[Characteristics of auditory brainstom response and auditory steady state evoked responses in noise-induced hearing loss population].

Objective: To explore the characteristics of auditory steady state evoked responses (ASSR) and auditory brainstem response (ABR) in noise-induced hearing loss population and the relationship between the response threshold of corresponding frequency and pure tone audiometry (PTA) . Methods: Noise-induced hearing loss patients who completed subjective and objective audiometry in our hospital from October 2014 to October 2018 were collected. The results of PTA, ABR, ASSR and the correlation between subjective and objective audiometry were discussed. Results: A total of 381 ears of 193 patients were enrolled. The difference of 0.5, 1.0, 2.0 and 4.0 kHz between ASSR threshold and PTA was 5.9, 6.9, 11.8 and 1.8 dB, respectively. The correlation coefficients were 0.638, 0.680, 0.657 and 0.608. The difference of 1.0, 2.0, 3.0 and 4.0 kHz between ABR threshold and PTA was 44.2, 35.0, 19.0 and 2.0 dB. With the increase of frequency, the threshold difference between ABRt V wave and PTA decreased gradually. Conclusion: ASSR and ABR response thresholds are valuable in subjective assessment on noise-induced hearing loss. The thresholds of ASSR and ABR at 4 kHz are close to those of PTA.

Effect evaluation of cisplatin-gemcitabine combination chemotherapy for advanced non-small cell lung cancer patients using microarray data.

OBJECTIVE: This study was performed to evaluate the therapeutic effect of cisplatin-gemcitabine combination chemotherapy for advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Dataset GSE39345 from patients who underwent cisplatin-gemcitabine combination chemotherapy and normal controls was downloaded from Gene Expression Omnibus. Differentially expressed genes (DEGs) were identified using Limma package and divided into 3 datasets: unique DEGs in NSCLC before chemotherapy vs. control samples (dataset A), common DEGs (dataset B), unique DEGs in NSCLC after chemotherapy vs. control samples (dataset C). Enrichment analysis was to identify functions or pathways of DEGs. Protein-protein interaction (PPI) analysis was to identify hub nodes and interacting pairs in dataset C and constructed into PPI network using Cytoscape software, followed by screening of small molecules using Connectivity Map. RESULTS: Herein, 230 unique DEGs in dataset A, 584 common DEGs in dataset B and 1562 unique DEGs in dataset C were obtained. The 230 DEGs were significantly enriched in methylation and positive regulation of cell differentiation; the 584 DEGs were significantly enriched in positive regulation of cell differentiation and cytokine-cytokine receptor interaction pathway; the 1562 DEGs were enriched in functions associated with defense response. RELA and PLCB3 correlated with PLCE1 and INADL were hub nodes in the PPI network. Cefoperazone was the small molecule negatively correlated with DEGs. CONCLUSIONS: Chemotherapy could prevent genes from aberrant methylation, partially restore cell differentiation process, fail to regulate cytokine-cytokine receptor interaction and induce weakened defense response. Cefoperazone could be used as a supplementary drug.

High FoxP3 expression in tumour cells predicts better survival in gastric cancer and its role in tumour microenvironment.

BACKGROUND: Forkhead Box P3 (FoxP3) is thought to be a key transcription factor in regulatory T cells (Tregs), and recent data indicate that it is expressed in several tumour cells. However, its precise roles in gastric cancer (GC) and the underlying mechanisms regulating the interaction between GC cells and lymphocytes remain unclear. METHODS: FoxP3 expression was examined in tumour cells and Tregs in 150 cases of gastric precancer and cancer, and their prognostic significances were evaluated, respectively, using a tissue microarray containing 135 GC patient samples with a mean 102-month follow-up. FoxP3 involvement in the tumour cells-lymphocytes interaction and its gene function were further investigated. RESULTS: strong cytoplasmic staining of FoxP3 was observed in GC cells. FoxP3 protein expression in tumour cells predicts a good prognosis, whereas high-density Treg predicts a poor prognosis. Moreover, FoxP3 expression in GC cells increased after coculture with peripheral blood mononuclear cells through coculture systems. Upregulation of FoxP3 inhibited tumour growth in tumour-bearing nude mice. CONCLUSIONS: High FoxP3 expression in tumour cells predicts better survival in GC, possibility in relation to interaction between tumour cells and lymphocytes in microenvironment. Interfering with FoxP3 expression may open a new therapeutic strategy against tumour progression.

