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Introduction: Bone lesions are diverse and can develop at any site in the bone. They can be non-neoplastic or benign or malignant neoplasms. These neoplasms are most commonly developed during the first few decades of life, but this is not the thumb rule. Bone lesions differ in their clinical and histopathological features, posing diagnostic challenges. Aim: To analyse the level of agreement between the initial clinico-radiological and the subsequent histopathological diagnosis of bone tumours and tumour-like lesions. Materials and Methods: This prospective study was carried out in the Department of Pathology at Ramaiah Medical College and Hospital, Bengaluru, Karnataka, from May 2009 to April 2011 over a period of two years, including analysis performed over a period of month. Data presentation was done in bivariate tables and to understand association between diagnostic entities kappa statistics was estimated and interpreted. Results: In this study, 64 cases consented to be included for the concurrence study. It was observed that among the total number of cases, males were more frequently affected than females, with a ratio of 2.2:1. The peak age of incidence for bone lesions was found to be the second and third decade of life, accounting for 32.3% (n=30) of all cases. Pain with swelling constituted the most common presenting feature (n=28, 43.8%). Osteogenic (n=17, 25%) and Giant cell (n=17, 25%) tumours were the commonest lesions. Kappa statistical coefficient of 0.749 was observed, showing substantial concurrence between the histopathological and radiological diagnosis. Conclusion: The present study revealed that there was a reliable agreement between clinico-radiological and histopathological diagnosis. Histopathological confirmation of radiological diagnosis should be performed before conclusive treatment.

Objective: To investigate the feasibility and accuracy of computer vision-based artificial intelligence technology in detecting and recognizing instruments and organs in the scenario of radical laparoscopic gastrectomy for gastric cancer. Methods: Eight complete laparoscopic distal radical gastrectomy surgery videos were collected from four large tertiary hospitals in China (First Medical Center of Chinese PLA General Hospital [three cases], Liaoning Cancer Hospital [two cases], Liyang Branch of Jiangsu Province People's Hospital [two cases], and Fudan University Shanghai Cancer Center [one case]). PR software was used to extract frames every 5-10 seconds and convert them into image frames. To ensure quality, deduplication was performed manually to remove obvious duplication and blurred image frames. After conversion and deduplication, there were 3369 frame images with a resolution of 1,920×1,080 PPI. LabelMe was used for instance segmentation of the images into the following 23 categories: veins, arteries, sutures, needle holders, ultrasonic knives, suction devices, bleeding, colon, forceps, gallbladder, small gauze, Hem-o-lok, Hem-o-lok appliers, electrocautery hooks, small intestine, hepatogastric ligaments, liver, omentum, pancreas, spleen, surgical staplers, stomach, and trocars. The frame images were randomly allocated to training and validation sets in a 9:1 ratio. The YOLOv8 deep learning framework was used for model training and validation. Precision, recall, average precision (AP), and mean average precision (mAP) were used to evaluate detection and recognition accuracy. Results: The training set contained 3032 frame images comprising 30 895 instance segmentation counts across 23 categories. The validation set contained 337 frame images comprising 3407 instance segmentation counts. The YOLOv8m model was used for training. The loss curve of the training set showed a smooth gradual decrease in loss value as the number of iteration calculations increased. In the training set, the AP values of all 23 categories were above 0.90, with a mAP of 0.99, whereas in the validation set, the mAP of the 23 categories was 0.82. As to individual categories, the AP values for ultrasonic knives, needle holders, forceps, gallbladders, small pieces of gauze, and surgical staplers were 0.96, 0.94, 0.91, 0.91, 0.91, and 0.91, respectively. The model successfully inferred and applied to a 5-minutes video segment of laparoscopic gastroenterostomy suturing. Conclusion: The primary finding of this multicenter study is that computer vision can efficiently, accurately, and in real-time detect organs and instruments in various scenarios of radical laparoscopic gastrectomy for gastric cancer.

Background: Accurate acetabular component positioning is paramount to the success of total hip arthroplasty (THA). Two-dimensional imaging alone remains a popular tool for implant position assessment despite known limitations. We investigated the accuracy of a novel method for assessing acetabular component position based upon orthogonal simultaneous biplanar X-ray images., Methods: There were forty consecutive patients who had a preexisting THA on the contralateral side who underwent both computed tomography (CT) and simultaneous orthogonal biplanar radiographic scans for preoperative planning of THA. The operative inclination (OI) and operative anteversion (OA) of the acetabular cup were calculated by a new measurement method using the biplanar simultaneous scans. Those measurements were compared to measurement of the cup orientation on CT. The measurements were made by 2 independent observers. Interobserver correlation coefficients were calculated between the 2 observers to measure reliability., Results: The mean error in OA measurement of the acetabular cup between simultaneous orthogonal biplanar radiographic and CT imaging was 0.5° (SD: 1.9°, minimum -4.0°, maximum 5.0°), the mean error in OI was 0.0° (SD: 1.7°, minimum -5.0°, maximum 4.0°). The average absolute error was 1.5° for OA and 1.2° for OI. Interobserver correlation coefficient was 0.83 for OA and 0.93 for OI., Conclusion: The novel method of measuring cup orientation using simultaneous biplanar radiographic scans utilized in this study was accurate and reproducible between observers compared to CT measurements., (Copyright © 2023. Published by Elsevier Inc.)

Objective: To explore the feasibility and preliminary technical experience of the double-tract reconstruction combined with π-shaped esophagojejunal anastomosis after total laparoscopic proximal gastrectomy (TLPG) in the treatment of adenocarcinoma of esophagogastric junction (AEG). Methods: A descriptive case series study method was used. Clinical data of 12 AEG patients who underwent the double-tract reconstruction combined with π-shaped esophagojejunal anastomosis after TLPG from January 2021 to June 2021 at the Department of General Surgery, First Medical Center, PLA General Hospital were retrospectively analyzed. Among the 12 patients, the median tumor diameter was 2.0 (1.5-2.9) cm, and the pathological stage was T1-3N0-3aM0. All the patients routinely underwent TLPG and D2 lymph node dissection with double-tract reconstruction combined with π-shaped esophagojejunal anastomosis: (1) Double-tract reconstruction combined with π-shaped esophagojejunal anastomosis: mesentery 25 cm away from the Trevor ligament was treated, and an incision of about 1 cm was made on the mesenteric border of the intestinal wall and the right wall of the esophagus, two arms of the linear cutting closure were inserted, and esophagojejunal side-to-side anastomosis was performed. A linear stapler was used to cut off the lower edge of the anastomosis and close the common opening to complete the esophagojejunal π-shaped anastomosis. (2) Side-to-side gastrojejunostomy anastomosis: an incision of about 1 cm was made at the jejunum to mesenteric border and at the greater curvature of the remnant stomach 15 cm from the esophagojejunostomy, and a linear stapler was inserted to complete the gastrojejunostomy side-to-side anastomosis. (3) Side-to-side jejunojejunal anastomosis: an incision of about 1 cm was made at the proximal and distal jejunum to the mesangial border 40 cm from the esophagojejunostomy, and two arms of the linear stapler were inserted respectively to complete the side-to-side jejunojejunal anastomosis. A midline incision about 4-6 cm in the upper abdomen was conducted to take out the specimen, and an abdominal drainage tube was placed, then layer-by-layer abdominal closure was performed., Indications: (1) adenocarcinoma of esophagogastric junction (Seiwert type II-III) was diagnosed by endoscopy and pathological examination; (2) ability to preserve at least 1/2 of the distal stomach after R0 resection of proximal stomach was evaluated preoperatively., Contraindications: (1) evaluation indicated distant metastasis of tumor or invasion of other organs; (2) short abdominal esophagus or existence of diaphragmatic hiatal hernia was assessed during the operation; (3) mesentery was too short or the tension was too high; (4) existence of severe comorbidities before surgery; (5) only palliative surgery was required in preoperative evaluation; (6) poor nutritional status., Main Outcome Measures: operation time, intraoperative blood loss, postoperative complications, time to first flatus and time to start liquid diet, postoperative hospital stay, operation cost, etc. Continuous variables that conformed to normal distribution were presented as mean ± standard deviation, and those that did not conform to normal distribution were presented as median ( Q 1, Q 3). Results: All the patients successfully completed TLPG with double-tract reconstruction combined with π-shaped esophagojejunal anastomosis, and postoperative pathology showed that no cancer cells were found on the upper incision margin. The operation time was (247.9±62.4) minutes, the median intraoperative blood loss was 100.0 (62.5, 100.0) ml, no intraoperative blood transfusion was required, the incision length was (4.9±1.0) cm, and the operation cost was (55.5±0.7) thousand yuan. The median time to start liquid diet was 1.0 (1.0, 2.0) days, and the mean time to flatus was (3.1±0.9) days. All the patients were discharged uneventfully. Only 1 patient developed postoperative paralytic ileus and infectious pneumonia with Clavien-Dindo classification of grade II. The patient recovered after conservative treatment. There was no surgery-related death. The postoperative hospital stay was (8.3±2.1) days. Conclusion: The double-tract reconstruction combined with π-shaped esophagojejunal anastomosis after TLPG is safe and feasible, which can minimize surgical trauma and accelerate postoperative recovery.

