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Objective: To observe the morphologic changes and the expression of suppressor of cytokine signaling-1/3 (SOCS-1/3) in renal tubular epithelial cells induced by high glucose (HG) and to investigate their significance., Methods: The renal tubular epithelial cell line (HKCs) cultured in vitro were divided into blank control group, HG group, and Janus kinase 2 inhibitor AG490 group. HKC of blank control group was cultured for 8 hours in 5.5 mmol/L glucose, and the other two groups were cultured in 300.0 mmol/L glucose or 300.0 mmol/L glucose+10 μmol/L AG490 for 2, 4, 6, 12, 24, 48 hours (n=6). The morphology and ultrastructure were observed with inversion microscope and electron microscope at different time points. Protein expression of SOCS-1/3 was assayed by immunocytochemistry and Western blotting; SOCS-1/3 mRNA was assessed by reverse transcription-polymerase chain reaction (RT-PCR)., Results: Under inversion microscope it was showed that 12 hours after being cultured with HG, the cells assumed a spindle-shape, with irregular protrusions, and cellular membrane became indistinguishable with prolongation of time, with increase of intracellular granules. Under the electron microscope, it was seen that there was distinct decrease in microvilli on the cell membrane and mitochondria, with an increase in rough endoplasmic reticulum. The cellular changes were not obvious in AG490 group. Furthermore, immunocytochemistry and Western blotting showed that the immunoreactivity was localized in the cytoplasm as well as in the nuclei, and there was basic expression of SOCS-1/3 protein in normal HKC (0.218±0.023, 0.337±0.009). HG was shown to induce up-regulation of the expression of SOCS-1/3 protein at 4, 6, 12, 24 hours compared with blank control group. The expression of SOCS-1 was highest at 4 hours (1.022±0.072), and that of SOCS-3 was highest at 6 hours (1.256±0.105, both P<0.01), while the expression of SOCS-1/3 protein in AG490 group was lower than that in HG group (4 hours SOCS-1: 0.589±0.167, 6 hours SOCS-3 : 0.656±0.075, both P<0.05). However, HG induced a higher expression of SOCS-1/3 mRNA at 2, 4, 6, 12 hours compared with blank control group. The expression of SOCS-1 was highest at 4 hours (1.716±0.098 vs. 0.475±0.045, P<0.05), and that of SOCS-3 was highest at 6 hours (2.848±0.116 vs. 0.749±0.086, P<0.01), while the expression of SOCS-1/3 mRNA in AG490 group was lower (4 hours SOCS-1: 0.865±0.075, 6 hours SOCS-3: 0.923±0.116, both P<0.05)., Conclusion: HG could produce morphology and ultrastructure changes in renal tubular epithelial cell, and it induces up-regulation of SOCS-1/3 expression. These changes might be related with negative regulation of Janus kinase (JAK)/signal transducers and activators of transcription (STAT)/SOCS pathway.

