Genetic manipulation of human pluripotent stem cells (hPSCs) provides a powerful tool for modeling diseases and developing future medicine. Recently a number of independent genome-editing techniques were developed, including plasmid, bacterial artificial chromosome, adeno-associated virus vector, zinc finger nuclease, transcription activator-like effecter nuclease, and helper-dependent adenoviral vector. Gene editing has been successfully employed in different aspects of stem cell research such as gene correction, mutation knock-in, and establishment of reporter cell lines (Raya et al., 2009; Howden et al., 2011; Li et al., 2011; Liu et al., 2011b; Papapetrou et al., 2011; Sebastiano et al., 2011; Soldner et al., 2011; Zou et al., 2011a). These techniques combined with the utility of hPSCs will significantly influence the area of regenerative medicine.
Cell Line ; Chromosomes, Artificial, Bacterial ; genetics ; Deoxyribonucleases ; genetics ; Dependovirus ; genetics ; Gene Targeting ; methods ; Genetic Engineering ; methods ; Genetic Vectors ; Genome, Human ; Humans ; Mutagenesis, Insertional ; Mutation ; Plasmids ; Pluripotent Stem Cells ; cytology ; metabolism ; Zinc Fingers ; genetics

OBJECTIVETo introduce a method for repairing and restoring hand function of the patients suffering from large surface area burn with scarce normal skin for reconstruction.

METHODSSeven patients (ten hands) were treated in our department from April 1994 to February 2001. The TBSA involved with second- or third-degree burns was 85%-96%. All the hands had severe scar contracture on the dorsum and lost most of their function. A scarred skin flap, based on the ulnar border of the hand was elevated integrally on the dorsum. A random-pattern abdominal flap at a less-scarred area was designed and elevated to cover the defect of the hand while the scarred skin flap of the hand was transferred to the donor site of the abdominal flap.

RESULTSAll patients were followed for 0.5 to 4 years postoperatively. The range of motion of the metacarpophalangeal joint and the space capacity of the first web were greatly improved. All patients regained self-care ability.

CONCLUSIONSThis method is simple and has satisfactory results. Under the circumstances where normal skin was not available for reconstruction, the function of the burned hand could be greatly improved by this method.

Abdominal Wall ; surgery ; Adolescent ; Adult ; Burns ; surgery ; Female ; Hand Injuries ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Surgery, Plastic ; methods ; Surgical Flaps ; Treatment Outcome

Objective To investigate the prognostic factors affecting the postoperative survival of patients with invasive bladder cancer,and to predict the survival time of the patients.Methods We retro- spectively analyzed the clinical and follow-up data of 178 patients with invasive bladder cancer treated by radical cystectomy and urinary diversion from 1991 to 2004.A multivariate analysis was performed in these patients by the Cox proportional hazard model.A prognostic index(PI)based on the Cox regression was con- structed.According to the individualized PI,the patients were classified into different hazard groups and the expected survival curve of each patient was calculated.Results Cox regression analysis showed that the factors which influenced the postoperative survival included tumor stage(RR=1.982,P=0.000),grade (RR=1.978,P =0.042),lymph node metastasis(RR=2.142,P=0.048),Tis(RR=6.177,P= 0.000),tumor shape(RR=0.416,P=0.003),number of tumors( RR=1.820,P=0.035),pathological type(RR=2.228,P=0.032),patient age(RR=0.672,P=0.025)and neoadjuvant chemotherapy (RR=0.257,P=0.016).Based on the percentile of PI,patients were classified into 3 prognostic groups; the median survival time of 3 groups were 42.5,22.5 and 7.0 months,respectively.There were significant differences between each 2 among the 3 groups(P＜0.01).Conclusions Neoadjuvant chemotherapy, tumor stage,grade,lymph node metastasis,Tis,shape and number of tumors,pathological type,patient age were important prognostic factors.PI value can be used to predict the prognosis of patients with invasive blad- der cancer.

A fetal/maternal multi-parameter monitor is introduced here in the paper. It can monitor the vital signs of a fetus and his/her mother in a same screen synchronously. It is more useful in obstetric clinics. Its other functions include management of patient file, computer-assistant analyses.
Adult ; Automatic Data Processing ; instrumentation ; Electrocardiography, Ambulatory ; instrumentation ; Equipment Design ; Female ; Fetal Monitoring ; instrumentation ; Heart Rate, Fetal ; Humans ; Microcomputers ; Monitoring, Ambulatory ; instrumentation ; Pregnancy ; Signal Processing, Computer-Assisted ; Software

OBJECTIVETo investigate clinical features and treatments of cervical spinal injury in aged patients.

METHODSFrom July 2006 to October 2011, 27 patients with cervical spinal cord injury were divided into experiment group, including 20 males and 7 females with an average age of 69 years old (ranged 65 to 78 years old). The other 22 patients with the same degree of cervical spianl cord injury and the same period hospitalization were chosen to regard as control group, including 16 males and 6 females with an average age of 47 years old (ranged 38 to 65 years old). All of them had clear history of trauma, and were admitted to hospital within one week. Clinical data and result of follow up were evaluated between two group. The function of the spinal cord was measured by Frankel classification at admission and final follow-up.