Objective: To investigate the pharmacodynamic material basis, mechanism of actions and targeted diseases of Salicornia europaea L. (SE) based on the network pharmacology method, and to verify the antidepressant-like effect of the SE extract by pharmacological experiments., Methods: Retrieval tools including Chinese medicine (CM), PubMed, PharmMapper, MAS 3.0 and Cytoscape were used to search the components of SE, predict its targets and related therapeutic diseases, and construct the "Component-Target-Pathway" network of SE for central nervous system (CNS) diseases. Further, protein-protein interaction (PPI) network, Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) function annotation of depression-related targets were analyzed to predict the antidepressant mechanism of SE. Chronic unpredictable mild stress (CUMS) model was used to construct a mouse model with depression-like symptoms. And the animals were randomly divided into 6 groups (n=10) including the normal group (nonstressed mice administered with distilled water), the CUMS group (CUMS mice administered with distilled water), the venlafaxine group (CUMS mice administered with venlafaxine 9.38 mg/kg), SE high-, medium-, and low-dose groups (CUMS mice administered with SE 1.8, 1.35 and 0.9 g/kg, respectively). Then some relevant indicators were determined for experimental verification by the forced swim test (FST), the tail suspension test (TST) and open-field test (OFT). Dopamine (DA) concentration in hippocampus and cerebral cortex, IL-2 and corticosterone (CORT) levels in blood, and nuclear factor E2 related factor 2 (Nrf2), kelch-like epichlorohydrin related protein 1 (Keap1), NAD(P) H dehydrogenase [quinone] 1 (NQO1) and heme oxygenase-1 (HO-1) levels in mice were measured by enzyme linked immunosorbent assay (ELISA) and Western blot respectively to explore the possible mechanisms., Results: The "target-disease" network diagram predicted by network pharmacology, showed that the potential target of SE involves a variety of CNS diseases, among which depression accounts for the majority. The experimental results showed that SE (1.8, 1.35 g/kg) significantly decreased the immobility period, compared with the CUMS group in FST and TST in mice after 3-week treatment, while SE exhibited no significant effect on exploratory behavior in OFT in mice. Compared with CUMS group, the SE group (0.9 g/kg) showed significant differences (P<0.05) in DA levels in the hippocampus and cerebral cortex. In addition, compared with CUMS control group, SE (1.8 g/kg) group showed a significant effect on decreasing the activities of CORT (P<0.05), and serum IL-2 level with no statistical significance. Finally, Western blot results showed that compared with the model group, Nrf2, Keap1, NQO1 and HO-1 protein expressions in SE group (1.8 g/kg) were up-regulated (all P<0.01)., Conclusion: The SE extract may have an antidepressant effect, which appeared to regulate Nrf2-ARE pathway and increased levels of DA and CORT in the hippocampus and cortex., (© 2022. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Total knee arthroplasty (TKA) represents a major national health expenditure. The last decade has seen a surge in robotic-assisted TKA (roTKA); however, literature on the costs of roTKA as compared to conventional TKA (cTKA) is limited. The purpose of this study was to assess the costs associated with roTKA as compared to cTKA., Methods: This was a retrospective cohort cost-analysis study of patients undergoing primary, elective roTKA or cTKA from July 2020 to March 2021. Time-driven activity-based costing (TDABC) was used to determine granular costs. Patient demographics, medical/surgical details, and costs were compared., Results: A total of 2058 TKAs were analyzed (1795 cTKAs and 263 roTKAs). roTKA patients were more often male (50.2% vs 42.3%; P  = .016), and discharged home (98.5% vs 93.7%; P  = .017), and had longer operating room (OR) time (144.6 vs 130.9 minutes; P < .0001), and lower length of stay (LOS) (1.8 vs 2.1 days; P < .0001). roTKA costs were 2.17× greater for supplies excluding implant ( P < .0001), 1.18× for total supplies ( P < .0001), 1.12× for OR personnel ( P < .0001), and 1.05× for total personnel ( P  = .0001). Implant costs were similar ( P  = .076), but 0.98× cheaper for post-anesthesia care unit personnel ( P  = .018) and 0.84× for inpatient personnel ( P < .0001). Overall hospital costs for roTKA were 1.10× more than cTKA ( P < .0001)., Conclusion: roTKA had higher total hospital costs than cTKA. Despite a lower LOS, the longer OR time with higher supply and personnel costs resulted in a costlier procedure. Understanding the costs of roTKA is essential when considering the value (ie, outcomes per dollars spent) of this modern technology., (© 2021 The Authors.)

