Showing papers in "National Medical Journal of China in 2010"

[Therapeutic effects and mechanism of saikosaponin-d in mice with bleomycin-induced pulmonary fibrosis].

Abstract: OBJECTIVE: To study the therapeutic effects and mechanism of saikosaponin-d (SSd) in mice with bleomycin (BLM)-induced pulmonary fibrosis. METHODS: According to the random number table, 180 mice were randomly divided into 5 groups. Four groups were pulmonary fibrosis models. Fibrosis model mice were established by intratracheal injection of bleomycin (5 mgxkg(-1)). They were BLM, DXM, SSd and SSd + DXM groups (n = 40 each). At 1 hour post-modeling, DXM, SSd and SSd + DXM groups were injected ip with dexamethasone (DXM, 5 mgxkg(-1)xd(-1), 0.1 ml), SSd (1.8 mgxkg(-1)xd(-1), 0.18 ml), DXM + SSd (0.28 ml) respectively qd until Day 28. BLM group was similarly dosed with normal saline. In addition, a normal control group (NC group, n = 20) treated likewise. The mice were anesthetized and sacrificed at Days 3, 7, 14, 28 for harvests of serum and lung tissue samples. The conventional histopathological changes of lung tissue were observed. Except for NC group, modeling groups of mice were used to observe the natural survival rate. Such indices as superoxide dismutase (SOD) and malonaldehyde (MDA) were examined both in lung tissue and serum samples. And hydroxyproline (HYP) was tested only in lung tissue. RESULTS: SSd could markedly increase the survival rate (80.0% in SSd and SSd + DXM groups vs 50.0% in BLM group, P < 0.05) and reduce alveolitis and fibrosis in mice. In comparison with BLM group, the levels of HYP of three treatment groups (DXM, SSd and SSd + DXM) in lung tissue was significantly lower (P < 0.05) at Days 14 and 28. The levels of MDA both in serum and lung tissue were significantly lower at Days 3, 7 and 14 (P < 0.05). The serum level of SOD was significantly higher at Days 3, 7 and 14 while the level of SOD in lung tissue was significantly higher at Days 3 and 7 (P < 0.05, P < 0.01). CONCLUSIONS: SSd has marked therapeutic effects upon bleomycin-induced pulmonary fibrosis in mice. And the mechanism may be associated with its anti-lipid peroxidation effect.

[Levofloxacin-based triple therapy for first-line Helicobacter pylori eradication treatment: a multi-central, randomized, controlled clinical study].

Abstract: Objective To compare efficacy and tolerability of 7-day standard triple therapy versus 7-day levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori ( H. pylori) infection.Methods Three hundred consecutive H. pylori positive patients were randomized to receive: clarithromycin,amoxicillin, lansoprazole (Group A: n = 150) ; or amoxicillin, levofloxacin, lansoprazole (Group B: n =150). H. pylori status was rechecked by ~(13)C-urea breath test 4 weeks after the end of therapy. Results The eradication rates in intention to treat (ITT) and per protocol (PP) analyses were: Group A, 74. 5% ( 111/149) and 78. 2% (111/142) ; and Group B, 82.4% (122/148) and 83.0% (122/147). Although the eradication rate achieved with levofloxacin-based triple therapy was higher than that with standard therapies in either ITT or PP analysis, but no significantly difference was found between the two triple therapies. The incidence of side effects was similar among groups. Conclusions A 7-day levofloxacin-based triple therapy can achieve higher H. pylori eradication rate than standard regimen. The levofloxacin-based regimen can be one effective therapy for the first-line anti-H, pylori treatment. Key words: Helicobacter pylori; Ofloxacin; Randomized controlled trails

[Efficacy and safety of high-dose α-lipoic acid in the treatment of diabetic polyneuropathy].

Abstract: Objective To evaluate the efficacy and safety of high-dose α-lipoic acid in the treatment of diabetic polyneuropthy with regards to sensory symptoms and nerve conduction velocity. Methods A total of 236 diabetics with symptomatic polyneuropathy were enrolled into this 5-center, randomized,double-blind and placebo-controlled study of α-lipoic acid 1800 mg daily ( n = 117) or matching placebo ( n = 119) for 12 weeks. The primary outcome was total symptom score (TSS). Secondary end points included nerve conduction velocity, individual symptom score, HbA1c and safety parameters. The above parameters were reviewed and recorded at zero point and after treatment for 2, 4, 8, 12 weeks separately. Results 73. 27%patients with symptomatic polyneurnpathy improved after treatment with α-lipoic acid for 12 weeks versus 18.27% with placebo. TSS declined by 2.6 ±2. 3 with α-lipoic acid. And it was more than 0. 7 ± 1.4 versus placebo (P ＜ 0. 05 ). TSS decreased quickly after treatment with α-lipoic acid for 2 weeks (P ＜ 0. 05 ). And it was better than placebo. Individual symptom scores of pain, extremity numbness, burning sensation or resting abnormal sensations were significantly diminished as compared to those before treatment and placebo group ( all P ＜ 0. 05 ). Nerve conduction velocity had no change. HbA l c further decreased at the end of trial after α-lipoic acid treatment ( P ＜ 0. 05 ). The incidence rates of adverse effects were 25.4% vs 11.8% in the treatment and control groups. The major manifestation was burning sensation from throat to stomach ( 12. 7% ). Conclusion Oral treatment with high-dose α-lipoic acid for 12 weeks may improve symptoms in patients with diabetic polyneuropathy. Dose of 600mg thrice daily for 2 weeks has marked effects with a reasonable safety. Key words: Alpha -lipoic acid; Diabetic polyneuropathy; Nerve conduction velocity

[Current status of primary hypertension in Xinjiang:an epidemiological study of Han, Uygur and Hazakh populations].

Abstract: Objective To investigate the prevalence and distribution pattern of hypertension in Xinjiang adult population. Methods A total of 15 061 adults at 35 years old or over were surveyed. Fourstage selected random sampling was employed to analyze the prevalence and distribution pattern of selfreported congestive hypertension in different groups of nationality, age and gender. The sampled adult population was collected from 7 localities ( Urumqi, Ke lamayi, Fukang, Turfan Basin, Hetian, Altay, Yili Hazakh autonomous prefecture) in 23 municipalities and 5 autonomous counties in Xinjiang. The proportion of male to female was 50% each. Results The prevalence of hypertension was 36.21% (male: 38.70% vs female: 34.22% ). The Prevalence of hypertension was 33.42% , 28.50% and 48.69% in Han, Uygur and Hazakh populations respectively. The prevalence of hypertension was higher in Hazakh than Han people ( χ2 = 29.36,P ＜ 0.01 ). The males had a higher frequency of hypertension than the females ( χ2 = 20.01, P＜0.01). The risk of hypertension increased substantially with age. The analysis of multiple logistic regression revealed that age ( OR = 1.06 ), alcohol consumption, obesity ( OR = 3.12 ) and levels of triglyceride( OR = 1.30) and cholesterol( OR = 1.32) and serum glucose ( OR = 1.41 ) were risk factors of hypertension. The corresponding relative hazards were age, alcohol consumption, obesity and levels of triglyceride and cholesterol and serum glucose for Han; the risk factors were similar in Uygur except serum glucose. Age, obesity and levels of triglyceride were only for Hazakh. Conclusion There is still a higher prevalence of hypertension in Xinjiang. The prevalence of hypertension increases substantially with age and there is difference between different nationalities. Key words: Hypertension; Prevalence; Epidemiology

