[The clinical predictors for the prognosis of patients with osteosarcoma].

Osteosarcoma is a kind of primary malignant tumor of bone originated from mesenchymal tissue, which mainly occurs in children and adolescents, and presents the characteristics of high malignancy, rapid growth, early metastasis and poor prognosis. Currently, most of the studies at home and abroad mainly focused on therapeutic procedures. However, reliable prediction indices or evaluation systems are also pivotal for monitoring disease change, guiding treatment and evaluating prognosis. Multiple clinical predictors have been reported to be related to the prognosis of osteosarcoma, which can be roughly divided into 9 categories according to their characteristics. Each kind of predictor owns its inherent advantage and disadvantage, and full understanding of them and their characteristics can be helpful to improve the prognosis of osteosarcoma.

[Clinicopathological characteristics and therapeutic effects of adult rhabdomyosarcoma patients].

Objective: This study aimed to investigate the clinicopathological characteristics and prognosis of adult rhabdomyosarcoma (RMS) patients. Methods: The clinical data of 34 adult RMS patients were retrospectively analyzed. Based on their intervention and treatment, patients were divided into operation group (n=7), chemotherapy group (n=8) and operation plus chemotherapy group (n=19). The clinical characteristics and treatment outcomes of the three groups were compared. Results: A statically significant difference was found in IRSG surgical-pathological stage among the three groups (P=0.026), while no significant difference existed in gender, age of disease onset, primary site, tumor size, pathological subtypes and IRSG risk group in the three groups (all P>0.05). In the operation group, three CR, one PR, one SD and two PD were achieved and one CR, one PR, one SD and five PD were obtained in the chemotherapy group. While in the chemotherapy plus operation group, four CR, twelve PR, one SD and two PD were achieved. A significant difference was found in response (P=0.043) and median overall survival (OS) (P=0.036) among the three groups, which were 44.7, 26.9 and 53.6 months, respectively. Conclusions: Pleomorphic RMS was the main histological subtype for adult RMS patients, and the prognosis for adult RMS was usually poorer than that for pediatric RMS patients. Single therapeutic approach could not achieve satisfactory outcomes, while multimodal treatment consisted of surgery, chemotherapy and radiotherapy are helpful to improve the prognosis of adult patients with RMS.

[The relationship between accommodative accuracy at different near-work distances and early-onset myopia].

OBJECTIVE: To observe the accommodative accuracy of children with early-onset myopia at different near-work distances, and discuss the relationship between accommodative accuracy and early-onset myopia. METHODS: This was a case-control study. Thirty-seven emmetropic children, 41 early-onset myopic children without correction, and 39 early-onset myopic children with spectacles, aged 7 to 13 years, were included. Measures of refractive errors and accommodative accuracy at four near-work distances, including 50 cm, 40 cm, 30 cm, and 20 cm, were made using the binocular fusion cross cylinder (FCC) of an automatic phoropter. RESULTS: Most candidates showed accommodative lags, including the children with emmetropia. The ratio of lags in all candidates at different near-work distances was 75.21% (50 cm), 87.18% (40 cm), 92.31% (30 cm), and 98.29% (20 cm), respectively. All accommodative accuracies became worse, and the accommodative lag ratio and values of FCC increased, along with the shortening of the distance. The difference in accommodative accuracy among groups was statistically significant at 30 cm (χ(2)=7.852, P= 0.020) and 20 cm (χ(2)=6.480, P=0.039). The values of FCC among groups were significantly different at 30 cm (F=3.626, P=0.030) and 20 cm (F=3.703, P=0.028), but not at 50 cm and 40 cm (P>0.05). In addition, the FCC values of 30 cm and 20 cm had a statistically significant difference between myopic children without correction [(1.25±0.44) D and (1.76±0.43) D] and emmetropic children [(0.95±0.52) D and (1.41±0.58) D] (P=0.012, 0.008). The correlation between diopters of myopia and accommodative accuracy at different nearwork distances was not statistically significant (P>0.05). However, the correlation between diopters of myopia and the accommodative lag value (FCC) at 20 cm was statistically significant (r=0.246, P=0.028). CONCLUSIONS: The closer the near-work distance is, the worse the accommodative accuracy is. This is more significant in early-onset myopia, especially myopia without correction, than emmetropia. Wearing spectacles may improve the threshold and sensitivity of accommodations, and the accommodative accuracy at near-work distances (<30 cm) to some extent. The poor accommodative accuracy at near-work distances may be not related to early-onset myopia, but the value of FCC (20 cm) is related to early-onset myopia. The higher the FCC value is, the higher the diopter is. (Chin J Ophthalmol, 2016, 52: 520-524).

