Tenofovir versus entecavir on the prognosis of hepatitis B virus-related hepatocellular carcinoma: a reconstructed individual patient data meta-analysis.

Background: Hepatitis B, often leading to Hepatocellular carcinoma (HCC), poses a major global health challenge. While Tenofovir (TDF) and Entecavir (ETV) are potent treatments, their comparative effectiveness in improving recurrence-free survival (RFS) and overall survival (OS) rates in HBV-related HCC is not well-established. Methods: We conducted an individual patient data meta-analysis using survival data from randomized trials and high-quality propensity score-matched studies to compare the impact of Tenofovir (TDF) and Entecavir (ETV) on RFS and OS in HBV-related HCC patients. Data from six databases and gray literature up to 30 August 2023, were analyzed, utilizing Kaplan-Meier curves, stratified Cox models, and shared frailty models for survival rate assessment and to address between-study heterogeneity. The study employed restricted mean survival time analysis to evaluate differences in RFS and OS between TDF-treated and ETV-treated patients. Additionally, landmark analyses compared early (<2 years) and late (≥2 years) tumor recurrence in these cohorts. Results: This study incorporated seven research articles, covering 4,602 patients with HBV-related HCC (2,082 on TDF and 2,520 on ETV). Within the overall cohort, TDF recipients demonstrated significantly higher RFS (p = 0.042) and OS (p < 0.001) than those on ETV. The stratified Cox model revealed significantly improved OS for the TDF group compared to the ETV group (hazard ratio, 0.756; 95% confidence interval, 0.639-0.896; p = 0.001), a result corroborated by the shared frailty model. Over a follow-up period of 1-8 years, no significant difference was noted in the mean time to death between the TDF and ETV groups. The rates of early recurrence did not significantly differ between the groups (p = 0.735). However, TDF treatment was significantly associated with a reduced risk of late recurrence compared to ETV (p < 0.001). In the HCC resection subgroup, the disparities in OS, early, and late recurrence rates between the two treatments paralleled those seen in the overall cohort. Conclusion: Compared to ETV, TDF may enhance OS and reduce late tumor recurrence risk in HBV-related HCC patients receiving curative treatment. However, there was no statistically significant distinction in the timing of tumor recurrence and mortality between patients administered TDF and those prescribed ETV. Systematic Review Registration: http://www.crd.york.ac.uk/prospero/.

Community integration and its predictors in people with stroke: a multicenter longitudinal study.

OBJECTIVE: To investigate the community integration of patients following stroke and determine the predictors of their level of community integration at 1-year follow-up. DESIGN: A multicenter, longitudinal, and observational study. SUBJECTS: Sixty-five inpatients (41 men) with a mean age of 56.9 (standard deviation = 17.0) years, who had their first stroke at least 1 month prior to this study were recruited from 4 rehabilitation inpatient wards in China. METHODS: In the initial assessment, the participants were evaluated using the Community Integration Questionnaire, the Fugl-Meyer Assessment, the Berg Balance Scale, the Modified Barthel Index, the Mini Mental State Examination, and the Modified Ashworth Scale. In the follow-up assessments, which were conducted via telephone no less than 1 year after discharge, the participants were evaluated using the Community Integration Questionnaire and also assessed for other disease-related conditions. RESULTS: The participants' scores on the Community Integration Questionnaire in the follow-up assessment were significantly greater than those at the initial assessment (p < 0.05). In addition, the participants' Community Integration Questionnaire scores in the follow-up assessment were significantly correlated with their ages, numbers of years of education, and Modified Barthel Index, Berg Balance Scale, Mini Mental State Examination scores in the initial assessment (p < 0.05), and marginally significantly correlated with their scores on Fugl-Meyer Assessment in the initial assessment (p = 0.058). The participants' ages, numbers of years of education, and Modified Barthel Index, Berg Balance Scale, Mini Mental State Examination, Fugl-Meyer Assessment of the lower extremity, and Fugl-Meyer Assessment scores in the initial assessment were predictive of their Community Integration Questionnaire scores at follow-up, with coefficients of determination ranging from 0.254 to 0.056 (p < 0.05). CONCLUSIONS: The level of community integration of the participants was generally low, but it was greater at 1-year follow-up than it was initially. Balance function and daily living ability may be key predictors of community integration of patients following stroke.

