OBJECTIVETo summarize the clinical features, diagnosis and treatment of patients with primary biliary cirrhosis (PBC) in China.

METHODSSystematic analysis of clinical characteristics by searching the Chinese literatures.

RESULTSFrom 1955 to 2007, 2740 PBC patients were reported in 103 papers (duplicated reports were deleted). The detailed information of 985 patients from 16 papers were collected. Female : male was 6.82:1. The age range was 42 to 56.2-year-old. The time from onset to diagnosis was 12 to 98.4 months. The most common symptoms were fatigue (72.40%), jaundice (67.41%), anorexia (68.58%) and pruritus (45.60%). 20% patients were asymptomatic at onset. The most frequent physical signs were splenomegaly (57.53%), hepatomegaly (43.56%) and ascites (18.45%). Serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGT) levels were markedly elevated in most of these patients. The immunological marks of AMA and M2 were positive in 88.98% and 82.65% patients, respectively. The most common comorbidity were Sjögren syndrome (9.14%), rheumatoid arthritis (3.95%) and diabetes type II (2.54%). Of the 507 patients treated with ursodeoxycholic acid (UDCA), 345 patients got complete or partial clinical biochemical response. The common complications were gastrointestinal bleeding (41.67%) and liver failure (41.67%). Liver transplantation was the only effective way for the treatment of the end-stage liver disease.

CONCLUSIONThe clinical feature of primary biliary cirrhosis in China was similar to the overseas literatures. Further research should focus on epidemic investigation, early diagnosis, long term follow up of asymptomatic patients, immunological mechanism and the efficacy of liver transplantation.

Adult ; Alanine Transaminase ; blood ; Autoantibodies ; analysis ; Biomarkers ; blood ; China ; epidemiology ; Female ; Humans ; Immunoglobulin M ; blood ; Liver Cirrhosis, Biliary ; diagnosis ; epidemiology ; immunology ; therapy ; Liver Function Tests ; Liver Transplantation ; Male ; Middle Aged ; Mitochondria, Liver ; immunology ; Retrospective Studies ; Ursodeoxycholic Acid ; therapeutic use ; gamma-Glutamyltransferase ; blood

OBJECTIVETo describe the pregnant women's utilization of prenatal screening for Down's syndrome and its influencing factors.

METHODSFrom October 2007 to December 2008, 4250 lying-in women in 54 hospitals were surveyed by stratified cluster sampling method in Zhejiang, Hunan and Sichuan, which located in Eastern, Central and Western China, respectively. Demographic characteristics, knowledge and health behaviors were collected by the questionnaire of lying-in women's utilization and influencing factors of prenatal screening for Down's syndrome. Whether to use prenatal screening was determined by the lying-in women's medical history. Chi-square test and logistic regression analysis were used to analyze data.

RESULTSRespondents' age was (26.92 ± 4.60) years old. The total utilization rate of prenatal screening for Down's syndrome was 40.0% (1696/4237), and screening utilization rates in Zhejiang, Hunan and Sichuan were 48.23% (682/1414), 41.73% (616/1476) and 29.55% (398/1347), respectively. Screening utilization rates of respondents with college degree or above and high school or below were 72.68% (697/959) and 30.46% (998/3276), respectively. Screening utilization rates of urban and rural respondents were 63.00% (952/1511) and 27.11% (732/2700), respectively. Screening utilization rates of respondents under 35 years old and over 35 years old were 41.40% (1645/3973) and 19.32% (51/264). All differences were significant (all P values < 0.05). A total of 79.14% (1419/1793) of respondents thought it was necessary to take prenatal screening for Down's syndrome, and 79.47% (1506/1895) of respondents received doctors' suggestions, 24.2% (654/2702) of respondents who heard of prenatal screening for Down's syndrome could figure out the main pathogenic factors, while 23.0% (621/2702) didn't know any factors; 77.8% (2102/2702) of respondents heard of prenatal screening for Down's syndrome, but 12.3% (259/2102) didn't know the appropriate gestational weeks to uptake the screening, 47.0% (988/2102) knew of prenatal screening for Down's syndrome through healthcare providers. Logistic regression analysis result demonstrated that living in Zhejiang (OR = 1.62, 95%CI: 1.26 - 2.08), city residence (OR = 2.06, 95%CI: 1.63 - 2.60), with positive attitude to screening (OR = 5.00, 95%CI: 3.97 - 6.29), pregnant women's age below 35 years old (OR = 3.86, 95%CI: 2.53 - 5.89), receiving advices from healthcare providers (OR = 12.64, 95.0%CI: 9.97 - 16.02), college degree or above educational level (OR = 2.67, 95%CI: 2.03 - 3.50) were facilitating factors on utilization of prenatal screening for Down's Syndrome.

