[Clinical efficacy of intraarticular vancomycin in preventing early periprosthetic joint infection after primary knee arthroplasty].

Objective: To investigate the clinical effect of intraarticular vancomycin on early periprosthetic joint infection (PJI) in knee arthroplasty and the incidence of postoperative complications. Methods: This is a retrospective cohort study. The clinical data of 1 867 patients who underwent primary knee arthroplasty at Department of Joint Surgery, the Affiliated Hospital of Qingdao University from April 2022 to June 2023 were retrospectively analysed, including total knee arthroplasty (TKA), robotic-assisted total knee arthroplasty (RA-TKA) and unicondylar knee arthroplasty (UKA). There were 687 males and 1 180 females, aged (68.0±11.2)years(range:45 to 87 years). Patients were divided into the vancomycin group and the control group according to whether or not intra-articular injection of 1 g of vancomycin powder dissolved in 30 ml of saline was performed after intraoperative joint capsule closure. In the vancomycin group, 925 patients were included, including 782 TKA, 27 RA-TKA and 116 UKA.In the control group, 942 patients were included, including 767 TKA, 99 RA-TKA and 76 UKA. Early PJI, wound complications, and vancomycin-related toxicity including acute renal collapse, ototoxicity, and allergic reactions were assessed within 3 months postoperatively. The data were compared using the independent sample t test, χ² test, and Fisher's exact probability method, as appropriate. Major Extremity Trauma Research Consortium (METRC). Results: No PJI was found in all patients in the vancomycin group.Five cases (0.7%,5/767) of early PJI were found in TKA patients in the control group, with a statistically significant difference (P=0.030); 1 case of early PJI was found in each RA-TKA and UKA patients, with non-significant difference compared with vancomycin group (all P>0.05). Two cases (0.3%,2/782) of incisional complications were found in TKA patients in the vancomycin group, and 4 cases (0.5%, 4/767) of incisional complications were found in TKA patients in the control group, with non-significant difference(P=0.449); no incisional complication was found in RA-TKA patients in the vancomycin group, and 1 case (1.0%,1/99) of incisional complications were found in RA-TKA patients in the control group, the difference was not statistically significant (P>0.05); no incisional complication was found in both groups of UKA patients.No vancomycin-related acute kidney injury, ototoxicity, or allergic reactions was observed in all patients. Conclusion: Intra-articular injection of 1 g of vancomycin suspension after arthrotomy closure during TKA maybe lower the risk of early PJI without increasing the risk of wound complication and vancomycin-associated systemic toxicity.

[Clinical analysis of 140 cases of mantle cell lymphoma].

Objective: To study the clinical features, therapeutic effects, prognostic factors of 140 patents with mantle cell lymphoma (MCL). Methods: Clinical data of 140 MCL patients admitted from June 2009 to January 2016 in our hospital were retrospectively analyzed. Results: The median age of 140 patients was 59 years with a ratio of 6∶1 for men and women. There were 134 cases (95.7%) in Ann-Arbor stage Ⅲ-Ⅳ, 37 cases (26.4%) with B symptoms, 61 cases (43.6%) with bone marrow involvement and 38 cases (27.1%) with enlarged spleen. The overall response rate (ORR), 3-year survival rate and progression-free survival rate in the treatment group with rituximab were 87.1%, 68.1% and 59.5% respectively, which were significantly higher than those in the rituximab-free treatment group (66.6%, 51.5% and 31.7%, respectively). The difference was statistically significant (all P<0.05). Among patients treated with rituximab, the complete remission rates (70.8% and 77.8%) of R-HyperCVAD/MA and VcR-CAP regimens were higher than those of R-CHOP regimen (39.0%, both P<0.05). However, there was no significant difference in the overall response rate, overall survival rate and progression-free survival rate (all P>0.05). Univariate analysis showed that age, Ki-67 index, B symptoms, bone marrow invasion, platelet count, LDH, ß(2)-MG and MIPI scores were associated with overall survival (all P<0.05). Multivariate analysis showed that age (HR=4.940, 95% CI: 2.347 to 10.397), B symptom (HR=2.900, 95% CI: 1.517-5.544), ß(2)-MG (HR=2.945, 95% CI: 1.656-5.238), Ki-67 index (HR=4.915, 95% CI: 2.554-9.456) and treatment with rituximab-containing regimen (HR=2.450, 95% CI: 1.352-4.440) were independent factors for OS. Conclusions: Most patients with MCL were older adults and usually had bone marrow involvement and spleen involvement. Rituximab combined with chemotherapy (especially R-HyprCVAD/MA and VcR-CAP) had better clinical efficacy than conventional chemotherapy.

