Objective To analyze the clinical manifestations and the features of brain MRI and cerebrospinal fluid (CSF) findings in adult Chinese patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods We reviewed the clinical manifestations,brain MRI and CSF examinations of 29 patients who were diagnosed as anti-NMDAR encephalitis.Results The major clinical features of anti-NMDAR encephalitis patients included psychiatric symptoms (86％,25/29),seizures (83％,24/29),decreased consciousness (55％,16/29),involuntary movements (55％,16/29),central hypoventilation (34％,10/29),and hypersalivation (17％,5/29).Some patients also experienced autonomic instability,hemiplegia and aphasia.Underlying ovarian teratoma was identified in 14％ of affected patients(4/29).Brain MRI was found abnormal in up to 62％ patients (18/29),located in the temporal lobes,hippocampus,thalamus,brain stem,cingulate gyrus,frontal and parietal cortex,corpus callosum,internal capsule,basal ganglia and periventricular area.CSF findings were abnormal in 83％ of patients with anti-NMDAR encephalitis.Oligoclonal banding in CSF was positive in 95％ patients (19/20).The recurrence rate during 3 years was 31％ (9/29).Conclusions Anti-NMDAR encephalitis is a treatable disease,yet with high recurrence rate.Its predominant clinical features are psychiatric symptoms and seizures,while involuntary movements,central hypoventilation and hypersalivation are its characteristic manifestations.Lesions in MRI are widespread,not only restricted to limbic lobe.

Objective To investigate ERCC1 expression in advanced breast cancer and its relationship with cisplatin resistance. Methods ERCC1 expression in 50 cases of advanced breast cancer was measured by RT-QPCR. The chemotherapy (CAF) was given. Gemcitabine and cisplatin were given because of metastasis. Results The expression of ERCC1 has no relationship with age, lymph node metastasis, clinicl stage, histologi-cal grade or human epidermal growth factor receptor-2 (HER2) expression. The effective rate was 18.8% (3/16) for ERCC1 high-expressed patients and 79.4%(27/34)for ERCC1 low-expressed patients in terms of cisplatin chemotherapy. The sensitity for cisplatin chemotherapy was high for patients with low ERCC1 expression and it was low for patients with high ERCC1 expression. The effective rate (complete remission+partial remission), and ineffective rate (stable disease+progressive disease) between the two had statastical significance (P<0.001). Con-clusions ERCC1 low-expressed patients can benefit from cisplatin. ERCC1 can be used as a moleculer marker for predicting chemotherapy efficacy in breast cancer.

Objective To study the prognostic and predictive significance of 21-gene assay ( oncotype DX)in breast cancer.Methods Real-time quantitative PCR(RT-QPCR)was used to detect 21 gene expression in breast cancer tissues (100 cases)and recurrence score(RS)was calculated.Results Among the 100 cases, 52 cases had low RS , 22 cases had middle RS , and 26 cases had high RS .The recurrence rate of five years was 1.92%,4.55%and 15.38%respectively.21 gene expression had nothing to do with patients'age, tumor size, histological grade , lymph node metastasis state , ER expression , or PR expression .It was associated with HER 2 expression .Conclusions 21 genes is a good prediction factor in breast cancer and its prognosis .

A FAST (fluorescence of advanced Maillard products and Soluble Tryptophan) method for identification of reconstituted milk made from skim milk powder in the fresh milk was developed. Considering milk and skim milk powders variations from different seasons and countries, milk was collected from different dairy farms in different seasons and skim milk powders were collected from different countries to measure the Tryptophan (Trp), advanced Maillard products (AMP) fluorescence values. The results showed that there were differences (P<0.01) between raw and reconstituted milk. The plot of values in each mixed level of raw and reconstituted milk had a correlation coefficient >0.97. The FAST method is a simple, rapid, low-cost and sensitive method enabling the detection of 5% reconstituted milk in fresh milk. The measurement of the Trp, AMP fluorescence values and calculation of the FAST index is a suitable method for large-scale monitoring of fresh milk samples.
Animals ; Cattle ; Food Analysis ; methods ; Food Contamination ; prevention & control ; Glycation End Products, Advanced ; analysis ; Maillard Reaction ; Milk ; chemistry ; classification ; Powders ; Spectrometry, Fluorescence ; methods ; Tryptophan ; analysis

OBJECTIVETo study the relationship between overweight/obesity, smoking, alcohol drinking and the stroke in Chinese residents, as to providing a scientific foundation to the causal prophylaxis of stroke.

METHODSApplying a meta-analysis with software of RevMan 4.2.9 version to systematically analyze the references in dealing about the relationship between overweight/obesity, smoking, alcohol drinking and the stroke in China during 1999 to 2006.

