Objective To differentiate between peri-prosthetic infection and aseptic loosening using quantitative analysis of triphasic bone scintigraphy.Methods Twenty-eight patients (9 males,19 females; mean age 67.5 years,range 49-80 years) with recurrent joint pain after arthroplasty were retrospectively assessed.All patients underwent triphasic bone scintigraphy.ROI of each joint was drawn and the ratios of affected to unaffected side were calculated.The ratios of blood flow phase,blood pool phase,static phase,Creactive protein (CRP) and erythrocyte sedimentation (ESR) were quantitatively analyzed by ROC curve.The final diagnosis was based on microbiological and histological examinations.The optimal cut-off value was chosen based on the ideal sensitivity and specificity.Results Nine patients were diagnosed as septic loosening,17 patients aseptic loosening,1 patient bursitis of hip joint and 1 patient suture reaction.Taking the positive results of blood flow phase or blood pool phase as standard for diagnosing septic loosening,the sensitivity,specificity and accuracy of bone scintigraphy were 7/9,78.9％ (15/19) and 78.6％ (22/28),respectively.The AUC of blood pool phase was 0.942,and the sensitivity and specificity were 8/9 and 78.9％(15/19),respectively,with the optimal cut-off value of 1.40.The AUCs of blood flow ratio and CRP were 0.816 and 0.795,with cut-off values of 1.53 and 1.20,respectively.The AUCs of static phase ratio and ESR were 0.474 and 0.722,respectively,both P＞0.05.Conclusions For the diagnosis of septic loosening,quantitative analysis of triphasic 99Tcm-MDP bone scintigraphy,particularly with the ratio of blood pool phase,is more accurate than qualitative analysis.

Objective To further observe the morphologic changes of in vitro model of granulomatous responses around Schistosoma japonica eggs and determine the relationship of reaction inten-suy to infection stage of those schistosome-infected mice from which the splenocytes were obtained for in vitro experiments.Methods The spleen cells isolated from schistosome-infected mice were incubated and dry schistosome eggs were added into those cultures. These splenocytes responses surrounding eggs were observed and counted under the microscope.Results The splenocytes from infected mice showed obvious adherent responses to the dry eggs. Adhering cells were,at first,granulocytes,then replaced by the macrophages. Around the eggs proliferating lymphocytes,later fibroblasts, were found. The reaction index (RI) of the spleen cells from infected mice were significantly higher (P

AIM: To explore the mechanisms of resistance to 5-fluorouracil(5-FU) in human colon cancer cells.METHODS: 5-FU-resistant cell lines were established and their IC50 were calculated by detection of cell survival rate.Western blotting was performed to analyze the expression of several proteins,by which the possible mechanisms of acquired resistance to 5-FU were determined in human colon cancer cells.RESULTS: The resistant cells were resistant to 5-FU-induced S phase arrest as well as the expression of DNA damage marker-phosphor-histone H2A.X.Furthermore,data demonstrated that over-expression of Bik,Bcl-Xs,and Bcl-XL proteins were observed in 5-FU-resistant cell lines.However,the DLD1/Bcl-XL cells were only partially resistant to 5-FU-induced apoptosis,but not 5-FU-induced S phase arrest and phosphor-histone H2A.X.CONCLUSION: Over-expression of Bcl-XL protein certainly contributes to acquired 5-FU resistance in human colon caners,but has no effect on 5-FU-induced DNA damage and cell cycle disorder,suggesting that other mechanisms are involved in acquired resistance to 5-FU in human colon cancer.

AIM: To explore the influence of Chrysanthemum morifolium Ramat on TNF-related apoptosis inducing ligand (TRAIL)-mediated apoptosis in human colon cancer cell line DLD-1 and its possible mechanism. METHODS: Adenovirus-mediated TRAIL gene AD/hTERT-gTRAIL was applied either alone or by combination with Chrysanthemum morifolium Ramat in human colon DLD-1 cell line. Cell growth and apoptosis were measured by inverted microscope, MTT method and flow cytometry. The expression of TRAIL mRNA, TRAIL-Rs mRNA and TRAIL protein expression after exposure to Chrysanthemum morifolium Ramat were measured by semi-quantitive RT-PCR and FACS, respectively. RESULTS: The suppression percentages and apoptotic rate of DLD-1 by Ad/hTERT-gTRAIL alone were 31.4% and 13.5%, respectively. Combination of TRAIL gene transfection with Chrysanthemum morifolium Ramat, the suppression and the apoptosis rate raised to 93.1% and 45.4%, respectively (P

OBJECTIVETo assess the reliability and validity of the Aging Males' Symptoms (AMS) scale in the male population of Shanghai.

