[Identification of alkaloids and flavonoids in all parts of Fritillaria thunbergii using LC-LTQ-Orbitrap MSn].

Alkaloids and flavonoids in flowers, flower buds, stems, leaves, and bulbs of Fritillaria thunbergii were identified by LC-LTQ-Orbitrap MSn.Alkaloids were identified by ACQUITY UPLC BEH C18（2.1 mm×50 mm, 1.7 µm ) chromatographic column with a mobile phase of 10 mmol•L⁻¹ ammonium formate-acetonitrile and gradient elution in positive MS scan mode.Meanwhile, flavonoids were analyzed by Agilent-Zorbax SB C18 (4.6 mm×250 mm, 5 µm) chromatographic column with a mobile phase of 0.2% acetic acid-acetonitrile and gradient elution in negative MS scan mode.Combined with literature reports, chemical constituents were identified and determined by accurate molecular weights and fragment ion peaks in the ESI-MS/MS spectra based on high resolution mass spectrometer.In all parts of F.thunbergii, 37 alkaloids including 7 alkaloids (zhebeininoside, peimisine, peimine, peiminine, ebeiedinone/puqiedinone, ebeiedine/ puqiedine, peimisine-N-oxide) were simultaneously analyzed.Moreover, 16 flavonoids including quercetin, kaempferol and their glycosides were identified.The results indicated that the aerial parts had the similar alkaloids as the bulbs on the whole.Meanwhile, it had a series of flavonoids undetected in the bulbs.Our results provided the scientific basis for the development and utilization of aerial parts of F.thunbergii.

Spatio-temporal analysis of female breast cancer incidence in Shenzhen, 2007-2012.

INTRODUCTION: Breast cancer is a leading tumor with a high mortality in women. This study examined the spatio-temporal distribution of the incidence of female breast cancer in Shenzhen between 2007 and 2012. METHODS: The data on breast cancer incidence were obtained from the Shenzhen Cancer Registry System. To describe the temporal trend, the average annual percentage change (AAPC) was analyzed using a joinpoint regression model. Spatial autocorrelation and a retrospective spatio-temporal scan approach were used to detect the spatio-temporal cluster distribution of breast cancer cases. RESULTS: Breast cancer ranked first among different types of cancer in women in Shenzhen between 2007 and 2012 with a crude incidence of 20.0/100,000 population. The age-standardized rate according to the world standard population was 21.1/100,000 in 2012, with an AAPC of 11.3%. The spatial autocorrelation analysis showed a spatial correlation characterized by the presence of a hotspot in south-central Shenzhen, which included the eastern part of Luohu District (Donghu and Liantang Streets) and Yantian District (Shatoujiao, Haishan, and Yantian Streets). Five spatio-temporal cluster areas were detected between 2010 and 2012, one of which was a Class 1 cluster located in southwestern Shenzhen in 2010, which included Yuehai, Nantou, Shahe, Shekou, and Nanshan Streets in Nanshan District with an incidence of 54.1/100,000 and a relative risk of 2.41; the other four were Class 2 clusters located in Yantian, Luohu, Futian, and Longhua Districts with a relative risk ranging from 1.70 to 3.25. CONCLUSIONS: This study revealed the spatio-temporal cluster pattern for the incidence of female breast cancer in Shenzhen, which will be useful for a better allocation of health resources in Shenzhen.

[Relationship of iron overload to bone mass density and bone turnover in postmenopausal women with fragility fractures of the hip].