Diffuse pigmented villonodular synovitis treated with arthroscopic total synovial peel.

BACKGROUND: Diffuse pigmented villonodular synovitis (PVNS) is prone to recurrence after surgery, and it is difficult to achieve a long-term complete cure. OBJECTIVE: To reduce the recurrence rate of PVNS, the author pioneered the arthroscopic total synovial peel (ATSP). METHODS: From March 2014 to July 2020, a total of 19 patients (6 males and 13 females) with diffuse PVNS of the knee were treated in our department and underwent ATSP. It's 'peel' rather than simple excision. This method is similar to peeling bark. Relapse rates and functional scores were determined, with follow-ups ranging from 12 to 72 months, on average 36 months. RESULTS: Treatment efficacy was assessed by imaging and functional scores. Imaging results indicated a recurrence rate of 10.5%. In patients without recurrence, the visual analog score (VAS) decreased from 4.76 ± 2.02 preoperatively to 1.56 ± 1.15 postoperatively. The Tegner-Lysholm knee function score (TLS) score increased from 67.76 ± 15.64 preoperatively to 90.32 ± 8.32 postoperatively. Compared with the literature, ATSP significantly reduces the postoperative recurrence rate of diffuse PVNS. The preliminarily findings suggest that this approach could greatly reduce the recurrence rate of postoperative PVNS in follow-up studies. CONCLUSION: This approach may be a viable option for treating diffuse PVNS via arthroscopy and is worthy of clinical consideration.

An Intraoperative Trajectory-Determined Strategy of Patient-Specific Drill Template for C2 Transoral Pedicle Insertion in Incomplete Reduction of Atlantoaxial Dislocation: An In Vitro Study.

OBJECTIVES: This study aims to explore a novel intraoperative trajectory-determined strategy of grouped patient-specific drill templates (PDTs) for transoral C2 pedicle screw insertion (C2 TOPI) for atlantoaxial dislocation (AAD) with incomplete reduction and to evaluate its efficiency and accuracy. METHODS: Ten cadaveric C2 specimens were scanned by computed tomography (CT) and randomly divided into two groups (the PDT and freehand groups). A novel intraoperative trajectory-determined strategy of grouped PDTs was created for AAD with incomplete reduction. C2 TOPI was performed by use of the PDT technique and the fluoroscopy-guided freehand technique. After surgery, the screw deviations from the centroid of the cross-section at the midpoint of the pedicle and screw position grades were assessed in both groups. RESULTS: Compared to the freehand group, the PDT group had a significantly shorter surgery time than the freehand group (47.7 vs 61.9 min, P < 0.001). The absolute deviations from the centroids between the preoperative designs and postoperative measurements on the axial plane of the pedicle were 1.19 ± 0.25 mm in the PDT group and 1.82 ± 0.51 mm in the freehand group. On the sagittal plane of the pedicle, the corresponding values were 1.10 ± 0.33 mm in the PDT group and 1.70 ± 0.49 mm in the freehand group. The absolute deviations of the free-hand group on both the axial and sagittal planes were higher than that of the freehand group (P < 0.05 and P < 0.05, respectively). For the grade of screw insertion position, nine (90%) were observed in type I and one (10%) in type II in the PDT group, whereas five (50%) were in type I, three (30%) were in type II, and two (20%) in type III in the freehand group. Statistical differences could not be found between the groups in terms of the screw positions (P > 0.05). CONCLUSION: The novel intraoperative trajectory-determined strategy of grouped PDTs can be used as an accurate and feasible method for C2 TOPI for AAD with incomplete reduction.

Protein post-translational modifications after spinal cord injury.

Deficits in intrinsic neuronal capacities in the spinal cord, a lack of growth support, and suppression of axonal outgrowth by inhibitory molecules mean that spinal cord injury almost always has devastating consequences. As such, one of the primary targets for the treatment of spinal cord injury is to develop strategies to antagonize extrinsic or intrinsic axonal growth-inhibitory factors or enhance the factors that support axonal growth. Among these factors, a series of individual protein level disorders have been identified during the generation of axons following spinal cord injury. Moreover, an increasing number of studies have indicated that post-translational modifications of these proteins have important implications for axonal growth. Some researchers have discovered a variety of post-translational modifications after spinal cord injury, such as tyrosination, acetylation, and phosphorylation. In this review, we reviewed the post-translational modifications for axonal growth, functional recovery, and neuropathic pain after spinal cord injury, a better understanding of which may elucidate the dynamic change of spinal cord injury-related molecules and facilitate the development of a new therapeutic strategy for spinal cord injury.