[New concept of chronic wound healing: advances in the research of wound management in palliative care].

With the aggravation of aging of global population and increase of incidence of various chronic diseases and injuries, patients with chronic wounds due to different causes (malnutrition, abnormal metabolism, compression, infection, tumor, etc.) have grown. Especially in some patients at the end of life, chronic wounds have the characteristics of difficult to heal and even unable to heal. There is an urgent need for palliative treatment for such wounds. Palliative treatment of chronic wounds focuses on the management of smell, pain, exudate, bleeding, and infection with the hope to effectively prevent infection, relief pain, improve quality of life, and reduce the economic burden of medical treatment for patients. This paper reviews the related studies of palliative treatment in chronic wounds at home and abroad, and explores the evaluation and management of palliative treatment of different wounds with the aim to provide new management strategies, new materials, and new concept for the treatment of chronic wounds.

[Epidemiological investigation on clinical characteristics of 801 inpatients with chronic wounds].

Objective: To analyze the clinical characteristics of 801 inpatients with chronic wounds. Methods: The medical records of patients with chronic wounds who were admitted to the General Hospital of Southern Theater Command of PLA (hereinafter referred to as the author's unit) from January 2013 to December 2017, including gender, occupation, wound type, age, department distribution, recovery status, recovery time, hospitalization time, hospitalization cost, treatment method, clinical outcome, and medical expenses were retrospectively analyzed. Data were statistically analyzed with chi-square test, Fisher's exact probability test, and Kruskal-Wallis H test. Results: Of 245 037 inpatients admitted to the author's unit within 5 years, 801 (3.3‰) patients with chronic wounds met the inclusion criteria. The composition ratio of chronic wound patients during the 5 years was 2.4‰ (106/44 230)-3.9‰ (191/49 342). Among chronic wound patients, there were 527 males and 274 females, with manual labor, retired, and unemployed patients accounted for a large proportion. The main type of chronic wound was unhealed wound after surgery, accounting for 28.2% (226/801), followed by diabetic wound, accounting for 22.7% (182/801) and traumatic wound, accounting for 16.5% (132/801). There was statistically significant difference in gender distribution of patients with different types of chronic wounds (χ(2)=28.236, P<0.05). The main types of wound in male patients were unhealed wound after surgery, diabetic wound, and traumatic wound, while the main types of wound in female patients were diabetic wound and unhealed wound after surgery. There was statistically significant difference in the age group distribution of patients with different types of chronic wounds (P<0.01). Patients aged 41-60 years had a high incidence of unhealed wound after surgery and traumatic wound, and patients aged 61-80 years had a high incidence of diabetic wound. Patients with chronic wounds in department of orthopedics had the highest recovery rate, followed by comprehensive department. There were statistically significant differences in hospitalization time and hospitalization cost of patients with chronic wounds admitted to different departments (χ(2)=47.390, 107.390, P<0.05). There were no statistically significant differences in cure status and cure time of patients with chronic wounds admitted to different departments (χ(2)=7.163, 15.510, P>0.05). Patients treated with surgery in combination with drug had higher recovery rates than patients given other treatment methods. There was no statistically significant difference in the cure rate of patients with different treatment methods (χ(2)=7.600, P>0.05). There were statistically significant differences in cure time, hospitalization cost, and hospitalization time of patients given different treatment methods (χ(2)=38.067, 130.520, 130.890, P<0.05). There were no statistically significant differences in hospitalization cost and hospitalization time of patients with different clinical outcomes (χ(2)=2.070, 5.790, P>0.05). The total medical cost of 801 patients with chronic wounds was about 47 million yuan, of which the total hospitalization cost per capita was 50, 725 yuan, with a minimum of 1 164 yuan and a maximum of about 1.16 million yuan per capita, and with drug and materials costs accounted for high proportions of the total cost. Conclusions: Patients with chronic wounds in the author's unit are mainly physical labor and middle-aged and elderly people, with more male patients than female patients. The main type of wound is unhealed wound after surgery, which brings serious economic burden to the patients and the society. Therefore, it is necessary to strengthen the public knowledge about chronic wounds and improve the awareness of prevention and treatment.

