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Background: This study aimed to investigate the clinical efficacy of intra-articular injections of medical chitosan for treating knee osteoarthritis (KOA) and measure the lipid metabolism profiles of the synovial tissue., Methods: Sixty patients with KOA undergoing conservative treatment were recruited and randomized into two groups: one without pharmacological intervention (OA group) and the other receiving course-based intra-articular medical chitosan injections (CSI group). Quantitative lipidomic profile of synovial tissue was analyzed. Functional scores, including Kellgren-Lawrence rating (K-L), Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scoring, and American Knee Society (AKS) scoring were conducted., Results: Survival from the initial conservative treatment to final knee arthroplasty was significantly longer in the CSI group compared to the OA group. Except for the presurgery VAS score, no statistically significant differences were observed in the other scores, including K-L, initial VAS, WOMAC, and AKS. However, the CSI group experienced more reductions in AKS-Knee subscores compared to the OA group. Compared to the CSI group, the OA group exhibited a significant upregulation in most differential lipids, particularly triacylglycerides (TAGs, 77%). The OA group had notably higher levels of long-chain unsaturated fatty acids., Conclusion: Intra-articular injection of medical chitosan significantly prolongs the survival period before knee arthroplasty and reduces the deposition of TAGs metabolites., Competing Interests: Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article., (Copyright © 2024, the Chinese Medical Association.)

With the increasing demand for electronic products, the electronic package gradually developed toward miniaturization and high density. The most significant advantage of the Wafer-Level Package (WLP) is that it can effectively reduce the volume and footprint area of the package. An important issue in the design of WLP is how to quickly and accurately predict the reliability life under the accelerated thermal cycling test (ATCT). If the simulation approach is not adopted, it usually takes several ACTCs to design a WLP, and each ACTC will take several months to get the reliability life results, which increases development time considerably. However, simulation results may differ depending on the designer's domain knowledge, ability, and experience. This shortcoming can be overcome with artificial intelligence (AI). In this study, finite element analysis (FEA) is combined with machine learning algorithms, e.g., Kernel Ridge Regression (KRR), to create an AI model for predicting the reliability life of electronic packaging. Kernel Ridge Regression (KRR) combined with the K-means cluster algorithm provides a highly accurate and efficient way to obtain AI models for large-scale data sets.

Background: This study aimed to investigate the correlation between the Alarmin S100A9 protein and Achilles tendinopathy (AT), and to reveal the role of this protein in inducing AT., Methods: In this study, 40 male Sprague-Dawley rats were randomly divided into four groups: Control group (received no treatment), Injury group (Achilles tendon tissues were cut intraoperatively), S100A9 group (received a subcutaneous injection of rhS100A9 solution), and S100A9 + Paquinimod group [received a subcutaneous injection of rhS100A9 and Paquinimod (1:1 ratio) into the Achilles tendon]. At 1 week postoperatively, the four groups of rats were euthanized, and the Achilles tendon tissues were isolated for histological staining, immunohistochemistry (IHC), immunofluorescence, Sirius Red (SR) staining, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay., Results: Compared with both the Control and S100A9 + Paquinimod groups, the Injury and S100A9 groups exhibited higher expression levels of S100A9 protein, matrix metalloproteinase-3 (MMP-3), and inflammatory factors. Regarding histomorphology [hematoxylin-eosin (HE) staining and Safranin O/fast green (SOFG; fast green and Safranin) training], the Achilles tendon tissues in the Injury and S100A9 groups showed AT-like changes, and the fibers were extremely disorderly, non-bundled, and ruptured, and some nuclei were spindles. As for collagen (Col) remodeling, a large number of fresh collagen fibers had formed, the amounts of Col-I and Col-II were lower, and a large quantity of Col-III was present. Additionally, a large number of tendon cells had died in both the Injury and S100A9 groups., Conclusions: This study showed that Alarmin S100A9 can induce AT-like morphological changes and local inflammatory reactions, trigger collagen fiber remodeling and tendon cell apoptosis, and ultimately induce AT., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/atm-21-5945). The authors have no conflicts of interest to declare., (2021 Annals of Translational Medicine. All rights reserved.)