Microstructure Analysis and Reconstruction of a Meniscus.

OBJECTIVE: To analyze the characteristics of menicus microstructure and to reconstruct a microstructure-mimicing 3D model of the menicus. METHODS: Human and sheep meniscus were collected and prepared for this study. Hematoxylin-eosin staining (HE) and Masson staining were conducted for histological analysis of the meniscus. For submicroscopic structure analysis, the meniscus was first freeze-dried and then scanned by scanning electron microscopy (SEM). The porosity of the meniscus was determined according to SEM images. A micro-MRI was used to scan each meniscus, immersed in distilled water, and a 3D digital model was reconstructed afterwards. A three-dimensional (3D) resin model was printed out based on the digital model. Before high-resolution micro-CT scanning, each meniscus was freeze-dried. Then, micro-scale two-dimensional (2D) CT projection images were obtained. The porosity of the meniscus was calculated according to micro-CT images. With micro-CT, multiple 2D projection images were collected. A 3D digital model based on 2D CT pictures was also reconstructed. The 3D digital model was exported as STL format. A 3D resin model was printed by 3D printer based on the 3D digital model. RESULTS: As revealed in the HE and Masson images, a meniscus is mostly composed of collagen, with a few cells disseminated between the collagen fiber bundles at the micro-scale. The SEM image clearly shows the path of highly cross-linked collagen fibers, and massive pores exist between the fibers. According to the SEM images, the porosity of the meniscus was 34.1% (34.1% ± 0.032%) and the diameters of the collagen fibers were varied. In addition, the cross-linking pattern of the fibers was irregular. The scanning accuracy of micro-MRI was 50 µm. The micro-MRI demonstrated the outline of the meniscus, but the microstructure was obscure. The micro-CT clearly displayed microfibers in the meniscus with a voxel size of 11.4 µm. The surface layer, lamellar layer, circumferential fibers, and radial fibers could be identified. The mean porosity of the meniscus according to micro-CT images was 33.92% (33.92% ± 0.03%). Moreover, a 3D model of the microstructure based on the micro-CT images was built. The microscale fibers could be displayed in the micro-CT image and the reconstructed 3D digital model. In addition, a 3D resin model was printed out based on the 3D digital model. CONCLUSION: It is extremely difficult to artificially simulate the microstructure of the meniscus because of the irregularity of the diameter and cross-linking pattern of fibers. The micro-MRI images failed to demonstrate the meniscus microstructure. Freeze-drying and micro-CT scanning are effective methods for 3D microstructure reconstruction of the meniscus, which is an important step towards mechanically functional 3D-printed meniscus grafts.

Efficiency of Zoledronic Acid in Inhibiting Accelerated Periprosthetic Bone Loss After Cementless Total Hip Arthroplasty in Osteoporotic Patients: A Prospective, Cohort Study.

OBJECTIVE: To investigate the influence of preoperative osteopenia/osteoporosis on periprosthetic bone loss after total hip arthroplasty (THA) and the efficiency of zoledronate (ZOL) treatment in periprosthetic bone preservation. METHODS: This multicenter, prospective cohort study was conducted in four centers between April 2015 and October 2017. Patients were assigned to Normal BMD, Osteopenia, and Osteoporosis+ZOL groups. Patients with osteopenia received daily oral calcium (600 mg/d) and vitamin D (0.5 µg/d), while patients in the Osteoporosis+ZOL group received additional ZOL annually (5 mg/year). Periprosthetic bone mineral density (BMD) in seven Gruen zones, radiographic parameters, Harris hip score, EuroQol 5-Dimensions (EQ-5D) score, and BMD in hip and spine were measured within 7 days, 3 months, 12 months postoperation and annually thereafter. RESULTS: A total of 266 patients were enrolled, while 81 patients that completed the first year follow-up were involved in the statistical analysis. The mean follow-up time was 1.3 years. There were significant decreases of mean BMD in total Gruen zones (-4.55%, P < 0.05) and Gruen zone 1 (-10.22%, P < 0.01) in patients with osteopenia during the first postoperative year. Patients in the Osteoporosis+ZOL group experienced a marked increase in BMD in Gruen zone 1 (+16%) at the first postoperative year, which had a significant difference when compared with the Normal BMD group (P < 0.05) and the Osteopenia Group (P < 0.001). Low preoperative BMD in hip and spine was predictive of bone loss in Gruen zone 1 at 12 months after THA in patients with normal BMD (R2 = 0.40, P < 0.05). CONCLUSIONS: Patients with osteopenia are prone to higher bone loss in the proximal femur after cementless total hip arthroplasty (THA). ZOL, not solely calcium and vitamin D, could prevent the accelerated periprosthetic bone loss after THA in patients with osteopenia and osteoporosis.

