Incidence and risk factors of postoperative delirium after pancreatic cancer surgery: a retrospective study.

PURPOSE: Postoperative delirium (POD) commonly occurs after major abdominal surgery and is associated with increased morbidity and mortality. There have been many studies on the relationship between POD and various surgeries, but research on POD after pancreatic cancer surgery is limited. The aim of this study was to identify the incidence and risk factors of POD after pancreatic cancer surgery. METHODS: The subjects of this retrospective analysis were 196 patients who were transferred for postoperative care after pancreatic cancer surgery, to a 12-bed critical care medicine ward at Shandong Provincial Hospital, affiliated with Shandong First Medical University, between January 2015 and December 2019. The patients were divided according to whether they suffered POD into a delirium group and a non-delirium group. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit and two independent medical practitioners analyzed all the data. Univariate and multiple logistic regression analyses were performed. RESULTS: The overall delirium incidence was 20.41%, which increased to 29.03% for patients aged ≥ 70 years. POD was associated with age, smoking, the American Society of Anesthesiologists classification, the Acute Physiology and Chronic Health Evaluation II score, and the TNM stage of the cancer. The variables concerning sex, drinking, hypertension, a history of cerebral disease, surgery type, operation time, amount of bleeding, and the intraoperative use of dexmedetomidine did not differ significantly between the two groups. There was no significant difference in the length of ICU stay, with the exclusion of long-term stay for complications, between the groups, but POD tended to prolong the postoperative hospital stay and increase the risk of mortality. There was also a gradual decline in the incidence of POD between 2015 and 2019, especially from 2015 to 2018, after preventive measures were implemented. CONCLUSION: POD is related to many risk factors and worthy of attention. Appropriate management can reduce its incidence or at least shorten its duration.

17 alpha-hydroxylase deficiency: A case report of young Chinese woman with a rare gene mutation.

We report a young adult woman with 17 alpha-hydroxylase deficiency (17α-OHD) in Shandong province of China. The patient carried compound heterozygous mutations in the CYP17A1 gene: c.985-987 delinsAA (p.Tyr329LysfsX90) and c.1486C > T (p.Arg496Cys). The patient's hypertension and hypokalemia were resolved after taking medications of glucocorticoid, aldactone, and calcium antagonists.

The influence of sedentary behaviour on mental health among children and adolescents: A systematic review and meta-analysis of longitudinal studies.

BACKGROUND: Systematic reviews that have examined associations between sedentary behaviour (SB) and mental health among children and adolescents are mainly based on cross-sectional investigations. There is a lack of evidence for a prospective relationship between SB and mental health in children and adolescents. This systematic review synthesized longitudinal studies that examined prospective associations between SB and mental health among children and adolescents. METHODS: We conducted computer searches for English language literature from electronic databases of PubMed, Embase, PsycInfo and Google scholar, and manually screened the references of existing relevant studies to select studies for the synthesis. We included observational longitudinal studies that assessed the association between SB and mental health among children and adolescents. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: In total, 58 longitudinal studies met the inclusion criteria and were synthesized in the review. We found that higher SB among children and adolescents was associated with increased depression, anxiety and other mental health problems later in life. A dose-response association between SB and mental health was observed, suggesting that children and adolescents who spend more time on SB may have a higher risk of developing poorer mental health later. CONCLUSIONS: The findings in the present study suggest that intervention programs targeting reducing SB may benefit to the prevention of poor mental health among children and adolescents. Future intervention studies especially randomized controlled trials are needed to elucidate a causal relationship between SB and mental health among children and adolescents.

The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review.

