Showing papers in "National Medical Journal of China in 2005"

[Thulium laser resection of prostate-tangerine technique in treatment of benign prostate hyperplasia].

Abstract: Objective To evaluate the safety and efficacy of thulium laser resection of prostate-tangerine technique (TmLRP) in treatment of benign prostate hyperplasia (BPH). Methods Thirty BPH patients, aged 74 (61-83), with a mean prostate volume of 58 ml, average international prostate symptom score (IPSS) of 19, and average maximum urinary flow (Q(max)) of 8.0 ml/s underwent TmLRP using 50 watt, 2.01 microm Tm laser. The values of hematocrit, serum sodium, potassium, and chlorine concentrations, hemoglobin, Q(max), and IPSS before and 1 and 3 months after TmLRP were compared. Results The mean operating time was 56 minutes. No significant bleeding was found during operation. Post-operative bladder irrigation was no necessary. The urethral catheter was indwelled for 1-3 days post-operatively. There were not significant differences in values of hematocrit, serum sodium, potassium, and chlorine concentrations, and hemoglobin before and 1-3 months after the operation. One month after the operation, the Q(max) was 23.1 ml/s and IPSS was 7.9, and 3 months after the operation the was 24.7 ml/s and the IPSS was 7.1. By the end of 3-month follow-up no new cases of impotence and retrograde ejaculation had been found. Conclusion TmLRP is a safe and efficient procedure in treatment of BPH.

Epidemiologic analysis of COPD in Guangdong province

Abstract: OBJECTIVE: To survey the prevalence of chronic obstructive pulmonary disease (COPD) in urban and rural areas in Guangdong Province and relevant risk factors. METHODS: Using the same protocol including Burden of Obstructive Lung Disease (BOLD) questionnaire, a questionnaire survey was conducted among 3449 respondents, 1370 males and 1916 females, aged over 40 with an average age of 56.8, by random disproportional cluster sampling in Liwang District of Guangzhou City and Yunyan Town, Lechang City, northern Guangdong Province. Spirometry was performed in all subjects. Lung function indices were regarded as gold criteria of diagnosis of COPD. RESULTS: There were 3286 cases with full data and good quality spirometry test, 1370 males and 1916 females, aged 56.8. The total prevalence of COPD was 9.4%. The prevalence of COPD in the males was 15.9%, significantly higher than that in the females (4.8%, P < 0.01). The prevalence in the rural area was 12.0%, significantly higher than that in the urban area (7.4%, chi(2) = 20.3, P < 0.01). 67.7% of the patients with COPD presented symptoms such as cough, expectoration and/or dyspnoea. 58.7% of the COPD patients (78.9% of the male patients and 10.9% of the female patients) smoked. The odd ratio (OR) for COPD in the smokers was 2.59 (95% CI 1.87 - 3.59). Only 15.1% of the smokers (17.9% of the male smokers and 4.1% of the female smokers) developed COPD. No significant relationship was found between pack years of cigarette smoking and COPD prevalence. The risk of COPD was increased when biomass fuels were used in house cooking (OR = 1.54 95% CI 1.08 - 2.20). Furthermore, the combination of biomass fuels and cigarette smoking further increased the risk with the OR of 4.41 (95% CI 3.22 - 6.04), indicating a synergetic impact of smoking and biomass burning on the prevalence of COPD. The Prevalence of doctor-diagnosed COPD based on the clinical manifestation was significant lower than the actual prevalence (only 31.0%). CONCLUSIONS: COPD is a very common disease in Guangdong. The prevalence of COPD is higher in the rural area than in the urban area, which may be attributed to the synergic effect of smoking and biomass burning. Lung function test is of great importance in COPD diagnosis, especially in the earlier stage of COPD and those asymptomatic COPD patients.

Epidemiological study of Helicobacter pylori infection and its risk factors in Shanghai

Abstract: Objective To explore the Helicobacter pylori (Hp) infection status in Shanghai and its risk factors. Methods A questionnaire survey including 60 items related to Hp was conducted among 1925 persons, 976 males (50.7%) and 949 females (49.3%), aged 37 +/- 11 (15 approximately 72), selected by cluster sampling in 12 rural and urban areas in Shanghai. Peripheral blood was collected to detect Hp IgG antibody so as to evaluate the past infection status and (14)C urea breath test (UBT) was performed so as to evaluate the present infection status. Fecal Hp antigen test was done in the subjects under 18 years of age. Results 1822 of the 1925 subjects (94.6%) underwent the 3 tests. were followed antibody detection and (14)C UBT and response with questionnaires. The Hp infection rate was 66.4% in general, and 68.4% in the females, somehow higher than in the males (64.3%, P = 0.067). The infection rate was different in different age groups, was the lowest in the age group of 15 approximately 19 (44.4%) and the highest 70% in age group of 20 approximately 30 (70%), then somewhat lower and gradually became higher. Socio-economic status was related to Hp infection. Hp infection was related with such factors as eating raw vegetables and fruits, and never washing raw vegetables and fruits before eating. The knowledge rate about Hp infection was only 33.2% among the respondents. Only 23.8% of the respondents knew well the transmission route of Hp. Conclusion Hp infection rate is rather high in Shanghai. Hp infection is related to socio-economic status, and family dietary and sanitary habits.

Comparison of effects of percutaneous radiofrequency ablation and surgical resection on small hepatocellular carcinoma

Abstract: Objective To compare the effectiveness of percutaneous radiofrequency ablation (PRFA) and surgical resection as an initial treatment for patients with small hepatocellular carcinoma (HCC). Methods Between March 2000 and June 2003, 112 patients with small HCC (with single nodule less than 5 cm in diameter) were divided at random into two groups: resection group (n = 65) and PRFA group (n = 47) to undergo surgical resection or PRFA respectively. Results The 1-, 2- and 3-year recurrence rates were 10.7%, 18.4%, and 24.6% respectively in the 65 patients of the resection group and were 8.5%, 19.1%, and 23.4% respectively in the 47 patients of the PRFA group. The 1-, 2-, and 3-year survival rates were 93.18%, 85.69%, and 67.26% respectively in the 65 patients of the resection group and were 92.79%, 82.03%, and 64.46% respectively in the 47 patients of the PRFA group (P = 0.7534). The 1-, 2- and 3-year survival rates of the patients with tumor less than 3 cm in diameter were slightly higher in the PRFA group than in the resection group, however, insignificantly (P = 0.1253). The 1-, 2- and 3- year survival rates of the patients with tumor 3.1 to 5 cm in diameter were higher in the resection group than in the PRFA group, however, insignificantly (P = 0.4617). The 1, 2, and 3-year survival rates of the patients at stage Ia were slightly higher in the PRFA group than in the resection group, however, insignificantly (P = 0.1253). The 1, 2, and 3-year survival rates of the patients at stage Ib were slightly higher in the resection group than in the PRFA group, however, insignificantly (P = 0.4617). Conclusion PRFA treatment is a less invasive form of treatment for small HCC than surgical resection and is equally effective as the more invasive surgical resection. PRFA is superior to surgical resection when used in the treatment of patients with HCC less than 3 cm in diameter. PRFA can be used instead of surgical resection in proper situations.

[Clinical features, hormonal profile, and metabolic abnormalities of obese women with obese polycystic ovary syndrome].

