Cardiomyopathy, Hypertrophic ; surgery ; Catheter Ablation ; Child, Preschool ; Humans ; Infant ; Myocardium

Objective To study the prevalence of thyroid diseases in systemic lupus erythematosus (SLE) patients and to analyze the prevalence of subclinical hypothyroidism (SCH) with lupus nephritis (LN).Methods A total of 813 hospitalized SLE patients were retrospectively analyzed.The demographic,clinical and biochemical data were collected.The prevalence of different thyroid diseases was calculated.Among all patients,83 patients with SCH and 562 patients without any thyroid diseases were recruited according to thyroid hormone,thyroid stimulating hormone (TSH) and anti-thyroid antibodies levels.Case control study was performed to explore the potential risk factors for SCH in SLE.T test,Mann-Whitney U test,x2 test and Logistic regression analysis were used for statistical analysis.Results Among the 813 patients,13 (1.6％) had clinical hypothyroidism,83(10.2％) had SCH,13 (1.6％) had central hypothyroidism,27(3.3％) had autoimmunethyroid disease (AITD),10 (1.2％) had hyperthyroidism,95 (11.7％) had euthyroid sick syndrome (ESS) and 11 (1.4％) had nodules.SCH was more frequent in patients with LN (13.7％,50/366) than those without LN [7.4％(33/447),x2=8.654,P＜0.01].Meanwhile,prevalence of LN was also significantly higher in SCH group in case control study [60.2％(50/83) vs 42.9％(241/562),x2=8.800,P＜0.01].Besides,SLE patients with SCH had more severe proteinuria,hypoalbuminemia,and hyperlipidemia,which were complications of LN.In addition,the SCH group presented significantly higher anti-dsDNA antibody positive rate [50.6％(42/83) vs 33.7％(212/562),x2=5.026,P＜0.01].In Logistic regression models,24-hour urine protein and serum creatinine was retained as independent correlated factors with SCH after adjusted for demographic variables,risk factors,and other potential confounders.The presence of SCH was associated with increased 24-hour urine protein levels,occurring in 10.4％ of subjects with 24-hour urine protein ≤ 150 mg,11.9％ with 24-hour urine protein 150.1-1 500 mg,17.2％ with 24-hour urine protein 1 500.1-3 500 mg,and d24.4％ with 24-hour urine protein ＞3 500 mg (P＜0.05 for trend).In addition,when eGFR ≥30 ml·min-1· 1.73 m-2,the prevalence of SCH was increased as eGFR decreased:occurring in 12.8％ with eGFR ≥90 ml·min-1· 1.73 m-2,12.6％ with eGFR 60-89.9 ml·min-1· 1.73 m-2 and 20.0％ with eGFR 30-59.9 ml ·min-1· 1.73 m-2.Conclusion Thyroid diseases are common in SLE patients,and SCH is closely related with LN and disease activity.

Objective To study the relationship between parameter settings in the intensity-modulated radiation therapy (IMRT) planning in order to explore the effect of parameters on absolute dose verification.Methods Forty-three esophageal carcinoma cases were optimized with Pinnacle 7.6c by experienced physicist using appropriate optimization parameters and dose constraints with a number of iterations to meet the clinical acceptance criteria.The plans were copied to water-phantem,0.13 cc ion Farmer chamber and DOSE1 dosimeter was used to measure the absolute dose.The statistical data of the parameters of beams for the 43 cases were collected,and the relationships among them were analyzed.The statistical data of the dosimetry error were collected,and comparative analysis was made for the relation between the parameters of beams and ion chamber absolute dose verification results.Results The parameters of beams were correlated among each other.Obvious affiliation existed between the dose accuracy and parameter settings.When the beam segment number of IMRT plan was more than 80,the dose deviation would be greater than 3％ ; however,if the beam segment number was less than 80,the dose deviation was smaller than 3％.When the beam segment number was more than 100,part of the dose deviation of this plan was greater than 4％.On the contrary,if the beam segment number was less than 100,the dose deviation was smaller than 4％ definitely.Conclusions In order to decrease the absolute dose verification error,less beam angles and less beam segments are needed and the beam segment number should be controlled within the range of 80.

Objective To investigate the effect of enteral nutrition tolerance assessment form on the early enteral nutrition tolerance in patients with gastric cancer after operation. Methods According to the admission sequence, 108 patients with gastric cancer were divided into the control group and the experiment group with 54 cases in each group. Enteral nutrition was used in the control group, while enteral nutrition tolerance assessment form was used to evaulate and care patients in experiment group. Finally, the two groups were compared in the anal exhaust time and the rate of complications. Result Anal exhaust in the experiment group was significantly earlier than that in the control group and the rate of complications was significantly smaller than that of the control group (P < 0.05). Conclusions The enteral nutrition tolerance assessment form for systemic evaluation and intervention is effective in improvement of the patients′tolerance to enteral nutrition in early postoperative enteral nutrition support to patients with gastric cancer. It can promote the recovery of patients.