BACKGROUND: The association between physical activity, sedentary behavior and health-related quality of life in children and adolescents has been mostly investigated in those young people with chronic disease conditions. No systematic review to date has synthesized the relationship between physical activity, sedentary behavior and health-related quality of life in the general healthy population of children and adolescents. The purpose of this study was to review systematically the existing literature that evaluated the relations between physical activity, sedentary behavior and health-related quality of life in the general population of children and adolescents. METHODS: We conducted a computer search for English language literature from databases of MEDLINE, EMBASE, PSYCINFO and PubMed-related articles as well as the reference lists of existing literature between 1946 and the second week of January 2017 to retrieve eligible studies. We included the studies that assessed associations between physical activity and/or sedentary behavior and health-related quality of life among the general population of children and adolescents aged between 3-18 years. The study design included cross-sectional, longitudinal and health intervention studies. We excluded the studies that examined associations between physical activity, sedentary behavior and health-related quality of life among children and adolescents with specific chronic diseases, and other studies and reports including reviews, meta-analyses, study protocols, comments, letters, case reports and guidelines. We followed up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement in the reporting of this review. The risk of bias of the primary studies was assessed by the Newcastle-Ottawa Scale. We synthesized the difference in health-related quality of life scores between different levels of physical activity and sedentary time. RESULTS: In total, 31 studies met the inclusion criteria and were synthesized in the review. Most of the included studies used a cross-sectional design (n = 21). There were six longitudinal studies and three school-based physical activity intervention studies. One study used both cross-sectional and longitudinal designs. We found that higher levels of physical activity were associated with better health-related quality of life and increased time of sedentary behavior was linked to lower health-related quality of life among children and adolescents. A dose-response relation between physical activity, sedentary behavior and health-related quality of life was observed in several studies suggesting that the higher frequency of physical activity or the less time being sedentary, the better the health-related quality of life. CONCLUSIONS: The findings in this study suggest that school health programs promoting active lifestyles among children and adolescents may contribute to the improvement of health-related quality of life. Future research is needed to extend studies on longitudinal relationships between physical activity, sedentary behavior and health-related quality of life, and on effects of physical activity interventions on health-related quality of life among children and youth.

[Atmospheric Pollutant Emission Characteristics from the Cooking Process of Traditional Beijing Roast Duck].

As one of the characteristics of traditional food in Beijing, there is a significant difference between roast duck and other foods in the cooking process, in that fruit trees are used as fuel in the former. However, system research about the emission characteristics of this food source has not been done domestically. In order to grasp such food source emission characteristics and provide technical basis for pollution control, we selected the representative roast duck restaurant in Beijing and studied the emission characteristics of atmospheric pollutants in the cooking process of roast duck. The results showed that the emission concentrations of cooking fumes, particulate matter, volatile organic compounds (VOCs), and aldehyde and ketone compounds were (0.74±0.45), (15.32±7.93), (7.60±3.41), and (1.22±0.59) mg·m-3, respectively. The emission concentration of particulate matter was much higher than that of cooking fumes. The VOC component composition was very complex, containing alkanes, alkenes, aromatic hydrocarbons, and oxygen VOCs, such as aldehydes, ketones, alcohols, ester compounds, and halogenated hydrocarbons, with the highest concentrations of 3-methylfuran, ethanol, and methyl acetate. The main components of aldehyde and ketone compounds were acetaldehyde, formaldehyde, and acrolein, of which C1-C3 compounds were 72.27%.

[Characteristics of C2-C6 Hydrocarbons During the Winter Air Pollution Period in Beijing Urban Area].

