Objective To investigate the correlation of CYP2D6 gene polymorphism and serum tamoxifen (TAM) and its active metabolites (4-hydroxy tamoxifen,4-OH-TAM) in terms of prognosis of breast cancer patients.Methods The oral mucosas and serum were obtained from 200 breast cancer patients receiving oral TAM from Jan 2008 to Oct 2010.Real-time RT-PCR was used to determine CYP2D6* 10 gene polymorphism.The relationship between CYP2D6* 10 gene polymorphism and clinicopathological features and prognosis was assessed by Chi-square test and Cox proportional model.Serum TAM and 4-OH-TAM concentration were determined by liquid chromatography-trap mass spectrometry (LC-MS).Results Of 200 breast cancer patients,CYP2D6 * 10/* 10 homozygotes were found in 94 cases (47％),CYP2D6 wt/wt wild type in 48 cases (24％) and CYP2D6 wt/* 10 heterozygote in 58 cases (29％).The concentration of serum 4-OH-TAM in patients with CYP2D6 wt/wt wild type and wt/* 10 heterozygote was significantly higher than that in patients with CYP2D6 * 10/ * 10 homozygote (F =4.31,P =0.01).CYP2D6 gene polymorphism was not related to clinicopathological features (P ＞ 0.05).Logrank test showed that patient's disease-free survival with mutational CYP2D6 (mean,47.2 months) was significantly shorter than that in patients without mutational CYP2D6 (mean,51.2 months) (P =0.018).Cox proportional model showed that CYP2D6 genotype was related to disease-free survival (HR =2.755,95％CI:1.230 ～6.173,P =0.014).Conclusions CYP2D6 *10/* 10 genotype is related to curative effect of TAM on breast cancer patients,detection of CYP2D6 * 10/* 10 genotype helps improve the choice of TAM therapy.

Sinus histiocytosis with massive lymphadenopathy( SHML) is also called Rosai-Dorfman disease.It is a kind of benign lymphoid tissue proliferative diseases with unknown etiology.SHML appeared mostly in children and adolescent.It has diverse clinical manifestations accompanied with multiple organ inju-ry,and no clear laboratory indicators could support the disease,being a rare disease in pediatrics,easyot miss diagnosis.Thsi article reviewde the latest progress on diagnostis and treatment of SHML,to improve teh un-derstanding of the disease.

DNA ; DNA Fingerprinting ; Homicide ; Humans

Adenoma, Pleomorphic ; surgery ; Humans ; Parotid Neoplasms ; surgery

BACKGROUND:Thoracolumbar fracture becomes more in the clinic. The fixation manner of thoracolumbar fracture is controversial. Injured vertebra pedicle screw fixation or traditional cross-segment pedicle screw fixation are controversial and lack the support of evidence-based medicine. OBJECTIVE: To evaluate the outcomes of injured vertebra pedicle screw and cross-segment pedicle screw fixation for thoracolumbar fractures. METHODS: According to Cochrane system evaluation, the folowing databases were retrieved: National Library of Medicine database, China National Knowledge Infrastructure, Wanfang database and VIP database. Conference proceedings were searched by hand. The retrieval time ranged from 2005 to March 2015. Randomized controled trials were colected. Meta-analysis was performed by using Cochrane Colaboration Revman 4.2. RESULTS AND CONCLUSION: By screening, a total of 14 clinical controled trials were selected, including 956 patients. Meta-analysis results showed that postoperative Cobb angle was improved significantly in the vertebral pedicle screw group than in the cross-segment pedicle screw fixation group (OR=-2.72, 95%CI:-3.08--2.35,P < 0.01). Correction rate of the vertebral height was higher in the vertebral pedicle screw group than in the cross-segment pedicle screw fixation group (OR=7.45, 95%CI:6.94-7.97,P < 0.01). The failure rate was lower in the vertebral pedicle screw group than in the cross-segment pedicle screw fixation group (OR=0.12, 95%CI: 0.05- 0.27,P < 0.01). Results verify that postoperative Cobb angle improved significantly after the injured vertebrae pedicle screw and cross-segment pedicle screw fixation for thoracolumbar fractures. The height was obviously corrected and fewer complications were caused such as implant failure. The fixation effect was good.

