Objective To investigate the value of modified T staging system in the diagnosis and treatment of hilar cholangiocarcinoma (HCCA).Methods The clinical data of 95 patients with HCCA who were admitted to the Memorial Sun Yat-Sen Hospital from December 1995 to January 2010 were retrospectively analyzed.Based on the results of imaging examination,preoperative staging was determined according the modified T staging system.The prognosis of the patients in difference T stages were compared.The data were analyzed by using the chi-square test and Fisher exact test.The survival curve was drawn by Kaplan-Meier method and the survival rate was compared by using the Log-rank test.Results The diagnostic rates of ultrasound + magnetic resonance cholangiopancreatography (MRCP),ultrasound + computed tomography (CT) or spiral CT were 93％ (37/40) and 66％ (23/35),respectively.The diagnostic rates of ultrasound + CT or spiral CT and endoscopic retrograde cholangiopancreatography (ERCP),ultrasound + CT or spiral CT and MRCP were 14/15 and 15/15,respectively.Of the 95 patients,44 received operation (including 28 cases of radical resection and 16 cases of palliative resection),16 received exploratory laparotomy,and 35 received simple internal or external drainage.For patients in T1,T2 and T3 stages,the resection rates were 71％ (30/42),50％ (12/24) and 7％ (2/29),respectively,with significant differences (x2 =30.182,P ＜0.05).The negative rates of the resection margins of patients in T1 and T2 stages were 77％ (23/30) and 5/12,respectively,2 patients in T3 stage were found with tumor residuals at the resection margin.There was a significant difference in the radical resection rate among patients in different T stages (x2 =8.204,P ＜ 0.05).Of the 44 patients who received surgical treatment,30 (68％) received concomitant partial hepatectomy.The ratios of patients in T1 and T2 stages who received concomitant partial hepatectomy were 70％ (21/30) and 9/12,respectively,with no significant difference (x2 =0.101,P ＞ 0.05).Fourteen (32％) patients received tumor resection.The incidences of complications and perioperative mortalities were 53％ (16/30) and 10％ (3/30) for patients who received concomitant partial hepatectomy,and 5/14 and 1/14 for patients who received tumor resection,with no significant differences between the 2 groups (x2 =1.188,0.094,P ＞ 0.05).The median survival time of patients who received concomitant partial hepatectomy was 29 months,which was significantly longer than 19 months of patients who received tumor resection (x2 =11.317,P ＜0.05).Eighty-six patients were followed up,and the median time of follow up was 15.6 months (range,3-70 months).The 1-year cumulative survival rates of patients in T1,T2 and T3 stages were 73.8％,58.0％ and 9.2％,respectively,and the 3-year cumulative survival rates of patients in T1,T2 and T3 stages were 33.5％,12.1％ and 0,respectively.The median survival time of patients in T1,T2 and T3 stages were 24,16 and 7 months,respectively.The prognosis of patients was getting poor as the increase of the T stages (x2 =37.07,P ＜ 0.05).Conclusions The modified T-staging system is beneficial to preoperative evaluation of patients with HCCA.Concomitant partial hepatectomy could improve the radical resection rate and prolong the median survival time of HCCA patients.

OBJECTIVE: To screen and identify the frequency and characteristic of mutation in stereocilium-related gene Taperin of Chinese prelingual nonsyndromic hearing impairment with DNA microarray combined with PCR. METHOD: One hundred and thirty-four patients of prelingual nonsyndromic deafness and one hundred health individuals in China were investigated in this study. Genomic DNA was extracted from the patients and was subjected to DNA microarray to screen mutations in 4 most common genes. The samples that carried none of the common mutant alleles were subjected to PCR and sequenced to detect mutations in Taperin gene. RESULT: Ninteen out of one hundred and thirty-four patients of prelingual nonsyndromic deafness were detected carring common deafness gene with DNA microarray. Taperin gene were detected in one hundred and fifteen patients with PCR. A187S was detected in Taperin as hetrozygous state in 2 patients and their unaffected members of their family. It occurred at the evolutionary conservation of the amino acids of taperin according to alignment analysis. Two polymorphism, 157C>T and 318C>T, were found in the patients and the control group. CONCLUSION A novel Taperin mutation, A187S was detected in Chinese patients with prelingual nonsyndromic hearing loss, which may be relevant to hearing loss. Two polymorphism, 157C>T and 318C>T, were found in Chinese in our research. The carrier frequency for Taperin mutation is about 1.74% of prelingual nonsyndromic deafness in Chinese patients.
Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; China ; Deafness ; genetics ; Female ; Humans ; Male ; Mutation ; Proteins ; genetics ; Young Adult

