Objective To compare the safety and effectiveness of two methods of perineal dissection in 60 consecutive patients of rectal carcinoma undergoing combined abdominoperineal resection.Methods In this retrospective study from 2007 to 2009, 30 cases underwent Miles' operation using modified method of perineal dissection( MM group) and 30 cases undergoing Miles' operation using classic method of perineal dissection ( CM group). Operative time, accidental tumor ( or rectal) perforation during the procedure, iatrogenic injury to the urethra ( or vagina) and postoperative perineal complications were compared between the two groups. Results The mean perineal operative time was (45±15) min in MM group and ( 70 ± 20) min in CM group respectively ( t = 5. 48, P ＜ 0. 05 ). There were no significant differences in the rate of tumor ( or rectal) perforation and that of urethral (vaginal) injury. There were significant difference in the rate of postoperative perineal complications (χ2=4.01, P＜0.05).Conclusions Modified method of perineal dissection is effective and safe, and this method offers a new approach for the perineal dissection during Miles' operation.

OBJECTIVETo explore the value of flow cytometric immunophenotyping (FCI) in the diagnosis and differentiated diagnosis of lymphoma and explain the immunophenotypic features and differences of malignant lymphoma.

METHODSSeventy four fresh samples of suspicious lymphoma were collected from Nov. 2004 to Aug. 2006. Each sample was individually evaluated by FCI. The results were analyzed and compared with the histopathological diagnosis.

RESULTSAmong the 74 cases, the FCI data consisted with the final morphological diagnosis in 61 cases (82.4%). For the diagnosis of B and T non-Hodgkin's lymphoma (NHL), thymoma, carcinoma and benign lesions of lymph node, the concordance between FCI data and morphological diagnosis were 93.5%, 100%, 100%, 100% and 81.3%, respectively.

CONCLUSIONMulti-parameter FCI analysis can provide important information and help for diagnosis of lymphoma. It is an assistant but necessary approach for the diagnosis and differential diagnosis of lymphoma.

Adolescent ; Adult ; Aged ; Child ; Female ; Flow Cytometry ; Humans ; Immunophenotyping ; methods ; Lymphoma ; diagnosis ; immunology ; pathology ; Male ; Middle Aged

Objective To study the risk factors for fractures among hemedialysis patients. Methods 160 patients who received maintenance hemodialysis in our center had been followed from January of 2003 to December of 2007. Fractures were identified and the schedule of dialysis, laboratory values and medications were recorded. Results A total of 32 bone fratures occurred in 160 patients. Associated risk factors included age, sex, yeats on hemodialysis, cumulative time on hemofihration per week, prior renal transplant, history of medications, needs assistance to walk, serum calcium, phosphorus, Hb, PTH and B2-microglobulin. Conclusions Two main mechanisms may account for the increased fracture risk in HD patients: either a lower resistance of bone after relatively minor traumas or an increased propensity to falls. We should pay much attention to the patients with older age, female gender, longer cumulative time on HD, needs assistance to walk, a history of falls and higher PTH level.

This paper summarized nursing measures of a patient with secondary hemochromatosis complicated with multiple organic lesions. As the result of defetoxamine treatment and nursing measures included postural care, movement guidance, observation of vital signs, low iron diet, skin care, liver treatment care,psychological care and discharged guidance, patient's blood serum iron returned to normal level and discharged from hospital.

Objective To explore the adverse reactions of Infliximab and its relevant nursing countermeasures. Methods The clinical data from 13 patients were collected. Condition of adverse reaction was observed and nursing countermeasures were conducted. Results A total of 65 times of Infliximab-infusion were conducted in the 13 patients. Serum sickness reaction appeared 6 times, infection occurred 7 times and liver dysfunction occurred 2 times. According with those adverse reactions, nursing interventions including standard medication,infection prevention and observation were conducted. Conclusions The highest incidence of all adverse reactions is infection followed by serum sickness reaction. The key of nursing care is prevention and care of infection, observation of serum sickness reaction and liver function in order to insure effectiveness and safetyduring treatment.

Objective To investigate cognition, behaviors and extend of being informed of patient safety and to explore factors affecting patients' involvement in patient safety so as to provide feasible suggestion on its practice. Methods 400 inpatients from three hospitals in Guangzhou were investigated with self-designed questionnaire. Results Data revealed that there was a lack of awareness of medical errors which led to insufficient attention to patient safety. Education served as the major factor affecting cognition and behaviors of patient safety. Conclusions Public attention to patient safety should be provoked, sufficient information is demanded, and patient-doctor communication should be encouraged to improve patients' involvement in patient safety.