As the integration of human parasitology and medical microbiology curriculum, pathogen biology, although constructed and developed about 20-years, didn't realize the true integration of the two disciplines. Beyond that, it was also faced with numerous difficulties such severe compression of human par-asitology class, lack of teaching materials to achieve the true meaning of integration, difficulty to cultivate teachers and so on. The organ-system based learning (OBL) curriculum model may provide new strategies for the dilemma, to be resolved through the following channels: Rearranging the curriculum and teaching materials based on the classification of pathogenic organism parasitic or invasive organs; Corresponding training in microbiology and parasitology teaching by teachers continuous realization, while highlighting the professional teaching level of highly qualified teachers in both courses.

Objective: To explore the pattem of lymphatic metastasis and influencing factors of thoracic esophageal carcinoma. Methods: We reviewed the pathological specimens from 229 esophageal carcinoma patients who underwent radical esophagectomy with two-field lymphadenectomy. A total of 2,458 lymph nodes were dissected. We analyzed the lymph node metastasis pattern of the primary tumor in different loca-tions and the corresponding influencing factors such as pathological T stage, tumor length, pathological mor-phology and tumor differentiation. Results: Lymph node metastasis rates were 44.5% (102/229) and 10.5% (258/2458), respectively. For patients with upper thoracic esophageal carcinomas, lymphatic metastasis rates in the superior mediastinum, the middle mediastinum, the inferior mediastinum and the abdominal cavity were 19.0%, 6.7%, 9.8% and 12.2%, respectively. For patients with middle thoracic esophageal carcinomas, the rates were 26.1%, 7.4%, 11.8% and 11.9%, respectively. For patietns with lower thoracic esophageal carcino-mas, the rates were 0, 1.6%, 5.3%, and 10.0%, respectively. Lymphatic metastasis rate in T_1, T_2, T_3, T_4, stage cancer were 28.6%, 43.8%, 47.6%, and 31.3%, respectively; the rate of positive lymph nodes were 7.9%, 10.8%, 10.7%, and 10.8%, respectively, with no significant differences among the four stages (x~2=2.733, P=0.435 and x~2=0.686, P=0.876). Lymphatic metastasis rate and rate of positive lymph nodes in patients with tu-mor ≤3cm, 3 to 5cm, and >5cm were 45.2% and 43.4%, 46.2% and 9.1%, and 11.6% and 11.7%, respective-ly, with no significant differences (x~2=0.094, P=0.954 and x~2=3.933, P=0.140). Lymphatic metastasis ratios of the pathological morphology in medullary, ulcerative, mushroom and stenotic types were 14.0%, 9.6%, 4.3% and 18.3%, respectively (x~2=19.292, P=0.000). Lymphatic metastasis rate and rate of positive lymph nodes of squamous cell carcinoma of moderately and poorly differentiation were 42.5%, 75.0% and 9.5%, 18.6%, re-spectively (x~2=4.852, P=0.028 and x~2=11.323, P=0.001). Patients with squamous cell carcinoma of poorly dif-ferentiation had a higher rate of lymph node metastasis. Conclusion: Lymphatic metastasis of esophageal car-cinoma metastasize widely even if in early T stage. Pathological morphology and tumor differentiation are re-lating facors of lymph node metastasis of thoracic esophageal carcinoma.

