1.Promoter hypermethylation of the RUNX3 gene in colorectal carcinogenesis and its prognostic significance
Maojun YAN ; Hongmei LU ; Qingxu SUN ; Xinai LI ; Huaiyu ZHOU
Chinese Journal of General Surgery 2012;27(8):664-667
ObjectiveToinvestigateRUNX3genepromoter methylationincolorectal carcinogenesis and its prognostic significance. MethodsThe protein expression of RUNX3 was detected by immunohistochemistry and the methylation status of the RUNX3 was determined by methylation-specific PCR (MSP) in colorectal normal mucosa and cancer tissue from 65 patients,and adenoma from 28 patients.5-year overall survival rate was analysed according to RUNX3 methylation status from cancer patients.Kruskal-Wallis rank sum test,x2 or Fisher's exact test,Log-rank test and multivariable Cox regression analysis were used for statistical analysis.ResultsThe protein expression of RUNX3 gene in adenoma and cancer was 85% (24/28) and 52% (34/65),significantly lower than that in normal mucosa 94% (61/65)( x2 =4.328,P =0.037 ; x2 =16.675,P =0.000),the difference between adenoma and cancer tissue was no statistic significance (x2 =3.266,P =0.071 ).No case showed RUNX3 methylation in normal mucosa,methylation rates in adenoma and cancer tissue were 21% (6/28) and 35% (23/65),significantly higher than in normal mucosa (P =0.000 ),but there was no statistic significance between adenoma and cancer tissue (x2 =1.766,P =0.183).The protein expression rate with RUNX3 methylation was 67% (4/6) in adenoma,unmethylation 91% (20/22) (P =0.191 ).The protein expression rate with RUNX3 methylation was 26% (6/23) in cancer,unmethylation was 88% (28/32).The presence of RUNX3 methylation was related to loss of protein ( x2 =9.810,P =0.002 ).5-year total survival rate with methylation in cancer was significantly lower with unmethylation ( x2 =5.87,P =0.016 ).Multivariate analysis showed RUNX3 methylayion wasanindependentprognosticfactoramongthefactorsanalyzed(P=0.033 ).ConclusionsRUNX3 methylation is important genetic event in colorectal carcinogenesis,possibly related to protein downregulation,and an independent prognostic factor for colorectal carcinoma.
2.Clinical management of measles in children—2015 report of the Committee on Infectious Diseases of American
Juan FAN ; Maojun LI ; Qing WU ; Changhui CHEN
Chinese Journal of Applied Clinical Pediatrics 2015;30(22):1684-1686
Measles is an acute viral disease, almost all deaths cases of measles in children occur in developing countries each year.Despite the availability of a safe and effective vaccine, measles is still one of the main causes of death of children in global area.2015 report of Committee on Infectious Diseases of American provided evidence of clinical diagnosis, treatment and prevention of measles.
3.Re-evaluation of Apgar score:introduction of policy statements of the Apgar score by American Academy of Pediatrics and American College of Obstetricians and Gynecologists
Maojun LI ; Qing WU ; Qian YANG ; Binzhi TANG ; Changhui CHEN
Chinese Journal of Applied Clinical Pediatrics 2016;31(14):1063-1065
As a widely accepted and convenient method,the Apgar score has been applied to assess the status of the newborn infants and the response to resuscitation since 1952.But the Apgar score has also been used inappropriately in infants to predict specific neurologic outcomes in many cases.The Apgar Score produced by American Academy of Pediatrics(AAP) in collaboration with American College of Obstetricians and Gynecologists(ACOG),updated policy statements of the Apgar score in October 2015.The Apgar score has limitations,and it is not appropriate to use it alone to establish the diagnosis of asphyxia;the method does not predict individual neonatal mortality or neurologic outcome.AAP/ACOG encourages the use of an expanded Apgar score reporting form that accounts for concurrent resuscitation interventions.
4.Clinical management of procedural pain in the neonate:policy statement of prevention and management of procedural pain in the neonate by American Academy of Pediatrics Committee on Fetus and New-born and Section on Anesthesiology and Pain Medicine
Juan FAN ; Maojun LI ; Qing WU ; Changhui CHEN
Chinese Pediatric Emergency Medicine 2017;24(1):28-33
Neonatal pain is a common phenomenon. For a long time neonatal pain had not been focus on properly and managed appropriately. American Academy of Pediatrics Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine published policy statement to emphasize the necessity of neonatal pain assessment,and summarize the neonatal operability pain assessment method,drug and non-drug control measures,also update prevention and management of procedural pain in the neonate in 2016. Until today the guideline for neonatal pain management has not yet been released in China. As the reference for clinicians in domestic,the content of policy statement will be reorganized and introduced.
