Communicable Diseases ; epidemiology ; Disease Outbreaks ; Humans ; Population Surveillance ; methods

We report the case of a 23-year-old woman who presentedwith prolonged menstruation and multiple bruises on thelimbs and trunk. Investigations revealed severethrombocytopenia and deranged coagulation profile withmarkedly prolonged activated partial thromboplastin time(aPTT). Lupus anticoagulant, anti-cardiolipin antibody andanti-beta-2-glycoprotein 1 antibody were positive. She wasdiagnosed with Immune Thrombocytopenic Purpura (ITP)with positive antiphospholipid antibody serology and givena course of intravenous methylprednisolone and taperingdoses of oral prednisolone. She was steroid free and had nobleeding or thrombotic event over two years follow up.

OBJECTIVETo investigate the clinical characteristics of acute myeloid leukemia patients with 3q abnormalities.

METHODSConventional cytogenetic analysis of R-banding was used to detect the abnormalities of 3q in 657 patients with acute myeloid leukemia (AML).

RESULTTwenty-four (3.7%) out of 657 patients had abnormalities of 3q, of which 3q21 or 3q26 were involved in 18 cases (75.0%); 3q21q26 abnormalities were harbored in 11 patients (45.8%), including 9 of t (3;3) and 2 cases of inv (3), of which 3 cases progressed from MDS. Ten patients presented with normal or elevated platelets and their bone marrow morphologies showed abnormal and striking proliferation of megakaryocytes. While in other 7 patients with 3q21 or 3q26, no one presented with high platelets and megakaryocytes. All 24 patients with 3q abnormalities received chemotherapies and only 4 patients achieved short-term remission with a median survival time of 6.7 months.

CONCLUSION3q21q26 anomaly is the most common karyotype in acute myeloid patients with 3q abnormalities. The patients with 3q anomaly had extremely poorer treatment outcome and prognosis.

Adult ; Aged ; Chromosome Aberrations ; Chromosome Banding ; Chromosomes, Human, Pair 3 ; genetics ; Female ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVETo study the impact of maternal weight gain during pregnancy on the risk of infant obesity within 1 year old.

METHODSA total of 785 infants who were born in Hefei and participated children medical care in one district health center and their mothers were chosen as the research subjects from September 2010 to September 2011. Three groups were classified by weight gain during pregnancy according to the percentiles: excessive pregnancy weight gain group of 126 pairs, adequate pregnancy weight gain group of 542 pairs and inadequate pregnancy weight gain group of 117 pairs. Mother's general demographic information was collected. The height and weight were measured when the infant was 42 days, 3, 6, 9, and 12 months of physical examination. Z score was calculated. The differences of Z score in different groups were compared and the RR values of different weight gain during pregnancy on infant obesity were computed.

RESULTSThe weight-for-age Z score (WAZ) of infant at 42 days 3, 6, 9 and 12 months in excessive pregnancy weight gain group were 0.23 ± 0.93, 0.25 ± 1.03, 0.23 ± 0.99, 0.28 ± 1.09, 0.26 ± 1.14, respectively, all higher than that of the corresponding age in adequate pregnancy weight gain group (-0.04 ± 1.02, -0.07 ± 0.99, -0.05 ± 0.98, -0.06 ± 0.97, -0.07 ± 0.95, respectively). The differences were statistically significant (all P values < 0.05). In excessive pregnancy weight gain group, infant body mass index (BMI) at 9 months ((18.01 ± 0.15) kg/m(2)) and 12 months ((17.66 ± 0.15) kg/m(2)) were higher than that of adequate pregnancy weight gain group ((17.63 ± 0.13) and (17.22 ± 0.15) kg/m(2), respectively). The differences were statistically significant (all P values < 0.05). Differences of infant Height-for-age Z score (HAZ) among three groups were not statistically significant (all P values > 0.05). Compared to adequate pregnancy weight gain group, RR (95%CI) value of infant obesity in excessive pregnancy weight gain group was 1.86 (1.14 - 3.03).

CONCLUSIONExcessive maternal weight gain during pregnancy increased the risk of infant obesity within 1 year old.

Female ; Humans ; Infant ; Infant, Newborn ; Obesity ; epidemiology ; Pregnancy ; Pregnancy Trimesters ; Weight Gain

OBJECTIVETo study the role of trisomy 8 in pathogenesis and progression of hematologic disease with trisomy 8.

METHODSThe clinical data on 38 cases with trisomy 8 were investigated retrospectively. Fluorescence in situ hybridization (FISH) using Spectrum Orange labeled chromosome 8 centromere specific probe was carried out to detect trisomy 8 in 10 cases.