Abstract: Objective To investigate and analyze the clinical presentation,hormonal profile,and metabolic abnormalities of obese women with polycystic ovary syndrome(PCOS).Methods The data of the anthropometric measurements,clinical manifestations of hyperandrogenism,serum levels of luteininzing hormone(LH),follicle stimulating hormone(FSH),estradiol(E_2),testosterone(T),prolactin(PRL),dehydro-epiandrosterone sulfate(DHEAS),sex-hormone-binding globulin(SGBG),and 17-oxyhydroprogesterone(17-OHP),fasting plasma glucose (FPG) and fasting insulin(FINS) detected after oral glucose tolerance test(OGTT),serum lipid levels,including total cholesterol(Chol),triglycerides(TG),high-density lipoprotein(HDL),and low-density lipoprotein(LDL),homeostasis model assessment(HOMA) and area under curve(AUC) so as to assess the insulin resistance(IR),free androgen index(FAI) to estimate the extent of hyperandrogenism,HOMA IS and ΔI_(30)/ΔG_(30) used to assess the function of islet β cells,were collected from 192 women with PCOS,aged 24±6,that were divided into 2 groups according to the body mass index(BMI) : Group A(n=70) with the BMI≥25 kg·m~(-2) and Group B((n=122)) with the BMI2 5 kg·m~(-2),and 65 age-matched bilateral tubal block factor infertile women served as controls that were divided into 2 groups as well: Group C(n=25) with the BMI≥25 kg·m~(-2);and Group D(n=79) with the BMI25 kg·m~(-2),and underwent a cross-sectional study.Results(1)Clinical phenotype: The presence of obesity was 36.46%(70/192) of which 80.00%(56/70) was central obesity.The incidence of acanthosis nigricans was 17.18%(33/192),35.71% in Group A and 6.56% in Group B.(P0.01) Groups A and C showed increased frequency of acanthosis nigricans compared with Group B.The value of FAI of Group A was 3.40±1.84,significantly higher than those of Group B(1.75±1.20) and Group C(1.65±0.90),(both P0.01).The LH/FSH ratio of Group B was 2.41±1.13,significantly higher than those of Groups A,C,and D(all P 0.01).(2) Hormonal profile: The IR rate was 43.23% in the 192 patients,82.86% in Group A and 20.49% in Group B.The LH and LH/FSH ratio were significantly higher in Group B than in Groups A,C,and D(all P0.01);T level was higher in Groups A and B than in Group C and D(all P0.05).SHBG was lower in Group A(108.70±81.35 nmol·L~(-1)) and Group C(150.34±106.23 nmol·L~(-1)) compared with Group B(192.49±(98.30 nmol·L~(-1))) and Group D(231.84±90.09 nmol·L~(-1))(P 0.01 and P0.05).FAI level was3.40±1.84 in Group A,significantly higher than those of Groups B(1.75±1.20),C(1.65±0.90),and D(0.84±0.45)(all P0.01).The FINS,TG,and HOMA IR of Groups A and C were all significantly higher than those of Groups B and D(all P0.01)/ The OGTT GAUC was significantly higher than those of Groups B,C,and D(P=0.006,0.028,and 0.031 respectively).(3) Metabolic profile: The prevalence of IR was 43.23%(83/192) with a higher prevalence rate in Group A(82.76%,58/70) compared with Group B(20.49%,25/122).The values of FINS,HOMA IR,GAUC,IAUC,and TG were all higher in Group A than in Group B(all P0.01).BMI and WHR were positively correlated with FAI and HOMA-IR(all P0.01),whereas negatively correlated with LH/FSH ratio(r=-0.345,-0.260,P0.01) There were no significant differences in HOMA-IS and ΔI_(30)/ΔG_(30) among these groups(all P0.05).Conclusion Obese PCOS women have more severe hyperandrogenism,IR and hyperinsulinism than normal-weight PCOS women,which may have some health implications later in life.

Clinical research of hemiprosthesis arthroplasty for the treatment of unstable intertrochanteric fractures in elderly patients

Abstract: Objective To report the clinical results of hemiprosthesis for unstable intertrochanteric fractures in elderly patients. Methods 86 cases (male 35 and females 51) of unstable intertrochanteric fractures in elderly patients were treated with hemiprosthesis arthroplasty in our hospital. The average age was 87 years old (range from 80 to 98 years old). According to the Evans classification of intertrochanteric fractures, there were 31 cases in type IIIA, 35 cases in IIIB and 20 cases in type IV. Most of the patients fell in the room and fractured, with concomitant diseases. After admitted to the hospital, the patients were consulted and treated for the concomitant diseases, and after the general conditions got stable and no absolute contraindications were found, the hemiprosthesis arthroplasty was performed. Almost all of the patients were operated on within 3 days with general anesthesia under the multi-function monitoring. The greater trochanter was reconstructed with figure of 8 wire fixation, the lesser trochanter with figure of 8 wire fixation, the lesser trochanter was fixed with circular wire around proximal femur. The defect within the femoral calcar was filled with bone cement and in a part of the patients, the intertrochanteric fracture was transformed into femoral neck fracture and the femoral calcar was fixed with femoral prosthesis stem. Results All operations were successful and the duration of the operation was 45 to 70 minutes with an average of 55 minutes. Blood was transfused in 73 patients during the operation between 400-800 ml with an average 450 ml. The patients got out of the bed within 3 days in 33 cases, 4-7 days in 43 cases, more than 8 days in 8 cases, and 2 patients couldn't get out of the bed. The period of hospitalization was between 13 to 27 days with an average of 16.8 days. Complications 2 patients got slight deep phlebitis, 5 patients showed psychological disorders, and disorders in bacterial spectrum appeared in 3 patients, and after appropriate treatments, the complications gradually recovered and had no effect on the function of the affected extremity. 2 cases died of multiple organ failure during the hospitalization. 59 patients were followed up for 6 to 48 months with an average 16 months. The result was excellent in 17 cases who resumed their activities as before they got fractured, good in 35 cases who could walk with walking aid, fair in 5 cases who could walk with others help, and poor in 2 cases who could not walk. 1 patient died of other diseases 5 months after discharged. No dislocation, loosening or late infections occurred. 88.1% showed excellent or good result. Conclusion It's an effective method to treat the unstable intertrochanteric fractures in elderly patients with hemiprosthesis arthroplasty. The result was satisfactory. It can decrease the complications, reduce the mortality, improve the patient's the living quality, and reduce the burden of the patient's family.

[A multi-central, randomized, controlled clinical trial of glucosamine hydrochloride/sulfate in the treatment of knee osteoarthritis].

Abstract: Objective To evaluate the efficacy and safety of glucosamine hydrochloride (GH) in the treatment of patients with knee osteoarthritis (OA) comparing with glucosamine sulfate (GS). Methods A multi-central, randomized, parallel-controlled clinical trial of GH vs GS was performed. 142 patients suffering from knee OA were randomized into 2 groups, treated with GH and GS for 480 mg and 500 mg one time respectively. Patients received medicine 3 times daily with total 1440 mg per day for GH group and 1500 mg for GS group, orally for 4 weeks and were assessed for drug efficacy and safety for 2 more weeks. Knee pain at rest, at movement and at pressure, knee swelling, morning stiffness and walking ability were recorded at 1, 2,3,4 and 6 week according to Lequesne's criteria. Other features such as therapeutic efficacy, adverse events and laboratory parameters were also recorded. Results A considerable improvement in OA symptoms and a reduce of total Lequesne′s score were observed in both groups after the 4-week treatment. The Lequesne′s score decreased to 3.4±1.9 (P0.05) and 3.4±1.8 (P0.05) after 4-week treatment comparing to 0-week in the GH (9.4±1.8) group and GS (9.5±1.4) group respectively. There was no significant difference between 2 groups in decreasing the Lequesne′s score (P0.05). The symptomatic improvement rates in patients were 91.4% and 90.0% at 4-week treatment in the GH and GS group respectively (P0.05). There was a remnant therapeutic effect in both groups at 2 weeks after discontinuation of the treatment. And 4.2% (3/71) of patients on GH reported adverse events, vs 7.0% (5/71) adverse events with GS group (P0.05), mainly mild stomach discomfort and constipation. Conclusion There were no significant differences in efficacy and safety between GH and GS groups in the treatment of knee OA. Glucosamine hydrochloride is as effective and safe as glucosamine sulfate.

[Influence of taking aristolochic acid-containing Chinese drugs on occurrence of urinary transitional cell cancer in uremic uremic patients undergoing dialysis].

