Rare adult Kaposiform hemangioendothelioma with multiple-bone invasion - clinical experience and literature review.

BACKGROUND: Kaposiform hemangioendothelioma (KHE) is a borderline vascular tumor between hemangioma and malignant angiosarcoma. While KHE has strong local invasion with rare spontaneous regression, it is not observed with distant metastasis. Even if KHE is asymptomatic or without the Kasabach-Merritt phenomenon (KMP), bone or joint invasion should clearly receive proactive treatment. KHE commonly affects infants/children but is rarely seen in adults. CASE REPORT: We reported a rare adult KHE case with an invasion of >10 separate forearm/hand bones, who underwent multiple-lesion resection and finger amputation after tumor recurrence. Tumor recurrence and KMP were not observed during the 6-month follow-up after the final operation. During the hospitalization and follow-up period, the patient only received medications for infection prevention and pain relief. CONCLUSIONS: Multiple resectable lesions were found in the distal limb, for which complete resection might not present typical features (high-intensity T2-weighted MRI), which might fail to detect all KHE lesions. Therefore, complete excision is not optimal for multiple resectable KHE lesions.

[Incidence and risk factors of acute mountain sickness in grid construction personnel working at plateau].

Objective: To analyze the incidence and risk factors of acute mountain sickness (AMS) in grid construction personnel working at plateau. Methods: A total of 10 956 plateau construction personnel of Ali Network Project from January 1, 2019 to December 31, 2020 were included. Baseline information (including age, sex, body mass index, developmental and nutritional status, relevant clinical indicators, etc.) and follow-up data of AMS were obtained from the medical record of Ali Internet engineering staff medical station. The altitude of the residence place in early life and the working environment were obtained from the website (https://zh-cn.topographic-map.com/legal/). The incidences of overall AMS and its subgroups were calculated, and the Cox proportional hazards model was used to explore the risk factors for AMS. Results: The age of the participants was (36.1±10.5) years old at baseline, and 95.27% (10 438) of them were males. The follow-up time was (17.46±4.23) months. The altitude of the residence place in early-life and working environment were (1 959±937) m and (4 533±233) m, respectively. During the follow-up period, the incidence of AMS was 15.58% (1 707 cases), and the incidence for acute mountain sickness and high altitude pulmonary edema were 15.53% (1 702 cases) and 0.05% (5 cases), respectively. No high altitude cerebral edema patients were found. Cox proportional hazards model showed that the risk of AMS increased by 45% for every 100 m elevation in the altitude of working environment [HR (95%CI): 1.45 (1.41-1.51)]. The higher the altitude for the residence place in early-life, the lower the risk of AMS [HR (95%CI): 0.84 (0.80-0.88)]. Compared with the group with oxygen saturation during 90%-94%, the participants with oxygen saturation<75% [HR (95%CI): 1.67 (1.24-2.23)] at baseline was also associated with increased risk of AMS. Conclusions: The incidence of AMS is relatively low in grid construction workers working on plateau. The risk factors of AMS included higher working altitude, lower altitude of the residence place in early-life and oxygen saturation<75%.

[How to report adaptive design randomized trials-A interpretation of international reporting guideline ACE].

Concerns has been raised in improving the quality of adaptive design randomized trials reports. Based on the CONSORT 2010 (Consolidated Standards of Reporting Trials), The Adaptive designs CONSORT Extension (ACE) has developed items and reporting specifications for adaptive design trials. This paper presents a brief explanation of the extension and new items of ACE and introduces the applications of ACE checklist with examples.

The Diagnostic Value of Serum ST8SIA6-AS1 as Biomarker in Hepatocellular Carcinoma.

BACKGROUND: Long noncoding RNA (lncRNA) is a promising serum biomarker in cancer diagnosis. However, literature on the diagnostic value of the lncRNA for hepatocellular carcinoma (HCC) is scant. METHODS: The expression of ST8SIA6-AS1 in serum and HCC cell lines was detected by real-time PCR (RT-PCR). We then analyzed the relationship between clinicopathological characteristics and serum ST8SIA6-AS1 expression. In addition, we performed the receiver operating characteristic (ROC) curve and area under curve (AUC) analyses to determine the diagnostic ability of serum ST8SIA6-AS1. RESULTS: Our data demonstrated an up-regulation of ST8SIA6-AS1 in 77 HCC patients and HCC cell lines. Besides, clinicopathological analysis revealed that ST8SIA6-AS1 corresponds with tumor stages and metastasis, thus might be used for monitoring the HCC progress. Importantly, the ROC analysis demonstrated that ST8SIA6-AS1 yields a superior diagnostic ability. Compared with α-fetoprotein (AFP) alone, a combination of ST8SIA6-AS1 and AFP may achieve more reliable diagnostic results. CONCLUSIONS: Together, our results demonstrate that serum ST8SIA6-AS1 is a promising serum diagnostic bio-marker for HCC.