OBJECTIVE: To study relationships between serum ferritin and bone metabolism in patients with hip fragility fractures. METHODS: This cross-sectional study included 76 postmenopausal women with hip fracture from Feburary 2011 to June 2012. The mean age of the women was (73 ± 10) years (range, 55-93 years) and the mean duration of menstruation was (22 ± 10)years (range, 5-50 years). Serum concentrations of ferritin, transferrin, alkaline phosphatase (ALP), amino-terminal extension peptide of type I collagen (P1NP), C-terminal telopeptides of type I collagen (ß-CTX)and femoral and lumbar bone mineral density by dual-energy X-ray absorptiometry were measured. Bone metabolism was compared between normal and elevated ferritin groups with t-test, Pearson linear, partial correlation and multiple regression analysis examined associations between iron- and bone-related markers. RESULTS: Serum ferritin concentration raised to (230 ± 146)µg/L, transferrin concentration reduced to (1.89 ± 0.33)g/L. P1NP concentration raised to (61 ± 32) ng/L when the concentration of serum ALP and ß-CTX were in the normal range. T-scores for bone mineral density in the femoral neck (-2.0 ± 1.1) and lumbar (-2.1 ± 1.2) were below the normal ranges(-1.0-1.0). The subjects were divided into two groups according to serum ferritin concentration, normal group(serum ferritin concentration ≤ 150 µg/L, n = 25) and elevated group(serum ferritin concentration > 150 µg/L, n = 51). Patients of elevated group had lower bone mineral density in femoral neck and lumbar than normal group(t = 3.13,2.89, P < 0.01), and higher P1NP, ß-CTX concentration (t = -2.38, -3.59, P < 0.05) . In partial correlation analysis adjusted for confounders, serum ferritin concentration was correlated negatively with bone mineral density in both femoral neck and lumbar (r = -0.335,-0.295, P < 0.05), and positively with P1NP and ß-CTX (r = 0.467,0.414, P < 0.05), but not correlated with ALP (r = 0.188, P > 0.05). Transferrin concentration tended to be correlated positively with bone mineral density in both femoral neck and lumbar (r = 0.444, 0.262, P < 0.05) and negatively with ALP, P1NP and ß-CTX(r = -0.326,-0.285,-0.278, P < 0.05). CONCLUSIONS: Iron overload has a high prevalence in postmenopausal women with fragility fracture. Increased iron stores, which might lead to bone loss and lower bone mineral density by enhancing the activity of bone turnover, could be an independent factor to take effects on bone metabolism on postmenopausal women.

Development of machine learning prognostic models for overall survival of prostate cancer patients with lymph node-positive.

Prostate cancer (PCa) patients with lymph node involvement (LNI) constitute a single-risk group with varied prognoses. Existing studies on this group have focused solely on those who underwent prostatectomy (RP), using statistical models to predict prognosis. This study aimed to develop an easily accessible individual survival prediction tool based on multiple machine learning (ML) algorithms to predict survival probability for PCa patients with LNI. A total of 3280 PCa patients with LNI were identified from the Surveillance, Epidemiology, and End Results (SEER) database, covering the years 2000-2019. The primary endpoint was overall survival (OS). Gradient Boosting Survival Analysis (GBSA), Random Survival Forest (RSF), and Extra Survival Trees (EST) were used to develop prognosis models, which were compared to Cox regression. Discrimination was evaluated using the time-dependent areas under the receiver operating characteristic curve (time-dependent AUC) and the concordance index (c-index). Calibration was assessed using the time-dependent Brier score (time-dependent BS) and the integrated Brier score (IBS). Moreover, the beeswarm summary plot in SHAP (SHapley Additive exPlanations) was used to display the contribution of variables to the results. The 3280 patients were randomly split into a training cohort (n = 2624) and a validation cohort (n = 656). Nine variables including age at diagnosis, race, marital status, clinical T stage, prostate-specific antigen (PSA) level at diagnosis, Gleason Score (GS), number of positive lymph nodes, radical prostatectomy (RP), and radiotherapy (RT) were used to develop models. The mean time-dependent AUC for GBSA, RSF, and EST was 0.782 (95% confidence interval [CI] 0.779-0.783), 0.779 (95% CI 0.776-0.780), and 0.781 (95% CI 0.778-0.782), respectively, which were higher than the Cox regression model of 0.770 (95% CI 0.769-0.773). Additionally, all models demonstrated almost similar calibration, with low IBS. A web-based prediction tool was developed using the best-performing GBSA, which is accessible at https://pengzihexjtu-pca-n1.streamlit.app/ . ML algorithms showed better performance compared with Cox regression and we developed a web-based tool, which may help to guide patient treatment and follow-up.