Effects of metallothionein-3 and metallothionein-1E gene transfection on proliferation, cell cycle, and apoptosis of esophageal cancer cells.

Metallothionein (MT)-3 has cell growth inhibitory activity, and is the only currently known MT subtype with unique physiological functions. The expression levels of MT-1E, a subtype of MT-1, were positively correlated with the degree of esophageal cancer malignancy. The present study aimed to investigate the effects of MT-3 and MT-1E gene transfection on the proliferation, cell cycle, and apoptosis of esophageal cancer cells. The cationic liposome method was used to transfect the esophageal cancer strains Eca-109 and TE13. Reverse transcription-polymerase chain reaction was used to detect target gene expression, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide reduction was applied to detect cell proliferation, and flow cytometry was used for cell cycle and apoptosis detection. Esophageal cancer cells with MT-3 and MT-1E gene transfection showed high expression of the foreign target gene and mRNA. Cells with MT-3 gene transfection showed markedly inhibited proliferation (P < 0.05), a significantly higher proportion of cells in the G0/G1 phase (P < 0.05), a significantly lower proportion of cells in the S phase (P < 0.05), and a significantly increased apoptosis rate (P < 0.05). Cells with MT-1E gene transfection did not show significant changes in proliferation, cell cycle, or apoptosis rate (P > 0.05). Therefore, the upregulation of MT-3 gene expression can inhibit esophageal cancer cell proliferation and induce apoptosis, which may be achieved by blocking the tumor cell growth cycle, whereas effects of the MT-1E gene on the proliferation of esophageal cancer cells were not evident.

Expression of ADAM9 (meltrin-gamma) around aseptically loosened total hip replacement implants.

OBJECTIVE: To investigate the involvement of a disintegrin and the metalloproteinase ADAM9 (meltrin-gamma) in the formation of multinuclear giant cells and osteoclasts in aseptic loosening of hip replacement implants. METHODS: We used in situ hybridization, immunohistochemical staining and western blotting of interface membrane surrounding loosened hip implants, macrophage-colony stimulating factor (M-CSF) and receptor activator of nuclear factor kappaB ligand (RANKL) costimulation and polymethyl methacrylate (PMMA) particle stimulation of human monocytes followed by immunofluorescence staining and flow cytometric analysis. RESULTS: Morphometric analysis revealed that the ADAM9+ area in the revision total hip replacement (THR) interface was larger than in primary THR samples (37.6+/-5.1 vs 5.2+/-0.8%, P=0.002). Double immunofluorescence staining showed that CD68+ interface tissue macrophages and multinuclear giant cells were ADAM9+. ADAM9 mRNA containing mononuclear and multinuclear cells was often seen in a close spatial relationship with other ADAM9+ cells. Western blotting disclosed a 50 kDa ADAM9 band in tissue extracts. Upon M-CSF and RANKL costimulation of human monocytes, the ADAM9 staining pattern changed over time and ADAM9+ cells formed bi- and multinuclear cells. Flow cytometry disclosed that cells of the monocyte/macrophage lineage changed from ADAM9-negative cells into strongly positive cells during a 3-day culture. CONCLUSION: ADAM9 is expressed in interface tissues around aseptically loosened THR implants. ADAM9 may play a role as a fusion molecule in the formation of multinuclear giant cells and osteoclasts from mononuclear precursors in diseases characterized by bone tissue destruction.

Regulation of macrophage activation.

IFN-gamma rapidly primes the macrophage via JAK1/2-STAT1 pathway so that it can subsequently undergo a slower classical type 1 activation upon exposure to T helper (Th)1 cytokines such as IFNgamma or other activators, including tumor necrosis factor and lipopolysaccharide, e.g. in intracellular killing of phagocytosed Mycobacterium tuberculosis. If instead it is driven by Th2 cytokines interleukin (IL)-4 and IL-13, it undergoes alternate type 2 activation, which enhances endocytotic antigen uptake and presentation, mast cell and eosinophil involvement and type 2 granuloma formation, e.g. in response to parasitic and extracellular pathogens. Particle-induced macrophage activation was shown to differ from classical and alternate activation, showing in DNA microarray experiments (complete linkage/ Euclidean distance metric analysis) upregulation of nonsecreted structural/signaling molecules and lack of secreted proinflammatory cyto- and chemokines. The switch-off (deactivation) of already activated macrophages is an active, controlled process in which IL-10 and corticosteroids play important roles and to which 15dPGJ2, PGA1/2 and vasoactive intestinal peptide often contribute.