Objective: To determine serum adiponectin, C-reactive protein (CRP), TNF-α and IL-6 levels in impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) patients with periodontitis before and after periodontal intervention, and to investigate the relationship between T2DM and periodontitis., Methods: A total of 50 IGT and 106 T2DM patients with periodontitis were enrolled. The T2DM patients were divided into two groups: T2DM without macrovascular disease (DM1) group and T2DM with macrovascular disease (DM2) group. Each group was randomly divided into two subgroups according to whether they performed periodontal intervention. The normal control group (NC group) consisted of 30 healthy adults. The serum adiponectin, CRP, TNF-α and IL-6 levels were measured at baseline and 3 months after periodontal intervention., Results: The serum adiponectin levels at baseline had decreased tendency with significant difference between each two groups, while CRP, TNF-α, and IL-6 levels had increased tendency with significant difference between each two groups among NC, IGT, DM1 and DM2 groups (all P<0.01). At 3 months after periodontal intervention, the serum adiponectin levels were increased than those without periodontal intervention (all P<0.01), while CRP, IL-6 and TNF-α significantly decreased (all P<0.05) in both IGT and DM1 groups. In DM2 group, only CRP levels at 3 months after periodontal intervention were significantly decreased (P<0.05). Moreover, the HbAlc levels in T2DM patients were improved at 3 months after periodontal invention (P<0.01)., Conclusion: Periodontal intervention is helpful for glucose control, which may be associated with increased serum adiponectin levels and decreased inflammatory cytokine levels., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Objective: To investigate insulin secretion function and insulin resistance in Chinese newly diagnosed type 2 diabetes (obese and non-obese patients) in order to provide evidence for clinical treatment., Methods: 408 newly diagnosed type 2 diabetes and 40 normal controls were recruited. Height, weight were measured, insulin and glucose of 0 min, 30 min, 60 min, 120 min during oral glucose tolerance test were examined. The patients with fasting glucose level greater than 8.3mmol/L were treatment with Gliclazide for 1 - 3 months. After normalization of the plasma glucose levels for more than 2 weeks, and withdraw this medication for 48 hours, then OGTT were repeated to assess IR and IS., Results: The patients were divided into four groups based on fasting plasma glucose (DM1: FPG < 6.9mmol/L; DM2: 6.9 mmol/L < or = FPG < 8.3 mmol/L; DM3: 8.3 mmol/L < or = FPG < 9.7 mmol/L; DM4: FPG > or = 9.7 mmol/L). Every groups were further stratified to subgroups by cut point of BMI = 24 kg/m(2). Their insulin sensitivity and insulin secretion function compared between subgroups. (1) True insulin level in BMI > or = 24 (FPG < 6.9 mmol/L) subgroups were higher than control's (3.5 +/- 0.5 vs 3.2 +/- 0.6 natural logarithm) (P < 0.05). (2) In BMI > or = 24 subgroups, their insulin sensitivity were even worse than BMI < 24 groups', but their insulin secretion function were better at the same FPG level. (3) After intervention, the change of insulin sensitivity in BMI < 24 group was better than BMI > or = 24 group's (-4.7 +/- 0.9 vs -5.5 +/- 1.4 natural logarithm) (P < 0.05); but the change of insulin secretion function in BMI < 24 group was worse., Conclusion: (1) In newly diagnostic type 2 diabetes, insulin sensitivity and insulin secretion function were decreased with the increase of FPG, but they were different between obese and non-obese group. (2) Insulin secretion function was recovered better in obese group when eliminated glucose toxicity.

Since the summer of 2006, bacterial boll rot of cotton has been observed on fruits of 'Xinluzao 31' (Xinluzao 6 × Acala) in Xinjiang Province. It resulted in as much as 20% yield loss in several fields. Symptoms do not appear on the outer carpel. In the infected cotton bolls, fibers do not mature completely and seed tissue exhibits brown necrotic coloration. Lint and seeds from 24 surface-disinfested cotton bolls were triturated and plated onto King's medium B (KB). Plates were incubated at 28°C for 48 h. Forty eight strains with yellow pigmentation on KB were characterized. All were nonfluorescent on KB, gram negative, facultatively anaerobic, unable to produce indole from tryptophan, able to reduce nitrate to nitrite, and produce acid from glucose, cellobiose, lactose, melibiose, and melonate. In addition, 16S rDNA in seven strains was amplified with universal primers (1). The PCR products were cloned into pGEM-T easy vector and sequenced. A BLAST search of the seven sequences against the GenBank nucleotide library indicated 100% identity with the 16S rDNA sequence of Enterobacter agglomerans strain A80. Then an additional primer pair, pagF and pagR (3), was used for more specific amplification of Pantoea agglomerans 16S rDNA, which resulted in single highly specific fragments of approximately 1 kb. On the basis of morphological, physiological, biochemical characteristics, and 16S rRNA gene sequence analysis, we identified the bacterium to be P. agglomerans. To confirm pathogenicity, cell suspensions (1 × 10 8 CFU/ml) of eight representative strains were used to inoculate cotton at peak bolling stage in the field. Cell suspensions, or water as the control, were applied to stigma scars, wall sutures, and scratch wounds on bracts, calyxes, and bolls. Alternatively, a needle was used to puncture through a drop of suspension placed on the boll wall suture and bracts. At least 20 bolls or flowers were inoculated with each bacterial strain per inoculation method. Infection occurred only when bacterial injections breached the endocarp of the boll either through the carpel wall or a suture between carpel sections. Disease symptoms developed 1 week postinoculation. The inoculated organism was reisolated from the diseased tissues. P. agglomerans is generally regarded to be a soil saprophyte or leaf epiphyte, but strains can opportunistically infect plants triggering gall formations or human wounds causing septic arthritis. The disease symptoms and pathogen characteristics observed in this study are identical to those reported in the United States (2). To our knowledge, this is the first report of P. agglomerans causing boll rot of cotton in China. References: (1) S. Manulisi and I. Barash. Mol. Plant Pathol. 4:307, 2003. (2) E. G. Medrano et al. J. Appl. Microbiol. 103:436, 2007. (3) S. Vorwerk et al. Agric. For. Entomol. 9:57, 2007.