Feasibility and safety of early removal of incisional dressings following thoracic surgery.

OBJECTIVE: To investigate the feasibility and safety of early dressing removal of clean wounds following thoracotomy. SUBJECTS AND METHODS: A total of 230 patients (127 males, mean age 55.6 ± 16.7 years) were randomly divided into study and control groups. In the study group the cotton gauze dressing was removed 48 h after the surgery, whereas in the control group the dressing was kept on for 7-8 days until the removal of skin sutures. The infection and healing of the wounds were examined, and patients were followed up for 30 days. RESULTS: There was no statistically significant difference in age, sex, smoking rates, concurrent illnesses and operational characteristics between the study and control groups (p > 0.05). The wound infection rate in the study and control groups was 6 (5.2%) and 7 patients (6.1%), respectively (p = 0.775). Two patients (1.7%) from the study group and 1 (0.9%, p = 0.561) from the control group had partial wound approximation by day 7. Surrounding skin integrity was normal in 106 (92.2%) of the study group and 107 (93.0%) of the control group patients by postoperative day 7 (p = 0.801). CONCLUSION: Removal of wound dressing 48 h after thoracic surgery was not associated with an increased risk of surgical site infection. Hence the early removal of wound dressing did not appear to have an adverse impact on wound healing.

[Prevalence of diabetes in Shenzhen between 1997 and 2009].

OBJECTIVE: To analyze the trend of prevalence and major risk factors for diabetes between 1997 and 2009 in Shenzhen. METHODS: A total sample of 7956 and 8487 residents aged from 20 to 69 years were selected using multi-stage cluster sampling from two cross-sectional chronic diseases survey in Shenzhen in 1997 and 2009 respectively. The variation of prevalence between different age groups (divided into a 5-year age group) were compared. The effect of risk factors was evaluated by population attributable risk percentage (PARP), and time trend of PARP for risk factors were analyzed. RESULTS: Compared with that in 1997, the aged-adjusted prevalence of diabetes has increased from 3.85% (306/7956) to 5.21% (441/8487) in 2009 (χ(2) = 17.54, P < 0.001). The prevalence in age group 50 - 54, 60 - 64, and 65 - 69 years increased significantly from 7.88% (35/444), 8.55% (36/421) and 11.34 (33/291) to 12.09% (59/488), 14.63% (55/376) and 20.71% (70/338) respectively (χ(2) = 4.54, 7.25 and 10.01, P < 0.05). After controlling for age, the rates of abdominal obesity, family history of diabetes, dyslipidemia and hypertension increased from 21.56% (1715/7956), 4.39% (349/7956), 26.34% (2096/7956) and 11.53% (917/7956) to 31.88% (2706/8487), 12.84% (1090/8487), 41.38%(3512/8487) and 14.61% (1240/8487) respectively (χ(2) = 5.52, 14.83, 18.38 and 20.22, P < 0.01). For diabetes, the PARP of aging, dyslipidemia and abdominal obesity were 41.55%, 29.25% and 25.10% respectively. CONCLUSION: The prevalence of diabetes in Shenzhen increases rapidly and more patients are found in younger age. The rise of diabetes was mainly attributed to aging and increasing exposures to risk factors.

[Characteristics of Modified Biochars and Their Immobilization Effect on Cu and Cd in Polluted Farmland Soil Around Smelter].