Primary reconstruction of the mandible after excision of large benign lesions.

Small benign lesions occurring in the mandible, such as dental cysts or adamantinoma, are treated adequately by the dental surgeon using an intraoral approach and curettage (Brånemark et al., 1975). However, larger and recurrent lesions are better treated via the submandibular route (Boyne, 1969). After lesion clearance, the bone gap in the mandible needs to be bridged properly to avoid disabling functional and cosmetic results. This paper describes a modified conventional method of reconstruction which is simple and effective and gives excellent long-term results.

Complications of pressure therapy for post-burn hypertrophic scars. Biomechanical analysis based on 5 patients.

The complications of pressure therapy for post-burn hypertrophic scars are illustrated by 5 patients. The causes of such complications are discussed and recommendations for the prevention of such complications are presented.

The Krukenberg procedure: a method of treatment for unilateral anomalies of the upper limb in Chinese children.

Eight Chinese patients with congenital absence of the hand were treated with the Krukenberg procedure to provide a pinching function of the forearm bones. The rehabilitation program was simple and the functional results were satisfactory. We have selected three cases to illustrate the Krukenberg procedure and the indications for this operation, a procedure that is particularly suitable for the Chinese who are culturally adapted to chopstick functions.

Polydactyly of the thumb: a surgical plan based on ninety-five cases.

Preaxial polydactyly constitutes the most common group of congenital anomalies of the hand among the Chinese population of Hong Kong. Ninety-five cases from the Orthopaedic/Plastic and Reconstructive Surgery Unit, Princess Margaret Hospital, Hong Kong (March 1976 to March 1981), were reviewed. The cases were classified according to Wassel's classification (1969) into seven types. The most common category was type IV followed by types II, V, III, VII, I, and VI. The treatment of each type was analyzed. Bilhaut's procedure was satisfactory for type I, and a modified technique was used for types II and III. A method of shaving the incongruous articular cartilage was used in type IV. Removal of the extra digit and osteotomy of the metacarpal usually were required for type V. The experience with types VI and VII was too limited for assessment. Short-term results (1 to 6 years) have been satisfactory, but follow-up until skeletal maturity to assess the ultimate functional and cosmetic results is necessary.

Finger tip injuries--a prospective study on seven methods of treatment on 200 cases.

7 common methods of treatment were selected at random for 200 cases of finger tip injuries. The methods included split skin grafting, full-thickness skin grafting, volar V-Y advancement, Kutler's bilateral V-Y advancement, revision amputation, cross-finger flap and simple dressing. These cases were seen weekly until healing was completed and then at 3 and 6 months. A proper functional assessment was given to each case at the last visit. The results were analysed along the parameters of wound healing, appearance, scar condition, sensory return, finger joint movements, motor-power and sick-leave benefits. The best results were obtained from the volar V-Y advancement method. Results were most unfavourable when cross-finger flaps were used. This latter method, therefore, was condemned. Simple dressing gave excellent results if one disregarded the lengthy period of wound healing, a somewhat tender scar and possible beaking of the nails. The other methods gave satisfactory results but had no outstanding advantage.

Ectropion of all four eyelids associated with severe ichthyosis congenita: a case report.

Ichthyosis congenita associated with severe ectropion of all four eyelids is an extremely uncommon condition and has not previously been reported in a Chinese patient. Our experience of one case shows that a conservative regime of treatment designed to produce a humidified atmosphere combined with the application of local emulsifying agents can help improve the severity of the ectropion. Although these effects tend to be temporary this regime allows surgery to be postponed until the child is older and suitable non-scaly patches of skin can be clearly identified to serve as skin graft donor sites. In this case, full-thickness grafts from each groin were successful. Recurrence of the ectropion required a repetition of the skin grafting 18 months later.

Intravenous regional anaesthesia in hand surgery - experience with 632 cases.

Practical experience in the use of intravenous regional anaesthesia in hand surgery on 632 patients is reported. The safety of the anaesthesia, the efficacy of the procedure and the patient-comfort are well attested in this study. We recommend that its role should be established particularly in busy orthopaedic surgery departments where both elective and emergency work-loads on hand surgery are heavy.