[Clinical observation of three-dimensional printing donor tooth model in peri-operative period of autotransplantation of tooth].

Objective: To prepare a three-dimensional (3D) printing donor tooth model and to observe its application in the peri-operative period. Methods: In part one, 192 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ï¼»107 males and 85 females, age (34.2±10.7) yearsï¼½ which need autotransplantation of teeth (ATT) were collected. Whether the donor teeth can be completely extracted was predicted through clinical and imaging examination (first prediction). The second prediction was supplemented by the three-dimensional printing model of the donor teeth. Each of the prediction was compared with the actual results and the coincidence rate was calculated. In part two, 64 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ï¼»28 males, 36 females, age (30.2±8.3) yearsï¼½ which need ATT were randomly divided into the model group and the donor group. The time of alveolar fossa preparation, time of donor tooth in vitro, times of trial implantation and time of pulptomy and root canal location were recorded respectively. Results: In part one, the coincidence rate between the second prediction and the actual results ï¼»97.4%(187/192)ï¼½ was significantly higher than that of the first prediction ï¼»93.2%(179/192)ï¼½ (P<0.05). In part two, the preparation time of the alveolar fossa in the maxillary and mandibular were (18.8±4.6) and (22.7±3.4) min, the time of the teeth in vitro were (3.0±0.6) and (2.1±0.6) min, the times of trial implantation were (1.3±0.8) and (1.0±0.9), and the time of pulpotomy and root canal location were (4.3±0.6) and (4.0±0.5) min. All values in the model groups were better than those in the donor group (P<0.05). Conclusions: The 3D printing model is accurate. It can be used in autogenous tooth transplantation to shorten the preparation time of alveolar fossa and time of donor tooth in vitro, and reduce the times of trial implantation of donor teeth, and to help to improve the prediction accuracy of complete extraction of donor teeth and the time of pulpotomy and root canal location.

Dermatitis caused by Paederus fuscipes Curtis, 1840 (Coleoptera: Staphilinidae) in student hostels in Selangor, Malaysia.

We report a series of dermatitis cases caused by the staphilinid beetles, Paederusfuscipes Curtis, among university students staying in the residential college in Puncak Alam, Selangor, Malaysia from 1 January to 31 December 2010. A total of 360 cases (6.0%) were recorded in the Student Health Center throughout the year; the majority of patients stayed at a hostel near an oil palm plantation. Skin symptoms included erythema, edema, vesicular papules, painful blisters, burning sensation, pruritus, hyper pigmentation and peeling of skin. The commonly involved sites were the face, neck, shoulders and arms. Most students noticed the symptoms upon awakening in the morning. The patients were treated with fusidic acid cream and the symptoms resolved within 5 days. These beetles are nocturnally active and enter the room whenever a light source is available. The unintentional crushing of these beetles during sleep causes the release of its hemolymph (paederin) which is the cause of the dermatitis.

Application of nerve growth factor by gel increases formation of bone in mandibular distraction osteogenesis in rabbits.

The long period of bony consolidation is a concern in mandibular distraction osteogenesis (DO). We have previously shown that repeated local injections of human nerve growth factor beta (NGFß) can appreciably improve bony consolidation in a rabbit model of DO. The present study was designed to test the effect of a single injection of human NGFß delivered by collagen/nano-hydroxyapatite/kappa-carrageenan gels to sites of new bony formation in DO. Rabbits underwent mandibular DO at a rate of 0.75 mm/12h for 6 days. At the end of the distraction period, the following injections were given percutaneously into the callus (n=6 in each of the four groups): human NGFß in the gel; human NGFß in saline; the gels alone; and saline alone. Fourteen days after the end of distraction, mechanical testing, histological and histomorphometric variables of the new bone were evaluated. Histologically, the NGFß group had more advanced consolidation than the other three groups. Both maximal load and bone volume/total volume in this group were significantly higher than in the other three (P<0.05). In conclusion, the delivery of human NGFß in the gels results in better acceleration of new bone formation than when it is given in saline, and may be a possible way to shorten the duration of craniofacial DO.

Chronic ethanol-induced myocardial protection requires activation of mitochondrial K(ATP) channels.

