Development of visual detection of African swine fever virus using CRISPR/LwCas13a lateral flow strip based on structural protein gene D117L.

African swine fever virus (ASFV) is a large double stranded DNA arbovirus that is highly contagious and seriously endangers domestic and wild pigs. In the past decade, African swine fever (ASF) has spread in many countries in the Caucasus, Russian Federation, Eastern Europe and Asia, causing significant losses to the pig industry. At present, there is a lack of effective vaccine and treatment for ASF. Therefore, the rapid and accurate detection is crucial for ASF prevention and control. In this study, we have developed a portable lateral flow strip (LFS) detection mediated by recombinase polymerase amplification (RPA) and CRISPR/LwCas13a, which is performed at 37 ℃ and visualized by eyes without the need for complex instruments. This RPA-LwCas13a-LFS is based on the ASFV structural protein p17 gene (D117L), with a detection sensitivity up to 2 gene copies. This method is highly specific and has no cross reactivity to 7 other pig viruses. In the detection of two batches of 100 clinical samples, the p17 (D117L) RPA-LwCas13a-LFS had 100% coincidence with conventional quantitative PCR (qPCR). These findings demonstrate the potential of this simple, rapid, sensitive, and specific ASFV detection method for on-site ASFV detection.

Case report: Resolution of Guillain-Barré syndrome in a patient with dual primary tumors after treatment with rituximab.

Guillain-Barré syndrome (GBS) is a rare immune-related adverse event (irAE) that can occur in solid tumors such as hepatocellular carcinoma, gastric cancer, breast cancer, and colorectal cancer. It is characterized by progressive myasthenia and mild sensory abnormalities. The emergence of immune checkpoint inhibitors (ICIs) has significantly improved cancer patients' life expectancy but can also trigger various irAEs, including GBS. We report a rare case of GBS in a 64-year-old male patient with dual primary tumors of the colon and stomach who received toripalimab and chemotherapy for liver metastases. After five treatments, the patient experienced weakness and numbness in his limbs. Lumbar puncture, electromyography, and other tests confirmed the diagnosis of GBS. Intravenous immunoglobulin (IVIG) and methylprednisolone did not improve the patient's symptoms, but rituximab, which is not a standard regimen for GBS, was effective in eliminating B cells and improving symptoms. Following this, we effectively shifted from a regimen combining immunotherapy and chemotherapy to a targeted therapy regimen, resulting in prolonged patient survival. Currently, limited studies have been undertaken to evaluate the efficacy of rituximab in managing refractory neurological adverse events associated with ICI therapy. Using this case, we reviewed similar cases and formed our views.

Value of GPR, APPRI and FIB-4 in the early diagnosis of hepatocellular carcinoma: a prospective cohort study.

OBJECTIVE: There is an urgent need for novel biomarkers that are inexpensive, effective and easily accessible to complement the early diagnosis of hepatocellular carcinoma. This study aimed to analyze the relationship between serum gamma-glutamate-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index, fibrosis index based on four factors and the risk of hepatocellular carcinoma, and to determine the optimal cut-offs for predicting hepatocellular carcinoma. METHODS: Based on a prospective cohort study, 44 215 participants who were cancer-free at baseline (2011-13) were included in the study. Cox proportional hazard models and receiver operating characteristics curves were used to analyze the diagnostic value and optimal cut-off value of gamma-glutamyl-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index and fibrosis index based on four factors in predicting hepatocellular carcinoma patients. RESULTS: Gamma-glutamyl-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index and fibrosis index based on four factors can be used as early independent predictors of hepatocellular carcinoma risk. The risk of hepatocellular carcinoma in the fourth quantile of gamma-glutamyl-transpeptidase to platelet ratio and alkaline phosphatase-to-platelet ratio index was 4.04 times (hazard ratio = 4.04, 95% confidence interval: 2.09, 7.80) and 2.59 times (hazard ratio = 2.59, 95% confidence interval: 1.45, 4.61), respectively, compared with the first quantile. With fibrosis index based on four factors first quantile as a reference, fibrosis index based on four factors fourth quantile had the highest risk (hazard ratio = 18.58, 95% confidence interval: 7.55, 45.72). Receiver operating characteristic results showed that fibrosis index based on four factors had a stronger ability to predict the risk of hepatocellular carcinoma (area under curve = 0.81, 95% confidence interval: 0.80, 0.81), and similar results were shown for gender stratification. In the total population, the optimal cut-off values of gamma-glutamyl-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index and fibrosis index based on four factors were 0.208, 0.629 and 1.942, respectively. CONCLUSIONS: Gamma-glutamyl-transpeptidase to platelet ratio, alkaline phosphatase-to-platelet ratio index and fibrosis index based on four factors were independent predictors of hepatocellular carcinoma risk. Amongst them, fibrosis index based on four factors shows a stronger predictive ability for hepatocellular carcinoma risk, and gamma-glutamyl-transpeptidase to platelet ratio and alkaline phosphatase-to-platelet ratio index can be used as complementary indicators.