Radiologists in training draw from their early experiences in residency when choosing a fellowship. Once they have decided on an abdominal imaging fellowship, applicants must learn to navigate the interview process. During this challenging time, applicants explore the difference in clinical curricula and rotations, meet potential mentors and clinical faculty, consider potential academic interests and projects, and choose what location they would like to train for one year after residency. When in training, fellows undergo the challenge of finding employment while learning new skills and refining their abilities to become a well-rounded radiologist and clinician. This article summarizes key points potential applicants should consider when deciding on an abdominal imaging fellowship, how to prepare for the interview season, and how to plan their fellowship year before fellows take the next step to becoming attendings., (© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Background: Metastasis of pancreatic cancer to the colon is rare and the features need to be further elucidated. Herein, we report a rare case of pancreatic cancer with simultaneous liver and colon metastases., Case Summary: A 48-year-old man with intrahepatic space-occupying lesions based on a computed tomography scan was admitted to our hospital for further treatment. Abdominal magnetic resonance imaging revealed a 6.4 cm × 4.2 cm mass in the tail of the pancreas and multiple low-density masses in the liver parenchyma. In addition, a mass of 2.2 cm × 1.6 cm with surface congestive erosions in the sigmoid colon was detected by colonoscopy. Histopathological examination of biopsies from both the liver and colon lesions revealed a moderately to poorly differentiated adenocarcinoma. Immunohistochemical staining of the colon tumor was positive for cytokeratin (CK) 7 and CK, but negative for colorectal adenocarcinoma-related markers CK 20, CDX2, and SATB2, thus indicating that the metastasis originated from the pancreas. Next-generation sequencing for genomic profiling of the liver and colon metastases both found mutations in KRAS (p.G12D) and TP53 (c.376-1delG), with microsatellite stable and low tumor mutational burden without actionable or cancer-predisposing gene mutations detected. The patient was subsequently treated with 12 cycles of FOLFIRINOX which led to a sustainable response, followed by ongoing maintenance treatment with irinotecan plus fluorouracil., Conclusion: For this rare case, careful evaluation of histopathological and immunohistochemical staining results are required. The genomic profiling of colon lesions was revealed for the first time, and FOLFIRINOX showed good treatment efficacy in this patient., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Nomograms are rarely employed to estimate the survival of patients with advanced and metastatic pancreatic cancer (PC). Herein, we developed a comprehensive approach to using a nomogram to predict survival probability in patients with advanced and metastatic PC., Methods: A total of 323 patients with advanced and metastatic PC were identified from the Chinese People's Liberation Army (PLA) General Hospital. A baseline nomogram was constructed using baseline variables of 323 patients. Additionally, 233 patients, whose tumors showed initial responses to first-line chemotherapy, were enrolled in the chemotherapy response-based model. 128 patients and 108 patients with advanced and metastatic PC from January 2019 to April 2021 were selected for external validating baseline model and chemotherapy response-based model. The 1-year and 2-year survival probability was evaluated using multivariate COX regression models. The discrimination and calibration capacity of the nomograms were assessed using C-statistic and calibration plots. The predictive accuracy and net benefit of the nomograms were evaluated using ROC curve and DCA, respectively., Results: In the baseline model, six variables (gender, KPS, baseline TB, baseline N, baseline WBC and baseline CA19-9) were used in the final model. In the chemotherapy response-based model, nine variables (KPS, gender, ascites, baseline N, baseline CA 19-9, baseline CEA, change in CA 19-9 level at week, change in CEA level at week and initial response to chemotherapy) were included in the final model. The C-statistics of the baseline nomogram and the chemotherapy response-based nomogram were 0.67 (95% CI, 0.62-0.71) and 0.74 (95% CI, 0.69-0.77), respectively., Conclusion: These nomograms were constructed to predict the survival probability of patients of advanced and metastatic PC. The baseline model and chemotherapy response-based model performed well in survival prediction., (© 2021. The Author(s).)

Background: The incidence and mortality of pancreatic cancer (PC) has gradually increased. The aim of this study was to identify survival-related DNA methylation (DNAm)-driven genes and establish a nomogram to predict outcomes in patients with PC., Methods: The gene expression, DNA methylation database, and PC clinical samples were downloaded from TCGA. DNAm-driven genes were identified by integrating analyses of gene expression and DNA methylation data. Survival-related DNAm-driven genes were screened via univariate, least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analyses to develop a risk score model for prognosis. Based on analyses of clinical parameters and risk score, a nomogram was built and validated. The independent cohort from GEO database were used for external validation., Results: A total of 16 differentially expressed methylation-driven genes were identified. Based on LASSO Cox regression and multivariate Cox regression analysis, six genes (FERMT1, LIPH, LAMA3, PPP1R14D, NQO1, VSIG2) were chosen to develop the risk score model. In the Kaplan-Meier analysis, age, T stage, N stage, AJCC stage, radiation therapy history, tumor size, surgery type performed, pathological type, chemotherapy history, and risk score were potential prognostic factors in PC (P < 0.1). In the multivariate analysis, stage, chemotherapy, and risk score were significantly correlated to overall survival (P < 0.05). The nomogram was constructed with the three variables (stage, chemotherapy, and risk score) for predicting the 1-year, 2-year, and 3-year survival rates of PC patients. Nomogram performance was assessed by receiver operating characteristic (ROC) curves and calibration curves. 1-year, 2-year and 3-year AUC of nomogram model was 0.899, 0.765 and 0.776, respectively., Conclusions: In our study, we successfully identified the six DNAm-driven genes (FERMT1, LIPH, LAMA3, PPP1R14D, NQO1, VSIG2) with a relationship to the outcomes of PC patients. The nomogram including stage, chemotherapy, and risk score could be used to predict survival in PC patients., (© 2021. The Author(s).)

Background: MR enterography (MRE) is generally performed without bowel preparation, but the frequency and extent by which bowel contents affect bowel wall visualization are poorly described in the literature., Purpose: To evaluate MRE bowel wall visualization quality relative to bowel lumen contents and patient demographics., Study Type: Retrospective, single-center., Population: One hundred and four consecutive patients (mean age 29 years, range 5-76 years) without prior bowel resection who had undergone MRE., Field Strength/sequence: 3 T (N = 87) or 1.5 T (N = 17)/T2-weighted single-shot spin echo (T2WI) and fat-saturated T1-weighted gradient echo (T1WI) without and with gadolinium., Assessment: For the proximal and distal jejunum and ileum and colon, three readers independently categorized bowel lumen signal (water = bright T2 dark T1, T1-bright, or air = dark T2 and T1 signal) and scored distension (0 = poor, 1 = moderate, 2 = well) and wall enhancement (0 = unclear, 1 = perceptible, 2 = clear) based upon gadolinium enhanced T1WI for the 104 MRE exams). The bowel visualization score was the sum of the wall enhancement and distension scores and was considered adequate if ≥3., Statistical Tests: Wilcoxon signed-rank test., Results: The bowel lumen content was water signal in 93% (97/104 scans), 92% (95/104), 98% (102/104), and 93% (92/104) of the proximal and distal jejunum and proximal and distal ileum, respectively, but only in 12.5% (13/104) of the colon. There was adequate bowel visualization of 53.8%, 77.8%, 84.6%, 90.4% of the proximal and distal jejunum and proximal and distal ileum, respectively, but only 19.2% of the colon. In children (age < 18 years), the visualization score of the ileum was lower when the adjacent colon contained air (2.4 ± 0.97) compared to water (3.75 ± 0.29, P < 0.05) or T1-bright material (3.21 ± 0.82, P < 0.05)., Data Conclusion: Without bowel preparation, colon wall visualization was often unsatisfactory at MRE, and air-filled colon also degraded small bowel visualization, particularly in children., Level of Evidence: 4 TECHNICAL EFFICACY: Stage 1., (© 2021 International Society for Magnetic Resonance in Medicine.)

