Objective To assess the effectiveness of prevention program on iodine deficiency disorders and iodine nutritional status of residents in Guangdong Province.Methods Probability proportionate to size sampling(PPS) was employed in surveillance of iodine deficiency disorders.Thirty counties(cities,districts) were selected in Guangdong Province.In each county(city,district) one township(street) was selected; in each township (street) one primary school was selected and in each primary school 40 children aged 8-10 were chosen to examine their thyroid and to collect salt samples at their home for determination of salt iodine.Out of the 40 children,12 children were chosen to collect urine samples for determination of urinary iodine.From the primary schools chosen,40 grade 5 students were selected for intelligence quotient(IQ) test.In the nearby of the primary schools,3 townships(towns,street) were selected and in each township(town,street) 5 pregnant and 5 lactating women were selected to collect their urine samples for determination of urinary iodine.Type-B ultrasonic was used in measuring the thyroid volume.The iodine content of urine samples was measured by the method of arsenic and cerium catalysis spectrophotometry.The iodine content of salt was determined quantitatively with the titration method.IQ was tested by Chinese combined Raven's test.According to geographical location and the implementation of iodized salt,the effects of iodized salt on iodine deficiency disorders were analyzed in the plains and the Pearl River Delta Coastal region with mild iodine deficiency(iodized salt implementation region,referred to as the plains and the PRD),historical iodine deficiency areas (iodized implementation region) and the eastern and the western coastal areas of Guangdong(areas with non-iodized salt problem,referred to as the eastern and the western Guangdong).Results A total of 1200 children aged 8 to 10 were examined by type-B ultrasonic test,and goiter rate was 3.5％ (42/1200).The differences of goiter rate between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong were statistically significant (x2 =6.6,P ＜ 0.05).The goiter rate (6.1％) in the eastern and the western Guangdong was significantly higher than that of the plains and the PRD and the historical iodine deficiency areas (3.3％,2.0％,x2 =5.6,7.1,all P ＜ 0.05).A total of 1200 salt samples were examined.The median and coefficient of variation of iodine in the salt were 31.0 mg/kg and 23.2％,respectively.Coverage of iodized salt was 97.5％(1170/1200) while 96.1％(1153/1200) of consumed iodized salt was qualified.The median urinary iodine of 1200 children aged 8-10 was 186.5 μg/L,and the differences of median urinary iodine between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong were statistically significant(x2 =5.9,P ＜ 0.05).The median urinary iodine of the eastern and the western Guangdong(162.4 μg/L) was significantly lower than that of the plains and the PRD(207.5 μg/L,x2 =8.7,P ＜ 0.01).The difference of median urinary iodine between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong was statistically significant(x2 =58.9,P＜ 0.01).The median urinary iodine of the eastern and the western Guangdong(109.6 μg/L) was significantly lower than that of the historical iodine deficiency areas and the plains and the PRD(152.9,155.2 μg/L,x2 =18.3,20.6,all P ＜ 0.05).The mean IQ of the 1208 grade 5 students was 102.8 ± 14.3.The IQ of the plains and the PRD(104.3 ± 13.9) and the historical iodine deficiency areas(102.7 ± 14.3) was significantly higher than that of the eastern and the western Guangdong(100.3 ± 14.7,t =3.8,2.1,P＜ 0.01 orP＜ 0.05).Conclusions The goal of iodine deficiency disorders elimination is achieved as scheduled in Guangdong Province.The health level of general population has been improved significantly.Iodine nutrition is in the appropriate range (100-199 μg/L) in general population but low in pregnant women.The selling of non-iodized salt in the eastern and the western Guangdong Province should be followed closely.

