[A follow-up study on the pain changes trend and effects in patients diagnosed with herpes zoster in Beijing City].

Objective: To understand the changes in pain and its effects in patients with the diagnosis of herpes zoster. Methods: A total of 3 487 patients diagnosed with herpes zoster (HZ) for the first time at the outpatient department of Miyun District Hospital from January 1, 2017, to December 31, 2019, were included in the study. The information of patients was registered and issued with a record card. Patients were required to record the time of pain and rash by themselves. Telephone follow-up was conducted at 21, 90, 180 and 365 days after the onset of rashes, including hospitalization, location of rash and pain, and the time of start and end. The impact of pain on life was evaluated by the Zoster Brief Pain Inventory (ZBPI). Results: The age of 2 999 HZ patients included in the analysis were (53±16) years old, including 1 377 (45.91%) males and 1 903 (63.45%) patients aged 50 years and older. After 21 days of rash, mild, moderate and severe pain accounted for 20.87% (626 cases), 37.98% (1 139 cases) and 33.81% (1 014 cases), respectively. Only 5.07% (152 cases) had no pain or discomfort, and 2.27% (68 cases) had no pain but discomfort. Most of the pain sites were consistent with the rash sites. The chest and back and waist and abdomen were the most common, accounting for 35.58% (1 067 cases) and 29.18% (875 cases), respectively, followed by the limbs and face and neck, accounting for 16.74% (502 cases) and 16.40% (492 cases), respectively. The M (Q1, Q3) of pain days in the HZ patients was 14 (8, 20) days, and the incidence of post-herpetic neuralgia (PHN) was 6.63% (171/2 580) (excluding 419 patients who refused to visit or lost to visit on 90 days after the onset of rash). The pain score of HZ patients within 21 days after the rash was (5.19±2.73) points, and the pain score of PHN patients was (7.61±2.13) points, which was significantly higher than that of non-PHN patients [(5.04±2.69) points] (P<0.001). Daily activities, emotions, walking ability, work, social interaction, sleep and recreation were affected for 21 days after the rash in HZ patients, ranging from 60.79% to 83.83%, with sleep being the most affected (83.83%). The impact scores of pain and life dimensions in PHN patients ranged from 4.59 to 7.61 points on the ZBPI scale, which were higher than those in non-PHN patients (2.49-5.04) (t values ranged from 8.86 to 11.67, all P values <0.001). Conclusion: The proportion of pain in HZ patients after the diagnosis is high, and the pain is more obvious in patients with PHN and HZ patients aged 50 and older, which has a greater impact on their daily lives.

A multicentre randomised controlled trial of the effect of intra-operative dexmedetomidine on cognitive decline after surgery.

Peri-operative dexmedetomidine can reduce rates of delirium immediately after surgery. We aimed to assess the effect of dexmedetomidine on cognition up to six postoperative months and its association with changes in serum concentrations of brain-derived neurotrophic factor on the third and seventh postoperative days. We randomly allocated 535 patients aged 65 years or more undergoing scheduled gastro-intestinal laparotomy to: intra-operative dexmedetomidine, 0.5 µg.kg-1 bolus followed by 0.4 µg.kg-1 .hr-1 infusion (n = 269), or placebo (n = 266). Dexmedetomidine reduced the rate of cognitive impairment: on the third postoperative day, 40/269 vs. 65/266, p = 0.006; on the seventh postoperative day, 31/269 vs. 49/266, p = 0.03 and at one postoperative month, 42/250 vs. 61/248, p = 0.04. Cognitive impairment at seven postoperative days was associated with changes in brain-derived neurotrophic factor concentrations on the third and seventh postoperative days; area under the receiver operating characteristic curve 0.63, p < 0.001 and 0.58, p = 0.016, respectively. Intra-operative dexmedetomidine reduced cognitive decline up to one postoperative month in elderly patients undergoing scheduled laparotomy, which was associated with changes in serum brain-derived neurotrophic factor.

[Analysis of herpes zoster incidence and hospitalization in three areas of Beijing in 2015 based on health information system of medical institutions].

