Objective To investigate the relationship between the plasma homocysteine (Hcy) and cerebral infarction.Methods 84 patients with cerebral infarction in our department were selected as study group and 56 cases from medical examination center were selected as control group. The fasting plasma homocysteine (Hcy) was determined in both groups . Result The level of Hcy in cerebral infarction group was significantly higher than the control group, there was a significant difference ( <0.01) .Conclusion High homocysteine levels is an important independent risk factor of cerebral infarction.

Staging of hepatocellular carcinoma (HCC) need to consider tumor factors and functional status of liver,which is different from other solid tumors.Now there are many clinical staging and prognosis systems of HCC.Intermediate stage HCC is commonly occurred at disease diagnosis,with varied clinicopathological charactertics,therapeutic options and survival outcomes of patients.In this review,the definition,current therapeutic strategies,substaging model of intermediatestage HCC and the efficacy of liver resection for patients of intermediate-stage HCC are discussed for further improving feasibility of individualized surgical therapy.

Death, Sudden, Cardiac ; Genetic Testing ; Humans

Blood Donors ; Child ; Cord Blood Stem Cell Transplantation ; adverse effects ; methods ; Female ; Follow-Up Studies ; Graft vs Host Disease ; prevention & control ; Humans ; Infant, Newborn ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; surgery ; Transplantation, Homologous ; Treatment Outcome

Objective:To observe the co-antitumor effect and hepatic protection of melatonin on unresectable advanced primary liver cancer treated by transcatheter arterial chemoembolization (TACE). Methods:One hundred and forty patients with unresectable advanced primary liver cancer were divided into 2 groups at random, seventy patients received TACE alone while the other 70 patients were treated by TACE+Mel (20 mg/d at 8:00 P.M orally, 7 d before each TACE and lasted for 21 d). Results: The partly resolution rate of TACE and TACE+Mel were 12.86% and 22.86% respectively( P

Objective To investigate the insula and its related network of schizophrenia patients and its correlation to behavior performance with functional magnetic resonance imaging.Methods Fourteen patients with paranoid schizophrenia and sixteen normal subjects received blood oxygenation level dependent functional magnetic resonance imaging(BOLD-fMRI) examinations based on resting state and digital 2-back working memory task.The fMRI data were processed and analyzed with SPM2,AFNI and Matlab software packages (thresholded at P =0.005,uncorrected).Medial prefrontal cortex (MPFC,BA10) was placed as region of interest (ROI).Results The functional connectivity positively or negatively correlated with MPFC was lower for patient group than that for control group in resting and task states.In resting state,the brain areas negatively correlated with MPFC mainly included the bilateral superior temporal gyrus (BA22),cuneus (BA 18/19),inferior parietal lobule (BA40),right parahippocampus for patient group and the bilateral insula/superior temporal gyrus(BA22),inferior parietal lobule(BA40),paracentral lobule,parahippocampus for control group.The brain areas positively correlated with MPFC mainly included the pineal gland areas for patient group and the left anterior nucleus thalamus,bilateral medial superior frontal gyrus (BA6),right inferior corpus callosum (BA34) and the cerebellar vermis for control group in resting state.In 2-back task,the brain areas negatively correlated with MPFC mainly included the right cerebellar hemisphere,left superior parietal lobule/precuneus (BA7),left superior frontal gyrus (BA6) for patient group and the left medial dorsal thalamus,bilateral lateral premotor area (BA6),left inferior parietal lobule/precuneus (BA7),right cerebellar hemisphere for control group.The accuracy of reaction was lower in patient group than that in control group((78.30 ± 8.76) ％ vs (89.89 ± 8.05) ％,P =0.01) and the correlation between the accuracy and the left medial dorsal thalamus had statistical significance (r =-0.52,P =0.04).Conclusion The altered functional connectivitv of the bilateral insula and its related network indicates functional disintegration of the limbic system in patients with schizophrenia.Widespreadly reduced functional connectivity and the functional disconnection of left medial dorsal thalamus mav be one of the reasons for poor behavior performance in schizophrenia patients.