Heavy metals in farmland soil are one of the most hazardous pollutants in the environment, owing to their universality and irreversibility. Modified biochar has been widely used in the adsorption and immobilization of heavy metals in soil, and its applicability is mainly determined by the types of heavy metals, pollution levels, and soil environmental conditions. Soil pollution is gradually becoming more complex and diversified, and heavy metal pollutants mostly occur in the form of compound pollution. However, most studies have focused on single heavy metal pollutant or the addition of heavy metal to soil. This study used rice straw as a raw material to prepare biochar, and modified it with K3PO4, KMnO4, and NaOH. The physicochemical and structural characteristics of the modified biochars were detected using a BET accelerated surface area and porosimetry system, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), and the biochars were then analyzed for the availability and forms of Cd and Cu in soils contaminated with heavy metals in the mining area. The results showed that the surface roughness of the modified biochar increased to different degrees with increases in specific surface area and pore volume, with the NaOH modified biochar showing the most significant increases from 4.96 m2·g-1 to 60.79 m2·g-1, and from 0.02 cm3·g-1 to 0.12 cm3·g-1, respectively. The pore diameter changed in the opposite direction. The absorption peaks of the functional groups of the modified biochar were all changed, with K3PO4 modified biochar exhibiting the greatest degree of change. The addition of biochar significantly improved the soil pH value (P<0.05), and the pH value of the soil treated with K3PO4 modified biochar exhibited the largest increase. With an application of 20.5% K3PO4 modified biochar, the availability of Cu and Cd in the soil was significantly reduced, by 75.44% and 67.70%, respectively. The immobilization efficiency of Cu was much higher than that of Cd. The best immobilization efficiency of Cu and Cd in soil was achieved with K3PO4 modified biochar. With an addition of 2% K3PO4 modified biochar, the immobilization efficiency of Cu and Cd was 61.06% and 4.12%, respectively. In summary, K3PO4 modified biochar had a better immobilization effect on both Cu and Cd in compound contaminated soil.

[Clinical outcome of single-bundle versus anatomic double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis].

OBJECTIVE: To evaluate clinical outcome after anterior cruciate ligament (ACL) reconstruction with double-bundle or single-bundle by meta-analysis. METHODS: Randomized controlled trials (RCTs) on differences of clinical outcomes of ACL reconstruction were retrieved in Ovid Medline, PubMed, Embase, Cochrane Library, CBM and VIP database. Relevant journals or conference proceedings were also searched manually. Then extracted the date of KT-1000 arthrometer, pivot-shift testing, Lysholm score and IKDC final score in these researches. RevMan 5.0.23 software was used for data analyses. RESULTS: Eight prospective RCTs met the inclusion criteria. The combined results of meta-analysis indicated that there was statistical difference between two operative procedures on postoperative KT-1000 arthrometer side-to-side [WMD = -0.35, 95%CI (-0.61, -0.08), P = 0.01], Lysholm score [WMD = -1.91, 95%CI (-3.45, -0.37), P = 0.01]. But the difference of KT-1000 arthrometer side-to-side is demonstrated to be clinically insignificant. Others indicated that there was no statistical differences with respect to IKDC final score [OR = 1.80, 95%CI (0.98, 3.31), P = 0.06], having a normal or nearly normal pivot-shift testing [OR = 1.64, 95%CI (0.85, 3.16), P = 0.14]. CONCLUSIONS: Double-bundle reconstruction does not result in clinically significant advantage when compared with single-bundle. The results do not support the theory that double-bundle reconstruction controls knee rotation better.

[Application of 3D printing guide plate in total hip arthroplasty for developmental dysplasia of the hip].