Objective: To investigate the effects of fluvastatin on activation of Janus kinase 2 (JAK2) and signal transducers and activators of transcription 1, 3 (STAT1, 3) in glomerular mesangial cells(GMCs) under high concentration of glucose., Methods: Rat GMCs were cultured in vitro, and they were treated with glucose and fluvastatin respectively. Tyrosine phosphorylation of JAK2 (p-JAK2) expression was detected by immunoprecipitation and Western blotting analysis. The protein expressions of JAK2, STAT1, p-STAT1, STAT3 and p-STAT3 were assessed by Western blotting. The protein synthesis of transforming growth factor-beta1 (TGF-beta1) and fibronectin (FN) in the supernatants of the GMCs were determined by enzyme-linked immunoadsorbent assay (ELISA). TGF-beta1 mRNA was assessed by reverse transcription and polymerase chain reaction (RT-PCR)., Results: Compared with low glucose control group, the expressions of p-JAK2 (802+/-124 vs.204+/-31), p-STAT1 (2,856.6+/-337.8 vs. 617.7+/-76.2), p-STAT3 (3,049.8+/-421.3 vs. 946.7+/-141.2) and TGF-beta1 mRNA were significantly up-regulated in GMCs under high glucose medium, and the concentration of TGF-beta1 in the supernatants [(2.87+/-0.34) microg/L vs. (1.20+/-0.11) microg/L] and FN [(6.34+/-0.61) mg/L vs. (3.24+/-0.26) mg/L, both P<0.01] were higher in the supernatants. The expression levels of p-JAK2 (412+/-67), p-STAT1 (1,178.4+/-137.1), p-STAT3 (1,572.6+/-181.2) and TGF-beta1 mRNA were significantly lower in fluvastatin group than those in high glucose group. The concentration of TGF-beta1 [(1.94+/-0.27) microg/L] and FN [(4.27+/-0.33)mg/L] in the supernatants in fluvastatin group were lower than those in high glucose control group (all P<0.05)., Conclusion: Fluvastatin can inhibit overproduction of TGF-beta1 and FN in GMCs under high concentration of glucose, the underlying mechanism may partly be attributable to its influence on phosphorylation of JAK/STAT.

Objective: To investigate the expression and implication of osteopontin (OPN) in renal cortex of diabetic rats., Methods: Experimental diabetes was reproduced in uninephrectomized rats by giving streptozotocin (STZ). The animals were divided into two groups: control group and diabetic group (each n=24). Immunohistochemistry and Western blotting were used to detect the protein expression of OPN, CD68, and proliferating cell nuclear antigen (PCNA). At the same time the mRNA expression of OPN was detected by in situ hybridization., Results: Compared with control group, blood glucose, blood urea nitrogen (BUN), 24-hour urine protein quantum and quantification of OPN protein significantly increased while creatinine clearance rate (CCr) was significantly decreased in diabetic rat group 1, 2, 4 and 8 weeks after STZ injection. The protein of PCNA were also higher than that of control group 1 and 2 weeks after STZ injection (all P<0.05), and the increase in CD68 was observed at week 4 and week 8., Conclusion: Overexpression of OPN may be responsible for the proliferation of tubular cells at early stage of diabetic nephropathy and for the accumulation of macrophage at later stage.

To improve the removal rates of ammonium nitrogen in the constructed wetlands, the traditional wavy subsurface-flow constructed wetland (W-SFCW) was modified to install the aeration tube in the second wave interval to improve the DO and the nitrification rates within the constructed wetlands. It was found that as most of COD had been removed in the second wave interval, nitrifying bacteria become dominant in the third wave interval, which led to the nitrification extent reaching more than 90%, and the ability to endure the impact of hydraulic loading was enhanced. Recirculation rates of 50% were adopted to evaluate the effect on TN removal. It showed that with effluent recirculation the average removal efficiencies of TN obviously increased to 50% when the wastewater entered 1/3 of the wetland not infall. The hydraulic loading of wetland reached 0.8 m3/(m2 x d), and COD organic loading was 56-112 g/(m2 x d), and the ammonium loading rate was 20-28 g/(m2 x d).