RESULTSAll patients were followed up for 1 year except 6 died in aged group, among which 3 paients with complications were died during hospitalization and others were out of hospital. Twenty-three cases had accompanied diseases and 24 cases occurred complications in aged group. Contrast to control group, this difference was statistically significant. At the final follow-up, there were 2 cases at Frankel grade E in aged group and 6 cases in control group.

CONCLUSIONIn comparison with control group, there are more accompany diseases and higher complications and mortality rates in aged group, while poor improvement of spinal cord function. This patients were mainly treated with operation, but operation method should simplify and mainly focus on effective decompression and reconstuction stability and avoid expansion operation. It's nesscerry to pay more attention to prevent and treatment of respiratory complication.

Adult ; Aged ; Cervical Vertebrae ; injuries ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; mortality ; therapy ; Spinal Injuries ; physiopathology ; surgery

OBJECTIVETo investigate the food water sources of adults in the four cities of China in summer.

METHODSA total of 64 adults aged 18 - 60 yrs from four cities (Beijing, Shanghai, Chengdu and Guangzhou)were selected using convenient sampling method. The food samples were collected by using duplicate portion method and the water content of food samples were determined by using the national standard. The information on amounts and types of daily drinking soup was recorded by subjects using a quantitative measurement.

RESULTSA total of 63 subjects had completed the investigation. The median of daily water from food of subjects was 1157 ml, while water from staple food was 480 ml, the median ratio of which accounting for 41.8% of water from food. Water from dishes was 427 ml, the median ratio of which accounting for 37.9% of water from food. Water from soups was 133 ml, the median ratio of which accounting for 13.8% of water from food. Water from snacks was 0 ml, the median ratio of which accounting for 6.4% of water from food. The medians of water from staple food (384, 388 and 435 ml, respectively) in Beijing, Shanghai and Guangzhou was significant lower than that of Chengdu subjects' (900 ml, χ(2) = 21.27, P = 0.000). But the median proportion of water from staple food of subjects in Beijing (47.7%) was significantly higher than that in Chengdu (43.2%), Shanghai (42.9%) and Guangzhou (33.9%) (χ(2) = 8.69, P = 0.034). The median of amount and proportion of water from soups of subjects in Guangzhou (267 ml, 24.4%) and Chengdu(278 ml, 15.7%) was significantly higher than that in Shanghai (133 ml, 9.0%) and Beijing (100 ml, 5.8%) (amount: χ(2) = 22.52, P = 0.000;proportion: χ(2) = 16.27, P = 0.001).

CONCLUSIONThe staple food and dishes are the main sources of daily food water.

Adolescent ; Adult ; China ; Drinking ; Female ; Food Analysis ; Humans ; Male ; Middle Aged ; Seasons ; Surveys and Questionnaires ; Urban Population ; Young Adult

OBJECTIVETo analyze the clinical characteristics of 73 cases of macrodactyly.

METHODSReview the incidence, distribution, characteristic, X-rays, pathogenesis and treatment of involved digits on the base of the clinical documents of 73 macrodactyly which were treated from 1965 to 2006. Twenty-eight cases had been followed-up.

RESULTSUnilateral involved 71 cases, bilateral involved 2 cases. In upper deformities, the most involved digit was the index finger, followed by thumb and middle finger enlargement. In lower deformities, the second toes were affected more. There were 12 cases of static macrodactyly, which were all presented at or soon after birth. Sixty-one cases were progressive macrodactyly: 39 cases presented at birth; 17 cases occurred at about 2 years old; 5 cases were found after age 2. Thirty-seven cases of progressive type presented digital deviation; 3 cases associated with syndactyly; 16 cases complicated with thenar eminence hypertrophy; 8 cases of multiple-digit involved combined with palm and forearm hyperplasia.

CONCLUSIONSMacrodactyly in hand has a preference for the median nerve territory, mainly involving index, thumb and middle finger. Pedal macrodactyly prefers medial plantar nerve territory, the second toe is the most commonly affected. The progressive macrodactyly is more common than static. It may present at birth and combine with syndactyly, digital deviation, thenar eminence hypertrophy, palm and forearm hyperplasia.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Fingers ; abnormalities ; Follow-Up Studies ; Foot Deformities, Congenital ; surgery ; Hand Deformities, Congenital ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Retrospective Studies ; Toes ; abnormalities ; Treatment Outcome

OBJECTIVETo investigate the significance of three dimensional visualization and virtual surgery system in living related donor liver transplantation surgery.

METHODSTwo patients suffered biliary calculi were scanned by 64 slice helical computer tomography (CT) on livers and the data were imported into medical image proceeding system (MIPS) for sequence. Man-made segmentation and true-up on the image from the data were carried out. Three dimensional (3D) models of the liver and the intrahepatic vessels were reconstructed by VTK software respectively. The models were exported with format STL from it and then were imported into the FreeForm Modeling System for smoothing and modifying. At last, living related donor liver transplantation were simulated with the force-feedback equipment (PHANToM).

