Objective To observe the clinical effect of resin adsorbing devices combined with hemodialysis in the treatment for renal osteopathy in chronic renal failure patients undergoing maintenance hemodialysis.Methods Fifty two patients undergoing maintenance hemodialysis for at least 2 years,admitted from January 2004 to October 2006,were divided into three groups:group A,resin adsorbing devices combined with hemodialysis group(HP+HD);group B,hemodiafiltration group(HDF+HD);group C,active vitamin D peroral group(Oral vitamin D+HD).The changes in serum parathyroid hormone(iPTH)and phosphorus,urea nitrogen(BUN),creatinine(SCr),hemoglobin(Hb)were compared among the three groups before and after the treatment.Results No significant difference was found in BUN,SCr,and Hb contents among the three groups before and after the treatment.Compared with the data before the treatment,iPTH and phosphorus were decreased significantly after 12 weeks of treatment in group A(P

Objective To develop a chemiluminescence imaging DNA microarray method for simultaneous,quick and accurate detection of serotypes of human adenovirus (HAdV ),namely,HAdV3,HAdV7,HAdV11,HAdV14 and HAdV55.Methods Based on the specific gene sequences in the conserved region of adenovirus from GenBank, oligonucleotide primers and probes were designed and synthesized to prepare the oligonucleotide microarray.The specific genomic sequences were amplified by multiplex PCR method.The multiplex PCR amplification products were hybridized with the specific probes of microarray that was scanned after washing and chemiluminescenceb before the result was analyzed.After optimization of the multiple PCR system,hybridization reactions and conditions of chemiluminescence,the specificity,sensitivity and reproducibility of the chip were evaluated.Results The microarray displayed high sensitivity, specificity and reproducibility.The minimum detection limit of plasmidg DNA was 3 ×103 copies/reaction.The microarray detection results of 38 clinical samples were approximately consistent with those using the direct sequencing method(37 /38).Conclusion A chemiluminescence imaging DNA microarray method for quick,sensitive and specific detection of five serotypes of HAdV is established,which can provide a new means for detecting serotypes of HAdV.

Objective To investigate the effects and possible mechanism of Fructus lycii on renal calcium oxalate stone formation in rats. Methods Wistar rats were divided into several groups according to different stone inducer (cigarette smoking, ethylene glycol solution drinking or combination of both), either Fructus lycii infusion interference or not and different interfering concentrations (10% and 25%). Besides, a blank control group was set. After treatment for 40 d, 24 h urine was collected, and renal tissue samples were obtained. The concentrations of calcium, oxalate and citric acid in urine were measured. The deposit condition of calcium oxalate crystals in nephric tubules was observed and scored. The levels of malondialdehyde (MDA) and activity of total-superoxide dismutase (T-SOD) in renal tissues were detected. Apoptosis cells in kidney were observed with TUNEL staining, and index of apoptosis was calculated. Results Compared with blank control group, the urine calcium concentration in group of combination of cigarette smoking and ethylene glycol solution drinking were significantly higher (P<0.01), the scores of calcium oxalate crystals in renal tubules, the levels of MDA in renal tissues and the index of apoptosis of renal tubule epithelial cells in groups of ethylene glycol solution drinking and combination with smoking were higher, while the concentrations of citric acid in urine and activity of T-SOD in renal tissues were lower. Ten percent and 25% Fructus lycii infusion significantly decreased the urine concentrations of calcium in group of combination of cigarette smoking and ethylene glycol solution drinking (P<0.01), decreased the scores of calcium oxalate crystals in renal tubules, the levels of MDA in renal tissues and the index of apoptosis of renal tubule epithelial cells in groups of ethylene glycol solution drinking and combination with smoking, and increased the concentrations of citric acid in urine and activity of T-SOD in renal tissues. There was no significant dose-effect relationship between two concentrations of Fructus lycii infusion. Conclusion Fructus lycii infusion can effectively inhibit the formation of renal calcium oxalate stone in rats with smoking and/or ethylene glycol drinking by reducing the free radicals and apoptosis of renal tissue, decreasing the concentration of elements for stone formation and increasing the concentration of elements for inhibition of stone formation in urine.

