Objective To assess the status and severity of bone disease in patients with multiple myeloma (MM) by using chest computerized tomography (CT) and the relationship between clinical prognostic parameters and bone disease.Methods All 46 newly diagnosed MM in-patients received both imaging tests of chest CT and plain X ray.An experienced radiologist reviewed all the imaging data.Clinical laboratory parameters,stages of Durie-Salmon (DS) and International Staging System (ISS) were evaluated.Five cytogenetic abnormalities of bone marrow myeloma cells were tested by fluorescence in situ hybridization (FISH).Results The sensitivity of CT and X ray to determine pathological fractures was comparable,the positive rates of which were 41.3％ (19/46) and 30.4％ (14/46) respectively (P =0.29).Nevertheless,the positive rate of osteolytic lesions ascertained by CT was significantly higher than that by X ray (P ＜ 0.001),60.9％ (28/46) vs 13.0％ (6/46) with diameter 5-10 mm and 50.0％ (23/46) vs 10.9％ (5/ 46) with diameter more than 10 mm.Osteolytic lesion numbers found by CT were more than those by X ray [5(0-21) vs0(0-4) lesions with diameter5-10 mm (P＜0.001),2(0-14) vs0(0-2) lesions with diameter more than 10 mm (P ＜ 0.001),respectively].Patients with positive osteolytic lesions had higher percentage of RB1 gene deletion[46.7％ (14/30) vs 18.8％ (3/16),P ＜0.001],D13s319 deletion [43.3％ (13/30) vs 18.8％ (3/16),P ＜0.001] and high risk cytogenetic abnormalities[50.0％ (15/30) vs 25.0％ (4/16),P ＜ 0.001].Conclusions Chest CT is more sensitive than plain X ray in detecting osteolytic myeloma bone disease.Osteolysis determined by CT is relevant to clinical DS stages and risk stratification of cytogenetic abnormalities.

OBJECTIVETo investigate the association of -141C insert/delete polymorphism with schizophrenia in Wuhan of Hubei province.

METHODSA case-control study was conducted to analyze the polymorphism in the D(2) receptor gene promoter region with schizophrenia. A total of 120 cases of schizophrenia diagnosed according to CCMD-II R criteria and 100 normal controls were recruited in the study.

RESULTSIn this sample, the allele and genotype showed statistically significant differences between patients and normal controls (P<0.05).Especially, the frequency of -141C del was 11% in patients and 18% in control(OR 0.55, 95% CI 0.30-0.96; P<0.05). This allele was less common in schizophrenia than in normal controls (P<0.05).

CONCLUSIONThe -141C del polymorphism is associated with schizophrenia.The polymorphism may modify the association with other factors. Possibly -141C del in the DRD(2) promoter region is a strong candidate for a protective factor for this trait.

Adult ; Alleles ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Promoter Regions, Genetic ; genetics ; Receptors, Dopamine D2 ; genetics ; Schizophrenia ; diagnosis ; genetics

OBJECTIVETo evaluate the exploratory development of bone graft by titanium mesh with bone allograft in treatment of cervical spinal tuberculosis.

METHODSThirty two cases of cervical spinal tuberculosis treated with anterior radical debridement, decompression and inter fixation from January 2002 to January 2007 were included (at least two years follow-up). 18 male and 14 female, age from 18 to 72, mean 41.3 years old. 0.5 - 15.0 months before visit, mean 6.9 months. There were 13 cases in initial treatment group and 19 cases in retreatment group. All cases were divided into two groups (group A and group B) by resource of bone graft. Group A, titanium mesh with bone allograft, 17 cases. Group B, autograft with ilium, 15 cases. Operation time, blood loss, curing conditions, cervical curvature (absolute rotation angle, ARA), function of spinal cord and the rate for bone graft fusions in two groups were compared. The mean follow-up was 3.5 years (range 2 - 5 years).

RESULTSThe primary healing rate of incisions was 93.8% (30/32), and total healing rate was 96.9% (31/32). There were no significant differences in operation time or in blood loss between two groups (P > 0.05). Operation time and blood loss, 72 min/121 ml in group A and 90 min/198 ml in group B, there were significant differences between two groups (P < 0.05). In each group, there were significant differences in the function of spinal cord between preoperative and immediately post operative, between preoperative and follow-up, and between immediately post operative and follow-up (P < 0.05), and there were significant differences in ARA between preoperative and immediately post operative, and between preoperative and follow-up (P < 0.05), and there were no significant differences between immediately post operative and follow-up (P > 0.05). On preoperative, immediately post operative and follow-up, there were no significant differences in the function of spinal cord or in ARA between two groups (P > 0.05).

CONCLUSIONFor cervical spinal tuberculosis followed by effective individual chemotherapy, a good effect can be obtained by treated with radical debridement and bone allograft with titanium mesh.