Diverticular disease of the colon and small bowel is an important cause of pathology leading to emergency department visits and urgent gastrointestinal surgery. CT is a highly sensitive and specific modality for the diagnosis of acute diverticulitis and its complications as well as for the exclusion of alternate causes of pathology. Ultrasound, MRI and virtual CT colonoscopy have important adjunct roles for screening and workup of complications in specific patient populations. While diverticular disease most commonly involves the descending and sigmoid colon, it can also affect the proximal colon and small bowel. Acute diverticulitis may be categorized as uncomplicated or complicated according to the degree of inflammatory changes and related complications it induces, although some degree of overlap exists in clinical practice. Uncomplicated diverticulitis is classically characterized by localized inflammation surrounding a diverticulum ranging from wall thickening and phlegmonous change to the development of small, localized pericolic abscesses. Complicated forms of disease manifest with larger pericolic and distant abscesses, fistulae to adjacent organs, perforation, and peritonitis. Recurrent episodes of diverticulitis may lead to muscular hypertrophy of the bowel wall and luminal narrowing, potentially leading to bowel obstruction. Several imaging features may help to differentiate diverticulitis from colonic malignancy, however this remains a diagnostic imaging challenge that often requires further evaluation with colonoscopy. In this review, we discuss the pathophysiology and key imaging features of acute diverticulitis and its complications. We explore both common and uncommon presentations of the disease involving the colon and small bowel, acute and chronic manifestations of disease, and pitfalls to recognize when imaging alone may be insufficient to distinguish benign from malignant., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: This study describes the experience of patients who initially failed total joint arthroplasty preoperative screening criteria but were subsequently optimized and underwent surgery., Methods: Time to optimization from the patients' initial clinic visit was recorded. Following surgery, patients' body mass index and lab work were tracked to determine whether they "relapsed" to their preoptimized state. Descriptive statistics determined (1) the length of time to meet screening criteria and (2) which screening criteria took the longest to optimize., Results: Only 11 of 84 patients (13%) required greater than 1 year to meet criteria. Most patients (76%) "relapsed" to their previous nonqualifying status after surgery; however, this reversion did not contribute significantly to an increased rate of complication in short-term follow-up (P = .4298)., Conclusion: Patients in this study were able to achieve preoperative screening criteria for total joint arthroplasty in less than 1 year. Relapsing after surgery does not appear to adversely affect clinical outcomes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Based on dendrochronological methods, we established residual chronologies (RES) of Abies georgei at low, middle and high altitudes with ring width data on the eastern slope of Yulong Snow Mountain. We examined the relationship between the radial growth and climate factors (temperature and precipitation) by response function analysis and redundancy analysis (RDA) to identify the key climatic factors driving the radial growth of A. georgei. The results showed that the responses of radial growth of A. georgei to climates were consistent at three altitudes, which was jointly controlled by temperature and precipitation. This consistency was related to the steep terrain of Yulong Snow Mountain, the high-altitude distribution, and shallow root characteristics of A. georgei. At all three altitudes, tree growth showed significantly positive correlation with mean temperature of the current July, mean temperature of the previous November, and precipitation of the current January, but negative correlation with precipitation of the current June. The comprehensive application of response function analysis and redundancy analysis could accurately reveal the relationship between tree growth and climatic factors along environmental gradients. Our results provided a scientific basis for climatic reconstruction and forest management in the area.

Objective: This study aimed at investigating the role of Neurotrophin-3 (NT-3) in the bone fracture healing of rats and to provide a reference for clinical treatment., Materials and Methods: 40 Sprague-Dawley (SD) rats were randomly divided into control group and NT-3 group. The tibia fracture model was made in NT-3 group, and the tibia bone mineral density (BMD) was measured before and after the surgery. The biomechanics indexes were inspected after the surgery, including elasticity modulus, max load, and bending rigidity. The levels of bone morphogenetic protein (BMP)-2 and transforming growth factor (TGF)-β1 in serum were examined by enzyme-linked immunosorbent assay (ELISA). Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the levels of hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) mRNA expression in callus tissue. The pathological profile of tibia fracture healing was characterized after the surgery., Results: The levels of BMD in NT-3 group were significantly higher than that in control group after the surgery (p < 0.05). The levels of elasticity modulus, maximum load, stiffness of shinbone, BMP-2 and TGF-β1 were significantly higher in NT-3 group than those in control group after the surgery (p < 0.05). Compared with the control group, the expression of HIF-1α mRNA was significantly lower and the expression of VEGF mRNA was significantly higher in NT-3 group after the surgery (p < 0.05). Histological study showed that the periosteal reaction, capillary proliferation, cartilage cells production and ossification were happened after treating NT-3 for tibia fracture model rats., Conclusions: NT-3 can significantly improve fracture healing in rats.

This study aims to investigate the efficacy of bevacizumab-combined chemotherapy (BCC) in Chinese stage IV colorectal cancer (CRC), and analyze the relationship between clinicopathological features with survival. Patients with stage IV CRC treated with BCC were analyzed retrospectively. 217 metastatic CRC (mCRC) patients were collected, out of which79 were right-sided CRCs and 138 were left-sided ones. Patients with Eastern Cooperative Oncology Group (ECOG) performance status ≤2, single agent chemotherapy, poor/mucous/signet ring cell component, second-and further-line of bevacizumab administration, multiple metastasis sites had comparatively worse survival. Among 141 patients with known KRAS status, 55 patients harbored KRAS mutation and 86 had wild type KRAS. The ORR and DCR were 41.9% and 78.9%, respectively, in patients with wild type KRAS, while ORR and DCR was 38.7% and 77.9%, respectively, in patients with KRAS mutation. The median PFS of patients with wild type and mutant KRAS were 8.38, and9.59 months, respectively; whereas the OS was 23.00 and 21.26 months, respectively for mCRC patients with wild-type and mutant KRAS. Cumulatively, our study indicated that BCC was effective and beneficial for Chinese stage IV CRC patients. KRAS mutation status and tumor location were not a prognostic factor for survival.

Background: Leucine-rich alpha-2-glycoprotein-1 (encoded by LRG1 ) has been shown to be involved in multiple cancer progression and angiogenesis. LRG1 has been shown to be one of the five plasma proteins that can be used for colorectal cancer (CRC) diagnosis. The objective of the current study was to explore relationship between LRG1 protein expression and microvessel density (MVD) in stage III CRC., Methods: A single-center retrospective analysis of all stage III CRC who underwent surgery and adjuvant chemotherapy was carried out. LRG1 and CD34 were tested in tumor tissues by immunohistochemistry (IHC)., Results: LRG1 protein expression was significantly associated with MVD ( P <0.001) and other clinicopathological parameters, including T stage ( P =0.028), differentiation ( P =0.035) and vascular invasion ( P =0.007). Cox multivariate regression analysis showed that LRG1 protein expression was an independent poor predictive factor for both disease-free and overall survival., Conclusion: LRG1 protein expression can be used as a prognostic marker for stage III CRC along with its use as a diagnostic marker for CRC in general., Competing Interests: CONFLICTS OF INTEREST The authors declare that they do not have any conflict of interest.

Objective: To summarize the prognostic factors of stage 3 colorectal cancer., Methods: The clinical data of 433 patients with stage 3 colorectal cancer who were admitted to our hospital from January 2005 to December 2008 for radical surgery and adjuvant chemotherapy were retrospectively analyzed. Relationship of their clinicopathologic features and treatment with the prognosis were analyzed., Results: Of these 433 stage 3 patients,the mean disease-free survival was (72.37 ± 2.11) months and mean overall survival was (79.91 ± 2.02) months; however, the median survival times were not reached. The 1-,3-, and 5-year disease-free survival rate were 86.8%,77.9%, and 57.0% and the overall survival rate were 91.5%,75.1%, and 63.3%. Multivariate COX regression analysis displayed that intestine obstruction before surgery, complications after surgery,tumor location,positive surgical margin, neural cell infiltration,vessel cancer embolus, TNM stage, lymph node ratio, adjuvant chemotherapy regimens, and chemotherapy duration were the independent factors affecting disease-free and overall survivals in patients with stage 3 colorectal cancer. The efficacies of FOLFOX and XELOX regimens were significantly correlated with patient's age, complications,tumor location,and chemotherapy duration., Conclusions: Complications,tumor location, TNM stage, and positive surgical margin are the independent prognostic factors of stage 3 colorectal cancer. FOLFOX and XELOX regimen can remarkably improve prognosis,and a longer duration of chemotherapy can achieve better survival.