Clinicopathological and molecular characteristics of synchronous gastric adenocarcinoma and gastrointestinal stromal tumors.

Synchronous gastric tumors that consist of both gastrointestinal stromal tumor (GIST) and adenocarcinoma are rare. We studied the clinicopathological and molecular characteristics of six cases containing both gastric adenocarcinoma and GIST. By means of immunohistochemical analysis, all GIST cells expressed CD117, CD34 and Dog1 in all six synchronous gastric adenocarcinomas with GIST, and in GIST alone. Sequencing analysis demonstrated that exon 11 c-kit mutations were present in two of six synchronous tumors and four of five GISTs. One of the two exon 11 c-kit mutations in synchronous adenocarcinomas with GISTs was an uncommon mutation of CTT > CCA at amino acid 576, and the other was a GTT deletion at amino acid 560. The mutation was a homozygous A > G mutation in exon 12 (amino acid 567) of PDGFR-α. We concluded that the exon 11 mutations were the most important in both cases of synchronous gastric adenocarcinoma with GIST and GIST alone. The mutation rate was higher in GIST alone than in synchronous adenocarcinoma with GIST.

[Risk Assessment of Snail Output Via the Mud Balls of Transplanted Seedlings in a Nursery Stock Park in Middle Region of Zhejiang Province].

Objective: To investigate the distribution of snails in a nursery stock park in the middle region of Zhejiang Province and assess the risk of snail output via the mud balls of transplanted seedlings, to provide scientific data for making strategies for snail control. Methods: We selected three species of seedlings including Osmanthus fragrans (a large tree), Camellia sasanqua (a small tree), and Purpus privet (a type of shrub) in a nursery stock park in a snail-positive middle region of Zhejiang Province during 2014-2016 to calculate the areas of regions with snails and the density of living snails. In 30 trees of each species, the distribution of snails within the seedlings ground diameter (radius of investigation, 100 cm for Osmanthus fragrans; 30 cm for Camellia Sasanqua and Purpus Privet) and in different soil layers (surface and superficial layers, 0-3 cm; deep layer, 3-10 cm) was assessed. In addition, the presence of snails in mud balls of 50 trees of Photinia fraseri (a small tree with high density of snails) was investigated to assess the risk of snail output. Results: In the planting areas of Osmanthus fragrans（3 930 m2）, Camellia sasanqua（2 000 m2）, and Purpus privet （1 700 m2）, the areas of snail-positive regions were 200, 900 and 800 m2, respectively, with the density of living snails being 0.08, 0.56 and 0.55/0.1 m2. For Osmanthus fragrans, Camellia sasanqua and Purpus privet, 238, 654 and 645 snails were detected respectively within their seedlings ground diameter, including 159（66.8%）, 461（70.5%） and 376 （58.3%） snails in the surface layer, respectively, which were significantly higher than those in the superficial and deep layers（P＜0.01）. Snails were found in all the 50 trees of Photinia fraseri（3 726 snails, 706 adult snails and 3 020 immature snails, 75 snails/tree on average）. Conclusion: There is a high density of snails in the nursery stock park in the middle region of Zhejiang Province. The snails are distributed mainly in the surface layer, suggesting a risk of snail output through mud balls.

[Role of Oncomelania hupensis in transmission of schistosomiasis japonica].

Oncomelania hupensis is the only intermediate host of Schistosomajaponicum, and its ecological characteristics and compatibility with Schistosoma which have a great significance to the schistosomiasis control, play a very important role in the transmission of schistosomiasis. This paper reviews the researches on the ecological factors which effect the survive of Oncomelania snails such as temperature, humidity, vegetation, and soil, as well as the snail density, the development and breeding of snails in the foreign habitats, and its compatibility with Schistosoma.

[Slow-release recombinant human bone morphogenetic protein-2 suppresses chromium wear particle-induced osteolysis in rats].

OBJECTIVE: To observe the effect of a slow-release recombinant human bone morphogenetic protein-2 (rhBMP-2) formulation on the expressions of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) in a murine air pouch model of bone implantation. METHODS: A cranial bone allograft was implanted in the air pouch induced on the back of the recipients. The rat models were then randomized into 5 groups, including a blank control group, chromium particle group, and 3 rhBMP-2 groups receiving 50, 100 or 200 µg/L slow-release rhBMP-2 in addition to chromium particles. Three weeks later, the expressions of RANKL and OPG in the air pouch was detected using Western blotting and RT-PCR, and the positively stained area for osteoclasts in the bone graft was determined with TRAP staining for drug effect assessment. RESULTS: RANKL and OPG expressions were found in the air pouches in all the 5 groups. RANKL and OPG protein and mRNA expressions, RANKL/OPG ratio and osteoclast staining area in the bone graft were the highest in chromium particle group (P<0.05), but were significantly decreased by treatment with the slow-release rhBMP-2 formulation (P<0.05); the measurements showed no significant differences between the blank control group and 200 µg/L rhBMP-2 group (P>0.05). CONCLUSION: Chromium particles can cause osteolysis by increasing the RANKL/OPG ratio in rats, and intervention with slow-release rhBMP-2 can significantly promote bone formation and suppress bone resorption by decreasing RANKL/OPG ratio.

[Strategy of solidification and surveillance for schistosomiasis in transmission-interrupted provinces in China].

In schistosomiasis transmission-interrupted provinces in China, the endogenous source of infection has been basically cleared, and the exogenous source of infection is considered as a major threat. The residual snail area has been increasing in different degrees, and imported snails are regarded as a potential risk. So the possibility of schistosomiasis recrudescence still remains. According to the endemic characteristics, the integrated solidification strategy with emphasis on control of residual snails and imported cases should be taken in the future.

[Quality control assessments of feces examination for schistosomiasis in province-level laboratories of Zhejiang Province].

OBJECTIVE: To understand and evaluate the quality of feces examination for schistosomiasis in province-level laboratories of Zhejiang Province. METHOD: With the single-blind method, the stool samples were detected by the stool hatching method and sediment detection method. RESULTS: In the 3 quality control assessments in 2006, 2008 and 2009, most laboratories finished the examinations on time. The accordance rates of detections were 88.9%, 100% and 93.9%, respectively. CONCLUSION: The province-level laboratories for schistosomiasis feces examination of Zhejiang Province is coming into standardization, and the techniques of schistosomiasis feces examination are optimized gradually.

Development of a rapid dipstick with latex immunochromatographic assay (DLIA) for diagnosis of schistosomiasis japonica.

BACKGROUND: Schistosomiasis japonica (schistosomiasis) is a zoonosis that can seriously affect human health. At present, the immunodiagnostic assays for schistosomiasis detection are time-consuming and require well-trained personnel and special instruments, which can limit their use in the field. Thus, there is a pressing need for a simple and rapid immunoassay to screen patients on a large scale. In this study, we developed a novel rapid dipstick with latex immunochromatographic assay (DLIA) to detect anti-Schisaosoma japonicum antibodies in human serum. RESULTS: Using latex microspheres as a color probe, DLIA was established to test standard positive and negative sera, in comparison with the classical enzyme-linked immunosorbent assay (ELISA). The sensitivity and specificity of DLIA were 95.10% (97/102) and 94.91% (261/275), respectively. The cross-reaction rates with clonorchiosis, intestinal nematodes, Angiostrongylus cantonensis and paragonimiasis were 0, 0, 0 and 42.11% respectively. All the results showed no significant difference to the ELISA. In field tests, 333 human serum samples from an endemic area were tested with DLIA, and compared with ELISA and Kato-Katz method. There was no significant difference between DLIA and ELISA on positive and negative rates of detection; however, significant differences existed between DLIA and Kato-Katz method, and between ELISA and Kato-Katz method. The kappa value between DLIA and ELISA was 0.90. CONCLUSIONS: This is the first study in which DLIA was used to detect anti-Schistosoma japonicum antibody. The results show that DLIA is a simple, rapid, convenient, sensitive and specific assay for the diagnosis of schistosomiasis and is therefore very suitable for large-scale field applications and clinical detection.