Crocin exerts anti-tumor effect in colon cancer cells via repressing the JAK pathway.

Crocin has been reported to have therapeutic effects on multiple cancers including colon cancer, but its specific mechanism is still ambiguous and needs to be further explored. Human colorectal adenocarcinoma cells (HCT-116) and human normal colonic epithelial cells (CCD841) were first treated with increasing concentrations of crocin. Subsequently, with 150 and 200 µM of crocin, the cell vitality was examined by cell counting kit 8. Cell apoptosis and proliferation were tested by TUNEL staining and colony formation assay, respectively. The expression of Ki-67 was assessed by immunofluorescence. Enzyme-linked immunosorbent assay was used to evaluate the level of inflammation- and oxidative-related factors. The reactive oxygen species (ROS) production and mitochondrial membrane potential (MMP) were examined by flow cytometer. Janus kinase (JAK), signal transducer and activator of transcription 3 (STAT3), and extracellular regulated protein kinases (ERK) in HCT-116 cells were tested by Western blot. Different concentrations of crocin barely affected the CCD841 cell vitality, while crocin restrained the HCT-116 cells vitality, proliferation and the expression of Ki-67, while inducing apoptosis in a concentration-dependent manner. Moreover, the contents of inflammation- and oxidative-related factors in HCT-116 cells were largely blunted by crocin that enhanced ROS and restrained the MMP and suppressed p-JAK2/JAK2, p-STAT3/STAT3, and p-ERK/ERK expression in HCT-116 cells. Crocin induced apoptosis and restored mitochondrial function in HCT-116 cells via repressing the JAK pathway. If the threptic effect works in patients, it could herald a new, effective treatment for colon cancer, improving the patients' prognosis and quality of life.

Progression from different blood glucose states to cardiovascular diseases: a prospective study based on multi-state model.

AIMS: To quantify the trajectories from normoglycaemia to pre-diabetes, subsequently to type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and cardiovascular death, and the effects of risk factors on the rates of transition. METHODS AND RESULTS: We used data from the Jinchang Cohort of 42 585 adults aged 20-88 free of coronary heart disease (CHD) and stroke at baseline. A multistate model was applied for analysing the progression of CVD and its relation to various risk factors. During a median follow-up of 7 years, 7498 participants developed pre-diabetes, 2307 developed T2DM, 2499 developed CVD, and 324 died from CVD. Among 15 postulated transitions, transition from comorbid CHD and stroke to cardiovascular death had the highest rate (157.21/1000 person-years), followed by transition from stroke alone to cardiovascular death (69.31/1000 person-years) and transition from pre-diabetes to normoglycaemia (46.51/1000 person-years). Pre-diabetes had a sojourn time of 6.77 years, and controlling weight, blood lipids, blood pressure, and uric acid within normal limits may promote reversion to normoglycaemia. Among transitions to CHD alone and stroke alone, transition from T2DM had the highest rate (12.21/1000 and 12.16/1000 person-years), followed by transition from pre-diabetes (6.81/1000 and 4.93/1000 person-years) and normoglycaemia (3.28/1000 and 2.39/1000 person-years). Age and hypertension were associated with an accelerated rate for most transitions. Overweight/obesity, smoking, dyslipidaemia, and hyperuricaemia played crucial but different roles in transitions. CONCLUSION: Pre-diabetes was the optimal intervention stage in the disease trajectory. The derived transition rates, sojourn time, and influence factors could provide scientific support for the primary prevention of both T2DM and CVD.