Abstract: OBJECTIVE To investigate the prevalence and clinical characteristics of urinary transitional cell cancer (TCC) in uremic patients undergoing dialysis who have history of taking aristolochic acid (AA)-containing Chinese drugs. METHODS A questionnaire survey was conducted among 283 uremic patients with history of taking aristolochic acid (AA)-containing Chinese drug who were undergoing dialysis, 118 males and 165 females, aged 59 +/- 13 (22-88), to understand the drug-taking history, nephropathy-related situation, and prevalence and clinic TCC pathological features of TCC. RESULTS Twenty-four of the 283 were suffering concomitant TCC with a prevalence rate of 8.48%. Sixty-six of the 283 patients had a history of taking AA-containing Chinese drugs, 22 of which had developed TCC with a prevalence rate of 33.3%, significantly higher than that among the 198 patients without a history of taking AA-containing Chinese drugs (1.0%, P 100 ml after dialysis (8/38, 21.0%) and was not found in those with anuria after dialysis. The first symptom in the 18 TCC cases was intermittent painless hematuria. The positive rates of imageology and nuclear matrix protein (NMP)-22 detection were both more than 90%. Tumor was found in the urinary bladder or ureter (11/18, 61.2%). The relapse rate after routine surgery was 27.8%. CONCLUSION With a very high prevalence of TCC, the patients with a history of taking AA-containing Chinese drugs should be monitored closely.

[Dendritic cells reduce the number and function of CD4+CD25+ cells in cytokine-induced killer cells].

Abstract: OBJECTIVE To investigate the influence of dendritic cells (DCs) on the prevalence and function of regulatory T cells (Tregs) in cytokine induced killer (CIK) cells. METHODS The blood samples of 20 patients with solid tumors were collected. The peripheral mononuclear cells (PBMCs) were isolated. CIK cells were added into the culture fluid without CD(4)(+)CD(25)(+)T cells (CIK-Treg(del) cells) and the culture fluid of regular PBMCs respectively, and the proliferation and cytotoxicity of the CIK cells were detected by BrdU method and with the cells of human lung carcinoma, breast carcinoma, colon carcinoma, and lymphoma as target cells respectively. CD(4)(+)CD(25)(+)T cells were added into another culture fluid of CIK-Treg(del) cells at the proportions of 20:1, 10:1, and 5:1 respectively, then the proliferation and cytotoxicity of the CIK cells were detected as described above. Flow cytometry was used to detect the surface markers of CIK cells. To identify the influence of DCs on the anti-tumor activity of CIK, PBMCs were isolated from the patients with solid tumor to culture the DCs and CIK cells. Dendritic cells were harvested on day 7 and co-cultured with the CIK cells (DC+CIK cells). The frequency of Tregs in CIK was determined by flow cytometry. The cytotoxicity was examined by LDH assay. The levels of TGF-beta, IL-10, IFN-gamma, IL-2, and IL-6 were analyzed by ELISA. RESULTS The rates of the main effector cells in CIK cells (CD(3)(+)CD(56)(+) cells) were 17% +/- 5% and 28% +/- 5% in the regular CIK cells and CIK-Treg(del) cells respectively. LDH method showed that the cytotoxicity towards tumor cells of the CIK-Treg(del) cells The rates of the main effector cells in CIK cells (CD(3)(+)CD(56)(+) cells) were 17% +/- 5% and 28% +/- 5% in the regular CIK cells and CIK-Treg(del) cells respectively. LDH method showed that the cytotoxicity towards tumor cells of the CIK-Treg(del) cells was higher than that of the regular CIK cells (P < 0.05), however, after the addition of selected cells, the cytotoxicity of the CIK-Treg(del) cells decreased. Flow cytometry showed that the proportions of CD(4)(+)CD(25)(+) Treg cells in the CIK cells and DC-CIK cells were 13% +/- 5% and 10% +/- 4% respectively (t = 3.977, P = 0.001). After the DC induction the cytotoxicity of CIK cells was significantly higher than that of the regular CIK cells. ELISA showed that after DC induction the levels of TGF-beta and IL-10 of the DC+CIK group were significantly lower than those of the regular CIK cells (t = 2.136, P = 0.046; and t = 2.965, P = 0.008), and the level of IFN-gamma was significantly higher in the DC+CIK group (t = 2.220, P = 0.039). CONCLUSION CD(4)(+)CD(25)(+) regulatory T cells inhibit the anti-tumor activity of CIK cells. The interaction between CIK cells and DCs is sufficient for the blockage of the properties of regulatory T cells. CIK cells have the desirable properties for immunotherapy approaches, especially after co-culture with DCs.

Homologous dermal acellular matrix graft for urethral reconstruction in man (report of 16 cases)

Abstract: Objective To investigated the value of homologous dermal acellular matrix graft (AMG) for urethral reconstruction in man, and found an ideal replacement material to simplify the urethroplastic surgery. Methods 16 male patients, aged 18-46 (mean 26.5), with urethral diseases were treated with allograft of tissue engineering material AMG. The causes of urethroplasty were complex urethral stricture followed by pelvic fracture (13 cases), anterior urethral stricture (2 cases), hypospadia (1 case). During the operation, AMG was sutured to a tubular graft and replaced the defect urethra. A 18-22 Fr silicone catheter was inserted in the reconstructed urethra for 4-6 weeks. Results All 16 patients were voiding well after removing the catheter, urethrography reveal excellent caliber of the reconstructed urethra. Urethroscopic examination showed the graft urethra was covered by epithelial tissue and grew into the native tissue. But stenosis was developed in 3 patients postoperatively, 1 patients received transurethral incision, another 2 needed urethral sounding. The patients were followed-up for 12-72 months (mean 45.6), no rejection was observed, all patients voided normally except 4 cases needed urethral dilatation periodically. Conclusion The homologous dermal acellular matrix graft may serve as an ideal replacement material for complex urethral stricture or defect, without concern of rejection.

The expression of hepatocyte growth factor and its receptor in brain astrocytomas

Abstract: OBJECTIVE: To investigate the expression of hepatocyte growth factor (HGF) mRNA and its receptor (c-Met) mRNA in brain astrocytomas and their relationships with tumor proliferation, angiogenesis, clinical pathology and prognosis. METHODS: The expression of HGF mRNA, c-Met mRNA in the resected tumor tissues of 76 patients with brain astrocytomas, 43 males and 33 females, aged 20 - 71, were detected by in situ hybridization. Immunohistochemistry technique was used to test the expression of proliferating cell nuclear antigen (PCNA) protein and the microvessel density (MVD) was determined by immunohistochemistry with monoclonal antibody against CD34. RESULTS: The positive rates of expression of HGF, c-Met and PCNA in low pathologic grades of brain astrocytoma were 34.5%, 44.8% and 15% +/- 9% respectively, and in high pathologic grades of brain astrocytoma were 34.5%, 44.8% and 48% +/- 12% respectively (P < 0.05). MVD in low and high pathologic grades of brain astrocytoma were 17 +/- 7 and 31 +/- 13 respectively (P < 0.05). The expression of HGF, c-Met, PCNA and CD34 was not related to sex, age, position of tumor and diameter of tumor. The expression of c-Met was related to the expression of HGF, PCNA and the MVD in the tumor tissues of these patients. The pathological grade, position of tumor, HGF, c-Met, PCNA, MVD had a significant influence on the survival time. CONCLUSION: HGF/c-Met plays an important role in the formation and progression of the brain astrocytoma and can promote tumor proliferation and intratumoral microvascular formation, and is closely related to the prognosis of the patients.

[Induction of uridine 5'-diphosphate-glucuronosyltransferase gene expression by sulforaphane and its mechanism: experimental study in human colon cancel cells].

