BACKGROUNDMarked interindividual variation exists in blood pressure response to benazepril, which is considered to have genetic basis. Our objectives were to evaluate whether the E112D polymorphism in the prolylcarboxypeptidase (PRCP) gene has impact on blood pressure response to benazepril.

METHODSHypertensive patients from Huoqiu County and Yuexi County of Anhui Province received daily treatment with an oral dosage of 10 mg benazepril for 15 days. Genotypes of the E112D polymorphism in the PRCP gene were determined by TaqMan SNP genotyping assay. Multivariate linear and Logistic regressions using generalized estimating equation model were performed in a total of 1092 patients to evaluate the association of PRCP genotypes and blood pressure response to benazepril.

RESULTSPatients carrying ED or DD genotype had a less systolic blood pressure reduction (adjusted beta = -3.7 + or - 1.1, P < 0.001), a less diastolic blood pressure reduction (adjusted beta = -3.1 + or - 0.8, P < 0.001) and a lower percentage of reaching target blood pressure defined as SBP lower than 140 mmHg and DBP lower than 90 mmHg (adjusted OR = 0.6, P = 0.005) than those patients carrying EE genotype. In addition, the results from stratified analysis by county (Huoqiu or Yuexi) were similar to those observed in the pooled population.

CONCLUSIONSOur data suggest that the E112D polymorphism in the PRCP gene may be a useful genetic marker to predict the antihypertensive effect of short-term benazepril treatment in hypertensive patients of Anhui Province, China.

Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Benzazepines ; therapeutic use ; Blood Pressure ; drug effects ; Carboxypeptidases ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Hypertension ; drug therapy ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; genetics ; physiology ; Young Adult

OBJECTIVETo measure the diameter of T4 pedicle-rib compomers in normal human spines and discuss the importance of related dates.

METHODST4 computerized tomography (CT) images,including two-dimensional,three-dimensional reconstruction, of 12 random adult patients were harvested. There were 7 males and 5 females with a mean age of 23 years (ranged, 19 to 28 years). The patients were divided into groups by self control,which means the diameter of pedicle compared with that of pedicle-rib unit in the same side of each T4. The facility was GE light speed 16. Measurement of the body specimens from T3 to T5 . The parameter included the width of pedicle-rib unit compared with pedicle,the longitudinal diameter of pedicle-rib unit compared with pedicle, especially for the pedicle-rib overlap.

RESULTSThe relationship of T4 pedicle and rib were not on the same level but overlapping. The width of pedicle-rib unit was significantly larger than that of pedicle (P<0.05). The longitudinal diameters of pedicle-rib unit or pedicle were significantly larger than those of pedicle-rib overlap (P<0.05); while there was no significantly difference between the pedicle-rib unit and pedicle (P>0.05).

CONCLUSIONThe overlapping relationship of T4 pedicle and rib is partly but not whole, which means the longitudinal diameter of T4 pedicle-rib overlap should not be considered as the same of unit or pedicle.

Adult ; Female ; Humans ; Male ; Ribs ; anatomy & histology ; Thoracic Vertebrae ; anatomy & histology ; Tomography, X-Ray Computed ; Young Adult

The influences of E23K polymorphism of inwardly rectifying K~+channel 6.2 (Kir6.2) gene on the clinical phenotype of type 2 diabetes and glucose-lowering effect of gliclazide were investigated.The result showed that E23K polymorphism did not influence glucose-lowering effect of gliclazide,but serum creatinine level of patients with K/K genotype was higher than those of E/E and E/K genotypes (P

OBJECTIVESTo investigate the spatial structure of pedicle rib units in normal thoracic human spines and to compare the dimensions of the pedicle rib unit with corresponding dimensions.

METHODSThoracic spine specimens in four fresh adult cadaveric were used. Computerized tomographic (CT) images (including two-dimensional, three-dimensional reconstruction) of the thoracic spines were obtained. Measurement parameters include:the width, the height, the chord length and the sagittal angles of the pedicle rib unit compared with pedicle, especially for the pedicle-rib overlapping height.

