Objective To investigate the correlation of plasma homocysteine(Hcy)level and the polymorphisms of its key metabolic enzymes methylenetetrahy-drofolate reductase(MTHFR)gene with ischemic stroke(IS).Methods A total of 310 patients with IS were enrolled as the case group and 330 healthy subjects during the same period were selected as the control group.Plasma Hcy concentration was detected by enzyme cycling method,and the real-time fluorescent quantitative PCR(RT-qPCR)was used to detecte the genotypes of MTHFR C677T.Results The frequencies of TT genotype(36.13%),CT genotype(10.00%)and T allele(28.06%)of MTHFR gene C677T locus in stroke patients were significantly higher than that in control group(P＜0.05).The frequency of the TT genotype was significantly higher in IS group compared to control group,indicating a recessive mode of inheritance(P＜0.05);In the dominant mode of inheritance,the frequency of CT+TT genotype in IS group was also significantly higher than that in control group(P＜0.05);The plasma Hay concentration of MTHFR C677T genotype TT,CT and CC patients was statistically different(P＜0.05),which were(20.91±6.78)μmol/L(17.20±5.39)μmol/L,(14.35±4.32)μmol/L,respectively;The area under the ROC curve(AUC)of plas-ma total Hcy level was 0.610(95%CI:0.566～0.653,P＜0.001).It indicated that it might play an impor-tant role in predicting the risk of suffering from IS.Multivariate Logistic regression analysis showed that plasma Hcy level and MTHFR C677T gene polymorphism were important risk factors of IS.Conclusions Elevated plasma Hcy level is associated with IS,and the synergistic effect of elevated Hcy level and MTHFR C677T gene mutation may increase the risk of IS.

Objective To investigate the relationship between methylenetetra-hydrofolatereductase(MTHFR)gene polymorphism and serum homocysteine(Hcy)level and subtypes of ischemic stroke(IS).Methods The study was conducted according to the matched principle of case-control design,310 patients with IS and 330 healthy people during the same period were selected as the case group and the control group.Recycling enzyme method and the real-time fluorescent quantitative PCR(RT-qPCR)method were used to detect the level of serum Hcy and the genotypes of MTHFR C677T,respectively.Results There was a significantly difference in MTHFR C677T genotype and allele frequency between the case and control groups(P＜0.05).The correlation analysis with different subtypes indicated that the frequencies of CT genotype(38.02%),TT genotype(10.74%),and T allele(29.75%)were significantly different in the LAA group(OR=1.662,95%CI:1.058-2.608,P＜0.05;OR=2.373,95%CI:1.110-5.073,P＜0.05;OR=1.663,95%CI:1.190-2.323,P＜0.05);The frequencies of TT genotype(10.53%)and T allele(27.30%)in SAO group were also significantly different(OR=2.130,95%CI:1.046-4.336,P＜0.05;OR=1.474,95%CI:1.075-2.021,P＜0.05).Further analysis of serum Hcy level showed that LAA group(19.55±5.61)μmol/L and SAO group(16.37±5.20)μmol/L were significantly higher than the control group(14.46±4.61)μmol/L(P＜0.001);Among the patients of both subtypes the serum Hcy levels in those with CT genotypes and TT genotypes were significantly higher than those in patients of CC genotypes(P＜0.001).Conclusions The gene polymorphism of MTHFR C677T has a significant effect on Hcy level in pa-tients with LAA and SAO stroke.

Objective To investigate the efficacy of conventional laparoscopy and mini-laparoscopic surgery in the treatment of endometriosis(EM). Methods From September 2015 to November 2016, 35 cases of endometriosis were treated with mini-laparoscopic surgery(mini group,15 cases)or conventional laparoscopic surgery(conventional group,20 cases)in Beijing Huafu Women&Children's Hospital.The peri-operative parameters,incidence of complications, and symptom relief rate were observed in both groups. Results The operation time was(68.2 ±2.1)min in the mini group,which was significantly shorter than that in the conventional group[(78.4 ±2.3)min,t=13.468,P=0.000].The intraoperative blood loss was significantly less in the mini group (12.1 ±6.7)ml than that in the conventional group[(21.4 ±7.8)ml, t=-3.703, P =0.000].The recovery time of gastrointestinal function was significantly lower in the mini group(21.5 ±7.6)h than that in the conventional group[(28.6 ± 7.4)h,t=-2.777, P=0.009].The hospital stay was significantly shorter in the mini group(2.7 ±1.1)d than that in the conventional group[(3.7 ±1.1)d,t=-2.662,P=0.012].The incidence of postoperative complications was 6.7%(1/15)in the mini group,which was significantly lower than that in the conventional group[40.0%(8/20), Fisher exact test, P =0.048]. Postoperative pathology:the mini group had 6 cases of deep infiltration type EM, 9 cases of pelvic EM, and 7 cases of ovarian chocolate cysts; the traditional group had 13 cases of deep infiltration type EM, 7 cases of pelvic EM, and 10 cases of ovarian chocolate cysts.The follow-up time was 3-9 months,including 15 cases in the mini group for(6.2 ±2.8)months and 20 cases in the conventional group for(6.8 ±2.6)months.There was no significant difference between the two groups in symptom relief rate[93.3%(14/15)vs.85.0%(17/20)]and the recurrence rate[20.0%(3/15)vs.20.0%(4/20), Fisher exact test, P=0.619 and 1.000]. Conclusion Mini-laparoscopic surgery for EM has advantages of small incision, shorter hospital stay, and less postoperative complications,being worthy of clinical promotion.

