Preoperative combination score of neutrophils, monocytes, and lymphocytes as a predictor for locally advanced rectal cancer.

OBJECTIVE: The aim of this study was to investigate the prognostic value of baseline peripheral blood neutrophils, monocytes, and lymphocytes on locally advanced rectal cancer (LARC) patients. METHODS: Clinicopathologic data of 317 LARC patients during July 2010 and October 2016 were retrospectively gathered. X-tile software was used to acquire the optimal cutoff values of neutrophils, monocytes, and lymphocytes. Peripheral blood immune score (PBIS) system was proposed and built based on neutrophils, monocytes, and lymphocytes. The Cox model was used to analyze the associations between clinicopathological characteristics and potential outcomes. C-index was used to assess model performance. A nomogram was constructed to predict prognosis, and a calibration plot was used to verify the accuracy of the nomogram prediction model. RESULTS: Cutoff values of neutrophils, lymphocytes, and monocytes were 4.46 (× 109/L), 1.66 (× 109/L), and 0.39 (× 109/L), respectively. PBIS was related to sex (P < 0.001), tumor length (P = 0.003), and tumor thickness (P = 0.014). Multivariate Cox regression analysis revealed that PBIS (HR = 0.707, 95% CI: 0.549-0.912, P = 0.008) was an independent predictor of DFS. High PBIS (HR = 0.697, 95% CI: 0.492-0.988, P = 0.043) and high lymphocyte count (HR = 0.511, 95%CI: 0.273-0.958, P = 0.036) were favorable factors of OS. Both C-index (0.74, 95% CI: 0.549-0.912) and the calibration plot showed good prediction ability of the nomogram for DFS. CONCLUSION: PBIS, composed of baseline peripheral blood neutrophils, monocytes, and lymphocytes, is an independent predictor of the prognosis of LARC. Combination of PBIS and ypTNM stage may be a promising marker to guide adjuvant therapy after the operation.

Near-surface softening and healing in eastern Honshu associated with the 2011 magnitude-9 Tohoku-Oki Earthquake.

The near-surface part of the crust, also called the skin of the earth, is the arena of human activity of which the stiffness is of great concern to engineers in infrastructure construction. The stiffness reduction of near-surface geomaterials also plays a vital role in geohazards triggering. However, the physical mechanism behind the material softening is still not fully understood. Here, we report a coseismic shear-wave velocity reduction in the near surface by up to a few tens of percent during the strongest shaking from the 11 March 2011 Tohoku-Oki Earthquake and a subsequent two-stage healing process including a rapid recovery within a few minutes and a slow recovery over many years. We also present a theoretical contact model between mineral grains in geomaterials containing multiple metastable contacts at small separations due to the oscillatory hydration interaction, which can explain the emergence of different stages in the healing process.

Eight-year survival of AIDS patients treated with Chinese herbal medicine.

Treatment of acquired immunodeficiency syndrome (AIDS) currently relies on the use of antiretroviral drugs. Little is known about Chinese herbal medicine (CHM) outcomes in patients living with AIDS. We conducted a cohort study to investigate long-term survival among CHM-treated AIDS patients. Patients were poor farmers who contracted HIV-1 infection when selling blood in the 1990s. Symptoms of AIDS included recurring respiratory tract infections with a clinical diagnosis of pneumonia, swollen lymph nodes and weight loss. 385 patients with AIDS were included and 165 of them used a 16-herb formula for 14 days to 9 months. The eight-year survival rate was 87% for the CHM users and 34% for the non-users (increased survival probability for CHM user, 9.6; 95% CI = 6.0-15.4; p < 0.0001). Survival probability further increased 14.6-fold (95% CI = 8.2-26.1), when excluding the users who received CHM for less than three months. Zero deaths were found in patients who used CHM for six to nine months. All the survivors regained their body weight and none of them experienced a relapse of AIDS or any severe adverse events. After the CHM treatment for an average of 3.6 months, the plasma HIV load was 74.7% lower (paired t-test, p = 0.151) and the number of blood CD4+ lymphocytes increased from 253 to 314 (paired t-test, p = 0.021). Without life-long medication, CHM may be beneficial for long-term survival of AIDS patients.

[Study of CD4+ CD25+ regulatory T cells and expression of Foxp3 mRNA in bronchiolitis and glucocorticoid regulation].

OBJECTIVE: To explore the pathogenesis of respiratory syncytial viruses (RSV) bronchiolitis and its treatment with glucocorticoids. METHODS: The pediatric patients with RSV bronchiolitis were divided into an atopic group (n = 50) and a non-atopic group (n = 50) based on whether there were IgE elevation, eczema and dermatitis. Another 25 normal subjects were chosen as a control group. Divided into mild, medium and severe groups, they were finally randomly divided into hormone (dexamethasone) and non-hormone groups. The proportion of CD4+ CD25+ regulatory T cells (Treg) and the expression of Foxp3 mRNA were tested by flow cytometry and RT-PCR retrospectively. RESULTS: The proportion of CD4+ CD25+ Treg and the Foxp3 mRNA expression in the control, non-atopic, and atopic groups reached (10.5 +/- 1.6)% and 0.34 +/- 0.11, (8.8 +/- 2.2)% and 0.26 +/- 0.08, (7.6 +/- 1.8)% and 0.21 +/- 0.09, respectively. There were significant differences among these groups (all P < 0.05). The mild, medium and severe bronchiolitis groups reached (9.7 +/- 1.6)% and 0.28 +/- 0.08, (7.8 +/- 2.1)% and 0.24 +/- 0.06, (6.7 +/- 1.3)% and 0.20 +/- 0.07 respectively (all P < 0.05). The proportion of CD4+ CD25+ Treg and the expression of Foxp3 showed significantly negative correlations with severity (r = -0.62, -0.71, both P < 0.01). That is, they correlated with the severity of disease. The proportion of the CD4+ CD25+ Treg and the expression of Foxp3 mRNA of the hormone group were higher than those of the non-hormone group [(9.5 +/- 2.1)% and 0.33 +/- 0.10 vs (8.5 +/- 1.8)% and 0.27 +/- 0.12, P < 0.05 and < 0.01] respectively. CONCLUSION: CD4+ CD25+ Treg and Foxp3 mRNA are involved in the inflammation of bronchiolitis. And the levels of CD4+ CD25+ Treg and Foxp3 mRNA level is an objective indicator of the severity of RSV bronchiolitis. The effect of glucocorticoids upon RSV bronchiolitis may be in part due to the direct enhancement of production and functions of CD4+ CD25+ Treg and Foxp3 mRNA.