A C2-C6 hydrocarbons monitoring campaign was carried out in the Beijing Southeastern Urban Area during December 2015. Twenty-five compounds excluding benzene were detected by an on-line VOCs analyzer; the sum of their concentrations is referred to as C2-C6 HCs in this study. During the monitoring period, C2-C6 HCs ranged from 12.4×10-9 to 297.5×10-9. The mean value of C2-C6 HCs reached 29.4×10-9, 63.2×10-9, 85.5×10-9, 94.9×10-9, and 131.8×10-9, respectively, in AQ Ⅰ (air quality) (hourly PM2.5<35 µg·m-3), AQ Ⅱ (hourly PM2.5:35-75 µg·m-3), AQ Ⅲ (hourly PM2.5:75-150 µg·m-3), AQ Ⅳ (hourly PM2.5:150-250 µg·m-3), and AQ Ⅴ (hourly PM2.5:>250 µg·m-3). Moreover, the mole percentage of alkanes, alkenes, and ethyne significantly varied, 47% vs. 59%, 45% vs. 30%, and 7% vs. 12% (AQ I vs. AQ V). The diurnal variation of C2-C6 HCs presented two peaks at 08:00-09:00 and 17:00-18:00 not only in clean days (when 24-h PM2.5<75 µg·m-3) but also in polluted days (when 24-h PM2.5>75 µg·m-3). This result is consistent with the normal traffic pattern and indicates the significant impact of vehicle emissions on atmospheric hydrocarbon concentrations. Furthermore, we calculated the HCs/CO (×10-9/×10-6) ratio to prevent the impact of meteorological diffusion on C2-C6 HCs and to trace the physical transport process and the chemical degradation process of hydrocarbons. The C2-C6 HCs/CO ratio and the individual hydrocarbon to CO ratio presented a notable decreasing trend with worsening air quality, 90.6 (AQ Ⅰ), 63.8 (AQ Ⅱ), 56.9 (AQ Ⅲ), 37.4 (AQ Ⅳ), and 36.4 (AQ Ⅴ). However, the rate of decrease in the ratio of individual hydrocarbons to CO in the polluted period (AQ Ⅲ-Ⅴ) relative to the clean period (AQ I-Ⅱ) was never effectively related to the kinetic parameters of the reactions with the OH radical. Therefore, the strong chemical degradation of C2-C6 hydrocarbons in the polluted air was denied as the main reason. The HYSPLIT trajectory model showed that the transported air mass from the north and northwest and from the south and southwest prevail in the clean period and in the polluted period, respectively. Compared to the northern region, there were more sources of fossil fuel combustion in the southern region, which led to a lower HCs/CO ratio for the air mass in the southern region. Therefore, the increase in C2-C6 hydrocarbons during the polluted period was not only caused by the accumulation of local emissions but also by the air mass transport from the south.

[Precipitation and Its Effects on Atmospheric Pollutants in a Representative Region of Beijing in Summer].

Atmospheric precipitation samples were collected in a representative region of Beijing in summer of 2015 to investigate the physical and chemical characteristics of atmospheric precipitation, the changes and causes of major chemical components in rainwater during the course of typical precipitation, and the impacts of typical precipitation processes on atmospheric pollutants. The volume-weighted mean pH value of rainwater in the representative region of Beijing in summer was 6.21 with the range of 5.15-7.34,and acid rain seldom occurred. The pollution elements Cd, Ca and Mn were moderately enriched, and Cu, Zn, Pb and S were seriously enriched in rainwater, of which Ca and S were main pollution elements, which accounted for 45.43% and 43.93% of the total pollution elements respectively, and Zn, Mn, Cu, Pb and Cd were main heavy metal pollution elements, which accounted for 1.32% of the total pollution elements. Different rates of precipitations could have different impacts on atmospheric pollutants. PM2.5 could be scavenged by raindrop, and SO2, NO2 and O3 could be scavenged greatly by raindrop during the precipitation episode at a relatively high rainfall rate, containing four significant stages, such as clear-out of atmospheric pollutants, accumulation, both accumulation and clear-out, and another clear-out of airborne pollutants. Atmospheric pollutants such as PM2.5, SO2, NO2 and O3 could mainly be scavenged by in-cloud scavenging processes during the precipitation episode at a relatively low rainfall rate, including four important stages, such as clear-out, both clear-out and accumulation, accumulation, and another clear-out of atmospheric pollutants. The effect of rainfall at a relatively high rate on atmospheric pollutants was bigger than that of rainfall at a relatively low rate.

[Finite element analysis of the angulation designment of implant planning in the anterior maxilla].