Abstract: OBJECTIVE To study the induction of expression of uridine 5'-diphosphate (UDP)-glucuronosyltransferase (UGT) 1A in colon cancer cells by sulforaphane (SFN) and its possible mechanism. METHODS Human colon cancer cells of the line Caco-2 were cultured and added with SFN of different terminal concentrations, all below the concentration of IC(50). RT-PCR was used to examine the expression of UGT1A mRNA induced by SFN. Western blotting was used to detect the expression of UGT1A protein. The glucuronidation rate of N-hydroxy-PhIP was measured by high performance liquid chromatography (HPLC). The nuclear localization of transcription factor Nrf2 was observed by confocal laser microscopy. RESULTS (1) Expression of UGT1A mRNA was observed in the Cac0-2 cells induced by SFN of the concentrations of 10 micromol/L approximately 35 micromol/L in a dose-independent manner (P < 0.05). Sulforaphane of the concentration of 25 micromol/L induced the UGT1A mRNA expression time-dependently. The levels of UGT1A1, UGT1A8, and UGT1A10 mRNA expression were significantly increased in the cells treated with 25 micromol/L sulforaphane compared to that in the controls (P = 0.006, P = 0.017, and P = 0.008 respectively). (2) The UGT1A protein band intensity increased significantly in the Coco-2 cells treated with sulforaphane of the concentrations 10 micromol/L approximately 30 micromol/L for 24 h in comparison with the control cells. (3) When the microsomes from the untreated Caco-2 cells were incubated with N-hydroxy-PhIP there was a minor HPLC peak at the expected retention time for N-hydroxy-PhIP-N2-glucuronide. This peak was dramatically increased in the sulforaphane-treated cells, suggesting higher activities of glucuronidation of N-hydroxy-PhIP. (4) Cytoplasmic labeling of NF-E2-related factor 2 (Nrf2), a transcription factor, with no nuclear staining was observed in the non-stimulated cells, whereas an intense nuclear labeling was observed in the sulforaphane-treated cells, indicating the induction of nuclear translocation of Nrf2 by sulforaphane. CONCLUSION (1) Low dose sulforaphane induces the expression of UGT1A, UGT1A1, UGT1A A8, and UGT1A A10 mRNA significantly. These changes are accompanied by an increase in UGT1A1 protein and increase in heterocyclic aromatic amine glucuronidation. (2) The induction of the phase II enzyme activity by SFN occurs at the transcriptional level and is regulated by Nrf2.

[Genetic polymorphisms of apoptosis-associated genes FAS and FASL and risk of colorectal cancer].

Abstract: Objective The FAS and FASL system plays a key role in regulating apoptotic cell death and corruption of this signaling pathway has been shown to participate in tumorigenesis. We previously have shown that the FAS-1377G/A and FASL-844T/C polymorphisms are associated with esophageal cancer. This case-control study was to examine the contribution of the polymorphisms to susceptibility of colorectal cancer. Methods PCR-RFLP method was used to determine the genotypes of FAS-1377G/A and FASL-844T/C in 382 patients with colorectal cancer and 648 controls. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression model. Results The subjects with the AA genotype of FAS-1377G/A and CC genotype of FASL-844T/C had an increased risk for colorectal cancer compared with those with the FAS-1377GG genotype (adjusted OR, 1.65; 95% CI, 1.14-2.38) and FASL-844TT genotype (adjusted OR, 1.76; 95% CI, 1.37-2.28). Furthermore, the effect of FAS and FASL polymorphisms on risk of colorectal cancer displayed a significantly gene-gene interaction (likelihood ratio test, P = 0.002). Conclusion These findings suggest that the FAS-1377G/A and FASL-844T/C polymorphisms may be genetic susceptibility factors for colorectal cancer among Chinese population.

[Influence of elemene on the expression of Bcl-2 family genes in rat C6 glioma cells].

Abstract: OBJECTIVE To observe the effects of elemene on the induction of apoptosis in rat C6 glioma cells and its influence on expression of Bcl-2 family genes. METHODS Rat C6 glioma cells were cultured. Elemene of the concentrations of 0, 20, 40, 60, and 80 microg/ml were added for 12, 24, 36, 48, and 72 hours respectively. RT-PCR was used to detect the mRNA expression of Bcl-2/Bcl-x/1 genes. Western blotting was used to detect the protein expression of Bcl-2/Bcl-x/1 genes. The apoptosis of the cells was examined by flow cytometry. RESULTS The cell counts of the 20, 40, 60, and 80 microg/ml elemene groups were 536 +/- 9, 375 +/- 10, 246 +/- 9, and 112 +/- 10/visual field respectively, all significantly lower than that of the 0 microg/ml elemene group (all F = 1292.416, P < 0.05) and the apoptotic rates of the 20, 40, 60, and 80 microg/ml elemene groups were (27 +/- 2)%, (29 +/- 4)%, (32 +/- 3)%, and (35 +/- 5)% respectively with an Ap peak. The protein expression of Bcl-2/Bcl-x/l genes was decreased in the elemene groups dose and time-dependently. The expression of Bax protein was decreased in the elemene groups too, however, not dose and time-dependently. CONCLUSION Apoptosis caused by elemene may be associated with the down-regulation of Bcl-2/Bcl-x/l genes.

[Adverse effects of attenuated yellow fever vaccine with multiple organ injury--a case report].

Abstract: 患者男,60岁, 美籍华裔,汉族.2004年8月12日因拟赴非洲旅游首次接受黄热减毒活疫苗及流脑疫苗各0.5 ml皮下注射,未再接种其他疫苗.8月16日无明显诱因出现发热, 8月18日逐渐出现皮肤黄染.8月19日就诊于北京协和医院急诊.患者2003年因"直肠癌"行直肠癌根治术.术后放化疗,最后一次化疗于2004年3月结束.2004年2月以来未到流行病流行区域居住或旅行.患者入急诊时体温38.5℃,心率120 次/min,呼吸34次/min,血压60/50 mmHg(1 mm Hg = 0.133 kPa).精神恍惚,皮肤、巩膜轻-中度黄染,无尿。

Pleuropulmonary manifestations of systemic lupus erythematosus

Abstract: Objective: To analyze the incidence, clinical features, and prognosis of pleuropulmonary involvement in patients with systemic lupus erythematosus (SLE) Methods: The medical records of 320 SLE inpatients hospitalized in Peking Union Medical College Hospital 2004, 50 males and 270 females, aged 33 ± 14 (8-75), were retrospectively analyzed Results: Pleuropul monary involvement occurred in 142 cases with an incidence rate of 444% The incidence of pleural involvement was 25% (80/320) and the incidence of pulmonary parenchyma involvement was 338% (108/320) The mortality rate of the SLE patients with thoracic involvement was 70%, significantly higher than that of the SLE patients without thoracic involvement (10%, P = 0006) The incidence of acute lupus pneumonitis (ALP) was 13% and the survival rate of ALP was 100% The clinical manifestations of ALP included hypoxemia, dyspnea, fever, and cough and chest radiograph characteristically showed unilateral or bilateral patchy acinar infiltrates predominantly in the lower lung zone The incidence of diffuse alveolar hemorrhage (DAH) was 19% with a mortality rate of 667% The clinical manifestations of DAH included hemoptysis, hypoxemia, cough, anemia and bloody bronchoalveolar lavage and the chest radiographic findings included new acinar infiltrates that were typically diffuse and bilateral and might be patchy The other common pleuropulmonary complications of SLE included pleural disease (25%), chronic interstitial pneumonitis (69%), pulmonary hypertension (153%), pulmonary embolism (19%), and pulmonary infection (191%) Conclusion: SLE may affect all components of the respiratory system Thoracic involvement is an adverse prognostic sign Life-threatening pulmonary involvement is not uncommon The clinicoradiographic features of the SLE-associated pulmonary syndromes overlap Aggressive diagnostic evaluations such as blood culture, sputum culture, fibreoptic bronchoscopy, and lung biopsy are very important

Effect of pulse wave velocity on coronary flow reserve in patients with essential hypertension