RESULTSThe pedicle rib unit was not a simple two-dimensional structure but a three-dimensional structure. The shortest height of pedicle rib unit was (12.6 ± 0.8) mm (T(1)), while the longest was (16.9 ± 1.1) mm (T(11)). The shortest height of pedicle-rib overlap was (7.2 ± 0.3) mm (T(1)), while the longest was (11.8 ± 1.0) mm (T(10)). The height of pedicle rib unit and the height of pedicle were significantly larger than that of the pedicle-rib overlap (P < 0.05), while there was no significantly difference between the height of pedicle rib unit and the height of pedicle (P > 0.05).

CONCLUSIONSThe pedicle rib unit is a complicated spatial structure, and the longitudinal height of pedicle-rib overlap should be taken as the real height of the unit.

Adult ; Bone Screws ; Humans ; Male ; Radiography ; Ribs ; anatomy & histology ; diagnostic imaging ; Thoracic Vertebrae ; anatomy & histology ; diagnostic imaging ; surgery

OBJECTIVETo discuss the prevention and management of the neurological complications during treatment for severe scoliosis.

METHODSSeventy-one patients with the coronal Cobb angle more than 80 degrees underwent operation. The average coronal Cobb angle was 96.6 degrees (80 degrees - 135 degrees ), and 31 patients combined with kyphotic deformity with average sagittal Cobb angle 83.0 degrees (52 degrees - 145 degrees ). Fourteen patients were treated with posterior pedicle screw fixation alone, 21 combined with posterior wedge resection, 34 with staged operation, and 2 with combined anterior and posterior approach. Intraoperative somatosensory evoked potentials (SEP) monitoring and wake up test were used in 61 cases, and wake up test was used alone in 10 cases.

RESULTSThe average coronal curve correction was 59.2% (average 39.6 degrees ) and sagittal curve correction was 61.6% (average 31.9 degrees ). Thirty-nine patients were followed up with average 51 months (5 - 81 months). Among them, 33 patients achieved solid spinal fusion and the rate of correction loss was 2.1%. Two patients underwent reoperation because of the breakages of the internal fixation. Among 8 patients with neurological dysfunction pre-operatively, 3 patients obtained complete recovery, 1 patient incomplete recovery, and the rest had not recovered because of post-poliomyelitis syndrome. Four of 5 patients developed neurological dysfunction post-operatively obtained complete recovery and 1 partial recovery.

CONCLUSIONSHalo-pelvic distraction and apical vertebra osteotomy are useful for increasing the correction rate and decreasing the neurological dysfunction. Intraoperative SEP monitoring combined with wake up test can call attention to early nerve injury. Early using of glucocorticoids and dehydration therapy promptly post-operatively is benefit to prevent neurological complications.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Monitoring, Intraoperative ; Nervous System Diseases ; etiology ; prevention & control ; therapy ; Osteotomy ; methods ; Postoperative Complications ; prevention & control ; therapy ; Scoliosis ; pathology ; surgery ; Traction ; methods

OBJECTIVETo introduce a new kind of grade system for thoracic pedicle screws placement by performing postoperative computerized tomography (CT) scanning and discussion the clinical purpose.

METHODSFour hundred and fifty thoracic pedicle screws were implanted in 64 patients with the assistance of fluoroscopy. Postoperative CT scanning was conducted to determine a grade for each screw: Part A, screw entirely contained within pedicle; Part B(1), violate lateral or upper pedicle but screw tip entirely contained within the vertebral body (VB); Part B(2), violate medial or inferior of pedicle; Part B(3), tip penetrated anterior or lateral VB; Part C, violate pedicle or VB and endangers spinal cord, nerve roots, or great vessels. Based on anatomical morphometry, thoracic vertebral were subdivided into upper (T(1 - 2)), middle (T(3 - 6)), and lower (T(7 - 12)) regions. The mean follow-up period was 25.8 months.