OBJECTIVE: To explore the value of 3D-printed navigation template using in total hip arthroplasty(THA)for developmental dysplasia of the hip (DDH). METHODS: Twenty five patients with DDH underwent total hip arthroplasty from February 2016 to May 2018 were analyzed retrospectively, including 4 males and 21 females, aged from 40 to 75 years old. Among them, 5 cases were Crowe typeⅡ, 14 cases were Crowe type Ⅲ and 6 cases were Crowe type Ⅳ. Twelve cases of them underwent THA with the 3D printing navigation plate, another 13 cases underwent the same operation but without the aid of navigation templates. All patients were treated by the same operators. The operating time, intra- and post-operative hemorrhage and Harris Hip Score(HHS) at six months postoperativelywere compared, anteversion angle, abduction angle and the distance from rotation center to the ischial tuberosity connection between ipsilateral and contralateral sides were also compared. RESULTS: All of the patients were followed up for 12 to 26 months. The operation time, intra- and post-operative hemorrhage and Harris score in the 3D printing group were better than those in the conventional hip replacement group(P<0.05). There were no significant differences in anteversion angle, abduction angle and the distance from rotation center to the ischial tuberosity connection between ipsilateral and contralateral sides in 3D printing group (P>0.05). The abduction angle and the distance from rotation center to the ischial tuberosity connection were significantly different between the two sides in the traditional group (P< 0.05), the abduction angles had no statistical difference (P=0.487) between two sides. CONCLUSION: The 3D-printed operation navigation template technique is an individualized, accurate and promisingtechnique for THA with DDH.

Non-coding RNA LOXL1-AS1 exhibits oncogenic activity in ovarian cancer via regulation of miR-18b-5p/VMA21 axis.

Long non-coding RNAs (lncRNAs) exert critical effects in the process of malignant cancers and lncRNA LOXL1 Antisense RNA 1 (LOXL1-AS1) has been demonstrated to be a pro-oncogene in multiple tumor types. In the current study, we illuminated the precise roles of LOXL1-AS1 in the development of ovarian cancer. LOXL1-AS1 is significantly overexpressed in ovarian carcinoma tissue compared with adjacent non-cancerous sample. The luciferase reporter gene assay reveals the relationship between LOXL1-AS1 and miR-18b-5p, miR-18b-5p and its target gene, Vacuolar ATPase Assembly Factor VMA21 (VMA21). Transfection of LOXL1-AS1 siRNA or miR-18b-5p mimics inhibits the growth and aggressive phenotypes of SKOV3 and OVCAR3 cell. Furthermore, miR-18b-5p suppresses ovarian carcinoma cell proliferation and metastasis by targeting VMA21 and LOXL1-AS1 regulates ovarian carcinoma cell growth and metastasis through sponging miR-18b-5p. These findings suggest that lncRNA LOXL1-AS1 promotes ovarian cancer cell growth, migratory and invasiveness via modulating miR-18b-5p/VMA21 axis.

Mechanisms of potentially toxic metal removal from biogas residues via vermicomposting revealed by synchrotron radiation-based spectromicroscopies.

Biogas residues (BR) contaminated with potentially toxic metals pose environmental risks to soils and food chains, and strategies are needed to decrease the concentration and bioavailability of potentially toxic metals in BR. Here, metal fractions and removal mechanisms were quantified by synchrotron radiation-based Fourier transform infrared and micro X-ray fluorescence spectromicroscopies on BR and earthworms subject to vermicomposting. Vermicomposting resulted in decreases in concentrations of potentially toxic metals in BR and increases in metal removal efficiencies due to uptake by earthworms. Prior to vermicomposting, Zn, Cu and Pb were associated with N-H, O-H, aromatic C, aliphatic C, and amide functional groups, but following maturation during vermicomposting, metals were associated with N-H, O-H, aliphatic C and polysaccharide functional groups. Following vermicomposting, Zn and Cu were mainly distributed in the dermal portions of earthworms, whereas Pb was more homogeneously distributed among the inner and outer portions of the earthworms, revealing that different metals may have different uptake routes. These findings provide a new strategy for safe utilization of BR by using earthworms via vermicomposting to remove potentially toxic metals and in situ insights into how metals binding and distribution characteristics in BR and earthworms during compost and vermicomposting processes.