Purpose: To analyze the correlation between contrast-enhanced ultrasound image features and axillary lymph node metastasis of primary breast cancer and its diagnostic value., Methods: In this study, 64 patients with axillary lymph node metastasis of primary breast cancer diagnosed and treated in our hospital from February 2011 to March 2013 were collected as an observation group, and 54 patients without axillary lymph node metastasis were collected as a control group. All patients underwent a contrast-enhanced ultrasound examination, and the correlation between the contrast-enhanced ultrasound image features and axillary lymph node metastasis and its diagnostic value were analyzed. They were divided into two groups according to their survival conditions: the group with good efficacy and group with poor efficacy, and the prognostic factors of breast cancer in the two groups were analyzed., Results: There were statistical differences in the peripheral acoustic halo, blood flow classification, ratio of length to diameter (L/D), maximum cortical thickness, and enhancement mode of lymph nodes between the two groups (p < 0.05). The area under ROC curve for diagnosis of axillary lymph node metastasis by contrast-enhanced ultrasound was 0.854, sensitivity was 83.33%, and specificity was 87.5%; L/D and enhancement mode were independent prognostic factors for breast cancer., Conclusions: Contrast-enhanced ultrasound image features have diagnostic and prognostic value for axillary lymph node metastasis of breast cancer.

Background: Many classification systems of thoracolumbar spinal fractures have been proposed to enhance treatment protocols, but none have achieved universal adoption., Aim: To develop a new patient scoring system for cases with thoracolumbar injury classification and severity score (TLICS) = 4, namely the load-sharing thoracolumbar injury score (LSTLIS)., Methods: Based on thoracolumbar injury classification and severity score, this study proposes the use of the established load-sharing classification (LSC) to develop an improved classification system (LSTLIS). To prove the reliability and reproducibility of LSTLIS, a retrospective analysis for patients with thoracolumbar vertebral fractures has been conducted., Results: A total of 102 cases were enrolled in the study. The scoring trend of LSTLIS is roughly similar as the LSC scoring, however, the average deviation based on the former method is relatively smaller than that of the latter. Thus, the robustness of the LSTLIS scoring method is better than that of LSC. LSTLIS can further classify patients with TLICS = 4, so as to assess more accurately this particular circumstance, and the majority of LSTLIS recommendations are consistent with actual clinical decisions., Conclusion: LSTLIS is a scoring system that combines LSC and TLICS to compensate for the lack of appropriate inclusion of anterior and middle column compression fractures with TLICS. Following preliminary clinical verification, LSTLIS has greater feasibility and reliability value, is more practical in comprehensively assessing certain clinical circumstances, and has better accuracy with clinically significant guidelines., Competing Interests: Conflict-of-interest statement: The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Conventional plain X-ray images of rats, the most common animals used as degeneration models, exhibit unclear vertebral structure and blurry intervertebral disc spaces due to their small size, slender vertebral bodies., Aim: To apply molybdenum target X-ray photography in the evaluation of caudal intervertebral disc (IVD) degeneration in rat models., Methods: Two types of rat caudal IVD degeneration models (needle-punctured model and endplate-destructed model) were established, and their effectiveness was verified using nuclear magnetic resonance imaging. Molybdenum target inspection and routine plain X-ray were then performed on these models. Additionally, four observers were assigned to measure the intervertebral height of degenerated segments on molybdenum target plain X-ray images and routine plain X-ray images, respectively. The degeneration was evaluated and statistical analysis was subsequently conducted., Results: Nine rats in the needle-punctured model and 10 rats in the endplate-destructed model were effective. Compared with routine plain X-ray images, molybdenum target plain X-ray images showed higher clarity, stronger contrast, as well as clearer and more accurate structural development. The McNemar test confirmed that the difference was statistically significant ( P = 0.031). In the two models, the reliability of the intervertebral height measured by the four observers on routine plain X-ray images was poor (ICC < 0.4), while the data obtained from the molybdenum target plain X-ray images were more reliable., Conclusion: Molybdenum target inspection can obtain clearer images and display fine calcification in the imaging evaluation of caudal IVD degeneration in rats, thus ensuring a more accurate evaluation of degeneration., Competing Interests: Conflict-of-interest statement: The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To analyze the clinical efficacy and safety of rituximab therapy for patients with Epstein-Barr virus (EBV) positive diffuse large B-cell lymphoma (DLBCL), and to explore the factors influencing the clinical efficacy., Methods: According to therapeutic regimen, 66 patients with EBV-positive DLBCL were divided into two groups: CHOP group (32 cases) and R-CHOP group (CHOP+ rituximab, 34 cases). The clinical efficacy and the incidence of complication were compared between two groups. The clinical risk factors for the clinical efficacy in patients with EBV-positive DLBCL were confirmed by multivariate Logistic analysis., Results: Compared with CHOP group, the complete remission rate, partial remission rate and the overall effective rate in R-CHOP group all were high (P＜0.05), moreover the disease progression rate in R-CHOP group were low (P＜0.05). The occurrences rate of myelotoxicity, hepatic injury and gastrointestinal reaction were not statistically significantly different between two groups (P＞0.05). Multivariate Logistic analysis showed that the Ann Arbor staging, IPI risk score and Ki-67 positive rate were independent risk factors for the clinical efficacy in patients with EBV-positive DLBCL (OR=2.689, P=0.038; OR=3.232, P=0.025; OR=2.919, P=0.023)., Conclusion: The clinical efficacy and safety of the therapy with rituximab on the patients with EBV-positive DLBCL are better. The poor Ann Arbor stage, high IPI risk score and the Ki-67 positive rate are factors affecting the clinical efficacy for the patients with EBV-positive DLBCL.