Objective: Using data of health information system (HIS) of medical institutions to study the incidence and hospitalization of herpes zoster in three districts of Beijing. Methods: According to the different level of economic development and geographical features in Beijing, 3 districts of Xicheng, Changping and Miyun were chosen and all 110 medical institutions of the first level and above in the 3 districts are included in the survey. All the outpatient and inpatient herpes zoster cases in 2015 were retrospectively reviewed by HIS system. After distinguishing the reduplicated cases, Using the first outpatient case as a molecule and the resident population as denominator to estimate the annual incidence rate, as well as the annual hospitalization rate was estimated based on primary diagnostic hospitalized cases as molecule and the resident population as denominator. Results: A total of 32 313 primary visit outpatient cases were investigated, of which 18 360 cases (56.8%) were women and 20 923 cases (64.8%) were ≥50 years old. The overall estimated incidence of the 3 districts was 8.8‰ with an increase trends with age and reached to the highest in ≥80 years old (30.5/1 000). The incidence of Xicheng, Changping and Miyun districts are respectively 16.2‰, 4.0‰ and 5.7‰. A total of 701 primary visit inpatient cases were identified, of which 366 cases (52.2%) were women and 651 cases (92.9%) were ≥50 years old. The estimated annual hospitalization rate was 19.4/100 000, with the primary and secondary diagnostic hospitalization rate are respectively 5.9/100 000 (212 cases) and 13.5/100 000 (489 cases). The disease types of secondary diagnostic inpatient herpes zoster cases were as follows: cardiovascular disease (19.0%, 93 cases), stroke (14.5%, 71 cases), pneumonia/chronic obstructive pulmonary disease (14.1%, 69 cases), tumor (12.5%, 61 cases) and diabetes (5.7%, 28 cases). Conclusion: Most of the herpes zoster cases in Beijing are over 50 years old, and the incidence of female is slightly higher than male. This disease should become a public health issue of great concern.

[Effect of goal-directed haemodynamic management on the postoperative outcome in elderly patients with fragile cardiac function undergoing abdominal surgery].

Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45). After anesthesia induction, in group G, the SVV and CI were monitored by Vigileo and according SVV (≤12%), CI (≥2.5 L·min-1·m-2) and MAP (maintain the base value of ±20%) to adjust the preloaded infusion fluid and give positive inotropic drugs and positive pressure drugs; in group E, fluid and vasoactive agent were used according to the experience of anesthesiologist.Multi-mode monitoring anesthesia management using BIS, TCI of propofol, low-tidal-volume lung protective ventilation management strategy, body temperature protection, and postoperative multimodal analgesia techniques was performed in the two groups.Values of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) were recorded before operation, at the end of operation, and postoperative 24 h. The incidence of myocardial infarction/angina, heart failure, arrhythmia and cerebral infarction, renal failure, length of hospitalization, and complications in 30-days after surgery were recorded by telephone follow-up. Results: Crystal, colloid, total liquid of group E were (1 110.20±332.00), (536.65±72.25), (1 677.20±424.44) ml and these of group G were (708.72±240.85), (414.41±74.31), (878.51±199.13) ml, respectively.Compared with group E, the fluid infusion were reduced in group G (t=6.057, 2.701, 9.742, all P<0.05). The lactic acid value of 24 hours after surgery in group G was significantly lower than that in group E [(0.89±0.31) mmol/L vs (1.11±0.43) mmol/L, t=-2.848, P<0.05]. Arterial partial pressure of oxygen at 24 hours after surgery in group G was higher than that in group E [(78.77±6.86) mmHg vs (76.46±10.96) mmHg, t=-1.108, P<0.05]. The length of hospitalization of group G was shorter than that of group E [(12.21±2.20) d vs (13.16±3.84) d, t=-1.341, P<0.05]. The incidence of total complication in hospital and in 30-days after surgery of group G were 10.26% and 5.13%, while these of group E were 29.73% and 24.32%, (χ2=4.545, 4.520, all P<0.05). ΔNT-proBNP1 (the base value of NT-proBNP's minus the value of NT-proBNP's at the end of the operation) and ΔNT-proBNP2 (the base value of NT-proBNP's minus the value of NT-proBNP's 24 hours postoperatively) of group G were 12.0(-291.0, 1 517.0) and 0(-6 770.0, 291.0), both higher than these of group E [0(-440.0, 200.0) and -12.0(-7 200, 22.0), (Z=-2.412, -2.163, all P<0.05)]. Conclusion: Goal-directed haemodynamic management based on SVV, CI and MAP could improve the outcome of the elderly patients with fragile heart function undergoing abdominal surgery.