Moderate alcohol consumption protects against coronary heart disease by unclear mechanisms. We tested whether chronic ethanol preconditioning requires activation of mitochondrial K(ATP)channels. Rats were fed 18% (v/v) ethanol in drinking water for 10 months. Blood alcohol levels at sacrifice were 3 mmol/l (0.015 gram percent). Isolated crystalloid-perfused hearts were subjected to global ischemia and reperfusion on a modified Langendorff apparatus. Prior alcohol exposure doubled the recovery of LVDP during reperfusion (45+/-5%v 20+/-3% of baseline for controls, n=6, P<0.01) and blunted the rise in LVEDP (3.5+/-0.5 v 5.5+/-0.4 times baseline for controls, n=6, P<0.01). Ethanol feeding also reduced creatine kinase release during reperfusion. Inhibition of mitochondrial K(ATP)channels with 5-hydroxydecanoate had no effect on baseline LVDP, LVEDP, or coronary flow but abolished the beneficial effects of alcohol on LV contractile recovery and myocyte necrosis. We conclude that mitochondrial K(ATP)channel activity is required for chronic ethanol-induced protection.

Pattern of morphological diversification in the Leptocarabus ground beetles (Coleoptera: Carabidae) as deduced from mitochondrial ND5 gene and nuclear 28S rDNA sequences.

Most of the mitochondrial NADH dehydrogenase subunit 5 (ND5) gene and a part of nuclear 28S ribosomal RNA gene were sequenced for 14 species of ground beetles belonging to the genus Leptocarabus. In both the ND5 and the 28S rDNA phylogenetic trees of Leptocarabus, three major lineages were recognized: (1) L. marcilhaci/L. yokoael/Leptocarabus sp. from China, (2) L. koreanus/L. truncaticollis/L. seishinensis/L. semiopacus/L. canaliculatus/L. kurilensis from the northern Eurasian continent including Korea and Hokkaido, Japan, and (3) all of the Japanese species except L. kurilensis. Clustering of the species in the trees is largely linked to their geographic distribution and does not correlate with morphological characters. The species belonging to different species groups are clustered in the same lineages, and those in the same species group are scattered among the different lineages. One of the possible interpretations of the present results would be that morphological transformations independently took place in the different lineages, sometimes with accompanying parallel morphological evolution, resulting in the occurrence of the morphological species belonging to the same species group (= type) in the different lineages.

Respiratory syncytial virus that lacks open reading frame 2 of the M2 gene (M2-2) has altered growth characteristics and is attenuated in rodents.

The M2 gene of respiratory syncytial virus (RSV) encodes two putative proteins: M2-1 and M2-2; both are believed to be involved in the RNA transcription or replication process. To understand the function of the M2-2 protein in virus replication, we deleted the majority of the M2-2 open reading frame from an infectious cDNA clone derived from the human RSV A2 strain. Transfection of HEp-2 cells with the cDNA clone containing the M2-2 deletion, together with plasmids that encoded the RSV N, P, and L proteins, produced a recombinant RSV that lacked the M2-2 protein (rA2DeltaM2-2). Recombinant virus rA2DeltaM2-2 was recovered and characterized. The levels of viral mRNA expression for 10 RSV genes examined were unchanged in cells infected with rA2DeltaM2-2, except that a shorter M2 mRNA was detected. However, the ratio of viral genomic or antigenomic RNA to mRNA was reduced in rA2DeltaM2-2-infected cells. By use of an antibody directed against the bacterially expressed M2-2 protein, the putative M2-2 protein was detected in cells infected with wild-type RSV but not in cells infected with rA2DeltaM2-2. rA2DeltaM2-2 displayed a small-plaque morphology and grew much more slowly than wild-type RSV in HEp-2 cells. In infected Vero cells, rA2DeltaM2-2 exhibited very large syncytium formation compared to that of wild-type recombinant RSV. rA2DeltaM2-2 appeared to be a host range mutant, since it replicated poorly in HEp-2, HeLa, and MRC5 cells but replicated efficiently in Vero and LLC-MK2 cells. Replication of rA2DeltaM2-2 in the upper and lower respiratory tracts of mice and cotton rats was highly restricted. Despite its attenuated replication in rodents, rA2DeltaM2-2 was able to provide protection against challenge with wild-type RSV A2. The genotype and phenotype of the M2-2 deletion mutant were stably maintained after extensive in vitro passages. The attenuated phenotype of rA2DeltaM2-2 suggested that rA2DeltaM2-2 may be a potential candidate for use as a live attenuated vaccine.