RESULTSIt had great verisimilar image for the reconstructed 3D liver models with artery, hepatic vein, portal vein and bile duct. By seeing through liver, it had high fidelity and strong 3D effect for the intrahepatic artery, hepatic vein, portal vein and bile duct, and their spatial disposition and course and co-relationship were shown clearly. In the virtual surgery system, the virtual scalpel could be manipulated on 3D liver model with PHANToM. The simulating effect was the same as the clinic operation for living related donor liver transplantation.

CONCLUSIONSThe visualized liver model reconstructed is 3D and verisimilar, and it is helpful to design reasonable scheme for liver transplantation. It can improve the surgical effect, decrease the surgical risk, reduce the complication, enhance the communication between doctor and patient through designing surgical plan and demonstrating visualized operation before surgery.

Adult ; Computer Simulation ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Liver ; diagnostic imaging ; Liver Transplantation ; Living Donors ; Models, Anatomic ; Tomography, Spiral Computed ; User-Computer Interface

OBJECTIVETo investigate the mutations in Polymerase region and hepatitis B virus (HBV) genotypes in chronic hepatitis B patients with poor response to Lamivudine treatment.

METHODS631 chronic hepatitis B patients with poor response to Lamivudine were recruited in this study. Real-time PCR and DNA sequencing were used to determine HBV genotypes; direct sequencing was performed to detect mutations, and real-time PCR was used to quantify HBV DNA load. Mutations in polymerase region were investigated in different HBV genotypes.

RESULTS272 patients were infected with HBV of genotype B, and 359 patients were infected with HBV of genotype C. The mean age of patients infected with HBV of genotype C (39.1+/-11.4 years old) were significant higher than that of patients infected with HBV of genotype B (33.7+/-9.7 years old) (t = -6.55, P less than 0.01). The patients infected with HBV of genotype C had relatively higher HBV DNA load [(5.96+/-1.22) log10 copies/ml] than the patients infected with HBV of genotype B [(5.58+/-1.21) log10 copies/ml] (t = -2.01, P less than 0.05). The overall incidence rate of A181V/T mutation in genotype C (5.3%) was significantly higher than that in genotype B (0.4%) (x2=12.23, P less than 0.01), but the incidence rate of M204I/V, L180M, T184A/G/I/S, S202G/I and V173L mutations was not significantly different between genotype B and C (each P more than 0.05). M204I mutation in genotype B (20.6%) was more frequent than that in genotype C (13.9%) (x2=4.91, P less than 0.05). The Lamivudine resistance mutations were not significantly different between genotype B and genotype C (x2 = 0.00, P more than 0.05).

CONCLUSIONSThe incidence rate of lamivudine resistance mutation is not significantly different between genotype B and genotype C, but patients infected with HBV of genotype C have higher HBV DNA load than patients infected with HBV of genotype B.

Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; DNA-Directed DNA Polymerase ; genetics ; Drug Resistance, Viral ; Female ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Mutation ; Viral Load ; Viral Proteins ; genetics ; Young Adult

OBJECTIVETo assess the risk of renal dysfunction caused by occupational lead exposure through epidemiological investigation.

METHODSThe workers in a battery factory were selected as the subjects for the exposure and effect assessment. The occupational environmental monitoring data was collected and used to calculate the total external dose of lead. The relationship between external dose and internal dose of lead was analyzed. The external dose, blood lead (BPb) and urinary lead (UPb) were used as exposure biomarkers while the urinary N-acetyl-D-glucosaminidase (UNAG), and urinary albumin (UALB) were used as the effect biomarkers for the renal dysfunction caused by lead. Software of BMDS (BMDS 11311) was used to calculate BMD.

RESULTSThe external and internal does of lead was positively correlated (BPb: r = 0.466, P < 0.01; UPb: r = 0.383, P < 0.01). The levels of BPb, UPb in exposure group (654.03 microg/L, 143.45 microg/g Cr) were significantly higher than those in the control group (57.12 microg/L, 7.20 microg/g Cr), so were UALB, UNAG; in addition, all of them presented significant dose-response relationship. The BPb BMD of UALB, UNAG were 607.76, 362.56 microg/L respectively and the UPb BMD of UALB, UNAG were 117.79, 78.79 microg/gCr respectively.

CONCLUSIONOccupational lead exposure can cause renal dysfunction, which presents dose-response relationship; the risk assessment of renal dysfunction caused by occupational lead exposure is performed by BMD calculation of BPb and UPb.

Adolescent ; Adult ; Biomarkers ; blood ; urine ; Environmental Monitoring ; Female ; Humans ; Kidney ; drug effects ; Kidney Diseases ; chemically induced ; Lead ; blood ; urine ; Male ; Middle Aged ; Occupational Exposure ; Risk Assessment ; Surveys and Questionnaires ; Young Adult