Microsurgical management of tuberculum sellae meningiomas

Abstract: OBJECTIVE To explore the approach and efficacy of microsurgery for tuberculum sellae meningiomas. METHODS The clinical data of 56 patients with tuberculum sellae meningiomas treated at our department from 1991 - 2009 were analyzed retrospectively. There were 20 males and 36 females with an age range of 32 - 65 years old (mean: 46). All patients underwent microsurgery through pterional, unilateral subfrontal, orbitozygomatic or supraorbital keyhole approach. RESULTS Among these patients, there were total resection (n = 51) and subtotal resection (n = 5). Postoperatively, 53 patients recovered well, 2 had a mild disability, 1 suffered a severe disability and there was no mortality. CONCLUSION Most cases of tuberculum sellae meningiomas can be removed safely and totally. Several approaches may be employed to achieve the best outcomes. Microsurgery can markedly boost the total resection rate of tuberculum salle meningiomas and lower the postoperative complications and mortality.

[Toll-like receptor gene polymorphisms and susceptibility to inflammatory bowel disease in Chinese Han and Caucasian populations].

Abstract: Objective To explore the distribution of Toll-like receptors gene polymorphisms in inflammatory bowel disease (IBD) in Chinese Han patients and Caucasians. Methods The toll-like receptor 2 (TLR2) genes Arg677Trp and Arg753Glu, TLR4 genes Asp299Gly and Thr399Ile, and TLR9 gene 1237T/C polymorphisms were genotypes in 113 patients with IBD and 120 age and gender-matched healthy controls by the analyses of polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP).A meta-analysis was performed to test whether TLR4 Asp299Gly and Thr399Ile polymorphisms were associated with ulcerative colitis (UC) or Crohn's disease (CD) susceptibility and whether 299Gly carriage was associated with phenotypes of CD patients in the Caucasian population. Results We found two carriers of TLR9 1237C in UC patients, one carrier in CD patients and one in healthy controls respectively(CD:P=0. 361;UC:P=0. 569) . There was no statistically significant difference in both allelic and genotypic frequencies. The mutant genotypes of TLR2 gene Arg677Trp and Arg753Glu, TLR4 gene Asp299Gly and Thr399Ile were not found in either the IBD patients or the healthy controls. The TLR4 299G allele showed a significant association with CD and UC in Caucasian population (OR=1. 29,95% CI:1. 08-1. 54,P=0. 004 and OR=1. 28, 95% CI:1. 08-1. 51, P=0. 004 respectively) . Similar association was detected between T399I polymorphism and susceptibility to IBD (OR=1.37,95% CI:1. 12-1. 68, P=0. 002 and OR=1. 46, 95% CI:1. 13-1. 88,P=0. 003 respectively). However, no significant association was identified between CD phenotypes and 299Gly carriage. Conclusion TLR2 genes Arg677Trp and Arg753Glu,TLR4 genes Asp299Gly and Thr399Ile and TLR9 gene 1237T/C polymorphisms are not associated with IBD in Chinese Han patients.In Caucasians.both TLR4 299G and 399I confer a significant risk for developing CD and UC.The contribution of genetic determinants may differ significantly between ethnicities. Key words: Toll-like receptors; Colitis,ulcerative; Crohn disease; Meta-analysis

Protective effect of Xingnaojing and Xuesaitong injections on cerebral ischemic reperfusion injury in rats

Abstract: OBJECTIVE To investigate the mechanism of protective effect of Xingnaojing and Xuesaitong injections on cerebral ischemic reperfusion injury in rats. METHODS The focal cerebral ischemia & reperfusion model was established by middle cerebral artery occlusion (MCAO). A total of 152 male SD rats were randomly assigned into 19 groups: sham operated group, Xingnaojing group, Xingnaojing plus Xuesaitong group and control group according to different reperfusion durations: 2, 4, 8, 24, 48, 72 h. Each group had 8 rats. Rats in Xingnaojing group received the ip injections of Xingnaojing (1 ml x 100 (-1) x d(-1)) until an onset of ischemia; Xingnaojing plus Xuesaitong group received the ip injections of Xingnaojing (1 ml x 100 g(-1) x d(-1)) and Xuesaitong (1 ml x 100 g(-1) x d(-1)) until an onset of ischemia; In the meantime, rats in control group received the same ip dose of saline. The levels of SOD and MDA were detected. The number of apoptotic neurons was detected by terminal-deoxynucleotidyl transferase medicated nick end labeling (TUNEL). RESULTS During ischemic reperfusion, the MDA content of brain homogenate increased while the SOD activity decreased (P < 0.05). Xingnaojing could significantly inhibit the increase of MDA after cerebral ischemic reperfusion (P < 0.05) and the decrease of SOD activity in rats. The changes of SOD and MDA were smaller in the Xingnaojing plus Xuesaitong group than those in the Xinnaojing group (P < 0.01). The number of apoptotic neurons in the Xingnaojing group was significantly lower than that in control group (P < 0.05). And the number of apoptotic neurons in the Xingnaojing plus Xuesaitong group was even lower than that in the Xingnaojing group(4,8 h: P < 0.05, 24, 48, 72 h: P < 0.01). CONCLUSION The Xingnaojing plus Xuesaitong injection has protective function after cerebral ischemic reperfusion.

[Male breast cancer: a pairing comparison of survival with women breast cancer]

Abstract: Objective To investigate clinicopathological characteristics of male breast cancer patients and women breast cancer patients, compare disease-free survival and overall survival in a group of matched men and women with breast cancer. Methods The clinical data and survival status of 45 cases operable male breast cancer treated in our hospital from 1982. 9 to 2006. 12 were collected. Each man with breast cancer recorded in the database was matched with two women. Matching was done based on age, year of diagnosis, stage and pathology. SPSS16. 0 software was used for statistic treatment. Chi-square test was used for the comparison of frequency data between groups. Kaplan-Meier method was applied to analyze survivals. And Log-Rank was used to compare curves between groups. Statistical significance was considered at P ＜ 0. 05. Results The 45 male breast cancer patients were matched with 90 female patients. The median age at diagnosis was 59 (26 ～ 75 ) years for men and 57 (22 ～ 76) years for women. The median follow-up was 61(5 ～262) months for men and 71 (29 ～283) months for women. Mass location, receptor status, chemotherapy and hormonal therapy were statistically significant between male BC and female BC groups. About male BC patients, monofactorial analysis showed tumor size, lymph node state and TNM stage were prognostic factors. The 5-year disease-free survival of male BC and women BC were respectively 62. 3% and 78. 8%, 10-year DFS were 35.3% and 45.3% ;The 5-year overall survival of male BC and female BC were respectively 70. 5% and 82. 5% ,10-year OS were 42. 8% and 62. 4%. Conclusions After the matching of age, year of diagnosis, stage and pathology, the prognosis for men with breast carcinoma is significantly poor comparing with women. We should play more emphasization on early diagnosis and early therapy, and think highly of chemotherapy and hormonal therapy to improve the prognosis of male BC patients. Key words: Male breast cancer; women breast cancer; clinical characteristics; therapy; prognosis

[Analysis of correlative factors and prevalence on China's youth myopia].