Objective To analyze the susceptibilities of Escherichia coli isolates collected from blood and the prevalence of ESBLs encoding genes.Methods A total of 121 Escherichia coli isolates collected from blood during 2012 were analyzed for antimicrobial susceptibilities by software of WHONET 5.6,the production of ESBLs was confirmed by confirmatory pheno-typic testing,PCR and DNA sequence were further implemented to analyze the ESBLs-encoding genes.Results 121 E.coli isolates displayed high resistance towards broad spectrum penicillin and 2nd or 3rd generation cephalosporins,levofloxacin and cotrimoxazole,with the resistance rates being more than 40%,susceptibilities to imipenem,piperacillin/tazobactam,ami-kacin were observed,with the resistance rates to be less than 12%,86(88.7%)out of 121 isolates were found to produce ESBLs.Among them,59.5% (72),38.8% (47)and 4.1% (5)were confirmed to carry blaCTX-M,blaTEM and blaSHV genes.Additionally,2(1.7%)isolates carried all the genes detected,30(24.8%)isolates carried both of blaCTX and bla-TEM,1(0.8%)isolate carried both of blaSHV andblaTEM.Conclusion Most of the E.coli isolates from the blood culture in Nanjing Gulou Hospital produce ESBLs,and displayed resistance towards most of the penicillins,cephalosporins and sin-gle amide antimicrobial agents should be chosen according to susceptibility results.

Objective To determine the methylation level of P15INK4B gene promoter in different types of myelodysplastic syndromes (MDS) and its correlation with its prognosis.Methods Methylation frequency of the P15INK4B gene promoter in 44 cases of MDS were determined by methylation-specific polymerase chain reaction (PCR) and pyrosequencing,and its correlation with clinical classification and characteristics of MDS were statistically analyzed.Results Frequency of P15INK4B gene promoter methylation in myelodysplastic syndromes-refractory anemia with excess blasts Ⅱ (MDS-RAEB Ⅱ) patients was (46.89 ± 15.41) ％,significandy higher than that in other types of MDS (P ＜ 0.05),but no difference in promoter methylation frequency was detected among the other types of MDS (P ＞ 0.05) ; frequency of P15INK4B gene promoter methylation was found to be correlated with decline in platelet upon diagnosis (t =9.02,P ＜ 0.01),but showed no significant correlation with drop of hemoglobin or leukopenia (P ＞0.05).As for the correlation between P15INK4B gene promoter methylation and MDS risk stratification,no significant difference was detected between the low-risk and very low-risk groups (P ＞ 0.05),but significant differences were detected among the medium-risk,high-risk,and very high-risk groups (P ＜ 0.05).In addition,frequency of P15INK4B gene promoter methylation was (49.21 ± 8.78)％ in MDS patients that developed leukemia in the following two year,significantly higher than that in MDS patients who didn't (19.64 ± 6.24) ％ (P ＜ 0.05).Conclusions P15INK4B gene promoter methylation frequency is a valuable indicator of prognosis of MDS patients.

Objective To investigate the overall survival prediction of the Bolondi substaging model for patients in intermediate-stage of Barcelona clinic liver cancer (BCLC) after hepatectomy.Methods The retrospective cohort study was adopted.The clinical data of 343 patients with intermediate-stage hepatocellular carcinoma (HCC) who were admitted to the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University between February 2008 and January 2010 were collected.All the patients received the detailed medical history collection,physical examination,laboratory and imaging examinations after admission,and then hepatectomy was performed according to the results of above examinations.Research methods:(1) patients were allocated into the B1,B2 and B3/4 groups based on the Bolondi's substaging model,and the prognostic analyses among groups were conducted.(2) The related factors affecting the prognosis of patients in the B1 and B2 groups were analyzed.(3) The patients in the B1 and B2 groups were allocated into the 4 groups [patients of B1 group with negative microvascular invasion (MVI) were divided in the M1 group,patients of B1 group with positive MVI in the M2 group,patients of B2 group with negative MVI in the M3 group and patients of B2 group with positive MVI in the M4 group] according to the situations of MVI,and stratified analysis was conducted.Observation indicators:basic clinical and pathological features and survival of patients in the B1,B2 and B3/4 groups were observed.Risk factors analysis affecting the prognosis of patients and stratified analysis of MVI in the B1 and B2 groups were conducted.All the patients were followed up by outpatient examination and telephone interview up to February 2014,and the abdominal ultrasound,liver function and serum alpha-fetoprotein (AFP) tests was performed once every 3 months within 2 years postoperatively and once every 6 months after 2 years postoperatively.The continuous variables and categorical variables were respectively represented as M(Qn) and percentage.The comparisons of continuous variables and categorical variables among groups were analyzed by ANOVA or Kruskal-Wallis test and chi-square test or Fisher exact probability,respectively,and one-way ordinal categorical variables were analyzed by the Kruskal-Wallis test.The survival curve was drawn using the KaplanMeier method.The univariate analysis and multivariate analysis were done using the Log-rank test and COX regression model.Results (1) The basic clinical pathological features:of 343 patients with HCC,143,183 and 17 patients (12 in the B3 substaging and 5 in the B4 substaging) were respectively allocated into the B1,B2 and B3/4 groups.There were statistically significant differences in the age,peritoneal effusion,total bilirubin (TBil),albumin (Alb),alanine transaminase (ALT),prothrombin time (PT),platelet (PLT),alpha-fetoprotein (AFP),extent of liver resection,surgical margin ivasion,tumor diameter,number of tumor,Edmondson-Steiner grade,Up-to-7 score,Up-to-7 standard and Child-pugh score among the 3 groups (F =3.377,NA,11.245,32.616,6.884,11.564,33.100,12.902,NA,NA,239.089,10.357,x2=8.906,F =251.508,x2 =343.000,106.790,P ＜ 0.05).(2) Survival of patients:all the patients were followed up for 2.8-70.8 months with a median time of 38.7 months.The 1-,3-,5-year survival rates and median survival time in the B1,B2 and B3/4 groups were 85.8％,72.8％,52.9％ and 63.2％,47.5％,16.8％ and 45.5％,30.4％,8.4％ and 55.1 months,35.1 months,12.2 months,respectively,showing a statistically significant difference (x2 =22.800,P ＜ 0.05).(3) Risk factors analysis:the results of univariate analysis showed that the peritoneal effusion,Alb,Hb,AFP,esophagogastric varices,surgical margin invasion,tumor diameter,MVI and Edmondson-Steiner grade were related risk factors affecting the prognosis of patients with HCC after hepatectomy [HR =2.04,2.46,2.50,1.78,1.55,3.54,1.71,1.76,1.69,95％ confidence interval (CI):1.13-3.69,1.20-5.02,1.51-4.15,1.29-2.45,1.06-2.25,1.65-7.61,1.23-2.38,1.23-2.51,1.08-2.64,P＜0.05].The results of multivariate analysis showed that the Alb ＜ 35 g/L,Alb ＜ low limit of normal,tumor invading to surgical margin,tumor diameter ＞ 5 cm and positive MVI were independent risk factors affecting the overall survival of patients with HCC after hepatectomy (HR =2.82,2.16,2.93,1.48,1.53,95％ CI:1.37-5.80,1.27-3.69,1.33-6.44,1.05-2.09,1.06-2.22,P＜0.05).(4) There were 61,82,57 and 126 patients in the M1,M2,M3 and M4 groups,and M2 and M3 groups were merged into the M2/3 group because of being similar survival situations of patients.The 1-,3-,5-year survival rates and median survival time in the M1,M2/3,and M4 groups were 90.0％,83.2％,67.7％ and 68.8％,59.9％,41.6％ and 52.7％,42.1％,23.6％ and 69.0 months,49.2 months,24.9 months,respectively,with a statistically significant difference among the 3 groups(x2=20.200,P ＜ 0.05).Conclusions The Bolondi substaging model produces an optimal survival prediction for patients in intermediate stage of BCLC after hepatectomy.The patients in the B1 and B2 substaging have better long-term survival outcomes after hepatectomy.

Objective To investigate the corelation between platelet activating factor acetylhydrolase (PAF-AH) genetic polymorphism and ischemic stroke. Methods The plasma PAF-AH genotype was determined in 205 patients with iachemic stroke and 114 normal subjects by the polymerase chain reaction. The levels of plasma platelet activating factor (PAF), platelet α-granule membrane glycoprotein-140(GMP-140), β-thromboglobulin (β-TG) and the levels of platelet factor 4 (PF4) were analyzed. Results The prevalence of the mutation genotype and plasma PAF, GMP-140, β-TG and PF4 in the patients with isehemic stroke [42.44%,(91.08 ± 39.10) ng/L, (36.46 ± 13.10) μg/L, (41.75 ± 11.18) μg/L, (29.05 ± 9.16) g/L, respectively] were significantly higher than those in the controls[21.05%,(64.30 ± 18.81) ng/L, (18.27 ± 7.68) μg/L, (30.94 ± 8.47) μg/L, (18.75 ± 6.06) μg/L](P< 0.01). The levels of plasma PAF, GMP-140 were significantly higher in mutation genotype patients than those in the normal genotype patients (P < 0.01). Conclusions The activation function of platelet in the acute phase of patients with ischemic stroke increases, and it is associated with genetic polymorphism of PAF-AH. The PAF-AH gene mutation may be a novel genetic marker for high risk of ischemic stroke.