[Analysis of clinical and pathological characteristics of high- risk HPV-negative carcinoma of the uterine cervix].

Objective: To study the clinical and pathological characteristics of HPV-negative cervical cancer patients. Methods: Retrospective analysis of 785 cervical cancer patients in Guangdong Women and Children Hospital from Jan. 2005 to Oct. 2015. By detecting high- risk HPV infection by flow-through hybridization genechip technique. Results: (1)Among 785 cases of cervical cancer, 71 cases were negative for HPV infection tested by genechip technique, accounting for 9.0%(71/785), and the relative light units/cut off(RLU/CO)ratios of these 71 cases were less than 1 by hybird capture Ⅱ(HC-Ⅱ)methods. The results showed that the positive coincident rate of genechip technique detecting result with HC-Ⅱ method was 100.0%(71/71).(2)There was no difference between 43(60.6%)cases from 41-55 years old of 71 cases of HPV-negative patients and 392(54.9%)cases from 41- 55 years old of 714 cases of HPV infection patients(χ2=15.63, P=0.571). Among 71 cases of HPV-negative patients, 32 cases of patients with doing TCT, 6(18.8%)cases for normal, 10(31.2%)cases for atypical squamous cells of undetermined significance(ASCUS), 3(9.4%)cases for atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion(ASC-H), 3(9.4%)cases for low-grade squamous intraepithelial lesions(LSIL), 8(25.0%)cases for hight-grade squamous intraepithelial lesions(HSIL), 2(6.2%)cases for squamous cell carcinoma(SCC). And there were 391 cases of patients with doing thin-prep cytologic test(TCT)of 714 HPV infection patients, 60(15.3%)cases for normal, 61(15.6%)cases for ASCUS, 28(7.2%)cases for ASC-H, 29(7.4%)cases for LSIL, 164(41.9%)cases for HSIL, 49(12.5%)cases for SCC. There was no difference of TCT between HPV infection and HPV-negative patients(P>0.05). Among 70 cases from 71 patients with negative for HPV infection, there were 8(11.4%)cases in stage Ⅰ a, 26(37.1%)cases in stage Ⅰ b1, 12(17.1%)cases in stage Ⅰb2, 11(15.7%)cases in stage Ⅱa, 10(14.3%)cases in stage Ⅱb, 3(4.3%)cases in stage Ⅲ-Ⅳ. There were 118(16.6%)cases in stage Ⅰa, 261(36.8%)cases in stage Ⅰb1, 72(10.1%)cases in stage Ⅰb2, 152(21.4%)cases in stage Ⅱa, 87(12.3%)cases in stage Ⅱb, 20(2.8%)cases in stage Ⅲ-Ⅳ in 710 cases of HPV infection patients, in which there were no difference of clinical stage between HPV infection and HPV-negative patients(P>0.05). Among 69 cases from 71 patients HPV-negative infection, there were 51(73.9%)cases for squamous carcinoma, 13(18.8%)cases for adenocarcinoma, 5(7.2%)cases for adenosquamous carcinoma; and 593(87.2%)cases for squamous carcinoma, 38(5.6%)cases for adenocarcinoma, 39(5.7%)cases for adenosquamous carcinoma, 10(1.5%)case for others were in 680 patients of HPV infection, in which there was significant difference of adenocarcinoma between HPV infection and HPV-negative patients(χ2=11.96, P=0.001). Conclusions: Flow-through hybridization genechip technique is the method of high sensitivity to detect high-risk type HPV, as like HC-Ⅱ method. HPV-negative of cervical cancer occurs mainly in 41- 55 years old. Adenocarcinoma incidence is significantly higher in HPV-negative cases than those patients with infection of HPV positive.