Objective: To investigate the feasibility and efficiency of the autologous minced muscle-derived regenerate as a living patch graft for the urethral reconstruction with the assistance of human umbilical cord mesenchymal stem cells (hUC-MSCs) in the rabbit model., Materials and Methods: The hUC-MSCs and minced-muscle-derived regenerate tissue was prepared and used as potential autologous patch graft for the reconstruction of the defective rabbit urethra. Animal with autologous free skeletal muscle piece was observed as control. Histopathological and immunohistochemical staining methods were adopted to evaluate the regenerating effect; the reconstructive effects in New Zealand rabbit were observed in both groups by retrograde urethrography and urinary microscopy., Results: The expression of desmin and anti-human specific nuclear antigen (ANA) were positive for co-culture microsomes in vivo and in vitro; after the reconstructive surgery, histopathological studies revealed fibrous connective tissues and abundant muscle fibers constituted the main body of the patch-grafted urethra. Urethrography and urethroscopy showed no urethral obstruction, stenosis, fistula or diverticula anomaly existed in experimental group., Conclusions: Our preclinical study showed that the hUC-MSCs and minced-muscle-derived regenerate could be used as an autologous pre-vascularized living patch graft for urethral reconstruction.

Objective: To explore the mechanism of erectile dysfunction (ED) with testosterone deficiency and discuss the feasibility of long-term testosterone replacement therapy (TRT) by observing a case of ED with testosterone deficiency treated by TRT for 65 months., Methods: We treated an ED patient with testosterone deficiency by TST for 65 months, and evaluated the therapeutic effects by analyzing his IIEF-5 score, dynamic changes in testosterone, PSA, hemoglobin and red blood cell count, and adverse events., Results: The patient was a 46-year-old man, with an IIEF-5 score of 7, baseline serum total testosterone (TT) of 2.79 ng/ml, and no response to phosphodiesterases-5 inhibitors (PDE5i). He was diagnosed with late-onset hypogonadism (LOH) and treated by TRT: testosterone undecanoate at 80 mg bid po for the first 2 weeks and then at 40 mg bid po. Two months after medication, the TT level was increased to normal (3.45 ng/ml), and physical fitness and anxiety symptoms were markedly improved, with no significant improvement in sexual function. Then we administered PDE5i on demand in addition, which elevated his IIEF-5 score to > 21. The combined medication of TRT and on-demand PDE5i lasted for 45 months followed by TRT alone for another 18 months. The patient was restored to normal penile erection and sexual satisfaction, with the IIEF-5 score remaining at > 21. Regular follow-up revealed no significant abnormalities in the testosterone level, PSA, and routine blood tests., Conclusion: TRT enhances the effect of PDE5i in the treatment of androgen deficiency-induced ED, and long-term TRT is safe and effective for androgen deficiency.

Objective: To explore the role of the P38 signaling pathway in the apoptosis of arsenic trioxide (As2 O3)-induced androgen-independent prostate cancer PC-3 cells., Methods: Androgen-independent prostate cancer PC-3 cells were treated with different concentrations of As2 O3 for 24, 48 and 72 hours. The inhibitory effect of As2 O3 on the cell growth was measured by MTT, the expression of p- P38 detected by Western blot, and the rate of cell apoptosis determined by Annexin V and PI double staining before and after interfering the P38 signaling pathway by SB203580, a highly selective P38 inhibitor., Results: As2 O3 inhibited the proliferation of PC-3 cells in a concentration- and time-dependent manner, and quickly activated P38 phosphorylation, thus giving full play to its biological activities. After 24 hours of treatment with As2 O3 at the concentrations of 2, 10 and 20 micromol/L, the apoptosis rates of the PC-3 cells were (18.9 +/- 0.43), (24.7 +/- 0.29) and (49.7 +/- 1.79)%, respectively, which were reduced to (14.8 +/- 0.81), (22.1 +/- 0.51) and (39.6 +/- 1.74)% after interfering the P38 pathway with SB203580. Inhibition of the P38 pathway significantly reduced the apoptosis of the PC-3 cells induced by As2 O3 (P < 0.05)., Conclusion: As2 O3 can induce the apoptosis of prostate cancer PC-3 cells by activating the P38 signaling pathway, and interfering the P38 signaling pathway can reduce their apoptosis, which suggests that the P38 signaling pathway is involved in the apoptosis of As2 O3-induced androgen-independent prostate cancer PC-3 cells.

Objective: To summarize the 5-year follow-up to 2 micron continuous wave laser vaporesection for the treatment of patients with low urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), and evaluate the safety and clinical effects of the treatment., Methods: From October 2006 to September 2007, 236 cases with low urinary tract symptom secondary to BPH were treated transurethrally under epidural or general anesthesia using the 70 Watt 2 micron laser system. Vaporesection of the prostate was performed with the traditional "U" or the "dividing" method. The 210 cases who met the inclusion criteria in this study were selected for further observation. Baseline and perioperative data were recorded and evaluated in resection time, transfusion rate, catheter-time, improvements in maximal urinary flow rate (Qmax), international prostate symptom scores (IPSS), quality of life (QoL), and post voiding residual volume (PVR)., Results: Out of the 210 cases, 179 cases were followed up to 5 years finally. All the surgical procedures were successfully conducted under epidural or general anesthesia. Mean operation time was (80 ± 22) minutes, and mean retrieved prostatic tissue was (24.9 ± 4.2) g. Resected prostatic tissues could be easily flashed out of the bladder. There were no significant differences in serum sodium concentrations and hemoglobin levels before and after the surgery. Mean catheter time and hospital stay was (114 ± 35) hours and (5.7 ± 1.9) days respectively. Only one postoperative secondary hemorrhage was found and treated with blood transfusion. During the 5-year follow-up, Qmax increased from (8.6 ± 3.5) ml/s preoperatively to (23.6 ± 4.2) ml/s by the end of the follow-up (P < 0.01), IPSS and QoL-Score improved from 25.3 ± 5.2 and 4.1 ± 1.3 to 6.1 ± 3.0 and 1.4 ± 0.8 respectively (P < 0.01), and PVR decreased from (248 ± 89) ml to (15 ± 13) ml. The 3 patients developed urinary incontinence and recovered 3 months later through functional exercises with the help of acupuncture. Five patients were found to have urethral stricture 3 months after the surgery and recovered with the treatment of urethral dilatation (3 cases) or internal urethrotomy (2 cases) respectively., Conclusions: Transurethral vaporesection of prostate using the 2 micron continuous wave laser system is a safe and effective treatment for benign prostatic hyperplasia with obvious improvements in subjective and objective voiding parameters, which were evident at 3 months after the surgery and were sustained throughout the 5-year long-term follow-up.

Objective: Pituitary prolactinoma with severe erectile dysfunction (ED) as the initial symptom is often misdiagnosed. This article explores the diagnosis and treatment of severe ED caused by pituitary prolactinoma., Methods: We retrospectively analyzed the diagnosis and treatment of 4 cases of pituitary prolactinoma with severe ED (IIEF-5 score 5 - 7) as the initial clinical symptom confirmed by MRI., Results: The 4 cases of pituitary prolactinoma-induced severe ED, with serum prolactin 10 times above the maximum normal level, were misdiagnosed for 2 years. All failed to respond to the PDE5 inhibitor therapy, and then 3 of them underwent transnasal hypophysectomy. Twenty-four months of follow-up found the level of prolactin restored to normal in 1 case (IIEF-5 = 19), and reduced to 600 and 768 IU/L respectively (IIEF-5 = 15) in the other 2. Then administration of the PDE5 inhibitor was followed, which produced satisfactory efficacy. One case was treated with oral bromocriptine, which restored the prolactin level to normal at 12 months (IIEF-5 > 21)., Conclusion: Prolactin detection and brain MRI can help to confirm pituitary prolactinoma with severe ED at the onset. As for its treatment, in case of an extremely high level of prolactin, simple administration of the PDE5 inhibitor is ineffective. When the prolactin level is reduced after surgery or medication, the symptom of ED can be improved and, in case of no obvious relief, administration of the PDE5 inhibitor can be followed, which may achieve satisfactory results.

Acrylamide (AA) contents in 294 snack foods including cereal-based, root- and tuber-based, and seafood-based foods, nuts, dried beans, and dried fruits purchased in Taiwan were determined by gas chromatography-mass spectrometry in this study. The highest levels of average AA content were found in root- and tuber-based snack foods (435 μg/kg), followed by cereal-based snack foods (299 μg/kg). Rice flour-based, seafood-based, and dried fruit snack foods had the lowest average AA content (<50 μg/kg). This is the first large surveillance of AA content in snack foods in Taiwan. The results could provide important data regarding intake information from the snack foods. In addition, the results showed a great diversity of AA content in snack foods prepared from different ingredients. Rice- and seafood-based products had much lower AA than those made from other ingredients. This information could constitute a good reference for consumers to select products for healthy snacking.

Objective: Diabetes mellitus may impair bone healing after dental implant placement. The objective of this study was to evaluate the effects of the local delivery of basic fibroblast growth factor (bFGF) from poly(lactide-co-glycolide) (PLGA) microspheres on osseointegration around titanium implants in diabetic rats., Study Design: The bFGF-PLGA microspheres were prepared by the W/O/W double-emulsion solvent evaporation method. A total of 20 rats were used to create diabetic animal models by giving them a high-fat and high-sugar diet and a low-dose streptozotocin intraperitoneal injection. Titanium implants were planted into the tibias of the diabetic rats and into 10 normal rats. Microspheres were loaded on the surfaces of the implants in the bFGF intervention group before they were placed into the rats. After 4 or 8 weeks, the tibias containing the implants were removed and embedded with resin. Uncalcified tissue slices were prepared to compare osseointegration., Results: At 4 weeks, the bone-implant contact rate in the diabetic control group was less than that in the control group and the bFGF intervention group (P < .05). At 8 weeks, the results among the 3 groups were similar to those at 4 weeks., Conclusions: The local delivery of bFGF from PLGA microspheres into areas around titanium implants may improve osseointegration in diabetic rats., (Copyright © 2012 Elsevier Inc. All rights reserved.)

In order to understand the mechanisms of poor osseointegration following dental implants in type 2 diabetics, it is important to study the biological properties of alveolar bone osteoblasts isolated from these patients. We collected alveolar bone chips under aseptic conditions and cultured them in vitro using the tissue explants adherent method. The biological properties of these cells were characterized using the following methods: alkaline phosphatase (ALP) chemical staining for cell viability, Alizarin red staining for osteogenic characteristics, MTT test for cell proliferation, enzyme dynamics for ALP contents, radio-immunoassay for bone gla protein (BGP) concentration, and ELISA for the concentration of type I collagen (COL-I) in the supernatant. Furthermore, we detected the adhesion ability of two types of cells from titanium slices using non-specific immunofluorescence staining and cell count. The two cell forms showed no significant difference in morphology under the same culture conditions. However, the alveolar bone osteoblasts received from type 2 diabetic patients had slower growth, lower cell activity and calcium nodule formation than the normal ones. The concentration of ALP, BGP and COL-I was lower in the supernatant of alveolar bone osteoblasts received from type 2 diabetic patients than in that received from normal subjects (P < 0.05). The alveolar bone osteoblasts obtained from type 2 diabetic patients can be successfully cultured in vitro with the same morphology and biological characteristics as those from normal patients, but with slower growth and lower concentration of specific secretion and lower combining ability with titanium than normal ones.

Objective: To investigate the characteristics of transurethral partial cystectomy with a 2 µm laser in diagnosis and treatment for the bladder submucosal lesions in adults., Methods: Nine patients with suspected pathological diagnosed bladder submucosal lesions in out-patient department were diagnosed and treated transurethral with a 2 µm laser under sacral block between August 2009 and December 2010. The diameters of tumors were 1.5 - 2.5 cm. A 2 µm laser was used to incise the full-thickness bladder wall around the tumors. The entire bladder wall was peeled between the detrusor muscle layer and outer connective tissues. Tumors with bladder wall at the base were removed together and sent for pathological examination. The surgical procedures, intraoperative hemorrhage, intraoperative and postoperative complications were observed, pathological diagnosis and postoperative follow-up were performed., Results: All operations were successful. Mean operative time was 36.4 minutes (range 25 to 47 minutes), perioperative blood loss was minimal. There was no obturator nerve reflection and no hemorrhage detected after surgery. Postoperative pathological diagnosis included leiomyoma in 3 cases, pheochromocytoma in 3 cases, endometriosis in 1 case and metastatic bladder cancer in 2 cases., Conclusions: Transurethral partial cystectomy with a 2 µm laser can diagnose and treat bladder submucosal lesions. The procedures are effective and safe. Patients could get accurate pathological diagnosis without further painful and some bladder tumors can be treated by minimally invasive surgery.

Objective: To investigate the safety and efficacy of minimally invasive achilles tendon lengthening and system rehabilitation for the treatment of contracture of achilles tendon., Methods: From January 2002 to December 2010, 27 patients (31 feet) with contracture of achilles tendon were treated with minimally invasive achilles tendon lengthening and system rehabilitation. There were 11 males and 16 females with an average age of 35.5 years (ranged 3 to 65 years). Right foot was in 13 cases, left foot was in 10 cases, both feet were in 4 cases. Course of disease was from 1 to 5 years with an average of 2.3 years. The cause of contracture included postoperative complication of tibia fractures treated with intramedullary nailing in 7 feet, sequelae of lower leg compartment syndrome in 11 feet, congenital talipes equinovarus in 13 feet (both feet in 4). Before operation, all the patients walked with limping, plantar flexion anomaly was from 15 degrees to 50 degrees with an average of 35.5 degrees. The strength of quadriceps muscle of thigh was grade V in 27 feet, grade IV in 4 feet, the strength of musculus triceps surae was grade V in 24 feet, grade IV in 7 feet., Results: All the patients were followed-up for 6-24 months with an average of 11.3 months. According to standard of Arner-Lindholm to evaluate function of ankle joint, 29 feet obtained excellent results and 2 feet good. No infection, re-rupture or re-contracture was found., Conclusion: Minimally invasive achilles tendon lengthening and system rehabilitation in treating contracture of achilles tendon has advantage such as simple operation, less complication, lower recurrence rate, which is favourable for thoroughly rehabilitation of patients. But, the case in which the strength of quadriceps muscle of thigh or musculus triceps surae still less than grade III after preoperative rehabilitation care should not choose the method.

Introduction: To evaluate clinical value of a new self-sequential longitudinal reference intervals of thyroid function during pregnancy., Material and Methods: WE ESTABLISHED TWO DIFFERENT SERIES OF REFERENCE INTERVALS: self-sequential longitudinal reference intervals (SLRI) and general gestation-specific reference intervals (GSRI). For SLRI, the serum of 301 cases were collected five times in every case throughout the gestation. For GSRI, A total of 1455 subjects included in the study. We collected the serum respectively at various trimesters. We used TSH of both reference intervals to screen 1744 pregnant women, and compared the percentage of potential misclassification., Results: Both SLRI and GSRI differed substantially from that for non-pregnant women (p < 0.05). There are similar fluctuations of serum TSH, FT4 and TPO-Ab during normal pregnancy. Although there were no significant differences in most reference intervals between SLRI and GSRI. But the IQR of SLRI were usually smaller than GSRI , especially in 1(st) trimester. Two hundred and fifty two women (14.4%) at various trimesters whose serum TSH concentration was within SLRI would be misclassified, while 23 women (1.3%) with a TSH concentration outside limit would not be identified. 0.11-3.84% women would got thyroid diseases during pregnancy. Subclinical hypothyroidism is most common maternal thyroid disorders., Conclusions: The SLRI can reflected the changes of thyroid function realistically, and can be used to decrease the percentage of potential misclassification of thyroid dysfunction during pregnancy. Screening for thyroid dysfunction of pregnant women is recommended and important.

The objective of this study is to establish self-sequential longitudinal reference intervals of thyroid function in normal pregnant women. According to the selection criteria, 301 cases were taken as the normal pregnant population to establish a normal reference range. Meanwhile, 150 healthy women were selected as the normal non-pregnant control group. To establish their own self-sequential longitudinal reference intervals, we collected samples five times in every case throughout the gestation (including first trimester, second trimester, third trimester, prenatal and postpartum), and detected the levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibodies (TPO-Ab), and then established the self-sequential longitudinal reference intervals. The levels of TSH, FT4 and TPO-Ab were quantified by electrochemistry immunoassay (ECL) and statistically analyzed using SPSS 13.0 software. Serum TSH of normal pregnant women was at a low level in the first trimester (P < 0.05) and began to rise continuously. Not until prenatal phase was it restored to the non-pregnant state (P > 0.05). During pregnancy, serum FT4 of normal pregnant women were consistently lower than non-pregnant levels (P < 0.05) and kept at low levels. Serum TPO-Ab increased significantly in the third trimester and prenatal phase (P < 0.05). Of normal pregnant women, 6.5% were TPO-Ab positive. In conclusion, the reference intervals in our case will reflect the changes of thyroid function in pregnant women more realistically, resulting in a more accurate value for clinical diagnosis and therapy.

Background: The safety and efficiency of transurethral laser resection of the prostate to treat benign prostatic hyperplasia have been verified. However, this method does still not manage large volume prostates efficiently. To tackle this problem, we have designed a method of "transurethral dividing vaporesection of prostate" using a 2 micron continuous wave laser. The aim of this study was to evaluate the safety and efficiency of this method in the management of large prostates (> 80 ml)., Methods: In this study, 45 cases of benign prostatic hyperplasia with a median prostatic volume of (123.7 ± 26.7) ml (range, 80.2-159.8 ml) were treated by the same surgeon under epidural anesthesia. During the surgery, superapubic catheters were needed, and saline solution was used for irrigation. First, the prostate was divided longitudinally into several parts from the bladder neck to the prostatic apex, and then gradually incised transversely chip by chip. Intraoperative blood transfusion rate, postoperative complications, maximum urinary flow rate, International Prostate Symptom Score and quality of life scores were recorded for statistical analysis using SPSS 16.0 software., Results: Intraoperatively, no transurethral resection syndrome was observed, and no blood transfusions were needed. The resected prostatic chips were easily flushed out of the bladder through the resectoscope sheath without the use of a morcellator. Median vaporesection time was (95.0 ± 13.2) minutes (range, 75-120 minutes), and the median retrieved and removed prostatic tissue were (25.2 ± 5.1) g (range, 15.5-34.7 g) and (75.4 ± 16.4) g (range, 43.8-106.1 g), respectively. Median catheter time and hospital stay were (3.3 ± 0.9) days (range, 3-5 days) and (4.8 ± 1.8) days (range, 3-9 days), respectively. After a follow-up of 6 to 12 months, two patients had stress urinary incontinence and three had anterior urethral strictures. Satisfactory improvement was seen in maximum urinary flow rate, International Prostate Symptom Score and quality of life scores., Conclusions: This study showed that 2 micron laser vaporesection is a safe treatment for benign prostatic hyperplasia patients with large prostates, and the method of "dividing vaporesection" may help improve both surgical efficiency and patient outcomes.

The PBS material that in the form of insoluble biodegradable polymers pellets was investigated as the solid carbon source and the biofilm carrier for nitrate removal from wastewater. The denitrification of nitrate removal and kinetic process were carried out in a packed-bed reactor in order to remove nitrate in recirculation aquaculture system. The experimental results indicated that the optimal influent loading rate was in the range of 0.107-1.098 kg/(m3 x d), when the water temperature was (29 +/- 1) degrees C and the influent nitrate concentration was in the range of 25-334 mg/L. The maximum nitrate volumetric removal rate of 0.577 kg/(m3 x d) was achieved at the influent loading rate of 1.098 kg/(m3 x d). When the influent loading rate exceeded 1.098 kg/(m3 x d), the nitrate volumetric removal rate was declined. The kinetic experimental results show that the denitrification rate of PBS as the solid carbon source and the biofilm carrier corresponds to first-order kinetics. Based on the kinetics characteristics, constants n and K used in Eckenfelder model were deduced, which can be successfully applied for the prediction of effluent nitrate concentration. The two groups' predictive values and actual values were analyzed by using SPSS 16.0 software for Paired-Samples t test analysis. The Paired-Samples t test analysis indicates that the corresponding p > 0.05 values are 0.553 and 0.632, which proved that no significant differences exist between the predictive values and actual values of the model.

Objective: To investigate the safety and efficacy of close reduction and percutaneous needle fixation for the treatment of anterior dislocation of sternoclavicular joint., Methods: A retrospective analysis was performed with 6 cases of anterior sternoclavicular dislocation by close reduction and percutaneous needle fixation with Kirschner wire treated from January 2001 to February 2009, including 5 males and 1 female aged from 19 to 45 with an average of 28.8 years old. Among the 6 cases, 4 were on right lateral and 2 were on left lateral. The time from injured to treatment was from 6 hours to 12 days (averaged 4.5 days). The clinical effects were evaluated according to Rockwood scoring and the complications were observed., Results: All 6 patients were followed-up for 3 to 13 months (averaged 6 months). According to Rockwood scoring,the preoperative score was (7.00 +/- 0.89) points, postoperative score was (13.17 +/- 1.72) points; the results showed excellent in 5 cases and good in 1 case. No local infection, postoperative pain,recurrent dislocation,broken needle, and other complications were observed in this study., Conclusion: The treatment of anterior sternoclavicular joint dislocation with Kirschner wire minimally invasive fixation is an easy, reliable fixation with less complications.

Objectives: To observe the vaporesection efficiency of the 2 micron laser to the prostatic gland in benign prostatic hyperplasia, and investigate the method of estimating the amount of the vaporesected prostatic tissues during transurethral vaporesection of the prostate using the 2 micron laser system in the treatment of benign prostatic hyperplasia., Methods: Total 9 fresh prostatic gland specimens were obtained from patients with BPH under open surgical procedures, and vaporesected under a simulated transurethral environment with the 2 micron laser system immediately after weighted. Energies and time consumptions were noted, collections of vaporesected tissue specimens and the remnants of the prostatic glands were weighted after the procedures. The ratios of the vaporized tissues and the collected tissues to the whole vaporesected tissues were calculated respectively. The vaporesection efficiency of the 2 micron laser to the prostatic tissues was also calculated., Results: Among the total lost tissues, about (65.6 +/- 1.5) percent of which were that of vaporized, and nearly (34.5 +/- 1.5) percent were resected. Linear correlation between the weight of collected prostatic tissue(x) and the weight of prostatic gland specimens(y) could be defined as a formula of [y = 3.245x - 6.475 (t = 15.097, P = 0.000)]., Conclusion: The amounts of the whole prostatic tissues removed by the 2 micron laser could be calculated from the collected resected prostatic specimens under a simulated transurethral surgical procedure.

