OBJECTIVE: To investigate the correlation of laryngeal squamous cell carcinoma (LSCC) and precancerous lesion with HPV infection subtypes and possible clinical relationship. METHOD: Eighty-three cases in paraffin embedded tissues were detected with thirty seven HPV subtypes by flow-through hybridization and gene chip (HybriMax), including 31 cases of laryngeal squamous cell carcinoma, 52 cases of precancerous lesions (29 cases of vocal cord leukoplakia and 23 cases of laryngeal papilloma), and 36 cases of vocal cord polyp as normal vocal mucosa were used as control. RESULT: The total positive rate of HPV was 19.4% in the group of laryngeal squamous cell carcinoma (6/31), 0 in vocal cord leukoplakia, 65.2% in laryngeal papilloma (15/23), and the control group were all negative, HPV virus subtype of HPV-positive laryngeal squamous cell carcinoma were all high-risk HPV16; and there were 6 HPV virus subtypes in laryngeal papilloma (8: HPV6,4: HPV52, 1: HPV11, 1: HPV18, 2: HPV45, 3: HPV16), individual mixing two or more subtypes infection. HPV infection of laryngeal squamous cell carcinoma and precancerous lesions has no statistically significant difference according to gender, high low-risk subtypes. CONCLUSION HPV infection related to laryngeal squamous cell carcinoma and precancerous lesions, but no significant correlation with the subtype distribution of high and low risk; HPV detection is making positive sense to clinical diagnosis of laryngeal carcinoma and precancerous lesions as well as the development of specific HPV subtype vaccine.
Carcinoma, Squamous Cell ; complications ; virology ; Genotype ; Head and Neck Neoplasms ; complications ; virology ; Human papillomavirus 11 ; Humans ; Laryngeal Neoplasms ; complications ; virology ; Papilloma ; complications ; virology ; Papillomaviridae ; classification ; Papillomavirus Infections ; complications ; virology ; Precancerous Conditions ; Squamous Cell Carcinoma of Head and Neck

Purpose To evaluate renal function recovery state with color Doppler ultrasound before and after ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy. Materials and Methods 79 patients with 81 kidneys with upper urinary tract stones underwent ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy, renal parenchymal thickness, renal collecting system separation degree and renal arterial resistance index (RI) were measured with color Doppler ultrasound before and after the operation, subjects were divided into renal dysfunction group (both preoperative and postoperative GFR <20 ml/min, the difference <20 ml/min), renal function significantly improved group (postoperative GFR greater than preoperative, the difference>20 ml/min), renal function significantly impaired group (postoperative GFR less than preoperative GFR, the difference>20 ml/min) and no significant improvement group (both preoperative and postoperative GFR were >20 ml/min, the difference <20 ml/min) according to the preoperative and postoperative glomerular filtration rate (GFR) difference. Renal parenchymal thickness, renal collecting system separation degree and renal artery RI of each group were compared, and their correlation with GFR was analyzed. Results Statistically significant differences (F=129.750, 110.953, 45.411, 18.530, 18.904, 12.565, 27.291, 24.263; P<0.05) were detected in all the four groups between preoperative and postoperative renal parenchymal thickness, renal collecting system separation degree, interlobar renal artery (IRA) and main renal artery (MRA) RI. There was a significant positive correlation (r=0.916, P<0.05) between renal parenchymal thickness and pre-and post-lithotripsy GFR, and a significant negative correlation (r=-0.886,-0.903,-0.923;P<0.05) between renal collecting system separation degree, IRA and MRA RI with pre-and post-lithotripsy GFR. The sensitivity and specificity were 93.4%and 97.3%, respectively when taking renal parenchymal thickness<0.32 cm, renal collecting system separation degree >4.27 cm, IRA RI and MRA RI>0.8 as diagnostic standard for kidney dysfunction; and the sensitivity and specificity were 87.4% and 85.7%respectively when taking IRA RI<0.72 as diagnostic standard for renal function improvement. Conclusion Renal parenchymal thickness <0.32 cm, renal collecting system separation degree >4.27 cm, IRA and MRA RI >0.8, and IRA RI <0.72 can be regarded as clinical reference standard for renal function prognosis of kidney dysfunction and hypo-functional before conducting ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy.