Histone modifications of Notch1 promoter affect lung CD4+ T cell differentiation in asthmatic rats.

Asthma is an inflammatory disease of the airways, and the current treatment in managing asthma is the control of inflammation. Notch signaling pathway has been linked to T-cell imbalance. The present study aimed to explore the histone modifications of Notch1 promoter in normal and asthmatic lung CD4+ T cells. Chromatin immunoprecipitation analysis showed that the acetylation levels of total H3, H4, site-specific H3K9, H3K14, H3K27, H3K18, H4K16, and the trimethylation levels of H3K4, H3K79 of Notch1 gene promoter were increased significantly in asthmatic lung CD4+ T cells compared to the control group, which correlated with increased P300, PCAF activity and decreased HDAC1, HDAC2 activity. After intervention of garcinol, a potent inhibitor of histone acetyltransferases, in asthmatic lung CD4+ T cells, HAT activity decreased significantly and the increased Notch1 and hes-1 expression was reversed. The total H3ac, H4ac, site-specific H3K9ac, H3K14ac, H3K27ac, H3K18ac, H4K16ac and H3K79me3 levels of Notch1 gene promoter decreased significantly, and the H3K4me3, H3K9me3, H4K20me3 levels had no significant difference. We further investigated the suppressive effects of GAR on asthmatic parameters. Results showed that the levels of IL-4, IL-5 and IL-13 were significantly reduced and a small reverse trend was found in the level of IFN-g after GAR treatment. Furthermore, the expression of NF-κB and AP-1 reduced significantly. These results suggest that asthma is associated with changes in the epigenetic status of Notch1 promoter, including abnormal histone acetylation and methylation, and GAR may have applications in the treatment of asthma.

YES-associated protein 1 promotes adenocarcinoma growth and metastasis through activation of the receptor tyrosine kinase Axl.

Yes-associated protein 1 (YAP1), a nuclear effector of the Hippo pathway, plays an important role in tumorigenesis and progression of multiple cancers. The present study aimed to investigate the clinical significance of YAP1 and receptor tyrosine kinase Axl expression in human lung adenocarcinomas (LAC). We further explored possible molecular mechanisms mediated by YAP1 in LAC and gastric adenocarcinoma (GAC) cells. Forty-nine cases of human LAC and normal lung tissue (NLT) were collected. The expression of YAP1 and Axl was assessed by immunohistochemical assay through tissue microarray procedure and the clinicopathologic characteristics of all patients were analyzed. Using a loss of function approach, we investigated the effects of small hairpin RNA (shRNA)-mediated knockdown of YAP1 on the expression of Axl, proliferating cell nuclear antigen (PCNA) and matrix metalloproteinase-9 (MMP-9), and the proliferative activities and invasive potential in LAC A549 and GAC SGC-7901 cell lines. As a result, the expression of YAP1 and Axl was found in LAC tissues with higher strong reactivity rate compared to the NLT (87.8 percent vs.60.8 percent, P=0.000; 77.6 percent vs 0.0 percent, P=0.000), but they did not associate with the age, gender, tumor size, TNM staging or lymph node metastases of LAC patients (each P>0.05). Spearman rank correlation analysis showed a positive correlation between YAP1 and Axl expression. Furthermore, knockdown of YAP in vitro markedly down-regulated the expression of Axl, PCNA and MMP-9, and inhibited the proliferation and invasion of LAC and GAC cells. Taken together, YAP1 and Axl are highly expressed in LAC compared to the NLT, and knockdown of YAP1 may inhibit the proliferation and invasion of adenocarcinoma cells through downregulation of the Axl pathway, representing a potential therapeutic target for the treatment of cancer.

[Reconstruction of teaching mode of Human Parasitology among rural order-oriented medical students in the context of curriculum ideology and politics].

To set the cultivation goal with adaptation to rural order-oriented medical students, the teaching mode of Human Parasitology was reformed in the context of curriculum ideological and political education. The new teaching mode not only enables students to harvest medical knowledge during the school education stage, but also plays a guiding role in cultivation of humanistic qualities and professional spirit, which provides a basis for cultivating general practitioners serving for grassroots healthcare.