22R-Hydroxycholesterol induces differentiation of human NT2 precursor (Ntera2/D1 teratocarcinoma) cells.

Recently, we have shown that 22R-hydroxycholesterol, a steroid intermediate in the pathway of pregnenolone formation from cholesterol, is present at lower levels in Alzheimer's disease (AD) hippocampus and frontal cortex tissue specimens than in age-matched controls, and that this substance protects against cell death induced by amyloid beta-peptide in both rat sympathetic nerve pheochromocytoma (PC12) and differentiated human Ntera2/D1 teratocarcinoma neurons. Herein we report that 22R-hydroxycholesterol inhibits the proliferation of human Ntera2/D1 teratocarcinoma precursor cells (NT2) and induces these cells to differentiate into "neuron-like" or "astrocyte-like" cells. 22R-Hydroxycholesterol-induced differentiation of NT2 cells is associated with increases in the expression of neurofilament protein NF200, the cytoskeletal proteins microtubule-associated protein type II (MAP2) a and MAP2b, glial fibrillary acidic protein (GFAP) and glial cell line-derived neurotrophic factor receptor-alpha 2 (GFRalpha2). These effects of 22R-hydroxycholesterol are considered to be stereospecific because its enantiomer 22S-hydroxycholesterol and other steroids failed to induce differentiation of NT2 cells. 22R-Hydroxycholesterol was found to lack specific binding for numerous receptors, including all steroid receptors tested. However, using a cholesterol protein binding blot assay we demonstrated the presence of a 22R-hydroxycholesterol-binding protein in NT2 cells distinct from the human oxysterol receptors liver X receptor LXRalpha and beta.

Peripheral-type benzodiazepine receptor in neurosteroid biosynthesis, neuropathology and neurological disorders.

The peripheral-type benzodiazepine receptor is a mitochondrial protein expressed at high levels in steroid synthesizing tissues, including the glial cells of the brain. Peripheral-type benzodiazepine receptor binds cholesterol with high affinity and is a key element of the cholesterol mitochondrial import machinery responsible for supplying the substrate cholesterol to the first steroidogenic enzyme, thus initiating and maintaining neurosteroid biosynthesis. Neurosteroid formation and metabolism of steroid intermediates are critical components of normal brain function. Peripheral-type benzodiazepine receptor also binds with high affinity various classes of compounds. Upon ligand activation peripheral-type benzodiazepine receptor-dependent cholesterol transport into mitochondria is accelerated leading in increased formation of neuroactive steroids. These steroids, such as allopregnanolone, have been shown to be involved in various neurological disorders, such as anxiety and mood disorders. Thus, peripheral-type benzodiazepine receptor drug ligand-induced neuroactive steroid formation offers a means to regulate brain dysfunction. Peripheral-type benzodiazepine receptor basal expression is upregulated in a number of neuropathologies, including gliomas and neurodegenerative disorders, as well as in various forms of brain injury and inflammation. In Alzheimer's disease pathology neurosteroid biosynthesis is altered and a decrease in the intermediate 22R-hydroxycholesterol levels is observed. This steroid was found to exert neuroprotective properties against beta-amyloid neurotoxicity. Based on this observation, a stable spirostenol derivative showing to display neuroprotective properties was identified, suggesting that compounds developed based on critical intermediates of neurosteroid biosynthesis could offer novel means for neuroprotection. In conclusion, changes in peripheral-type benzodiazepine receptor and neurosteroid levels are part of the phenotype seen in neuropathology and neurological disorders and offer potential targets for new therapies.

[Current diagnosis and treatment of pseudoaneurysms of the internal carotid artery in postirradiated nasopharyngeal carcinoma].

Nasopharyngeal carcinoma is one of the most common of head and neck malignant tumors in southern region of China. Till date radiotherapy is considered as the first choice of treatment this disease.Although the rate of occurrence of pseudoaneurysms of the internal carotid artery in post radiation treatment of nasopharyngeal carcinoma is low, it is also a hot topic in department of otolaryngology and doctors because of its dangerous and lifethreatening emergencies.In order to improve the level of diagnosis and treatment of the disease, diagnosis, risk, treatment, prognosis and prevention are current summarized in this report.

Identification, localization, and function in steroidogenesis of PAP7: a peripheral-type benzodiazepine receptor- and PKA (RIalpha)-associated protein.

