Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Female ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Lymph Nodes ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; RNA, Messenger ; metabolism ; Vascular Endothelial Growth Factor C ; blood ; genetics ; metabolism

Objective To evaluate the clinical and functional outcome of biological reconstruction by using pasteurized autograft and massive allograft after en-bloc resection of primary femoral diaphyseal sarcomas.Methods Retrospectively reviewed 19 consecutive patients with primary femoral diaphyseal sarcomas between Feb.2005 and Dec.2013.There were 11 males and 8 females with the mean age of 18 (2-38) years old.Thirteen patients were diagnosed as osteogenic sarcoma (OS),while five Ewing' s sarcoma (EWS) and one malignant fibrous histocytoma (MFH).All patients were treated with wide local excision,and 9patients were reconstructed by intercalary femur segmental allograft and 10 by pasteurized autograft.The median length of the resected bone was 16.9 (9-24) cm.15 segmental grafts were fixed by using plates including 10 intramedullary free vascularised fibular graft constructs,the other 4 segmental grafts were fixed by intramedullary nails.The average operation time for pasteurized autograft construct was 5.1 hours,while the time for intercalary allograft construct was 4.22 hours.Of 38 host-donor junctions,there are 28 diaphyseal junctions and 10 metaphyseal junctions.Results The average operation time for pausterized autograft construct tended to be longer than intercalary allograft (5.1h Vs 4.22h),although the difference did not reach the significance.Bone union occurred at a median of 10.3 months and 7.25 months at diaphyseal and metaphyseal junction for pasteurized autograft-host construct; 13.8 months at the diapyhseal junction and 11.5 months at the metaphyseal junction for allograft-host construct.Bone healing time of diaphyseal junction and metaphyseal junction between these two constructs were significant difference.Eight of 19patients (42.1％) developed complications:5 bone unnunion/fracture (including 1 subsequently developed local recurrence),1deep infection and 2 local recurrence (including 1 soft tissue recurrence).The mean overall follow-up was 33.5 months (3-107),five patients died of lung metastases,the cumulative patient survival was 76.5％ at 2 years and 61.2％ at 5 years determined by Kaplan-Meier method.All living patients except the MFH patients who received amputation,had a mean MSTS score of 83.7％ (70％-95％).Conclusion Although the reconstructive procedure with pasteurized autograft is more complicated and needs longer operation time than allograft reconstruction,the bone healing time with autograft is significant shorter than allograft.Our observations suggest the pausterized autograft shell with intramedullary free fibular graft is strongly recommeded.

Objective To determine the feasibility of limb salvage with major vascular reconstruction for sarcomas of extremities, focusing on the early complications, oncological and functional outcomes.Methods Between August 2004 and June 2009, 13 patients (mean age 38 years, range 14-63 years) underwent wide resection of upper and lower extremity sarcomas to include the involved arterial and venous segments. 4 patients had bone sarcomas and 9 soft tissue sarcomas, 6 patients only had underwent artery replacement and the other 7 had underwent both artery and vein. 8 resected vessels were reconstructed with vascular graft and 5 with ipsilateral or contralateral saphenous vein. Results No patient suffered from reperfusion injury and infection. The patient with osteosarcoma in proximal humerus had suffered acute arterial graft thrombosis at first day postoperatively; however, the limb was salvaged after successful thrombectomy. 5 of 8 patients with synthetic graft developed minor delayed wound healing and hematoma, but the other 5 patients with autologous saphenous vein replacement did not. The mean follow-up was 19.4 months (7-45months). One patient died of pulmonary metastasis; the patient with osteosarcoma in proximal humerus had developed local recurrence, but refused amputation and was alive with metastasis. No arterial occlusion was observed at final follow-up or at the time of death, but the patency of artery and vein was 100% and 28.6%respectively. One patient who has pulmonary metastases before operation died of metastases 7.5 months after operation. Four patients developed pulmonary metastases, therefore, Kaplan-Meier survival analysis showed that 2-year overall and metastasis-free survival rate was 90.9% and 63.6% respectively. Functional status were judged as good or excellent (mean MSTS score 72%) in 12 of 13 patients. Conclusion The study indicate that malignant involvement of major vessels is not a contraindication for limb-salvage. Vascular reconstruction is a feasible option in limb salvage surgery. Wide resection with vascular reconstruction provide acceptable oncological and functional outcome of limb salvage.

H7N9 avian influenza is a new subtype of avian influenza, first found in the Yangtze River Delta at the end of February 2013. H7N9 avian influenza, infection in human is transmitted through the respiratory airway, causing acute respiratory infectious disease. Due to the species barrier, H7N9 avian influenza virus only infect human via birds occasionally under very specific circumstances, and at present, there is no exact evidence of H7N9 avian influenza virus transmission between humans. However, H7N9 avian influenza remains a continuous public health threat. So far, China has had six outbreaks of H7N9 avian influenza. A total of 1567 cases of H7N9 influenza virus infection have been reported to WHO, including 615 deaths. When H7N9 avian influenza virus infects the human body, their primary target of infection is the respiratory mucosal epithelial cells. Therefore, the respiratory epithelium plays a key role in the process of virus transmission and infection. Hence, the main purpose of this review is to collate the current understanding of immune responses and their corresponding molecular mechanisms of mucosal damage caused by H7N9 avian influenza infection, and how it contributes to cross species human infection.

