Objective To analyse the difference between stage Ⅰ pure bronchioloalveolar carcinoma (BAC) and stage Ⅰ adenocarcinoma of the lung among operative cases.Methods We use the Lobectomy Cases Registration and Statistics System database (2006-2011) to compare the epidemiology,clinical presentation,image characteristics,surgical outcomes,recurrence and overall survival between BAC and adenocarcinoma groups.All the patients received lobectomy procedure in the department of thoracic surgery of Peking University People' s Hospital.Results Excluding those cases with both BAC and adenocarcinoma aspects,337 patients were enrolled.Thirty-nine patients were stage Ⅰ pure BAC and 298 patients were stage Ⅰadenocarcinoma.BAC has its proper clinical spectrum,occurring more frequently in women (69.2％ vs.52.0％,P =0.042)and in younger patients (57.4 vs.61.8,P =0.014).BAC also seems to be less dependent on tobacco exposure (12.8％ vs.29.9％,P =0.026).The percentage of ground-glass opacity (GGO) in CT scan of BAC patients was much more than that registered in adenocarcinoma patients (35.9％ vs.9.7％,P ＜0.001).And the tumor size of BAC group was smaller than that of the adenocarcinoma group (1.4 cm vs.2.3 cm,P ＜0.001).The operation method,time,blood loss and complications were similar between the two groups.Kaplan-Meier survival curves showed that both 3-year disease-free survival (DFS) and overall survival (OS) were significantly higher in patients affected by BAC (100％ vs.76.1％,P =0.030 and 100％ vs.86.1％,P =0.041).Conclusion BAC presents specificity in its epidemical,clinical,radiological and evolutionary aspects.Stage Ⅰ pure BAC patients have better prognosis following video-assisted thoracoscopic lobectomy and system lymph node dissection than the similar stage adenocarcinoma patients.

Objectives To report a generalized atrophic benign epidermolysis bullosa family,identify the deficient protein and related pathogenic gene mutation. Methods The diagnosis was confirmed based on clinical manifestations and necessary examinations. Electron microscopy and immunofluorescent staining were used to detect the deficient protein. The pathogenic gene mutation was identified by PCR amplification of ge-nomic DNA with primers targeting the flanking introns, followed by direct automated sequencing. Results In the family, the affected individuals were homozygous for a novel 4-bp deletion in COL17A1, 3897delATCT, which resulted in a downstream premature termination codon. Conclusions 3897delATCT of COL17A1 is the pathogenic gene mutation in the patients and probably results in nonsense-mediated mRNA decay and abrogation of type XⅦ collagen synthesis, as documented in the literature.

Objective To investigate the effect of platelet-derived growth factor-D (PDGF-D) on the prostate cancer cells migration and its possible mechanism. Methods The expressions of PDGF-D in LNCaP and PC-3 cells were detected with western blot.PDGF-D siRNA was synthesized according to mRNA sequence of PDGF-D gene and was transfected into PC-3 cell.The cells were treated with PDGF-D and PDGF-D siRNA,the cell migration was examined by Boyden chamber migration assay.The expression changes of VEGF and MMP-9 mRNA were detected by RT-PCR. Results The results of western blot indicated that the PDGF-D protein expression level was lower in LNCaP cells (29.47 ± 1.68) than that in PC-3 cells (63.43 ±2.10),(P ＜ 0.05).PDGF-D siRNA could down-regulate the PDGF-D protein expression in the transfected group (35.19 ± 1.51).The exogenous PDGF-D could promote migration of LNCaP and PC-3cells,and up-regulate the expression of VEGF,MMP-9 mRNA in PC-3 cells (P ＜ 0.05,compared with control group).PDGF-D siRNA inhibited PC-3 cells' migration and decreased the level of VEGF,MMP-9mRNA expression (0.72 ± 0.09 vs 0.43 ± 0.18,0.65 ±0.07 vs 0.22 ± 0.08) (P ＜ 0.05). Conclusion PDGF-D is involved in the promotion of prostate cancer invasion and angiogenesis.