Adult ; Aged ; Female ; Hepatitis, Chronic ; mortality ; therapy ; Humans ; Liver Failure ; therapy ; Male ; Middle Aged ; Prognosis ; Sorption Detoxification ; Survival Rate

BACKGROUND: There is growing evidence that 5-fluorouracil (5-FU) combined with therapeutic trauma can effectively induce skin repigmentation in vitiligo patients who are unresponsive to conventional treatments. Previous studies have mainly focused on identifying the antimitotic activity of 5-FU for the treatment of skin cancer, but few studies have investigated its extra-genotoxic actions favoring melanocyte recruitment. METHODS: We utilized the full thickness excisional skin wound model in Dct-LacZ transgenic mice to dynamically assess the migration of melanocytes in the margins of wounds treated with or without 5-FU. The in-situ expression of CXCL12 was examined in the wound beds using immunofluorescence staining. Quantitative real-time polymerase chain reaction and Western blotting analyses were performed to detect the expression levels of CXCL12 mRNA and protein in primary mouse dermal fibroblasts treated with or without 5-FU. Transwell assays and fluorescein isothiocyanate (FITC)-phalloidin staining were used to observe cell migration and filamentous actin (F-actin) changes of melan-a murine melanocytes. RESULTS: Whole mount and cryosection X-gal staining showed that the cell numbers of LacZ-positive melanocytes were much higher in the margins of dorsal and tail skin wounds treated with 5-FU compared with the controls. Meanwhile, CXCL12 immunostaining was significantly increased in the dermal compartment of wounds treated with 5-FU (control vs. 5-FU, 22.47 ± 8.85 vs. 44.69 ± 5.97, P < 0.05). Moreover, 5-FU significantly upregulated the expression levels of CXCL12 mRNA (control vs. 5-FU, 1.00 ± 0.08 vs. 1.54 ± 0.06, P < 0.05) and protein (control vs. 5-FU, 1.00 ± 0.06 vs. 2.93 ± 0.10, P < 0.05) in cultured fibroblasts. Inhibition of the CXCL12/CXCR4 axis suppressed melanocyte migration in vitro using a CXCL12 small interfering RNA (siRNA) or a CXCR4 antagonist (AMD3100). CONCLUSION 5-FU possesses a pro-pigmentary activity through activation of the CXCL12/CXCR4 axis to drive the chemotactic migration of melanocytes.
Animals ; Cell Movement ; Cell Proliferation ; Chemokine CXCL12/genetics* ; Fibroblasts ; Fluorouracil/therapeutic use* ; Humans ; Mice ; RNA, Messenger ; Receptors, CXCR4

OBJECTIVETo explore the prognostic factors for very severe aplastic anemia (VSAA) patients treated mainly with Chinese Kidney (Shen)-invigorating drugs (CKID) combined with anti-lymphocyte globulin (ALG) or anti-thymocyte globulin (ATG).

METHODSTwenty-seven VSAA patients were treated with CSID+ALG/ATG therapy in conjunction with cyclosporine A, androgen, hemopoietic growth factor, etc. The relationship of the effectiveness and some factors (age of patients, course of illness, blood and bone marrow figures, etc.) were analyzed.

RESULTSIn the 25 evaluated VSAA patients who had been followed up for over 1 year, 9 patients (36.0%) were basically cured, 5 (20.0%) remitted, 6 (24.0%) were markedly improved, and 5 (20.0%) were treated in vain, with the total effective rate of treatment being 80.0% (20/25). Better clinical therapeutic effects were shown in patients newly diagnosed with VSAA, of male sex (P=0.037), >20 years old (P=0.045), with an illness course [Symbol: see text] month (P=0.048), with peripheral neutrophil count >0.1 × 10(9)/L (P=0.023), and with reticulocyte count >10 × 10(9)/L (P=0.002). Platelet count (P=0.620) and bone marrow lymphocyte percentage (P=0.736) showed no correlation with the therapeutic effectiveness. Multi-factor analysis by the Kaplan-Meier procedure on the factors influencing survival showed that rather longer survival times occurred in patients > 20 years old, with peripheral neutrophil count [Symbol: see text] 0.1 × 10(9)/L, reticulocyte count [Symbol: see text]10 × 10(9)/L, and platelet count > 10 × 10(9)/L (all P=0.0001). Bone marrow lymphocyte percentage and the initiation time of ALG/ATG application (from onset of the illness) showed no significant influence on patients' survival time (P=0.085 and P=0.935, respectively).

