Objective To explore the relationship between serum 25-hydroxy vitamin D 3 level and carotid atherosclerosis plaque in elderly patients with type 2 diabetes .Methods 308 elderly patients with type 2 diabetes were selected .The carotid artery intimal plaque was measured .According to the characteristics and size of plaque ,they were divided into the medium/big group,small plaque group and no plaque group .Blood pressure,body mass index (BMI),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),blood lipids,c-reactive protein(CRP)and the concentration of serum 25-hydroxy vitamin D 3 were detected .The risk factors forcarotid atherosclerosis plaque were analyzed,exploring the the relationship between serum 25-hydroxy vitamin D3 level and carotid atherosclerosis plaque . Results Age,CRP(4.21 ±1.61) mg/L in the medium/big group was significantly higher than those of the small plaque group(3.41 ±1.92)mg/L and the no plaque group(2.52 ±1.18)mg/L(t=1.96,3.14,all P<0.05).The level of serum 25-hydroxy vitamin D3 in the medium/big group(15.28 ±5.86)nmol/L was significantly less than that of the small plaque group(24.30 ±7.60)nmol/L and the no plaque group(32.74 ±8.13)nmol/L(t=4.67,3.41,all P<0.01).The level of serum 25-hydroxy vitamin D3 in the small plaque group was significantly less than that of the no plaque group(t=2.51,P<0.05).There was positive correlation between carotid atherosclerotic plaques and age , BMI,HbA1c,CRP and LDL-C( r=0.45,0.38,0.53,0.47,all P<0.05).There was negtive correlation between carotid atherosclerotic plaques and 25-hydroxy vitamin D3(r=-0.62,P<0.05).Logstic regression analysis showed that age,BMI,HbA1c,CRP,LDL-C and 25-hydroxy vitamin D3 were independent risk factors for the development of carotid atherosclerotic plaque .Conclusion The risk factors for carotid atherosclerotic plaques in elderly patients with type 2 diabetes are age,BMI,HbA1c,CRP,LDL-C and 25-hydroxy vitamin D3 concentration.25-hydroxy vitamin D3 may be a predictor of carotid atherosclerotic plaques .

Objective To observe the effects of stereotactic implanting depth electrode into the hippocampus on monitoring mesial temporal lobe epilepsy. Methods Thirteen patients with pharmacoresistant epilepsy were included in the present study.The epilcptogenic zone might be located in the hippocampus based on the symptoms and MRI data.Eight-contact depth electrode was implanted into the patients' hippocampus by stereotactic procedures to record the electroencephalogram(EEG).The duration of monitoring lasted for 24-72 hours or more,so as to be sure if the epileptogenic zone was located in the hippocampus,and to provide evidences for surgical resection of epileptic focus.Results Thirteen patients with mesial temporal lobe epilepsy underwent video electroencephalogram monitoring for 72 hours.Twentynine epileptic seizures in 7 patients were detected.Ictal EEG changes manifested as paroxysmal slow wave or spike and slow waves on the background.The epileptiform discharges started from some electrode points,and then propagated to others or the contralateral electrode. After 1-2 seconds of delay,high amplitude slow waves with the frequency of 3-4 Hz were observed on the ipsilateral scalp EEG. Clinical epileptic seizures were not detected in 6 patients during monitoring,depth electrode showed paroxysmal focal high amplitude slow wave or spike and sharp waves,scalp EEG did not find abnormality.Six of thirteen patients received surgical resection of epileptic foci,the outcome during follow-up of 3-8 months was satisfactory.Conclusions To record hippocampal EEG in patients with intractable epilepsy by stereotactic implanting depth electrode into the hippocampus might be a safe and reliable method.It might provide strong evidences for the diagnosis of patients with mesial temporal lobe epilepsy,and for the location of epilcptogenic zone.

Objective To observe the effect of scalp-acupuncture combined with physical therapy on spastic cerebral palsy.Methods 80 children with spastic cerebral palsy were randomly divided into observation group and a control group,40 cases in each group.The observation group was treated with scalp-acupuncture combined with physical therapy,and the control group with physical therapy only.They were assessed with the Functional Independence Measure for children(WeeFIM) and the Gross Motor Function Measure(GMFM) before and 3 months after treatment.Results No side-effect was observed during the treatment.The scores of WeeFIM and GMFM of the observation group were significantly superior to the control group(P<0.05).Conclusion The scalp-acupuncture can improve the efficiency of physical therapy on motor function in the children with spastic cerebral palsy.