PURPOSE: To provide theoretical reference for maxillary anterior restoration designment in clinics by observing the masticatory stress distribution of the implant-bone interface and the displacement of implant. METHODS: This study built simplified 3 dimensional finite models with different angles, which included partial implant (4.3 mm×11.5 mm), abutment and all ceramic crown (Zirconia) and combined with angle of implant A between the long axis of ideal implant and factual implant (0°, 5°, 10°, 15°, 20°, 25°), as well as angle of abutment B between the long axis of abutment and implant (0°, 5°,10°,15°,20°,25°). A force load of 178 N was applied 2 mm below the incisal edge on the palatal surface of the crown, with an approximately 130° angle to the long axis of the crown. The displacement of implant maximum principal stress value and distribution of the implant-bone interface were determined by using Ansys 13.0 software. RESULTS: Sixteen 3-dimensional models of different implant restoration plan of implant dentures of maxillary incisor were built. When the angle of abutment was increasing with the same labial inclination of implant, the objective functions were enhanced. When the labial inclination of implant was increasing with the same angle of abutment, the objective functions were also improved. With the change of labial inclination of implant and angled abutment, the labial inclination of implant concentrated more than the angle of abutment on the objective functions. When the angle of abutment was between 0 degree and 20 degree, the amplitude of all the objective functions were gentle, while the labial inclination of implant and amplitude of all the objective functions were increased when the angle of abutment increased to 25 degree. CONCLUSIONS: A positive correlation is found between the value of stress of the bone around the implant, and the displacement of implant and the labial inclination of the implant and the angle of abutment. It is necessary to decrease the labial inclination of the implant and the angle of abutment, especially strictly control the labial inclination of the implant. Taking the stress and displacement into consideration, both of two angles ranging from 0 degree to 20 degree are the best optimal choice for the anterior implants. When both of two angles increase to much greater than 20 degree, the value of stress increase remarkably, which will decrease the chance of successful implant.

Prognostic significance of preoperative lymphocyte-monocyte ratio in patients with resectable esophageal squamous cell carcinoma.

BACKGROUND: The interaction between tumor cells and inflammatory cells has not been systematically investigated in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to evaluate whether preoperative the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) could predict the prognosis of ESCC patients undergoing esophagectomy. MATERIALS AND METHODS: Records from 218 patients with histologically diagnosed ESCC who underwent attempted curative surgery from January 2007 to December 2008 were retrospectively reviewed. Besides clinicopathological prognostic factors, we evaluated the prognostic value of the LMR, the NLR, and the PLR using Kaplan-Meier curves and Cox regression models. RESULTS: The median follow-up was 38.6 months (range 3-71 months). The cut-off values of 2.57 for the LMR, 2.60 for the NLR and 244 for the PLR were chosen as optimal to discriminate between survival and death by applying receiver operating curve (ROC) analysis. Kaplan-Meier survival analysis of patients with low preoperative LMR demonstrated a significant worse prognosis for DFS (p=0.004) and OS (p=0.002) than those with high preoperative LMR. The high NLR cohort had lower DFS (p=0.004) and OS (p=0.011). Marginally reduced DFS (p=0.068) and lower OS (p=0.039) were found in the high PLR cohort. On multivariate analysis, only preoperative LMR was an independent prognostic factor for both DFS (p=0.009, HR=1.639, 95% CI 1.129-2.381) and OS (p=0.004, HR=1.759, 95% CI 1.201-2.576) in ESCC patients. CONCLUSIONS: Preoperative LMR better predicts cancer survival compared with the cellular components of systemic inflammation in patients with ESCC undergoing esophagectomy.

[Determination of arsenic speciation in Scomberomorus niphonius by capillary electrophoresis-inductively coupled plasma mass spectrometry].

A method for the detection of arsenocholine (AsC), arsenobetaine (AsB), As(III), dimethylarsinic (DMA), monomethylarsonic (MMA) and As (V) by capillary electrophoresis-inductively coupled plasma mass spectrometry (CE-ICP-MS) was established. The results showed that the six species of arsenic were separated within 20 min under the optimized conditions. Good linearities of 6 arsenic species were observed in the range from 2 to 50 µg x L(-1) with the linear correlation greater than 0.996, the detection limits were 0.10-1.08 µg x L(-1) and the RSDs (n = 5) of the peak areas were smaller than 7%. The method was successfully adopted to the determination of the species in Scomberomorus niphonius. The recoveries were between 93% and 98%, and we found the arsenobetaine (AsB) was the main species in the sample. The method was suitable for the analysis of other biological samples with the advantages of good stability, less sample consumption, short analysis time and convenience.

E-cadherin promotes proliferation of human ovarian cancer cells in vitro via activating MEK/ERK pathway.