Objective To describe the status of the self-efficacy and coping styles of tuberculosis patients,analysis the relationship between self-efficacy and coping styles. Methods With the method of convenient sampling, used the general information questionnaire self-designed, General Self-Efficacy Scale (GSES) and Medical Coping Modes Questionnaire (MCMQ) to take questionnaire survey on 132 patients with pulmonary tuberculosis.Applicated SPSS19.0 software for the statistics, and analyzed the relationship between self-efficacy and coping styles on patients with pulmonary tuberculosis. Results The mean score of self-efficacy in 132 pulmonary tuberculosis patients was 24.90 ± 7.04,which was in the medium to low level. The proportion of mediun,lower,higher level of self-efficacy was 44.70% (59/132), 39.40%(52/132),15.90%(21/132).Scores of the coping styles on face,avoid, yield were 21.16±9.23,16.55± 2.83,9.68 ± 4.12.Patients self-efficacy level was positively correlated with face coping style (r=0.242, P<0.05), avoid coping style (r=0.150, P<0.05),and negatively correlated with the yield response (r=-0.008, P<0.05). Conclusions The general self-efficacy level of tuberculosis patients is at a lower level. Tuberculosis patients should have more choice to handle it.

China ; Humans ; Occupational Health Services

Objective: To observe the morphological changes of enteric deep muscular plexuses interstitial cells of Cajal (ICC-DMP) in rats with multiple organ dysfunction syndrome (MODS). Methods: Forty Wistar rats were randomly divided into control group and MODS model group. The enteric ICC-DMP network was observed using c-kit immunohistochemical staining with whole-mount preparation technique and confocal laser scanning microscopy , and the ultraslructural features of ICC-DMP was evaluated using transmission electron microscope. Results: Compared with those in control group, the distributions and densities of intestine ICC-DMP in MODS group were significantly decreased (P < 0. 05) , the ICC-DMP network was disrupted and the ultrastructural features of ICC-DMP were severely damaged. Conclusion: The ICC-DMP network was severely damaged in rats with MODS, and the mechanism of gastrointestinal dysmotility in MODS may be related to the morphological changes of ICC-DMP.

Atrophy ; Disability Evaluation ; Humans ; Kidney

Objective To observe the changes in platelet parameters including platelet volume distribution width (PDW),plateletcrit (PCT) and platelet large cell ratio (PLCR) in patients with septic shock,and to approach its predictive effect on prognosis to obtain the indexes predicting the prognosis quickly and conveniently.Methods A retrospective study was conducted.Data from septic shock patients admitted to Peking Union Medical College Hospital from January 1 to December 31,2012 were collected.The patients were divided into two groups according to prognosis.The general condition,laboratory parameters,infection,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,and platelet parameters at 5 days after admission and 2 days before discharge from hospital,such as platelet count (PLT),Mean platelet volume (MPV),PDW,PCT and PLCR were recorded.Receiver operating characteristic curve (ROC curve) was drawn for those parameters and the area under curve was compared.Results A total 124 septic shock patients were enrolled finally,88 of the patients died and 36 remained alive.PDW and PLCR were elevated with the progress of the disease,the PLT and PCT were declined,and MPV maintained at a high level.The control group showed an opposite trend.MPV in non-survivor group was significantly higher than that in survivor group [fl:11.2 (10.5,12.5) vs.10.3 (9.7,11.0),relative risk (RR)=3.362,P=0.009].There was no significant difference in PLT,PDW,PCT and PLCR between non-survivor group and survivor group [PLT(× 109/L):105.0(47.5,191.5) vs.164.0 (85.0,236.0),RR=1.004,P=0.441; PDW:0.14 (0.12,0.17) vs.0.12 (0.11,0.13),RR=1.053,P=0.795;PCT:0.13 (0.07,0.21)％vs.0.18 (0.09,0.24)％,RR=0.234,P=0.747; PLCR:33.7 (28.1,42.8)％vs.26.8 (23.2,32.0)％,RR=0.924,P=0.324].ROC curve showed the best cutoff value for PLT was ＞487.0 × 109/L,with AUC of 0.377,sensitivity of 1.14％,specificity of 100％,diagnosis accuracy of 29.27％ and Youden index of 0.011; the best cutoff value for MPV was ＞ 10.5 fl,with AUC of 0.812,sensitivity of 81.82％,specificity of 65.71％,diagnosis accuracy of 75.61％ and Youden index of 0.475; the best cutoff value for PLCR was ＞39.3％,with AUC of 0.758,sensitivity of 48.86％,specificity of 91.43％,diagnosis accuracy of 60.98％ and Youden index of 0.403;the best cutoff value for PCT was ＞0.33％,with AUC of 0.380,sensitivity of 7.96％,specificity of 97.14％,diagnosis accuracy of 32.52％ and Youden index of 0.051 ; the best cutoff value for PDW was ＞0.12,with AUC of 0.747,sensitivity of 82.96％,specificity of 57.14％,diagnosis accuracy of 74.80％ and Youden index of 0.401.Conclusions Different change trends of platelet parameters can be seen between the non-survivors and survivors of septic shock patients.If PDW,PLCR and MPV show increased trend while PLT and PCT show decreased trend,a poor prognosis maybe indicated.MPV may be most useful in prognosis forecast because of its biggest AUC.