OBJECTIVETo explore the effects of trichloroethylene (TCE) and its by-products (trichloroacetic acid, TCA; dichloroacetic acid, DCA) on the normal human peripheral blood lymphocyte and the role of DCA in dermatitis medicamentosa- like induced by trichloroethylene (DMLT).

METHODSLymphocyte was isolated from peripheral venous blood, and cytotoxicity of human lymphocytes treated with different concentrations (0.02 approximately 30.00 mmol/L) of DCA was determined at indicated times (2 h and 4 h) based on the MTS assay. Action of DCA on cell viability, membrane integrity was assessed by neutral red uptake (NRU) assay and lactate dehydrogenase (LDH) release test and measurement of superoxide dismutase (SOD) activity. Fluorescence quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) was employed for detection and quantization of the chemokine receptor CXCR2 and chemokine receptor CXCR3 mRNA in peripheral blood lymphocyte treated with different concentrations of DCA.

RESULTSDCA had a more vital effect on peripheral blood lymphocyte than TCE and TCA. A concentration-dependent release of LDH was observed at 4 h after cells were exposed to different doses of DCA (0.88, 1.75, 3.50 and 7.00 mmol/L) (P < 0.05), and DCA also caused an inhibition of SOD activity in a concentration-dependent manner (P < 0.05). The results of FQ- RT- PCR indicated that CXCR2 and CXCR3 mRNA were all over- expression. At 48 h after the DCA of 0.5 mmol/L and 10.00 mmol/L was used, CXCR2 and CXCR3 mRNA were 10.34, 5.66-fold and 19.43, 8.75-fold of those in the control group (P < 0.01).

CONCLUSIONDCA is of a great cytotoxicity and may be one of crucial evocators on DMLT.

Adolescent ; Cells, Cultured ; Dichloroacetic Acid ; toxicity ; Female ; Humans ; Lymphocytes ; drug effects ; metabolism ; Male ; Receptors, CXCR3 ; metabolism ; Receptors, Interleukin-8B ; metabolism ; Trichloroethylene ; toxicity ; Young Adult

OBJECTIVETo analyze the chemical constituents of the non-alkaloid fraction of Uncaria macrophylla.

METHODSThe constituents were separated and purified by silica gel chromatography and recrystalization, and their structures were identified by infrared, mass and nuclear magnetic resonance spectrometry.

RESULTSSix compounds were isolated from the non-alkaloid fraction of Uncaria macrophylla, whose structures were identified as beta-sitosterol, beta-daucosterol, ursolic acid, alpha-amyrin acetate, 3beta, 6beta, 23-trihydroxyurs-12-en-28-oic acid, 3beta-hydroxyurs-12-en-27, and 3beta-hydroxyurs-12-en-27, 28-dioic acid, respectively.

CONCLUSIONSUrsolic acid is the main component in the non-alkaloid fraction of Uncaria macrophylla. Alpha-amyrin acetate and 3beta-hydroxyurs-12-en-27, 28-dioic acid are isolated and characterized for the first time from this plant.

Oleanolic Acid ; analogs & derivatives ; isolation & purification ; Triterpenes ; isolation & purification ; Uncaria ; chemistry

OBJECTIVETo determine whether the matrix metalloproteinase 9 gene (MMP9) polymorphism is associated with the onset or progression of adolescent idiopathic scoliosis (AIS) in Chinese Han female.

METHODSThree single nucleotide polymorphisms (SNPs) (rs17576, rs2250889, rs1805088) were genotyped through TaqMan-based real-time PCR assay in 190 AIS patients and 190 controls, all of whom were females from Chinese Han population with matched age. Analyses performed included Hardy Weinberg equilibrium test, Pearson chi-square test, Logistic regression analysis, linkage disequilibrium analysis and haplotype analysis. The mean maximum Cobb angles with different genotypes in case-only dataset were also compared.

RESULTSAll 3 SNPs have reached Hardy-Weinberg equilibrium in the controls. Genotype and allele frequencies of all SNPs were found similar between cases and controls by Pearson chi-square test and Logistic regression. Genotype-phenotype analysis showed that patients with CC genotype in rs2250889 featured larger maximum Cobb angles.

CONCLUSIONMMP9 may not be a predisposition gene of AIS in Han female. However, homozygous mutation in rs2250889 can render scoliosis more severe, implying that MMP9 defect may result in deterioration of AIS.

