Objective To study the impact of obesity on the perioperative outcomes of hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization (LSED).Methods The clinical data of patients who underwent hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization between Jan.2013 and Nov.2015 were retrospectively analyzed.The patients were classified as obese group A (BMI≥28 kg/m2) or non-obese group B (BMI ＜ 28 kg/m2).Group A was further divided into two subgroups:group A1 massive splenomegaly (diameter ＞ 20 cm) and A2 splenomegaly (diameter ≤20 cm).The conversion rates,operative complications,mortality,length of stay,operative time,and blood loss were analyzed and compared.Results One hundred and sixty patients who underwent hand-assisted LSED were included into this study.54 patients were in group A and 106 in group B.A significantly longer operative time was found in group A (291 min vs.261 min,P ＜ 0.05).The conversion rates,blood loss,length of hospital stay,overall morbidity rates,and mortality rates were similar in the two groups (P ＞0.05).The mean operative time was significantly longer in group A1 (336 min vs.270 min;P ＜0.01)although blood loss,conversion rates,and overall morbidity rates were higher in group A1.However,there were no significant differences (P ＞ 0.05).Conclusions Hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization for obese patients was safe and feasible.However,for patients with massive splenomegaly,LSED should be performed with caution.

ObjectiveTo analyze the classifications of the abnormalities of cervical curvature and its treatments with manipulation. Methods209 patients with cervical lordosis were analyzed. The abnormalities of the cervical curvature were classified as over-curvature (>45°), hypo-curvature (0°～30°), the straightened cervix (0°), backward curvature(0°～―20°), multiple curvatures (the cervical curvature showed "S" shaped). The C_5 subluxation were restored with manipulation in patients with hypo-curvature and straightened cervix, or other vertebra subluxation in multiple curvatures. Results1~4 yeared follow-up, 127 cases were excellently well being, 59 were well being, 23 were improved.ConclusionManipulation is effective on abnormalities of cervical curvature.

Objective To evaluate the safety and efficacy of neoadjuvant chemotherapy combined with PA-MSHA injection for the treatment of locally advanced breast cancer. Methods An open, randomized, controlled clinical trial was conducted in this study. 42 locally advanced breast cancer patients were randomly assigned to two groups, namely the experimental group (20 cases) and control group (22 cases). All the patients received chemotherapy of TEC regimen, while, in addition, the patients in experiment group received PA-MSHA injection. After the treatment, the efficacy of treatment was evaluated. The safety and tolerance of patients were also measured during the treatment. Results The overall response rate (CR+PR) [75.0 %(15/20)]in the experiment group was significant higher than that [54.6 %(12/22)]in control group (P < 0.01). Adverse reactions were found for 9 cases in experiment group, four of whom received medical care while the others recovered automatically. Conclusion PA-MSHA injection can significantly enhance the efficaey of neoadjuvant chemotherapy on the patients with locally advanced breast cancer. The PA-MSHA injection which has been proved safety in treatment is an ideal supplementary therapy for breast cancer.

OBJECTIVETo examine whether the implementation of Macao Medical Voucher Program has helped promote the health outcomes of the residents in the case of mortality from circulatory system diseases.

METHODSBased on 144 monthly observations of the mortality from circulatory system diseases in Macao during 2001-2012, we carried out a trend analysis of the time series to identify significant differences in the mortality data after the implementation of the Medical Voucher in Macao. This study was controlled for the compounding factors including medical resources (numbers of physicians, nurses and patient beds per thousand population and public healthcare expenditure), economic development level (GDP per capita), social human development level, population aging factor, natural seasonal effects and long-term trends.

RESULTSDuring 2010-2012 when the Medical Voucher Program in Macao was implemented, the annual mortality rates from circulatory system diseases were significantly lowered by 24% as compared with those recorded during 2001-2009 (P<0.01), which was equivalent to avoiding 123 deaths related of circulatory system diseases per year.

CONCLUSIONEvidence in this study suggests a robust connection between the timing of the implementation of Macao Medical Voucher Program and a significant decrease in the mortality from circulatory system diseases in Macao, but their causal relationship awaits confirmation in further research.

The Yellow Fever (YF) vaccine, an attenuated yellow fever 17D (YF-17D) live vaccine, is one of the most effective and safest vaccines in the world and is regarded as one of the best candidates for viral expression vector. We here first reported in China the construction and characterization of the recombinant expression vector of yellow fever 17D which contained the proteinase 2A fragment of foot-and-mouth disease virus (FMDV). Three cDNA fragments representing the full-length YF-17D genome, named 5'-end cDNA (A), 3'-end cDNA (B) and middle cDNA (C), were obtained by reverse transcription polymerase chain reaction (RT-PCR), together with the introduction of SP6 enhancer, necessary restriction sites and overlaps for homologous recombination in yeast. Fragment A and B were then introduced into pRS424 in turn by DNA recombination, followed by transfection of fragment C and the recombinant pRS424 containing A and B (pRS-A-B) into yeast. A recombinant vector containing full length cDNA of YF-17D (pRS-YF) was obtained by screening on medium lack of tryptophan and uracil. A recombinant YF-17D expression vector containing FMDV-2A gene fragment (pRS-YF-2A1) was then constructed by methods of DNA recombination and homologous recombination in yeast described above. In vitro transcription of the recombinant vector pRS-YF-2A1 was then carried out and introduced into BHK-21 cells by electroporation. Results of indirect immunofluorescence assay (IFA) and titer determination showed a stable infectious recombinant virus was gotten, whose features such as growth curve were similar to those of the parental YF-17D. The results suggest that the recombinant vector pRS-YF-2A1, by introduction of heterogenous genes via 2A region, is potential to be an effective live vaccine expression vector.
Animals ; Cell Line ; Cloning, Molecular ; Cricetinae ; Epitopes ; immunology ; Foot-and-Mouth Disease ; prevention & control ; Foot-and-Mouth Disease Virus ; genetics ; immunology ; Genetic Engineering ; Genetic Vectors ; Recombination, Genetic ; Saccharomyces cerevisiae ; genetics ; metabolism ; Vaccines, Attenuated ; Viral Vaccines ; genetics ; immunology ; Yellow fever virus ; genetics ; immunology

We have isolated a strain C611 that used methane as the sole carbon sources for growth from paddy soil in Taiyuan of Shanxi province. Based on the physiological characteristics and 16S rDNA sequence analysis, we identified the strain as Klebsiella sp.. We used statistic-based experimental design (RSM) to optimize the culture conditions for C611 strain. The optimum conditions were as follows: temperature of 24.4 degrees C, inoculum volume of 6.7% and methane content of 25%. We studied the response time and the relationship between consumption of dissolved oxygen and methane gas contents with PVA-H3BO3 immobilized cell of C611 using electrochemical method. The response time was no more than 100 s of this reaction system, and the linear range of detection of methane content was from 0 to 10%. The standard gas sample 3% methane was measured by this method with the mean content value of 3.09%, RSD of 3.48%, and the relative error of 3%. Hence, it has the potential in developing biosensor for methane.
Environmental Monitoring ; methods ; Klebsiella ; isolation & purification ; metabolism ; Methane ; analysis ; metabolism ; Soil Microbiology

INTRODUCTIONThe aims of this article were to review the role of surgical resection in the management of high-grade gliomas and to determine whether there is any survival benefit from surgical resection.

METHODSA literature review of the influence of surgical resection on outcome was carried out. Relevant original and review papers were obtained through a PubMed search using the following keywords: glioma, resection, prognosis and outcome.

RESULTSPresently, there is a lack of evidence to support a survival benefit with aggressive glioma resection, but this should not detract patients from undergoing surgery as there are many other clinical benefits of glioma excision. In addition, limiting surgical morbidity through the use of adjuvant techniques such as intraoperative magnetic resonance imaging (MRI), functional MRI and awake craniotomy is becoming increasingly important.

CONCLUSIONSIdeally, a randomised controlled trial would be the best way to resolve the issue of whether (and to what extent) surgical resection leads to improvements in patient outcome and survival, but this would not be ethical. The second best option would be well-controlled retrospective studies with a multivariate analysis of all potential confounding factors.

In order to facilitate the detection of newly emerging or rare viral infectious diseases, a negative-strand RNA virus-severe fever with thrombocytopenia syndrome bunyavirus, and a positive-strand RNA virus-dengue virus, were used to investigate RNA viral genome unspecific amplification by multiple displacement amplification technique from clinical samples. Series of 10-fold diluted purified viral RNA were utilized as analog samples with different pathogen loads, after a series of reactions were sequentially processed, single-strand cDNA, double-strand cDNA, double-strand cDNA treated with ligation without or with supplemental RNA were generated, then a Phi29 DNA polymerase depended isothermal amplification was employed, and finally the target gene copies were detected by real time PCR assays to evaluate the amplification efficiencies of various methods. The results showed that multiple displacement amplification effects of single-strand or double-strand cDNA templates were limited, while the fold increases of double-strand cDNA templates treated with ligation could be up to 6 X 10(3), even 2 X 10(5) when supplemental RNA existed, and better results were obtained when viral RNA loads were lower. A RNA viral genome amplification system using multiple displacement amplification technique was established in this study and effective amplification of RNA viral genome with low load was achieved, which could provide a tool to synthesize adequate viral genome for multiplex pathogens detection.
Bunyaviridae Infections ; diagnosis ; virology ; Cell Line ; DNA Ligases ; metabolism ; DNA, Complementary ; analysis ; genetics ; DNA-Directed DNA Polymerase ; metabolism ; Dengue ; diagnosis ; virology ; Dengue Virus ; genetics ; isolation & purification ; Genome, Viral ; genetics ; Humans ; Phlebovirus ; genetics ; isolation & purification ; RNA, Viral ; analysis ; genetics ; Reference Standards ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Viral Load

Placental site nodule as a kind of benign trophoblastic disease is rare.The features of placental site nodule are known very little. Pathological diagnosis is the gold standard, while the pathological features of atypical placental site nodule are known very little. Here we report a case of mass in uterus with atypical placental site nodule, which can supplement our knowledge of this disease.