Survivin is essential for fertile egg production and female fertility in mice.

Survivin is the smallest member of the inhibitor of apoptosis protein (IAP) family and acts as a bifunctional protein involved in mitosis regulation and apoptosis inhibition. To identify the physiological role of Survivin in female reproduction, we selectively disrupted Survivin expression in oocytes and granulosa cells (GCs), two major cell types in the ovary, by two different Cre-Loxp conditional knockout systems, and found that both led to defective female fertility. Survivin deletion in oocytes did not affect oocyte growth, viability and ovulation, but caused tetraploid egg production and thus female infertility. Further exploration revealed that Survivin was essential for regulating proper meiotic spindle organization, spindle assembly checkpoint activity, timely metaphase-to-anaphase transition and cytokinesis. Mutant mice with Survivin depleted in GCs showed reduced ovulation and subfertility, caused by defective follicular growth, increased follicular atresia and impaired luteinization. These findings suggest that Survivin has an important role in regulating folliculogenesis and oogenesis in the adult mouse ovary.

Posterior lumbar interbody fusion using spinous process and laminae.

Posterior lumbar interbody fusion (PLIF) is indicated for many patients with pain and/or instability of the lumbar spine. We performed 36 PLIF procedures using the patient's lumbar spinous process and laminae, which were inserted as a bone graft between two vertebral bodies without using a cage. The mean lumbar lordosis and mean disc height to vertebral body ratio were restored and preserved after surgery. There were no serious complications. These results suggest that this procedure is safe and effective.

[Protective effect of polysaccharide sulfate on human umbilical vein endothelial cell (HUVEC) injury in vitro].

The influence of four kinds of polysaccharide sulfate [heparin (Hep), low molecular weight heparin (LMWH), proglylene glucol mannate sulfate (MS871), chondroitin A sulfate (CAS)] on HUVEC injured by polycations and oxygen free radicals was investigated. The degree of injury was determined by checking the release of LDH to medium and 3H-TdR incorporation. The four kinds of polysaccharide sulfate were shown to protect cells from injury caused by polylysine concentration-dependently. The study also showed that the effects of Hep and CAS were stronger than those of LMWH and MS871 at the same dose level. In view of the level of LDH, the four kinds of polysaccharide sulfate can protect cells from oxygen free radical injury. The effects of Hep and CAS were more active than those of LMWH.

Evaluation of EMIT Cyclosporine Assay for use with whole blood.

We evaluated the EMIT Cyclosporine Assay, designed for specific quantification of cyclosporine (CsA) in whole blood. The assay was run on the Roche Cobas Mira or Cobas Mira S analyzer. Analytical recovery from both normal donor whole blood and transplant patients' samples was within 17% of the standards. Measurement of diluted out-of-range samples also yielded excellent recovery (101-105%). Within-run, between-run, and total CVs were < or = 8.1%, 10.9%, and 12.1%, respectively. The detection limit was < 32 micrograms/L. The assay was linear from 0 to 500 micrograms/L. No significant cross-reactivity was observed for CsA metabolites AM1, AM19, and AM4N. Slight cross-reactivity occurred with metabolite AM9; 670 micrograms/L AM9 increased the measured CsA concentration by 49 micrograms/L. High concentrations of bilirubin, uric acid, triglycerides, and cholesterol, as well as 54 commonly coadministered drugs did not interfere with CsA quantification. Similarly, neither extreme values of hematocrit nor choice of anticoagulant affected CsA recovery. Sample extract stability was > 4 h, and assay calibration was stable for at least 2 weeks. Patients' samples analyzed by the EMIT assay showed strong correlation with both HPLC and 125I-RIA (r > 0.97). We conclude that the EMIT Cyclosporine Assay provides a convenient, accurate, and precise method for specific quantification of CsA in whole blood.