Abstract: Objective To understand and address our vision changes in primary and secondary students,in order to explore the prevention of juvenile myopia to provide a response and suggestions.Methods A random cluster sampling method,random sample of 90 rural and urban schools in Shandong,Qinghai,Yunnan,Shanghai and Wenzhou from May 2008 to September 2009,including 20 000 students(per province,4000×5)from elementary school and junior high school of focus and non-focus,primary 11 246,junior high school students 3673,high school 4220,of which 11 177 were from the urban students,rural students in 7962,aged 6 to 19 years old,male to female ratio is basically the same.For myopia and related survey.a total of 19,139 valid questionnaires were recovered.Using SPSS 13.0 software statistical analysis,different regions and different grades was used to compare the prevalence of myopia X~2 test.using Logistic regression analysis on the major risk factors for myopia.Results The survey are as follows,the prevalence of myopia in primary was 13.7%;the prevalence of myopia in junior high was 42.9%,the prevalence of myopia in high school was 69.7%.The highest rate of myopia prevalence of primarv school students in Shandong was 19.7%,the lowest was 11.9% in Qinghal,Shanghai,Wenzhou and Yunnan are similar;prevalence myopia of junior high in Wenzhou up to 50.6%,followed by Shanghai,and 47.2%,the lowest was 33.6%in Qinghai;the highest prevalence of myopia and high school students in Shandong,reaching 87.3%,followed by 72.0%in Wenzhou,and the lowest was 60.2% in Shanghai.Conclusion This survey shows that the prevalence of myopia of China's primary and secondary schools in coastal was higher than areas of mainland,in developed regions was higher than in less developed regions,and the plateau region and the strong ultraviolet light similar to the plain areas.Provincial prevalence of myopia increased from primary to high school continued the same trend. Key words: Youth; Myopia; Prevalence; Influencing factors

Application study of periarticular multimodal drug injection in total knee arthroplasty

Abstract: Objective To investigate and compare the analgesic effect of a periarticular multimodal drug injection and patient-controlled epidural analgesia (PCEA) in total knee arthroplasty (TKA). Methods Thirty-six patients undergoing unilateral TKA were randomly divided into two groups (A and B). Group A received a periarticular injection of ropivacaine, morphine and epinephrine at operation and Group B did not. All patients received postoperative patient-controlled epidural analgesia (PCEA). Preoperative baseline data, surgery-related conditions, postoperative VAS (visual analog score) , range of motion( ROM), time of opening PCEA, drug dosage in PCEA and side effects were recorded respectively. Results At 6, 12 hour VAS in Group A was lower than Group B ( P ＜ 0. 05 ). The time of opening PCEA in Group A was longer than Group B ( P ＜0. 05 ). The drug dosage in PCEA in Group A was less than Group B ( P ＜0.05 ). There was no difference of surgical conditions, ROM, 24/48 hour VAS and side effects between two groups (P ＞0. 05 ). Conclusion Periarticular drug injection during TKA can relieve pain early after TKA, prolong the time of opening PCEA and reduce the drug dosage in PCEA. Key words: Arthroplasty,replacement, knee; Joint prosthesis; Anesthetics,local; Injections

[Treatment of non-traumatic avascular talar necrosis by transposition of vascularized cuneiform bone flap plus iliac cancellous bone grafting].

Abstract: ：Objective To evaluatethe outcome of cancellous bone grafting plus iliac cancellous bone in the treatment ofnon-traumatic avascular talar necrosis.Methods Twenty patients,14 males and sixfemales,eight at stage Ⅱ,ten at stage Ⅲ and three at stage Ⅳ according to the modified Ficat & Arlet necrosisclassification system,were treated with vascularized bone flap from January 2000 to June2005.Results All patients were followed up for a mean of 37 months(range:14 to 68months).The clinical function outcome evaluated by Kenwright criteria were excellent in 8cases,good in 10 cases,fair in 1 case and poor in 1 case.Clinical symptom Was completelyor partially relieved.The necrotic area was fiIled with newly formed bone and theexcellent-to-good rate was 90%.Conclusion Transposition of vascularized cuneiform boneflap plus iliac cancellous bone grafting may be an ideal therapeutic method fornon-traumatic avascular talar necrosis.And the clinical outcome is satisfactory. Key words: Osteonecrosis; Talus; Transplantation,autologous

[Effects of BNP preconditioning on myocardial cell apoptosis and expressions of bcl-2 and Bax during myocardial ischemia-reperfusion injury in rats]

Abstract: Objective To study the effects of B-type natriuretic peptide (BNP) preconditioning on the apoptosis and expressions of bcl-2 and Bax in rat cardiomyocytes during myocardial ischemia-reperfusion.Methods Twenty-one male Sprague-Dawley rats weighing (250 ± 50) g were randomly divided into 3 groups of sham operation ( SHAM ), ischemia-reperfusion (I/R) and B-type natriuretic peptide ( BNP). A rat model of in vivo myocardial ischemia-reperfusion injury was established by ligating the left anterior descending coronary artery for 35 minutes and then reperfusing for 240 minutes. The apoptosis of myocardial cell was determined by terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end-labeling (TUNEL) method. Real-time polymerase chain reaction and Western blot were used to detect the expression changes of bcl-2 and Bax in rat ischemia myocardium. Results The apoptotic indices of SHAM, BNP and L/R groups were 5.4% ±4.2%, 22.5% ±9.5% and 45.2% ±13.0% respectively (P＜0.05). The bcl2 protein expression of SHAM, BNP and I/R groups were 0. 87 ± 0. 09, 0. 70 ± 0. 07 and 0. 38 ± 0. 09respectively ( P ＜ 0. 05). The Bax protein expression of SHAM, BNP and I/R groups were 0.08 ± 0. 04,0. 39 ±0. 09 and 0. 71 ± 0. 18 respectively ( P ＜0. 01 ). The bcl-2/Bax mRNA ratio of SHAN, BNP and I/R groups were 0. 763 ± 0. 154, 0. 099 ± 0. 025 and 0. 022 ± 0. 024 respectively ( P ＜ 0. 05 ). Conclusion The BNP preconditioning can decrease the myocardial apoptosis induced by ischemia-reperfusion injury. The mechanisms may be associated with an elevated expression of bcl-2, an increased ratio of bcl-2/Bax and a lowered expression of Bax. Key words: Natriuretic peptide,brain; Myocardial reperfusion injury; Apoptosis

[Protective effects of uric acid on nigrostriatal system injury induced by 6-hydroxydopamine in rats].