Edible seed watermelon, Citrullus lanatus var. lanatus, is a type of watermelon from which only the seeds are consumed. Between 2003 and 2005, a bacterial disease was discovered on this type of watermelon in several regions of Xinjiang Province in western China, with a diseased area of 40,000 ha. The average disease incidence on fruit and seedlings was approximately 30 and 20%, respectively. Symptoms were most noticeable on fruit. Lesions on the fruit rind were first noticeable as small pinpoint water-soaked areas. As the lesions rapidly enlarged, black, starshaped cracks formed in the rind, and the rind along with the flesh around the spots hardened. If no secondary invaders or saprophytes entered through the cracks, the inside flesh often disintegrated into dry stiff cavities. The fruit with necrotic spots became markedly malformed. The pathogen also infected seedlings. First symptoms on the seedling appeared as dark, water-soaked lesions on the underside and edge of the cotyledons. As the cotyledon expanded, the lesions become necrotic and often extended along the length of the midrib and eventually merged into large, black, withered areas. To determine the causal agent of the disease, 54 bacterial strains were isolated from cotyledons, fruits, or seeds of edible seed watermelon. By spray inoculation, these strains were inoculated onto edible seed watermelon cv. Xinzigua1 at the two-true-leaf stage with bacterial concentrations at 10 7 CFU/ml. All strains were strongly virulent to cv. Xinzigua1, which is planted in large areas in Xinjiang, by forming many water-soaked spots on cotyledons and true leaves. There were no symptoms in the control that was sprayed with sterile deionized water. Through biological and biochemical characteristics, including Gram reaction and tests for catalase, oxidase, and oxygen requirement, all strains were identified as Acidovorax avenae subsp. citrulli. To verify pathogen identification, specific polymerase chain reaction was also carried out. One set of 16S primers, WFB1/WFB2 for A. avenae subsp. citrulli, was used (1). A single unique band of approximately 360 bp was amplified for all strains tested. To our knowledge, this is the first report of A. avenae subsp. citrulli infecting edible seed watermelon. Reference: (1) R. R. Walcott and R. D. Gitaitis. Plant Dis.84:470, 2000.

Objective: To investigate the relationship between retroviruses and autoimmune diseases, to clone the novel retroviral NP9 gene from human endogenous retrovirus (HERV), and to construct its expression vector., Methods: The viral NP9 gene was amplified and cloned by RT-PCR and T-A clone techniques, and its sequence was determined with Perkin-Elmer 377 DNA Sequencer. The amplified viral NP9 gene was subcloned into the prokaryotic express vector pQE30. The recombinant plasmids were identified by restriction endonuclease digestion and sequencing. The recombinant pQE30-NP9 protein was expressed in M15 host cells under the IPTG induction and showed with SDS-PAGE,and the corresponding NP9 viral protein was identified with Western blot analysis., Result: A specific band of 250 bp was amplified using RT-PCR from total RNA of peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) and confirmed as the NP9 gene via T-A clone and DNA sequencing analyses. SDS-PAGE profile showed a clear protein band with a relative molecular weight 9 kD in the IPTG-induced samples, which was confirmed as viral NP9 protein by Western blot analysis., Conclusion: The NP9 gene has been successfully isolated and cloned from PBMCs of SLE patients and the corresponding NP9 viral protein expressed in prokaryotic expression vector.

Objective: To investigate the expression of a novel retroviral (NP9) gene transcripts and the possible role of its protein in systemic lupus erythematosus (SLE) patients., Methods: The retroviral NP9 gene in SLE patients was isolated and cloned using RT-PCR and TA cloning techniques, and it was analyzed by sequencing. The expression of the NP9 genes in 40 patients with SLE and 48 normal controls using RT-PCR was detected. NCBI BLAST and DNASIS 3.1 software were used to analyze the features of protein of NP9 gene., Results: The positive ratio (77.5%) of the mRNA expression of the retroviral NP9 gene in SLE patients is significantly higher than that (8.3%) in normal subjects (P<0.01). The recombinant NP9 protein comprises 74 AA with pI 9.59. Amino acid sequence analysis indicates that the retroviral NP9 protein shares higher homologies with several human proteins with important biological functions., Conclusion: SLE patients possess specific novel retroviral NP9 transcripts. The expression of the retroviral NP9 gene may involve in the genesis or development of SLE.