Background: Postoperative unobstructed drainage is an important measure for avoiding hematoma formation and preventing complications from anterior cervical surgery., Aim: To discuss the characteristics and key points of clinical management of two types of commonly used negative pressure drainage systems in clinical settings., Methods: Two types of commonly used silica gel negative pressure drainage balls and a type of gastrointestinal decompression apparatus were fully emptied and then injected with different amounts of water and air. Following this, the negative pressure values of the three devices were measured. Meanwhile, we undertook a retrospective analysis of the clinical data of 1328 patients who had been treated with different negative pressure drainage apparatuses during their anterior cervical surgery in our department between January 2007 and January 2018., Results: As the amount of injected air or water increased, the negative pressure of the silica gel negative pressure drainage ball decreased rapidly, dropping to zero when 150 mL of water or air was injected. In contrast, the negative pressure of gastrointestinal decompression apparatus decreased slowly, maintaining an ideal value even when 300 mL of water or air was injected. And statistical analysis demonstrated that patients who had been treated with the gastrointestinal decompression apparatus were less likely to develop severe complications than those who had been treated with the silica gel negative pressure drainage ball ( P < 0.05)., Conclusion: This study showed that the gastrointestinal decompression apparatus has the advantages of large suction capacity, long duration of continuous negative pressure, and good drainage effect, all of which are the favorable factors for the use of this apparatus for negative pressure drainage in anterior cervical surgery., Competing Interests: Conflict-of-interest statement: The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To investigate the proliferation, differentiation potential and autophagic mechanism HL-60 cells via ULK1 protein targeted by Haishengsu extracted from Tegillarca granosa., Methods: The HL-60 cells were divided into five groups: Haishengsu of 10,100,1000 mg/L-treated group, all-trans retinoic acid (ATRA) 5 μmol/L-treated group and control group. The cell proliferation rates were detected by MTT after culture 12,24,48 h and 72 h. The expression of differentiation and maturation markers CD11b and CD15 were detected by flow cytometry, and the expression of autophagy molecules ULK1 and LC-3 proteins were measured by Western blot., Results: After cultured for 48 and 72 h the cell proliferation rates of HL-60 in Haishengsu 100 and 1000 mg/L groups were significantly lower than those of ATRA 5 μmol/L group and Haishengsu 10 mg/L group and control group (P<0.05). After 72 h, the levels of CD11b, CD15, ULK1 and LC-3 expression of HL-60 cell in Haishengsu 100 and 1000 mg/L groups were higher than those in ATRA 5 μmol/L group, Haishengsu 10 mg/L group and control group (P<0.05). While the HL-60 cells in Haishengsu 10, 100 and 1000 mg/L group were treated with ULK1 protein inhibitor and after cultured for 72 h, the proliferation rate of HL-60 cell increased, levels of CD11b and CD15 expression decreased at the same time, and the levels of ULK1 and LC-3 proteins in HL-60 cells also decreased (P<0.05)., Conclusion: Haishengsu, which extracted from Tegillarca granosa, can induce HL-60 cell proliferation and differentiation by targeting ULK1 protein in a concentration and time dependent manner, its effective mochanism may be mediating autophagic activity, promoting cell differentiation and maturation.