Objective To evaluate the effect of BinaxNOW rapid diagnostic devices for malaria in the field. Methods The symptomatic patients were detected by using the BinaxNOW devices and the results were compared with the microscopic examination of Giemsa-stained blood smears(as a golden standard). The sensitivity and specificity were calculated. The double-blind method was used in this study. Results In 443 symptomatic patients,151 cases were positive for malaria. The sensitivity was 98.69% and the specificity was 100%,and the coincidence rate of BinaxNOW with the microscopic examination was 99.55%. The sensitivity and specificity of Plasmodium falciparum were 100% and 99.66%,respectively,and the coincidence rate was 99.76%. The sensitivity and specificity of non-falciparum Plasmodium were 90.91% and 100%,respectively,and the coincidence rate was 99.36%. Conclusion The BinaxNOW rapid diagnostic devices for malaria are sensitive,specific,and stable for malaria diagnosis in the field.

Objective To explore the inhibiting effect of valsartan and spironolactone on cardiac fibrosis and the expression of integrin ? 1 and fibronectin in the heart of spontaneously hypertensive rats. Methods Eighteen 6 week old SHR were randomly divided into 3 groups with 6 in each: SHR control group, valsartan treating group(30 mg?kg -1 ?d -1 ) and spironolactone treating group ( 20 mg?kg -1 ?d -1 ). Six homogenous male WKY rats served as normal group. After 14 weeks of treatment, systolic blood pressure, left ventricular mass, the ratio of left ventricular mass to body weight (LVM/BW), collagen volume fraction(CVF) and perivascular collagen area(PVCA) were determined and compared among these groups. The expression of integrin ? 1 and fibronectin were also examined by immunohistochemical method. Results Compared with the untreated SHR S, systolic blood pressure was significantly decreased in both treatment groups. LVM/BW〔(2 84?0 14)?10 -3 vs(3 22?0 15)?10 -3 〕, CVF〔(3 21?0 22)%vs(4 00?0 28)%〕, PVCA〔(0 62?0 15)%vs(0 94?0 56)%〕 were lower in both treatment groups, these parameters in SHR V group were even lower than those in SHR S group. Compared with the untreated SHR S, the expression of integrin ? 1 was significantly reduced in SHR V group, while the expression of fibronectin was markedly reduced in both treatment groups. Conclusions Both valsartan and spironolactone could control blood pressure, and effectively inhibit the cardiac fibrosis. Valsartan could also inhibit the expression of cardiac integrin ? 1 and fibronectin, which might be the reason that valsartan is better than spironolactone in inhibiting cardiac fibrosis.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with resistance to thyroid hormone syndrome (RTH). METHODS: Exons 7 to 10 of the THRbeta gene were sequenced for the proband and members of his pedigree. RESULTS: Three patients from the pedigree were identified. All have presented with palpitation, fatigue, goiter, elevated free thyroid hormone and free triiodothyronine, and normal or elevated thyrotropin. Genetic testing revealed that the proband, his mother, second sister and one of her daughters had carried a heterozygous c.1336T>A variant of the THRbeta gene, which resulted in substitution of Cysteine by Serine at position 446. The variant was unreported previously. Based on the American College of Medical Genetics and Genomics standards and guidelines, the c.1336T>A(p.Cys446Ser) variant of THRbeta gene was predicted to be lilely pathogenic(PM1+PM2+PM5+PP3). CONCLUSION The c.1336T>A variant, identified in the exon 10 of the THRbeta gene, probably underlay the RTH in this pedigree. Genetic testing has validated the clinical diagnosis for this pedigree.
Female ; Genomics ; Heterozygote ; Humans ; Mothers ; Mutation ; Pedigree

Objective: To investigate the effect of gross total resection on the local control and survival of patients with stage IV neuroblastoma (NB) and analyze the extent of surgical resection of primary tumors that affects patient survival. Methods: A total of 96 patients with stage Ⅳ NB who were admitted to the Sun Yat-Sen University Cancer Center between January 2000 and December 2011 were analyzed. The patients were treated with combined-modality therapy, including chemotherapy, surgery, and/or radiotherapy. The patients were divided according to the extent of surgical resection of primary tumor into the following groups: group A, biopsy or tumor removal of less than 50% of the primary lesion; group B, incomplete resection of more than 50% but less than 90% of the lesion; group C, removal of more than 90% of the lesion; and group D, complete resection with or without macroscopic residual tumors. The survival rates of each group were analyzed. Results: The median age of the 96 patients was 4.4 years, ranging from 1.2-18.8 years. The overall 3-year progression-free survival (PFS) and overall survival (OS) of the total patients were 32.8% and 36.7%, respectively. A total of 24 cases were assigned in group A, 10 in group B, 23 in group C, and 39 in group D. Subgroup analysis revealed that the 3-year PFS rate was 17.5% for group A, 20.0% for group B, 45.1% for group C, and 40.5% for group D. The PFS rates were not statistically significant-ly different between groups A and B (P=0.352) and between groups C and D (P = 0.792). However, the OS was higher in groups C and D than that in groups A and B. The 3-year PFS rates were 42.2% and 17.8% for groups C and D (P<0.001), respectively. Conclu-sion: Resection extension of more than 90% of the primary tumor combined with chemotherapy and (or) radiation therapy can improve the survival of patients with stage Ⅳ NB. However, this treatment modality does not affect the treatment outcomes for minimal gross tu-mor residuals.

Preoperative concurrent chemoradiotherapy based on 5-fluorouracil (5-FU) is an standard treatment mode for patients with locally advanced rectal cancer (LARC). Currently, more and more interests has now focused on new chemotherapeutic drugs, such as capecitabine, oxaliplatin, irinotecan, bevacizumab, and cetuximab in this treatment mode. Many prospective phase I-III clinical trials have been developed to explore these new drugs efficacy in the neoadjuvant chemoradiation (nCRT) for patients with LARC. Some results are very encouraging, yet others are undesirable. Capecitabine has been widely recognized in the nCRT for patients with LARC, and has the tendency to replace 5-FU. However, there are some controversies for oxaliplatin, irinotecan, and biologically targeted drugs in the nCRT mode because of their limited clinical benefits. It is potentially the development direction to study the mutual interaction mechanism among concurrent drugs or radiation and biologically targeted drugs, find new predicatively responsive targets, and screen the appropriate patient in the treatment of neoCRT for patients with LARC in the future.
Antineoplastic Agents ; therapeutic use ; Camptothecin ; analogs & derivatives ; therapeutic use ; Capecitabine ; Chemotherapy, Adjuvant ; Deoxycytidine ; analogs & derivatives ; therapeutic use ; Fluorouracil ; analogs & derivatives ; therapeutic use ; Humans ; Organoplatinum Compounds ; therapeutic use ; Rectal Neoplasms ; drug therapy ; surgery

ObjectiveTo investigated the effect of post-operative primary site radiotherapy on stage Ⅳ neuroblastoma.Methods From Jan 2003 to Dem 2010,47 newly diagnosed stage Ⅳ neuroblastoma treated in Sun Yet-sen university cancer center.The treatment protocol for these patients were induction chemotherapy 4- 12 cycles,followed by surgery if possible,then 4-6 cycles consolidation chemotherapy and/or primary site radiotherapy and maintenance immunotherapy.The median age was 4 years old,the median induction chemotherapy cycles was 5.37 patients received resection of the primary tumor (total resection and nearly gross resection).24 out of 37 received primary site radiotherapy.ResultsThe followup rate was 89％.34 cases were followed up more than 36 months.For patients with or without postoperative primary site radiotherapy,the local recurrence rate were 13％ ( 3/24 ) and 54％ ( 7/13 ),respectively ( P =0.016),the 3-year local control rate were 84％ and 47％,respectively ( χ2 =7.95,P =0.005 ).The 3-year overall survival rate were 56％ and 28％,respectively ( χ2 =5.44,P =0.020 ). There was no severe radiation side effect. Conclusions This study indicated that postoperative primary site after induction chemotherapy and surgery could reduce the local recurrence rate and possibly improve the overall survival rate of stage Ⅳ neuroblastoma.

Objective To study the application value of endoscopic thyroidectomy via total membrane dissection. Methods One hundred and sixteen patients with benign thyroid nodules were given axillo-breast approach endoscopic thyroidectomy via total membrane dissection from January 2014 to December 2016. Results Endoscopic thyroidectomy was completed in all the patients without conversion to open surgery.The operation time was 45-125 min[mean,(65.6 ±36.7)min],the blood loss was 10-220 ml[mean,(43.2 ±22.7)ml],the postoperative drainage volume was 25-305 ml[mean,(95.3 ±53.8)ml], the postoperative drainage time was 2-4 d[mean,(2.3 ±0.7)d)],and the length of hospital stay was 3-6 d[mean,(4.1 ±1.1)d].Short-term twitch occurred in 1 case and seroma occurred in 2 cases.No other complications such as hoarseness,bucking or asphyxia occurred in this series. Conclusion Endoscopic thyroidectomy via total membrane dissection can effectively avoid the injury of recurrent laryngeal nerve and parathyroid gland.