Abstract: OBJECTIVE To observe the effect of pulse wave velocity (PWV) on coronary flow reserve (CFR) in patients with essential hypertension (EH). METHODS 108 patients with EH were divided into three groups according to the blood pressure (BP) status and antihypertensive drug therapy (ADT): group A (n = 41, with ADT and BP failing to reach the standard), group B (n = 27, with high BP and without ADT), and group C (n = 40, with ADT and BP reaching the standard). Twenty-five sex, age, body mass index, waist/hip ratio, heart rate, fasting glycemia and lipid level-matched healthy persons were used as controls (group D). PWV, CFR, left ventricle mass index (LVMI), E/A ratio, left ventricle isovolumetric relaxation time (IVRT), left ventricular ejection fraction (LVEF) were detected in each group. Correlation analysis was conducted. RESULTS (1) the PWV values in group A, B, and C were 12.7 m/s +/- 1.3 m/s, 11.9 m/s +/- 2.2 m/s, and 9.6 m/s +/- 0.9 m/s respectively, all significantly higher than that in the group D (8.9 m/s +/- 0.7 m/s, all P < 0.05) and with significant differences between group A and group C and between group B and group C (both P < 0.05). The CFR values in group A, B, and C were 2.56 +/- 0.18, 2.54 +/- 0.19, and 2.97 +/- 0.19 respectively, all significantly lower than that in group D (3.26 +/- 0.26, all P < 0.05), with significant differences between group A and group C and between group B and group C (both P < 0.05). The values of average peak velocity of baseline (APVb) in groups A, B, and C were 38 cm/s +/- 4 cm/s, 36 cm/s +/- 4 cm/s, and 34 cm/s +/- 4 cm/s respectively, significantly higher than that in group D (29 cm/s +/- 4 cm/s, all P < 0.05), without significant difference among group A, B, and C. (2) The values of LVMI in group A, B, and C were 117 g/m(2) +/- 8 g/m(2), 113 g/m(2) +/- 11 g/m(2), and 98 g/m(2) +/- 11 g/m(2) respectively, all significantly higher than that of group D (88 g/m(2) +/- 7 g/m(2), all P < 0.05), with significant differences between group A and group C and between group B and group C. The E/A ratios in groups A and B were 0.76 +/- 0.19 and 0.87 +/- 0.18 respectively, significantly lower than those in group C and D (1.08 +/- 0.18 and 1.19 +/- 0.15 respectively, all P < 0.05). The values of IVRT in group A, B and C were 134 ms +/- 11 ms, 138 ms +/- 11 ms, and 109 ms +/- 12 ms respectively, all significantly higher than that in group D (84 ms +/- 12 ms, all P < 0.05) with a significant difference between group A and group C and between group B and group C (both P < 0.05). There was no significant difference of LVEF among different groups. (3) Stepwise linear regression of PWV showed that the factors significantly influencing PWV were age, LVMI, E/A ratio and SBP, the factors significantly influencing CFR were LVMI and PWV, and PWV was significant negatively correlated to CFR and significant positively correlated to APVb. CONCLUSION PWV is increased in hypertensive patients. The increase of LVMI and increase of PWV contribute to the decrease of CFR in hypertensive patients. Increase of PWV that attributes to left ventricular hypertrophy and decrease of E/A ratio in patients with hypertension leads to further decrease of CFR. Decrease of CFR in hypertensive patients may cause cardiovascular diseases. Early detection and prevention of increased PWV may decrease the morbidity of cardiovascular diseases.

Detection of Angiostrongylus cantonensis circulating antigen by monoclonal antibodies

Abstract: OBJECTIVE: To prepare monoclonal antibodies (McAbs) against soluble antigens of adult worms of Angiostrongylus cantonensis (A. cantonensis) on the purpose to detect CAg of A. cantonensis. METHODS: Female BALB/c mice were immunized with soluble antigens of adult worms of A. cantonensis and the spleen cells were fused with myeloma SP2/0 cells. The hybridoma cell strains were screened by enzyme-linked immunosorbent assay (ELISA) and Western blotting. Two McAbs (3F1 and 4H2) were applied to detect the CAg in the sera of rats and mice infected with A. cantonensis and angiostrongyliasis patients respectively by double antibody sandwich ELISA. RESULTS: Three McAbs against A. cantonensis adult were obtained. Two McAbs (3F1, 4H2) were identified as IgG1 and one McAb (2A2) was identified as IgM. The titers of culture fluid and ascites was 1:25,600, 1:25,600, 1:12,800 and 1:80,000, 1:80,000, 1:40,000 respectively. Western blotting results showed three McAb could be used to identify 15,000 protein of adult worms of A. cantonensis. The detection rates of the CAg in the sera of infected rats and mice were 84.2% (48/57) and 87.2% (41/47) respectively. The detection rate of the CAg in the sera of angiostrongyliasis patients was 86.4% (19/22), and no cross reactions with sera from patients with schistosomiasis, cysticercosis cellulose, paragonimiasis and trichinellosis were observed. The CAg in the sera from mice examined at different periods after infection revealed positive 2 week after inoculation and the titer of CAg peaked 4 week after inoculation. CONCLUSION: A new method of sandwich ELISA with high sensitivity and specificity to detect the serum A. cantonensis CAg has been obtained, it could be applicable to the diagnosis, observation of curative effect and epidemiology of angiostrongyliasis.

The clinical study of the relationship between allergic rhinitis and allergic asthma in the patients with autumnal pollinosis

Abstract: OBJECTIVE To investigate the relationship between allergic rhinitis and allergic asthma in the patients with autumnal pollinosis. METHODS 1120 patients with autumnal pollinosis, aged 5 - 75, excluding those with typical symptoms of seasonal rhinitis or asthma but with positive skin test and serum IgE specific to dustmite and fungi, underwent standardized clinical questionnaire survey, including the onset age, onset time, and symptoms as well as the severity of asthma, skin tests, and examination of serum IgE specific to autumnal pollens. RESULTS The average onset age of the allergic rhinitis patients induced by autumnal pollens was 27.9 years, significantly younger than that of the allergic asthma patients (32.6 years, P < 0.001). Out of the 1120 patients 1096 (97.9%) had allergic rhinitis, 602 (53.8%) had asthma, 507 (45.3%) had allergic rhinitis only, and 10 (0.9%) had allergic asthma only. Among the 1096 patients with allergic rhinitis 585 (53.4%) suffered from seasonal asthma. Among the 602 patients with asthma 585 (97.2%) suffered from seasonal rhinitis, and 183 of the 602 patients (30.8%) needed emergency treatment. CONCLUSION Autumnal pollens are very important causes which induce asthma during autumnal season in northern China.

[Transforming growth factor-beta1 stimulates matrix metalloproteinase-9 production through ERK activation pathway and upregulation of Ets-1 protein].

Abstract: OBJECTIVE: To investigate the molecular mechanism of transforming growth factor-beta1 (TGF-beta1) in regulating the production of matrix metalloproteinase-9 (MMP-9) protein METHODS: Mouse immortal podocyte cells were cultured Different concentrations (1, 2, and 5 ng/l) of TGF-beta1 were added into the culture medium Cell culture without TGF-beta1 stimulation was used as control group The activity of MMP-9 in the supernatant of the culture medion was assayed by gelatin zymography, expression of MMP-9 mRNA was assessed by RT-PCR; the activation of ERK pathway and the level of a transcriptional factor Ets-1 protein was analyzed by Western blotting PD98059, a specific inhibitor of ERK1/2 activation, was added into the culture fluid of the podocytes for 30 minutes, than 2 ng/ml TGF-beta1 was added The above mentioned tested were conducted to observe the influence of the inhibitor of ERK1/2 activation RESULTS: The MMP-9 activity was very week in the supernatant of culture fluid of the control group and was increased in the TGF-beta1 groups dose-dependently After the podocytes were co-incubated with 1 ng/ml TGF-beta1 for 24 hours, the MMP-9 activity was 2686 times that of the control group (P < 001) Since the 12th hour after co-incubation with 2 ng/ml TGF-beta1 the MMP-9 activity in the supernatant of culture fluid began to be significantly increased and remained at high level till the 48 th hour RT-PCR showed that low-level MMP-9 mRNA expression in the control group After stimulation of 2 ng/ml TGF-beta1 for 6 hours the MMP-9 mRNA expression was 271 times that of the control group (P < 001) and the high-level expression lasted 24 hours Western blotting showed low-level Ets-1 protein in the control group At the time point of 12 th hour after stimulation of TGF-beta1 the Ets-1 protein expression was increased in all the three TGF-beta1 groups After stimulation with 2 ng/ml TGF-beta1 for 4 hours the Ets-1 protein expression was 271 times that of the control group (P <001) After pretreatment of the podocyte with PD98059 for 30 minutes, the added 2 ng/ml TGF-beta1 failed to increase the MMP-9 activity and up-regulate the MMP-9 mRNA expression CONCLUSION: TGF-beta1 stimulates the production of MMP-9 by activation of cytoplasmic ERK signaling pathway and upregulation of Ets-1 expression

[The role of KiSS-1 and matrix metalloproteinase-9 in regulation of invasion of trophoblasts].