The development of a predictive method for the estimation of flux through polydimethylsiloxane membranes. IV. Application to a series of substituted quinolines.

The steady-state flux of 33 substituted quinoline derivatives was determined in polydimethylsiloxane membranes using isopropyl alcohol as the receiver solvent. These diffusants constituted a diverse group of compounds possessing a wide range of hydrophobic, steric, and electronic characteristics. Various parameters representing these physicochemical properties such as cyclohexane-water fragmental constants, molar refractivity, Hammett's sigma constants, intramolecular hydrogen bonding ability, melting point, and mole fraction solubility were employed to develop empirical models capable of relating the rate of diffusion to these characteristics of either the substituent on the quinoline ring or the compound itself.

The development of a predictive method for the estimation of flux through polydimethylsiloxane membranes. III. Application to a series of substituted pyridines.

The steady-state flux of 35 substituted pyridine derivatives was determined in polydimethylsiloxane membranes using isopropyl alcohol as the receiver solvent. These diffusants constituted a diverse group of compounds possessing a wide range of hydrophobic, steric, and electronic characteristics. Various parameters representing these physicochemical properties such as cyclohexane-water fragmental constants, molar refractivity, Hammett's sigma constants, melting point, and mole fraction solubility were employed to develop empirical models capable of relating the flux to these characteristics of either the substituent on the pyridine ring or the compound itself.

Measurement of vancomycin in renally impaired patient samples using a new high-performance liquid chromatography method with vitamin B12 internal standard: comparison of high-performance liquid chromatography, emit, and fluorescence polarization immunoassay methods.

A new reverse-phase high-performance liquid chromatographic (HPLC) procedure has been developed for the quantitation of vancomycin and its crystalline degradation product, CDP-1. The new HPLC procedure involves a liquid-liquid extraction pretreatment procedure and an HPLC internal standard, vitamin B12. The new HPLC procedure was used to measure 50 renally impaired patient samples. Samples were than analyzed by the monoclonal antibody Emit vancomycin assay, and the polyclonal antibody fluorescence polarization immunoassay (FPIA) vancomycin assay, and the results were compared. The Emit vancomycin assay correlated well with HPLC, but FPIA quantitated higher than Emit and HPLC. We conclude that the polyclonal antibody FPIA assay detects CDP-1 in the samples of renally impaired patients, accounting for an average of 10% of the FPIA/Emit bias, and should therefore be used with caution when monitoring vancomycin levels in renally impaired patients.

Specific antibodies to theophylline for use in a homogeneous enzyme immunoassay.

Bovine serum albumin conjugate of 1-methyl-3-(3'-carboxypropyl)xanthine elicits highly specific anti-theophylline antibodies when injected into sheep. When used in a homogeneous enzyme immunoassay for theophylline these antibodies show insignificant cross-reactivity (less than 1%) to 1-methyl- and 1,3-dimethyluric acid, 3-methylxanthine, caffeine, and theobromine. In contrast, immunogens prepared from the C-8 functionalized drug afford antibodies which show more serious cross-reactivity to these compounds. Plausible rationale for attachment of the drug to carrier proteins through its N-3 position which furnished specific antibodies are given.

Homogeneous enzyme immunoassay for cannabinoids in urine.

We describe a homogeneous enzyme immunoassay for measurement of cannabinoid metabolites, as well as delta9-tetrahydrocannabinol (I) in urine. Malate dehydrogenase from pig heart mitochondria was labeled with a derivative of I. The compound used to calibrate the assay was the I metabolite, 11-nor-delta9-tetrahydrocannabinol-9-carboxylic acid (II). With 15 microgram of II per liter of urine as the cutoff concentration, the assay can detect 25 microgram of II per liter with greater than 95% confidence. A positive response was obtained for urine specimens assayed within 30 min after exposure to cannabinoids. However, the persistence of metabolites of I in urine indicates that assay of this fluid is useful as an indicator of cannabinoid use but not as an indicator of intoxication.