ObjectiveTo evaluate the therapeutic value of neoadjuvant chemotherapy for patients with stages Ⅱ and ⅢA(Only T3N1M0) breast cancer,and assess the relationship of the tumor size and pathologically complete response.MethodA total of 408 breast cancers patients at stages Ⅱ and ⅢA,were studied,which were divided into neoadjuvant chemotherapy group (group A) and control group (group B).All patients of group A received 2-4 cycles NAC with TE scheme in breast cancer.The impact of neoadjuvant chemotherapy on surgical methods choice,local control rate,5-year overall survival rate and 5-year disease free survival rate were analyzed.ResultsFor patients of stage Ⅱ,the rate of breast conservation significantly increased from 23.6％ to 49.1％ (P =0.000) and there was no significant difference between groups A and B ( P =0.939,0.858 ) in 5-year overall survival rate and disease free survival rate.For patients of stage ⅢA,the 5-year overall survival rate (59.8％ ) and disease free survival rate (51.8％) in group A were greatly higher than that in group B (35.7％ and 27.6％ ) (P =0.000,0.000).The 3-year local relapse and metastasis rate(7.9％ ) was lower than group B (18.4％)(P ＜ 0.05 ).The tumor less than 3.0 cm is easy to achieve pathological complete remission (P =0.001 ).ConclusionsThe neoadjuvant chemotherapy can improve potential rate of breast conservation,reduce the rate of local-regional recurrence rate for the patients with stage Ⅱ and ⅢA breast cancer,and also improve the 5-year survival rate for the patients of stage ⅢA.Patients with clinically complete response or PCR may have higher 5- year overall survival rate and disease free survival rate.Primary tumor size was found to be the significant predictive factor for pathologically complete response to neoadjuvant chemotherapy in patients with breast cancer,particularly,the small tumor is easy to reach pathologically complete response.

Objective To find out the risk factors of postoperative low cardiac output syndrome(LCOS) of patients undergoing cardiac valvular surgery in ICU in order to provide basic for prevention and control measures.Methods Ninety-six valve replacement patients with valvular heart disease were enrolled as our subjects and they were hospitalized in ICU of the First People's hospital of Yichang from Jan.2008 to May.2013.The patients postoperative LCOS (Dopamine ＞ 10 μg/(kg · min)) were served as observation group (n =41),and the other were control groups(n =55).All data of the patients were recorded.Non-conditions Logistic regressions analysis were adopted to analyze the independent risk factors which resulted in LCOS undergoing cardiac valvular surgery.Results Of 96 patients undergoing cardiac vavular surgery,41cases (42.7％) had postoperative LCOS.Single factor analysis showed that hepatomegaly (P =0.007),course of diseases ≥ 15 years (P =0.042),cardiopulmonary bypass ≥ 120 min (x2 =3.937,P =0.047),pre-operative cardiac function ≥ Ⅲ degree (P =0.003) were the independent risk factors of postoperative LCOS undergoing cardiac valvular surgery.The Logistic multi factor regression analysis showed that the independent risk factors of postoperative LCOS undergoing cardiac valvular surgery included course of diseases ≥ 15 years (OR =2.825,95％ CI =(1.015-7.861)),Pre-operative cardiac function ≥ Ⅲ degree (OR =7.306,95％ CI =(2.050-26.035),P=0.002).Conclusion Course of diseases ≥15 years and Pre-operative cardiac function≥ Ⅲ-Ⅳ degree are the independent risk factors of LCOS undergoing cardiac valvular surgery.

OBJECTIVETo study the reliability and validity of Chinese version of International Physical Activity Questionnaire (IPAQ) and to provide an instrument for physical activity measurement in Chinese-spoken population.

METHODSTest-retest reliability was systemically assessed in 94 participants sampled from college students. Questionnaires were completed twice with a three-day interval. The validity was established in 39 volunteers by Caltrac accelerometer monitoring and 24-hour activity recording for seven consecutive days.

RESULTSBoth long vision (LV) and short vision (SV) had intraclass correlation coefficients above 0.7 for physical activity. The total energy expenditure measured by LV, SV and PA records were 264.5 +/- 260.9, 185.4 +/- 128.9 (compared with activity records, P < 0.05) and 250.5 +/- 141.2 MET-min/d respectively. Energy expenditure of moderate physical activity were 81.7 +/- 165.4, 32.0 +/- 42.5 (compared with activity record, P < 0.05) and 61.3 +/- 72.0 MET-min/d. Caltrac accelerometer was moderately correlated with LV (r = 0.50) and SV (r = 0.63) while SV measured total daily energy expenditure was lower than activity records. When participants were categorized into two groups according to their time spent in physical activity above or below the target level, proportions of agreement of questionnaires and 24-hour activity records were high, including vigorous physical activity above 90% and moderate physical activity above 70%. LV, SV and activity records were measured during sedentary condition at an approximate level.