Background: Posterior malleolar fractures have been reported to occur in < 40% of ankle fractures., Aim: To reveal the recurrent patterns and characteristics of posterior malleolar fractures by creating fracture maps of the posterior malleolar fractures through the use of computed tomography mapping., Methods: A consecutive series of posterior malleolar fractures was used to create three-dimensional reconstruction images, which were oriented and superimposed to fit an ankle model template by both aligning specific biolandmarks and reducing reconstructed fracture fragments. Fracture lines were found and traced in order to generate an ankle fracture map., Results: This study involved 112 patients with a mean age of 49, comprising 32 pronation-external rotation grade IV fractures and 80 supination-external rotation grade IV fractures according to the Lauge-Hansen classification system. Three-dimensional maps showed that the posterior ankle fracture fragments in the supination-external rotation grade IV group were relatively smaller than those in the pronation-external rotation grade IV group after posterior malleolus fracture. In addition, the distribution analyses on posterior malleolus fracture lines indicated that the supination-external rotation grade IV group tended to have higher linear density but more concentrated and orderly distribution fractures compared to the pronation-external rotation grade IV group., Conclusion: Fracture maps revealed the fracture characteristics and recurrent patterns of posterior malleolar fractures, which might help to improve the understanding of ankle fracture as well as increase opportunities for follow-up research and aid clinical decision-making., Competing Interests: Conflict-of-interest statement: The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Osteosarcoma is a rare primary malignancy of bone that is prone to early metastasis. Resection surgery and chemotherapeutic regimens are current standard treatments for osteosarcoma. However, the long-term survival rate of patients with osteosarcoma is low due to a high risk of metastasis. Hence, a new approach is urgently needed to improve the treatment of osteosarcoma. Compared with chemotherapy, natural active constituents isolated from herbs exhibit less adverse effects and better anti-tumor effects. This study aimed to summarize the anticancer effects of constituents of herbs on the progression and metastasis of osteosarcoma cells. It showed that many constituents of herbs inhibited osteosarcoma by targeting proliferation, matrix metalloproteinases, integrin and cadherin, and angiogenesis. The findings might be beneficial for the development of new drugs and treatment strategies.

Tenascin-C (TN-C) is an extracellular matrix glycoprotein markedly upregulated during liver fibrosis. The study is performed to explore the role of TN-C during the growth and activation of hepatic stellate cells (HSCs). We found that TN-C was accumulated accompanying with the HSC activation. Our data on cell migration assay revealed that the rTN-C treatment enhanced HSC migration in a dose- and time-dependent manner, but did not influence their proliferation. HSCs transfected with pTARGET-TN-C overexpression vector displayed increased the type I collagen (Col I) production. TN-C overexpression enhanced the process of HSC activation through TGF-β1 signaling. Moreover, the anti-α9β1 integrin antibody treatment blocked the TN-C-driven Col I increase in rat HSCs. Collectively, TN-C had a positive role in activation of HSCs mediated by TGF-β1 and α9β1 integrin, manifesting elevation of Col I production and promotion of cell migration. Our results provide a potential insight for the therapy of hepatic fibrosis.