RESULTSThe postoperative CT scanning-documented grade were determined: Part A, 367 screws (81.6%); Part B, 78 (17.3%), B(1) 40 (8.1%); Part B(2), 23 (5.1%); Part B(3), 15 (3.4%); Part C, 5 (1.1%). There were not significant difference between upper and lower thoracic that the placement of pedicle screws in part B or C. In part C, 5 pedicle screws were all in the middle thoracic.

CONCLUSIONPostoperative CT scanning should be considered as a routine examination for evaluating thoracic pedicle screw placement.

Adolescent ; Adult ; Aged ; Bone Screws ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Spinal Fusion ; instrumentation ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; methods

BACKGROUNDAlthough the first leading cause of death in China was malignant neoplasms (mortality, 374.1 per 100,000 person-years), the full impact of primary brain tumors (PBT) on the healthcare system is not completely described because there are a few well documented reports about the epidemiologic features of brain tumors. This study aimed to report a comprehensive assessment on the prevalence of PBT.

METHODSA multicenter cross-sectional study on brain tumor (MCSBT) in China was initiated in five regional centers: Daqing (northeast), Puyang (north of China), Shiyan (center of China), Ma'anshan (center of China) and Shanghai (southeast). Prevalence rate was calculated by counting the number of people living with a PBT between October 1, 2005 and September 30, 2006 and dividing by the total population of the five communities at January 1, 2006. Estimates of prevalence were expressed as percentages and grouped according to gender and to age in fifteen-year categories. Within these strata, the rates were estimated with 95% confidence intervals (CI) using the accurate calculation of CI for Poisson distribution. A chi-square test was used to compare the various frequencies with α < 0.05. Age-standardized prevalence with the direct method was calculated with the ten-year age-specific prevalence and the age distribution of the Chinese population in 2010, obtained from World population prospects: the 2008 revision.

RESULTSWe estimated that the overall prevalence of PBT was 24.56 per 100,000 (95%CI, 14.85 to 34.27), and the overall prevalence of PBT in female population (30.57 per 100,000 and its 95%CI ranged from 19.73 to 41.41) was higher than that in male population (18.84 per 100,000 and its 95%CI ranged from 10.33 to 27.35). However, the discrepancy between genders was not statistically significant because the 95%CI overlapped. Of 272 cases of newly diagnosed PBT, the proportion of histological subtypes by age groups, gender was statistically different (χ(2) = 52.6510, P < 0.0001). More than half of all reported tumors (52.57%) were either gliomas or meningiomas. For the youngest (aged from 0 - 19) strata of the population, glioma appeared to occur more than other subtypes, accounting for 55.56% of all of cases. The majority of brain tumors presented in those aged from 20 to 59 years was pituitary adenomas (45.12%) and gliomas (31.10%). Opposed to brain tumors in adults and teenage, gliomas only accounted for 22.22%. Meanwhile, the median ages at diagnosis of the patients with PBT were similar between males and females except for pituitary adenomas (male: 59 years old; female: 45 years old).

CONCLUSIONSAge standardized prevalence of PBT is 22.52 per 100,000 (95%CI, 13.22 to 31.82) for all populations, 17.64 per 100,000 (95%CI, 9.41 to 25.87) for men, and 27.94 per 100,000 (95%CI, 17.58 to 38.30) for women. Age standardization to China's 2010 population yielded an estimated population of 304 954 cases with PBT. Our prevalence estimates provide a conservative basis on which to plan health care services and to develop programmatic strategies for surviving. In the future, it would be helpful to have long-term observed survival rates that would make the assumptions and the resulting imprecision in the current estimates unnecessary.

Adolescent ; Adult ; Age Distribution ; Aged ; Brain Neoplasms ; diagnosis ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Young Adult