RESULTSThirty-two of 38(84.2%) cases with trisomy 8, and fourteen of 17(82.4%) cases with trisomy 8 as the sole chromosome aberration were myeloid disorders such as myelodysplastic syndrome (MDS), acute myelocytic leukemia (AML), chronic myelocytic leukemia (CML). The incidence of trisomy 8 was higher in myeloid disease than in lymphocytic disease (5% vs 1.3%); the incidence of trisomy 8 was higher in acute monocytic leukemia than in other AML (6.1% vs 2.4%), and the incidence of trisomy 8 in chronic myelomonocytic leukemia( CMML) was higher than that in other myelodysplastic syndrome (MDS) (25% vs 13.2%); 17 cases had trisomy 8 as the sole chromosome aberration, 21 cases had other additional chromosome aberrations. The chromosome aberration was confirmed by FISH in 10 cases with trisomy 8 as the sole chromosome aberration. Eleven cases were treated with chemotherapy, among them only 10 cases data were available. Seven cases acquired complete remission but 3 of them were M3, the other 3 cases had no response after two courses of chemotherapy.

CONCLUSIONTrisomy 8 may play an important role in the pathogenesis and progression of the hematological disease, especially myeloid disease. Trisomy 8 might be related with differentiation abnormality of monocyte.

Adolescent ; Adult ; Aged ; Chromosomes, Human, Pair 8 ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia ; genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; Trisomy

BACKGROUND AND OBJECTIVECT-guided microwave coagulation is a minimally invasive surgery for patients with liver cancer. Total intravenous anesthesia with propofol and fentanyl is commonly used. The depth of anesthesia during microwave coagulation for liver cancer is still monitored by clinical signs. There are few subjective and effective indicators. This study explored the application of Narcotrend-assisted "depth of anesthesia" monitoring on microwave coagulation for patients with liver cancer during total intravenous anesthesia with propofol and fentanyl.

METHODSForty liver cancer patients underwent CT-guided microwave coagulation were randomly assigned to receive Narcotrend index monitoring or standard clinical monitoring for depth of anesthesia with 20 patients in each group. All patients received total intravenous anesthesia with propofol and fentanyl. The depth of anesthesia for patients in the Narcotrend group was measured according to a Narcotrend index, which was maintained between D2 and E0. The depth of anesthesia for those in the standard clinical practice group was measured according to heart rate, mean arterial pressure, and patient movement. Changes of hemodynamics, the duration of the emergence from anesthesia, and the recovery of orientation were recorded. The doses of propofol and fentanyl, postoperative visual analogue scores (VAS), and the incidence of postoperative nausea and vomiting were also recorded.

RESULTSThere was no significant alteration in heart rate or mean arterial pressure between the two groups. Compared with other anesthetic stages, both heart rate and mean arterial pressure decreased during the induction of the anesthesia in the two groups(P<0.05). The doses of propofol were higher in the standard clinical practice group than in the Narcotrend group [(460+/-30) mg vs. (380+/-35) mg, P<0.01]. The duration of emergence and orientation were longer in the standard clinical practice group than in the Narcotrend group [(9.5+/-2.9) min vs. (4.9+/-2.2) min, P<0.01; (12.2+/-3.5) min vs. (6.6+/-3.2) min, P<0.01, respectively]. There was no difference in the dosage of fentanyl, VAS, or the incidence of postoperative nausea or vomiting between the two groups (P>0.05).

CONCLUSIONFor patients with liver cancer, monitoring the depth of anesthesia with Narcotrend on microwave coagulation can contribute to lower dosage of propofol and shorten duration of recovery during total intravenous anesthesia with propofol and fentanyl.

Adult ; Aged ; Anesthesia, Intravenous ; Anesthetics, Intravenous ; administration & dosage ; Electrocoagulation ; methods ; Fentanyl ; administration & dosage ; Hemodynamics ; Humans ; Liver Neoplasms ; surgery ; Male ; Microwaves ; Middle Aged ; Monitoring, Intraoperative ; instrumentation ; methods ; Propofol ; administration & dosage ; Tomography, X-Ray Computed

OBJECTIVETo examine whether the enhanced expression of CD40L cDNA on murine ovarian cancer (OVHM) cells could induce the secretion of Th1 cytokines from dendritic cells (DC).

METHODSOVHM cells were transfected with the full-length mouse CD40L cDNA by lipofectamine 2000 and then G418 resistant cells as positive cells were selected. They were examined for their expression of CD40L with flow cytometry. Bone marrow cells were firstly depleted of erythrocytes, macrophages, T and B cells with PE-conjugated magnetic beads, and then cultured in 10% FCS RPMI 1640 medium supplemented with recombinant mouse GM-CSF and IL-4 for 10 days. PKH67-labeled tumor cells were cultured with DC, and then the stained cells were analyzed for the expression of MHC-I, MHC-II, CD80, CD86, CCR7 in DC with flow cytometry. The expression of p40, p19, p35, p28, EBI3 subunits, IL-18, IFN-gamma, Mig gene in cocultured DC-tumor cells were detected by RT-PCR.