Discovery and identification of fatigue-related biomarkers in human saliva.

OBJECTIVE: To identify stable and specific biomarkers/biomarker combinations for fatigue assessment and establish a discriminant model. PATIENTS AND METHODS: Saliva was collected and electroencephalogram analysis was performed for 47 emergency physicians while awake and after continuoutas duty for 18-24 h. Physicians were divided into the fatigue and non-fatigue groups. Protein spectra of completely quantified saliva specimens were identified before and after long working hours using mass spectrometry. Data were analyzed through Proteome Discoverer software combined with SEQUEST to search protein databases. Proteins were characterized by collision-induced dissociation spectra. A global internal standard (GIS) was added to each group of samples and labeled by tandem mass tags m/z 131.1. All data were compared with GIS, and data between groups were further compared. Qualitative and quantitative data on proteins were exported for fatigue-related proteomic analysis, and a fatigue assessment model was established. RESULTS: We identified 767 salivary proteins in the fatigue group. The correct rates of the discriminant function of the non-fatigue and fatigue groups were 97.1% and 91.7%, respectively (the total correct rate was 95.7%). CONCLUSIONS: We identified 30 fatigue-related protein markers from saliva. We also established a fatigue assessment model for emergency physicians using salivary biomarkers.

First-principles investigation of strain effects on the energy gaps in silicon nanoclusters.

First-principles density functional calculations were performed to study strain effects on the energy gaps in silicon nanoclusters with diameter ranging from 0.6 to 2 nm. Hydrostatic and non-hydrostatic strains have been found to affect the energy gaps differently. For the same strain energy density, non-hydrostatic strain leads to a significantly larger change in the energy gap of silicon clusters compared to that of the hydrostatic strain case. In contrast, hydrostatic and non-hydrostatic strain effects on the energy gaps of bulk Si or larger size Si quantum dots are comparable. Non-hydrostatic strains break the tetrahedral bonding symmetry in silicon, resulting in significant variation in the energy gaps due to the splitting of the degenerate orbitals in the clusters. Our results suggest that the combination of energy gaps and strains permits the engineering of photoluminescence in silicon nanoclusters and offers the possibility of designing novel optical devices and chemical sensors.

[Genomic diversity and population structure of Helicobacter pylori isolates in China].

Objective: To learn about the overall genomic characteristics and population structure of Helicobacter pylori isolated in China. Methods: In this study, we used 10 public available genome sequences of H. pylori strains isolated in China, combined with other H. pylori sequences from GenBank, to analyzed the overall genomic characteristics of H. pylori isolated in China. Core genes and strain specific genes were determined for a further function definition. Results: A total of 1 203 core genes were found among all sequenced China H. pylori isolates. The number of strain specific genes ranged from 19 to 32. These genes mainly encodes hypothetical proteins which might play an important role in adaption to different hosts. Genomic variation regions were mainly in genes encoding type four secretion systems and restriction modification systems. All the China isolates belong to hpEastAsia group, hspEAsia subgroup. Prophages sequences were found in three China H. pylori strains, carrying key elements required for phage assembly. Conclusion: China H. pylori isolates belong to hpEastAsia group, hspEAsia subgroup, and some isolates contain prophages.

Estrogen/ERR-α signaling axis is associated with fiber-type conversion of upper airway muscles in patients with obstructive sleep apnea hypopnea syndrome.