AIM: E-cadherin is unusually highly expressed in most ovarian cancers. This study was designed to investigate the roles of E-cadherin in the carcinogenesis and progression of ovarian cancers. METHODS: Human ovarian adenocarcinoma cell line SKOV-3 was examined. E-cadherin gene CDH1 in SKOV-3 cells was knocked down via RNA interference (RNAi), and the resultant variation of biological behavior was observed using CCK-8 and colony formation experiment. E-cadherin-mediated Ca(2+)-dependent cell-cell adhesion was used to study the mechanisms underlying the effects of E-cadherin on the proliferation and survival of SKOV-3 cells. The expression levels of E-cadherin, extracellular signal-related kinase (ERK), phosphorylated ERK (P-ERK) were measured using Western blot assays. RESULTS: Transfection with CDH1-siRNA for 24-96 h significantly suppressed the growth and proliferation of SKOV-3 cells. E-cadherin-mediated calcium-dependent cell-cell adhesion of SKOV-3 cells resulted in a rapid increase of P-ERK, but did not modify the expression of ERK protein. The phosphorylation of ERK in the cells was blocked by pretreatment with the MEK1 specific inhibitor PD98059 (50 µmol/L), but not by the PI3K inhibitor wortmannin (1 µmol/L) or PKA inhibitor H89 (10 µmol/L). CONCLUSION: E-cadherin may function as a tumor proliferation enhancer via activating the MEK/ERK pathway in development of ovarian epithelial cancers.

[Histologic analysis and long-term effect of acellular dermal matrix combined with autologous thin split-thickness skin graft].

OBJECTIVE: To evaluate the long-term therapeutic effect and histologic result of ADM combined with autologous thin split-thickness skin graft. METHODS: 23 patients were treated with acellular dermal matrix (ADM) combined with autologous thin split-thickness skin graft. The patients were followed up at 3, 6, 12, and 18 months after operation. The histological analysis was also performed. RESULTS: 3, 6, 12, 18 months after operation, the composite skin grafts became smooth with no hypertrophic scar and hyperpigmentation. It was soft and elastic. The joints could move randomly. The histologic study showed the composite skin graft had a similar appearance as the normal skin. CONCLUSION: As for the treatment of wound, the composite skin graft with ADM is smooth and soft with good elasticity after transplantation, but it has no perspiration.

[Characteristics of re-suspended road dust and its significant effect on the airborne particulate pollution in Beijing].

The re-suspended road dust samples from 53 sites that could cover basically the entire Beijing in summer, and aerosol samples from three representative sites in Beijing in four seasons were collected to study concentrations and spatial variations of elements and ions in resuspended road dust and its contribution to the air-borne particulate pollution. Ca, S, Cu, Zn, Ni, Pb and Cd were main pollution elements, and Ca2+, SO4(2-), Cl-, K+, Na+ and NO3- were major ions in re-suspended road dust. Al, Ti, Sc, Co and Mg in re-suspended road dust were mainly originated from crustal source, while Cu, Zn, Ni and Pb were mainly originated from traffic emissions and coal burning, and Fe, Mn and Cd were mainly from industrial emissions and coal combustion. Ca2+ and SO4(2-) mainly came from construction activities, construction materials and secondary gas-particle conversions, Cl- and Na+ were derived from industrial wastewater disposal and chemical industrial emissions, and NO3- and K+ were from vehicle emissions, photochemical reactions of NO,, biomass and vegetable burning. The contribution of mineral aerosol from inside Beijing to the total mineral aerosols was 30% in spring of 2002, 70% in summer of 2002, 80% in autumn of 2003, 20% in winter of 2002. The pollution levels of some major pollution species, Ca, S, Cu, Zn, Ni, Pb, Fe, Mn, and Cd in resuspended road dust reached 76%, 87%, 75%, 80%, 82%, 90%, 45%, 51%, and 94%, respectively, and their contributions to the related elements in PM10 were 20%-45%, 5%-18%, 4%-50%, 2%-46%, 4%-52%, 5%-20%, 30%-60%, 20%-40% and 2%-25%. Re-suspended road dust from the traffic and construction activities is one of the major sources of the air-born particulate pollution in Beijing.

Blockade of TRAIL pathway ameliorates HBV-induced hepatocyte apoptosis in an acute hepatitis model.

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) may play important roles during hepatitis B virus (HBV) infection. In this study, we used a recombinant human soluble death receptor 5 (sDR5) to explore its effect in a mouse model of HBV-induced acute hepatitis. By measuring blood transaminase activity and hepatocyte apoptosis, we found that sDR5 could alleviate liver damage by blocking TRAIL-induced apoptosis of HBV-transfected hepatocytes. sDR5 injection at 16 mg/kg 24h before HBV transfection was the most effective. Additionally, we showed that sDR5 was equally effective in protecting liver injury as the Stronger Neo-Minophagen C (SNMC), a commonly used drug for patients with liver diseases. Thus, sDR5 represents a potential novel therapeutic drug for patients with fulminant hepatitis.

Caspase family proteases and apoptosis.

Apoptosis, or programmed cell death, is an essential physiological process that plays a critical role in development and tissue homeostasis. The progress of apoptosis is regulated in an orderly way by a series of signal cascades under certain circumstances. The caspase-cascade system plays vital roles in the induction, transduction and amplification of intracellular apoptotic signals. Caspases, closely associated with apoptosis, are aspartate-specific cysteine proteases and members of the interleukin-1beta-converting enzyme family. The activation and function of caspases, involved in the delicate caspase-cascade system, are regulated by various kinds of molecules, such as the inhibitor of apoptosis protein, Bcl-2 family proteins, calpain, and Ca2+. Based on the latest research, the members of the caspase family, caspase-cascade system and caspase-regulating molecules involved in apoptosis are reviewed.

Effect of NS-398 on colon cancer cells.

AIM: To study the effect of NS-398, a selective cyclooxygenase-2 (COX-2) inhibitor, on invasion of colon cancer cell line HT-29 in vitro and to explore its mechanisms. METHODS: Invasive behaviors of the malignant colon cancer cell line HT-29 were investigated in this study. Expressions of COX-2 and CD44v6 in HT-29 cells were detected by flow cytometry. Cellular survival rate was determined by MTT assay. The invasive capacity was quantified by a modified Boyden chamber model. Alterations of cytoskeleton component F-actin were observed by confocal laser scanning microscope. RESULTS: Flow cytometry analysis showed that COX-2 was highly expressed in HT-29 cells. The invasive capability of HT-29 cells could be greatly inhibited by NS-398 at the experimental concentrations of 0.1, 1.0 and 10 micormol/L with an inhibitory rate of 22.74%, 42.35% and 58.61% (P<0.01), respectively. MTT assay showed that NS-398 at the experimental concentrations had no significant influence on cellular viability, indicating that such anti-invasive effects had no relationship with cytotoxicity. F-actin was mainly distributed around nuclei forming annular structure in HT-29 cells. After exposure to NS-398 of 10 micromol/L, the annular structure around nuclei disappeared and the fluorescence intensity of F-actin decreased obviously. Treatment with NS-398 could down-regulate the expression of CD44v6 as well. CONCLUSION: NS-398 has anti-invasive effects on colon cancer HT-29 cells in vitro, which may be mediated by a novel mechanism of disruption of cytoskeleton. Down-regulation of CD44v6 expression may be related to alterations of cytoskeleton.

Antisense oligonucleotide targeting at the initiator of hTERT arrests growth of hepatoma cells.