RESULTSThe CD40L cDNA was successfully transfected into OVHM cells. Bone marrow-derived DCs, when cultured with CD40L/OVHM, formed clusters with the tumors and showed an upregulated expression of MHC- I, MHC-II, CD80, CD86, CCR7. Expression of the IL-12, IL-23, IL-27, IL-18, interferon-gamma (IFN-gamma) and Mig (monokine induced by IFN-gamma) genes was induced in the DCs that were cultured with CD40L/OVHM but not with OVHM cells.

CONCLUSIONThese data directly showed that the expression of CD40L on ovarian cancer cells facilitates the interaction between DCs and tumors, enhances the maturation of DCs, induces secretion of Th1 cytokines, especially for IL-12, IL-23 and IL-27, which maybe one of the possible antitumor mechanism for CD40L-transfected ovarian cancer cell line.

Animals ; CD40 Ligand ; genetics ; metabolism ; Cell Line, Tumor ; Cells, Cultured ; Coculture Techniques ; Cytokines ; secretion ; DNA, Complementary ; genetics ; Dendritic Cells ; cytology ; metabolism ; Female ; Interleukin-12 ; secretion ; Interleukin-23 ; secretion ; Interleukins ; secretion ; Mice ; Ovarian Neoplasms ; metabolism ; pathology ; Th1 Cells ; secretion ; Transfection

Objective To compare the different thresholds of 'moving percentile method' for outbreak detection in the China Infectious Diseases Automated-alert and Response System (CIDARS). Methods The thresholds of P50, P60, P70, P80 and P90 were respectively adopted as the candidates of early warning thresholds on the moving percentile method. Aberration was detected through the reported cases of 19 notifiable infectious diseases nationwide from July 1,2008 to June 30,2010. Number of outbreaks and time to detection were recorded and the amount of signals acted as the indicators for determining the optimal threshold of moving percentile method in CIDARS. Results The optimal threshold for bacillary and amebic dysentery was P50. For non-cholera infectious diarrhea,dysentery, typhoid and paratyphoid, and epidemic mumps, it was P60. As for hepatitis A, influenza and rubella, the threshold was P70, but for epidemic encephalitis B it was P80. For the following diseses as scarlet fever, typhoid and paratyphoid, hepatitis E, acute hemorrhagic conjunctivitis, malaria, epidemic hemorrhagic fever, meningococcal meningitis, leptospirosis, dengue fever, epidemic endemic typhus,hepatitis C and measles, it was P90. When adopting the adjusted optimal threshold for 19 infectious diseases respectively, 64 840(12.20%)signals had a decrease, comparing to the adoption of the former defaulted threshold(P50)during the 2 years. However, it did not reduce the number of outbreaks being detected as well as the time to detection, in the two year period. Conclusion The optimal thresholds of moving percentile method for different kinds of diseases were different.Adoption of the right optimal threshold for a specific disease could further optimize the performance of outbreak detection for CIDARS.

China ; epidemiology ; Disease Outbreaks ; Humans

OBJECTIVETo understand the national situation of quality and consumption of iodized salt at production and household levels.

METHODSDetailed surveillance method could be found in 'national iodized salt surveillance scheme', issued by MOH in 2004. The iodine concentrations in salt (except some special kinds of salt) were detected by direct titration with national standard of GB/T 13025.7-1999, in which the iodine content in qualified iodized salt was set as between 20 and 50 mg/kg and that in non-iodized salt was set as below 5 mg/kg.

RESULTSAt production level, the national lot qualified rate was 98.36% and all the provincial lot qualified rate of production level was over 90%. At household level, the national iodized salt coverage rate of household was 96.87% and the national qualified iodized salt coverage rate was 93.75%. 4 provinces (Tibet, Hainan, Xinjiang and Guangdong) had an iodized salt coverage rate lower than 90%. Further, the qualified iodized salt coverage rate of 5 provinces (Tibet, Hainan, Xinjiang, Guangdong and Qinghai) was below 90%. In 2006,80 counties did not conduct the iodized salt surveillance and non-iodized salt coverage rate of 185 counties was higher than 10%. In the respect of the qualified iodized salt coverage rate at household level, there were about 10 percent lagging behind the national goal that 95% of all the counties in China should achieve virtual elimination of iodine deficiency disorder before 2010.

CONCLUSIONAt national level,the lot qualified rate at production level and the iodized salt coverage rate at household level maintained comparatively well. However, at county level, there were 75 counties whose iodized salt coverage rate was below 70%.

China ; Goiter ; prevention & control ; Humans ; Iodine ; deficiency ; Population Surveillance ; Sodium Chloride, Dietary