Objective To assess the outcome of de-epithelialied ileocystoplasty combined with strengthened pelvic floor in patients with neurogenic bladder.Methods Twelve patients (9 male,3 female) aged from 18 -27 years (averaged 25 years) with neurogenic bladder received de-mucosalized seromuscular ileocystoplasty combined with strengthened pelvic floor,and were evaluated by urodynamic parmeters,upper urinary tract image appearance,and serum creatinine before and one year after operation.Results After operation,the max cystometric capacity (412 ± 32 ml),bladder compliance (26.2 ± 4.0ml/H2O),relative safety cystometric capacity (368 ±26 ml) and max flow rate (20 ±3 ml/s) were respectively significantly higher than those preoperation(247 ±27 ml,4.4 ± 1.2 ml/cm H2O,206 ±24 ml,11 ±2ml/s,P ＜ 0.05).Moreover,the post voided residual (26 ± 8 ml) and detmsor leakage point pressure (17.8 ±3.6 cm H2O) were significantly lower than those of preoperation (136 ± 25 ml,63.1 ± 4.9cm H2O,P ＜0.05).The vesicoureteral reflux disappeared in five (63％) cases,and was relieved in the remaining three cases.Of the five cases with renal insufficiency,three (60％) cases had normal serum creatinine level,none had increased serum creatinine levels.After operation,late healing occurred in two ( 17％ ) cases,intestinal obstruction in one (8％),vesicoabdominal fistula in one (8％),and no cases had mucous urine.Clean intermittent self-catheterization was performed in one case (8％) to empty the bladder due to a fever resulting from urinary tract infection,the remaining 12 (92％) cases could empty their bladders through abdominal pressure.Conclusions De-mucosalized seromuscular ileocystoplasty combined with strengthened pelvic floor results in a good outcome for the patients with neurogenic bladder.

Objective To evaluate the value of 99Tcm-MDP uptake by left femoral neck for diagnosing osteopomsis.Methods A total of 58 cases (23 males,35 females,mean age:(66.15±8.45) years) with spondyloarthmpathies from May to December of 2012 were selected.Serum concentrations of type Ⅰ collagen telopeptide (sCTX-1) and bone ALP (BALP) were determined.All patients underwent dual-energy X-ray absorptiometry (DXA) to detect bone mineral density (BMD).According to the T scores,patients were divided into 2 groups:normal group (NG) (T＞-1.0) and osteoporosis group (OG) (T≤-2.5).99TcmMDP bone scan was further performed.The average radioactive ratio of the left femoral neck to the medial soft tissue of left femur (T/N) was measured.Data differences between the 2 groups were compared by twosample t test and Pearson correlation analysis.Results According to BMD,13 patients (7 males,6 females) were included in NG and 28 patients (10 males,18 females) were included in OG.The mean ages of OG and NG were significantly different ((68.82± 10.41) years vs (62.46± 11.77) years; t =3.560,P＜0.05).The BMD of left femoral neck in OG was significantly lower than that in NG ((0.67±0.08) g/cm2 vs (0.91±0.10) g/cm2 ; t=9.917,P＜0.01).Although BALP level of OG was significantly higher than that of NG ((35.92±11.58) U/L vs (22.38±6.34) U/L; t=-3.397,P＜0.05),no significant difference was observed on sCTX-1 between the 2 groups (t=-0.463,P＞0.05).T/N ratio of OG (11.63±6.22) was higher than that of NG (9.74±4.44) (t =-3.027,P＜ 0.05).There were significant correlations between the T/N ratio of the left femoral neck and the sCTX-1 and BALP concentrations (r=0.376,0.483,both P＜0.01).No correlations between the T/N ratio of the left femoral neck and age,BMI and BMD were observed (r=-2.031,-0.017,0.134,all P＞0.05).Conclusion The uptake ratio of the left femoral neck in 99Tcm-MDP bone scan could evaluate the metabolism of bone,and it is useful for the early diagnosis of osteoporosis.