Former single-outcome studies on the relationship between glycaemia and cardiovascular disease (CVD) may ignore the complexity and multi-transformations across the multiple stages from normoglycaemia to CVD in real-world setting. We aimed to quantify the trajectories from normoglycaemia to pre-diabetes, subsequently to type 2 diabetes, CVD, and cardiovascular death. Pre-diabetes was the optimal intervention stage in the disease trajectory. Transitions from CVD to death had much higher rates than other transitions. Age and hypertension were associated with an accelerated rate for most transitions. Overweight/obesity, smoking, dyslipidaemia, and hyperuricaemia played crucial but different roles in transitions.

Genomic characterization of two new viruses infecting Ageratum conyzoides in China.

Two new RNA viruses were identified in Ageratum conyzoides in China using high-throughput sequencing, and their genome sequences were determined using PCR and rapid amplification of cDNA ends. The new viruses, which have positive-sense, single-stranded RNA genomes, were provisionally named "ageratum virus 1" (AgV1) and "ageratum virus 2" (AgV2). AgV1 has a genome of 3,526 nucleotides with three open reading frames (ORFs) and shares 49.9% nucleotide sequence identity with the complete genome of Ethiopian tobacco bushy top virus (genus Umbravirus, family Tombusviridae). The genome of AgV2 consists of 5,523 nucleotides and contains five ORFs that are commonly observed in members of the genus Enamovirus of the family Solemoviridae. Proteins encoded by AgV2 exhibited the highest amino acid sequence similarity (31.7-75.0% identity) to the corresponding proteins of pepper enamovirus R1 (an unclassified enamovirus) and citrus vein enation virus (genus Enamovirus). Based on their genome organization, sequence, and phylogenetic relationships, AgV1 is proposed to be a new umbra-like virus of the family Tombusviridae, and AgV2 is proposed to be a new member of the genus Enamovirus of the family Solemoviridae.

Application of Artificial Intelligence in Radiotherapy of Nasopharyngeal Carcinoma with Magnetic Resonance Imaging.

The value of automatic organ-at-risk outlining software for radiotherapy is based on artificial intelligence technology in clinical applications. The accuracy of automatic segmentation of organs at risk (OARs) in radiotherapy for nasopharyngeal carcinoma was investigated. In the automatic segmentation model which is proposed in this paper, after CT scans and manual segmentation by physicians, CT images of 147 nasopharyngeal cancer patients and their corresponding outlined OARs structures were selected and grouped into a training set (115 cases), a validation set (12 cases), and a test set (20 cases) by complete randomization. Adaptive histogram equalization is used to preprocess the CT images. End-to-end training is utilized to improve modeling efficiency and an improved network based on 3D Unet (AUnet) is implemented to introduce organ size as prior knowledge into the convolutional kernel size design to enable the network to adaptively extract features from organs of different sizes, thus improving the performance of the model. The DSC (Dice Similarity Coefficient) coefficients and Hausdorff (HD) distances of automatic and manual segmentation are compared to verify the effectiveness of the AUnet network. The mean DSC and HD of the test set were 0.86 ± 0.02 and 4.0 ± 2.0 mm, respectively. Except for optic nerve and optic cross, there was no statistical difference between AUnet and manual segmentation results (P > 0.05). With the introduction of the adaptive mechanism, AUnet can achieve automatic segmentation of the endangered organs of nasopharyngeal carcinoma based on CT images more accurately, which can substantially improve the efficiency and consistency of segmentation of doctors in clinical applications.

Construction of a New Tumor Immunity-Related Signature to Assess and Classify the Prognostic Risk of Colorectal Cancer.

PURPOSE: Although immunotherapy and checkpoint inhibitors contribute to the treatment of colorectal cancer (CRC), few patients can benefit from these treatments. Therefore, our goal was to develop a marker based on immune-related genes to predict the prognosis of patients with CRC to guide treatment strategies. METHODS: Gene expression data from colorectal cancer patients in the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas were analyzed systematically. We used Cox regression to identify immune-related genes with potential prognostic value. The expression of immune genes, infiltration level of immune cells, and several immune-related molecules were further compared between the high-risk and low-risk groups. Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes pathway analyses were used for functional analysis. RESULTS: Five GEO datasets were integrated into a merged GEO dataset, which showed obvious survival in StromalScore and ESTIMATEScore. WGCNA showed that 749 genes of the pink module are related to immunity, 95 of which are related to prognosis, correlating with cytokine-cytokine receptor interaction and natural killer cell-mediated cytotoxicity. Among these genes, an 11-gene signature was developed through stability selection and LASSO Cox regression. Univariate and multifactorial Cox regression analyses demonstrated that gene signature was an independent prognostic factor for predicting survival in patients with colorectal cancer. Samples from the low-risk group may be more sensitive to immunotherapy. In addition, the nomogram risk prediction model effectively predicted the prognosis of CRC patients by appropriately stratifying the risk scores. CONCLUSION: In conclusion, we developed a novel immune-related gene signature that may be useful in predicting cancer progression and prognosis, thus contributing to the individualized management of colorectal cancer patients.

Value of radiomics model based on enhanced computed tomography in risk grade prediction of gastrointestinal stromal tumors.

To explore the application of computed tomography (CT)-enhanced radiomics for the risk-grade prediction of gastrointestinal stromal tumors (GIST). GIST patients (n = 292) confirmed by surgery or endoscopic pathology during June 2013-2019 were reviewed and categorized into low-grade (very low to low risk) and high-grade (medium to high risk) groups. The tumor region of interest (ROI) was depicted layer by layer on each patient's enhanced CT venous phase images using the ITK-SNAP. The texture features were extracted using the Analysis Kit (AK) and then randomly divided into the training (n = 205) and test (n = 87) groups in a ratio of 7:3. After dimension reduction by the least absolute shrinkage and the selection operator algorithm (LASSO), a prediction model was constructed using the logistic regression method. The clinical data of the two groups were statistically analyzed, and the multivariate regression prediction model was constructed by using statistically significant features. The ROC curve was applied to evaluate the prediction performance of the proposed model. A radiomics-prediction model was constructed based on 10 characteristic parameters selected from 396 quantitative feature parameters extracted from the CT images. The proposed radiomics model exhibited effective risk-grade prediction of GIST. For the training group, the area under curve (AUC), sensitivity, specificity, and accuracy rate were 0.793 (95%CI: 0.733-0.854), 83.3%, 64.3%, and 72.7%, respectively; the corresponding values for the test group were 0.791 (95%CI: 0.696-0.886), 84.2%, 69.3%, and 75.9%, respectively. There were significant differences in age (t value: - 3.133, P = 0.008), maximum tumor diameter (Z value: - 12.163, P = 0.000) and tumor morphology (χ2 value:10.409, P = 0.001) between the two groups, which were used to establish a clinical prediction model. The area under the receiver operating characteristic curve of the clinical model was 0.718 (95%CI: 0.659-0.776). The proposed CT-enhanced radiomics model exhibited better accuracy and effective performance than the clinical model, which can be used for the assessment of risk grades of GIST.

Effects of cold and hot temperature on metabolic indicators in adults from a prospective cohort study.

BACKGROUND: Previous studies have found that exposed to low and high outdoor temperature was associated with cardiovascular diseases morbidity and mortality. The risk factors for cardiovascular disease include high blood lipid, high uric acid (UA) and high fasting plasma glucose (FPG). However, few studies have explored the effects of low and high temperature on these metabolic indicators. OBJECTIVE: To explore the effect of low and high temperature on metabolic indicators in adults from northwest of China. METHODS: Based on a prospective cohort study, a total of 30,759 individuals who participated in both baseline and first follow-up from 2011 to 2015 were selected in this study. The meteorological observation data and environmental monitoring data were collected in the same period. Associations between cold and hot temperature and blood lipid (total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C)), UA and FPG were conducted with mixed effect models after adjusting for confounding factors. RESULTS: A nonlinear relationship between outdoor temperature and metabolic indicators was found. For the cold effects, each 5 °C decrease of mean temperature was associated with an increase of 5.07% (95% CI: 3.52%, 6.63%) in TG and 2.85% (95% CI: 2.18%, 3.53%) in UA, While a decrease of 3.38% (95% CI: 2.67%, 4.09%) in HDL-C and 1.26% (95% CI: 0.48%, 2.04%) in LDL-C. For the heat effects, each 5 °C increase in mean temperature was associated with 1.82% (95% CI: 0.89%, 2.76%), 0.56% (95% CI: 0.11%, 1.00%), 5.82% (95% CI: 4.58%, 7.06%), 9.02% (95% CI: 7.17%, 10.87%), 0.20% (95% CI: 0.01%, 0.40%), and 1.22% (95% CI: 0.19%, 2.24%) decrease in TC, TG, HDL-C, LDL-C, UA and FPG. Age, smoking, drinking, high-oil diet and hyperlipidemia might modify the association between mean temperature and metabolic indicators. CONCLUSION: There was a significant effect of cold and hot temperature on metabolic indicators in a high altitude area of northwestern China. These results provide a basis for understanding the underlying mechanism of the influence of temperature on metabolic diseases.

Interference Torque of a Gas-Dynamic Bearing Gyroscope Subject to a Uniform Change of the Specific Force and the Carrier Angular Velocity.

The work is devoted to an analysis of interference torque of a gas-dynamic bearing gyroscope, while a condition with uniformly changed specific force and carrier angular velocity are taken into account. A five-degrees-of-freedom (5-DOF) model is established considering the translation and tilt of the rotor, which solves dynamic rotor equations and the Reynolds equation simultaneously. The model makes it possible to obtain the rotor trajectory under time-transient specific force and carrier angular velocity. The interference torque of the gyroscope is analyzed based on the rotor trajectory. Results indicate that the gas-dynamic bearings show a significant hysteresis effect with a perturbation of bearing force or bearing moment, which indicates the necessity of transient research. Interference torque is large when the carrier angular velocity starts to change or stops to change, and when the specific force stops to change. When the specific force change rate is less than 8.4 km/s3 with no change of the carrier angular velocity, the condition could be simplified as a steady state, which is consistent with the previous study.

Effects of hepatitis B virus infection, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase on prediabetes and diabetes mellitus: A cohort study.

INTRODUCTION AND OBJECTIVES: The purpose of this study was to confirm whether hepatitis B virus (HBV) infection and the levels of liver enzymes would increase the risk of prediabetes and diabetes mellitus (DM) in China. MATERIALS AND METHODS: A total of 10,741 individuals was enrolled in this prospective cohort study. Cox regression analysis was used to calculate the Hazard ratios (HRs) to evaluate the relationships between HBV infection and the risk of DM and prediabetes. Decision trees and dose response analysis were used to explore the effects of liver enzymes levels on DM and prediabetes. RESULTS: In baseline population, HBV infection ratio was 5.31%. In non-adjustment model, the HR of DM in HBV infection group was 1.312 (95% CI, 0.529-3.254). In model adjusted for gender, age and liver cirrhosis, the HR of DM in HBV infection group were 1.188 (95% CI, 0.478-2.951). In model adjusted for gender, age, liver cirrhosis, smoking, drinking, the HR of DM was 1.178 (95% CI, 0.473-2.934). In model further adjusted for education, family income and occupation, the HR of DM was 1.230 (95% CI, 0.493-3.067). With the increases of levels of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Gamma-glutamyl transferase (GGT), the risk of prediabetes was gradually increasing (Pnon-linearity<0.05). There were dose-response relationships between ALT, GGT and the risk of DM (Pnon-linearity<0.05). CONCLUSIONS: HBV infection was not associated with the risk of prediabetes and DM. The levels of liver enzymes increased the risk of prediabetes and DM.

Occupational exposure to heavy metals, alcohol intake, and risk of type 2 diabetes and prediabetes among Chinese male workers.

OBJECTIVE: Both exposure to heavy metals and alcohol intake have been related to the risk of type 2 diabetes (T2D). In this study, we aimed to assess the potential interactions between metal exposure and alcohol intake on the risk of T2D and prediabetes in a cohort of Chinese male workers. METHODS: We conducted a cross-sectional analysis of 26,008 Chinese male workers in an occupational cohort study from 2011 to 2013. We assessed metal exposure and alcohol consumption at baseline in these workers who were aged ≥20 years. Based on occupations which were categorized according to measured urine metal levels, multiple logistic regression analyses were used to evaluate the independent and joint effects of metal and alcohol exposure on the risk of T2D and prediabetes. RESULTS: Risks of T2D (P trend = 0.001) and prediabetes (P trend = 0.001) were significantly elevated with increasing number of standard drinks per week, years of drinking, and lifetime alcohol consumption. An adjusted odds ratio (OR) of 6.1 (95% confidence interval [CI]: 4.8-7.8) was observed for the smelting/refining workers (highest metal exposure levels) who had the highest lifetime alcohol consumption (>873 kg) (P interaction = 0.018), whereas no statistically significant joint effect was found for prediabetes (P interaction = 0.515). CONCLUSIONS: Both exposures to metal and heavy alcohol intake were associated with the risk of diabetes in this large cohort of male workers. There was a strong interaction between these two exposures in affecting diabetes risk that needs to be confirmed in future studies.

LncRNA TP73-AS1 predicts poor prognosis and functions as oncogenic lncRNA in osteosarcoma.

TP73 antisense RNA 1 (TP73-AS1), a novel long noncoding RNA (lncRNA), has been suggested to be deregulated in various human cancers and serve as a tumor suppressor or promoter, depending on tumor types. The role of TP73-AS1 in osteosarcoma is still unknown. In our results, TP73-AS1 was highly expressed in osteosarcoma tissue samples and cell lines compared with matching adjacent nontumor tissue specimens and a normal human osteoblast cell line, respectively. Moreover, high expression of TP73-AS1 was statistically associated with advanced Enneking stage, large tumor size, present distant metastasis, and poor histological grade, while exhibiting no statistical association with age, sex, and tumor site. The survival analyses showed that patients with osteosarcoma with high expression of TP73-AS1 obviously had lower overall survival than osteosarcoma patients with low expression of TP73-AS1, and high expression of TP73-AS1 was an independent poor prognostic factor for osteosarcoma patients. The experiments in vitro indicated that inhibition of TP73-AS1 expression depressed osteosarcoma cell viability, migration, and invasion, and arrested cell cycle. In conclusion, TP73-AS1 serves as oncogenic lncRNA participated in osteosarcoma progression.

Time to include burden of surgical injuries after disasters in the Global Surgery agenda? An assessment of DALYs and averted burden by surgery after the 2008 Wenchuan earthquake.

Unlike other disasters, injury rates after earthquakes are still on the rise at a global scale. With an estimated one million people injured by earthquakes in the last decade, the burden of injury is considerable. Importantly, the surgical procedures carried out by healthcare facilities are capable to avert part of this burden. Yet both burdens remain unquantified using understandable metrics. We explored in this analysis a method to calculate them using disability-adjusted life years (DALYs), an internationally accepted measure expressing years of healthy life lost due to a health condition. We used data from a large standardised hospital database of earthquake-related injuries with complete information on International Classification of Diseases for injury and surgical procedures, sex and age information. DALYs and averted DALYs were calculated by injury types and per patient using disability weights available in the literature and expert opinion. We also suggested how DALYs might be further converted into an economic measure using approaches in the published literature. We estimated 10 397 DALYs as the earthquake surgical-injury burden produced in 1861 hospitalised patients treated in a single hospital (on average, 5.6 DALYs per patient). Our study also assessed that 4379 DALYs, or 2.4 DALYs per patient, were averted by surgery (42%). In economic terms, DALY losses amounted to US$36.1 million, from which US$15.2 million were averted by surgery in our case study. We urge to systematically estimate these impacts through improvements in the routine reporting of injury diagnoses and surgical procedures by health systems, potentially improving prevention policies and resource allocation to healthcare facilities.

[Biomechanical comparative study on proximal femoral locking plate and Gamma3 for treatment of stable intertrochanteric fracture].

OBJECTIVE: To compare the biomechanical properties between the proximal femoral locking plate and Gamma3 for fixing stable intertrochanteric fracture so as to provide a theoretical basis for selecting internal fixation in the clinical application. METHODS: Five pairs of antiseptic femur specimens were selected. Specimens of each pair of matching were randomly divided into groups A and B (n=5). All specimens were made the intertrochanteric fracture of 31A1.1 type according to AO/Association for the Study of Internal Fixation (AO/ASIF) classification. Fracture was fixed with Gamma3 in group A and with proximal femoral locking plate in group B. The axial compression, destruction, and torsion tests were carried out on the mechanical testing machine. RESULTS: Axial compression test: The load-displacement curve of groups A and B was basically a straight line; axial stiffness of groups A and B was (621.00 ± 36.48) N/mm and (542.55 ± 46.94) N/mm respectively, showing significant difference (t = 3.648, P = 0.036). Destruction test: The maximum yield load of groups A and B was (4,394.82 ± 450.37) N and (2,987.54 ± 112.14) N respectively, showing significant difference (t = 5.433, P = -0.032). After loading maximum yield load, femoral fracture occurred again, and internal fixation and bone interface loosening were observed in group A; bending and breaking of proximal locking screw for internal fixation were found in group B, but loosening of internal fixation and bone interface was more obvious in group A than in group B. Torsion test: The torque of specimens in 2 groups increased with the increase of torsion angle (P < 0.05), the torque corresponding to the torsion angle in group B was larger than that in group A, but the difference was not significant (P > 0.05). The torsional stiffness of groups A and B was (1.78 ± 0.16) N·mm/deg and (2.01 ± 0.08) N·mm/deg respectively, showing no significant difference (t = -3.833, P = 0.162). CONCLUSION: Proximal femoral locking plate and Gamma3 in the treatment of stable intertrochanteric fracture have good biomechanical properties, which can meet the requirements of minimal invasion, strong internal fixation, and early activity.

Hospital stay as a proxy indicator for severe injury in earthquakes: a retrospective analysis.

INTRODUCTION: Earthquakes are the most violent type of natural disasters and injuries are the dominant medical problem in the early phases after earthquakes. However, likely because of poor data availability, high-quality research on injuries after earthquakes is lacking. Length of hospital stay (LOS) has been validated as a proxy indicator for injury severity in high-income settings and could potentially be used in retrospective research of injuries after earthquakes. In this study, we assessed LOS as an adequate proxy indicator for severe injury in trauma survivors of an earthquake. METHODS: A retrospective analysis was conducted using a database of 1,878 injured patients from the 2008 Wenchuan earthquake. Our primary outcome was severe injury, defined as a composite measure of serious injury or resource use. Secondary outcomes were serious injury and resource use, analysed separately. Non-parametric receiver operating characteristics (ROC) and area under the curve (AUC) analysis was used to test the discriminatory accuracy of LOS when used to identify severe injury. An 0.7

Endotoxin{middle dot}albumin complexes transfer endotoxin monomers to MD-2 resulting in activation of TLR4.

Response to Gram-negative bacteria (GNB) is partially mediated by the recognition of GNB-derived endotoxin by host cells. Potent host response to endotoxin depends on the sequential interaction of endotoxin with lipopolysaccharide binding protein (LBP), CD14, MD-2 and TLR4. While CD14 facilitates the efficient transfer of endotoxin monomers to MD-2 and MD-2·TLR4, activation of MD-2·TLR4 can occur in the absence of CD14 through an unknown mechanism. Here, we show that incubation of purified endotoxin (E) aggregates (E(agg), M ( r ) ≥ 20 million) in PBS with ≥ 0.1% albumin in the absence of divalent cations Ca(2+) and Mg(2+), yields E·albumin complexes (M ( r ) ∼70,000). E·albumin transfers E monomers to sMD-2 or sMD-2·TLR4 ectodomain (TLR4(ecd)) with a 'K (d)' of ∼4 nM and induces MD-2·TLR4-dependent, CD14-independent cell activation with a potency only 10-fold less than that of monomeric E·CD14 complexes. Our findings demonstrate, for the first time, a mechanistic basis for delivery of endotoxin monomers to MD-2 and for activation of TLR4 that is independent of CD14.

[Operative treatment of sacroiliac joint fracture and dislocation in Tile C pelvic fracture with Colorado 2 system].

OBJECTIVE: To explore the effectiveness of Colorado 2 system in the stability reconstruction of sacroiliac joint fracture and dislocation in Tile C pelvic fracture. METHODS: Between February 2009 and January 2011, 8 cases of Tile C pelvic fracture were treated with Colorado 2 system. There were 3 males and 5 females with an average age of 34.4 years (range, 22-52 years). Fractures were caused by traffic accident in 3 cases, by falling from height in 3 cases, and by crash of heavy object in 2 cases. According to Tile classification, 5 cases were classified as C1-2, 2 cases as C1-3, and 1 case as C2. The time between injury and operation was 5-10 days (mean, 7 days). After skeletal traction reduction, Colorado 2 system was used to fix sacroiliac joint, and reconstruction plate or external fixation was selectively adopted. RESULTS: The postoperative X-ray films showed that the reduction of vertical and rotatory dislocation was satisfactory, posterior pelvic ring achieved effective stability. All the incisions healed by first intention, and no blood vessel or nerve injury occurred. Eight patients were followed up 6-24 months (mean, 12 months). No loosening or breakage of internal fixation was observed and no re-dislocation of sacroiliac joint occurred. The bone healing time was 6-12 months (mean, 9 months). According to Majeed's functional criterion, the results were excellent in 5 cases, good in 2 cases, and fair in 1 case at last follow-up. CONCLUSION: Colorado 2 system could provide immediate stability of pelvic posterior ring and good maintenance of reduction effect, which is an effective method in the therapy of sacroiliac joint fracture and dislocation in Tile C pelvic fracture.

[Effect of Wnt-1 on the process of inducing neural stem cells into neurons by all-trans-retinoic acid in vitro].

OBJECTIVE: To explore the expression of Wnt-1 during the process of inducing neural stem cells (NSCs) into neurons by using all-trans-retinoic acid (ATRA) in vitro and the effect of Wnt-1 on NSCs differentiation. METHODS: NSCs isolated from cerebral cortex of SD rat embryo (12-16 days' gestation) were cultured. The concentration of cells at passage 3 were adjusted to 1 x 10(6) cells /mL and treated with ATRA at 0.5, 1.0, 5.0 and 10.0 micromol/L, respectively. Differentiation ratio of NSCs into neurons in each group was detected by double-labelling immunofluorescence technique and flow cytometry, and 1.0 micromol/L was selected as the best concentration for ATRA to promote NSCs differentiation. In experimental group, NSCs at passage 3 were cultured with ATRA at 1.0 micromol/L in vitro, and expression of Wnt-1 was detected by immunocytochemistry staining, real-time fluorescent quantitive PCR and Western blot at 3, 5, 7 and 9 days after culture, respectively. The cells at passage 3 receiving no ATRA served as control group. RESULTS: Immunocytochemistry staining: in the control group, there was little Wnt-1 protein expression; in the experimental group, peak expression of Wnt-1 and numerous positive cells occurred at 3 days after culture, the positive expression of Wnt-1 was still evident at 5 days after culture, and there was significant difference between two groups in integrated absorbance (IA) value at 3 and 5 days after culture(P < 0.05), obvious decrease of positive expression of Wnt-1 was evident, and no significant difference was evident between two groups in IA value at 7 and 9 days (P > 0.05). Real-time fluorescence quantitative PCR: the relative expression of Wnt-1 mRNA in the control group was 0.021 7 +/- 0.072 1; the relative expression of Wnt-1 mRNA in the experimental group at 3, 5, 7 and 9 days was 0.512 2 +/- 0.280 0, 0.216 4 +/- 0.887 0, 0.038 5 +/- 0.299 4 and 0.035 5 +/- 0.309 5, respectively, indicating the value decreased over time, and there were significant difference between two groups at 3 and 5 days (P < 0.05), and no significant difference at 7 and 9 days (P > 0.05) . Western blot detection: specific and visible staining band was noted; in the control group, Wnt-1 protein expression was 0.005 1 +/- 0.558 3; in the experimental group, Wnt-1 protein expression at 3, 5, 7 and 9 days was 0.451 7 +/- 0.071 3, 0.311 7 +/- 0.080 5, 0.007 3 +/- 0.052 7 and 0.004 7 +/- 0.9314, respectively, suggesting the value decreased over time; there were significant differences between two groups at 3 and 5 days (P < 0.05), and no significant differences at 7 and 9 days (P > 0.05). CONCLUSION: With the induction of ATRA at 1.0 mmicromol/L, Wnt-1 and NSCs differentiation in early stage are positively correlated. Its possible mechanism may rely on the activation of such signals as classic Wnt-1 signal pathway, indicating Wnt-1 relates to the differentiation of NSCs into neurons.