METHODSWe enrolled 973 males aged 40 years and over in a community of Shanghai, China. Using the AMS scale, we calculated the split-half reliability coefficient and Cronbach's alpha coefficient, assessed the validity through confirmatory factor analysis and correlation analysis, and obtained the domain scores of different people by analysis of variance and independent sample test.

RESULTSThe split-half reliability was > 0.78 (P < 0.01) and Cronbach's alpha coefficients of all the dimensions > 0.82 (P < 0.01). Confirmatory factor analysis showed 3 domains in the AMS scale, Pearson correlation coefficients of all the items to their domains were > 0.49 (P < 0.01), and the total testosterone level was not correlated with AMS scores, with Pearson correlation coefficient of -0.04 (P > 0.05). Statistically significant differences were found in AMS scores among different age groups as well as among those with different chronic disease histories, but not in the psychological domain among different age groups.

CONCLUSIONThe reliability and validity of the AMS scale are acceptable in assessing aging males'symptoms among the male population of Shanghai, but further studies are needed to determine whether it could be used as a tool for screening late-onset hypogonadism (LOH) in males.

Adult ; Aged ; Aging ; China ; epidemiology ; Humans ; Hypogonadism ; epidemiology ; psychology ; Male ; Middle Aged ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires

AIM: To assess the accuracy of predicting intraocular lens(IOL)power after myopic refractive surgery using the Pentacam system's true net power(TNP)in the 3 mm zone combined with the SRK/T formula [i.e. TNP 3 mm(SRK/T)].METHODS: Retrospective study. This study enrolled 35 cases(50 eyes)of patients undergoing cataract surgery after laser assisted in situ keratomileusis(LASIK)or photorefractive keratectomy(PRK)from July 2019 to December 2021. Preoperatively, IOL power of 50 eyes, 34 eyes and 41 eyes was calculated by TNP 3 mm(SRK/T), Barrett True-K and Olsen 2 formulas, respectively, with at least 2 formulas used to calculate IOL power for each patient. The actual diopter was recorded 3 mo postoperatively. Prediction errors(PE)of IOL power were compared among the three calculation methods, and the proportion of eyes with PE within ±0.5 D and ±1.0 D was analyzed.RESULTS: The PE at 3 mo postoperatively for TNP 3 mm(SRK/T), Barrett True-K, and Olsen 2 was -0.02±0.63, -0.54±0.80, and 0.25±0.80 D, respectively(P<0.001). The proportions of PE within ±0.5 D were 66%(33/50), 44%(15/34)and 37%(15/41), respectively(P<0.05); the proportions of PE within ±1.0 D were 88%(44/50), 71%(24/34)and 80%(33/41), respectively(P>0.05).CONCLUSION: The Pentacam TNP 3 mm(SRK/T)method is simple to operate and provides accurate calculation of IOL power after corneal refractive surgery.

Aim To investigate the effects of astragalus polysaccharide (APS) on depressive behaviors, hippocampal damage and Nrf2-ARE signaling pathway in rats. Methods Wistar rats were randomly divided into control group, depression group, APS low dose group and APS high dose group. Rats (except the control group) underwent chronic unpredictable mild stress (CUMS) for 28 days. The depressive behaviors were assessed by tail suspension test, forced swim test and sucrose preference test. The histopathological changes of the hippocampus were valuated by HE staining. Levels of nuclear factor erythroid 2-related factor 2 (Nrf2) protein and Nrf2 mRNA were measured. The hippocampal levels of oxidative stress were evaluated. Results Compared with the control group, the depression group showed significant depressive behaviors and hippocampal damage. The depression group had higher levels of Nrf2 and MDA, but lower levels of HO-1, SOD, CAT and GSH-Px than the control group. However, APS does-dependently attenuated the hippocampal damage and depressive behaviors, increased hippocampal levels of Nrf2, HO-1, SOD, CAT and GSH-Px, but decreased hippocampal levels of MDA in rats. Conclusions APS can attenuate CUMS-induced hippocampal damage and depressive behaviors in rats, and the effects may be associated with the activation of Nrf2-ARE signaling pathway.

BACKGROUNDCyclosporine A (CsA) has been widely used in the treatment of aplastic anemia (AA), but the application of CsA was limited in patients who had liver diseases or abnormal liver function due to its liver toxicity. Glycyrrhizin has long been used in China in the treatment of various liver diseases to lower transaminases. In this study, we observed the efficacy and safety of glycyrrhizic acid combined with CsA in the treatment of newly diagnosed patients with non-severe AA (NSAA).

METHODSA total number of 76 patients with newly diagnosed NSAA were enrolled into the study at our hospital between July 2005 and June 2010. The patients were divided randomly into two groups: the glycyrrhizin-treatment group (group A) and the control group (group B) with 38 patients in each group. All patients received 3 - 5 mg×kg(-1)×d(-1) CsA for at least 4 months and were treated either with or without glycyrrhizin for 4 months.