ObjectiveTo evaluate the feasibility of the completely thoracoscopic lobectomy for clinical N0 and postoperatively pathological N2 non-small-cell lung cancer(NSCLC).MethodsFrom Sep.2006 to Jan.2010, 216 patients with NSCLC received completely thoracoscopic lobectomy in our center.Two hundred and six patients were clinical N0 preoperatively(103 males and 103 females, median age of 62.3 years, rang 29 to 85 years).They were divided into two groups based on postoperatively pathological staging, pN0 group and pN2 group.Some perioperative factors including age, gender,tumor size,tumor location,pathological type, pathological differentiation,rate of conversion to thoractomy,operation time,blood loss,lymph node dissection, time of drainge, hospitalization and complications were studied and compared between two groups.Results There were 203 cases of lobectomy, 2 cases of composite lobectomy and 1 case of pneumonectomy.All procedures were carried out safely without serious complication except for one operative death result from respiratory failure.There were 168 cases in pN0 group and 38 cases in pN2 group.Age and gender were similar between two groups.The tumor size in pN0 group was smaller than that in pN2 group [ (2.6 ± 1.6) cm vs (3.7 ± 1.9) cm, P = 0.001 ].The tumors in pN0 group were lesser appearance in the bilateral lower lobes (31.0％ vs 50.0％, P = 0.026).There was a approximate proportion of adenocarcinoma in two groups (82.7％ vs 73.7％, P = 0.181), but the proportion of poorly differentiated carcinoma in pN0 group was significantly lower than that in pN2 group(19.0％ vs 42.1％, P = 0.002).There were no differences in the rate of conversion to thoractomy(7.1％ vs 7.9％, P = 1.000), operation time[ (196.1 ± 53.7) min vs (208.6 ± 56.8) min, P = 0.202 ], blood loss[ (253.2 ±247.9) ml vs(279.0±183.3) ml, P=0.475], time of drainage[ (7.7 ±3.2) days vs (9.7 ±6.3) days,P=0.066], hospitalization[ (10.6 ±4.6) days vs (13.0 ±7.6) days, P =0.063]and complications(12.5％ vs 21.1％,P =0.171).The stations of mediastinal lymph node dissection were equivalent in two groups(3.1 ± 1.2 vs 3.3 ± 1.1, P =0.237) , but there were fewer numbers of mediastinal lymph node dissection in pN0 group (9.9 ± 6.8 vs 12.7 ± 8.4, P =0.038).ConclusionCompletely thoracoscopic lobectomy is a feasible surgical therapy for cN0-pN2 non-small-cell lung cancer without loss of curability.

Objective To evaluate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for CT-positive mediastinal lymph nodes. Methods From September 2009 to December 2009, 28 patients with confirmed or suspected non-small-cell lung cancer with CT scan demonstrating enlarged ( ≥ 1 cm) mediastinal lymph nodes underwent EBUS-TBNA. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were evaluated. Results 28 patients with 40 lymph nodes were studied. 27 patients had been performed successfully with enough specimens. No complications happened in the group. Mediastinal metastases were confirmed by EBUS-TBNA in 20 patients. 8 patients with benign mediastinal nodes as detected by EBUS-TBNA underwent surgery and mediastinal lymph node dissection, which confirmed N2 disease in 2 patients. Overall diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA in the detection of mediastinal metastasis were 92.9%, 90.9%,100%, 100%, 75% respectively. Conclusion EBUS-TBNA is a safe and effective technique for CT-positive mediastinal lymph nodes on CT scan.

Objective To evaluate the effect of multiplex polymerase chain reaction(Multiple-PCR) in identification of Brucella strains.Methods Six standard Brucella strains (Brucella abortus,Brucella melitensis,Brucella suis,Brucella canis,Brucella ovis,Brucella neotomae) were used as positive controls and Escherichia coli O∶157 and Yersinia enterocolitica O∶9 were used as negative controls.A total of 29 Brucella strains were tested.Brucella strains were amplified by BCSP31-PCR and the species of Brucella with positive results were identified with Multiple-PCR method.Results The results of all 29 amplified Brucella strains were positive with BCSP31-PCR.The identified results of all Brucella strains were positive with Multiple-PCR,including 20 strains of Brucella melitensis,5 isolates of Brucella suis,3 strains of Brucella abortus and 1 strain of Brucella canis.Conclusion Multiple-PCR method is a rapid,specific,simple and low risk method for identification of Brucella species.

Adult ; Chemical and Drug Induced Liver Injury ; Dimethylformamide ; poisoning ; Humans ; Male