CONCLUSIONSCSKD+ALG/ATG therapy for treatment of VSAA could enhance the current clinical therapeutic effects and elevate patients' survival rate. Conditions including male sex, age >20 years, illness course [Symbol: see text]1 month, neutrophil count >0.1 × 10(9)/L, and reticulocyte count >10 × 10(9)/L are the likely effective indices for predicting favorable therapeutic effectiveness in newly diagnosed VSAA patients.

Adolescent ; Adult ; Anemia, Aplastic ; diagnosis ; drug therapy ; pathology ; Animals ; Antilymphocyte Serum ; pharmacology ; therapeutic use ; Child ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Horses ; Humans ; Kidney ; drug effects ; Male ; Middle Aged ; Prognosis ; Survival Analysis ; Sus scrofa ; Time Factors ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the efficacy of anterior percutaneous screw fixation in the treatment of odontoid process fractures in aged people.

METHODSFrom February 2001 to April 2009, 15 elderly patients with odontoid fracture were treated with anterior percutaneous screw fixation,including 13 males and 2 females; the average age was 69.3 years (ranged, 60 to 86 years). According to Anderson classification, there were 10 patients with type II fractures (type II A in 7 cases, type II B in 3 cases, based on Eysel and Roosen classification), 4 patients with shallow type III fractures, 1 patient with deep type III fractures. Thirteen patients were fresh fractures, 2 patients were obsolete fractures. All patients had varying degrees of neck or shoulder pain, and limit activity of neck. There were 4 patients with neural symptoms including 2 grade D and 2 grade C according to Frankel classification. All the patients were followed up and were assessed by radiology. Clinical examination included neck activity, neurological function and the degree of neck pain. Radiology examinations including anteroposterior, lateral, open mouth position and flexion-extension radiographs of cervical vertebra were performed.

RESULTSAfter surgery, all patients were followed up,and the duration ranged from 6 to 60 months (averaged 31.3 months). Two patients died of other diseases during the follow-up period (18 and 22 months after surgery respectively). All patients got satisfactory results, and all screws were in good position. As the screw was too long, esophagus was compressed by screw tail in one case. One case showed fibrous union, 12 cases had achieved solid bony union, 2 cases showed nonunion without clinical symptoms. The rotation of neck in 3 cases was mildly limited,the neck function of the remaining patients were normal. Four patients with symptoms nerve injuries improved after operation (Frankel E in 3 cases, Frankel D in 1 case). The symptom of neck pain had a significant improvement after surgery (P < 0.001). The VAS score decreased from preoperative (6.07 +/- 1.44) (4 to 8 scores),to postoperative (1.13 +/- 0.92) (0 to 3 scores). And there were no severe postoperative complications.

CONCLUSIONThe anterior percutaneous screw fixation is less traumatic than conventional approaches for aged people in dealing with odontoid process fractures. Most patients will achieve satisfactory clinical results, as long as the general conditions of them are comprehensively assess. However, this procedure should not be used in patients with comminuted odontoid fractures or severe osteoporosis.

Aged ; Aged, 80 and over ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Odontoid Process ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Skin ; Tomography, X-Ray Computed

BACKGROUNDAn epidemiologic link between hepatitis C virus (HCV) and abnormal glycometabolism had been established. This study was designed to investigate the prevalence of type 2 diabetes mellitus and insulin resistance, and to explore the relation between insulin resistance and hepatitis C virus genotype, serum hepatitis C virus-RNA level in chronic hepatitis C (CHC) patients.