Non-progressive congenital myopathy is a group of muscle diseases occurring at birth or during teenage years. A number of new reports of congenital myopathy, such as homogeneous bodies myopathy, muscle quality control myopathy and type 1 fiber predominance have recently been reported, but they lack of sufficient quantity and constant clinico-pathologic manifestations. This paper reports two cases of congenital myopathy with type 1 fiber predominance confirmed by muscle biopsy. The clinical manifestations of the two children (a 4.5-year-old girl and an 11-year-old boy) included non-progressive symptoms of muscle weakness, skeletal deformities and other clinical features of congenital myopathy. The physical examinations showed a long face or figure and funnel chest or kyphosis/scoliosis, high palatal arch and wing-like shoulder. Serum levels of creatine kinase were normal but slightly elevated serum lactate dehydrogenase levels were noted in the two children. The skeletal muscle biopsy by ATPase staining showed that type 1 fibers accounted for more than 90% of the total number of muscle fibers. No other abnormal pathological changes, such as central cores, muscle tube and central nuclei, were found in the two children.
Diagnosis, Differential ; Female ; Humans ; Infant ; Male ; Muscle, Skeletal ; pathology ; Myopathies, Structural, Congenital ; diagnosis ; pathology ; therapy

OBJECTIVETo investigate the expression of integrin-linked kinase (ILK) in kidneys of mice with unilateral ureteral obstruction and its relevance with the epithelial-mesenchymal transition.

METHODSMice were randomly divided into two groups, sham operation (C, n = 20) and unilateral ureteral obstruction (UUO, n = 40). The animals were sacrificed at day 1, 3, 7 and 14 respectively after the surgery. Tubulointerstitial fibrosis (TIF) was graded according to Masson staining. The protein level of ILK was examined by Western blot. Tissue/cytological expression for ILK, alpha-SMA and E-cadherin were investigated by immunohistochemistry. The mRNA levels of ILK, alpha-SMA and E-cadherin were analyzed by quantitative real-time PCR.

RESULTSIn the control animals (group C), weak staining for ILK was detected mainly in the podocytes. Significant increase of staining for ILK in the experimental mice (UUO group) was detected from day 1 onward (t = 16.5, P < 0.01), reaching the peak at day 7. The protein expression of E-cadherin was continuously down-regulated from day 3 onward after surgery (t = 21.0, P < 0.01), while expression for alpha-SMA was up-regulated. From day 1 to day 7, the protein expression of ILK was positively correlated with alpha-SMA (R = 0.88, P < 0.01), but negatively correlated with E-cadherin (R = -0.87, P < 0.01). The mRNA expression of ILK and alpha-SMA analyzed by real-time PCR increased from postoperative day 1 and 3 respectively, but the mRNA expression of E-cadherin decreased from day 3 onward.

CONCLUSIONIncreasing expression of ILK occurs in the early phase of UUO mouse and may play an important role in the process of TIF through mediating the epithelial-mesenchymal transition.

Actins ; biosynthesis ; genetics ; Animals ; Blotting, Western ; Cadherins ; biosynthesis ; genetics ; Epithelial Cells ; metabolism ; pathology ; Fibrosis ; Immunohistochemistry ; Kidney Tubules ; metabolism ; pathology ; Male ; Mesoderm ; metabolism ; pathology ; Mice ; Muscle, Smooth ; chemistry ; Protein-Serine-Threonine Kinases ; biosynthesis ; genetics ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Ureteral Obstruction ; genetics ; metabolism ; pathology

OBJECTIVETo investigate the expression of annexin I in esophageal squamous cell carcinoma (SCC) and carcinomas of other histological types in order to analyze the correlation between the expression of annexin I and carcinogenesis.

METHODSFirst, a set of tissue microarray was established, which consisted of SCC from the esophagus (208 cases), lung, larynx, cervix, and external genital organs; adenocarcinomas from the lung, stomach, colon and rectum, liver, pancreas, breast, thyroid and kidney with 30 cases in each group, meanwhile, the corresponding normal tissue was also obtained for control. Immunohistochemistry was used to detect the expression of annexin I in different types of carcinomas and the corresponding normal controls from different organs. The correlation between the expression of annexin I and the clinicopathological feature was analyzed and compared, which included age, gender, differentiation grade and lymph node metastasis.

