Adolescent ; Child ; Child, Preschool ; Electroencephalography ; Female ; Humans ; Infant ; Retrospective Studies ; Rett Syndrome ; pathology ; physiopathology

Objective To investigate the potential relationship between initial 131Ⅰ uptake by lung metastases from differentiated thyroid cancer (DTC) and treatment outcomes. Methods From 1997 to 2009, 41 patients with DTC lung metastases were treated in the authors' department. 131Ⅰ whole body scan (WBS), serum Tg levels and other imaging results were analyzed to evaluate the therapeutic effects. Complete response (CR) or partial response (PR) was considered to be effective. The x2 test and correlation analysis were performed using SPSS 11.5 software package. Results 131 Ⅰ treatment was effective in 63% (26/41) patients with DTC lung metastases, CR in 8 patients and PR in 18 patients. In other 37% ( 15/41 ) patients, 131Ⅰ treatment was ineffective, including one case died of distant metastases. Patients with initial presence of 131Ⅰ lung uptake had higher effective rate than those with 131Ⅰ lung uptake during the second or later 131Ⅰ treatment (76% (22/29)vs33% (4/12),x2 =4.911, P=0.027). Also, significantly higher effective rate was found in patients with lung metastases alone than those with extra-pulmonary metastases (75% (24/32) vs 22% (2/9), x2 = 6. 312, P =0.012). However, the effective rate in patients with diffuse metastases was not significantly different from that in patients with focal metastases (67% (12/18)vs 61% ( 14/23), x2 =0. 146, P=0.702). The positive rate of initial 131Ⅰ uptake by lung metastases was higher in patients with total thyroidectomy than those with partial thyroidectomy (83% (24/29) vs 42% (5/12) ). Those positive rates in patients with papilary DTC and patients with follicular DTC were 72% (23/32) and 6/9, respectively. The surgical mode was correlated with the initial 131Ⅰ uptake by lung metastases (r = 0.411, P ＜ 0.05), but no correlation was found between the histological type and the initial 131Ⅰ uptake by lung metastases ( r = 0. 047, P ＞ 0.05 ). Conclusion Initial uptake of 131 Ⅰ by lung metastases alone is a favorable prognostic factor for DTC patients treated by131Ⅰ, and total thyroidectomy may be beneficial for initial 131Ⅰ uptake by lung metastases.

The purpose of this study is to investigate the reversal effect and its mechanism of arsenic trioxide (As2O3) on multidrug resistance of gastric carcinoma cells. The concentration of vincristine (VCR) increased gradually to induce the drug resistance of gastric carcinoma cell SGC7901. MTT assay was used to determine the lethal effect of anticarcinogens on tumor cells and Western blotting assay was applied to determine the expression of P-glucoprotein (P-gp) and glutathione S-transferase (GST-s) in tumor cells. As a result, the resistance of SGC7901/VCR cells to VCR, fluorouracil and epirubicin was 16.56, 2.69 and 13.05 times, respectively, more than that of SGC7901 cells. After 24 h precondition with As2O3, RI of vincristine, fluorouracil and epirubicin decreased significantly (P < 0.05). Expression of P-gp and GST-s in resting SGC7901/VCR cells was significantly higher than that in carcinogen-sensitive SGC7901 cells. As2O3 decreased the expression of P-gp and GST-s in SGC7901/VCR cells significantly, while it showed no significant effect on carcinogen-sensitive SGC7901 cells. The result suggested that As2O3 could partly reverse drug resistance of SGC7901/VCR cells by probably the mechanism of decreasing the expression of P-gp and GST-s.
ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Adenocarcinoma ; metabolism ; pathology ; Antineoplastic Agents ; pharmacology ; Arsenicals ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Epirubicin ; pharmacology ; Fluorouracil ; pharmacology ; Glutathione Transferase ; metabolism ; Humans ; Oxides ; pharmacology ; Stomach Neoplasms ; metabolism ; pathology ; Vincristine ; pharmacology

OBJECTIVETo explore the effect of new model for tuberculosis (TB) control and management, and provide a scientific basis and justification for making TB control strategies in rural communities.