METHODSThree hundred and fifty-nine consecutive patients (CHC, n = 296; chronic hepatitis B (CHB), n = 63) were evaluated. HCV genotyping was performed by restriction fragment method and serum hepatitis C virus-RNA quantified PCR for all CHC patients in the baseline serum. Fasting levels of insulin and glucose were measured in all patients and the homeostatic assessment of insulin resistance was calculated in the baseline serum.

RESULTSType 2 diabetes mellitus was diagnosed in 15.5% of 296 CHC patients. Insulin resistance was present in 23.8% of the 235 nondiabetic CHC patients, in 23.1% of the 182 nondiabetic and noncirrhotic CHC patients, and associated with high serum HCV RNA level (OR: 1.754; 95%CI: 1.207 - 2.548, P = 0.003) and age > 40 years (OR: 3.542; 95%CI: 1.257 - 9.978, P = 0.017). Insulin resistance was less frequent in CHB than in matched CHC (7.9% vs. 21.4% respectively, P < 0.0001).

CONCLUSIONThe incidence of insulin resistance in CHC was significantly higher than that in CHB patients, associated with high serum HCV RNA level and age > 40 years.

Adult ; Aged ; Blood Glucose ; metabolism ; China ; Diabetes Mellitus, Type 2 ; blood ; metabolism ; virology ; Female ; Genotype ; Hepacivirus ; classification ; genetics ; pathogenicity ; Hepatitis C, Chronic ; blood ; metabolism ; virology ; Humans ; Insulin ; blood ; Insulin Resistance ; genetics ; physiology ; Male ; Middle Aged ; Polymerase Chain Reaction ; RNA, Viral ; genetics ; Risk Factors

OBJECTIVETo investigate the possible influence of cryoglobulinemia on the antiviral effect in chronic hepatitis C patients, who were treated with combination therapy of pegylated interferon alpha-2a and ribavirin.

METHODSForty consecutive patients with chronic hepatitis C (CHC) were enrolled in the study. They received pegylated interferon alfa-2a (40kD, 180mug/w) along with ribavirin. Baseline cryoglobulins were detected in the sera by cryoprecipitation. Hepatitis C virus (HCV) genotyping was performed and HCV viral load was detected at baseline, and at 4, 12 weeks during treatment, 24 weeks after cessation of treatment.

RESULTSEighteen (45.0%) patients infected with HCV were cryoglobulins positive at baseline. Mean serum HCV RNA level in cryoglobulins positive patients was higher than that in cryoglobulins negative patients (6.36+/-0.63 vs. 5.70+/-1.20, P = 0.032). The rapid virological response (RVR) rate was statically different between cryoglobulins positive patients and cryoglobulins negative ones (6/18, 33.3% vs. 15/22, 68.2%, P = 0.028). In contrast, no difference was found in early virological response (EVR) rate between the cryoglobulins positive patients and cryoglobulins negative ones (14/17, 82.4% vs. 18/21, 85.7%, P = 1.0). Sustained virological response (SVR) rate in cryoglobulins positive and cryoglobulins negative was different (0/3, 0 vs 6/6, 100%, P = 0.012). The rate of patients achieved RVR was different between the patients infected with HCV genotype 1 b of two groups (cryoglobulins positive: 2/13, 15.4% vs cryoglobulins negative 14/21; 66.7%, P = 0.005). However, the rate of EVR in patients infected HCV genotype 1 b was not statistically different (cryoglobulins positive: 9/12, 75.0% vs. cryoglobulins negative 17/20; 81.2%, P = 0.647).

CONCLUSIONThe rates of RVR and SVR achievement in cryoglobulinemia positive CHC patients are lower than those in cryoglobulinemia negative CHC patients.