CONCLUSIONSBoth LV and SV of IPAQ appeared to have acceptable reliability and validity, compared to other physical activity instruments that were used in various large epidemiological studies. The total or physical energy expenditures were similar between LV and activity records. For activity levels, the proportion of agreement were similar between activity records and LV or SV. However, SV underestimated the energy expenditure of total and moderate physical activity.

Adult ; China ; Exercise ; Female ; Humans ; Internationality ; Language ; Male ; Reproducibility of Results ; Surveys and Questionnaires ; standards

OBJECTIVETo evaluate the early clinical effects of arthroscopic treatment for cruciate ligament cysts of the knee.

METHODSFrom September 2008 to January 2014, 23 patients with cruciate cysts were treated with arthroscopic surgery. There were 11 males and 17 females, with an average age of 28.3 years old (ranged, 16 to 56 years old). Twenty patients had injuries on the right knee and 8 patients had injuries on the left knee. Eight patients had a history of injury,5 patients had a history of chronic injury,and the other 15 patients had no obvious reasons for the symptom. Before the operation, 24 patients were clearly diagnosed as the cruciate ligament cysts of knee joint,and 4 patients were diagnosed as other problems of the knee, but the diagnosis were corrected after the operation. According to the MRI before the surgery,all the patients could be divided into 3 types: 14 were type I, 6 were type II, 8 were type III. After the operation, the patients were suggested to have a rest for 2 weeks, and take exercises everyday at the same time. The knee range of motion, Lysholm score, International Knee Documentation Committee (IKDC) 2000 subjective score, GLASGOW criteria, and McMurray test, pivot shift test, and anterior drawer test were observed to evaluate clinical results.

RESULTSAll the incisions healed at the first stage without complications. Twenty-five patients were followed up, and the duration ranged from 12 to 52 months, with a mean of 26.7 months. Three patients accepted the reconstruction of ACL or tightened elongated ACL using bipolar radio frequency. The Lysholm score increased from preoperative 59.80 +/- 6.58 to 75.32 +/- 6.49 at the latest follow-up; IKDC 2000 score increased from preoperative 65.36 +/- 6.26 to 81.00 +/- 5.76 at the latest follow-up. According to GLASGOW criteria,23 patients got an excellent result and 2 good.

CONCLUSIONIt has a satisfactory curative effect on ACL reconstruction using bipolar radio frequency. It has advantages of firm fixation, simple and secure operation as well as quick postoperative recovery. It's very important to check the MRI before operations, and carefully seek the cysts during the operations, avoiding the omission of any cysts,especially the cases of multiple cysts. Finally, patients should take exercises actively after operations.

Adolescent ; Adult ; Anterior Cruciate Ligament ; physiopathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Arthroscopy ; Cysts ; surgery ; Female ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Young Adult

OBJECTIVETo explore type 2 diabetes prevalence and its risk factors among migrants and nonmigrants aged 35 years and older in Three Gorge Dam area in Yichang City of Hubei province, China.

METHODSA sample of 9865 rural residents (including 1949 Three Gorge Dam migrants and 7916 nonmigrants) aged 35 years old and over was selected from September to December in 2007 by the method of multi-stage cluster random sampling in Yiling district, Yichang City of Hubei province. The study subjects were assessed by interview, examination, and blood samples. Information on demographics, migrant information, lifestyle, history of diabetes and hypertension was obtained by a questionnaire interview. An overnight fasting blood specimen was collected to measure serum glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). Height, weight, waist circumference, hip circumference and blood pressure were measured. Oral glucose tolerance test (OGTT) was carried out for those whose fasting glucose was equal to or exceeded 6.1 mmol/L. The standardized prevalence of type 2 diabetes was calculated based on national census in the year of 2000. Multiple logistic regression analysis was used to explore the potential risk factors of type 2 diabetes.