Abstract: Objective To investigate the protective effects of uric acid on nigrostriatal system injury induced by 6-hydroxydopamine in rats. Methods Thirty male SD rats were divided into four groups. Uric acid of 100 mg/kg, 200 mg/kg, 250 mg/kg were injected intrapefitoneally (ip) into 5, 10, 5 rats twice daily at a 2-hour interval for five days and saline was injected ip into 10 rats as controls. At Day 6, 6hydroxydopamine was injected into striatum to establish Parkinsen's disease (PD) model in rats. Then uric acid was injected ip into three groups and saline into controls for five days. Locomotion test, amphetamineinduced rotation and forepaw adjusting step test were performed at Weeks 3 and 4 respectively after injection of 6-hydroxydopamine. HPLC-MS/MS was performed to detect the contents of dopamine and its metabolite homovanillic acid (HVA) in striatum at Week 5. Results The scores of locomotion in 2 minutes of 200 mg/kg uric acid group ( 14 ±4/2 min) was higher significantly than saline group (4±5/2 min,P ＜0. 01 ).The amphetamine-induced rotation number in the 200 mg/kg uric acid group (10. 8 ± 7.5 ) was lower significanfly that in the saline group ( 19. 3 ± 5.2, P ＜ 0. 01 ). Forepaw adjusting step test scores of 200 mg/kg uric acid group were higher significantly than those in the saline group (9. 89 ±3.41 vs 4. 36±3.72,P＜0.01). HPLC-MS/MS showed that the contents of DA (0.29 +0. 19) and HVA (1.22 ±0.5) in injured striatum of 200 mg/kg uric acid group were higher significantly than those in the saline group (0.05 ±0.03,P＜0.01;0.24±0.13,P＜0.05). Conclusion An appropriately elevated level of uric acid may protect the dopamine neuron of nigrostriatal system from injury of 6-hydroxydopamine in rats. Key words: Uric acid; 6-hydroxydopamine; Rats; Behavior; Parkinson disease; Dopamine

[Study of incidence and correlation factors of depression, anxiety and insomnia in patients with myasthenia gravis].

Abstract: Objective To investigate the incidence rate and correlation factors of depression,anxiety and insomnia in patients with myasthenia gravis (MG).Methods A total of 161 MG patients were assessed and graded with HAMD,HAMA,PSQI,QMG,ADL and a self-made scale chart.And the correlation factors were analyzed by Logistic stepwise regression.Results The prevalence of depression,anxiety and insomnia was 58.3%,45.3% and 39.1% respectively.The correlation factors with significant influences on MG were as follows: depression with age,physical weakness,score of QMG,life scale grading;anxiety with experience-sharing;insomnia age,dyspnea,thymoma,physical status at 1 month post-operation,prednisone dose and score of QMG.Conclusion Nearly one half of the MG patients suffer from affective disorders to different degrees.And an analysis of its correlation factors provides references to prevent and treat the affective disorders concurrently with MG. Key words: Myasthenia gravis; Depressive disorder; Anxiety; Sleep initiation and maintenance disorder

[Expression of proto-oncogene Wip1 in breast cancer and its clinical significance].

Abstract: Objective To investigate the expression of proto-oneogene Wip1 in breast cancer tissue and its clinical significance Methods Through the uses of semi-RT-PCR, immunohistochemieal technique and Western blot, the specimens from 70 patients of breast cancer and 20 normal controls were detected for Wip1 mRNA and protein expression At the same time, the authors analyzed the relations between the expression of Wip1 in human breast cancer and different clinical pathologic parameters Results RT-PCR:The values of gene expression of Wip1 mRNA in breast cancer tissue, perieaneerous tissue and normal breast tissue were 0 715±0 087, 0 175± 0 021 and 0 154±0 022 respectively Thus the value of gene expression in breast cancer tissue was significantly higher than that in perieaneerous tissue or normal breast tissue (P<0 01 ) Immunohistochemistry:The high expression rates of Wip1 protein in breast cancer tissue, perieancerous tissue and normal breast tissue were 62 9% (44/70), 2 9% (2/70) and 0(0/20)respectively and there was a significant difference among these three different tissues ( P<0 01 ) Western blot:The relative contents of Wip1 protein in breast cancer tissue, perieaneerous tissue and normal breast tissue were 0 688±0 151, 0 251±0 043 and 0 234±0 044 respectively The relative content of Wip1 protein in breast cancer tissue was significantly higher than that in pericaneerous tissue or normal breast tissue (P <0 01 ) The high expression of Wip1 protein was negatively correlated with the expression of p53, but it had nothing to do with tumor size, age, tumor staging, axillary lymph node metastasis and expressions of ER and PR Conclusion The high expression of Wip1 mRNA and its protein in breast cancer tissue may promote the growth of breast cancer Wip1 may become a new target for therapy of breast cancer Key words: Breast neoplasms; Proto-oneogene; Wip1 ; p53

The feasibility of Supreme laryngeal mask airway in gynecological laparoscopy surgery

Abstract: Objective To explore the safety, efficacy and side effect of Supreme laryngeal mask airway (LMA) used in gynecological laparoscopy. Methods From Oct 2009 to Apr. 2010 in First Hospital of Peking University, 125 patients undergoing general anesthesia for elective gynecological laparoscopy were reviewed, 69 of which were dealt with Supreme LMA (S) and 56 with endotracheal tube (T). After anesthesia induction, changes of HR and MAP were observed during intubation and extubation.The peak inspiratory airway pressure ( Ppeak ) and PETCO2 were monitored. Relevant perioperative side effects were recorded. Results HR and MAP in group T were increased right after intubation and during extubation (P ＜ 0. 05 ), which were significantly decreased in group S (P ＜ 0. 01 ). Ppeak and PETCO2 were comparable in the two groups at all the time points ( P ＞ 0. 05 ). There was no body movement or coughing at the time of intubation. Group S had less incidence of body movement, coughing and sore throat than group T during extubation (P ＜ 0. 05). Conclusion Supreme LMA can provide the same safe and effective ventilation as intubation and less stress response and side effects in gynecological laparoscopy. Key words: Supreme laryngeal mask airway; Endotracheal tube; Gynecological laparoscopy

Longitudinal study of aflatoxin exposure in the development of primary liver cancer in patients with chronic hepatitis