Adolescent ; Asian Continental Ancestry Group ; genetics ; Child ; China ; Female ; Genetic Association Studies ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Matrix Metalloproteinase 9 ; genetics ; Phenotype ; Polymorphism, Single Nucleotide ; genetics ; Scoliosis ; genetics

ObjectiveTo study the Electrocardiogram (ECG) changes in AIDS patients at different age grades. MethodsThe ECG of 400 AIDS patients at different age were analyzed retrospectively. Results(①)The rate of abnormal ECG in the age group of 46 ～50 years was significantly higher than 11 ～ 15(P =0. 008) ,21 ～25( P = 0. 041 ),31 ～ 35 ( P = 0. 022 ),41 ～ 45 ( P = 0. 001 ) and 51 ～ 55 ( P = 0. 047 ) years groups respectively. (②)The rate of bradyarrhythmia in the age group of 46 ～ 50 years was significantly higher than 31 ～ 35 (U = 2. 44) ,36 -40( U = 2. 18 ) ,41 ～ 45 ( U = 2. 57 ) years groups ( P ＜ 0. 05 respectively. (③)The rate of left atrial and ventricular hypertrophy in 11 ～ 15 years group was significantly lower than the age groups older than 46 (except for 51 ～ 55years group) ;those aged ＞60 had higher atrial and ventricular hypertrophy rate than 36 ～40,41 ～45 and 51 ～55years groups ( P ＜ 0. 05 respectively). ConclusionsAIDS patients at all ages may present abnormal ECG, which is positively correlated with age.

【Objective】 To compare the diagnostic efficacy of full-field digital mammography(FFDM), digital breast mammography(DBT) and dynamic enhanced magnetic resonance imaging(DCE-MRI) for breast tumors in different gland types. 【Methods】 Retrospective analyses of 56 breast lesions in 49 patients who underwent FFDM, DBT and MRI in the Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from October 2018 to December 2019 were performed. The breasts were divided into the non-dense or dense pattern, according to FFDM images. The breast lesions were diagnosed as benign(BI-RADS grade 4a and below) or malignant(BI-RADS grade 4b and above), based on the images of FFDM, DBT and MRI, respectively. All patients underwent surgery or biopsy to get a pathological diagnosis. The kappa consistency tests and receiver operating characteristics(ROC) analyses were used to compare the efficacy of FFDM, DBT and MRI in the diagnosis of breast tumor in different gland patterns. 【Results】 In all breasts, MRI (kappa = 0.66) was moderately consistent with pathological diagnosis, which was higher than DBT(kappa = 0.44), while there was no significant difference between FFDM(kappa = 0.14) and pathological diagnosis. In non-dense breasts, MRI (kappa = 0.88) was moderately consistent with pathological diagnosis, which was higher than DBT(kappa = 0.51), while there was no significant difference between FFDM(kappa = 0.18) and pathological diagnosis. In dense breasts, MRI(kappa = 0.54) was moderately consistent with pathological diagnosis, which was higher than DBT(kappa = 0.37), while there was no significant difference between FFDM(kappa = 0.10) and pathological diagnosis. In all breasts, the diagnostic efficacy of MRI, DBT and FFDM for breast tumor decreased gradually(AUC = 0.83; 0.73; 0.58). Specifically, the specificity of MRI, DBT and FFDM increased sequentially(77%, 82%, 86%), but the sensitivity decreased(88%, 65%, 29%). In non-dense breasts, the diagnostic efficacy of MRI, DBT and FFDM for breast tumor decreased gradually(AUC = 0.97; 0.84; 0.66). Specifically, the sensitivity of MRI(94%) was higher than that of DBT(69%) and FFDM(31%). In dense breasts, the diagnostic efficacy of MRI, DBT and FFDM for breast tumor decreased gradually(AUC = 0.77; 0.69; 0.55). Specifically, the specificity of MRI, DBT and FFDM increased sequentially(71%, 76%, 82%), but the sensitivity decreased(83%, 61%, 28%) . 【Conclusions】 In both dense and non-dense breasts, FFDM has the lowest diagnostic ability. In non-dense breasts, the diagnostic efficacy of MRI is higher than DBT. DBT shows its advantage over MRI in dense breasts, as it has a higher diagnostic specificity.

adrenocorticalcarcinoma；cortisolhypersecretion；hypokalemia；prognosis 【Objective】To analyze the prognostic determinants of adreno cortical carcinoma（ACC）inadults.【Methods】Alladult patients who were admitted to SunYat-sen Memorial Hospital，SunYat-sen University from December 2011 to March 2017 and pathologically diagnosed ACC were included in this study.Thec linical data and preoperative laboratory examinations of those patients were analyzed retrospectively. Overall survival or disease-free survival was calculated and survivalcurves were plotted by Kaplan-Meier and compared by log-rank test. Harzardratios（HRs） with their 95% confidenceintervals（CIs） were calculated by univariate and multivariate Coxregression model.【Results】The study included 20 adult patients with ACC， with a median follow-up of 13months （6~73 months）. The mean survival time of those patients was 49.2 months（6~73months），with a 1-year survival rate of 70.0%. The results of multivariate Coxregression analysis revealed that the presense of cortisol hypersecretion（HR=23.60，95%CI：2.49-223.79，P=0.006） and hypokalemia（HR=23.60，95%CI：2.49-223.79，P=0.006）were predictors of poorprognosis of ACC. Moreover，in 18 patients with completely resected ACC，the presense of hypokalemia resulted in a worse disease-free survival.【Conclusion】The presense of cortisol hypersecretion and hypokalemiaare independent risk factors associated with poorprognosis of ACC in adults.​