Objective To evaluate the efficacy and adverse effect caused by capecitabine compared with S-1 as maintenance treatment of patients with advanced gastric cancer (AGC). Methods A total of 123 AGC patients who did not suffer disease progression after first-line chemotherapy were randomized into three groups. The capecitabine group(Cap)received maintenance chemotherapy with capecitabine(1000 mg/m2 twice daily for 14 days,21 days/cycle),and the S-1 group(S1)received S-1(40,50,or 60 mg according to the body surface area and orally administered twice a day for 14 days ,21 days/cycle). The observation group was given the support-ive treatment. Patients kept this chemotherapy regimens until disease progressed or with intolerant toxicity. Re-sults The disease control rate was 70.7%in the Cap group and 80.5%in the S1 group(P=0.304). The median time of progression was 8.3 months in the Cap group and 8.5 months in the S1 group(P = 0.448). Maintenance chemotherapy groups showed better responses in the treatment group than the observation group ,which demonstrat-ed a median progression of 6.7 months(P<0.001). The median overall survival time was 15.3 months in the Cap group and 15.7 months in the S1 group(P = 0.637). Maintenance chemotherapy groups showed better responses than the observation group ,which demonstrated a median survival of 12.8 months (P < 0.05). The main side effects included hyperpigmentation,bone marrow suppression,nausea and vomiting and hand-foot syndrome. No death occurred in relation to the therapy. Conclusion The effectiveness of capecitabine and S-1 as maintenance chemotherapy in AGC patients after the first-line chemotherapy are similar,and both can prolong the time of overall survival. And the adverse reactions can be tolerated.

Objective To develop a detection method based on the technology of gene chips which can quickly distinguish genes of Enterococcus faecalis, E.faecium and vancomycin resistance.Methods Based on the specific gene ( ddl) sequences of two types of Enterococcus from GenBank, oligonucleotide probes which could detect and distinguish special genes and drug resistance genes ( vanA,vanB) of Enterococcus were designed and compounded.Then,the probes were dotted to modified slide.The target DNA fragments of vancomycin-resistant Enterococcus ( VRE) were labeled with biotin by multiple PCR amplification, and then hybridized with oligonucleotide probes on slide.The results were analyzed by portable imager.The multiple PCR system, hybridization reaction and condition of the chemiluminescence method were optimized before the specificity, sensitivity and reproducibility of the chip were evaluated.Results One universal primer, four specific primers, one universal probe and four specific probes were selected.This gene chip was demonstrated of high specificity and repeatability.The detection sensitivity was 103 CFU/ml.The gene chip detection results of 10 clinical samples were basically consistent with the drug sensitivity test ( 8/10 ) .Conclusion A gene chip technique for the detection of VRE is established successfully.It is possible to distinguish the type of VRE and detect the genetic phenotypes of drug resistance by gene chip technique.

OBJECTIVE: To explore the technique of autogenous bone graft combined with plate fixation in total knee arthroplasty(TKA) with severe proximal medial tibial bone defect. METHODS: From March 2012 to October 2018, 21 patients (9 males and 12 females) with severe bone defects in the proximal medial tibia during primary total knee arthroplasty were treated with autogenous structural bone grafting and steel plate fixation, with an age of 61 to 77 years old with an average of (69.6±9.1) years and a course of 64 to 257 months with an average of (73.6±170.7) months. According to Rand classification, there were 13 cases of type Ⅲb and 8 cases of type Ⅳb. Postoperative complications were observed, and knee joint function was evaluated by the Hospital for Special Surgery (HSS) score and SF-36 quality of life score. RESULTS: All 21 patients were followed up for 37 to 64 months with an average of (49.5±13.7) months. The incisions of all patients healed smoothly, and 2 patients developed lower limb intermuscular venous plexus thrombosis after operation. There were no periprosthetic infection, loosening of prosthesis and other complications. The autogenous bone grafts of all patients achieved bony healing during postoperative X-ray follow-up, and the healing time was 8 to 13 months with an average of (10.1±2.3) months. The HSS score of patients increased significantly from 30 to 48 with an average of (53.4±4.2) before operation to 75 to 92 with an average of (81.2±8.4) at the final follow-up (P<0.05). The SF-36 quality of life score of patients after operation was significantly different from that before operation (P<0.05). CONCLUSION The technique of autogenous bone graft combined with steel plate fixation can achieve satisfactory osseointegration effect in the treatment of severe proximal tibial bone defects in primary knee arthroplasty, with less complications and obvious improvement in knee function.
Male ; Female ; Humans ; Middle Aged ; Aged ; Arthroplasty, Replacement, Knee/methods* ; Tibia/transplantation* ; Bone Transplantation/methods* ; Quality of Life ; Transplantation, Autologous ; Steel