Objective: To investigate the effect of sodium ferulate (SF) on diabetic nephropathy (DN)., Methods: Forty-eight DN patients of early stage and 54 DN patients of clinical stage were randomly divided into two groups, the conventional treatment group and the SF treatment group. Indexes, including urinary albumin excretion rate (UAER), serum endothelin (ET), blood urea nitrogen (BUN), serum creatinine (Scr) and fasting blood glucose (FBG) were observed., Results: The levels of UAER, BUN and ET were decreased in all DN patients, either early stage or clinical stage, after treated with SF for 4 weeks (P < 0.05, P < 0.01), but changed insignificantly in those treated with conventional treatment., Conclusion: SF can decrease the levels of UAER and BUN in DN patients, the mechanism may relate with the decreasing of ET production and antagonizing to the binding of ET with its receptors.

Objectives: To evaluate the incidence of immediate postoperative pulmonary complications and their correlation to preoperative pulmonary function tests (PFTs), preoperative pulmonary symptoms and surgical approaches., Methods: The case records of 298 patients, who underwent anterior or posterior fusion, were reviewed. Preoperative PFTs were recorded and abnormal PFTs were defined as forced vital capacity (FVC) is less than 80% of FVC predicted. Preoperative pulmonary symptoms (breathless on exertion) were noted, and postoperative pulmonary complications were defined when the presence of atelectasis, infiltrates, pneumothorax, hemothorax, pneumonia or requirement of postoperative ventilatory support was noted., Results: The mean age of this group was 16.4 years (range from 6-62 years). The average coronal Cobb angle was 73.26 degrees (range from 45 degrees-141 degrees ). Of all the patients, 115 patients had normal preoperative PFTs, the other 183 cases had abnormal PFTs. Nineteen cases of all the patients were found with postoperative pulmonary complications including postoperative ventilatory support in 6 cases, atelectasis in 4 cases, infiltration in 2 cases, pneumothorax in 3 cases, pneumonia in 3 cases and hypoxemia in 1 case. The incidence of postoperative pulmonary complication was 6.4% in all the patients, while 18.99% in the 79 patients with thoracotomy and 1.85% in the 216 patients without. The correlation between postoperative pulmonary complications and the surgical approach was statistically significant (P=0.0000). When the patients were classified into 3 groups: 60%< FVCR <80%, 40%< FVCR <60%, FVCR <40%, the incidence of postoperative pulmonary complications were 2.72% (3/110), 7.40% (4/54) and 31.6% (6/19) respectively, which showed an increasing complication incidence. In the 115 patients with normal PFTs, 3 patients had preoperative pulmonary symptoms (2.68%), while 14 of the 183 patients with abnormal PFTs had preoperative pulmonary symptoms (7.65%). The correlation between presence of preoperative respiratory symptoms and abnormal results on PFTs was statistically significant (P=0.01). No significant correlation was found between preoperative respiratory symptoms and postoperative pulmonary complications (P=0.52)., Conclusions: The incidence of postoperative pulmonary complications increases with the deterioration of PFTs. The posterior procedure has a very low incidence of postoperative pulmonary possibility of complications, but a transthoracic procedure increases the complications significantly. Preoperative respiratory symptoms usually predict abnormal results of PFTs but have no correlation with postoperative pulmonary complication.

Objective: To define the criteria of selective thoracic fusion in adolescent idiopathic scoliosis patients., Methods: By reviewing the roentgenograms of adolescent idiopathic scoliosis patients undergoing selective thoracic fusion, the curve type, Cobb angle, apical rotation and translation, trunk shift, and thoracolumbar kyphosis were measured and analyzed., Results: There were 12 King type II patients (PUMC type: IIb1 9, IIc3 3). The coronal Cobb angle of thoracic curve before and after surgery were 54.0 degrees and 19.0 degrees respectively, and the average correction rate was 62.7%. The coronal Cobb angle of lumbar curve before and after surgery were 34.6 degrees and 12.5 degrees respectively, and the average spontaneous correction rate was 64.7%. At the final follow-up, the coronal Cobb angle of thoracic and lumbar curve was 18.8 degrees and 15.9 degrees respectively. There was no significant change in the coronal Cobb angle, apical vertebral translation and rotation compared with that after surgery. 1 patient had 12 degrees of thoracolumbar kyphosis after surgery, no progression was noted at the final follow-up. There was no trunk decompensation or deterioration of the lumbar curve. In this group, 3.5 levels were saved compared with fusing both the thoracic and lumbar curves., Conclusion: Selective thoracic fusion can be safely and effectively performed in patients with a moderate and flexible lumbar curves, which can save more mobile segments to maintain a good coronal and sagittal balance.