Objective To study the intervention effect of the fluorosis with the high aluminum plus soybean, selenium powder, spiral algae. Methods Two week-long SD rats were randomly allocated into 5 groups bases on body weight with 8 in each group, respectively being control, the high fluoride aluminum,the high fluoride aluminum plus soybean, the high fluoride aluminum plus selenium and the high fluoride aluminum plus spiral algae group. The control group was fed with corn produced in non-endemic area containing 5.20 mg/L of fluoride and 6.80 mg/L of aluminum and tap water of fluoride 0.70 mg/L and aluminum 0.20 mg/L. Other groups were fed primarily with corn produced in the endemic area with the content of fluoride of 110.00 mg/L and aluminum of 19.70 mg/L and tap water with high aluminum also with fluoride of 0.70 mg/L and aluminum of 90.00 mg/L. The high fluoride aluminum plus soybean group was added soybean in the beginning of the experiment, approximately 30% of the total amount. Selenium (3.00 mg/kg) was given to the high fluoride aluminum plus selenium groups and spiral algae (1000.00 mg/kg) to the high fluoride aluminum plus spiral algae groups after dental fluorosis was formed. The experiment lasted for 22 weeks. In the end of the experiment 24-hour urine and bones of the limbs were collected to test the content of fluorine and aluminum. The ultrastructure of femur spongiosa was observed under electron microscope. Results ① Bone fluoride in high fluoride aluminum group [(204.07 ± 63.78)mg/kg] was higher than that in the control group, high fluoride aluminum plus soybean group, high fluoride aluminum plus selenium group and high fluoride aluminum plus spiral algae group[(30.06 ± 6.11), (54.12 ± 14.56), (30.44 ± 5.02), (105.08 ± 21.07)mg/kg, t = 0.62,0.53,0.62,0.35, all P < 0.01], indicating that it was lower in high fluoride aluminum plus selenium group than high fluoride aluminum plus spiral algae group(t = 0.27, P < 0.01). ② The urinary fluoride levels in high fluoride aluminum group [(4.52 ± 3.09)mg/L] was higher than that in the control group [(0.89± 0.37)mg/L, t = 0.23, P < 0.01] and lower than that in the fluoride aluminum plus selenium group[(10.38 ± 1.58) mg/L, t = 0.34, P < 0.01], it was higher in high fluoride sluminum with selenium group than that in the high fluoride aluminum plus soybean group and high fluoride aluminum plus spiral algae group[(5.56 ± 1.69), (4.38 ± 3.36)mg/L, t = 0.28,0.35, all P < 0.05]. ③ The bone aluminum level in the control group[(3.32 ± 3.02)mg/kg] was lower than that in the high fluoride aluminum group, high fluoride aluminum plus soybean group, high fluoride aluminum plus selenium group and high fluoride aluminum plus spiral algae group [(374.21 ± 56.11), (118.20 ± 23.59), (114.01 ± 22.84), (67.11 ± 11.53)mg/kg, t = 1.42,0.44,0.42,0.24, all P < 0.05], it was higher in the high fluoride aluminum group than high fluoride aluminum plus the soybean and selenium and spiral algae groups (t = 0.56,0.57,0.68, all P < 0.01)lower in high fluoride aluminum plus spiral algae group than the soybean plus selenium group(t = 0.11,0.10, all P < 0.05). ④The urine aluminum level in high fluoride aluminum group [(1.14 ± 0.32)mg/L] was higher than that in the control group and the high fluoride aluminum plus the soybean group [(0.66 ± 0.10) mg/L, t = 1.92,2.24, all P< 0.05] and that in high fluoride aluminum plus the soybean group was lower than aluminum plus the selenium[(1.03 ± 0.22)mg/L] and aluminum plus spiral algae group[(1.10 ± 0.28) mg/L, t = 1.73,2.06, all P < 0.05]. ⑤ Under electron microscope, the collagenous fiber was arranged in disorder in high aluminum fluorine group, the trabeculum of bone merged into patches or mostly vanished, This phenomenon was alleviated in the intervened group compared to the high aluminum fluorine group, in an attenuating order of the selenium group, the spiral algae and the soybean group. Conclusion In this experiment the intervention measure alleviates fluorosis, the selenium is the best, spiral algae the second and soybean the last.

OBJECTIVEThe aim of this study was to investigate the clinicopathological characteristics, effective treatment and prognosis in childhood and adolescent Hodgkin's lymphoma.

METHODSA total of 88 patients with childhood and adolescent Hodgkin's lymphoma were treated in the Cancer Hospital of CAMS from 1998 to 2005. The clinicopathological and follow-up data of the patients were retrospectively reviewed. The survival rate was calculated by Kaplan-Meier method and compared by log-rank test. COX multivariate prognosis analysis was performed.

RESULTSThe 2-year event-free survival rate of the 88 patients was 86.4%, the 5-year event-free survival rate was 61.4%, and the 5-year overall survival rate was 95.5%. Univariate analysis showed that the stage of disease (P = 0.033), "B" symptoms (P = 0.028), bulky disease (P = 0.007), splenomegaly (P = 0.050), LDH elevation (P = 0.020), chemotherapy regimen (P = 0.003) were prognostic factors in the 5-year event-free survival rate. Splenomegaly (P = 0.039), LDH elevation (P = 0.033), chemotherapy regimen (P = 0.008) were prognostic factors of 5-year overall survival rate. Multivariate analysis showed that chemotherapy regimen (P = 0.033), stage of disease (P = 0.023), LDH elevation (P = 0.008), "B" symptoms (P = 0.044), bulky disease (P = 0.009) were independent prognostic factors of 5-year event-free survival rate. The chemotherapy regimen (P = 0.012) and LDH elevation (P = 0.046) were independent prognostic factors of 5-year overall survival rate.

CONCLUSIONSThe non-ABVD chemotherapy regimen, stage IV disease, LDH elevation, associated with "B" symptoms and bulky disease are independent prognostic factors of 5-year event-free survival rate. LDH elevation and non-ABVD chemotherapy regimen are independent prognostic factors of 5-year overall survival rate.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bleomycin ; therapeutic use ; Child ; Child, Preschool ; Combined Modality Therapy ; Cyclophosphamide ; therapeutic use ; Dacarbazine ; therapeutic use ; Disease-Free Survival ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Hodgkin Disease ; complications ; drug therapy ; pathology ; radiotherapy ; Humans ; L-Lactate Dehydrogenase ; blood ; Male ; Mechlorethamine ; therapeutic use ; Neoplasm Staging ; Prednisone ; therapeutic use ; Procarbazine ; therapeutic use ; Retrospective Studies ; Splenomegaly ; etiology ; Survival Rate ; Vinblastine ; therapeutic use ; Vincristine ; therapeutic use

Objective To elucidate the electrophysiological features of POEMS syndrome. Methods We retrospectively analyzed the electrophysiological findings of 22 patients of POEMS, and compared their results with those of 22 patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Results Compared with the CIDP group, the motor nerve conduction velocity was decreased in the POEMS group, but the difference was not significantstatistically (P>0.05); whereas, distal motor latency (DML) was significantly decreased (P<0.05), and terminal latency index (TLI) was significantly increased (P<0.05). The incidence rate of the nerve conduction block in the POEMS group was lower than that in the CIDP group (P<0.05). Compound muscle action potential (CMAP) of the tibial nerve was decreased significantly in the POEMS group as compared with the CIDP group (P<0.05), whereas CMAP of the median nerve was not significantly different (P>0.05). Abnormal electrophysiology was frequently observed in muscles of lower limbs in the POEMS group, and in comparison of upper limbs, the difference was not significant statistically (P<0.05).Conclusion In POEMS syndrome, slowing of nerve conduction velocity is more predominant in the intermediate segments of the peripheral nerve, and conduction block is rare. Abnormal nerve conduction may be correlated with limbs.

Objective To investigate the etiology of patients with severe to profound hearing loss and to identify the ratio of hereditary hearing loss in Chffeng area in Northern China. Methods DNA were extracted from peripheral blood of 134 deaf patients from Chifeng special educational school and 100 normal hearing controls in Northern China. Audiology examinations showed that all patients had severe to profound bilateral sensorineural hearing impairment. Sequence analysis of the whole coding areas of GJB2, GJB3, GJB6, SLC26A4, mtDNA12SrRNA and mtDNAtRNASer(LCN) were performed. Individuals carrying SLC26A4 mutation were given further temporal bone CT scan. Results The ratio of hearing loss related to genetic factors in this population was 60. 45% (81/134). About 33.58% (45/134) of the patients were given accurate genetic diagnosis. GJB2 mutations were responsible for approximately 17.16% of the cases in ChiFeng area. By screening SLC26A4 followed by temporal bone CT scan, we diagnosed 20 cases of enlarged vestibular aqueduct (EVA) and/or other inner ear malformation. SLC26A4 mutations account for about 14. 93% of the cases. The aminoglycoside-related mtDNA 1555A > G mutation accounted for 0.76% of the eases in Chifeng area. In addition, another 13.43% (18/134)of the cases carried heterozygous GJB2 mutation and their hearing loss may be related to GJB2. 6. 72% (9/134)of the cases carried heterezygous SLC26A4 mutation who were not found EVA by temporal bone CT or not took CT examination for some reasons. However, their hearing loss may also be SLC26A4-related. About 2. 24% (3/134)of the cases carried mtDNA 12SrRNA 1095 T > C which may also be an aminoglycoside-related mutation and very likely be the cause of hearing loss. GJB3 might participate in the pathomechanism of hearing loss in 1.49% (2/134) of the patients. GJB6 mutation was not detected in this population. Conclusions The ratio of hearing loss related to genetic factors in the sample drawing population from Chifeng was 60. 45% (81cases). GJB2 is the most common gene and SLC26A4 is the second common gene next to GJB2 that cause deafness in this area.

OBJECTIVETo analyze the correlation between prognosis and p53 expression in primary lesion and the surgical margin of laryngeal squamous cell carcinoma (SCC) as an indication of postoperative radiotherapy.

METHODSSixty-seven laryngeal SCC with pathological negative margin were analyzed retrospectively. Immunohistochemical method was used to detect the expression of p53.

RESULTSThe p53 positive rates in the primary tumor and the surgical margin were 19.4% (13/67) and 50.7% (34/67). In p53 positive primary tumor group, the survival rate was higher in patients who received postoperative radiotherapy than those without (60.6% vs 20.0%, P = 0.000 5) and the recurrent rate was just the reverse (42.1% vs 93.3%, P = 0.002), though these differences were not significant in p53 negative primary tumor group (87.5% vs 94.1%, P = 0.409 6; 25.0% vs 5.9%, P = 0.175). The recurrent rate and survival rate between patients with and without postoperative radiotherapy did not show any significant difference either in p53 positive surgical margin group (47.4% vs 20.0%, P = 0.378 1; 62.5% vs 80.0%, P = 1.0) or p53 negative ones (84.9% vs 66.6%, P = 0.074 3; 20.6% vs 40.7%, P = 0.248).

CONCLUSIONPostoperative radiotherapy should be given to patients with p53 positive primary laryngeal cancer. But those who are pathologically margin negative but p53 positive should not be taken, at least for the present, as candidates for postoperative radiotherapy.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; chemistry ; mortality ; radiotherapy ; Female ; Humans ; Laryngeal Neoplasms ; chemistry ; mortality ; radiotherapy ; Male ; Middle Aged ; Survival Rate ; Tumor Suppressor Protein p53 ; analysis

OBJECTIVETo assess the diagnostic value of tumor markers in the cerebrospinal fluid (CSF) for meningeal carcinomatosis (MC).

METHODSTwenty-one MC patients (including 13 adenocarcinoma and 8 non-adenocarcinoma patients), 72 patients with tuberculous meningitis (TBM) and 23 with primary intracerebral tumors (PIT) were enrolled in this study. Blood and CSF tumor markers including CEA, CA125, CA15-3, CA19-9, CA72-4, CYFRA21-1, AFP and NSE were measured by Roche E170 electrochemiluminescence analyzer and sandwich assay.

RESULTSCSF tumor markers CEA, CA125, CA199 and CYFRA21-1 and the serum tumor markers CEA, CA125, CA153, CA199 and AFP were significantly higher in MC group than in the other two groups. CSF CEA and CA15-3 were significantly higher in adenocarcinoma MC than in non-adenocarcinoma MC patients, but no significant differences were found in the serum tumor markers between the two groups (P>0.05). CSF tumor markers including CEA, CA125, CA15-3, CA72-4 and CYFRA21-1 were positively correlated to the serum tumor markers (P<0.05). CA199 was positively correlated to the disease course (P<0.05), and age was not correlated to any of the indexes (P>0.05).

CONCLUSIONDetection of the tumor markers in the CSF, especially CEA, CA125, CA19-9 and CYFRA21-1, may help in the early diagnosis of MC. CEA and CA15-3 can serve as indicators for differential diagnosis of adenocarcinoma and non-adenocarcinoma.

Adenocarcinoma ; cerebrospinal fluid ; diagnosis ; Adult ; Aged ; Antigens, Neoplasm ; cerebrospinal fluid ; Biomarkers, Tumor ; cerebrospinal fluid ; CA-125 Antigen ; cerebrospinal fluid ; CA-19-9 Antigen ; cerebrospinal fluid ; Carcinoembryonic Antigen ; cerebrospinal fluid ; Female ; Humans ; Keratin-19 ; cerebrospinal fluid ; Male ; Membrane Proteins ; cerebrospinal fluid ; Meningeal Neoplasms ; cerebrospinal fluid ; diagnosis ; Middle Aged ; Young Adult

BACKGROUNDX-linked hearing impairment is clinically and genetically a heterogeneous disease. Although many disorders manifest with hearing loss, a limited number of sex-linked loci and only one gene (POU3F4) have been shown to be implicated in X-linked non-syndromic hearing impairment. In the present study, we have performed a clinical and genetic analysis of a Chinese family with X-linked non-syndromic hearing loss, with emphasis on audiological findings and genomic mapping.

METHODSThe clinical features of Family JX01 were evaluated by physical and audiometric examination in eighteen family members. Mutation screening of POU3F4 was identified by polymerase chain reaction (PCR) amplification and sequencing. Molecular evaluation consisted of X-chromosome wide genotyping by microsatellite makers (STR), followed by analyzing using MLINK computer program.

RESULTSFive affected males demonstrated bilateral, symmetrical sensorineural and profound hearing loss. The hearing impairment started prelingual. The female carriers did not have any complain of hearing loss, however, two of them were tested with milder loss with high frequency. No causative mutations in POU3F4 gene were detected by DNA sequencing. Linkage analysis indicated that the responsible gene was linked to locus DXS1227 (maximum lod score = 2.04 at theta = 0).

CONCLUSIONSThe affected males in Family JX01 have profound prelingual sensorineural hearing impairment. In addition, two female carriers showed mild to moderate hearing losses. However, none of females complained of any hearing loss. Analysis of hereditary deafness in this family mapped most compatibly to the Xq27.2.

Asian Continental Ancestry Group ; genetics ; Chromosomes, Human, X ; genetics ; Female ; Genetic Linkage ; genetics ; Genotype ; Hearing Loss ; genetics ; Hearing Loss, Sensorineural ; genetics ; Humans ; Male ; Pedigree ; Phenotype

OBJECTIVETo investigate the relationship between hepatitis B virus (HBV) genotype and therapeutic efficacy during the early phase of lamivudine treatment.

METHODSTotally 595 patients with chronic hepatitis B were treated with lamivudine 100 mg/day for 12 months. HBV genotypes, contents of HBV DNA, HBeAg/anti-HBe and YMDD mutation after lamivudine treatment for 12 months were determined. The data were analyzed with SPSS software.

RESULTSIn 595 patients, 8 (1.4%) were genotype A; 53 (8.9%) genotype B; 360 (60.5%) genotype C; 112 (18.8%) were coinfection of genotype B and C; 14 (2.4%) of A and C; 15 (2.5%) A and B; 6 (1.0%) of A, B, and C, and remaining 27 (4.5%) were unspecified. Patients were treated with lamivudine 100 mg/day for 12 months. Genotype B with HBV DNA levels turned to be negative (HBV DNA < 0.1 ng/L) was 87.2%, genotype C was 89.51%, coinfection of genotype B and C was 93.04% (P > 0.05). HBeAg seroconversion of genotype B was 11.65%, of genotype C was 20.64%, and of coinfection of genotype B and C was 18.57% (P > 0.05). All 69 strains of YMDD mutation were detected after lamivudine treatment for 12 months, in which genotype B was in 16.98%, genotype C in 15.38%, and coinfection of genotype B and C was in 13.86% (P > 0.05).

CONCLUSIONThere was no difference in HBV genotypes and the rate of development of YMDD mutations, HBeAg seroconversion, descending of HBV DNA level in Chinese patients with chronic hepatitis B.

China ; Genotype ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; genetics ; immunology ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Lamivudine ; therapeutic use ; Reverse Transcriptase Inhibitors ; therapeutic use ; Treatment Outcome