To construct a recombinant plasmid Pet23a-M, the gene encoding severe acute respiratory syndrome (SARS) coronavirus membrane protein was amplified by RT-PCR and cloned into the expression plasmid Pet23a. Results of restriction endonuclease analysis, PCR detection and DNA sequencing analysis revealed that the cloned DNA sequence was the same as that reported. The recombinants were transformed into Escherichia coli (E. Coli) BL21 (DE3) and induced by Isopropyl-beta-D-thiogalactopyranoside (IPTG). The expression of 27 kD (1 kD=0.992 1 ku) protein was detected by SDS-PAGE and pured by metal chelated chromatography. Results of Western-blot showed that this expressed protein could react with antibodies in sera of SARS patients during convalescence. This provided the basis for the further study on SARS virus vaccine and diagnostic agents.
Cloning, Molecular ; Escherichia coli/genetics ; Escherichia coli/metabolism ; Membrane Proteins/*biosynthesis ; Membrane Proteins/genetics ; Membrane Proteins/isolation & purification ; Plasmids/biosynthesis ; Plasmids/genetics ; Recombinant Proteins/biosynthesis ; Recombinant Proteins/genetics ; Recombinant Proteins/isolation & purification ; Reverse Transcriptase Polymerase Chain Reaction ; SARS Virus/chemistry ; SARS Virus/*genetics ; Viral Vaccines/biosynthesis

Objective To study the FMS-like tyrosine kinase-3 (FLT3) gene, NPM1 gene and c-kit gene mutations in acute myeloid leukemia (AML) by extracting DNA from the storage of bone marrow slides, and to investigate the relationship between the three gene mutations and clinical features in AML. Methods The bone marrow slides of 55 patients diagnosed with AML were enrolled in this study. The PCR, DNA sequencing and molecular cloning were used to detect and analyse the FLT3-ITD, NPM1 and c-kit gene mutations. Patients' remission, progression and survival time were also recorded. Results The DNA was successfully extracted from the bone marrow slides with -20 ℃ frozen storage without Wright stained, chemically fixed, and room temperature storage Wright stained discoloured by phenol ∶ chloroform ∶ isoamyl alcohol method, which can be used in PCR, direct sequencing and molecular cloning sequencing analysis. 10 of the 55 cases (18.2 %) were FLT3-ITD positive, including 9 cases with heterozygous mutations and 1 case with homozygous mutation. FLT3-ITD positive group had lower complete remission (CR) rate, shorter event-free survival (EFS) time and overall survival (OS) time than the negative group (P< 0.05). 9 of the 55 cases (16.4 %) had NPM1 heterozygous gene mutations, all belonging to type A. The EFS rate of the patients with NPM1 mutation was higher in 10 months and the OS rate was higher in 19 months (P< 0.05). 3 of 9 NPM1 mutations patients were FLT3-ITD positive. The CR rates of the four groups after initial remission induction therapy in order were NPM1+FLT3-ITD-, NPM1-FLT3-ITD-, NPM1-FLT3-ITD+, NPM1+FLT3-ITD+(P<0.05). Besides, NPM1-FLT3-ITD+was a risk factor affecting the OS (RR=1.250, P=0.005). 2 of the 55 cases (3.6 %) had c-kit gene mutations, namely mutant D816H and mutant D816V. The c-kit gene mutations were not found in patients with FLT3-ITD and NPM1 mutations. Conclusions The FLT3-ITD mutation is a poor prognosis molecular marker in AML, and NPM1 mutation is a good factor for the prognosis. NPM1-FLT3-ITD+is a risk factor affecting OS. The rate of c-kit gene mutation is low in AML, without the overlap of FLT3 and NPM1 mutations.

Objective To evaluate image quality of 3D-FIESTA-C sequence displaying lumbar spinal nerves and intervertebral discs in patients with low back pain.Methods Routine protocol for lumbar MRI examinations (sagittal IDEAL,sagittal T1 WI and axial T2 WI sequences)and sagittal 3D-FIESTA-C sequence were performed in 40 patients with low back pain.The MPR of the 3D-FIESTA-C images were used for further analysis.Two radiologists scored the different sequences of images independently.The SNR and the CNR between spinal nerves and cerebrospinal fluid were calculated at 3D-FIESTA-C,IDEAL,T2 WI sequences.Results The image scores of 3D-FIESTA-C (4.77±0.42)was higher than that of the routine protocol (3.00±0.32),and the difference was statistically significant (P＜0.0 1 ). For 3D-FIESTA-C,IDEAL and T2 WI sequences,the SNR of the spinal nerves was 33.07±12.29,39.91 ±18.16,27.40±10.34,respectively,and there was no statistical difference between 3D-FIESTA-C and IDEAL,3D-FIESTA-C was better than T2 WI (P＜0.05).The SNR of cerebrospinal fluid was 26 9.1 5 ±70.30,21 3.1 3±40.52,1 1 9.25 ±35.1 5 ,respectively,and 3D-FIESTA-C was better than IDEAL,T2 WI sequences (P＝0.000).The CNR between spinal nerves and cerebrospinal fluid was 235.92±62.04,172.69±38.75,91.85±30.62,respectively,and 3D-FIESTA-C was better than IDEAL,T2 WI sequences (P＝0.000).Conclusion The 3D-FIESTA-C sequence could display spinal nerves and the relative spatial relationship between the spinal nerves and the intervertebral discs,and addition of a 3D-FIESTA-C sequence to a routine lumbar MR protocol may be useful in patients with low back pain.

Objective:This article explores the treatment of stage I thoracoscopic segmentectomy and lobectomy. The clinical efficacy of non-small cell lung cancer is to provide relevant evidence for clinical decision-making.Method:Computer searches were conducted on PubMed, the Cochrane Library, Embase, Web of Science, Science Direct, Ovid Medline, Scopus database, and Google Scholar. The search time was from the establishment of the library to March 2019. A comparative study of thoracic segmental resection and lobectomy for clinical stage I NSCLC was performed and meta-analysis was performed using Revman 5.3 software.Restlus:A total of 16 retrospective clinical controlled studies were included in the study, with a total of 2 090 patients, including 696 in the thoracoscopic segmental resection group and 1 394 in the thoracoscopic lobectomy group. Meta-analysis showed that for clinical stage Ⅰ NSCLC, the incidence of complications after laparoscopic resection and lobectomy( RR=0.78, 95% CI: 0.59-1.02, P=0.07), postoperative recurrence rate( RR=0.78, 95% CI: 0.52-1.17, P=0.23), postoperative hospital stay( MD=-0.27, 95% CI: -0.58 to -0.05, P=0.10) and 5-year survival rate( RR=0.94, 95% CI: 0.87-1.03, P=0.17), tumor-free survival time( RR=0.95, 95% CI: 0.92-1.09, P=0.34), operation time( MD=-0.43, 95% CI: -10.10-9.25, P=0.93) The difference was not statistically significant, but laparoscopic lung segmentectomy can reduce intraoperative blood loss( MD=-23.81, 95% CI: -42.00 to -5.63, P=0.01), shortening Posterior chest tube drainage time( MD=-0.31, 95% CI: -0.51 to -0.12, P=0.002), but in the lymph node dissection, the segmentectomy was less than the lobectomy, the number of lymph node dissection( MD=-4.89, 95% CI: -7.57 to -2.20, P=0.0004). Percentage of postoperative/preoperative FVC%( MD=7.50, 95% CI: 5.81-9.18, P<0.00001) and 1-year postoperative/preoperative FEV1%( MD=8.26, 95% CI: 6.43-10.09, P<0.00001). The difference was statistically significant. Conclusion:In The course of clinical stage I NSCLC treatment, the two procedures were similar in terms of postoperative complications, operation time, recurrence rate, 5-year survival rate, tumor-free survival time and hospital stay, and fewer lung segments in lymph node dissection. In lobectomy, thoracoscopic segmental resection is better in terms of intraoperative blood loss and postoperative chest drainage time. Thoracoscopic segmentectomy may be more suitable for early stage non-small cell lung cancer. treatment method.