Aim: To develop a population pharmacokinetic (PopPK) model of tacrolimus in healthy Chinese volunteers and liver transplant recipients for investigating the difference between the populations, and for potential individualized medication., Methods: A set of 1100 sparse trough concentration data points from 112 orthotopic liver transplant recipients, as well as 851 dense data points from 40 healthy volunteers receiving a single dose of tacrolimus (2 mg, p.o.) were collected. PopPK model of tacrolimus was constructed using the program NONMEM. Related covariates such as age, hepatic and renal functions that were potentially associated with tacrolimus disposition were evaluated. The final model was validated using bootstrapping and a visual predictive check., Results: A two-compartment model of tacrolimus could best describe the data from the two populations. The final model including two covariates, population (liver transplant recipients or volunteers) and serum ALT (alanine aminotransferase) level, was verified and adequately described the pharmacokinetic characteristics of tacrolimus. The estimates of V2/F, Q/F and V3/F were 22.7 L, 76.3 L/h and 916 L, respectively. The estimated CL/F in the volunteers and liver transplant recipients was 32.8 and 18.4 L/h, respectively. Serum ALT level was inversely related to CL/F, whereas age did not influence CL/F. Thus, the elderly (≥65 years) and adult (<65 years) groups in the liver transplant recipients showed no significant difference in the clearance of tacrolimus., Conclusion: Compared with using the sparse data only, the integrating modeling technique combining sparse data from the patients and dense data from the healthy volunteers improved the PopPK analysis of tacrolimus.

Objective: To study the clinicopathologic features and biological behavior of spermatocytic seminoma., Methods: A retrospective analysis of patients diagnosed as seminoma, spermatocytic seminoma between January 2003 and May 2011, was performed. Clinical data, HE stained section and immunohistochemical staining (SP method) were reviewed with follow-up., Results: Sixty-six cases of seminoma and 5 cases of spermatocytic seminoma were identified. The average age at the diagnosis of 5 cases of spermatocytic seminoma was 53 years, and no patient had a history of crytorchidism or germ cell tumor. All five patients had stage pT1 tumor. Immunohistochemical studies showed that spermatocytic seminoma was negative for CK, vimentin, OCT3/4, PLAP, and LCA, and PAS staining was also negative. All five patients were well after operation. In contrast, the average age at diagnosis of the 66 cases of seminoma was 37 years, in which 12% had a history of crytorchidism and 11% were in stage pT2 or the above. Immunohistochemical studies showed that seminoma was positive for OCT3/4, PLAP, and CD117. During the follow-up, 2 patients developed metastasis and 3 patients died of the disease., Conclusions: Spermatocytic seminoma is rare and appears to follow a benign clinical course Due to its favourable prognosis, further treatment is not necessary after orchidectomy. Accurate pathologic diagnosis is critical for patient management and for avoiding over-treatment.

In the title compound, C(12)H(18)NO(+)·PF(6) (-), the asymmetric unit consists of two cation-anion pairs. The six F atoms of one anion are disordered over two sets of sites in a 0.592 (6):0.408 (6) ratio. The morpholinium rings adopt chair conformations.

Objective: To investigate the effects of alprostadil (Lipo PGE1) in prevention of portal vein thrombogenesis (PVT) after splenectomy for portal hypertension., Methods: Seventy-six patients with portal hypertension undergoing splenectomy and pericardial devascularization were randomly divided into 2 groups :treatment group (n = 40), receiving intravenous drip of injection of radix Salviae miliorrhazae (RSM) 40 ml and alprostadil 20 microg, both once a day since the third day after operation for 2 weeks and then oral administration of dropping pill of SM, and control group (n = 36), receiving intravenous drip of injection of RSM and taking enteric coated aspirin 3 times a day for 2 weeks and then taking dropping pill of SM. Platelets (PLT), prothrombin time (PT), and liver function were detected periodically. Color Doppler ultrasonography was conducted every week to observe the blood flow velocity and diameter of the portal and splenic veins, and if PVT event and ascites occurred. All patients were followed up for 8 - 20 months., Results: No prolongation of coagulation time and bleeding tendency was found in both groups. The PLT number increased remarkably in the 7th to 14th days after operation without significant difference between the 2 groups (P >0.05). The PVT rate of the treatment group was 5.0%, significantly lower than that of the control group (25.0%, chi2 = 6.12, P < 0.05). The ascites rate of the treatment group was 10.0%, significantly lower than that of the control group (33.3%, chi2 = 7.44, P <0.01). The levels of ALT and total bilirubin 7 and 16 days after operation of the treatment group were all significantly lower than those of the control group (all P <0.05)., Conclusion: Use of alprostadil early after devascularization is an effective and safe measure to prevent PVT, improve liver function, and decrease ascites rate.