OBJECTIVETo investigate Lanzhou area cases of hepatitis C virus (H-CV) infection with a 5'-non coding region (NCR) 2i genotype and core (C), envelope protein (E) and non-structural protein (NS5) 2a genotype and the relationship with therapeutic response to interferon-alpha (IFNa).

METHODSNine patients who received IFNa-based treatment for HCV between 2007 and 2009 at the Second People's Hospital of Gansu Province were selected for analysis.Restriction enzyme analysis was carried out for the 5'-NCR and sequencing was carried out for the other gene areas.The relationship between genetic variants and IFNaresponse was examined.

RESULTSOf the total nine HCV cases treated with IFNa-based therapies, five of the patients achieved sustained virological response (SVR), which included two cases with type 2 genotype and three cases with no MboI restriction enzyme point of tangency (i.e.type 1b). The remaining four patients that did not achieve SVR included one case of type 2a, with a 1b and 2a mixed state, and one case with 5'-NCR 2i genotype and C area, NS5 area 2a genotype; the other two cases had 5'-NCR and C area type 1b. Of the five cases with 5'-NCR 2i genotype, all had C 2a genotype and two had C/E 2a and NS5 2a genotypes.The seven patients that showed no response to ordinary IFNa were converted to long-term IFNa plus ribavirin combination antiviral treatment; five (71.4%) of the cases showed response in HCV RNA level and the patients treated with the pegylated form showed greater response.

CONCLUSIONHCV genotyping can only provide information on the particular region of gene sequence examined, and it is important to sequence all gene regions where mutations related to antiviral drug response are located. Peg-IFNa-2a combined with ribavirin may achieve better therapeutic effect in patients infected with 2i/2a recombinant forms of HCV.

Angiogenesis Inhibitors ; Antiviral Agents ; Drug Therapy, Combination ; Genetic Variation ; Genotype ; Hepacivirus ; genetics ; Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-alpha ; Open Reading Frames ; Polyethylene Glycols ; Recombinant Proteins ; Recombination, Genetic ; Ribavirin ; Treatment Outcome

Objective To explore the characteristics and effects of interventional therapy of transplant renal artery rupture of donation after citizens death (DCD).Method Among 28 cases of DCD renal transplantations (from February 2012 to December 2013),the transplant renal artery rupture occurred in 4 cases.Vascular complications were treated with the guide wires to place stents in the pseudoaneurysms or bleeding period.Result Pseudoaneurysms occurred in 2 cases,and they were successfully discharged after interventional treatment.In the rest two patients,the artery residual ruptured and bled after the nephrectomy,and they recovered after interventional treatment to stop bleeding.Conclusion For kidney transplant recipients,the DCD postoperative infection is risky.Some transplant kidneys have local infection and erosion of renal artery,which causes arterial hemorrhage.The interventional treatment of transplant renal artery pseudoaneurysms and rupture bleeding has the advantages of small trauma and instant effect,and can be used as an alternative treatment of open surgery.

Objective To investigate the circulating levels of platelet-leukocyte aggregates (PLA) in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods The circulating levels of platelet-neutrophil aggregates (PNA) and platelet-monocyte aggregates (PMA) were quantified in 30 patients with DEACMP (DEACMP group) and 30 patients with acute carbon monoxide poisoning (ACOP group) by using flow cytometry assay,whose results were compared with those of 20 healthy subjects (controls).Results Circulating PNA and PMA levels in DEACMP group and ACOP group at acute stage were significantly higher than those in controls,respectively (P＜0.05),while no significant difference was noted between ACOP group and DEACMP group at acute stage (P＞0.05),indicating that platelets were in activation status and PLA levels raised significantly in patients with DEACMP and ACOP at acute stage.Circulating PNA and PMA levels were significantly higher in DEACMP group at acute stage than those in DEACMP group at stable stage (P＜ 0.05),suggesting that platelet activation were controlled after the illness state were stabilized in patients with DEACMP.Conclusion Platelet is involved in the pathogenesis of DEACMP and the change trend of circulating PLA levels is basically consistent with illness state.

To investigate the relationship between platelet-leukocyte aggregates (PLA) and serum high sensitive C-reactive protein (hs-CRP)in type 2 diabetic patients with retinopathy (DR).The blood levels of platelet-neutrophil aggregates( PNA )and platelet-monocyte aggregates ( PMA ) were determined by flow cytometry and serum hs-CRP by ELISA in 30 patients with proliferative diabetic retinopathy( PDR group),30 patients with no-proliferative diabetic retinopathy( NPDR group),25 diabetic patients without DR( DM group),and 30 normal controls.The levels of PNA,PMA,and hs-CRP in PDR group were significantly higher than those in normal control,NPDR,and DM groups.The levels of PNA,PMA,and hs-CRP in NPDR group were significantly higher than those in normal control and DM group( P＜0.01 or P＜0.05 ).The PNA and PMA were correlated positively with hs-CRP in patients with DR ( r =0.587,0.576 ; P ＜ 0.05 ).The data showed that the levels of PLA and hs-CRP were raised significantly in patients with DR,and the levels of PLA were positively correlated with inflammatory response and the seriousness of DR,suggesting that these findings may play an important role in the development of DR.