Adult ; Aged ; Antiviral Agents ; therapeutic use ; Cryoglobulinemia ; complications ; virology ; Female ; Genotype ; Hepacivirus ; genetics ; Hepatitis C, Chronic ; complications ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; therapeutic use ; RNA, Viral ; Recombinant Proteins ; therapeutic use ; Ribavirin ; therapeutic use ; Treatment Outcome

OBJECTIVETo observe the clinical efficacy of Chinese drugs combined with chemotherapy in the treatment of acute myeloid leukemia (AML) and to investigate the prognostic relevance of the main parameters in AML treated with integrative medicine.

METHODSForty AML patients hospitalized at the authors hospital were treated with Chinese drugs and chemotherapy. The routine examination, immunophenotype and karyotype analyses were carried out. The clinical efficacy was observed and the prognostic factors were analyzed.

RESULTS(1) Clinical efficacy: Twenty patients had complete remission (CR), with the CR rate being 50.0%. Among these patients, the CR rate was 73.9% (17/23) in de novo AML and 17.6% (3/17) in secondary or refractory AML, respectively. The median disease free survival (DFS) was 6 months (2-32 months) and median overall survival (OS) was 7 months (1-36 months). (2) Analysis of prognostic factors: Aging (> 60 years) and hepatosplenomegaly or extramedullary leukemia did not affect the treatment outcome. Patients with lower white blood cell (WBC) counts (<4.0x10(9)/L) had a significantly higher CR rate (P<0.01). Secondary or refractory AML was associated with a lower CR rate and shorter OS (P<0.01,P<0.05). Expression of CD34 was an adverse factor for obtaining CR (P<0.05) and survival in both DFS and OS (P<0.05,P<0.01). The expression of CD56 was significantly associated with a lower CR rate (P<0.05), but did not affect DFS and OS. Twenty-three (57.5%) out of 40 cases had chromosomal abnormalities. The CR rate was decreased and both DFS and OS shortened stepwise from the cases with favorable cytogenetics to those with intermediate and unfavorable cytogenetics (P<0.01).

CONCLUSIONSThe combined treatment of Chinese drugs with chemotherapy has a predominant effect in de novo AML. Secondary or refractory AML, expression of CD34 and CD56, and unfavorable cytogenetics were the main factors of poor prognosis in AML.

Adolescent ; Adult ; Aged ; Antibiotics, Antineoplastic ; therapeutic use ; Antineoplastic Agents, Phytogenic ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Chromosome Aberrations ; Cytarabine ; therapeutic use ; Daunorubicin ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Etoposide ; therapeutic use ; Female ; Humans ; Immunophenotyping ; Integrative Medicine ; Leukemia, Myeloid, Acute ; drug therapy ; genetics ; Male ; Middle Aged ; Mitoxantrone ; therapeutic use ; Prognosis ; Treatment Outcome ; Young Adult