Estrogen is related with the low morbidity associated with obstructive sleep apnea hypopnea syndrome (OSAS) in women, but the underlying mechanisms remain largely unknown. In this study, we examined the relationship between OSAS and estrogen related receptor-α (ERR-α). We found that the expression levels of ERR-α and Myh7 were both downregulated in palatopharyngeal tissues from OSAS patients. In addition, we report that ERR-α is dynamically expressed during differentiation of C2C12 myoblasts. Knockdown of ERR-α via instant siRNA resulted in reduced expression of Myh7, but not Myh4. Furthermore, differentiation of C2C12 cells under 3% chronic intermittent hypoxia, a model resembling human OSAS, was impaired and accompanied by a obvious reduction in Myh7 expression levels. Moreover, activation of ERR-α with 17ß-estradiol (E2) increased the expression of Myh7, whereas pretreatment with the ERR-α antagonist XCT790 reversed the E2-induced slow fiber-type switch. A rat ovariectomy model also demonstrated the switch to fast fiber type. Collectively, our findings suggest that ERR-α is involved in estrogen-mediated OSAS by regulating Myhc-slow expression. The present study illustrates an important role of the estrogen/ERR-α axis in the pathogenesis of OSAS, and may represent an attractive therapeutic target, especially in postmenopausal women.

Fat intake in Hong Kong Chinese children.

The people of Hong Kong are experiencing a transition in dietary practices and lifestyle that can be observed in the fat intakes of Hong Kong children as compared with those of their counterparts on mainland China. The studies described here include 1) a longitudinal and observational dietary survey beginning with a cohort of 174 newborns and concluding with 124 children at age 7 y; 2) a biochemical study of serum lipids in relation to dietary fat intake at age 7 y; 3) a chemical fatty acid analysis and comparison of duplicate meals collected from 20 Hong Kong and 20 mainland Chinese children at age 7 y; 4) a dietary assessment of 52 lactoovovegetarian children aged 4-14 y; and 5) a comparison of the growth of all subjects with US National Center for Health Statistics standards. About 30% of the total daily energy intake of Hong Kong Chinese children aged 1-7 y was contributed by fat-much more than that in the traditional Chinese diet. Growth of the children was not impaired, including that of children on the mainland and of those lactoovovegetarians in Hong Kong whose fat intakes were lower. Mean serum cholesterol of Hong Kong Chinese children at age 7 y was 4.59 mmol/L, significantly higher than that of their counterparts on the mainland, 4.16 mmol/L. Foods consumed in Hong Kong had a significantly lower ratio of 18:2 to 14:0. Nutritional deficiency was uncommon. Chinese children in Hong Kong had a dietary fat intake that was both quantitatively and qualitatively different from the traditional Chinese diet.

Serum fatty acid, lipid profile and dietary intake of Hong Kong Chinese omnivores and vegetarians.

OBJECTIVE: To examine the serum fatty acid and lipid profiles and dietary intake of Hong Kong Chinese omnivores and vegetarians with respect to cardiovascular health. DESIGN: Random population survey stratified by age and sex. SUBJECTS: One-hundred and ninety-four omnivore subjects (81 men, 113 women) age 25-70 y, and 60 ovo-lacto-vegetarian adults (15 men, 45 women) age 30-55 y. MEASUREMENTS: Nutrient quantitation was by a food frequency method. Serum fatty acids were analysed by gas chromatography, and serum lipid by standard laboratory methods. RESULTS: Compared with omnivores, vegetarians had higher serum concentrations of polyunsaturated (PUFA) and monosaturated fatty acids (MUFA), and lower saturated fatty acids (SFA), long chain omega-3 and trans fatty acids (TFA). They also had lower serum cholesterol and higher apoA-1 concentrations, but the LDL/HDL ratio was not different. The ratio of polyunsaturated to saturated fatty acids intake was higher in vegetarians. Compared with results from populations with higher incidences of coronary heart disease, while lower myristic and palmitic acid concentrations and higher eicosapentaneoic (EPA) and docosahexanoic acid (DHA) may partly account for the difference in incidence, linoleic acid concentration was higher. Although the Chinese vegetarian diet may be beneficial for heart health in that antioxidant and fibre intakes are higher and saturated fat lower, the low EPA and DHA due to omission from dietary source and suppressed formation by high linoleic acid level, and the presence of TFA in the diet, may exert an opposite effect. CONCLUSION: There are some favourable features in the serum fatty acid profile in the Hong Kong Chinese population with respect to cardiovascular health, but the consumption of TFA is of concern. The Chinese vegetarian diet also contains some adverse features.

Correlation of histology with anorectal function following stapled hemorrhoidectomy.