Adult ; African Continental Ancestry Group ; ethnology ; C-Reactive Protein ; metabolism ; Calcinosis ; complications ; Coronary Disease ; complications ; Female ; HIV Infections ; complications ; pathology ; physiopathology ; HIV-1 ; Heart Diseases ; pathology ; physiopathology ; Humans ; Lipid Metabolism ; Male ; Middle Aged ; Myocardium ; pathology

Objective To evaluate the gender differences in dose-response curve with cisatra-curium in epileptics.Methods Eighty ASA grade Ⅰ or Ⅱ epileptics were enrolled in this study.All patients were divided into male and the female groups and received the method of single dose injection under midazolam-fentanyl intravenous anesthesia.Each patient received intravenous bolus of 20,30, 40,50μg/kg of cisatracurium respectively.The neuromuscular block was measured by Neuromuscular Transmission Monitor and the responses were defined in terms of the percentages of maximum sup-pression in T1 of TOF of the adductor pollicis muscle.According to log-probit transformation of the data of dose and response,the dose-response curve of cisatracurium was established through linear re-gression.The onset time of cisatracurium was also observed.Results The ED50 ,ED75 ,ED90 ,ED95 values of cisatracurium in male epilepsy patients were 37.2±9.7,48.1±11.3,60.4±12.8,69.3± 14.0 μg/kg and that of female epilepsy patients were 36.6±4.3,47.5±7.7,60.5±14.0,70.1± 19.4 μg/kg.There was no significant difference between the two gender groups.No significant change in onset time was observed among 4 dose groups.Conclusion No gender differences are ob-served in dose-response curve of cisatracurium in epileptics.

Objective To evaluate the performance of China Infectious Disease Automatedalert and Response System(CIDARS). Methods A retrospective analysis was conducted on data related to the warning signals, the outcome of signal verification, the field investigation of CIDARS,and the emergent events reported through Public Health Emergency Events Surveillance System from July 1,2008 to June 30, 2010 in Zhejiang province. The performance of CIDARS was qualitatively evaluated by indicators on its sensitivity and rote of false alarm. Results In total, 26 446 signals were generated by the system which involving 17 diseases, with an average of 2.83 signals per country per week. Among all the signals, 99.95% of them were responded. 0.90% of the signals were judged as suspected events via the preliminary verification, and 30 outbreaks were finally confirmed by field investigation. The sensitivity of the system was 69.77% with the false alarm rate as 1.39%. Conclusion The system seemed to have worked on the outbreak early warning of infectious diseases and could directly reflect the anomaly event emerged from the infectious disease reporting system.However, more efforts should be paid to the following areas as how to decrease the false positive signals, select suitable thresholds and increase the quality of data in order to enhance the accuracy of the system.

AIMThe purpose of this study is to compare the effects of the two clutches on recording the condylar movement.

METHODOLOGYTen subjects (6 women, 4 men; mean age 25.4 years) participated in the study. The mandibular movement, sagittal condylar inclination angle, and transversal condylar inclination angle of each subject were recorded with the CADIAX using the two clutches, respectively. The characteristics of the tracings of the protrusion, opening, and mediotrusion were analyzed with the t-test statistics at a = 0.05 level. The Kappa values were calculated for an assessment of the congruence of the tracings.

RESULTSThe results showed that the contour, direction, and dimension of the tracings in the two clutches were approximately same, but the tracings determined by the functional occlusal clutch were more regular and congruent. In the group segment recorded with the tray clutch, opening/closing paths of one subject showed crossed and time curves of three subjects appeared peak-like changes of velocity, but none were statistically different (P>0.05).

CONCLUSIONThe research suggests that the functional occlusal clutch should be preferred in the evaluation of the mandibular function, as the tracings with the tray clutch are more likely to produce false positive results.

Adult ; Dental Occlusion ; Diagnosis, Computer-Assisted ; instrumentation ; Female ; Humans ; Jaw Relation Record ; instrumentation ; Male ; Mandibular Condyle ; physiology ; Movement ; Temporomandibular Joint ; physiology

AIMTo study the changes of synaptic plasticity in rat model with Alzheimer disease (AD).

METHODSAD rat model was conducted by D-galactose intraperitoneal injection combined with lesions of nucleus basalis of Meynert (nbM). Behavioral performance, LTP in dentate gyrus and synaptic morphology in hippocampal CA1 were observed.

RESULTS(1) Escape latencies in place test in model rats were longer than that in control rats, and swimming time and distance between the two groups in platform quadrant were significant differently (P < 0.01). (2) The numerical density (Nu) and surface density (Su) of synaptic contact zones markedly decreased (P < 0.01) in model rats. (3) Augment of population spike (PS) in perforant path-dentate gyrus of model rats after high frequency stimulation was smaller than that of the control (P < 0.05).

CONCLUSIONThe results suggest that the decreased synaptic plasticity in hippocampus could responsible for the impairment of spatial learning of model rats.

Alzheimer Disease ; physiopathology ; Animals ; Basal Nucleus of Meynert ; pathology ; Disease Models, Animal ; Female ; Galactose ; pharmacology ; Hippocampus ; physiopathology ; Long-Term Potentiation ; Male ; Neuronal Plasticity ; Rats ; Rats, Wistar

OBJECTIVETo examine the association between Ponderal index (PI) at birth and metabolic syndrome during middle age.

METHODSTotally, 975 adults (494 men and 481 women) aged 41-52 from the study cohort of Fetal Origin of Adult Disease were recruited in the study for clinic examinations, involving anthropometry and measurements of blood pressure, fasting and 2 hr plasma levels of glucose and insulin, serum lipid profile. Their HOMA-insulin resistance (IR) index was estimated. Metabolic syndrome (MS) was diagnosed according to 1999 WHO definition. Multivariate logistic regression analysis was used to estimate the effect of PI on MS and the interaction between PI at birth and body mass index (BMI) in adulthood.

RESULTSPrevalence of MS was 18.7% in this mid-aged population, 24.8%, 19.4%, 16.3% and 14.0% in those with less than the 25th percentile, the 25th to less than the 50th percentile, the 50th to less than the 75th percentile and more than 75th percentile of PI at birth, respectively, in a decreasing trend (chi2 M-H for trend=9.938 adjusted for gender, P=0.002). Logistic regression analysis showed that both PI at birth and BMI during adulthood could influence their occurrence of MS (beta=-0.125, P=0.002, for PI; and beta=0.430, P=0.000, for BMI). A synergistic effect between PI at birth and BMI in adulthood was observed in this population. Persons who were thin at birth with PI less than the 25th percentile, and became overweight with BMI greater than or equal to 24 kg/m2 later in their life, were at higher risk of suffering from metabolic syndrome (OR=29.1, 95% CI=13.6-62.1), in comparison with those who became overweight during adulthood from a higher PI at birth (OR=16.0, 95% CI=7.9-32.3) and those who were thin at birth and remained a appropriate BMI during their adulthood (OR=2.0, 95% CI=0.7-5.7). Attributable fraction of the interaction to MS was 34.6%.