Adolescent ; Adult ; Aged ; Bone Transplantation ; methods ; Cervical Vertebrae ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Surgical Mesh ; Titanium ; Transplantation, Homologous ; Treatment Outcome ; Tuberculosis, Spinal ; surgery ; Young Adult

The regulation of foreign gene expression in Insect-Baculovirus Expression System is very complex. In this report, the effect of 5'-UTR in the expression of hGH gene in cultured Sf9 cells was examined. A 18 bp length in the end of 5'-UTR of hGH (human Growth Hormone, hGH) cDNA including a stem-loop structure was deleted by PCR. The truncated hGH cDNA, delta 1hGH was cloned in pFastBac1, named pFast-Bac-delta 1hGH. After transforming into E. coli. DH10Bac, which have a shuttle vetor-Bacmid, the delta 1hGH was integrated into Bacmid by site-specific transposition, and an expression vector, rBacmid-delta 1hGH DNA was acquired. By transfecting the cultured Sf9 cells with the recombinant expression vector DNA, pure recombinant virus, rAcV-Bac-delta 1hGH was obtained, and hGH gene was expressed. Immuno-blot and Chemiluminescent assay revealed that the expressed hGH had normal immunological activity, the amount of hGH expression level in Sf9 cell supernatant infected with rAcV-Bac-delta 1hGH containing the truncated 5'UTR was four to five times higher than that infected with rAcV-Bac-hGH.
5' Untranslated Regions ; genetics ; Animals ; Base Sequence ; Cells, Cultured ; DNA, Complementary ; genetics ; Gene Expression Regulation ; Genetic Vectors ; genetics ; Human Growth Hormone ; genetics ; metabolism ; Humans ; Immunoblotting ; Insecta ; cytology ; genetics ; Recombinant Proteins ; isolation & purification ; metabolism

Objective: To investigate the effects of preoperative sarcopenia on postoperative clinical outcome in patients with gastric cancer. Methods: A prospective study was performed in 93 patients with gastric cancer and the skeletal muscle mass was examined by bioelectrical impedance. The primary outcome was postoperative complications. The secondary outcomes were postoperative length of stay, overall hospital costs, 60 days re-admission and mortality rate. Results: A significant difference (sarcopenia group vs. non-sarcopenia group) was observed in the rates of overall postoperative complications, incidence of pleural effusion and intra-abdominal infection, overall hospital stay and postoperative hospital stay (P ＜ 0. 05). The rates of 60 days readmission, 60 days mortality and hospital costs in sarcopenia group were not different between the two groups (P ＞ 0. 05). By univariate and multivariate analysis, preoperative sarcopenia and preoperative nutritional risk are the risk factors of postoperative complications. Conclusion: Sarcopenia is an independent risk factor for postoperative complications in patients with gastric cancer; preoperative patients with sarcopenia have a worse prognosis and should be screened and optimized before surgery.

Objective To evaluate the development level of public health in Zhejiang Province during China's 12th Five-Year Plan period (from 2011 to 2015)for health policy making in the future. Methods Totally 30 indexes were first summarized into 4 components, including the residents' health level, the allocation of public health resource, the level of public health service and public health security. The evaluation index system was developed by Delphi method. The indicators of 2010 were selected as the baseline for comparison with those corresponding indicators from 2011 to 2015. Each index(the comprehensive development index, the developmental speed, as well as the indicator index)calculated during 12th Five-Year Plan period was evaluated after the targeted indicators were weighed. Results Overall, at a provincial level of Zhejiang, the comprehensive development index was increased from 100 in 2010 to 138.44 in 2015, representing an annual average development speed of 6.72%. The annual average development speed of 13 indexes, ranging from 6.72% to 26.18%, were higher than those in the China's 11th Five-Year Plan period(6.72%); while the annual average development speed of another 17 indexes was lower, with 1 index below zero. However, the number of medical staff per 10000 population(5.23), the treatment success rate among new smear-positive cases (90.76%)and the number of annual outpatient visits in primary hospitals(49.45%)in Zhejiang Province were lower than those in China during the same period(6.39, 92.49%, 56.40%). At a prefectural level, the comprehensive development index fluctuated from 128.65 in Quzhou to 156.35 in Jiaxing and the developmental speed was from 3.90% to 11.26%. These results indicated that the coefficient variant(CV)was 5.76 during China's 12 th Five-year Plan period, which had recorded the historically lowest level since 2010. Conclusion During the China's 12th Five-year Plan period, the development of public health in Zhejiang Province was steadily enhanced. Public health variably developed across 11 prefectures with shrinking gaps. Nevertheless, the number of medical staff per 10 000 population, the treatment success rate among new smear-positive cases and the number of annual outpatient visits in primary hospitals should be improved.

Objective To explore the factors associated with the complications of cranioplasty, infection and local epidural hematoma, such as age, sex, primary disease, skull defect and concomitant hydrocephalus. Methods 211 patients after cranioplasty were reviewed. Results 8 cases (3.8%) complicated one of them, in which 6 cases with local epidural hematoma and 2 cases with infection. The infection was more likely related with the areas of skull defect (P=0.003). No factor was found related with the local epidural hematoma. Conclusion It is necessary to focus the size of the frontal sinus when repairing the the frontal bone, to avoid the screw into the frontal sinus caused infection.