Objective: To summarize the change of bladder tumor cells in irrigating solution after partial cystectomy by 2 microm continuous wave laser., Methods: From May 2008 to December 2008, a total of 30 patients of bladder cancer, the diameters of tumors from 0.5 to 3.0 cm. The diameter being regarded as the standard, patients were divided into two groups, 10 cases in group A (diameter < 2.0 cm) 20 cases in group B (diameter >or= 2.0 cm). The pre-operative pathologic histology diagnoses of all patients by biopsy were bladder urothelial carcinoma. Partial cystectomy by 2 microm continuous wave laser was given in operation. Due to the patients in group a with smaller tumors, the tumors were washed out of the bladder through the sheath of cystoscope directly. In group B, the larger tumors were cut into blocks by laser in the bladder, and washed out. After removing the tumors and debris, bladder irrigation was performed with about 150 ml solution for 5 times, then irrigating solution was centrifuged and numbered respectively before cellular pathology examination., Results: In group A, there were no tumor cells but epithelial cells and red blood cells could be seen in 8 cases. In the other 2 cases, a small amount of integrity and shape broken tumor cells could be seen in the No.1 and No.2 piece. There was no tumor cell in No.3, No.4, and No.5 pieces. In group B, tumor cells can be seen in No.1, No.2 and No.3 pieces in 14 cases, but cell density decreased gradually. There was no tumor cell in No.4, No.5 pieces, and tumor cells can be seen in No.1 to No.4 pieces for another 6 cases, and cell density also decreased gradually, there was no tumor cell in No.5 piece., Conclusion: After the surgery, 5 times of bladder irrigation in all cases of partial cystectomy by 2 microm continuous wave laser can reduce the remnants of the bladder tumor cells effectively.

The study monitored physiological parameter changes after 120-min of simulated driving. Blood pressures, heart rate (HR), heart rate variability (HRV) and palm temperatures were measured using an ANSWatch(®) monitor. Subjects were divided into two groups (A & B). Both groups performed 2-hour driving, but group B additionally took a 15-min exercise break. Heart rate, systolic pressure, LF/HF, and palm temperature decreased for group A after driving; for group B only HR and palm temperatures decreased. HRV and parasympathetic indices HF(AU) and HF(NU) increased for group A, while HRV and sympathetic index LF(AU) increased in group B. Group A had higher fatigue scores than group B. ANS activation may overcome some fatigue symptoms, but the recovery is nonetheless incomplete. Exercise break is proven to be an effective remedy, especially if accompanied by the ANS actions. The normalized parasympathetic index HF(NU), the normalized sympathetic index LF(NU), and the sympatho-vagal balance index LF/HF are three most promising parameters that could be further developed to monitor driver fatigue.

A autotrophic denitrifying bacterial strain, TD, was isolated from soil and the strain was identified and characterized. The strain was gram negative, strictly chemolithoautotrophic, and short rod shaped bacterium. The 16S rDNA sequence analysis revealed that strain TD had a similarity of 99.85% with Thiobacillus denitrificans. According to the morphologic, physiobiochemical characteristics and the analysis of its 16S rDNA, the strain was identified as Thiobacillus denitrificans. Studies showed that the optimal conditions for denitrification were pH 6.85 and 32.8 degrees C, while the optimal growth conditions were pH 6.90 and 29.5 degrees C. The bacteria grew slowly with no apparent stable phase. The maximal denitrification rate reached 2.245 mg x (L x h)(-1) which was found in exponential phase. In the process of the culture, the medium pH decreased significantly. Relatively high salinity restrained the denitrification activity of Thiobacillus denitrificans. The acute toxicity test results showed that Thiobacillus denitrificans was non-toxic.

Hepatitis B virus (HBV) infection is a major health concern world wide, and few effective treatments have been developed. It has recently been reported that inhibiting host-cell proteins can prevent viral infection. The human genome may contain more genes required for HBV infection and replication than the viral genome. A systematic approach to find these potential antiviral targets is by host gene expression analysis using DNA microarrays. The aim of this study was to identify and validate novel cellular anti-HBV targets. The Human Whole Genome Bioarray was used to analyze differentially expressed genes in HepG2.2.15 cells and HepG2 cells. Altered gene expression in HepG2.2.15 cells was studied following treatment with the anti-HBV drug, lamivudine. Genes that were differentially expressed during HBV infection and reversed with anti-HBV drugs were validated by semiquantitative reverse transcription-PCR. Bioinformatics analysis revealed ABHD2, EREG, ACVR2B, CDC34, KHDRBS3 and RORA as potential cellular anti-HBV targets. Antisense oligodeoxynucleotides were used to test the antiviral activity of these potential targets. Results strongly suggested that inhibition of ABHD2 or EREG significantly blocked HBV propagation in HepG2.2.15 cells. This study demonstrates that ABHD2 and EREG are essential for HBV propagation and provides strong evidence that these proteins could be used as potential targets for anti-HBV drugs.

The tumor suppressor p53-related p73 shares significant amino-acid sequence identity with p53. Like p53, p73 recognizes canonical p53 DNA-binding sites and activates p53-responsive target genes and induces apoptosis. Moreover, SIRT1 binds to p53 while repressing the expression of their target genes. Here, we report that SIRT1 also binds to p73 and suppresses p73-dependent transcriptional activity. SIRT1 in human cells reduces the transcriptional activity of p73, and partly inhibits apoptosis induced by p73. Furthermore, SIRT1 can deacetylate p73 protein acetylation both in vivo and in vitro. Collectively, these data suggest that SIRT1 can modulate p73 activity via deacetylation.

Purpose: To identify differentially expressed genes in mouse bone marrow involved in radiation-induced injury., Materials and Methods: Microarray analysis was used to identify the differentially expressed genes and other techniques, e.g., polymerase chain reaction (PCR), western-blotting and antisense were also used to validate the results., Results: DNA microarray analysis demonstrated that the mRNA of 34 genes increased and 69 genes decreased in mouse bone marrow cells (BMC) from C57BL mice 6 h after a whole body dose of 6.5 Gy. These differentially expressed genes were involved in a number of processes including DNA replication/repair, proliferation/apoptosis, cell cycle control and RNA processing. In these experiments, a decline of the mammalian homolog Sir2a (an acronym for the silent mating type information regulation 2 homolog [SIRT1]) mRNA accompanied by an increase of P53 protein acetylation was observed in irradiated BMC. To determine whether the reduced SIRT1 is related to the higher acetylation status of P53 after irradiation, we designed and synthesized antisense oligonucleotides (AS) targeting human SIRT1 mRNA. Notably, AS transfection increased tumor protein 53 (P53) protein acetylation and bax-luciferase activity in human bone marrow stromal cell line (HS-5) after radiation. Furthermore, the AS transfer stimulated cell apoptosis in post-irradiation HS-5 cells., Conclusion: Ionizing radiation (IR) affects the expression of a series of genes including genes involved in G1/S transition and the P53 pathway. Among those, reduction of SIRT1 was seen to be involved in transactivation of P53.