This study was purposed to evaluate the safety and curative effect of autologous cytokine induced killer cells (CIK) combined with low-dose IL-2 regimen containing immune enhancement of thymic peptide on elderly patients with B-cell chronic lymphocytic leukemia (B-CLL). Thymic peptide α1 was subcutaneously given as the immunoenhancement agent at a dose of 1.6 mg/d, 14 days as one cycle. Peripheral blood mononuclear cells (PBMNC) from 5 patients with B-CLL were isolated once a week to induce ex vivo CIK cells through culture in the context of interferon (IFN)-γ, interleukin (IL)-2 and anti-CD3 monoclonal antibody. The PBMNC were separated from patients before and after 14 days as one cycle of thymic peptide α1 administration. Parameters of amplification ability, effector cells quantity, lymphocyte subgroups percentage and antitumor cytotoxicity were compared before and after thymic peptide administration. The 5 patients were treated with CIK cells combined with low-dose IL-2 regimen immediately after injection of thymic peptide α1. The CIK cells plus low-dose IL-2 regimen containing thymic peptide enhancement was defined as: thymic peptide α1 1.6 mg/d was subcutaneously administered once every other day; (4 - 6) ×10(9) of CIK cells were transfused followed by IL-2 subcutaneous administration of 1 mU/d on days 1-10, 28 days as one cycle. Clinical evaluation parameters including cellular immunity function, CLL related biomarkers, disease state and infectious frequency and degree were investigated before and after CIK cells infusion puls IL-2. The results showed that the amount of amplified CIK cells, the percentage and amplification times of effector cells and antitumor cytotoxicity more significantly increased after thymic peptide α1 treatment than before its use (P < 0.05). The total 46 cycles of CIK cells infusion plus IL-2 were completed in the 5 CLL patients. No adverse reaction was observed. After treatment of CIK cells plus IL-2, the general conditions of 5 CLL patients were to different extent improved. Simultaneously, percentages of CD3(+), CD3(+)CD8(+), and CD3(+)CD56(+) cells in peripheral blood remarked by raised (P < 0.05), the serum level of β2 microglobulin was significantly declined (P < 0.05), and the frequency and degree of infection was also decreased (P < 0.05). Following CIK cells plus IL-2 therapy, the transformation of disease state from partial remission (PR) to complete remission was seen in 3 patients, from stable disease (SD) to PR in 1 patient, and from progress of disease to SD in 1 patient. It is concluded that the regimen of autologous CIK cells combined with low-dose IL-2 containing immune enhancement of thymic peptide is safety and effective for the treatment of elderly patients with B-CLL.
Aged ; Aged, 80 and over ; Cytokine-Induced Killer Cells ; immunology ; Humans ; Interleukin-2 ; administration & dosage ; therapeutic use ; Leukemia, Lymphocytic, Chronic, B-Cell ; therapy ; Male ; Thymosin ; immunology

The purpose of this study was to explore the clinicopathological features, therapy and prognostic factors of elderly patients with non-Hodgkin's lymphoma (NHL). The clinical data including general clinical characteristics, pathological features, chemotherapy selection and treatment response of 30 patients with NHL in our hospital from January 2003 to December 2012 were analyzed retrospectively. The survival was analyzed by using Kaplan-Meier methods, and the prognosis was evaluated by COX regression multivariate analysis model. The clinical parameters selected include age, Ann Arbor stage, international prognostic index (IPI), B symptom and lactate dehydrogenase (LDH) levels. The results showed that all the patients suffered from underlying disease, and the cardiovascular disease (hypertension, coronary heart disease, arrhythmia) is the most common, and minority (8/30) combined with secondary tumor, the 63% (19/30) cases had B symptoms at diagnosis. only 2 cases were diagnosed as T-cell lymphoma; the 93% (28/30) cases combined with B-cell lymphoma, 57% (17/28) of them combined with diffuse large B-cell lymphoma. Ann-Arbor stage ≤ IIwas 37% (11/30);10(37%) patient's IPI score was ≤ 2, and 67% (20/30) was scored 3-5; 13(43%) patient's serum LDH level was abnormal. Modified R-CHOP chemotherapy was given individually on the basis of clinical features. The patients achieved complete remission, partial remission, stable disease, or progressive disease accounted for 14 (46.7%), 13 (43.3%), 1 (3.3%), and 2 (6.7%), respectively; the total reaction rate was 90% after 4 cycles of chemotherapy; the overall survival (OS) rate at 1 and 2 years was 73.3% and 43.3%, and progression-free survival (PFS)rate at 0.5 and 1 years was 62.2% and 54.9%; multivariate analysis by COX regression showed that B symptoms and Ann-Arbor stage were independent factors (P = 0.014, 0.039; RR = 6.678, 4.939, respectively) affecting the OS of elderly NHL, and IPI score affected PFS independently. It is concluded that elderly patients with NHL usually are of late stage at newly diagnosis and have suffered from underlaying diseases. Besides strengthening supportive treatment, modified R-CHOP chemotherapy should be given individually according to different prognosis. B symptoms and Ann-Arbor stage >II are indicators for poor prognosis of elderly NHL.
Aged ; Aged, 80 and over ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; therapy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome