Objective To explore the clinical significance of joint detection of β2‐microglobulin(β2‐MG) ,glycated hemoglobin and Cystatin‐C (CysC) in early renal injury in patients with diabetes mellitus .Methods 60 patients with early diabetic renal damage were in early diabetic renal damage group and 100 patients with simple diabetes mellitus were in simple diabetes mellitus group .50 healthy persons were the control group .Using immunoturbidimetry to detect the serum level of CysC ,immunoturbidimetry trans‐mission to detect the urine level of β2‐microglobulin and ion exchange high performance liquid chromatography method to detect the level of HbA1c .Results There were statistically significant differences in the level of β2‐MG ,glycated hemoglobin between early diabetic renal damage group and the other two groups (P<0 .05) .There were statistically significant differenees in the level of gly‐cated hemoglobin between simple diabetes mellitus group and healthy control group (P<0 .05) .Conclusion It is important for pa‐tients with diabetes mellitus to detect the β2‐MG ,glycated Hemo globin and CysC in diagnosis ,monitoring .prevention of early renal injury .

Objective To explore Fms-like tyrosine kinase 3(FLT3)gene internal-tandem duplications(ITD)mutation in hematologic malignancy.Methods FLT3/ITD gene mutation was analyzed by polymerase chain reaction(PCR)amplification on the DNA samples from 332 patients with hematologic malignancies at the Nanfang Hospital from 2001 to 2005.Results The mutation of FLT3/ITD gene was detected in 22.3% acute myeloid leukemia(AML)cases,in 6.5% chronic myeloid leukemia(CML)-blast crisis(BC)cases,in 5.6% myelodysplastic syndromes(MDS)cases and in 2.6% acute lymphoblastic leukemia(ALL)cases;FLT3/ITD gene mutation was not detected in CML-chronic phase(CP),multiple myeloma(MM),non-Hodgkin lymphoma(NHL)and chronic lymphocytic leukemia(CLL)cases.FLT3/ITD+ AML indicate high white blood cell count and high percentage of bone marrow blast cells and had a unfavourable cumulative relapse rates.Conclusion AML patients with FLT3/ITD have a poor prognosis.Detection of FLT3/ITD gene mutation may be valuable in hematologic malignancy.

Objective To study the quantification of MDR1 and WT1 gene expression in patients with de novo acute myeloid leukemia(AML)and to explore the role of these two genes in clinical drug resistance and their correlation with risk stratification. Methods A real time quantitative reverse transcriptase polymerase chain reaction method was established for detecting MDR1 and WT1 gene expression levels in 63 de novo AML patients.Resuits The expression of WT1 and MDR1 was significantly higher in de novo AML patients than in normal controls (P＜0.001).WT1 levels were significantly correlated with corresponding levels of MDR1 gene in de novo AML patients(P=0.004).Expression levels of WT1 and MDR1 gene were not associated with FAB subtype and risk stratication(P＞0.05).AML patients with FLT3-ITD mutations had a significantly higher WT1 expression level as compared to with those without(P＜0.05),on the contrary MDR1 expression was not associated with FLT3-ITD mutations(P＞0.05).Patients with co-expression of high levels of WT1 and MDR1 had a significantly lower complete remission rate after induction therapy than those with low levels(P＜0.05).Conclusion There is a positive correlation between MDR1 gene expression and WT1 gene expression in AML.Quantification of the two gene expression together is more effective for judgement of prognosis in AML.

Objective:To study the biological effects of TCR on hepatoma cells by transfecting V?7 into lymphocytes.Methods:TCR V?7 gene was amplified by RT PCR and cloned to expression vector pLXSN. The recombinant was transferred into lymphocytes by Lipofectin Reagent transfection, then the lymphocytes were co cultured with hepatoma cells. The phenotype of lymphocytes was detected on the Flow Cytometry, the expression of TCR V?7.1 gene was detected by Laser Scanning Confocal Microscope ( LSCM) and the ultrastructure of the hepatoma cells was showed by electronic microscope.Results:The amount of the transmembrane protein expressed by TCR V?7.1 gene was increased significantly, and so was the amount of lymphocytes (P

Objective To observe the surface electromyographic characteristics of the bilateral submen-tal muscles in dysphagia secondary to unilateral brainstem stroke. Methods A total of 25 subjects were recrui-ted. There were 8 stroke patients with dysphagia secondary to a left brainstem stroke and 7 stroke patients with dysphagia secondary to a right brainstem stroke. There were also 10 healthy controls matched in age and gender. The duration and peak amplitude of the submental muscle when swallowing 5 ml of warm water were recorded u-sing a surface electromyograph. Results The average amplitude of the left submental muscle in patients with a left brainstem stroke was significantly longer than that of those with a right brainstem stroke, but no significant differences in average duration were observed. Conversely, the amplitude of the right submental muscle in pa-tients with a right brainstem stroke was significantly longer than that of those with left brainstem stroke, but again there were no significant differences in duration. No significant differences were observed among the healthy con-trols. The amplitude and duration of both the affected and healthy sides of the patients were of course significantly longer or stronger than those of the healthy controls. Conclusion The swallowing function of the bilateral sub-mental muscles may be impaired among unilateral stroke survivors with dysphagia. The damage on the affected side is more severe than on the opposite side.

Objective To study the radiation dose distribution in the X-ray room,and provide the strategy of radiation protection for the medical staff and the patient’s nursing who had to enter the room while the X-ray was exposing.Methods The thermolumi-nescent dosemeters(TLDs)was placed around the center of the X-ray tube with the same level of the bed.Then,exposure parame-ters,including the X-ray tube voltage value and the field of view,were changed for different groups while exposing.All of the TLDs were taken back to the lab for analysis.Results The differences between the two groups which had the same distance in different di-rections were statistically significant (P <0.01).With the same radiographic condition and direction,the radiation dose on the site of 10 cm from X-ray tube center was the maximum,while the site of 120 cm was the minimum.With the same radiographic condition and distance,the radiation dose on the anode side of the X-ray tube in the room was relative lower,while the site behind the X-ray tube was relative higher.With the same voltage value,distance and direction,the same sites that had the smaller FOV(34 cm×34 cm) received lower radiation dose than those with larger FOV(52.6 cm× 52.6 cm).Meanwhile,the sites with the voltage of 70 kV re-ceived the lower radiation dose than that with the voltage value of 120 kV.Conclusion In the X-ray room,the medical staff and the patient’s nursing can choose the area on the right side(anode side),keep far away from the X-ray tube center,avoid the rear of the X-ray tube and the cathodic direction of the X-ray tube to reduce the radiation dose.

Objective To investigate the removal effect of immunoadsorption (IA) on associated antibodies and the efficacy in late-onset myasthenia gravis (MG). Methods A total of 25 late-onset MG patients were randomly selected to enroll in this study. IA therapy was given to 10 patients (IA group), while immunoglobin (0.4 g·kg-1·d-1) was administrated to the other 15 patients for 5 days(Ig group). The titers of Titin antibody (Titin-ab), acetylcholine receptor antibody (AchR-ab) and presynaptic membrane antibody (PrsmR-ab) were detected before and after the treatment. Quantitive MG (QMG) score was assessed before and immediately after the entire course of treatment. The clinical efficacy, the duration of respiratory support and in-hospital were compared between two groups. The correlation between three antibodies and QMG score was also analyzed. Results Compared with that before treatment, the Titin-ab PIN values, the AchR-ab PIN values, and the PrsmR-ab P/N values of IA group were all decreased significantly after treatment (P<0.05, respectively). The P/N value of Titin-ab in IA group was decreased by 54.7%～3.5%, which was significantly higher than that in Ig group(19.9%±3.1%) (P<0.01). QMG score reduced by 42.4%± 4.2% and 23.8%±3.7% in IA group and Ig group respectively (P<0.01, respectively). Symptoms were effectively ameliorated by both treatments, but the effective power of IA group was higher than that of Ig group (70% vs 40%, P<0.05). Remission time of IA group was significantly shorter than that of Ig group [(5.38±0.42) d vs (8.4±1.54) d, P=0.008), so was the duration of in-hospital [(13.50±0.50) d vs (16.50±0.50) d, P<0.05). The number of respiratory support in IA group was less than that in Ig group (1/10 vs 6/15, P<0.05). By the Pearson correlation analysis, the decrease of Titin-ab showed a better longitudinal correlation with the decrease of QMG score than the other two antibodies (r=0.6315, P<0.01). Conclusion IA can rapidly and effectively clear the pathogenic antibodies of late-onset MG patients and its short-term clinical efficacy is better than immunoglobin.