5.The management of neonatal transfusion therapy: brief introduction of evidence-based recommendations of neonatal transfusion therapy in Italy
Maojun LI ; Qing WU ; Qian YANG ; Binzhi TANG ; Changhui CHEN
Chinese Journal of Applied Clinical Pediatrics 2017;32(14):1063-1066
Blood transfusion therapy is one of the commonly used intervention in newborn infants.Red blood cell transfusion is the only treatment for most cases of neonatal anemia,but the indications of application and implementation strategy are not yet perfect,and the benefits,adverse outcomes and potential risk of transfusion remains to be evaluated.There are many uncertain problems in transfusion management.This paper mainly introduces the evidence-based recommendations of neonatal blood transfusion released by Italian Society of Transfusion Medicine and Immunohaematology and Italian Society of Neonatology Working Group for reference of domestic clinicians.
6."Is the term ""neonatal encephalopathy"" better than ""hypoxic-ischemic encephalopathy ?——Introduction of the report of Task Force on Neonatal Encephalopathy published by the American College of Obstetricians and Gynecologists and the American Academy of Pe"
Maojun LI ; Qing WU ; Changhui CHEN ; Qian YANG ; Binzhi TANG
International Journal of Pediatrics 2015;42(3):351-354
Neonatal hypoxic-ischemic encephalopathy as a standard term has been used for over 30 years,but now increasingly being questioned.Most experts recommend using neonatal encephalopathy instead of hypoxic-ischemic encephalopathy.The American College of Obstetricians and Gynecologists and The American Academy of Pediatrics published separately the report of Task Force on Neonatal Encephalopathy Neonatal Encephalopathy and Neurologic Outcome,Second Edition in 2014.Definition,diagnosis and treatment of neonatal encephalopathy and other content have been updated in the report.It is recommended that a comprehensive multidimensional assessment be performed of neonatal encephalopathy.This article will introduce the controversy about neonatal encephalopathy or hypoxic-ischemic encephalopathy and contents of the report of Task Force on Neonatal Encephalopathy.
7.Clinical management of bronchiolitis——clinical practice guidelines by American Academy of Pediatrics
Juan FAN ; Maojun LI ; Qing WU ; Changhui CHEN
Chinese Journal of Applied Clinical Pediatrics 2015;30(10):730-732
Bronchiolitis is a common lower respiratory tract viral infection in infants.Incidence of bronchiolitis is greatly increasing in recent years,and seriously affecting the health of children.In order to better manage bronchiolitis,American Academy of Pediatrics (AAP) convened a new subcommittee to review and revise the 2006 bronchiolitis guideline.This evidence-based guideline amended to provide new evidence of diagnosis,treatment and prevention bronchiolitis for the clinician.
8.Traumatic brain injury in Ya'an earthquake: a report of 69 cases
Chaohua YANG ; Qiang LI ; Maojun CHEN ; Li LI ; Siqing HUANG ; Chao YOU
Chinese Journal of Trauma 2014;30(12):1176-1179
Objective To analyze the clinical features of patients with traumatic brain injury in the Ya' an earthquake and discuss the treatment experiences.Methods Medical records of 69 patients admitted from April 2013 to May 2013 because of traumatic brain injury in the Ya' an earthquake were collected.Retrospective review was performed for age,gender,causes of injury,time from injury to hospitalization,types of injury,associated injury,treatment methods and outcomes.Results There were 47 males and 22 females.Forty-two patients (61%) were injured from falling objects.Fifty-eight patients (84%) were sent to the West China Hospital within 72 hours postinjury.Twenty-two cases (32%) sustained associated injuries.Twenty-nine patients (42%) were critically injured.Twenty-four patients underwent operation at the local hospital and twelve patients had operation at our hospital.Outcome measure using GOS one month after treatment showed 55 favorable recovery,5 moderate disability,4 severe disability,and 5 coma.Conclusions Main cause of injury is hit by falling objects during the Ya' an earthquake.Majority of the patients obtained effective treatment in the time window.GCS in combination with patients' general condition used in casualty triage and critical patients charged by neurosurgeons and treated with the cooperation of multiple disciplinary teams are helpful to successful treatment.