Peptide hormones and cAMP acutely stimulate steroid biosynthesis by accelerating the transport of cholesterol into the mitochondria. The peripheral-type benzodiazepine receptor (PBR) has been shown to be an indispensable element of the cholesterol transport machinery. Using the yeast two-hybrid system and PBR as bait, we identified a protein that interacts with PBR, the PBR-associated protein PAP7. Using the regulatory subunit RIalpha of PKA as bait, we also isolated PAP7. Glutathione-S-transferase -PAP7 interacted with both the mitochondrial PBR and cytosolic PKA-RIalpha in MA-10 Leydig cells. PAP7 is a novel 52-kDa protein present in mouse, rat, and human tissues, and it has a major 3-kb mRNA transcript in all tissues examined. Immunohistochemical and in situ hybridization studies indicated that PAP7 is highly expressed in the gonads, adrenal, hippocampus, and distinct brain neuronal and glial populations. Overexpression of the full length PAP7 increased the hCG-induced steroid production. However, overexpression of a partial PAP7, which includes the PBR- and PKA-RIalpha-binding domains, inhibited the hormone-stimulated cholesterol transport and steroid synthesis. Treatment of MA-10 cells with oligonucleotides antisense to PAP7 also inhibited the hCG-stimulated steroid formation, suggesting that PAP7 is a functional element of the hormone-induced signal transduction cascade leading to steroidogenesis. PAP7 may function by targeting the PKA isoenzyme to organelles rich in PBR, i.e. mitochondria, where phosphorylation of specific protein substrates may induce the reorganization of PBR topography and function.

Artificial encapsulation of joint prostheses.

The great success of total joint replacement in surgery has been disturbed mainly by later loosening and wear-out of the plastic components. In an attempt to improve long term performance of joint prostheses and eliminate the adverse effects of wear debris, polymeric encapsulation as a main design feature has been proposed. The benefits of having an encapsulated and artificially lubricated joint prosthesis have been evaluated in tribological terms with particular reference to the UMIST shoulder joint. The selection of a number of biopolymers involved in this research project described. The possible interactions arising from the coexistence of these materials have been mechanically investigated. Much attention and a great deal of practical work has been focussed on the sealing of the capsule and on the relevant liquid permeability.

Free radicals and lipid peroxidation do not mediate beta-amyloid-induced neuronal cell death.

"beta Amyloid (Abeta)-induced free radical-mediated neurotoxicity" is a leading hypothesis as a cause of Alzheimer's disease (AD). Abeta increased free radical production and lipid peroxidation in PC12 nerve cells, leading to increased 4-hydroxy-2-nonenal (HNE) production and modification of specific mitochondrial target proteins, apoptosis and cell death. Pretreatment of the cells with isolated ginkgolides, the anti-oxidant component of Ginkgo biloba leaves, or vitamin E, prevented the Abeta-induced increase of reactive oxygen species (ROS). Ginkgolides, but not vitamin E, inhibited the Abeta-induced HNE modification of mitochondrial proteins. However, treatment with these anti-oxidants did not rescue the cells from Abeta-induced apoptosis and cell death. These results indicate that free radicals and lipid peroxidation may not mediate Abeta-induced neurotoxicity.

[Fetal breast estrogen receptor (ER) and breast cancer].

The estrogen receptor in bilateral breasts of 36 6 to 10-month fetuses (17 male, 19 female) were examined. All fetal breasts had ER positive cells (greater than 50-90%). The ER levels were similar regardless of sex and age. When the ER status of 84 female breast cancer patients was analysed, ER was considered as an essential but not the only etiologic factor in mammary carcinogenesis. A positive correlation between the degree of differentiation and the ER level of breast cancer cells was demonstrated and the ER level did not correlate with the clinical staging of breast cancer. The results are briefly discussed in relation to the rationale of hormonal therapy of breast cancer.

[Studies on constituents of ganoderma capense IV. The chemical structures of ganoine, ganodine and ganoderpurine].

Two novel pyrrole alkaloids--ganoine and ganodine and a novel purine alkaloid ganoderpurine have been isolated from the mycelium of Ganoderma capense (Lloyd)Teng (Polyporaceae) obtained by submerged fermentation. On the basis of spectroscopic data their structures were elucidated, ganoine is N-isopentyl-5-hydroxymethyl-pyrryl alldehyde. Ganodine is N-phenylethyl-5-hydroxymethyl-pyrryl aldehyde and ganoderpurine is N9-(alpha, alpha dimethyl-gamma-oxobutyl) adenine.