RESULTSIt was found that the expression of annexin I was decreased in esophageal SCC, when compared with normal esophageal squamous epithelia (P < 0.001), the similarity was also found in SCC of the lung, larynx and cervix. However, though negative in normal epidermis, annexin I expression was detected in some cases with SCC from external genital organs. Annexin I was found to be overexpressed in adenocarcinomas of the lung, stomach, colon and rectum, liver, pancreas, breast, thyroid and kidney, particularly very strong expression of annexin I was seen in lung adenocarcinoma, uterine endometrioid adenocarcinoma and ovarian serous adenocarcinoma. Interestingly, it was found to be positive in all thyroid papillary carcinomas, but negative in all normal thyroid glands. However, annexin I expression was found to be negative in all hepatocellular carcinoma and normal hepatocytes; and it was only detected in myoepithelium of normal breast tissue, but not in ductal luminal cells, and rarely in infiltrating ductal adenocarcinoma. In SCC, annexin I expression was stronger in well differentiated ones than that in the poorly differentiated ones. However, contrasting with SCC, in the adenocarcinomas from different organs, annexin I expression was much stronger in poorly differentiated ones than that in the well differentiate ones, especially in the adenocarcinomas from stomach, colon and rectum, pancreas, ovarian and kidney.

CONCLUSIONAnnexin I expression is quite different among different types of carcinomas, and is correlated with histopathological type and differentiation grade. Further study is needed to investigate its role in the carcinogenesis.

Adenocarcinoma ; metabolism ; pathology ; Annexin A1 ; metabolism ; Carcinoma, Endometrioid ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Differentiation ; Endometrial Neoplasms ; metabolism ; pathology ; Epithelium ; metabolism ; Esophageal Neoplasms ; metabolism ; pathology ; Esophagus ; metabolism ; Female ; Humans ; Immunohistochemistry ; Lung Neoplasms ; metabolism ; pathology ; Stomach Neoplasms ; metabolism ; pathology

Spinal muscular atrophy (SMA) is a disorder characterized by degeneration of lower motor neurons and occasionally bulbar motor neurons leading to progressive limb and trunk paralysis as well as muscular atrophy. Three types of SMA are recognized depending on the age of onset, the maximum muscular activity achieved, and survivorship: SMA1, SMA2, and SMA3. The survival of motor neuron (SMN) gene has been identified as an SMA determining gene, whereas the neuronal apoptosis inhibitory protein (NAIP) gene is considered to be a modifying factor of the severity of SMA. The main objective of this study was to analyze the deletion of SMN1 and NAIP genes in southern Chinese children with SMA. Here, polymerase chain reaction (PCR) combined with restriction fragment length polymorphism (RFLP) was performed to detect the deletion of both exon 7 and exon 8 of SMN1 and exon 5 of NAIP in 62 southern Chinese children with strongly suspected clinical symptoms of SMA. All the 32 SMA1 patients and 76% (13/17) of SMA2 patients showed homozygous deletions for exon 7 and exon 8, and all the 13 SMA3 patients showed single deletion of SMN1 exon 7 along with 24% (4/17) of SMA2 patients. Eleven out of 32 (34%) SMA1 patients showed NAIP deletion, and none of SMA2 and SMA3 patients was found to have NAIP deletion. The findings of homozygous deletions of exon 7 and/or exon 8 of SMN1 gene confirmed the diagnosis of SMA, and suggested that the deletion of SMN1 exon 7 is a major cause of SMA in southern Chinese children, and that the NAIP gene may be a modifying factor for disease severity of SMA1. The molecular diagnosis system based on PCR-RFLP analysis can conveniently be applied in the clinical testing, genetic counseling, prenatal diagnosis and preimplantation genetic diagnosis of SMA.
Child ; Child, Preschool ; China ; epidemiology ; Female ; Gene Deletion ; Genetic Predisposition to Disease ; epidemiology ; genetics ; Humans ; Incidence ; Infant ; Male ; Neuronal Apoptosis-Inhibitory Protein ; genetics ; Polymorphism, Single Nucleotide ; genetics ; Spinal Muscular Atrophies of Childhood ; epidemiology ; genetics ; Survival of Motor Neuron 1 Protein ; genetics