RESULTSSix, six and six articles dealing about overweight/obesity, smoking, alcohol drinking and the stroke were searched respectively. Incorporated by fix effect model, random effect model and random effect model after the heterogeneity tests, the values of OR were 1.81 (95% CI: 1.40-2.35), 1.22 (95% CI:1.08-1.37) and 1.19 (95% CI:1.03-1.38). After Z tests, the Z values were performed with 4.52, 3.24 and 2.36 respectively (all the P values were less than 0.05). Additionally, the funnel plots were protracted and the sensibility analysis was performed.

CONCLUSIONSThe publication biases were little and the results were creditable. The overweight/obesity, smoking and alcohol drinking in residents in China should be the risk factors of the stroke.

Alcohol Drinking ; adverse effects ; epidemiology ; Body Mass Index ; China ; epidemiology ; Humans ; Obesity ; complications ; epidemiology ; Overweight ; complications ; epidemiology ; Risk Factors ; Smoking ; adverse effects ; epidemiology ; Stroke ; epidemiology ; etiology ; Waist-Hip Ratio

OBJECTIVETo investigate the role of single nucleotide polymorphisms of the gene of diacylglycerol kinase κ (DGKK) in hypospadias in Chinese children.

METHODSWe performed direct sequencing on 2 hypospadias-related candidate single nucleotide polymorphisms of the DGKK gene (rs1934179 and rs7063116, never previously reported in the Chinese population) from 300 children with sporadic hypospadias and 200 healthy controls, and compared the results between the two groups.

RESULTSThe mutation frequencies of rs1934179 and rs7063116 were 5.0% (15/300) and 5.67% (17/300) respectively in the hypospadias patients, significantly higher than 1.5% (3/200) and 2.0% (4/200) in the normal controls (P <0.05). The mutation frequencies of rs1934179 and rs7063116 in the cases of distal and middle hypospadias were also remarkably higher (6.5%, [13/200] and 7.5% [15/200], P <0.05), but those in the proximal cases (both 2.0% [2/100]) showed no statistically significant difference from the control (P >0.05).

CONCLUSIONThe polymorphisms of the DGKK gene may be associated with hypospadias, particularly distal and middle hypospadias, in Chinese children.

Asian Continental Ancestry Group ; Case-Control Studies ; Child ; China ; Diacylglycerol Kinase ; genetics ; Humans ; Hypospadias ; enzymology ; genetics ; Male ; Polymorphism, Single Nucleotide

Objective To investigate the expression of thymidylate synthase (TS) in breast cancer and its relationship with fluorouracil sensibility and patients' prognosis.Methods TS expression in 80 cases of breast cancer was measured by RT-QPCR.The chemotherapy (CAF) was given.Relationship between TS and fluorouracil sensibility was studied,as well as the relation between TS expression and prognosis of breast cancer.Result Positive expression of TS gene was detected by Q-PCR 1n 27.5％ of the breast cancer specimens.The expression of TS had no relation with age,lymphatic metastasis,histological grade or clinical stage,while it was obviously correlated with HER2 (P＜0.01).The expression of TS had negative correlation with the antitumor effect of fluorouracil.The five-year survival rate of TS positive patients was lower than that of TS negative patients (P＜0.01).Conclusions Breast cancer patients with low expression of TS may benefit from fluorouracil.TS can be used as a molecule marker for predicting efficacy of breast cancer chemotherapy.

OBJECTIVETo demonstrate the ablation of segmental glissonian pedicle by ultrasound-guided radiofrequency in precision liver resection in porcine model.

METHODSThe study was carried out on 6 Bama miniature pigs. Coagulative desiccation of the vessels feeding the segment to be resected was induced by introduction of a "cooled-tip" radiofrequency electrode under intraoperative ultrasound guidance at the level of the vessels. Then, an area of marked discoloration on the surface of the liver became obvious. Liver parenchymal transection followed without any form of hepatic inflow occlusion. Three segments (segment 3, 5, and 6) were resected on each pig. The criteria studied the local and general tolerance, the change of blood flow parameters of each segmental arterial and portal branches, and the microscopic appearance of the segmental arterial, portal and biliary tract branches. Using t test as the statistical methods.

RESULTSPostoperative mortality and morbidity were 0 and all serum parameters had normalized by 14 days. Demarcation area was obtained in 15 segments. The flow rate of the resected segmental portal branches was 0 cm/s after radiofrequency and the value of the arterial branches was (28 ± 18) cm/s which was significantly lower than pre-radiofrequency, which were (10.2 ± 3.0) cm/s and (60 ± 17) cm/s (t = 14.439, 5.502; P = 0.000). There was no significant difference in the flow rate of the remnant segmental arterial and portal branches among pre-radiofrequency, post-radiofrequency and 14 days after operation. On microscopic observation, the mean ablated length of segmental portal, arterial and biliary tract branches were (1.6 ± 0.4) cm, (1.2 ± 0.4) cm, and (1.7 ± 0.3) cm respectively.