[Low dose X-irradiation promotes callus mineralization: experiment with rats].

OBJECTIVE: To investigate the effect of low dose irradiation (LDI) on callus formation and mineralization. METHODS: 80 SD rats were subjected to standard closed fracture on right femur so as to establish animal models and then were randomly divided into 2 equal groups: LDI group undergoing low dose whole body X-ray irradiation of 1Gy right after fracture induction and control group without irradiation. 1, 2, 3, 4, and 8 weeks later blood samples were collected from the heart to examine the amounts of white blood cells and platelets and alkaline phosphatase (ALP) level. Conventional X-ray films were taken and MicroCT was conducted to evaluate the callus bridging. Then the rats were killed to take out the femurs to undergo histological examination. Peripheral quantitative computed tomography (pQCT) was conducted to quantify the bone mineral content (BMC). Four-point bending test was used to examine the mechanical properties of the callus. RESULTS: The maximum load value and histological score 2 weeks later of the LDI group were both lower than those of the control group, however, the serum ALP, BMC, maximum load level, callus bridging score, and histological score 3 weeks later of the LDI group were all significantly higher than those of the control groups (all P<0.05). 4 and 8 weeks later there were not significant differences in all these parameters between the 2 groups. The WBC amount in the first 2 weeks of experiment of the LDI group was remarkably lower in these 2 groups, however, in the third week, the WBC value of the LDI group was higher than that of the control group (P<0.05). CONCLUSION: LDI promotes the mineralization at the stage of hard callus formation which is probably associated with progenitor cell mobilization.

MicroRNA-139-3p Inhibits The Growth And Metastasis Of Ovarian Cancer By Inhibiting ELAVL1.

BACKGROUND: The aberrant expression of microRNA-139-3p (miR-139-3p) has been recently involved in the development of multiple tumor types, but its function in ovarian cancer remains not well investigated. In this study, we mainly investigated the function of miR-139-3p in the progression of ovarian cancer. METHODS: The levels of miR-139-3p in ovarian cancer cells and tissues were detected using quantitative real-time-PCR (qRT-PCR) assay. The proliferation, colony formation, migration and invasion of ovarian cancer cell were determined, respectively. A luciferase reporter assay was used to confirm ELAV Like RNA Binding Protein 1 (ELAVL1) was a target gene of miR-139-3p. The expression of ELAVL1 was detected using Western blotting and immunofluorescence staining assay. The roles of miR-139-3p on the growth and metastasis of ovarian cancer cell in vivo were explored using transplanted tumor model and experimental lung metastasis model. RESULTS: MiR-139-3p was down-regulated in ovarian cancer tissues and ovarian cancer cell lines (SK-OV-3, A2780 and OVCAR-3). Overexpression of miR-139-3p decreased the growth, colony formation, migration and invasiveness of SK-OV-3 and OVCAR-3 cells. Moreover, overexpression of miR-139-3p reduced the growth and lung metastasis of ovarian cancer cells in vivo. The luciferase reporter gene assay indicated that ELAVL1 was a target of miR-139-3p and its expression was negatively regulated by miR-139-3p. Furthermore, the expression of ELAVL1 was inversely correlated with miR-139-3p level in ovarian cancer tissue. CONCLUSION: Taken together, we demonstrated that miR-139-3p regulated ovarian cancer growth and metastasis by modulating the expression of ELAVL1.

The GDF11-FTO-PPARγ axis controls the shift of osteoporotic MSC fate to adipocyte and inhibits bone formation during osteoporosis.

