrate that the CSS coating and CSS-mediated antibody immobilization offers an appealing strategy to functionalize electrospun synthetic polymer fibers and confer cell-specific functions on the fiber scaffolds, which can be mechanically robust but often lack biological functions.

Preparation, structure and drug release behaviour of chitosan-based nanofibres.

Biomimetic polymeric nanofibres are of great interest in tissue engineering and wound repair because of their structural similarity to extracellular matrix. In this work, biomimetic chitosan-based nanofibres with various diameters were prepared by ionically cross-linking with tripolyphosphate (TPP) in adipic acid medium and characterised using transmission electron microscopy, X-ray diffraction and Fourier-transform infrared spectroscopy. Using dexamethasone sodium phosphate (DMP) and bovine serum albumin (BSA) as low and high molecular-weight bioactive molecule models, respectively, drug loading and in vitro release behaviours of chitosan-TPP nanofibres were investigated. The drug-loaded chitosan-TPP nanofibres showed a prolonged release profile with three distinct stages in physiological conditions because of the complicated release mechanisms involving diffusion of the drug and degradation of the nanofibre, and BSA-loaded nanofibres showed a smaller release rate than DMP-loaded nanofibres. It is proposed that biomimetic chitosan-based nanofibres may be of use in tissue engineering for sustained release of bioactive agents.

[The clinical and pathologic study of embeded supernumerary teeth].

OBJECTIVE: To analyse the clinic and pathologic features of 100 embedded supernumerary teeth, to find out the rule of cystic change of supernumerary teeth and its relationship to malocclusion, and to present the methods of therapy. METHODS: Analysis of clinical data, X-ray manifestation,comparison of the findings on operation and pathological changes demonstrated the correct diagnosis of supernumerary teeth. RESULTS: On statistics and analysis,66% of the crowns of the supernumerary teeth were showed different sizes of circular photic shades,but only 35% were proved to be cystic change by biopsies. CONCLUSION: This study showed that 35% had cystic change among 100 cases,so if the diagnosis can be made in these cases with indication of operation the extraction of the supernumerary teeth must be done as soon as possible.

Treatment of traumatic defect of the tibia with two exposed fractured ends--reduction and lengthening at the proximal metaphysics of tibia.

From Jan. 1995 to June 1996, 6 cases of traumatic defect of the tibia were treated by remodeling and reduction of fractured ends and osteotomy and distraction at the proximal metaphysics of the tibia. In 6 patients, aged 19 to 54, with the limb-length discrepancy being at least 3 to 4.5 cm, the tibia was lengthened by 3 cm in 3 cases, 4 to 4.5 cm in 3 cases. The consolidation and maturation of the bone were accomplished within 3 to 6 months. The authors believe that this procedure is simple, less invasive and involves no bone-graft.

Clinical significance of childhood acute myeloid leukemias expressing lymphoid-associated antigens.

The clinical significance of the expression of lymphoid-associated antigens in leukemic cells was studied in 66 children with newly diagnosed acute myeloid leukemia (AML). Among 66 AML cases, 17% were CD7-positive, 15% were CD19-positive, 8% were CD2-positive, and 5% were CD10-positive. In 23 (35%) of the 66 AML cases, at least one lymphoid-associated antigen was expressed in the leukemic cells. When the clinical features and laboratory findings were compared at diagnosis between the 23 Ly+ and the 43 Ly- AML cases, no statistically significant difference was found. The expression of CD34 was significantly more frequent in Ly+ AML cases (91%) than in Ly- AML cases (31%). Chromosomal analysis revealed t(8;21) in 6 of the 21 Ly+ AML cases examined. No other specific chromosome aberration was noted. The 3-year event-free survival rates of Ly+ AML cases and Ly- AML cases were 34% +/- 12% and 26% +/- 8%, respectively. There was no statistically significant difference between the two groups. Further studies are required to determine the prognostic significance of lymphoid-associated antigen expression.

[Results of the CCLSG high risk ALL 874 protocol in childhood acute lymphoblastic leukemia. Children's Cancer and Leukemia Study Group].

One hundred and eighty eight children with acute lymphoblastic leukemia (ALL) were treated in a Children's Cancer and Leukemia Study Group high-risk ALL 874 study from April, 1987 to September, 1991. These patients received a four-drug induction regimen followed by the early consolidation regimen, cranial irradiation at 6 months of remission and three years of continuation therapy with rotational administration of four drugs. The patients were randomized into two regimens. In regimen A, the consolidation chemotherapy consisted of the intermediate dose cytosine arabinoside (Ara-C), cyclophosphamide (CPM) plus 6MP, and in regimen B, it consisted of high-dose Ara-C plus CPM. Regimen A was given to 106 patients and 82 patients received regimen B. The complete remission induction rate for regimen A and B was 89.4% (93/104) and 98.7% (78/79), respectively. The 3-year event-free-survival (EFS) rate was 70.6% for regimen A, which was higher than the 56.7% for regimen B. The 3-year EFS rate was 44.4% for the 53 patients with an initial leukocyte count > or = 10 x 10(4)/microliters and 72.2% for 132 patients with a leukocyte count < 10 x 10(4)/microliter. We considered that Ara-C plus L-asp, added to the conventional high-risk ALL 811 protocol, improved the prognosis of the high risk ALL patients. However, further intensive chemotherapy was required for improvement of the outcome of the patients with hyperleukocytosis (> or = 10 x 10(4)/microliters).