Abstract: Objective To study the relationship between aflatoxin exposure and the development of primary liver cancer (PLC) in patients with chronic hepatitis. Methods A 21-year longitudinal study was carried out in a large cohort of 515 PLC high-risk individuals with HBV infection in PLC high prevalence region. Results (1) The PLC year-incidence of cohort was 1437. 25/100 000. And it was significantly higher than that of the same natural peoples (184. 53/100,000, P = 0. 000, RR =7.79). There was no significant difference in the incidence of other tumors between these two groups (P =0.576). (2)The PLC patients in the cohort were diagnosed at an average age 1.4 year younger than those in the same natrural peoples and had an average survival of 6. 42 months longer than the latter. (3 ) The PLC year-incidence of those with the exposure to aflatoxin was significantly higher than that of unexposed people (2784. 96/100 000 vs 1251. 02/100 000, P = 0.008, RR =2.23). There was no relationship between the incidence rate of other tumors and the aflatoxin exposure. (4)The PLC year-incidence of aflatoxin-exposing people increased with the rising urine excretion of AFM,. When the urine excretion of AFM, was more than 100 ng during 24 hours, the PLC year-incidence was high as 4 717.82/100 000. The urine excretion of AFM, was also obviously related with the abnormal liver function ( P = 0.035 ). There was no relationship with the positive rate of HBeAg ( P = 0. 812). (5) The PLC year-incidence of those with the exposure to aflatoxin were infected with HBV (2 784. 96/100 000) significantly higher than that of cohort people (P =0. 001) and the same natural peoples ( P = 0. 000, RR = 15. 09). ( 6) It took an average time of 14. 65 years ( median 13.68) from hepatitis occurrence to PLC diagnosis and 7.38 years (median 6.40)from liver cirrhosis to PLC diagnosis.Conclusion HBV infection is a main etiological factor of PLC and the aflatoxin exposure has obvious synergistic effect in the carcinogenesis of PLC.Regular observation in a PLC high-risk cohort is effective for an early diagnosis and treatment.Hepatitis control and aflatoxin de-pollution is effective to inhibit the occurrence of PLC. Key words: Hepatocellular carcinoma; Hepatitis B virus; Aflatoxin; Cohort study

Study of variations in adult sphenoid sinus by multislice spiral computed tomography

Abstract: Objective Explore the anatomic variations of adult sphenoid sinus and delineate the precise relationship between sphenoid sinus and adjacent structures.MethodsUsing multi planner reformation (MPR),the images of 260 spiral computed tomography (CT) scans were reviewed through a doctor station.Results The sphenoid was divided into 6 types:no development,conchal,pre-sellar,half-sellar,full-sellar and post-sellar.The prevalence was 0.19%,1.54%,8.08%,22.88%,20.58% and 46.73% respectively.And there was no difference between left and right.The prevalence of accessory septa or bone spur inside sphenoid sinus was 51.5%.With the gasification spreading,the prevalence was rising.And there was statistical significance among them.The dorsum sella was divided into three types:Ⅰ,Ⅱ,Ⅲ.And its prevalence was 48.08%,25.19% and 26.73% respectively.The difference of sphenoethmoid distribution among the various type sinus had no statistical significance.The prevalence of vidian canal and foramen rotundum protrusion was 39.2% and 15.8% respectively.And all occurred in pterygoid process cells.Internal carotid artery (ICA) was divided into 4 types.And the prevalence of type 0 to 3 was 13.5%,50.0%,26.9% and 9.6% respectively.With the gasification spreading,the prevalence of types 2,3 was rising.And there were statistical significance among them.The prevalence of type 0 to 4 CN Ⅱ was 4.4%,19.2%,26.0%,29.0% and 21.4% respectively.With the gasification spreading,the prevalence of type 3,4 CN Ⅱ was rising.And the difference had statistical significance.Conclusion MPR and multislice spiral CT can facilitate a precise study of anatomic variations in adult sphenoid sinus and delineate the relationships between sphenoid sinus and adjacent structures.Caution must be exercised during sphenoid and trans-sphenoid surgery to minimize the risk of inadvertently injuring the adjacent structures. Key words: Sphenoid sinus; Tomography,X-ray computed; Anatomy

[Study of serotype distribution, antimicrobial resistance patterns and molecular epidemiology in 148 isolates of invasive Streptococcus pneumoniae].

Abstract: Objective To investigate the serotype distribution, antimicrobial resistance patterns and molecular epidemiology of Streptococcus pneumoniae ( 5. pneumoniae) isolated from invasive pneumococcal diseases in order to provide rationales for antibiotics application and immunity control of 5. pneumoniae. Methods A total of 148 isolates of invasive S. pneumoniae were collected from blood, cerebrospinal fluid and other sterile body fluids from 15 regions between January 2005 and August 2008 nationwide. Agar dilution method was used to determine the minimal inhibitory concentrations (MICs) of penicillin and other antibiotics against these isolates. Simplified chessboard system and capsule swelling reaction were used for serotyping of S. pneumoniae. Multilocus sequence typing ( MLST) was used to determine the genetic relationship of 53 strains of serogroup-19. Results Twenty serotypes/serogroups were identified in 148 strains. The prevalent serotypes (70. 9% ) were 19A, 19F, 3, 23F, 5, 6, 14 and 9 respectively. Serotypes 19A (22. 3% , 33/148) and 19F (16. 9% , 25/148) were the most frequent type observed. And serotypes 3 (7. 4% , 11/148) and 23F(6. 8% , 10/148) were less prevalent Of all 36 strains isolated from infants under 2 years old, 33. 3% (12/36) were covered by 7-valent pneumococcal conjugate vaccine (PCV7). The resistant rates to amoxicillin/clavulanic acid, erythromycin and other antibiotics in PCV7-related pneumococcal strains were significantly higher than those in PCV7-unrelated group (P < 0. 05). Fifty-three strains of serogroup-19 were genotyped by MLST and 9 sequence types (STs) identified. ST320 (52. 8% , 28/53) and ST271 (22.6% , 12/53) were the most frequent STs. Conclusions The major serotypes of invasive S. pneumoniae are 19A, 19F, 3 and 23F. Antimicrobial-resistant S. pneumoniae has become a serious issue of public health. Key words: Streptococcus pneumoniae; Serotyping; Drug resistance,microbial; Multilocus sequence typing; Invasive diseases

[Efficacy study of single-agent gemcitabine versus gemcitabine plus carboplatin in untreated elderly patients with stage IIIb/IV non-small-cell lung cancer].

Abstract: Objective To explore a chemotherapeutic regimen suitable for non-small cell lung cancer (NSCLC) in elderly patients. Methods A total of 68 elderly patients with NSCLC (stage Ⅲb/Ⅳ )were equally and randomly divided into single-agent and combinded groups. Patients in single-agent group received gemcitabine 1000 mg/m~2 at Days 1 and 8 for a 21-day cycle. Those in combined group received gemcitabine 1000 mg/m~2 at Days 1 and 8 in combination carboplatin AUC5 at Day 2 for a 21-day cycle. The drugs were intravenously administered. All patients received 3 cycles of treatment. Results In single-agent and combined groups, CR 1 and 1, PR 12 and 13, response rates 38% and 41% were respectively observed. There was no statistically significant difference between two groups ( P ＞ 0. 05 ). The 1-year and 2-year survival rates of single-agent and combined groups were 31% vs 32% and 12% vs 14% with a median survival of 9. 9 and 9. 8 months without a statistically significant difference ( P ＞ 0. 05 ). The rates of leucopenia and thrombecytopenia (Ⅲ -Ⅳ degree) were 47% and 38% in combined group and they were higher than 24% and 15% in single-agent group with a statistically significant difference (P ＜0. 05 ). The observer scale of lung cancer symptom scale showed that the post-treatment scores of appetite, fatigue and pain significantly improved in single-agent group while no improvement was observed in combined group.Also the scores of appetite, fatigue and pain of single-agent group were higher than those of combined group after chemotherapy ( P ＜ 0. 05 ) . Conclusion Single-agent gemcitabine regimen is more suitable for advanced NSCLC in elderly patients. Key words: Carcinoma, non-small-cell lung; Elderly; Carboplatin; Gemcitabine