[Immunogenicity and safety of three consecutive lots on an inactivated hepatitis A vaccine: a double-blind, immunogenicity and safety of three consecutive lots on a inactivated hepatitis A vaccine:a double-blind, randomized and controlled trial in children].

OBJECTIVE: To evaluate the immunogenicity, safety, stability and consistency of three consecutive lots of an inactivated hepatitis A vaccine (Healive). METHODS: A double-blind, randomized and controlled clinical trial was conducted in healthy volunteers aged from 1 to 8 years. Totally, 400 subjects were enrolled and assigned into four groups, each receiving one of the three lots of Healive or a licensed control vaccine in 0 and 6th month. Safety was assessed through a 30 minutes and three days observation, thereafter. Anti-HAV titers were determined on the 1st, 6th and 7th month after the vaccination. RESULTS: Seroconversion rate of four groups were all 100% by the end of the schedule while GMTs of Healive were 3237.06-3814.14 mIU/ml but were not significantly different. GMT of control vaccine was 1467.49 mIU/ml. Healive and control vaccine were well tolerated with 1%-5% incidence of overall adverse reactions in which most of them were mild and moderate. No severe adverse reaction was reported. CONCLUSION: The three consecutive lots of Healive were well consistent as indicated by immunogenicity and safety while immunogenicity was better than the vaccine used as control.

Immunogenicity and safety of three consecutive lots of a new preservative-free inactivated hepatitis A vaccine (Healive): a double-blind, randomized and controlled trial.

Immunization is considered as the most effective way for the prophylaxis of hepatitis A virus (HAV) infection. This study aimed to evaluate the immunogenicity and safety of three consecutive lots of a new preservative-free inactivated hepatitis A vaccine (Healive) in healthy children. A double-blind, randomized and controlled clinical trial was conducted in healthy volunteers aged from 1 to 8 years. Total 400 subjects were enrolled and assigned into four groups, receiving one of the three lots of Healive or an established control vaccine. The vaccination was two-dose regimen with 6 months apart. Anti-HAV titers were determined at the 1st, 6th and 7th month. The results showed that Healive was highly immunogenic in children with 100% seroconversion rate (SR) and 3237-3814 mIU/ml geometry mean titer (GMT) 1 month after the second dose. The immunogenicity of Healive was statistically higher than that of the control vaccine with respect to GMT and SR (P=0.037 to P<0.001). Both Healive and control vaccine were well tolerated with 1-5% incidence of overall adverse reactions (P>0.298). Severe adverse reaction was not reported. Both SRs (1, 6 and 7 months) and GMTs (1 and 7 months) in subjects receiving one of the three consecutive lots of Healive had not statistical difference (P=0.114-0.710), suggesting that Healive was well consistent. The immune responses in younger children (1-3 years) and older children (4-8 years) were similar to each other (P=0.187-0.963). The present study indicated that Healive was greatly consistent between production lots, well tolerated and highly immunogenic in children, which made the preservative-free inactivated hepatitis A vaccine well suitable for inclusion in the routine programme of children vaccination.

[Surgical approach in plastic of shortened lower limb].

OBJECTIVE: To introduce a new surgical approach to rectify the shortened lower limbs. METHODS: From March 1985 to October 2000, 288 cases of shortened lower limbs were treated and reviewed. Closed fracture at the metaphysis was made by a self-made "needle saw", and then the "multiple-plane and double-track elongation instrument" was adopted to elongate the fractured bone. There were totally 161 cases of male and 127 cases of female included, with average age 21.3 years old, ranging from 12 to 29 years old, among which there were 268 cases elongated at the proximal metaphysis of the tibia, 16 cases at the distal femur and 4 cases at the distal tibia. All of the cases were followed up for 6 to 8 months before clinical evaluation. RESULTS: The lower limbs in 288 cases were elongated for 3.0 to 11.5 cm in 24 to 96 days, averaging 47 days, which fulfilled pre-operative plan. In the second week after the operation, new calculus and periosteum formed obviously in the gap between the fractured parts, and in 6 to 8 months bone union was observed at the fractured site in all cases. There was no nerve or blood vessel injury, or non-union of the metaphysis fracture. The function of the manipulated knee joints and ankle joints recovered well. CONCLUSION: It is a practical and safe surgical option to rectify the shortened lower limbs by closed fracture at the metaphysis, followed by elongation of the fractured bone, without any complication such as non-union or atrophy of manipulated bone, and with no need of internal fixation or bone grafting.