RESULTSThe crude prevalence of type 2 diabetes among nonmigrants was 3.93% (310/7885) (male: 3.90% (129/3304), female: 3.95% (181/4581)), and that of migrants was 6.55% (127/1939) (male: 6.85% (52/759), female: 6.36% (75/1180)). The crude prevalence of type 2 diabetes among migrants was higher than that of nonmigrants (χ² = 25.10, P < 0.01 (male: χ² = 12.59, P < 0.01; female: χ² = 12.78, P < 0.01)). The prevalence of type 2 diabetes among nonmigrants was 3.87% in males and 4.15% in females. The standardized prevalence of type 2 diabetes among migrants was 6.92% in males and 6.33% in females. Logistic regression analysis showed that age (taking 35 - 44 years old as reference, 45 - 54 years old: OR = 1.45, 95%CI: 1.07 - 1.95; 55 - 64 years old: OR = 2.08, 95%CI: 1.53 - 2.84; 65 years old and over: OR = 1.85, 95%CI: 1.25 - 2.75), family history of diabetes (OR = 2.83, 95%CI: 1.70 - 4.72), overweight or obesity (overweight: OR = 1.36, 95%CI: 1.05 - 1.78; obesity: OR = 2.11, 95%CI: 1.47 - 3.01), central obesity (OR = 1.84, 95%CI: 1.39 - 2.44), abnormal triglyceride (OR = 1.54, 95%CI: 1.21 - 1.97), abnormal total cholesterol (OR = 1.40, 95%CI: 1.11 - 1.77) and abnormal LDL-C (OR = 1.82, 95%CI: 1.19 - 2.79) increased the risk of type 2 diabetes, and regular physical activity (OR = 0.57, 95%CI: 0.45 - 0.72) was the protective factor of type 2 diabetes.

CONCLUSIONThe prevalence of type 2 diabetes among Three Gorge Dam migrants was higher than that of nonmigrants. Increasing age, regular physical activity, family history of diabetes, overweight or obesity, central obesity, abnormal triglyceride, abnormal total cholesterol and abnormal LDL-C were related to type 2 diabetes.

Adult ; Aged ; China ; epidemiology ; Diabetes Mellitus, Type 2 ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Transients and Migrants

Objective To evaluate the epidemiological features and control status of hypertension in rural area of The Three Gorges. Methods A cross-sectional survey was carried out in mral area of Yiling District, Yichang City, which was located north-west bank of Xiling Gorges in 2007. A standard structure questionnaire was used to collect data on the hypertension history and treatment, social-economic status and life-styles, and so on. Blood pressure was measured by trained observers using standardized mercury sphygmomanometer. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg( 1 mm Hg =0. 133kPa) and/or diastolic ≥90 mm Hg, or current treatment with antihypertensive medications. Hypertension control was defined as blood pressure levels of less than 140/90 mm Hg. Results A total of 9618 residents aged 35 years and above were included ( response rate: 81.3％ ), and 19. 7％ residents were the Three Gorges migrants. The age-adjusted prevalence of hypertension was 37.3％ for all, and 21.3％, 39. 8％,58.0％ for aged 35-44, 45-59, ≥60 years, respectively. The age-adjusted rate was higher in men for all (39.1％) and aged 35-44 years (27.0％) than in women (36.3％ for all and 17.8％ for aged 35-44years, P ＜ 0. 01 ). The age-adjusted rate of awareness, treatment and control rates of hypertension were lower in men (18.5％, 9. 0％, 0.9％, respectively) than in women (23.5％, 13.6％, 2. 0％,respectively, all P ＜ 0.01 ).Among the participants with treated hypertension, the control rate of hypertension was only 17.0％. Prevalence and rate of awareness, treatment and control of hypertension were similar between migrants and non-migrants. Conclusion The prevalence of hypertension is high, but the awareness, treatment, control rates were low in rural area of Yiling District. Efforts should be made to reduce the prevalence rate and to improve the control rate of hypertension in this area.

Objective To investigate the expression of a dismtegnn and metalloproteinase-12 (ADAM12) and proliferating cell nuclear antigen (PCNA) in human bladder carcinoma,and to explore their correlation with different grades and stages of bladder cancer.Methods Biopsies of 12 normal bladder and 43 bladder tumors were performed.And immunohistochemistry was conducted to detect the expression of ADAM12 and PCNA in the biopsies.Results Positive expression signals of ADAM12 were detected significantly higher inthe bladder cancer biopsies than that in the normal ones (Z =4.879,P ＜ 0.05),and the expression level of ADAM-12 in lower histological grade was significantly higher than that in the moderate and higher histological grades (x2 =22.3685,P ＜ 0.01).Positive expression signals of PCNA were detected significantly higher in the bladder cancer biopsies than that in the normal ones (Z =4.879,P ＜ 0.05)).Those with lower histological grade had a higher expression level of PCNA when compared with the moderate and higher histological grades (x2 =10.665,P =0.0137).The expression of ADAM-12 was positively correlated with PCNA in bladder cancer (r =1.000,P ＜ 0.0001).Conclusion The over expression of ADAM12 and PCNA maybe play an important role in development of the bladder tumors.And ADAM12 may be a promising biomarker of bladder cancer in the clinical behavior.

Objective To investigate the expression of adamalysin-12 (ADAM-12) and PCNA in human bladder carcinoma and to investigate their correlation with different grades and stages of bladder cancer.Methods Biopsies of 15 normal bladder and 43 bladder tumors were analyzed.Immunohistochemistry was conducted to detect the expression of ADAM12 and PCNA in the biopsies.Results Postive expression signals of ADAM12 were detected significantly higher in the bladder cancer biopsies than that in the normal ones (P = 0.010).Those with lower histological grade had a higher expression level of ADAM-12 compared to the higher histological grades (P ＜0.001 ).Positive expression signals of PCNA were detected significantly higher in the bladder cancer biopsies than that in the normal ones (P = 0.026).Those with lower histological grade had a higher expression level of PCNA (P =0.014).There was a positive correlation between the expression of ADAM-12 and PCNA in bladder cancer (r =0.997,P ＜ 0.001 ).Conclusions The overexpression of ADAM-12 and PCNA in the biopsies of bladder tumors shows that protein expression of ADAM-12 and PCNA correlated with tumor stage and grade.Furthermore,ADAM-12 may be a promising biomarker of bladder cancer in the clinical implication.

Stellate ganglion blockade (SGB) protects patients from focal cerebral ischemic injury, and transection of the cervical sympathetic trunk (TCST) in a rat model can mimic SGB in humans. The purpose of this study was to investigate the mechanisms underlying the neuroprotective effects of TCST on neuronal damage in the hippocampus in a rat model of middle cerebral artery occlusion (MCAO) in an attempt to elucidate the neuroprotective effects of SGB. The modified method of Zea Longa was used to establish the permanent MCAO model. Male Wistar rats were randomly divided into three groups: sham-operated group, MCAO group, and TCST group. The animals in TCST group were sacrificed 48 h after TCST which was performed after the establishment of the MCAO model. Proteins were extracted from the ipsilateral hippocampus and analyzed by two-dimensional difference gel electrophoresis (2D-DIGE) and peptide mass fingerprinting (PMF). The levels of N-ethylmaleimide-sensitive factor (NSF) were measured as well. The results showed that 11 types of proteins were identified by 2D-DIGE. The expressions of eight proteins were changed both in the sham-operated and TCST groups, and the expressions of the other three proteins were changed in all three groups. Moreover, the expression of NSF was higher in the TCST group than in the MCAO group but lower in the MCAO group than in sham-operated group. The ratio of NSF expression between the MCAO group and shamoperated group was -1.37 (P<0.05), whereas that between the TCST group and MCAO group was 1.35 (P<0.05). Our results imply that TCST increases the expression of NSF in the hippocampus of adult rats with focal cerebral ischemia, which may contribute to the protection of the injured brain. Our study provides a theoretical basis for the therapeutic application of SGB to patients with permanent cerebral ischemia.
Animals ; Brain Injuries ; genetics ; metabolism ; pathology ; Brain Ischemia ; genetics ; metabolism ; pathology ; Gene Expression Regulation ; Hippocampus ; metabolism ; pathology ; Male ; N-Ethylmaleimide-Sensitive Proteins ; biosynthesis ; genetics ; Rats ; Rats, Wistar ; Stellate Ganglion ; metabolism ; pathology ; Transfection

Objective To determine the influence of serum complement and IgG on rituximabdependent NK cell-mediated cytotoxicity to Raji cells in vitro.Methods FcγR Ⅲ a (CD16a) polymorphism of NK cells were detected by nest-PCR. Effects of serum IgG on FcγRⅢ a expression of NK cells in vitro were analyzed by flow cytometry.The target cells(Raji cells) were stained with DIO,cultured with effector cells(NK cells) and rituximab with or without serum IgG/complement,and finally stained with propidium iodide (PI),then these cells were tested by flow cytometry and the cytotoxic index was calculated as well. Results The cytotoxic indexes of the ADCC +CDC groups were higher than those of ADCC groups, but the serum IgG groups were lower than the ADCC groups. In FcγRⅢa-158Ⅴ/Ⅴ groups, the cytotoxic indexs of the ADCC+ CDC groups,the serum IgG groups and the ADCC groups were (94.25±1.79) ％,(59.79±0.66) ％ and(69.05± 2.38) ％,respectively,and the differences among the groups were statistically significant (P＜ 0.05).In FcγRⅢ a-158Ⅴ/F groups,the cytotoxic indexs of these three groups were (66.71±5.57) ％,(18.13±2.99) ％ and (39.63±3.86) ％, respectively, and the differences among the groups were also statistically significant (P＜ 0.05).Conclusions Complement may enhance the rituximab-mediated NK cell cytotoxicity to Raji cells, whereas,serum IgG may weaken the cytotoxicity against Raji cells. It is clued up that for patients treated by tumorspecific monolonal antibody (MAb), combined infusion of fresh frozen plasma could promote its anti-tumor effect,however,MAb combined with IVIG may impair its anti-tumor effect.