A total of 180 farmland soil samples were collected from the suburbs of Fuxin City, Liaoning Province, to investigate the contents and spatial distribution patterns of Cu, Zn, As and Ni, with the effects of mining on their accumulation and spatial distribution in test farmland soils discussed. The results indicated that in study area, farmland soils had an accumulation of Cu, Zn and Ni, with the geometric mean concentrations higher than the background values. Among the soils planted with different crops, vegetable soil had significantly higher contents of Cu, Zn and As than grain crop soil. The spatial distribution of four test metals showed the same pattern of urban > suburban, and the regions with high concentrations of heavy metals were well overlapped with mining areas, suggesting that mining activities might be one of the most important source of heavy metals in the farmland soils. The rapid increase of animal manure also contributed to the import of pollutants to farmland soils to some degree. The potential risks of soil heavy metals pollution should be considered in the arrangement of local agricultural and animal husbandry productions.

Massive amounts of pig manure are produced by intensive pig farm in China, and the composition of pig manure has changed much due to the use of feed additives. However, little is known about the exact Cu (copper) feed as additives or present as contaminants in pig feed and the residues in feces. One hundred and thirty-seven feeds and one hundred and forty-two fecal samples from 48 pig farms were collected in Beijing and Fuxin cities in 1999 and 2005, respectively. The concentrations of Cu were in the range of 6.86-395.19 mg/kg in the feed samples, and the mean values were in the order of weaner > grower-finisher > sow's feeds. The high concentrations over EU recommendations implied that excessive levels of Cu are fed on many pig farms in Beijing and Fuxin. Cu was also present in high concentrations in feces, and concentrations were highly variable. Cu concentrations in the feces from grower-finisher and weaner pigs were significantly greater than feces of sows. The super-intensive and small-scale farms had higher levels of Cu in feces than the middle farms. Cu concentrations in pig feces were approximately 5-times greater than in pig feeds. Feed management in grower-finisher pigs on super-intensive and small-scale pig farms is needed to reduce high Cu concentrations in feces and risks to soil contamination while feces are land-applied.

Objective: To investigate the constitutive characteristics and the change trend of gynecologic malignant tumors in hospitalized patients in Guangxi Zhuang Autonomous Region over the recent 20 years., Methods: Clinical data of 8009 in-patients who suffered from gynecologic malignant tumors in 23 hospitals from 1985 to 2004 in Guangxi Zhuang Autonomous Region were analyzed, with respect to the tumor types and change trend., Results: (1) The leading 4 types of malignant tumors were cervical cancers, ovarian cancers, endometrial cancers, and malignant trophoblastic tumors according to the constitutive ratios of the tumors. The constitutive ratio of cervical cancer patients rose year by year, from 17.48% during the 1985-1989 period to 49.25% during the 2000-2004 period (P < 0.01). While the constitutive ratio of malignant trophoblastic tumors dropped year by year. The changes of ovarian cancer, endometrial cancer, vulvar and vaginal carcinomas, and sarcoma of the uterus were not obvious (P > 0.05). (2) The occurring age of cervical cancers became younger obviously, from > or = 60 years old dropped to < 40 years old. (3) Cervical cancers were found mainly in urban residents in the former 10 years, the constitutive ratio being 67.1%; while in the latter 10 years it gradually shifted to rural residents, accounting for 52.6% of the total gynecological tumors. (4) Patients were usually at stages II, III, IV when they visited a doctor for their diseases. Especially for ovarian cancer, malignant trophoblastic tumors, sarcoma of the uterus, these patients were in the intermediate or advanced stage when they were diagnosed, mainly because of lack of obvious symptoms. The constitutive ratio of these advanced patients was over 60%., Conclusions: We should strengthen the screening program of cervical cancer, and pay more attention to prevention and control of other gynecological reproductive organ tumors at the same time. On the other hand, we should explore better tumor markers, new methods of diagnosis and treatment to improve early diagnosis and treatment of gynecologic malignant tumors.

Objective: To construct composite skin containing living cells and to observe its significance in the repair of full skin loss in mice., Methods: The dermal substitute was formed by culturing heterogeneous fibroblasts on the acellular chondrocyte collagen scaffold for 3 days, and then cultured on the epithelial membrane for another 10 days, to form the composite skin containing living cells. The composite skin was grafted onto full layer skin defect. The growth condition was observed and biopsies were harvested for histologic examination., Results: Both fibroblasts and stratified epithelium grew well in the collagen scaffold. The composite skin adhered tightly to wounds of the mice, with obvious vascularization one week after grafting. The grafts began to merge with the wound margin at 6 post operation weeks without obvious signs of rejection., Conclusion: Full skin loss could be repaired by composite skin formed by acellular chondrocyte collagen scaffold as a skin substitute.