Objective To investigate the epidemiological characteristics of human brucellosis in Ulanqab of Inner Mongolia.Methods Three hundred and twenty patients with suspected brucellosis were selected,who had registered in the Ulanqab Center for Endemic Disease Control of Inner Mongolia from April to June 2011.The investigation covered general situation,such as gender,age,occupation and main clinical symptoms and so on.Blood samples were collected,and Rose Bengal plate agglutination test(RBPT) was used for serum screening.Those who were tested positive in RBPT were confirmed with tube agglutination test (SAT).Brucellosis was diagnosed according to Diagnostic criteria for Brucellosis (WS 269-2007).Data were analyzed with statistical software(SPSS 17.0).Results One hundred and thirty-four cases were positive in RBPT of the 320 people surveyed,of which 93 cases were positive in SAT; antibody titers were higher than 1 ∶ 100(++),therefore they were diagnosed as brucellosis,and the ratio was 29.1％(93/320).The number of patients with suspected brucellosis who were negative in SAT test was 41,and the ratio was 12.8％ (41/320).Among the 93 people who were infected,the constituent ratio of farmers and herdsmen who engaged in livestock was the highest,accounted for 63.4％(59/93) and 24.7％ (23/93) of the total number of patients ; infection rate of male (30.9％,55/178) was higher than that of females (26.7％,38/142) ; the number(39) of brucellosis patients who were over the age of 51 was the highest,and the ratio is 42.0％.The onset season mainly in May and August; main route of exposure was bare hands lambing,midwifery and contact with infected sheep pollutants.Conclusions Sheep is the main source of human Brucella infection in Ulanqab.It is the key to control the spreading of brucellosis through improving awareness of disease prevention among farmers and herdsmen as well intensifying the prevention and control of Brucella infection between livestock.

OBJECTIVEAlport syndrome (AS) is a progressive hereditary nephritis presented with hematuria and renal failure, frequently associated with sensorineural deafness and ocular lesions. So far, more than 300 gene mutations in AS have been identified which provides a better way to analyze the association between genotype and phenotype. It is hard to understand all the phenotype according to the gene mutations, because the structure and function changes of the relevant protein, alpha5(IV) chain, encoded by mutated COL4A5 gene are rare to know. This study aimed to detect the proteins structure encoded by COL4A5 gene with different missense mutations and to analyze the effect of gene mutations on the secondary structure of alpha5(IV) chain and structure-phenotype relations.

METHODSTwo X-linked AS patients with different missense mutations (g.3246G > T resulting in p.G1015V and g.3290G > A resulting in p.G1030S, respectively) diagnosed by clinical manifestations, family history and skin or renal biopsy examinations, as well as a control were included in this study. The fragments of cDNA with the two mutations, respectively, and that of corresponding cDNA from the control were expressed in E. coli. The secondary structure of the recombinant polypeptides were analyzed by using circular dichroism (CD) spectroscopy.

RESULTSCD spectra of the control exhibited a negative peak near 200 nm whereas that of the patient 1 exhibited a negative peak near 220 nm. Furthermore, the magnitude of the negative peak of patient 1 decreased from -9000 deg x cm2 x dmol(-1) to -4000 deg x cm2 x dmol(-1) as compared with that of the control. CD spectra of the patient 2 were slightly changed with the negative peak remaining near 220 nm but the magnitude increasing from -9000 deg x cm2 x dmol(-1) to -11000 deg x cm2 x dmol(-1) as compared with that of the control. In addition, the secondary structure of the control polypeptide was mainly composed of beta-sheet and random coil without alpha-helix, whereas that of the patient 1 presented 12.9% alpha-helix. Although the secondary structure of polypeptide of the patient 2 was also mainly composed of beta-sheet and random coil, the composition of beta-sheet reduced and random coil increased.

CONCLUSIONAlthough the glycine substitutions existed in the same domain of alpha5(IV) chain, the patient 1 with the severe AS phenotype and g.3246G > T mutation, and patient 2 with the mild AS phenotype and g.3290G > A mutation were revealed with different secondary structures of alpha5(IV) chain. Moreover, the secondary structure changes of alpha5(IV) chain were consistent with their corresponding phenotype severity.

Collagen Type IV ; genetics ; Humans ; Mutation, Missense ; Nephritis, Hereditary ; genetics ; Phenotype ; Point Mutation ; Protein Structure, Secondary ; genetics ; Spectrum Analysis

Objective To establish a network laboratory for blood cell analysis and better calibrate haematology analyzers in local lab.Methods According to GB/T 15481《General requirements for the competence testing and calibration laboratories》(idt ISO/IEC 17025),we established a network laboratory providing traceability for blood cell analysis.Complete blood count was traced to Calibration Laboratory in NCCL;The secondary standard haematology analyzer with the same model and calibrator with same lot number were used for verification for a long period.Fresh blood from healthy people was used to calibrate haematology analyzers.Results Gradually we have improved our laboratory quality management system, precision as well as accuracy,which was satisfactory.The unified blood sample was adopted to calibrate different equipments in our hospital and showed consistence when compared with calibration analyzer.The correlation coefficient of all tests is more than 0.99.The relative deviation of WBC,RBC,HCT,HGB and PLT are within?7%,?3.5%,?4%,?3% and?15%,respectively.Conclusions Secondary standard systems provides good comparable results with calibration laboratory.Its tracing mode and quality control scheme could ensure the traceability and accuracy of completed blood count.Furthermore,using elective fresh blood from healthy people,the comparable results from different analyzers were achievable.