METHODSAmong those townships with low TB service accessibility by the county TB control institute in Guangxi Xingye county (population of 679 thousands), four townships with total population of 152 518 and inconvenient transportation, were selected as the experimental group to conduct a new model research project.Based on the accessibility for community services, setting diagnosis and treatment management centers in township hospitals, employing family treatment supporters to supervise the treatment process. The TB cases of the base-line and the project expiration of the experimental group were 44 and 117. Meanwhile, three townships including Dapingshan, Longan and Gaofeng in the county with the similar condition and total population of 133 303 were selected as the control group. The control group conducted the provisions of national TB control program in the county TB clinic management. The TB cases of the base-line and the project expiration of the control group were 56 and 110. By double-direction comparison method, the effect of the new model was evaluated through TB patients detection, treatment outcomes and TB control management data. SPSS 13.0 statistical software was adopted and Chi-square test was used for analyzing technical data.

RESULTSAfter two-year project research implementation, in the experimental group the detection rate of new smear-positive TB patients increased from 16.39/100 000 (25/152 518) to 51.14/100 000 (78/152 518) (χ(2) = 27.281, P < 0.01), the cure rate of new smear-positive cases increased from 71.4% (15/21)to 91.1% (51/56) (χ(2) = 4.812, P < 0.05), and the completing treatment rate in newly diagnosed smear-negative cases improved from 23.5% (4/17)to 71.4% (15/21) (χ(2) = 8.622, P < 0.01); the loss rate of newly diagnosed smear-positive cases dropped from 23.8% (5/21) to 0.0% (0/56) (χ(2) = 10.608, P < 0.01), and the loss rate of newly diagnosed smear-negative cases decreased from 64.7% (11/17) to 4.8% (1/21) (χ(2) = 15.624, P < 0.01). Meanwhile, the cure rate of new smear-positive cases in the experimental group, 91.1% (51/56), was higher than the control group, 72.0% (36/50) (χ(2) = 6.531, P < 0.05). The loss rate of newly diagnosed smear-positive cases in the experimental group (0.0% (0/56)) was lower than the control group (16.0% (8/50)) (χ(2) = 7.534, P < 0.01). During the project implementation, in the experimental group the on time rate of taking medicine, 91.5% (107/117) and receiving medicine, 100.0% (117/117), the reexamining sputum ratio, 83.6% (98/117) were higher than that in the control group: 81.8% (90/110), 92.7% (102/110) and 64.5% (71/110). The differences were statistically significant (χ(2) = 4.589, 8.820 and 11.005, P < 0.05).

CONCLUSIONThe new management model had been proved effective. It can improve TB case detection and cure rates, reduce the loss rate of patients, and improve patient treatment and management conditions as well.

China ; Communicable Disease Control ; methods ; Humans ; Outcome Assessment (Health Care) ; Rural Health ; Tuberculosis ; prevention & control

OBJECTIVETo investigate the association of the polymorphisms of methionine metabolism genes and the phenotype of X-linked adrenoleukodystrophy (X-ALD) and clinical severity.

METHODSThe clinical information of 120 X-ALD patients were analyzed and three genetic variants involved in the methionine metabolism, including cystathionine beta-synthase (CBS) c.844_855ins68, 5-methyltetrahydrofolate-homocysteine-S-methyltransferase (MTR) c.2756A to G, and transcobalamin 2 (TC2) c.776 C to G were analyzed by polymerase chain reaction and sequencing. The association between these polymorphisms and phenotype of X-ALD was studied.

RESULTSThe frequency of GG genotype of the TC2 c.776 C/G was higher in patients with central nervous system(CNS) demyelination than in controls (P= 0.012). However, the other two polymorphisms did not show any significant associations with the phenotypes.

CONCLUSIONThe GG genotype of TC2 c.776 C/G may contribute to X-ALD phenotype.

5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase ; genetics ; Adrenoleukodystrophy ; genetics ; Cystathionine beta-Synthase ; genetics ; Gene Frequency ; Genotype ; Humans ; Male ; Methionine ; metabolism ; Phenotype ; Polymorphism, Genetic ; Transcobalamins ; genetics

OBJECTIVETo evaluate the effect of post-treatment PSA kinetics on the prognosis of prostate cancer (PCa).

METHODSWe retrospectively reviewed the clinical data of 114 cases of locally advanced PCa treated by maximal androgen blockade (MAB) combined with brachytherapy, and analyzed the association of the changes in PSA kinetics with the prognosis of the patients.