[Expression of hypoxia-inducible factor-1α and vascular endothelial growth factor in the synovium of patients with osteoarthritis].

OBJECTIVE: To detect the expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in patients with osteoarthritis and investigate their roles in the synovial lesions of osteoarthritis. METHODS: The expressions of HIF-1α and VEGF in the synovium were detected by immunohistochemical staining in 30 osteoarthritis cases, 20 acute traumatic arthritis cases and 10 normal synovial biopsy samples. The correlation between HIF-1α and VEGF, and their relationships with osteoarthritis were analyzed. RESULTS: The rates of positive expression of HIF-1α and VEGF in osteoarthritis cases were significantly higher than those in acute traumatic arthritis (86.7% vs 60% and 80% vs 48%, P<0.05). Normal human synovium showed no positive expressions of HIF-1α and VEGF. HIF-1α expression was positively correlated to VEGF expression in acute traumatic synovitis and osteoarthritis cases, with correlation coefficients of 0.666 and 0.678, respectively. CONCLUSION: The expressions of HIF-1α and VEGF in the synovial tissue are significantly higher in osteoarthritis cases than in cases of acute traumatic arthritis. They have close relationship in the synovial lesions of osteoarthritis and both contribute to the development of osteoarthritis.

[Recent investigation and treatment of 1 060 advanced schistosomiasis cases in Zhejiang Province].

OBJECTIVE: To understand the current status of advanced schistosomiasis patients, deliver medical treatment, and improve the case management in Zhejiang Province. METHODS: The cases previously diagnosed or suspected as advanced schistosomiasis in the province were the subjects of the investigation. Questionnairing (demographical information, disease history, etc.), clinical examination (ascites syndrome, abdominal palpation), laboratory examination (blood biochemistry, anti-Schistosoma japonicum antibody, eggs), and ultrasonography of the abdomen were used confirming the diagnosis. Treatment was given to the patients. RESULTS: There were 1 060 advanced schistosomiasis patients in 32 counties of 7 prefectures in the province. Majority of them distributed in water network regions, and lived with poor economic conditions. The average age of the patients was (66.3 +/- 9.3), with 89.3% ranged from 50 to 80 years old. Clinically 71.3% of the cases were with splenomegaly, 27.6% with ascites, 0.9% cases of multiple granuloma in the colon and 0.2% cases with dwarfism. 1 023 patients (96.5%) had received medical treatments. 69.4% of the cases had serious complications with advanced schistosomiasis and 52.5% had concurrently disorders in other systems. 71.1% of the patients had subjective symptoms and 65.2% had hepatosplenomegaly with hepatic fibrosis and dysfunction. The serum positive rate of anti-S. japonicum antibody was 15.7%. Stool hatching test and microscopy revealed no eggs in fecal samples, but 24 out of 38 cases were found metamorphic eggs by rectal biopsy. Three years' medical treatment improved the clinical conditions in 74.3% of the cases. CONCLUSION: Situation of the advanced schistosomiasis patients is quite critical. Treatment and care are urgently needed especially for those aged 50 to 80 years old. [

[Evaluation of complex diet dry matter digestibility of sheep using spectra difference].

The present study aimed to predict the dry matter digestibility (DMD) of animals fed complex diet using the spectra difference between diets and feces by near infrared reflectance spectroscopy (NIRS). Four indoor experiments were carried out with artificial mixed complex diets in the state field observatory stations located at Hebei province. The sheep were used as tested animals. One hundred and four parts of "diet-feces" were obtained and divided into a calibration sample set (70 samples) and a validation sample set (34 samples). The spectra difference between diets and feces, and the partial least square (PLS) were used to calibrate the models of DMD of sheep. The results indicated that the optimum range of spectrum was 8 656-4 310 cm(-1). The optimum proceeding method was multivariate scattering correction + first derivative + Norris smoothing. The optimum number of factors was 7. The root mean square error of prediction (RMSEP) was 2.46%, and the RPD value of validation was above 2.5. The coefficient of correlation between the actual and predicted DMD using the NIRS was 0.8339, indicating that the NIRS could be used to evaluate dry matter digestibility of sheep fed complex diets.