Comparison and superiority of streamlined liner of the pharynx airway to laryngeal mask airway or tracheal tubes for gynecological laparoscopy

Abstract: Objective To compare the variations of hemodynamics or respiratory parameters and postoperative complications incidence in gynecological laparoscopy to perform Laryngeal Mask Airway (LMA) , Streamlined Liner of the Pharynx Airway (SLIPA~(TM) ) or Tracheal Tube(TT) and to appraise the safety or superiority SLIPA~(TM) in gynecological laparoscopy. Methods 90 patients as ASA I -Ⅱ grade for gynecological laparoscopy to divide randomly into three groups ( n = 30 ) :SLIPA~(TM) group ( S ) , LMA group ( L), IT group(T). Patients were intubated with SLIPA~(TM), LMA or TT respectively after general anesthesia induction. Record and count baseline or variable values on heart rate, mean arterial pressure, peak inspiratory pressure, flat inspiratory pressure, airway compliance, airway resistance as pre- and post-intubation. To observe intra- and post-complications on backflow or aspiration, airway shifting, oral mucosa damage, cough or expectoration, pharyngodynia, trachyphonia and to appraise patient' s comfort as extubation. Results S or L group is more stable than T on hemodynamic (P < 0.05) during intubation, S group is more stable than L or T group on respiratory parameters (P <0. 05). Intraoperative incidences are significantly lower in S group than I, group on backflow or aspiration, airway shifting or oral mucosa damage ( P <0. 05 ) , postoperative incidences are significantly lower in S group than L or T group on pharyngodynia, trachyphonia or cough or expectoration ( P < 0. 05). In addition, extubation comfort degree is better to patient as resuscitation(P<0. 05). Conclusions SLIPA~(TM) are safely or conveniently applicable in gynecological laparoscopy. It impacts little on variations of hemodynamics or respiratory parameters after general anesthesia and reduces intra- or post-operative complications significantly compared to L or T group, increases patient's comfort as extubation. SLIPA~(TM) is superior to other two on clinical applications. Key words: Laryngeal mask; Tracheal tube; Laparoscope; Gynecological surgery; SLIPA~(TM)

Comparative analysis of TACE alone or plus RFA in the treatment of 167 cases of intermediate and advanced staged primary hepatocellular carcinoma

Abstract: Objective To evaluate the clinical efficacy and survival rate of transarterial chemoembolization(TACE)alone or plus radiofrequency ablation(RFA)in patients with intermediate or advanced stage primary hepatocellular carcinoma(HCC). Methods In this retrospective study, 467 cases received RFA or TACE plus RFA. Among them, 167 cases with strict clinical procedure(TACE alone or plus RFA)and complete follow-up data were included. Eighty-seven cases received TACE and 80 cases had TACE plus RFA between January 2000 and December 2006. Hierarchical analyses were performed using logrank tests and survival curve was estimated by Kaplan-Meier method. Results A total of 167 patients received TACE alone or plus RFA for a follow-up period of 1 to 89 months. In the TACE alone group, the time-to-progression(TTP)was an average of 3.6 months. The median survival was 13 months, one-year survival rate 52. 9%, three-year survival rate 11.5% and five-year survival rate 4. 6%. In the TACE plus RFA group, the TTP time was an average of 10. 8 months. The median survival time was 30 months, oneyear survival rate 85.0%, three-year survival rate 45.0% and five-year survival rate 11.3%. In the TACE alone group, the median survival of intermediate stage HCC was 14 months, one-year survival rate 62. 2%,three-year survival rate 13. 3% and five-year survival rate 4. 4%; In the TACE plus RFA group, the median survival of intermediate stage HCC was 14 months, one-year survival rate 90. 1%, three-year survival rate 52.9% and five-year survival rate 13. 7%. AIl differences of two groups has statistical significance(P ＜0. 05). In intermediate stage HCC, the median survival of TACE alone group was 14 months, one-year survival rate 62. 2%, three-year survival rate 13.3%, five-year survival rate 4.4% versus 32 months,90. 1%, 52. 9% , 13.7% in the TACE plus RFA group respectively. For the advanced stage HCC, the median survival time was 12 months, one-year survival rate 35%, three-year survival rate 7. 1% and fiveyear survival rate 0 in the TACE alone group versus 28 months, 62. 1% , 24. 1% and 6. 9% in the TACE plus RFA group(P =0. 00). There was significantly statistic difference between both groups in intermediate and advanced staging HCC. Among them, 60/485(12. 4%)patients required a therapy of post-TACE hepatic dysfunctions versus 13/168(7. 7%)in the TACE plus RFA group(P =0. 004, ANOVA method).Conclusion The regimen of TACE plus RFA has the advantages of tumor control, liver function protection and survival extending in the treatment of HCC than TACE alone in intermediate or advanced stage HCC. Key words: Carcinoma, hepatocellular; Drug therapy,combination; Catheter ablation

Effects on structure and secretion of pituitary gland in rats after electromagnetic pulse exposure

Abstract: Objective To investigate the exposure effect of electromagnetic pulse (EMP) on the structure and secretion of pituitary gland in rats.Methods Forty-eight male SD rats were randomly divided into eight groups.Four groups were subject to the EMP exposure of 200 kV/m and the others received a sham exposure.At different time points (12,24,48 & 96 h) post-exposure,the pathological changes of pituitary gland were observed by light and transmission electron microscope.And the serum levels of prolactin (PRL),growth hormone (GH),adrenocorticotropic hormone (ACTH),thyroid stimulating hormone (TSH) and luteinizing hormone (LH) were measured dynamically by radioimmunoassay.Results At 12 h post-exposure,swollen mitochondria with cristae loss,dilatation of Golgi complex and diffusive lysosomes were found in endocrine cells of pituitary gland.The above changes became gradually worse.Mitochondrial vacuolization,the formation of myelin figures,distinct dilatation of endoplasmic reticulum,the occurrence of numerous secondary lysosomes and the clustering of heterochromatin under the nuclear membranes could be observed at 48 h.These lesions were alleviated to some degree at 96 h.The serum levels of PRL and ACTH both increased significantly at 12 h (P ＜ 0.01,P ＜ 0.05) and returned to normal at 24 h.The level of GH decreased significantly at 12 h and then returned gradually to normal at 48 h.The level of TSH decreased at 12 h and reached the lowest point at 24 h,then returned to normal at 96 h.LH increased significantly from 24 h to 96 h.Conclusion The EMP exposure of 200 kV/m may induce the changes of the structure and secretion of pituitary gland in rats. Key words: Radiation; Pituitary gland; Ultrastructure

[A multicenter study of Chinese patent medicine wenweishu/yangweishu in the treatment of Helicobacter pylori positive patients with chronic gastritis and peptic ulcer]

Abstract: Objective To evaluate the efficacy of Chinese patent medicine wenweishu (温胃舒)/yangweishu(养胃舒) in the treatment of Helicobacter pylori ( H. priori ) positive patients with chronic gastritis and peptic ulcer. Methods A randomized, controlled and multicenter trial was conducted in 642H. pylori positive patients with chronic gastritis or peptic ulcer. They were randomized to three groups : PCM group (n = 222, pantoprazole 40 mg twice a day, clarithromycin 500 mg twice a day, metronidazole 400 mg twice a day, for 7 days) ; PCM plus wenweishu(温胃舒) group (n = 196) ; and PCM plus yangweishu(养胃舒) group (n =224).~(14)C breath test was performed 4 weeks after therapy. For the patients with gastric ulcer, ulcer healing was determined by endoscopy after therapy. Results Intention-to-treat H. pylori eradication rate for PCM group, PCM plus wenweishu(温胃舒) group, and PCM plus yangweishu(养胃舒)group were 57. 2% ( 127/222), 62. 2% ( 122/196), 60. 3% ( 135/224), respectively (P =0. 295, 0. 512). Per-protocol H. pylori eradication rates were 62. 3% ( 127/204), 70. 1% (122/174), 65.2% ( 135/207), respectively ( P = 0. 108, 0. 532 ). Per-protocol analysis gastric ulcer healing rate were 61.9% ( 13/21 ) 100.0% (18/18) ,86.4% ( 19/22 ) respectively. The healing rate in PCM plus wenweishu ( 温胃舒)groups was statistically significantly higher than the rate in PCM group (P = 0. 004). The rates of symptom relief in PCM plus wenweishu (温胃舒) groups and PCM plus yangweishu (养胃舒) were statistically significantly higher than the rate in PCM group ( both P＜0. 01 ). Side-effects were rare and comparable between groups. Conclusion Although PCM combined with wenweishu(温胃舒) or yangweishu(养胃舒) in the treatment of H. pylori positive patients with chronic gastritis and peptic ulcer can not reach a significantly higher eradication rate, it can increase the rates of both gastric ulcer healing and symptom relief. Key words: Gastritis; Peptic ulcer; Helicobacter pylori; Chinese patent medicine; Randomized controlled trails

[Relationship of adipocyte fatty acid-binding protein to adiponectin ratio with femoral intima-media thickness and endothelium-dependent vasodilation in patients with newly-diagnosed type 2 diabetes mellitus].

Abstract: ：Objective To explore therelationship between plasma adipocyte fatty acid-binding protein(A-FABP),adiponectin (APN)levels and A-FABP/APN ratio with femoral intima-media thickness (FA-IMT)andendothelium-dependent vasodilation in patients with newly diagnosed type 2 diabetesmellitus (T2DM).Methods Plasma A-FABP and APN in 133 patients with newly diagnosed T2DMwere measured by enzyme-linked immunosorbent assays.FA-IMT,endothelium-dependent andindependent vasodilation of brachial artery was measured by high-resolution vascularultrasound.Upper quartile of FA-IMT was regarded as a criterion of elevated FA-IMT,defined as early atherosclerosis (AS). The patients were subdivided into low FA-IMT group( FA-IMT <0. 60 mm, n =34), middle FA-IMT group (0. 60 mm≤FA-IMT <0. 73 mm,n = 33),high FA-IMT group (0. 73 mm ≤ FA-IMT < 0. 80 mm, n = 33) and early AS group ( FA-IMT≥0. 80 mm, n = 33 ). ResultsPlasma A-FABP/APN ratio was higher in early AS group than in low IMT control group[A-FABP/APN × 1000, 3.9(2. 8～6. 1 ) vs 2. 9( 1.8～5.7), P <0. 05]. FA-IMTcorrelated positively with plasma A-FABP/APN ratio (r =0. 216, P =0. 006) and negativelywith APN (r = -0. 179,P=0. 020). After adjusted for age, gender and BMI, FA-IMT stillcorrelated positively with plasma A-FABP/APN ratio (r =0.217, P =0.007) and negativelywith APN (r = -0.172, P =0.026).Endothelium-depondent vasodilation correlated negativelywith plasma A-FABP/APN ratio ( r = - 0. 166,P =0. 028). After adjusted for age, gender andBMI, endothelium-dependent vasodilation still correlated negatively with plasma A-FABP/APNratio (r =-0. 153, P =0. 042). Conclusion Plasma A-FABP/APN ratio is closely associatedwith FA-IMT and endothelium-dependent vasodilation. Plasma A-FABP/APN ratio may be abetter clinical marker of AS and endothelial dysfunction than A-FABP or APN alone inpatients with newly diagnosed T2DM. Key words: Diabetes mellitus; type 2 ; Adiponectin; Tunica media; Vasodilation

Diagnostic value of 64 multislice CT in typing of congenital aortic anomaly in neonates and infants

Abstract: Objective To study diagnostic value of 64 multislice CT in typing of congenital aortic anomaly in neonates and infants.Methods 120 pediatric patients (under one year of age) with congenital heart disease (CHD) underwent 64 contrast-enhanced MSCT before a corrective operations.The diagnostic sensitivity,specificity and accuracy of 64 MSCT were evaluated and also compared with those of echocardiography with Doppler.The patients were randomly assigned to two groups (72 and 48 persons)respectively according to tube tension of 80 and 100 kV.The differences of the image qualities were compared between them.Results 36 congenital aortic anomalies were found (36/120,30%) by 64 MSCT,which were furtherly distinguished into 2 cases in double aortic arch,2 cases in left-sided aortic arch with aberrant right subclavian artery,22 cases in right aortic arch (6 cases in right-sided aortic arch with aberrant left subclavian artery,12 cases in right aortic arch with mirror image branching),10 cases in coarctation ofaorta.Diagnostic sensitivity,specificity and accuracy of 64 MSCT were all 100%.By contrast,those of echocardiography with Doppler were 27.8%,97.6%,76.7%,respectively.The quality scores were 4.69 ±0.52,4.58±0.58 at 80 kV and 100 kV,respectively.No significant statistical difference was found between them(t = 1.08,P = 0.28 ).Conclusion MSCT allows a detailed assessment of the anatomy of congenital aortic anomaly,which can be used as an important supplementary method in diagnosing CHD and offer important information for operation.80 kV should be selected in CHD patients less than one year old for CT examination to reduce radiation exposure. Key words: Heart defects,congenital; Tomography,X-ray computed; Angiocardiography

[Depot-specific expression of retinol-binding protein 4 in human adipose tissue and their relationship with obesity and insulin resistance].

Abstract: Objective To explore the depot-specific mRNA and protein expression of retinolbinding protein 4 (RBP4) in human subcutaneous and omental adipose tissue and investigate their relationship with the serum RRP4 levels, obesity and insulin resistance. Methods A total of 41 subjects with normal glucose regulation were recruited. Among them, there were 29 cases with normal body mass index (BMI) and 12 cases with BMI ≥24 kg/m2. All were prepared to undergone a selective abdominal surgery. The levels of serum RBP4 and fasting insulin ( FINS ) were measured by ELISA ( enzyme-linked immunosorbent assay) and chemiluminescence ELISA kit respectively. Fasting plasma glucose (FPG) was tested by glucose oxidase and the home model insulin resistance index (HOMA-IR) calculated. Real-time PCR (RT-PCR) and Western blot were employed to assess the relative mRNA and protein expression of RBP4 in subcutaneous and omental adipose tissues. The mRNA and protein expression of RBP4 from different fat depots were compared and their correlations with BMI, the serum RBP4 concentrations and HOMA-IR analyzed. Results (1) The serum concentrations of RBP4, FINS and HOMA-IR were significantly higher in overweight and obesity group than those in the normal BMI group [RBP4: (39. 61 ±1.57) mg/L vs (33.40 ± 1.28) mg/L, P ＜0. 01; FINS: (8. 82 ±3.79) mU/L vs (6. 43 ±4. 38) mU/L, P＜0. 05; HOMA-IR:1. 91 ±0. 85 vs 1.36 ±0. 72, P ＜0. 05]. (2) The expression levels of RBP4 mRNA and protein were significantly higher in omental adipose tissues than those in subcutaneous adipose tissue [mRNA: (5. 88 ±2. 37)vs(2. 07 ± 1.66), P ＜0. 01; protein: (0. 76 ±0. 18 vs 0. 15 ±0. 07, P ＜0. 05]and these depots difference in both groups ( P ＜ 0. 05) . Moreover, the overweight patients had the higher expression levels of RBP4 mRNA and protein in omental adipose tissue than normal BMI group (mRNA:7.52±0.58 vs 4.37 ±0.45, P＜0. 01; protein: 0.92 ±0.23 vs 0.57 ±0.13, P ＜0.05). (3) The expressions of both RBP4 mRNA and protein in the omental adipose tissue were positively correlated with BMI, waist circumstance, serum concentrations of RBP4, FINS and HOMA-IR. The expression of was negatively correlated with HOMA-IR ( r = - 0. 635, P ＜ 0. 05 ) in subcutaneous adipose tissue. No correlations were found between the expressions of RBP4 mRNA and protein in subcutaneous adipose tissue with BMI, waist circumstance, serum RBP4 and FINS concentrations. Conclusions There is depot-specific expression of RBP4 in human subcutaneous and omental adipose tissues. A high expression of RBP4 in omental adipose tissue and an elevated level of serum RBP4 may contribute to the pathogenesis of obesity and IR. Key words: Retinol-binding proteins; Adipose tissue; Obesity; Insulin resistance

Modified minimally invasive percutaneous pedicle screws osteosynthesis for the treatment of thoracolumbar fracture without neural impairment

Abstract: Objective To explore the feasibility and efficacy of modified minimally invasive percutaneous pedicle screws osteosynthesis for the treatment of thoracolumbar vertebral compression fracture. Methods Twenty cases of thoracolumbar fracture without neural impairment were enrolled. None needed laminotomy decompression. With the aid of C-arm image intensifier, the GSS Ⅱ pedicle screws were inserted through four small longitudinal incisions and modified surgical instruments. Perioperative parameters and postoperative imaging indices were compared with those undergoing conventional open pedicle screws osteosynthesis in other 20 cases. Results There was no significant difference in operative time between minimal invasive group and conventional group (P > 0. 05); but the length of incisions, length of hospital stay, the volume of operative hemorrhage and post-operative drainage in minimal invasive group were significantly shorter than those in conventional group (P 0. 05 ) ; The incidence rate of chronic lower back pain in minimal invasive group was obviously lower than conventional group during the follow-up visit. Conclusion The percutaneous internal pedicle screw fixation using modified instruments has the advantages of simple manipulation, less trauma and hemorrhage, quicker recovery, less pain, shorter hospital stay and a lower incidence rate of chronic lower back pain. Key words: Surgical procedures, minimally invasive; Spine; Internal fixators

Clinical manifestations and mutation study in 16 Chinese patients with Fabry disease

Abstract: Objective To investigate the clinical manifestations and to characterize mutations of the GLA gene in Chinese patients with Fabry disease so to enhance the diagnosis of Fabry disease. Methods Sixteen Chinese affected males (from 16 unrelated families) with the classic phenotype of Fabry disease were investigated. The patients were diagnosed by a deficiency of α-galactesidase A(α-Gal A) activity. All seven exons and the neighboring intronic sequences of GLA gene were analyzed by PCR amplification and automated sequencing. ResultsA total of 14 mutations were identified including 12 single-base substitutions( 11 missense and 1 nonsense mutations) ,1 small deletion and 1 splicing mutation. Eight novel mutations( c. 119 C>A, c. 275 A>T, c. 520T>C, c. 547G>C, c. 647A>G, c. 929T>G, c. 1045T>A,IVS1-1G>A)were identified. The novel mutations were not tested by RFLP on 100 GLA alleles in Chinese population, and were highly conservative in mammalian species. ConclusionFabry disease is often misdiagnosed in China. There is no hot spot for mutations in Chinese patients. GLA gene mutation analysis is a reliable method to diagnosis for Fabry disease. Key words: Fabry disease; Alpha-galactosidase; Mutation; GLA gene

Change of serum ACTH and cortisol levels in Alzheimer disease and mild cognition impairment

Abstract: Objective To characterize the response of adrenocortieotropic hormone(ACTH)and cortisol in the patients with Alzheimer disease(AD)and those with mild cognition impairment(MCI).Methods The AD or MCI patients at our department from July 5, 2007 to August 31,2009 were enrolled.The levels of 8am serum ACTH and cortisol were measured by chemiluminescence in 54 AD patients, 41 MCI patients and 42 age -matched controls. Results The serum ACTH values in 3 groups were(16 ±5),(16 ±5)and(17 ±4)ng/L respectively. The serum ACTH values had insignificant changes in 3 groups(P＞0.05). The serum cortisol values were(595 ± 58),(568 ± 70)and(410 ± 81)nmol/L in 3 groups respectively. And the serum cortisol values significantly increased in AD and MCI groups(P ＜0. 01). The levels of serum cortisol in MCI group were lower than those in AD group. But there was no significant difference(P ＞ 0. 05). Through an analysis of rank correlation, the severity of AD had a positive correlation with serum concentration of cortisol(P ＜ 0.05); there was a negative correlation between the serum level of cortisol and the scores of MMSE in AD patients(P ＜ 0.05). There was no significant change of serum level of cortisol for different genders in 3 groups(P ＞ 0.05). Conclusion The level of serum ACTH has no significant change. A high level of serum cortisol is observed in AD and MCI groups. There is a positive correlation between serum level of cortisol and the severity of AD and a negative correlation between serum level of cortisol and the scores. Key words: Alzheimer disease; Cognitivedeficit; Adreno-cortico-tropic-hormone; Cortisol