CONCLUSIONSThin at birth was a predictor for later occurrence of metabolic syndrome, as well as an effect modifier for the association between of later BMI and metabolic syndrome, i.e., overweight later in his life was most deleterious for a person with growth retardation at birth.

Adult ; Birth Weight ; Blood Glucose ; metabolism ; Body Mass Index ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Insulin Resistance ; physiology ; Lipids ; blood ; Logistic Models ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Prevalence ; Risk Factors

OBJECTIVEThe purpose of this study was to investigate the distribution of collagen I, II , X, alkaline phosphatase (ALP) and their roles during initiation of condylar cartilage of the fetal mouse.

METHODSCoronary sections of mandible of mouse embryo aged from 14th to 18th day were studied under light microscope after stained by immunohistochemical method with antibody of types I, II, X collagen and ALP.

RESULTSOn the 14th day of mouse embryo, it was found that mesenchymal cells condensation continuous with the periosteum. Type I collagen and ALP were positive behind the terminal of the ossifying mandibular periosteum where future condylar will form. On the 15th day, positive staining for types I, II collagen was found in mesenchymal cells around hypertrophic cells and type X collagen was detected in hypertrophic cells. ALP was positive in both mesenchymal cells and hypertrophic cells. On the 16th day, type I collagen was observed from periosteal osteogenic cells and mesenchymal cells of the fibrous cell layer to the upper hypertrophic cell layer while Type II collagen was restricted from the lower polymorphic cell layer to the bottom of the hypertropic cell layer. Type X collagen was positive in the hypertrophic cell layer. ALP was positive in periosteal osteogenic cells and hypertrophic chondral cells, but not in the polymorphic cell layer.

CONCLUSIONDevelopment of condylar cartilage is different from that of limb bone. Types I, II, X collagen are expressed in the condylar chondrocyte on the early stage of endochondral ossification. The histology evidence supports the conjecture that condylar cartilage is derived from differentiated mesenchymal cells of the preperiosteum or periosteum of the mandible where ALP is positively expressed.

Alkaline Phosphatase ; Animals ; Cartilage ; Cell Differentiation ; Chondrocytes ; Collagen ; Collagen Type I ; Mandible ; Mandibular Condyle ; Mice ; Osteogenesis

OBJECTIVEThis article reports a population genetic study on six short tandem repeat(STR) loci, D7S820, D19S253, D12S391, D5S818, D16S539 and D8S1179, in a sample of unrelated Chinese Han individuals(n=122-173) living in Hebei province.

METHODSDNA extraction from blood samples (200 in number) and multiplex amplification of the above six loci were carried out. Using denaturing polyacrylamide gel electrophoresis and silver stain, the authors investigated the distribution of allele frequencies of the six loci in Han population in Hebei province.

RESULTSThe STR polymorphisms at all of the six loci were observed in Chinese Han population in Hebei province. The observed heterozygosities of D7S820, D19S253, D12S391, D5S818, D16S539 and D8S1179 were 0.828, 0.757, 0.769, 0.837, 0.785 and 0.852, respectively. The measured values of the power of discrimination (PD) were 0.914, 0.919, 0.940, 0.909, 0.917, 0.944; of the mean exclusion chance(MEC) 0.618, 0.740, 0.801, 0.557, 0.655, 0.696 and of the polymorphism information content (PIC) in Chinese 0.771, 0.760, 0.762, 0.708, 0.776 and 0.794, respectively.

CONCLUSIONThe genotype distributions of the six STR were in accordance with Hardy-Weinberg equilibrium. The numerical values of the PD and MEC are relatively high in Hebei province, and thus can be of significant application in population genetics and forensic medicine.

Asian Continental Ancestry Group ; genetics ; China ; ethnology ; DNA ; analysis ; Female ; Gene Frequency ; Genetics, Population ; Humans ; Male ; Microsatellite Repeats ; genetics ; Polymorphism, Genetic ; Population Groups ; Tandem Repeat Sequences ; genetics ; physiology