Abstract: OBJECTIVE To explore the role of metastasis-related gene KiSS-1 and matrix metalloproteinase (MMP)-9 in regulation of invasion of trophoblasts. METHODS RT-PCR and Western blotting were used to detect the MMP-9 and KiSS-1 expression levels in the placental tissues obtained from 90 cases of normal pregnant women undergoing artificial abortion, induction of labor with water bag or selective cesarean section among which 30 cases were in the first trimester, 30 in second-trimester and 30 cases of term pregnancy, and in the placental tissues of 40 cases of preeclampsia (15 cases of mild and 25 cases of severe preeclampsia) undergoing cesarean section, and tissues of 90 cases of hydatidiform mole, 9 cases of invasive mole and 8 cases of choriocarcinoma, all undergoing surgery. RESULTS The expression levels of MMP-9 mRNA and protein were higher in first-trimester [A value 0.391 +/- 0.215, (36 +/- 7) microg/100 microg total protein] and then decreased gradually with the progress of gestation. The expression levels of MMP-9mRNA and protein in the term placental samples were significantly lower than those of first-trimester (both P < 0.01). The expression levels of KiSS-1mRNA and metastin in normal placenta increased along with the progress of gestation (both P < 0.01). The KISS-1 mRNA expression level and MMP-9 protein expression level in the placental tissue of preeclampsia were 0.09 +/- 0.06 (A value) and (9.6 +/- 4.3) microg/100 microg total protein respectively, both significantly lower than those of the term placenta (both P < 0.01). The expression levels of MMP-9 mRNA and protein in the tissues of gestational trophoblastic disease were significantly higher than those in the first-trimester placenta (both P < 0.01). The expression level of KISS-1 mRNA and metastin in the tissues of hyddatidiform mole and invasive mole were both significantly lower than those in the first trimester placenta (P < 0.05, P < 0.01). The expression of KiSS-1mRNA and metastin in the tissues of choriocarcinoma could not be detected. CONCLUSION The expression of the invasion-related gene, MMP-9, is positively related with, while the invasion suppressor gene, KiSS-1, is negatively related with the invasive ability of trophoblasts. The interaction of these two genes plays an important role in regulation of the invasion of trophoblasts.

Efficacy of anti-HIV treatment and drug-resistance mutations in some parts of China

Abstract: Objective To evaluate the Virologic and Immunologic efficacy of HAART on Chinese HIV/AIDS patients and to assess the impact of of HAART on drug resistance mutations. Methods Three cohorts of Liaoning, Jilin and Henan province received three different regimens for 6 months respectively. Regimen of Liaoning cohort comprised Efavirenz + Indinavir (EFV + IDV), regimen of Jilin cohort comprised Stavudine + Didanosine + Efavirenz (d4T + ddI + EFV) and regimen of Henan cohort comprised Stavudine + Didanosine + Nevirapine (d4T + ddI + NVP). Viral load, CD4(+) T cell count and drug resistance genotype were detected on the three cohorts before and after treatment. Partial HIV-1 pol genes encoding protease and 1 - 220 amino acid of reverse transcriptase were amplified by RT-PCR and then automatically sequenced. All sequences were compared with the data of Stanford HIV Drug Resistance Database to assess resistance mutations against reverse transcriptase inhibitors (RTIs) and protease inhibitors (PIs). Results During observation of 6 months, viral suppression to undetectable level and Elevated CD4(+)T cell count efficacy were achieved on partial Chinese HIV/AIDS patients in each of the three different regimens, even in some patients with rather low CD4(+)T cell count baseline. Before HAART, no primary mutations against PIs and RTIs were detected on the three cohorts, except one patient in Liaoning cohort. But after HAART, drug resistance mutations against RTIs occurred on each of the three cohorts. K103N is the most common mutation against NNRTIs, which can cause high-level resistance to each of the available NNRTIs. Y181C is another common mutation occurred in Henan cohort, which causes crossing drug resistance and multi-drug resistance to NNRTIs. In addition, intermediate level and low level resistance against NRTIs caused by K65R and L74V can also be found, but less commonly. Conclusion Treatment naive Chinese HIV/AIDS patients were sensitive to HAART. Expected virologic and immunologic efficacy of HAART were achieved on Chinese HIV/AIDS patients, but after the introduce of HAART, the high prevalence of drug resistance mutations against NNRTIs and NRTIs, crossing drug resistance and multi-drug resistance reminded us to pay more attention to the drug resistance mutations detection, treatment standardization, and to avoid drugs wasting and prevent the prevalence of drug resistance strains.

[Effect of polymorphism of transforming growth factor beta1 gene on HBV-induced liver cirrhosis].

Abstract: Objective To explore the effects of transforming growth factor β1 (TGFβ1) gene polymorphism on liver cirrhosis induced by HBV infection and on plasma concentration of TGFβ1. Methods Peripheral blood samples were collected from 134 patients with HBV-induced liver cirrhosis, which were further classified into three groups (A, B and C groups) according to Child-Pugh classification and ~92 healthy blood donors. The polymorphisms at position-988,-800,-509 and codon10, codon25, and codon263 of TGFβ1 gene were determined by PCR-ARMS-and Lightcycler respectively, combined with sequence analysis. The concentrations of TGFβ1 and collagen type Ⅳ were measured by ELISA, and the plasma concentrations of hyaluronan and N-terminal type Ⅲ procollagen peptide were measured by RIA. ARLEQUIN Ver 2.0 software was used to analyze the linkage disequilibrium between-509CT and codon10TC polymorphisms. Results No polymorphism was found at positions-800,-988, codon25 and codon263. No significant difference for-509CT polymorphism between the diseased and control groups was found, however, the frequencies of genotype TT and allele T at codon10 in the diseased group were 0.313 and 0.537 respectively, both significantly higher than those of the control group (0.916 and 0.440 respectively, both P0.05). In Child-Pugh C grade group the frequency of C allele at position-509 was 0.631, significantly higher than that of T allele (0.325), but there was no significant difference for codon10TC polymorphism. The TGFβ1 plasma concentration did not show any difference between the genotypes-509CC and TT in the control group, however, the TGFβ1 plasma concentration was statistically lower in the those with TT genotype than in those with CC genotype in the diseased group. Linkage disequilibrium was found between-509 CT and codon10 TC polymorphisms and the major haplotypes were C-T and T-C, of which C-T frequency was significantly higher in the patients than in the control group. The plasma concentration of TGFβ1 was significantly higher in the populations of haplotype C-T than in those of other haplotypes. Conclusion No relationship is found between-509 CT polymorphism of TGFβ1 and liver cirrhosis in Chinese populations, but the presence of C allele at position-509 may play an important role in the progression of liver cirrhosis and may influence plasma concentration of TGFβ1 in liver cirrhosis patients.Codon10 TC polymorphism may play a significant role in development of liver cirrhosis, but has no correlation with plasma concentration of TGFβ1 and progression of liver cirrhosis. The-509CT and codon10 TC polymorphisms are in tight linkage disequilibrium, and the major haplotypes are C-T and T-C. The haplotype C-T influences plasma concentration of TGFβ1 and is closely related to liver cirrhosis.