OBJECTIVETo search for an effective therapy for functional anejaculation (AE).

METHODSFifty-five AE patients were randomized into a treatment group (n = 30) and a control group (n = 25), the former treated with Yangjing Capsule (once 5 pills, tid) and low-dose tadalafil (5 mg, qd alt, 1 h before bedtime), while the latter with oral ephedrine (25 mg before bedtime). Meanwhile, the patients were advised to expose themselves to sexual stimulation, reduce the frequency of sexual intercourses and quit masturbation. The medication lasted 1-3 months, followed by observation of the therapeutic effects.

RESULTSThe total effectiveness rate was 83.34% in the treatment group, 11 cases cured, 8 obviously improved, 6 improved and 5 unimproved, significantly higher than 40.00% in the control group, 4 cases cured, 3 obviously improved, 3 improved and 15 unimproved (P < 0.05).

CONCLUSIONYangiing Capsule plus low-dose tadalafil is safe and effective for the treatment of functional anejaculation.

Adult ; Capsules ; Carbolines ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Infertility, Male ; drug therapy ; Male ; Phytotherapy ; Sexual Dysfunction, Physiological ; drug therapy ; Tadalafil ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the image features and the diagnostic value of spiral CT for cystic renal cell carcinoma.

METHODSThe clinical data and CT manifestations of 17 operated and pathologically proven cystic renal cell carcinoma were retrospectively analyzed. There were 12 males and 5 females with an average age of 47.3 years (33 - 82 years). Plain and contrast CT scan (Siemens somatom) single layer sensation 16 layer spiral CT had been performed before operation. The image of artery phase (30 - 40 s), venous (60 - 70 s) and excretory (120 - 180 s) were respectively obtained after contrast administration. Various image reconstructions were done using Siemens Wizard workstation based on the raw images.

RESULTSIt was found that 5 cystic renal cell cancers located in the right kidney and 12 in the left kidney. The long dimension of the tumor arranged from 21 - 100 mm with an average of 57 mm. The tumor looked like a round or round-like shape with density similar to fluid on plain CT scan. Some cystic renal carcinomas had a thick wall. Some had single or multiple cystic spaces filled with fluid of different densities. Some had infiltrated out of kidney surface or into renal sinus. Some showed enhanced nodules on the wall.

CONCLUSIONCystic renal cell carcinoma has its own specific morphologic features in spiral CT scan. Spiral CT may be very helpful in the diagnosis of cystic renal cell carcinoma before operation.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Kidney Diseases, Cystic ; diagnostic imaging ; Kidney Neoplasms ; diagnostic imaging ; Male ; Middle Aged ; Radiographic Image Enhancement ; Retrospective Studies ; Tomography, Spiral Computed ; methods

BACKGROUNDNeovascular glaucoma (NVG) is a refractory disease which is difficult to manage. This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab (IVB) injection in conjunction with Ahmed glaucoma valve implantation (AGVI) in the management of NVG.

METHODSThis was a retrospective study of patients with NVG in whom AGVI was performed between October 2008 and May 2012. The sample was divided into two groups according to the pretreatment: with adjunctive IVB injection (the IVB group, n = 25 eyes) and without adjunctive IVB injection (the control group, n = 28 eyes). The surgical success rate, number of antiglaucoma medications used, best-corrected visual acuity (BCVA), postoperative complications, regression, and recurrence of iris neovascularization (NVI) were analyzed between the groups.

RESULTSThe surgical outcomes of the two groups were compared. The complete success rates in the IVB and control groups were 84.0% and 64.3% at 12 months and 80.0% and 53.6% at 18 months, respectively. There was a significant difference between the two groups (P = 0.041). Mean postoperative intraocular pressures, mean number of postoperative antiglaucoma medications, and BCVA were not significant between the two groups. The NVI in 22 (88.0%) eyes had completely regressed within 2 - 8 days after IVB. However, NVI recurred in 10 eyes (40.0%) 2 - 9 months later after IVB. The IVB group had only 1 case (4.0%) of hyphema out of 25 eyes, while there were 8 (28.6%) cases of hyphema out of 28 eyes in the control group (P = 0.026).

CONCLUSIONSThis study showed that preoperative IVB injection reduced NVI remarkably, decreased hyphema, and led to higher surgical success rates. Pre-operative IVB injection may be an effective adjunct to AGVI in the management of NVG.

Adult ; Aged ; Angiogenesis Inhibitors ; administration & dosage ; Antibodies, Monoclonal, Humanized ; administration & dosage ; Bevacizumab ; Female ; Glaucoma Drainage Implants ; adverse effects ; Glaucoma, Neovascular ; therapy ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Male ; Middle Aged ; Prosthesis Implantation ; methods ; Retrospective Studies ; Visual Acuity