RESULTSsixty-eight patients were eligible for evaluation. In the control group, 9.09% patients (n = 3) achieved a complete response while 51.52% (n = 17) attained a partial response. The overall response rate was 60.61% (n = 20). The remaining 13 patients (39.39%) did not have any response. In the glycyrrhizin-treatment group, complete response rate was 20% (n = 7) and partial response rate was 62.86% (n = 22). The overall response rate was 82.86% (n = 29) and the non-response rate was 17.14% (n = 6). Response rate was significantly increased with the addition of glycyrrhizin to CsA compared with CsA alone (P < 0.05).

CONCLUSIONThe combination of glycyrrhizin and cyclosporine regimen was an effective treatment for NSAA in terms of improvement of response rate, reduction in CsA-related liver injury, and attenuation of severity of nausea and other adverse events in the treatment of patients with NSAA.

Adolescent ; Adult ; Aged ; Anemia, Aplastic ; drug therapy ; immunology ; Cyclosporine ; administration & dosage ; adverse effects ; Drug Therapy, Combination ; Female ; Glycyrrhizic Acid ; administration & dosage ; adverse effects ; Humans ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Male ; Middle Aged

OBJECTIVETo investigate the therapeutic effect of fibular head composite flap for bone and skin defect at medial malleolus in children.

METHODSFrom Aug. 2005 to Apr. 2009, 4 children cases (2 male, 2 female, from 3 to 11 year) with bone and skin defect at medial malleolus were reconstructed with fibular head composite flaps pedicled with lateral inferior genicular vascular bundle. The skin defect was 3- 6 cm x 8-10 cm in size.

RESULTSAll the 4 composite flaps survived completely. The patients were followed up for 4 months to 4 years with good bony healing. Both esthetic and functional results were satisfactory in ankle joint.

CONCLUSIONSThe fibular head composite tissue flap has a good therapeutic effect for bone and skin defect at medial malleolus in children.

Ankle Injuries ; surgery ; Bone and Bones ; injuries ; Child ; Child, Preschool ; Female ; Fibula ; surgery ; Follow-Up Studies ; Humans ; Male ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Treatment Outcome

Objective To investigate the expression level of hypoxia-inducible factor-lot (HIF-1ot) in gastric cancer and its relationship with clinicopathological characteristics and prognosis of patients with gastric cancer.Methods From March 3,2011 to September 28,2012,49 patients with gastric adenocarcinoma tissue chips were selected from pathology department of our hospital.They were matched with paracancerous tissues.The expression levels of HIF-1α were measured by immunohistochemistry method in gastric cancer tissues and paracancerous tissues chips.Kaplan-Meier was used to evaluate the progression-free survival (PFS) and overall survival (OS),and the Cox proportional hazards model was used to analyze whether HIF-1α was a prognostic factor.Results The high expression rate of HIF-1α protein in gastric cancer was significantly higher than that in paired para-carcinoma group (42.9％ vs.4.1％,x2 =20.509,P ＜ 0.001).The expression of HIF-1 α protein was related to TNM stage (x2 =4.601,P =0.032),vascular invasion (x2 =6.766,P =0.009) and degree of differentiation (x2 =7.969,P =0.005).Compared with patients with low expression of HIF-1α,the median PFS (16.2 months vs.27.3 months) and median OS (34.8 months vs.43.8 months) were shorter in the patients with high expression of HIF-1 α,and the differences were statistically significant (median PFS:x2 =4.661,P =0.002;median OS:x2 =6.903,P =0.009).The results of single factor analysis showed that overexpre-ssion of HIF-1α was correlated with PFS and OS (PFS:HR =4.461,95％ CI:1.969-10.802,P ＜0.001;OS:HR =3.109,95％CI:1.274-7.588,P =0.013).The results of Cox multivariate analysis showed that overexpression of HIF-1α was the independent risk factor that affected the survival and prognosis of patients with gastric cancer (PFS:HR =4.747,95％ CI:2.175-10.230,P ＜0.001;OS:HR =3.171,95％ CI:1.358-7.404,P =0.008).Conclusion The high expression rate of HIF-1α protein in gastric cancer tissues is significantly higher than that in paracancerous tissues.The expression of HIF-1α is associated with TNM stage,vascular invasion,degree of differentiation in patients with gastric cancer.The high expression of HIF-1α is associa-ted with the shorter median OS and PFS.The high expression of HIF-1α is an independent risk factor for the survival and prognosis of patients with gastric cancer,which is expected to be an independent marker of poor prognosis.