Objective: To investigate the susceptibility gene of type 2 diabetes mellitus (T2DM) through a novel strategy., Methods: Firstly, the common feature of the putative susceptibility genes in the reported susceptibility loci was searched by using NCBI BLAST, and a functional L1 retrotransposon in the loci was found. Secondly, the mRNA expression level of the functional L1 retrotransposon in 25 Han T2DM patients and 22 normal controls was investigated by reverse transcription-polymerase chain reaction, and statistical analysis was implemented in statistical package SPSS10.0. Thirdly, L1 retrotransponson genome mutation screening was performed via sequencing., Results: Screening the human genome for the retrotransposon genome via alignment with the L1 genome using NCBI BLAST showed the functional L1 retrotransposons distribute on most chromosomes except for chromosomes 19, 21 and Y on which rare type 2 diabetes susceptibility loci were reported to reside, and their distribution sites are consistent with the locations of the reported candidate type 2 diabetes susceptibility loci. The mRNA expression level of the functional L1 retrotransposon in the T2DM patients was significantly lower than that in normal subjects (P<0.001). Nonsense mutations including deletion and/or point mutations were observed in all of the 6 T2DM patients tested, but no mutation was observed in all of the 4 normal controls tested., Conclusion: The functional L1 retrotransposon may be a candidate susceptibility gene of type 2 diabetes or a key regulator of the susceptibility genes, and it may be an ideal candidate biomarker for screening type 2 diabetes.

Monolayer and multilayer films of trichlorogermane hexyl propylate (Ge6) were formed by the self-assembly method on hydroxylated silicon substrates. The results showed that this kind of trichlorogermane had virtually the same self-assembly behavior as trichlorosilanes. Ellipsometry proved that the self-assembled monolayers and multilayers (SAMs) of Ge6 exhibited a tilted orientation to the substrate surface. The multilayer film of Ge6 on silicon substrate was obtained by reducing the monolayer SAMs to alcohol hydroxylated surface with LiAlH(4) and repeating the self-assembly process. The self-assembled multilayer film was calcined in air at 500 degrees C to form a thin layer of GeO(2) on SiO(2)/Si substrate surface. The XPS measurement detected the formation of GeO(2) layer. Copyright 1999 Academic Press.

The serum soluble interleukin 2 receptor (sIL2R) was measured in 38 first visited patients with Graves' disease and 29 normal controls. The serum sIL2R in 17 patients with Graves' disease was determined after treatment with antithyroid drugs (propylthiouracil) for a short period (1.2 +/- 0.5 months). The serum sIL2R was measured by sandwich enzyme linked immunosorbent assay. The sIL2R was significantly higher in patients before (3.04 +/- 0.19 U/ml) and after treatment (2.56 +/- 0.41 U/ml) than in normal controls (2.20 +/- 0.27 U/ml, P < 0.01). The mean value of serum sIL2R in 17 patients after treatment (2.56 +/- 0.41 U/ml) was substantially decreased as compared with that before treatment (2.99 +/- 0.14 U/ml, P < 0.01). The serum level of sIL2R in pretreatment patients was correlated significantly with T3(r = 0.5032, P < 0.05), but was not obviously related to T4 or rT3. These findings suggest that the human lymphocytes in patients with Graves' disease were activated in vivo and that sIL2R may be an useful immunological indicator of disease activity.

Eighty-five patients with a total of 103 foci of chronic hematogenous osteomyelitis were treated in the period from 1965-1982. Only patients who had been followed for two or more years of treatment were included in the series for evaluation. All foci were treated surgically with thorough debridement. According to the management of the wounds, patients were divided into three groups: wound healing by secondary intention in cases where skin closure was impossible; primary closure of wound with or without pedicle muscle transfer in cases of a small debrided cavity or in cases where a nearby skeletal muscle is available; and closed irrigation and suction drainage of the wound cavity. After a long-term follow-up period, satisfactory results to varying degrees were obtained in each group. Closed intermittent irrigation and suction drainage with high concentrations of antibiotic solutions gave the best results. In instances of failure, the causes may be due to inadequate removal of infected sclerotic bone and sequestra, obstruction of drainage tubes, resistance to antibiotics, or inadequate systemic antibiotic treatment. The use of myocutaneous flap transference to close the postoperative wound of chronic osteomyelitis was introduced, and preliminary results are encouraging.