INTRODUCTION: The inadvertent removal of smooth muscle during the use of stapled hemorrhoidectomy had raised concerns about its effects on postoperative anorectal function. We correlated the amount of smooth muscle removed with anorectal function in the early postoperative period. METHODS: Patients were assessed preoperatively with an Eypasch quality-of-life questionnaire and underwent anorectal manometry and physiology testing. This was followed by a similar examination at three months postoperatively. Patients were operated on by a single surgeon and the excised anorectal mucosa was sent for histologic examination. The amount of smooth muscle excised was expressed semiquantitatively as a percentage of the total tissue removed. RESULTS: Sixty-eight patients (33 males) were recruited prospectively, with median age of 44 years. Six patients were lost to follow-up. Removal of anal transitional zone did not increase the incidence of incontinence. Both median preoperative and postoperative continence scores were good. Only one patient had incontinence to gas as a result of the operation. Median preoperative and postoperative quality-of-life scores were 114 and 131, respectively, out of a total of 144, the higher postoperative scores showing an improvement. Correlation of quality-of-life scores and mean resting anal pressures with percentage of smooth muscle removed did not show any statistical significance. CONCLUSIONS: Some smooth muscle will invariably be excised in stapled hemorrhoidectomy but the amount of smooth muscle removed did not significantly affect the continence score, quality of life, or mean anal resting pressure after stapled hemorrhoidectomy. It remains a safe and preferred procedure for the treatment of hemorrhoids.

[Influence of IFN-alpha and IFN-alpha combined with GM-CSF on expression of the genes related to cell apoptosis of MNCs from bone marrow in CML patients].

OBJECTIVE: To investigate the effects of interferon-alpha(IFN-alpha) and IFN-alpha combined with granulocytic macrophage colony-stimulating factor(GM-CSF) on expression of bcr-abl, bcl-2 and c-myc genes in the mononuclear cells(MNCs) from bone marrow(BM) of the patients with chronic myelogenous leukemia at chronic phase(CML-CP). METHODS: The MNCs were collected from bone marrow of 14 CML-CP patients by centrifugalization in lymphocyte-separation medium, and cultivated in the medium with IFN-alpha and IFN-alpha plus GM-CSF for 24 hours. The expression levels of bcr-abl, bcl-2, c-myc and beta-actin were detected by using relatively quantitative reverse transcriptase polymerase chain reaction (RT-PCR) and optical density scanning technology for the amplified fragments. The statistical differences between each inducing experimental group and the control were analyzed by t-test in pairs. RESULTS: Both IFN-alpha (200 U.ml-1) and IFN-alpha combined with GM-CSF (10 ng.ml-1) significantly inhibited bcr-abl gene expression, meanwhile IFN-alpha partially suppressed c-myc and bcl-2 gene expression, and GM-CSF significantly inhibited bcl-2 gene expression but partially upregulated bcr-abl and c-myc gene expression levels on the basis of IFN-alpha effects. CONCLUSIONS: Both IFN-alpha and IFN-alpha plus GM-CSF can inhibit the expression of anti-apoptosis gene such as bcr-abl and bcl-2, and regulate the expression of c-myc. It is the possible mechanism of IFN-alpha therapy or combined therapy on CML at chronic phase that the malignant clone expansion is inhibited by promoting apoptotic cell death.

Insulins from different species--chicken and snake.

We have worked out a new adsorption method for the preparation of insulins from different species. At present, we are mainly involved in chicken and snake insulins. In all insulins so far studied, only chicken insulin has been reported to have much higher activity. However, results from different laboratories are quite different from one another. We have obtained chicken insulin in typical rhombohedral crystalline form and determined its activity in vivo which is not appreciably different from that of porcine insulin. From the pancreas of a non-venomous snake, Zaocys dhumnades dhumnades (Cantor), we have prepared snake insulin which is different from rattle snake insulin reported earlier. The dodecahedral crystals of the snake insulin are similar to those of zinc-free porcine insulin.

Body fat estimation in children by magnetic resonance imaging, bioelectrical impedance, skinfold and body mass index: a pilot study.