Chronic dipyridamole therapy produces sustained protection against cardiac ischemia-reperfusion injury.

Sustained protection against ischemia-reperfusion injury is not available for patients at risk for myocardial infarction who may require emergent reperfusion therapy. Whereas ischemic preconditioning and adenosinergic agents reduce myocardial injury, they are only effective when given immediately before ischemia or reperfusion. We recently found chronic ethanol exposure, an adenosine uptake inhibitor, produced sustained cardioprotection against ischemia-reperfusion injury. We now ask whether chronic dipyridamole therapy, a clinically usable nucleoside transport inhibitor, induces similar cardioprotection. Perfused hearts from guinea pigs, given dipyridamole (4 mg. kg(-1). day(-1)) in their water for 2-6 wk (n = 10 for each group), underwent ischemia-reperfusion. Injury was assessed by recovery of left ventricular developed (LVDP) and end-diastolic (LVEDP) pressures and creatine kinase release. During reperfusion, hearts from dipyridamole-treated animals (6 wk) had 74% higher LVDP, 28% lower LVEDP, and 61% lower creatine kinase release versus controls. Adenosine A(1)-receptor antagonism (8-cyclopentyl-1, 3-dipropylxanthine; 200 nM) abolished the protection of dipyridamole but A(2) antagonism (3,7-dimethyl-1-propargylxanthine; 10 mM) did not. Dipyridamole therapy produces sustained protection against ischemia-reperfusion injury in guinea pigs. This cardioprotection requires adenosine A(1) receptor signaling at the time of ischemia.

Sustained in vivo cardiac protection by a rationally designed peptide that causes epsilon protein kinase C translocation.

Brief periods of cardiac ischemia trigger protection from subsequent prolonged ischemia (preconditioning). epsilon Protein kinase C (epsilonPKC) has been suggested to mediate preconditioning. Here, we describe an epsilonPKC-selective agonist octapeptide, psiepsilon receptor for activated C-kinase (psiepsilonRACK), derived from an epsilonPKC sequence homologous to its anchoring protein, epsilonRACK. Introduction of psiepsilonRACK into isolated cardiomyocytes, or its postnatal expression as a transgene in mouse hearts, increased epsilonPKC translocation and caused cardio-protection from ischemia without any deleterious effects. Our data demonstrate that epsilonPKC activation is required for protection from ischemic insult and suggest that small molecules that mimic this epsilonPKC agonist octapeptide provide a powerful therapeutic approach to protect hearts at risk for ischemia.

[SPE analysis of 4 rodenticides in whole blood and liver by HPLC].

A solid phase extraction (SPE) method has been developed for the analysis of 4 rodenticides: warfarin, couatetralyl, bromadiolone and brodifacoum, using reverse phase high performance liquid chromatograph (HPLC) as determination system. The recovery is 62.6-90.0% (RSD5.1-7.8%) and 37.5-67.7% (RSD5.4%-12.8%) in whole blood and liver sample respectively. The procedure is simple and stable. And the method was confirmed to be effective in the animal experiment.

Recombinant human respiratory syncytial virus (RSV) from cDNA and construction of subgroup A and B chimeric RSV.

Infectious human respiratory syncytial virus (RSV) was produced from a cDNA clone that contains 15,222 nucleotides of RSV genome derived from the A2 strain of subgroup A. Recovery of infectious RSV from cDNA required cotransfection of only three expression plasmids encoding the nucleoprotein (N), the phosphoprotein (P), and the major polymerase protein (L). Inclusion of the M2-1 plasmid was not required in the transfection reaction and if included did not significantly increase the rescue efficiency. However, a single nucleotide substitution in the RSV leader region (C to G at position 4 in the antigenomic sense), greatly increased the amount of infectious virus recovered from cDNA. A recombinant RSVA2 virus that expresses an additional structural G protein derived from a subgroup B RSV was also obtained. Both A2 and B strain G glycoproteins were expressed in cells infected with the chimeric RSV. A chimeric RSV that expresses a heterologous subgroup antigen in a live attenuated vaccine candidate may be important for prevention of diseases associated with both RSV subgroup A and subgroup B infection.

Alcohol consumption reduces ischemia-reperfusion injury by species-specific signaling in guinea pigs and rats.