Objective To investigate the result and side effect of late course accelerated three-di-mensional conformal radiotherapy (3DCRT) for esophageal carcinoma. Methods From July 2003 to March 2006, 55 patients with esophageal carcinoma receiving 3DCRT were randomly divided into late course accel-erated radiation group (group A, 27 patients) and conventional fractionation group (group B, 28 patients). The prescribed dose in group B was 64 -66 Gy, 2 Gy per fraction, 1 fraction per day, 5 fractions per week for about 6.5 weeks. Patients in group A received conventional fractionation irradiation for the first 4 weeks. Then the dose was increased to 3 Gy per fraction to a total dose of 67 -70 Gy. The treatment course in group A was about 6 weeks. The treatment response, acute site effects, 1-, 3-and 5-year local control rates and o-verall survival rates of the two groups were observed. Results In group A, 23 patients (85%) achievedcomplete response (CR) and 4(15%) achieved partial response (PR). While in group B, 16 patients (57%) achieved CR and 12(43%) achieved PR. The CR rate was significant higher in group A (χ~2 = 5.24,P=0.022). The 1-, 3-, 5-year local control rates were 85%, 54%, 54% in group A, and 70%, 56%, 33 % in group B (χ~2 = 0.68, P = 0.409), respectively. The 1 -,3-,5-year overall survival rates of the two groups were 81%, 37%, 29% and 61%, 39%, 23% (χ~2 = 0.06, P = O. 804), respectively. Both lo-cal control and overall survival were similar between the two groups. The incidences of acute radiation esoph-agitis in the two groups were similar (85% vs. 89% ;χ~2 =0. 00,P=0. 959), and the incidence of radiation pneumonitis was slightly higher in group A than in group B (67% vs 43% ;χ~2 =3.14,P =0.076). By the last follow up, 19 patients in group A and 21 in group B died. Among them, 10 in group A and 15 in group B died of local failure, while 7 in group A and 5 in group B died of metastasis. Conclusions When com-pared with conventional fractionation 3DCRT, late course accelerated 3DCRT for esophageal carcinoma can achieve better results in clinical response, though not in long-term local control or survival. The incidence of acute radiation esophagitis and pneumonitis is clinically acceptable.

Objective To observe the incidence of RP in NSCLC and esophageal carcinoma treated with 3DCRT and investigate the relationship between acute RP and lung function and dosimetric parameters.Methods From October 2006 to August 2008, 3DCRT plus concurrent chemotherapy of NP or LFP were applied to 64 patients with locally advanced NSCLC or esophageal carcinoma. twenty-three patients suffered form NSCLC and 41 patients from esophageal carcinoma, the prescription doses were 60 Gy/30fx and 58 -64 Gy/29 -32fx, respectively. Results For patients with esophageal carcinoma, 34% developed RP(9 grade 1,3 grade 2 and 2 grade 3). For patients with NSCLC, 96% developed RP(9 grade 1, 8 grade 2 and 5 grade 3). There was significant difference between the two groups(t =5. 55,P=0. 000). The FEV1.0/FVC and DLCO of patients with NSCLC were significantly lower than those of esophageal carcinoma, the ratio were 75.6%:82.7%(t=2.75,P=0.008)and 71.7%:81.0%(t=2.50, P=0.015),respectively. For patients whose FEV1.0, FEV1.0/FVC%, DLCO ＜80% and ≥80% before irradiation,the incidence of ≥2grade ARP were 35% vs 25% ,31% vs 26% and 35% vs 19%, respectively(x2 = 1.81,0.15,2. 13,P =0.179,0.697,0.144). While for patients whose FEV1.0 ＜ 70% and ≥70%, the incidence of severe ARP were 67% and 22% ,respectively(x2 =5.64, P =0.018). Spearman correlated analysis indicated that all the dosimetric parameters had relation with ≥ 2 grade ARP . The V20 of lung and MLD were found independently associated with RP according to multivariate analysis(x2 = 4.61,6.97, P = 0.032,0.008).Conclusions Parameters of basic lung function can predict the incidence of ≥2 grade RP to some extent,especially when the value of FEV1.0, FEV1.0/FVC%, and DLCO was lower. However, the V20 of lung and MLD may be the most valuable predictors.

Colon, Sigmoid/surgery* ; Colostomy ; Humans ; Ostomy ; Prolapse ; Surgical Stomas

Objective To obtain the fusion genes of several human orphan G protein coupled receptors (oGPCRs) with Gi1α subtype of G protein and their expression system. Methods The whole open reading frames of GPR45, GPR85, GPR174 and Gilα were cloned by RT-PCR from HepG2 cDNA separately,and the corresponding fusion genes were amplified by overlap extension PCR. Then, the fusion genes-containing pBacmids were successfully constructed with the Bac-to-Bac baculovirus expression system indicated by specific transposition and virus recombination. The insect Sf9 cells were transfected with pBacmid-oGPCRs-Gi1α, and the supernatant containing recombinant virus was harvested. With the supernatant, insect Sf9 cells were infected under an optimized condition (MOI=5, infection time=72 h) and the fusion proteins were prepared and detected by Western blotting.Results The three fusion genes of GPCR45, GPR85 or GPR174 with Gi1α were obtained. The corresponding fusion proteins could be properly prepared in Sf9 cells.Conclusion Human oGPCRs could be fused with Gilα, and the fusion genes could be expressed using the Bac-to-Bac baculovirus expression system in insect Sf9 cells.