Objective: To investigate the relationship between blood concentration of lactic acid (LA) and tissue oxygenation in severely burned patients with shock., Methods: Thirty-four severely burned patients admitted during early postburn stage were included in this study and were randomly divided into A (n = 18) and B (n = 16) groups. The patients in A group were resuscitated with modified anti-shock programme by which the patients' urine output was maintained roughly around 100ml per hour, while the patients in B group were treated by our traditional resuscitation formula by which the patients urine was kept at 40 ml per hour. The blood concentration of LA and usual indices (urine output, blood pressure, heart rate, and mental status) were simultaneously monitored before and 1, 8, 16, 24, 48 and 72 hours after resuscitation in patients of both groups., Results: (1) The average blood LA level in patients of A group was (3.2 +/- 0.4) mmol/L within 24 hours of resuscitation, while the monitored indices remained within normal range. Nevertheless the LA level in B group was (7.4 +/- 1.6) mmol/L (P < 0.01, compared with that of A group), and hyperlactacidemia lasted for more than 72 hours while other indices were normal. (2) The mortality in B group was high (31.2%), whilst that in A-group was only 5.5% (P < 0.01). (3) There was negative correlation between blood LA and urine output and positive correlation between blood LA and heart rate., Conclusion: (1) Blood LA concentration might be taken as an immediate, sensitive, simple and useful index of tissue oxygenation of the whole body during burn shock stage. (2) It was suggested by our results that fluid resuscitation should be extended to 72 PBHs (postburn hours) with urine output over 100 ml/h, so as to ensure the quality and effects of the resuscitation of burn shock.

Activities of combinations of beta-lactams, daptomycin, gentamicin, teicoplanin, and vancomycin against 11 clinical isolates of Enterococcus faecium highly resistant to glycopeptides, three plasmid-cured derivatives, eight E. faecalis and E. faecium transconjugants, and two susceptible recipient strains were tested. A marked synergy between penicillins or imipenem and glycopeptides against the glycopeptide-resistant strains but not against the glycopeptide-susceptible strains was observed by the double-disk agar diffusion assay. The synergy of combinations of amoxicillin, imipenem, penicillin G, or piperacillin with vancomycin or teicoplanin against resistant strains was confirmed by the checkerboard technique. The fractional inhibitory concentration indexes were generally below 0.25, except for one strain of E. faecium resistant to high levels of penicillin G. However, the combinations were not bactericidal as tested by time-killing experiments, and high concentrations (64 micrograms/ml) of amoxicillin, penicillin G, or piperacillin combined with 8 micrograms of vancomycin or teicoplanin per ml tended to be antagonistic. Addition of 4 micrograms of gentamicin per ml to these combinations enhanced their bactericidal effect, but they occasionally remained slightly less effective than beta-lactams associated with gentamicin. The combination of 10 micrograms of daptomycin per ml with gentamicin was bactericidal after 6 h against 11 glycopeptide-resistant strains.

A serosurvey for antibodies to Rickettsia japonica was conducted on Hainan Island of China. Serum specimens were collected from 1,030 outpatients at hospitals in different parts of the island regardless of their diagnosis. Only two among 538 serum specimens collected in Baoting and Tongshi counties, located in the southern part of the island, were demonstrated to contain antibodies reactive with R. japonica at a high dilution. The specimens also reacted with R. rickettsii at the same titer as with R. japonica. These two specimens reacted with other pathogenic spotted fever group (SFG) rickettsiae to a lesser extent. On the other hand, the specimens were shown to possess antibodies reactive with R. typhi at a significantly lower dilution or were not reactive at all. The findings suggested the occurrence of an SFG rickettsiosis on Hainan Island. More than half of the serum specimens collected from patients with suspected rickettsial infections in the southern area were found to contain IgM and IgG antibodies to R. typhi, indicating a high incidence of murine typhus.