AIM: To evaluate the inhibitory effect of antisense phosphorothioate oligonucleotide (asON) complementary to the initiator of human telomerase catalytic subunit (hTERT) on the growth of hepatoma cells. METHODS: The as-hTERT was synthesized by using a DNA synthesizer. HepG2.2.15 cells were treated with as-hTERT at the concentration of 10 micromol/L. After 72 h, these cells were obtained for detecting growth inhibition, telomerase activity using the methods of MTT, TRAP-PCR-ELISA, respectively. BALB/c(nu/nu) mice were injected HepG2.2.15 cells and a human-nude mice model was obtained. There were three groups for anti-tumor activity study. Once tumors were established, these animals in the first group were administered as-hTERT and saline. Apoptosis of tumor cells was detected by FCM. In the 2nd group, the animals were injected HepG2.2.15 cells together with as-hTERT. In the third group, the animals were given as-hTERT 24 hours postinjection of HepG2.2.15 cells. The anti-HBV effects were assayed with ELISA in vitro and in vivo. RESULTS: Growth inhibition was observed in cells treated with as-hTERT in vitro. A significant different in the value of A570-A630 was found between cells treated with as-hTERT and control (P<0.01) by MTT method. The telomerase activity of tumor cells treated with as-hTERT was reduced, the value of A450 nm was 0.42 compared to control (1.49) with TRAP-PCR-ELISA. The peak of apoptosis in tumor cells given as-hTERT was 21.12%, but not seen in saline-treated control. A prolonged period of carcinogenesis was observed in the second and third group animals. There was inhibitory effect on the expression of HBsAg and HBeAg in vivo and in vitro. CONCLUSION: As-hTERT has an anti-tumor activity, which may be useful for gene therapy of tumors.

Therapeutic effects of the levonorgestrel-releasing intrauterine system in the treatment of idiopathic menorrhagia.

OBJECTIVE: To investigate the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of idiopathic menorrhagia. DESIGN: Measurements of menstrual blood loss (MBL), hemoglobin, and serum ferritin before and after LNG-IUS insertion. SETTING: National Research Institute for Family Planning and Beijing Gynecology and Obstetrics Hospital, Beijing, People's Republic of China. PATIENT(S): Thirty-four patients with MBL over 80 mL. INTERVENTION(S): Insertion of the LNG-IUS on cycle days 5-7 and follow-up at 3-month intervals for 3 years. MAIN OUTCOME MEASURE(S): Measurement of MBL, serum ferritin, and hemoglobin for evaluation of efficacy of treatment. RESULT(S): A significant reduction of MBL to 23.4 mL (78.7% decrease), 26.4 mL (83.8% decrease), 2.7 mL (97.7% decrease), and 13.7 mL (85.0% decrease) at 6, 12, 24, and 36 months, respectively. After 6 months, one-third of the patients experienced amenorrhea, and one-fourth, spotting. Hemoglobin increased significantly from 121.5 g/L preinsertion to 135.5 g/L after 36 months, while serum ferritin levels increased significantly from 21.9 ng/mL before insertion to 92.8 ng/mL after 36 months. In women using the LNG-IUS for 3-4 years, the E2 levels in 20 samples were 239.4 pmol/L, P levels were 11.1 nmol/L, and serum LNG levels were maintained at an average of 511 pmol/L. CONCLUSION(S): The significant reduction of MBL and the increase in hemoglobin and serum ferritin levels in the treatment of menorrhagia with the LNG-IUS has great implications for women's reproductive health, particularly in developing countries.

[Inhibition of HBV DNA replication and expression in 2.2.15 hepatoma cells infected with AFP-mediated HBX antisense RNA].

OBJECTIVE: To study the specific expression of the antisense RNA against hepatitis B virus X (HBX) gene in hepatoblastoma cell line and its anti -HBV activity. METHODS: HBX gene (nt.1370-1827) was amplified by PCR, then cloned into EB virus vector pEBAF which contained human alpha-fetoprotein promoter and enhancer. After transfected into 2.2.15 hepatoma cells and ECV304 human endothelial cells by lipofectin, northern blot, ELISA and real-time qualitative PCR were carried out to assay the expression of HBX mRNA, HBV antigens and HBV DNA level, respectively. RESULTS: The HBX antisense RNA expression vector pEBAF-as-HBX which could be expressed specifically in 2.2.15 hepatoblastoma cells was successfully constructed. Both HBV DNA level and the expressions of hepatitis B virus surface antigen (HBsAg) and e antigen (HBeAg) in 2.2.15 hepatoblastoma cells were inhibited by pEBAF-as-HBX. Compared with those in sense control (pEBAF-s-HBX), the inhibitory rates of HBsAg, HBeAg, and HBV DNA were 37.9%, 36.8%, and 25%, respectively. CONCLUSIONS: The pEBAF-as-HBX expression vector may lead to targeted-expression of HBX antisense RNA in hepatoma cells and shows great inhibition effect on HBV.