9.Effects of intravenous infusion of bilirubin on the expression of phospho-p38 mitogen-activated protein kinase and the apoptosis in splenocytes of neonatal rats
Xiaoming LIANG ; Changhui CHEN ; Tianwei SHAO ; Juan LUO ; Fulan ZOU ; Maojun LI ; Binzhi TANG
Chinese Journal of Applied Clinical Pediatrics 2014;29(12):931-935
Objective To explore the effects of bilirubin on myeloid differentiation factor phospho-p38 mitogen-activated protein kinase (p-p38MAPK) and apoptosis in splenocytes of neonatal rats.Methods Seven-day-old Sprague Dawley rats (clean grade),male or female,weighting 12.0-15.0 g,were randomly assigned to 6 groups.There were blank control group (Ⅰ),lipopolysaccharide (LPS) control group (Ⅱ),15 mg/kg bilirubin control (free-LPS) group (Ⅲ),15 mg/kg group (Ⅳa),30 mg/kg group (Ⅳb) and 50 mg/kg group (Ⅳc),and then subsequently divided into 2 h,5 h and 24 h subgroups in each groups.Some of the 200 newborn rats died amid the experiment,tinally,a total of 144 cases were involved in the analysis of results,and 8 rats in each subgroups.Newborn Sprague Dawley rats were administered at various doses of bilirubin (15 mg/kg,30 mg/kg and 50 mg/kg,respectively) intravenously; 1 h after injection,the rats were administered LPS intraperitoneally at a dose of 1 mg/kg;p-p38MAPK were detected by immunohistochemistry;Apoptosis in splenocytes was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling methods at 2 h 5 h and 24 h after the injection of bilirubin.Results 1.Expression of p-p38MAPK in each group:bilirubin in low-mid concentrations of range inhibited LPS-induced p38MAPK activation (qⅣa =20.93,10.37,respectively at 2 h,and 5 h,all P < 0.01 ;qⅣ b =79.97,14.79,all P < 0.01).The inhibition strengthened with increasing concentration of bilirubin.The effect was observed at 2 h,strengthened at 5 h,disappeared at 24 h.Bilirubin in the high concentrations of range stimulated the expression of p-p38MAPK (qⅣc =32.55,19.23,27.72,respectively at 2 h,5 h and 24 h,all P <0.01),observed at 5 h,reduced at 24 h.2.Effects of bilirubin on apoptosis in splenocytes:LPS could increased the apoptosis index (AI) of splenocytes(q =54.62,P < 0.01);The AI of splenocytes had no significant change in low concentrations of range of bilirubin (q =43.92,P > 0.05).Low-mid concentration of bilirubin with LPS reduced the AI of splenocytes (q Ⅳ a =4.48,P < 0.01 ;q Ⅳ b =2.07,P < 0.05),while high concentration of bilirubin with LPS increased the AI of splenocytes (q =5.08,P < 0.01).Conclusions Bilirubin in low-mid concentrations of range could inhibit the expression of LPS-induced p38MAPK,while bilirubin in high concentrations of range stimulated the expression.As the concentration of bilirubin elevated,its inhibition was prolonged.Bilirubin in high concentrations of range bilirubin could induce apoptosis in splenocytes.The immune dysfunction in neonatal hyperbilirubinemia may have something to do with the regulation of phosphorylation of p38MAPK and activation of apoptotic pathways.
10.Laparoscopic cholecystecomy on porcelain gallbladder
Yingfeng FU ; Mingyin LAN ; Heng LI ; Bin JIANG ; Maojun DI ; Meng ZHOU
Chinese Journal of Digestive Endoscopy 2001;0(02):-
Objective To explore the method and points for attention in laparoscopic cholecystectomy(LC) of porcelain gallbladder.Methods Twenty-eight cases of porcelain gallbladder, especially 17 LC cases, from January 1980 to January 2005 were analyzed retrospectively.Results Of 28 cases(0.44%) of porcelain gallbladder in 6328 cholecystectomy patients,calcification of gallbladder occurred in 92.86% patients diagnosed by B ultrasonography 17 LC patients were cured. Two cases with gallbladder carcinoma no implantion or metastases happened.Conclusion B ultrasonography before operation and improving of the operative mode and skill in LC are the keys to get the successful results.