RESULTSThe median survival time of the patients was 81 (15 - 144) months, with 1-, 3- and 5-year survival rates of 91. 23%, 78.07% and 68.42% , respectively. Univariate analysis indicated that the baseline PSA level, PSA nadir, the time of PSA decreasing to nadir, PSA doubling time, and the extent of PSA declining were all predictive factors for the survival time of the PCa patients. Multivariate analysis demonstrated that PSA nadir, the time of PSA decreasing to nadir, and the extent of PSA declining were three independent prognostic factors, which prolonged the long-term survival of the patients by 1.7, 3.2 and 6.8 times, respectively.

CONCLUSIONFor locally advanced PCa treated by MAB combined with brachytherapy, PSA nadir <1 micro g/L, the time to nadir <3 months, and the extent of PSA declining >96% are independent prognostic factors.

Aged ; Aged, 80 and over ; Androgens ; administration & dosage ; therapeutic use ; Brachytherapy ; Humans ; Male ; Middle Aged ; Prognosis ; Prostate-Specific Antigen ; metabolism ; Prostatic Neoplasms ; metabolism ; therapy ; Retrospective Studies

OBJECTIVERett syndrome (RTT, MIM 312750) is a progressive neurodevelopmental disorder that affects females almost exclusively, caused by mutations in MECP2 gene on chromosome Xq28, with symptoms such as autism, severe mental deficiency, deceleration of head growth, ataxia, loss of purposeful hand function and characteristic stereotypic hand movements. Over 80% MECP2 mutations located in the exon 3 and exon 4 were confirmed by our work and large-scale studies. RTT is defined based on clinical presentation. It is difficult to diagnose in the early life without definite biochemical abnormality, but genetic test is helpful for this. The aim of this study was to investigate the feasibility and clinical significance of applying long range polymerase chain reaction (PCR) to RTT diagnosis and establish a simple, economic, efficient method of genetic diagnosis.

METHODGenomic DNA was extracted using standard procedures from the peripheral blood leukocytes of each patient. Long range polymerase chain reaction(PCR)and DNA direct sequencing were employed to analyze the exon 3 and 4 of MECP2 gene simultaneity in 40 patients with RTT. The PCR products were checked by using 1.5% agarose gel.

RESULTIn total, 18 different MECP2 mutations were identified in 33 of the 40 diagnosed sporadic female patients with RTT. Missense mutations were 16, followed by 14 nonsense mutations and 3 deletions. The 314 base pairs large deletion was identified. The p. T158M mutation (21%, 7/33) was the most common, followed in order of frequency by p. R255X (12%, 4/33), p. R168X and p. R106W (9%, 3/33) respectively, p. R270X and p. Y141X (6%, 2/33) respectively, p. R133C, p. D156H, p. P157L, p. P225R, p. Q244X, p. Q262X, p. R294X, p. R306C, P322L, c. 1005del G, c.1005-1318del 314 bp and c.1127-1179del 53 bp (3%, 1/33), respectively.

CONCLUSIONLong range PCR is a simple, economic, quick, precise method of genetic diagnosis and was able to find 83% MECP2 gene mutations in RTT patients in this study. It is helpful for RTT clinical diagnosis in early stage. On the other hand, it may detect recurrent mutations and large deletions at the same time.

Child ; Child, Preschool ; DNA ; analysis ; Exons ; genetics ; Female ; Humans ; Methyl-CpG-Binding Protein 2 ; genetics ; Mutation ; Polymerase Chain Reaction ; methods ; Rett Syndrome ; diagnosis ; genetics