During osteoporosis, the shift of bone mesenchymal stem cell (BMSC) lineage commitment to adipocyte leads to the imbalance between bone mass and fat, which increases the risk of fracture. The mechanism underlying this process is not fully understood. Fat mass and obesity-associated protein (FTO) is an RNA demethylase that demethylates various methylated nucleic acids and participates in various physiological and pathological processes. Here we identified FTO as a regulator for BMSC fate determination during osteoporosis. FTO was up-regulated in bone marrow during aging or osteoporosis in human and mice in a GDF11(growth differentiation factor 11)-C/EBPα-dependent mechanism. The expression of FTO was also up-regulated during adipocyte differentiation of BMSCs whereas its expression was down-regulated during osteoblast differentiation. Gain-of-function and loss-of-function experiments showed that FTO favored the BMSCs to differentiate to adipocytes rather than osteoblasts. Further mechanism study demonstrated that FTO bound and demethylated the mRNA of the Peroxisome proliferator-activated receptor gamma (Pparg), leading to the increase in the expression of Pparg mRNA. Reversely, Pparg knockdown blocked the function of GDF11-FTO during osteoblast differentiation of BMSCs. Furthermore, conditionally genetic knockout of Fto in osteoblasts inhibited the development of osteopenia in mice. Collectively, our findings demonstrated that GDF11-FTO-Pparg axis promoted the shift of osteoporotic BMSC fate to adipocyte and inhibited bone formation during osteoporosis.

Metabolic profiling investigation of Fritillaria thunbergii Miq. by gas chromatography-mass spectrometry.

Thunberg fritillary bulb (the dry bulbs of Fritillaria thunbergii Miq.), a traditional Chinese Medicine, is widely applied as an expectorant and antitussive. In this investigation, the primary metabolites of bulbs, flowers, leaves, and stems of F. thunbergii were analyzed by gas chromatography-mass spectrometry. Principal component analysis, partial least squares-discriminate analysis, orthogonal projection to latent structures-discriminate analysis, and heat map analysis showed that there were dissimilar metabolites, and a negative correlation between amino acids and saccharides in different analytes. Furthermore, carbodiimide, tryptophan, glucose-6-phosphate, xylose, 2-piperidinecarboxylic acid, monoamidomalonic acid, phenylalanine, and histidine were found to play an important role in the plant metabolism net of F. thunbergii.

Highly efficient and mild cascade reactions triggered by bis(triphenyl)oxodiphosphonium trifluoromethanesulfonate and a concise total synthesis of camptothecin.

A mild and efficient cascade methodology is reported to construct variously substituted indolizino[1,2-b]quinolin-9(11H)-ones. Efficiently triggered by bis(triphenyl)oxodiphosphonium trifluoromethanesulfonate under mild conditions, this cascade achieved significant enhancements in chemical yields. Utilizing this highly efficient domino reaction followed by a Sharpless dihydroxylation, an eight-step total synthesis of camptothecin was accomplished from a known pyridine derivative in direct fashion with an overall yield of 47% and 95% ee.

[Mutation analysis in families with 21-hydroxylase deficiency].

OBJECTIVE: To investigate the steroid 21-hydroxylase gene (CYP21) mutations in families with 21-hydroxylase deficiency (21-OHD). METHODS: The CYP21 gene mutations were detected in four patients with 21-hydroxylase deficiency and their relatives. The genomic DNA of the patients was isolated from whole blood.Two pairs of primers were used to amplify the CYP21 gene. The amplified PCR products were purified by agarose gel and then directly sequenced. RESULTS: Six kinds of mutations were found. In the first family, the patient was a compound heterozygote carrying four different mutations (cluster E6, Q318X, A391T, P459H) onCYP21 gene, three mutations (cluster E6, Q318X, A391T) were on her maternal allele, a novel mutation was found:P459H. It located at codon 459 in exon 10 and changing a proline (CCC) to a histidine (CAC), and A391T was a rare mutation. In the second family, two kinds of mutations were found:cluster E6 and R483W. R483W was also a rare mutation. In the third family, the sequencing of the CYP21 gene of two patients revealed a homozygous T to A transition in codon 172 leading to substitution of isoleucine by asparagine (I172N). CONCLUSION: Six kinds of mutations were found in three families with 21-hydroxylase deficiency. Using DNA sequencing we have identified a novel mutation (P459H) and two rare mutations (A391T, R483W) of the CYP21 gene. Although microconversion events are the main cause of mutations in the CYP21 gene, random mutations can also be the cause of 21-hydroxylase deficiency.