Objective To investigate the clinical and immune pathological features of Ullrich congenital muscular dystrophy (UCMD) with sarcolemma-specific collagen Ⅵ deficiency (SSCD). Methods The clinical aspects of 2 patients with SSCD were analyzed and the muscle specimens from them were studied by immunofluorescence. Results SSCD patients were clinically characterized by neonatal hypotonia with proximal contractures and distal hyperlaxity at birth or early infancy. Immunofluorescence staining revealed partial deficiency of collagen Ⅵ. Double immunofluorescence staining revealed sarcolemma-specific deficiency of collagen Ⅵ, while collagen Ⅳ intact in thesarcolemma. Conclusions The clinical picture and severity of UCMD with SSCD are similar to the cases with collagen Ⅵ complete deficiency. The proximal contractures and distal hyperlaxity are the clinical hallmarks of both types. Sarcolemma-specific collagen Ⅵ deficiency can be better demonstrated by double immunofluorescence staining.

ObjectiveTo assess the feasibility and clinical efficacy of minimally invasive esophagectomy for esophageal cancer.MethodsFrom July 2007 to December 2009,eighty-one patients with esophageal cancer received combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck.All clinical data were retrospectively reviewed.ResultsThe median operative time was 270.5 min (range 196-315 min).The median time of gastric mobilization and abdominal lymph node dissection was 64.5 min,and the median time of esophageal dissection and mediastinall lymph node dissection was 81.2 min.The median blood loss was 121.5 ml for the thoracic phase and 42.4 ml for abdomen phase.The mean number of disected lymph nodes was 20.4 (range 5-41) with metastastic rate of 30.9% (25/81).The mean harvest lymph node was 12.5 in chest and 7.3 in abdomen.Perioperative complications rate was 27.2%,including respiratory failure in 1 case,pulmonary infection in 10,anastomotic leak in 3,chylothorax in 2,gastric tube dilatation in 1,gastric tube leak in 1.And recurrent laryneal nerve injury in 5 .Seventy-nine patients were followed up withmMean follow up time of 14.2 months( range 2-31 months).The overall one-year survival rate was 91.1%.Postoperative complications included anastomotic stenosis in 5 cases (6.3%),reflux esophagitis in 12 (15.2%) and recurrence or metastasis in 6 (7.6%).ConclusionMinimally invasive esophagectomy for esophageal cancer can mimimus trauma,reduce post-operative complications,improve the quality of life,which is feasible and effective from the point of the clinical efficacy and the purpose of tumor therapy.

Objective To investigate the clinical features and electron transfer flavoprotein dehydrogenase (ETFDH) gene mutations in 35 Chinese patients with lipid storage myopathy. Methods The clinical data of 35 cases with lipid storage myopathy confirmed by muscle biopsy were collected. The sequences of all 13 exons of ETFDH were analyzed. Results All 35 patients showed proximal weakness. Ten of them demonstrated masseter weakness and 28 of them showed weakness in neck flexion. Twenty-nine of 32 patients who were followed up showed improvement after treatment with VitB2 and CoQ10. Mutations of ETFDH were found in 30 of 35 patients,which included 8 homozygosises,20 compound heterozygosises and 2 single heterozygosises. Fourteen novel mutations were found, including 9 missense mutations ( c. 3G > C, c. 152G>A, c. 191G > A, c.349G>C, c.433G>C, c. 949C > A, c. 1454C > G, c. 1744A >T and c. 1763A>G), 1 nonsense mutation(c. 172G>T), 2 deletions(c. 1282_1283del and 1773_1774del) and 2 splice mutations (c. 405 + 1G > T and c. 1691 -3C > G). Nine of them showed c. 250G > A mutation and 6 of them showed c. 770A > G mutation. Conclusions Lipid storage myopathy is presented as proximal weakness. Multiple acyl-CoA dehydrogenase deficiency caused by mutations of ETFDH is the major cause of lipid storage disease in this group. ETFDH c. 250G > A and c. 770A > G mutations show a high frequency.