Objective During June 2-8, 2009, 11 cases of the novel influenza A (H1N1)occurred in Sichuan Province, China. We investigated this outbreak to identify the source of infection,mode of transmission and risk factors for infection. Methods The primary case, a U.S. citizen,developed disease on June 2. From June 3 to 5, she joined Tour Group A for a trip to Jiuzhaigou. We telephoned passengers of the three flights on which the primary case had traveled in China, and members of Tour Group A. We asked whether they had any influenza-like symptoms during May 27 to June 12. Health authorities placed passengers whose seats were within three rows of the primary case on flights and members of Tour Group A on medical observation, and isolated individuals if they developed symptoms. We used real-time RT-PCR to test the throat swabs from symptomatic persons for the novel influenza virus and defined a confirmed case as one with influenza-like symptoms and laboratory confirmation. A retrospective cohort investigation to identify the risk factors for infection was conducted. We interviewed all members of Tour Group A about their detailed contact history with the primary case. Results During June 5 to 6, 9 (30%) of the primary case' s 30 fellow tour group members developed disease, compared with none of her 87 fellow passengers to Jiuzhaigou and 1 of her 87 fellow passengers on the returning trip (when several of the members of Tour Group A were symptomatic). 56% of the tourists who had talked with the primary case in close range ( ＜2 m) for ≥2 minutes developed disease, whereas none of the 14 other tour group members developed disease (RR= ∞; exact 95%CI: 2.0- ∞ ). Having conversed with the primary case for ≥ 10 minutes (vs. 2-9 minutes) increased the risk by almost five fold (RR=4.8, exact 95%CI: 1.3-180). Conversely, other kinds of contact, such as dining at the same table, receiving chewing gum from the primary case and sharing bus rides or planes with the primary case played no roles during this outbreak. Conclusion This novel influenza A (H1N1) outbreak was caused by an imported case, and transmitted mainly via droplet transmission when the primary case was talking with her fellow tourists during a tour. These findings highlight the importance of preventing droplet transmission during a pandemic.

OBJECTIVETo investigate the possibility and efficacy of allograft transplantation in treating patient with huge tissue defect after radical giant malignant melanoma resection.

METHODSA male person received blood type matching was chosen as donor. Immediately after the donor's brain death, allograft was excised with the depth to the layer intervenient between periosteum and epicranial fascia in calvaria, the superficial layer of deep temporal fascia in both sides of temporal regions, close to zygomatic bones and mandibles including masseter and auricles upon in face, and cervical soft tissues including sternocleidomastoid muscles, cervical and external jugular vessels of both sides were excised simultaneously. After being perfused with 4 degrees C UW solution through both common carotid arteries, the homograft was sheared and radiated with X-ray before being preserved in UW solution for further use. During the operation, both sides of external auditory meatus were anastomosed with ears firstly, and vessels were anastomosed end-to-end sequently, at last, the border of skin flap was sutured intermittently. Combined use of MMF, FK506, Prednisone and Zenopax was performed as post-operation immunosuppressive treatment. Clinical observations were made on the signs and symptoms of graft survival or rejection as well as blood FK506 concentrations and immunological indexes were tested in laboratory. Biopsies of graft were also made at 1 h, 4 h, 8 h, 7 d, 14 d and 30 d after operation.

RESULTSThe circulation of the graft was satisfactory, and the temperature and color of skin were normal. Primary healing of suture and hair growth about 0.8 cm in a month were observed. Skin Biopsies of every time had no found of hyperacute or acute rejection. The concentration of FK506 was maintained 20 mg/ml 1 month after the operation.

CONCLUSIONAllograft transplantation with compound tissue of head skin flap and ears is a kind of effective and safe treatment in repairing huge tissue defect. Good tissue matching and combined use of currently available immunosuppressants can prevent hyperacute and acute rejection efficiently.

Aged ; Ear ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Melanoma ; surgery ; Neck ; Surgical Flaps ; Transplantation, Homologous

OBJECTIVETo observe the changes in gene expression of cyclooxygenase (COX) during spontaneous recovery from stress ulcer in rats exposed to water immersion and restraint stress (WRS).

METHODSA rat model of stress ulcer was established by means of WRS, in which the changes in COX expression were detected with immunohistochemistry and reverse transcription (RT)-PCR.

RESULTSVery low levels of COX-2 expression were detected in the gastric mucosa of the control rats, and the expression increased significantly during the healing process of the stress ulcer (P<0.05). COX-1 expression in the gastric mucosa showed no significant difference between the control group and the stress ulcer groups during healing (P>0.05).

CONCLUSIONCOX-1 and COX-2 expressions in rat gastric mucosa during the recovery from stress ulcer participate in the recovery of the damaged mucosa possibly by mediating prostaglandin secretion.

Animals ; Cyclooxygenase 1 ; biosynthesis ; genetics ; Cyclooxygenase 2 ; biosynthesis ; genetics ; Gastric Mucosa ; enzymology ; Male ; Prostaglandin-Endoperoxide Synthases ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Remission, Spontaneous ; Stomach Ulcer ; enzymology ; Stress, Physiological ; complications