Femoral midshaft fractures: expandable versus locked nailing.

Femoral midshaft fracture is one of the most common clinical injuries and is often caused by high-energy traffic accidents. Intramedullary nailings, plates, and external fixators are all used as treatment alternatives for a variety of patients depending on fracture location, displacement, comminution, soft tissue condition, and local tradition. Locked intramedullary nailing is currently the preferred treatment method for most diaphyseal fractures and has good clinical results. The goal of this study was to compare expandable and locked intramedullary nailing for the treatment of AO type 32A and 32B1 femoral midshaft fractures. The authors performed a retrospective analysis of 46 patients (33 men and 13 women; mean age, 32.3 years; range, 22-52 years) with femoral midshaft fractures who were divided into 2 groups-one treated with an expandable intramedullary nailing method and the other with a conventional locked intramedullary nailing. The 2 groups were compared with respect to operation time, fluoroscopic time, amount of estimated blood loss, hospitalization time, healing time, and complications. Patients were followed for at least 1 year. The results of this study showed that all of the patients achieved bone union within 12 to 24 months. Expandable nailing performed better than locked nailing in operation time, fluoroscopic time, amount of estimated blood loss, and healing time (P<.001). There was no difference in hospitalization time and no visible shortening or severe complications were observed in either group. Based on the results of this study, the expandable intramedullary nailing is an easy and effective treatment for AO type 32A and 32B1 diaphyseal femoral fractures.

Cigarette smoking and risk of hip fracture in women: a meta-analysis of prospective cohort studies.

BACKGROUND AND OBJECTIVES: Whether cigarette smoking can increase the risk of hip fracture in women is unclear. This meta-analysis, which pooled results from 10 prospective cohort studies, was performed to derive a more precise estimation between cigarette smoking and the risk of hip fracture in women. MATERIALS AND METHODS: Pubmed, Cochrane Central Register of Controlled Trials and ISI Web of Science were systematically searched to identify relevant studies. A meta-analysis was performed to examine the association among 10 studies. The pooled risk estimates were calculated by using both random- and fixed-effects model. Heterogeneity among articles and their publications bias were also tested. All of the statistical analyses were performed using the software programs STATA (version 12.0). RESULTS: Relative risk was significantly increased in current female smokers (pooled RR, 1.30; 95%CI, 1.16-1.45). The association was significant among the high-dose smokers (more than 15 cigarettes per day) while not among the low-does smokers (less than 15 cigarettes per day). Omission of any single study had little effect on the pooled risk estimate. Former smokers had a similar RR of hip fracture (RR, 1.02; 95%CI, 0.93-1.11) to published papers. Smoking cessation for ≥10 years leads to a significant decline in risk. CONCLUSIONS: Smoking is associated with an increased hip fracture risk in women. Cessation of smoking for ≥10 years had a decreased impact on risk of hip fracture. Given the inconsistency among the studies in the choice of adjustments, the associations between cigarette smoking and risk of hip fracture in women await further investigation.

A novel design of Rogowski coil for measurement of nanosecond-risetime high-level pulsed current.

In pulsed power systems, pulsed currents with risetimes from nanosecond to microsecond can be effectively measured by self-integrating Rogowski coils. Appropriate design of the structure and the integrating resistor is crucial to the high-frequency response of a coil. In this paper, several novel designs of Rogowski coil's integrating resistors were proposed and tested. Experimental results showed that the optimized coil could response square waves with fronts of ∼1.5 ns and had a sensitivity of ∼0.75 V/kA. The maximal peak current was designed as 100 kA.