CONCLUSIONSThe ablation of the segmental glissonian pedicle by ultrasound-guided radiofrequency is quick, safe and effective. The probe needs to be away from vessels feeding segments 1.5 cm at least to avoid thermal injuries.

Animals ; Catheter Ablation ; methods ; Female ; Hepatectomy ; methods ; Male ; Swine ; Swine, Miniature ; Ultrasonography

OBJECTIVETo explore the risk factors and prevention strategies of post-operative complications in elderly patients with colorectal cancer.

METHODSData of 107 elderly patients (≥75 years) undergoing surgery for colorectal cancer were collected from January 2006 to December 2009 in the Department of Gastrointestinal Surgery, Peking University People's Hospital. POSSUM and E-POSSUM scoring systems were used to predict post-operative complications. ROC curve and observe/expect(O/E) were used to assess the validity of scoring systems. Logistic regression was used to evaluate the independent risk factors associated with post-operative complications of elderly patients with colorectal cancer.

RESULTSThe predictive complication rates of E-POSSUM and POSSUM in elderly patients with colorectal cancer were 13.9%-86.6%(average, 32.7%) and 19.1%-99.1% (average, 55.5%). The predictive validity of E-POSSUM was better than POSSUM(AUC of ROC: 0.862 vs. 0.576, O/E: 0.771 vs. 0.454), the former was closer to the actual complication rate(25.2%, 27/107). Concurrent diabetes mellitus(P=0.019) and rectal lesion(P=0.005) were independent risk factors associated with surgery-related post-operative complications. Anastomotic leakage was the most common surgery-related post-operative complications. Chronic obstructive pulmonary disease(P=0.026), ASA score(P=0.025), intestinal obstruction(P=0.037) and perforation(P=0.001) were independent risk factors associated with non-surgery-related post-operative complications. Pulmonary infection was the most common non-surgery-related post-operative complication.

CONCLUSIONSThe application of E-POSSUM scoring system can provide more accurate prediction of post-operative complications in elderly patients undergoing surgery for colorectal cancer. Positive interventions should be taken for high-risk patients to prevent post-operative complications.

Aged ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Male ; Postoperative Complications ; etiology ; prevention & control ; Risk Factors

OBJECTIVETo study clinic therapeutic effect about reconstruction of severe orbital and cul-de-sac deformity after the radiotherapy with transcranial orbitotomy advancement combining cascade free flap both dorsum pedis flap and anterior tibial fascial flap.

METHODSFive cases was subjected to orbital and cut-de-sac severe deformities after both operation and radiotherapy because of retinoblastoma. The technique included transcranial orbital advancement by anterior orbital osteotomy and rigid fixed with titanic plate by coronal incision, and meanwhile incising the cul-de-sac which would be extended circumference around the central incision separation, and then designing extent of cascade flap consisted of dorsum pedis flap and anterior tibial fascial flap according to the size of cul-de-sac defect and extent of temporal depression. Then, the aforementioned two parts of cascade flap were transplanted into cul-de-sac and temple respectively. There is either the superficial temporal artery and vein or facial artery and jugular vein to chose vascular anastomosis.

RESULTSAll flaps survived. After 3 to 6 months following up, the results showed satisfactory orbital contour and temporal depression improved significantly in all cases. After the conjunctival sac were fixiformed with prefabricated eye prosthesis mode about 3 months. 3 cases have good appearance with wearing eye prosthesis and the other 2 cases' appearance is poor. One of the poor appearance cases, with depressed eye socket, have orbital implant underlying conjunctival sac in secondary operation. The other one, with swallowed inferior fornix, is transplanted autogenous hard palatal mucosa into inferior fornix in secondary operation. In addition, delayed healing in donor site of dorsum pedis occurred in one of the 4 cases.

CONCLUSIONSIt is a reliable procedure about reconstruction of severe orbital and cul-de-sac deformity after both the operation and radiotherapy with transcranial orbitotomy advancement combining cascade free flap both dorsum pedis flap and anterior tibial fascial flap. All deformity was corrected by one staged procedure which lessen patient's suffering and shorten patient's hospital stay and spare patient's costs.

Adolescent ; Adult ; Female ; Humans ; Male ; Orbital Diseases ; etiology ; surgery ; Osteotomy ; Radiotherapy ; adverse effects ; Reconstructive Surgical Procedures ; methods ; Retinoblastoma ; radiotherapy ; surgery ; Surgical Flaps ; Young Adult