Effect of enucleation of hysteromyoma by laparoscopic surgery on protein oxidation and lipid hyperoxidation

Abstract: Objective To evaluate the effect of laparoscopic surgery on and lipid hyperoxidation in patients with hysteromyoma. Methods Forty patients with hysteromyoma were randomly divided into 2 equal groups: laparoscopy group and laparotomy group. The plasma advanced oxidation protein products(AOPP), malondialdehyde (MDA), antioxidant activity (AOA), and glutathione peroxidase (GPx) activity were measured before operation, just after operation (5 minutes after deflation)and 24 hours after operation. Results (1) In the laparoscopy group, the levels of AOPP and MDA were (50.20±9.23) μmol/L and (1.85±0.19) μmol/L before operation, increased significantly just after operation [(68.75±12.69) μmol/L and (2.52±0.55) μmol/L respectively, both P0.01], and recovered to the normal level 24 hour postoperatively [(49.70±9.92) μmol/L and (2.05±0.68) μmol/L respectively, both P0.05]. The levels of GPx and AOA decreased significantly just after operation [(0.29±0.09) U/ml vs. (0.62±0.27) U/mL and (0.90±0.24) mmol/L vs. (1.41±0.39) mmol/L respectively,both P0.01], and the GPx level recovered 24 hours after operation [(0.52±0.06) U/mL,P0.05], however, the AOA level was still lower [(1.00±0.31) mmol/L,P0.01]. In the laparotomy group, the levels of plasma AOPP and MDA level slightly increased just after operation in comparison with those before operation [(53.39±9.86) μmol/L vs. (52.30±7.10) μmol/L and (2.09±0.51) μmol/L vs. (1.83±0.64) μmol/L respectively, both P0.05] and continued to increase 24 hours after operation [(63.40±15.5) μmol/L,P0.05, and (2.42±0.44) μmol/L,P0.01]; the GPx and AOA levels decreased a little just after operation [(0.51±0.17) U/mL vs. (0.57±0.21) U/mL and (1.20±0.46) mmol/L vs. (1.33±0.37) mmol/L,both P0.05] and continued to decrease 24 hours after operation [(0.35±0.19) U/mL and (0.92±0.22) mmol/L respectively,both P0.01]. Compared with those of the laparotomy group, the plasma AOPP and MDA levels of the laparoscopy group were both significantly lower(P0.01 and P0.05), and the GPx level was significantly higher(P0.01)24 hours after operation, however, the AOA level was not significantly different (P0.05). Conclusion Laparoscopic surgery is better than laparotomy. Protein oxidation and lipid hyperoxidation occur during the laparoscopic surgery, however, disappeared after operation. Free radicals are generated by the end of laparoscopic procedure, possibly as a result of an ischemia-reperfusion phenomenon induced by the inflation and deflation of the pneumoperitoneum. AOPP and MDA are induced during laparoscopic procedure and then return to the normal levels finally.

[Epidemiology of obesity and overweight and relation thereof to the prevalence of hypertension in 14 provinces/municipality in China].

Abstract: OBJECTIVE To investigate the current epidemiological characteristics of obesity and overweight in the middle-aged and elderly populations of china and to disclose their relation with such chronic diseases as hypertension. METHODS A questionnaire survey and physical examination were conducted among the 35-85-years-old persons from 14 densely populated residential areas representative in economic development and medical conditions in 14 provinces/municipality in China (i.e., Henna, Hebei, Shandong, Shanxi, Guangdong, Jiangxi, Tianjin, Inner Mongolia, Shaanxi, Hunan, Hubei, Yunnan, Sichuan, and Zhejiang) where a large-scale epidemiological survey of atrial fibrillation were being conducted, one residential area for a province, selected by cluster sampling to investigate the health-related personal conditions and examine the blood pressure (BP), body height, weight, body mass index (BMI), etc. so as to understand the prevalence of overweight and obesity based on the diagnostic criteria of Chinese adults recommended by the Working Group on Obesity in China. RESULTS 29056 persons, 13549 males with the average body height of 168 cm +/- 7 cm, average weight of 68 kg +/- 11 kg, and average body mass index (BMI) of 24 kg/m(2) +/- 3 kg/m(2), and 15507 females with the average body height of 156 cm +/- 6 cm, average weight of 60 kg +/- 10 kg, and average BMI of 24 kg/m(2) +/- 4 kg/m(2), were surveyed. The BMI of women was significantly higher than that of men (P = 0.005). The total prevalence of overweight in the 14 provinces/municipality was 38.93%, and the standardized prevalence of overweight was 37.17%, the total prevalence of obesity was 13.94%, and the standardized prevalence was 12.63%. The prevalence of obesity of men was 12.29%, significantly lower then that of women (15.39%, P < 0.001). The prevalence of overweight of men was 412.18%, significantly higher then that of women (36.97%, P < 0.001). The prevalence rates of obesity and overweight increased with age in the age group 35-64; and decreased with age in the age group 65 and over. In the men, the prevalence of overweight was the highest in the age group 45-54 (44.57%), and the prevalence of obesity was the highest in the age 55-64 (13.60%). In the women, the prevalence of overweight was the highest in the age group 55-64 (40.10%), and the prevalence of obesity was the highest in the age group 65-74 (19.97%). The prevalence of hypertension increased obviously with the BMI in these populations. CONCLUSION Overweight and obesity are prevalent in China. Control of body weight is of great importance to the prevention and treatment of such chronic diseases as hypertension.

Expression of vascular endothelial growth factor receptors in the ectopic and eutopic endometrium of women with endometriosis

Abstract: Objective To study the localization and expression of the vascular endothelial growth factor receptors (VEGFR) Fms-like tyrosine kinase (Flt-1) and kinase insert domain-containing receptor (KDR) in human ectopic and eutopic endometrium of patients with endometriosis Methods Specimens of endometriosis patients, aged (38±8) years, including 37 specimens of entopic endometrium, 34 specimens of ovarian chocolate cyst, 34 specimens of ovarian chocolate cyst, 15 specimens of red peritoneal endometriosis lesions, and 4 abdominal wall endometriosis lesions were collected Specimens of endometrium of 33 patients with other gynecological diseases, aged (36±8) years, were collected during operation and used as controls Immunohistochemistry was used to detect the location and expression of Flt-1 and KDR protein in different tissues Western blotting was used to detect the protein expression of Flt-1 and KDR protein in different tissues The mRNA expressions of Flt-1 and KDR were detected by RT-PCR Results Flt-1 and KDR were expressed in the endometrial glandular epithelium and stromal cells besides the endometrial blood vessels The positive expression rate of Flt-1 and KDR in the ectopic endometrium of endometriosis patients were 943% and 914% respectively, both significantly higher than those in the ovarian endometrial cyst (743% and 771% respectively, both P005), and similar to those in the eutopic endometrium of the endometriosis patients (938% and 906% respectively, both P005) In the eutopic endometrium of the endometriosis patients, the Flt-1 mRNA expression level was 24±12 and the Flt-1 protein expression level was 31±17, and the KDR mRNA expression level was 30±14 and the KDR protein expression level was 36±24, all significantly higher than those in the ovarian endometrial cyst (15±09 and 18±10 for the Flt-1 and KDR mRNA expressions, and 17±6 and 20±11 for the Flt-1 and KDR protein expressions, all P005), and similar to those in the eutopic endometrium of the non-endometriosis patients (19±08 and 23±13 for the Flt-1 and KDR mRNA expressions, and 24±18 and 25±16 for the Flt-1 and KDR protein expressions, all P005) Conclusion VEGF may play certain biological role in the development of endometriosis through VEGFR (Flt-1 and KDR) The expression of Flt-1 and KDR in the endometriotic lesion appears to be associated with neovascualization

[Evaluation of laparoscopic surgery in the early stage-malignant tumor of ovary with lower risk].