CONCLUSIONPregnant women's use of prenatal screening for Down's syndrome was not enough, and living in zhejiang, higher education level, rural respondents with age under 35 years old, receiving advice from healthcare providers or not and their attitude toward necessity were significant promotive factors of utilization of prenatal screening for Down's syndrome.

Adult ; China ; Down Syndrome ; prevention & control ; Factor Analysis, Statistical ; Female ; Humans ; Pregnancy ; Prenatal Diagnosis ; methods ; utilization ; Young Adult

It is generally accepted that the inhibition of apoptosis is one of the mechanism of drug resistance to tumor. Members of the bcl-2 gene family are the most important regulators in apoptosis. The purpose of this study is to evaluate the value of expression of bcl-2 and bax gene in predicting the prognosis of acute leukemia patients, and to explore the relationship between bcl-2 and bax expression and drug resistance. Seventy patients with acute leukemia entered this study. Expressions of bcl-2, bax and mdr-1 gene were measured by RT-PCR method and FCM. The result showed that: bcl-2 had been widely detected in specimens of blood or bone marrow from acute leukemia patients, the expression levels were much higher than those in normal control (1.46 vs 0.71, P < 0.05), bax expression levels and bax/bcl-2 ratio in patients had no significant difference with the control. No relationships were found between the expression levels of bcl-2 and bax and AL patients' age, sex, platelet counts, hemoglobin levels, percentage of marrow blasts, FAB classification, and S + G(2)M%. Both Bcl-2 protein expression (34.6% vs 69.2%, P < 0.03) and bax/bcl-2 mRNA ratio (37.1% vs 82.9%, P < 0.01) were associated with response to therapy and CR rate, bax/bcl-2 ratio also influences the overall survival time. There was no relationship between bcl-2 and bax expression levels and mdr-1 expression levels.

UNLABELLEDTo study the clinical significance of the expression of antiapoptosis gene, survivin and bcl-2, and proapoptosis gene, Fas and bax, in acute myeloid leukemia (AML), RT-PCR was used to examine the expression of survivin and flow cytometry (FCM) to detect the expression of Fas, bcl-2, bax and bcl-2/bax ratio in 68 cases of AML. The results demonstrated that: (1) The positivity of survivin mRNA expression was significantly higher in AML compared to control (70.6% vs 30%, P < 0.05). (2) The expression of Fas and bcl-2 in AML before treatment was significantly higher than that in control (P < 0.001), but the bax expression did not (P > 0.05). (3) The survivin-positive AML cases showed a significantly lower Fas and higher bcl-2 expression in comparison with survivin-negative ones (P < 0.01 and P < 0.001, respectively), but the bax did not (P > 0.01). (4) Survivin-positive AML cases had a lower CR rate as compared with survivin-negative cases (64.6% vs 90%, P < 0.05). (5) The survivin-positive CR cases showed a decreased expression of Fas and bcl-2 after treatment in comparison with pretreatment expression (P < 0.001), but the bax expression remained unchanged before and after therapy. The survivin-positive NR cases showed a significantly decreased Fas and increased bcl-2 expression as compared with pretreatment expression (P < 0.001). bcl-2/bax ratio was also significantly higher in NR cases.

IN CONCLUSION70.6% AML cases showed positive for survivin expression with a lower CR rate, the survivin-positive AML showed a low Fas with high bcl-2 expression and bcl-2/bax ratio as compared to the survivin-negative cases.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Biomarkers, Tumor ; biosynthesis ; genetics ; Bone Marrow Cells ; drug effects ; metabolism ; Female ; Flow Cytometry ; Gene Expression Regulation, Neoplastic ; Humans ; Inhibitor of Apoptosis Proteins ; Leukemia, Myeloid, Acute ; drug therapy ; genetics ; metabolism ; Male ; Microtubule-Associated Proteins ; genetics ; Middle Aged ; Neoplasm Proteins ; Proto-Oncogene Proteins ; biosynthesis ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; RNA, Messenger ; drug effects ; genetics ; metabolism ; bcl-2-Associated X Protein ; fas Receptor ; biosynthesis

OBJECTIVETo report a case of blastic natural killer cell leukemia with an aggressive clinical course.

METHODSThe characteristics of blastic NK cell leukemia and its treatment were discussed with review of literatures.

RESULTSAfter combination chemotherapy and spinal cord segmental radiotherapy, the patient entered hematological remission, but the extramedullary lesion remained unchanged.

CONCLUSIONBlastic NK cell leukemia has an aggressive clinical course with poor response to treatment and unfavorable prognosis.

Adult ; Combined Modality Therapy ; Humans ; Killer Cells, Natural ; pathology ; Leukemia, Lymphoid ; pathology ; therapy ; Leukemic Infiltration ; Male