Congenital syphilis: refining newborn evaluation and management in Shenzhen, southern China.

INTRODUCTION: Consistent definitions of congenital syphilis are critical for determining true incidences and setting up targets of elimination. This study aimed to assess the evaluation and management of infants at high risk of congenital syphilis with an antenatal syphilis-screening programme in the Shenzhen SEZ and to develop feasible definitions for the detection of congenital syphilis in China. METHODS: A retrospective study was conducted of all standardised records of pregnant women with positive syphilis between 2003 and 2007. Infants at high risk of congenital syphilis were evaluated by laboratory tests at birth and longitudinal follow-up. A screening test-positive congenital syphilis case was defined based on a positive 19S-IgM-FTA-ABS result at birth. Assuming that 19S-IgM-FTA-ABS was the gold standard, the sensitivity and specificity of the ascertainment methods were calculated. RESULTS: During the study period, 1010 live infants were born to women with active syphilis during pregnancy. 19S-IgM-FTA-ABS detected 42 screening-positive congenital syphilis cases and another nine cases were identified by longitudinal follow-up only. Using 19S-IgM-FTA-ABS as the gold standard, 'fourfold rapid plasma reagin (RPR) titres' had the highest sensitivity and specificity compared with the other two follow-up methods. DISCUSSION: 19S-IgM-FTA-ABS makes congenital syphilis case classification simpler and faster for newborns. In areas where 19S-IgM-FTA-ABS is not available, comparing newborn RPR titres with maternal titres can be an alternative method. Meanwhile, positive follow-up results act as treatment indicators for older infants. As congenital syphilis definitions vary over the country, the Shenzhen programme suggested a practical model for surveillance and treatment in areas with or without available 19S-IgM-FTA-ABS testing.

A risk model for congenital syphilis in infants born to mothers with syphilis treated in gestation: a prospective cohort study.

OBJECTIVE: To explore the risk factors underlying congenital syphilis (CS) and to build a hazards model to assess the risk of CS in offspring born to mothers with syphilis treated in gestation. METHODS: This prospective study observed 554 pregnant women with syphilis and their offspring recruited from August 2002 to May 2007 in Shenzhen Centre for Chronic Disease Control and Prevention. After treatment, all the women were followed up until the diagnosis of CS in their offspring was confirmed or denied. Comparisons were made between women bearing infants with CS and women bearing infants without CS to reveal the risk factors for CS. ORs and their 95% CI were calculated for each risk factor by using logistical regression analysis. RESULTS: Twenty-nine (5.2%) infants were diagnosed with CS. Univariable analyses showed that the reciprocal logarithm of the titre of non-treponemal antibodies in mothers (log (1/T); OR=11.18, p<0.001), gestational week (GW) at treatment (OR=1.10, p<0.001) and the interaction between these two variates (OR=1.09, p<0.001) was associated with CS. Multivariable analysis showed that only the interaction was significantly associated with CS (OR=1.09, p=0.047). CONCLUSIONS: The risk of CS could be predicted by the interaction between GW x log (1/T). Early treatment given to women with syphilis during antenatal care may be the only effective method to decrease the risk of CS.

[Interface shear stress between the artificial bones and injectable calcium phosphate glue: an experimental study in rabbits].

OBJECTIVE: To evaluate the effect of the composite bone material, fibrin glue (FG) combined with beta-tricalcium phosphate (beta-TCP)/monocalcium phosphate, in repairing bone defects and assess the feasibility of using this cement for artificial joint fixation. METHODS: Bone defects were induced in 16 normal adult New Zealand white rabbits at the bilateral femoral lateral condyles where an 8-mm-deep hole (4 mm in diameter) was drilled on each side. The composite FG/calcium phosphate cement (CPC) (solution: power volume ratio of 0.3:1) was injected on one side of the bone defects (experimental group) and pressurized for 10 minutes, and CPC was injected on the other side (control). The rabbits were sacrificed at 2, 4, 8 or 12 weeks after the operation for gross observation and biomechanical tests. RESULT: The composite material FG/CPC was more effective than CPC for bone defect repair, and biomechanical tests revealed significant differences between them (P<0.05). The shear stress of the artificial bone cement in the FG/CPC group was stronger than that in CPC group. CONCLUSION: The FG/CPC composite possesses good biocompatibility and osteoconductivity and may serve as an ideal material for repairing bone defects.