Abstract: Objective To evaluate the laparoscopic operation for early ovarian malignant tumor with low risk. Methods Ten patients with ovarian malignant tumor who underwent laparoscopic total hysterectomy, pelvic lymph nodes dissection,bilateral adnexectomy, ovarian aortic and vein high ligation, omentectomy, and additional appendectomy. Eleven patients with the same diagnosis who underwent operation by laparotomy were served as control group. The operation time, intraoperative blood loss, number of pelvic lymph nodes excised, and postoperative recovery were analyzed retrospectively. Results Frozen section method during operation proved the diagnosis of ovarian malignant tumor and cytological examination proved a negative result of the peritoneal irrigation liquid. The operation time was 298 min±60 min for the laparoscopy group and 182 min±43 min for the laparotomy group (P0.05). The intraoperative blood loss was 280 ml±156 ml for the laparoscopy group and 346 ml±170 ml for the laparotomy group (P0.05). The number of pelvic lymph node resected was 25±5 and 27±7 for the laparoscopy group and laparotomy group respectively (P0.05). The postoperative illness rate was 20.0% and 72.7% for the laparoscopy group and laparotomy group respectively (P0.01). Seven patients and 1 case in the laparoscopy group and laparotomy group left their beds 48 hours after operation (P0.05). The right obtuator nerve was injured and was sutured on 1 patient in the laparoscopy group. Conclusion The whole procedure of total hysterectomy, bilateral adnexectomy, pelvic lymph node dissection, ovarian aortic and vein high ligation, omentectomy, and additional appendectomy may be performed under laparoscope in the treatment of early stage ovarian malignant tumor with lower risk. The laparoscopic operation has the advantage of less intraoperative bleeding, less morbidity and rapid recovery.

[Effects of rhein on activity of caspase-3 in kidney and cell apoptosis on the progression of renal injury in glomerulosclerosis].

Abstract: Objective To investigate the effects of rhein on the progression of renal injury and cell apoptosis in glomerulosclerosis, and further explore the protective mechanism of rhein on glomerulosclerosisMethods Glomerulosclerosis models were made for SD rats by unilateral nephrectomy and being injected with Adriamycin into caudal vein, and randomly divided into control group, renal disease group, Rhein treatment group and Benazepril treatment group, and 6 rats in each group were killed at the 6th, 8th, 10th, 12th week respectively The apoptosis protease-3 (caspase-3) in renal cortex was determined by immunohistochemistry stain method, and the activity of caspase-3 was measured by colorimetry, and the activity of nuclear factor-kappa B(NF-κB) was analyzed by gel electrophoretic mobility shift assay (EMSA), and renal tissue cell apoptosis was tested by terminal -deoxynucleotidyl transferase mediated nick end labeling(TUNEL) in order to observe expressions of caspase-3 and NF-κB and cell apoptosis of renal tissueResults Renal disease group presented with distinct proteinuria, decreasing of blood albumin content and increasing of cholesterol concentration Glomerulosclerosis index, apoptosis index, activity of NF-κB and expression of caspase-3 in renal disease group were more significantly higher than those in control group(P005 or P001) as time passed Compared with the other time points in renal disease group, there were a great number of TUNEL-positive cells observed at the 10th week, slightly higher than that at the 12th week(93±23 vs 84±12,P005), the expression of Caspase-3 was also most obvious at the 10th week, significantly higher than that at the 12th week (114±25 vs 82±17, P005), which mainly located around capillary vessel in renal cortex, tending to be consistent with apoptosis cells expression After the 8 weeks treatment of rhein or Benazepril, The number of TUNEL-positive cells significantly decreased and maintained at a certain level, and the activity of NF-κB and expression of caspase-3 decreased(P005), and renal pathological changes and biochemical changes improved magnificently, moreover, the expression of caspase-3 showed positive correlation with apoptosis index(r=0836,P001) Conclusion Rhein could have significant protective effects on the progression of renal injury, and might regulate pathological changes by influencing the activities of NF-κB and caspase-3 in the early phase of glomerulosclerosis Therefore, down-regulating caspase-3 expression in kidney might be one of the molecular mechanisms in the way that rhein could alleviate renal tissue cell apoptosis in glomerulosclerosis

[Polymorphisms in nucleotide excision repair genes XPC and XPD and clinical responses to platinum-based chemotherapy in advanced non-small cell lung cancer].

Abstract: OBJECTIVE Nucleotide excision repair has been shown to have great impact on the sensitivity of tumors to platinum-based chemotherapy. This study was to examine the association between genetic polymorphisms in XPC and XPD, two important components in nucleotide excision repair system, and clinical response to platinum-based chemotherapy in advanced non-small cell lung cancer. METHODS Patients (n = 151) treated with platinum-based chemotherapy were genotyped for the AT dinucleotide insertion or deletion in intron 9 of XPC or Lys751Gln polymorphism in XPD. Clinical response to chemotherapy was obtained after 2 to 3 cycles. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression model and adjusted for sex, age, clinical stage, and regime of chemotherapy. RESULTS The overall response rate to the chemotherapy (CR + PR) was 35.1%, with 1 CR, 52 PR, 75 SD, and 23 PD. It was found that patients with the XPC LL genotype had significantly higher response rate than patients with the XPC SS genotype (adjusted OR = 3.19, 95% CI = 1.11 - 9.17; P = 0.031). However, no association was found between the XPD Lys751Gln polymorphism and response to the chemotherapy. In addition, these two polymorphisms seemed to have synergic effect, with the OR being 2.90 (95% CI = 1.07 - 7.86) for patients carrying the XPC LL and XPD Lys/Lys genotypes compared with those carrying the XPC SS or SL and XPD Lys/Lys genotypes. CONCLUSION These results suggest that genetic polymorphisms in nucleotide excision repair might be associated with clinical response to platinum-based chemotherapy.

Allogeneic umbilical cord blood stem cell transplantation in Duchenne muscular dystrophy

Abstract: OBJECTIVE To study the feasibility of treatment of Duchenne muscular dystrophy (DMD) with umbilical cord stem cell transplantation. METHODS HLA matching was conducted for a 11-year-old DMD boy with family history was underwent umbilical cord blood stem cell transplantation and a sample of umbilical cord stem cells with 5 matched HLA sites was found in the cord blood bank with 27.32 x 10(8) nucleated cells, about 2.6 times that of the treatment dosage for him. After pretreatment with busulfan 14 mg/kg.d, cyclophosphamide 50 mg/kg.d, and rabbit anti-human thymocyte globulin 10 mg/kg.d, the allogeneic cord blood stem cells were transplanted intravenously. Cyclosporin A, methylprednisolone and MMF were used after the transplantation so as to prevent graft versus host reaction. Prostaglandin E1 was used to prevent Budd-Chiari syndrome, and ganciclovir was used to prevent cytomegalovirus infection. At the same time, Gran, granulocytic cell stimulating factor, and gammaglobulin were also used. Biochemistry test, including serum creatine kinase (CK), was conducted. Evidence of reconstruction of blood making, including conversion of blood type, was observed. PCR-STR analysis was used to observe the status of implantation of the donor umbilical cord blood stem cells. RESULTS (1) 12 days after transplantation, the white blood cells (WBC) of peripheral blood were 0.5 x 10(9)/L, 14 days after, the numbers of WBC and neutrophils were 1.0 x 10(9)/L and 0.6 x 10(9)/L respectively. In 37 days, granulocytic cell stimulating factor was no more used, the peripheral blood WBC fluctuated around 3.34 approximately 12.2 x 10(9)/L. In the 27th day, the number of blood platelets was more than 20 x 10(9)/L and hemoglobin rose to 88 g/L. On the 24th day red blood cells transfusion was stopped. (2) In the 42nd day, the blood type of the patient transformed from type A before transplantation to type AB (the blood type of transplanted stem cells is type B). (3) PCR-STR test of the peripheral blood made 17, 26, and 42 days after transplantation showed that the gene type of the patient was mixed mosaic: The ratio of donor gradually increased from 40% approximately 45% to 55% approximately 65%. (4) In the 38th day I degrees GVHD appeared. (5) serum CK level declined from 6000 U/L to 600 approximately 2200 U/L. (6) In the 42nd day, physical examination revealed obviously improvement in walking, turning the body over, and standing up. CONCLUSION This is first case of prospective clinical transplantation on DMD by allogeneic cord blood stem cell. Umbilical cord stem cell transplantation helps re-build blood-making function, and improve locomotive function with a mild GVHD reaction. The genotype of rebuilt blood is mosaic but the ratio of gene mosaic gradually turn from recipient gene type > donor gene type to recipient gene type < donor gene type. The serum CK level decreases significantly after transplantation, which may slow down the necrosis of muscle cell. DMD patient will be benefited by stem cell transplantation.