We recently discovered that regular alcohol consumption reduces ischemia-reperfusion injury to the same degree as ischemic preconditioning in guinea pig hearts. Ischemic preconditioning, like this cardioprotective effect of alcohol, is mediated by adenosine signaling in guinea pigs. In rats, ischemic preconditioning may be mediated predominantly by alpha1-adrenergic signaling. To be certain that this protective effect of alcohol is a general biological response, we searched for alcohol's cardioprotection in rat and identified a potential signaling mechanism. Hearts isolated from alcohol-fed guinea pigs and rats were subjected to ischemia-reperfusion. Hearts from alcohol-fed animals showed greater recovery of left ventricular developed pressure than controls (guinea pigs, 46 vs. 29%; rats, 50 vs. 31%) and decreased myocyte necrosis assessed by creatine kinase release (guinea pigs, 204 +/- 42 vs. 440 +/- 70 U . ml-1 . g dry wt-1; rats 158 +/- 13 vs. 328 +/- 31 U . ml-1 . g dry wt-1). Adenosine receptor blockade [8-(p-sulfophenyl)theophylline] abolished alcohol's protection in guinea pig but not rat hearts. By contrast, alpha1-adrenergic blockade (prazosin) abolished alcohol's protection in rat but not guinea pig hearts. We conclude that regular alcohol consumption reduces ischemia-reperfusion injury and is mediated by species-specific signaling mechanisms. A major goal of cardiovascular research is to find a pharmacologically induced chronic state of preconditioning. Understanding the mechanisms of alcohol's cardioprotection against ischemia-reperfusion injury may aid in reaching this goal.

Inorganic phosphate and coronary perfusion pressure mediate contractile dysfunction during mild ischemia.

During mild graded ischemia in perfused rat hearts, we (V.M. Figueredo, R. Brandes, M. W. Weiner, B. M. Massie, and S. A. Camacho. J. Clin. Invest 90: 1794-1802, 1992) previously found a relationship between decreased left ventricular developed pressure (LVDP) and increased Pi, in which intracellular pH, cytosolic Ca2+ concentration ([Ca2+]i), ATP, and free-energy change of ATP hydrolysis were not altered enough to affect contractility. However, the contribution of decreased coronary perfusion pressure (CPP) to decreased LVDP could not be determined. Thus, in the present study, graded hypoxia in perfused rat hearts (95-37.5% O2) was used to increase Pi to similar levels produced during mild ischemia without altering CPP and minimizing changes of other potential mediators of contractile dysfunction. 31P-magnetic resonance spectroscopy and indo 1 fluorescence were used to assess energy metabolites and [Ca2+]i, respectively. The relationship between LVDP and Pi during graded hypoxia was fit to a monoexponential (LVDP = 105 x e-0.04Pi). These data were compared with the relationship of LVDP and Pi during mild ischemia (LVDP = 106 x e-0.08Pi) (V. M. Figueredo, R. Brandes, M. W. Weiner, B. M. Massie, and S. A. Camacho. J. Clin. Invest 90: 1794-1802, 1992). The exponential constant, which describes the effect of Pi on LVDP, was 50% lower during graded hypoxia relative to mild ischemia. This suggests that another mediator, which accounted for approximately 50% of the decrease of LVDP during mild ischemia, was not present during hypoxia. Because CPP decreased during ischemia but not hypoxia, these data suggest that CPP and Pi contribute similarly in mediating contractile dysfunction during mild ischemia.

[The exciting origin of guinea-pig inferior mesenteric ganglion neurons in vivo].

Intracellular recording in vivo showed that spontaneous activities of guinea-pig inferior mesenteric ganglion (IMG) neurons were inhibited when any one of the four groups of the nerves connected to the IMG was cutted or blocked, indicating that all the four groups of nerves sent in excitatory input. Colonic and hypogastric nerves convey the peripheral excitation respectively from colon and bladder. Intermesenteric nerve sends in peripheral excitatory input from colon and central from spinal cord. This finding suggests that the excitation of the prevertebral ganglia originates from not only spinal cord as claimed tranditionally, but also the peripheral organs. The latter exits stronger effect than the former. It seems that IMG is an integration neurocenter rather than a simple signal relay station from the central nervous system to peripheral effectors.

Determination of tetramine in postmortem specimens by GC-NPD.

A method for the determination of tetramine in postmortem specimens is reported. Tetramine is an organosulfur rodenticide. Parathion, an organophosphorous insecticide, was adopted as the internal standard. Both were extracted from biological materials by benzene and purified by an aluminum oxide column. The extract was analyzed by a gas chromatograph equipped with a nitrogen-phosphorous detector. The extraction efficiency was greater than 90%, and the limit of detection was 0.05 microgram/g for the liver. The standard curve was linear in the range 0.5-50 micrograms/g for the liver, and the correlation coefficient was equal to 0.9993.