Purification and characterization of DNA methylase from HL-60 cells.

A solid leukemia sarcoma has been successfully developed after subcutaneous inoculation of the cultured human promyelocytic leukemia cells (HL-60 cells) into nude mice. The solid leukemia sarcoma is a more plentiful source than the cultured cells for enzymatic study and its growing environment is closer to that of the human body than the cultured cells. We established an efficient procedure of purifying HL-60 cells DNA methylase which includes: disruption of HL-60 cells by homogenization and sonication, removing the cell fragments and cellular particles by centrifuge and ultracentrifuge (105,000 g); removing endogenous DNA by streptomycin sulfate, salting out by (NH4)2SO4, ion exchange chromatography on DEAE-cellulose (DE-52), gel filtration over Sephadex G-100 column. The DNA methylase from HL-60 cells has been purified 204 fold by this procedure. The purified enzyme shows a single-band on PG-PAGE. A 479-kD molecular weight of this enzyme is measured by PG-PAGE. The enzyme properties of HL-60 DNA methylase are also studied.

[Diagnostic criteria and their relation to prognosis in acute pancreatitis].

Investigations were carried out in 1041 consecutive patients of acute pancreatitis, to correlate the prognosis with their symptoms and signs. It has been found that there were 15 symptoms and signs may be related to their prognosis; that is age over 60, high intake of fatty food immediately before attack, severe upper abdominal pain with vomiting, pulse rate over 100/min, pulse pressure below 2.6 kPa, peritoneal irritation, absence of peristaltic sounds, bloody ascites, serum electrolytes disorder, acidosis, more than 4000 ml of fluid were needed in first 24 h, serum calcium level below 1.9 mmol/L, blood glucose over 8.3 mmol/L, BUN over 7.0 mmol/L, and poor liver functions. If there are less than 4 positive signs, edematous pancreatitis may be present, 5 to 8 positive signs may be necrotizing pancreatitis with high risk of mortality and early operation is indicated, and more than 8 positive signs the prognosis will be very poor.

[The biological characteristics of endothelial cells of human umbilical vein and the mechanism of intracellular signal transduction].

We observed the synthesis and release of vasoactive polypeptides (VPs) in the endothelial cells of human umbilical blood vessels (HUVEC). The results showed: (1) The content of VPs in the endothelial cells of non-innervated human umbilical vessels is higher than that of mesenteric vessels. (2) These VPs are synthesized by endothelial cells and released into the outside of cell bodies. (3) VIP and SP can stimulate the proliferation of HUVEC, but somatostatin (SOM) inhibits it. (4) VIP and SP increase opening probability of the Ca2+ channel in the membrane of HUVEC, while SOM decrease it, but VIP, SP and SOM result in the increase of concentrations of intracytosolic free Ca2+ and cAMP, while decreasing that of cGMP in HUVEC. In conclusion, we proved that there are local regulatory mechanisms in non-innervated human umbilical blood vessels, and VPs within endothelial cells may play an important role.

Clinical and histological observations on the application of intermingled auto- and porcine-skin heterografts in third degree burns.

Escharectomy and skin grafting with both homograft and porcine skin has become an effective method in treating massive third degree burns. Seventeen patients and 21 operations of intermingled transplantation of auto- and fresh porcine skin heterografts after escharectomy of the severe burn wounds have been carried out since March 1973. Clinical and histological data are summarized, among which we observed the 'fusing phenomena' of auto- and porcine skin heterografts in 6 patients. Vascularization, 'turning red', viability and rejection as well as ways to improve the results of the grafting method are discussed. No vascular communication between fresh porcine skin and the host wound has been observed during the early postoperative period. The cause of 'turning red' is a reddish transudation between the graft and the host wound seen through the thin porcine skin. Based on histological observations, porcine skin is viable after transplantation. With nutritional support apparently coming from the underlying plasma and tissue fluid. Eventually the process of rejection is similar to that of homograft Better results are found with porcine skin grafts 0.4-0.5 mm in thickness placed 0.5-0.75 cm apart. In order to avoid large sloughing wound surfaces less than 20 per cent area of porcine skin coverage is advisable.