OBJECTIVE: The aim of this study was to identify the clinical method to estimate body fat which gave best correlation of total body fat and percentage body fat as measured on MRI. METHODS: Magnetic resonance imaging (MRI) was used to estimate the total body fat volume and percentage body fat and this was compared with assessment by bioelectrical impedance (BEI), skinfold thickness and body mass index (BMI) in 8- to 12-year-old children. RESULTS: Total body fat measured on magnetic resonance imaging (TBF-MRI) significantly correlated with body mass index, triceps and subscapular skinfolds, and percentage body fat estimations by BEI. Multiple regression analysis showed that BMI and BEI together gave the best prediction of total body fat as measured on MRI from the equation: TBF-MRI=-25277.77+1457.61(BMI)+423.95(%fat-BEI), with R2=0.89. Percentage body fat measurement from MRI, BEI and skinfold were not significantly different but their results were not interchangeable. Linear regression of %body fat from MRI on those obtained from BEI and skinfold measurements showed a modest fit with R2=0.6973 and 0.5501, respectively. CONCLUSIONS: In children 8-12 years old, BMI gives a good estimation of the total body fat as measured on MRI. The estimation will be improved when both BEI and BMI are used in the prediction. Bioelectrical impedance has a low correlation with total body fat and its use alone in estimating total body fat is not recommended. Skinfold measurement also gives a reasonably good prediction of total body fat and addition of BMI and BEI does not improve the prediction. Both BEI and skinfold measurements give a modest prediction of %body fat measured by MRI method.

[Determination of vitamin D2 included with beta-cyclodextrin complex in "longmu zhuanggu chongji" by HPLC].

In order to enhance the stability of vitamin D2(VD2), the inclusion complex of VD2 with beta-cyclodextrin(beta-CD) was added in "Longmu Zhuanggu Chongji", a medicine of children for the prevention and cure of rickets. The VD2 in beta-CD-VD2 inclusion complex was satisfactorily determined by both reversed-phase high performance liquid chromatography(HPLC) and ultraviolet spectrometry(UV). The experimental results from UV were in well consistent with those from HPLC. The accuracy and recovery of HPLC measurement were analyzed, and their relative standard deviation(RSD) were given to be 0.63% and 1.54%, indicating the method is quite correct and reliable, and the linear regression equation is reasonable. The "Longmu Zhuanggu Chongji" containing beta-CD-VD2 inclusion complexes was saponified by a mixture of KOH, vitamin C (VC) and alcohol-water(1:2, V/V) at 70 degrees C, then extracted with petroleum ether. An accurate content of the VD2 product was obtained by HPLC. A simple and rapid HPLC method, which can detect VD2 in the inclusion complex and in "Longmu Zhuanggu Chongji", has been established in this work.

Body fatness and serum lipids of 11-year-old Chinese children.

It has been suggested that distribution of body fat has a stronger bearing on health risk than total body fat. Magnetic resonance imaging (MRI) was used to examine the distribution of fat and correlated with body fat assessed by the usual clinical methods-weight, weight-for-height, body mass index (BMI), triceps and subscapular skinfold thickness in 11-y-old Chinese children. Lipid profiles were used as indicators for coronary risk. Eighty-eight subjects had body fat distribution estimated by MRI, while 49 had serum lipids measured. Anthropometric parameters correlated significantly with total fat at the umbilical level measured by MRI (weight: r = 0.90 in boys, 0.75 in girls; BMI: r = 0.94 in boys, 0.87 in girls; percent median weight-for-height: r = 0.90 in boys, 0.79 in girls, triceps skinfold thickness: r = 0.89 in boys, 0.90 in girls; subscapular skinfold thickness: r = 0.93 in boys, 0.88 in girls). Obese subjects had proportionally less visceral fat than subcutaneous fat at umbilical level. Using stepwise multiple regression, predictive factors for high-density lipoprotein cholesterol were BMI in boys and breast-staging in girls. For triglycerides, it was genital staging in boys and for total cholesterol, it was breast-staging in girls. Visceral fat was not a significant determinant of serum lipids.