Objective To investigate the relationship between compatibilities of prescriptions for treating stroke and their dynasty and resource distribution, provide decision support for clinical applications. Methods Totally 905 prescriptions were selected from Database of Chinese Medicine Prescriptions. Information of selected prescriptions was standardized. The frequency of single herbs appeared in the prescriptions was counted. The core herb groups of the prescriptions were calculated by Apriori algorithm, and categorized by different dynasties. The concept of classical value of prescriptions (CVP) was proposed to characterizing the degree of classical of prescriptions and revealing the law of development of the prescriptions for treating stroke. Results The selected prescriptions involved 1479 different herbs, which were picked from 245 medical books. The top 3 most frequently used herbs were Saposhnikoviae Radix (40.22%), Angelicae Sinensis Radix (36.69%) and Chuanxiong Rhizoma (32.71%). Totally 29 3-item core herb groups were obtained, and the top three actions of relieving exterior syndrome, invigoration and calming wind. With support values>80 (frequency), the main effect was relieving exterior syndrome. CVP of selected prescriptions was calculated and categorized by dynasties. The top 10 books with largest reappearing rate and their high frequent herbs, and the top 10 books with largest proportion of all selected prescriptions were obtained. Conclusion The basic law of prescriptions for treating stroke in different medical books was obtained. The dynasty distribution of CVP indicates that the research of Chinese medicine for stroke increasingly getting systematic and becoming more accurate in choosing herbs. The principles of choosing herbs to combine a prescription for treating stroke are similar among the collections of selected medical books.

Objective To observe the clinical features, phenotypes and genotypes in a Chinese family with choroideremia (CHM). Methods A Chinese four-generation family (15 members) with CHM, including 5 patients (4 males/1 female), 2 female carriers and 8 healthy members, was enrolled in this study. Initially all family members underwent best corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus fluorescein angiography, optical coherence tomography (OCT), visual field and full view electroretinogram (ERG). BCVA was followed up for 3 years. Venous blood samples were collected, and all of the 15 coding exons and flanking intron regions were amplified in the proband by polymerase chain reaction followed by direct sequencing. Protein structure was modeled based on the protein data bank and mutations in DeepView v4.0.1 to predict the effect of the mutations. A total of 180 healthy volunteers were enrolled as control group to matching CHM gene sequences. Results The visual acuity (VA) of 3/4 adult male patients began to decrease at less than 10, 10 and 30 years old, the average BCVA was 0.43. There were characteristic signs and symptoms of CHM including narrow visual field, extinguished rod and cone response in ERG, disappeared junction line and intermediate line of photoreceptor inner segment/outer segment on OCT. After 3 years, the mean BCVA decreased to 0.11. The BCVA of one young male patient was 1.0 in both eyes with minor changes fundus and visual field. The VA of the female patient began to decrease at 50 years old, her BCVA of two eyes were 0.5 and 0.25, respectively. The fundus changes were typical of CHM, with relative scotomas in the peripheral visual field of OD, and big scotomas in the OS. After 3 years, her mean BCVA decreased to 0.2. Of 2 female carriers, one had minor fundus changes (patches of pigmentary deposits, atrophy spots of retinal pigment epithelium cells), and the other was normal. A novel heterozygous c.1837G>A mutation in exon 15 of CHM was detected in the proband, which resulted in the substitution of serine by proline at codon 613 (p.D613N). Based on molecular modeling, the misfolded protein caused by the mutation might destabilize the structure of the helix that potentially could affect the global stability of the Rep-1 protein. Conclusions A novel c.1837G>A (p.D613N) mutation may be the causative mutation for CHM in this family. Female CHM carriers may have some signs and symptoms.

The recent development and wide application of ultrasonography and ultrasonography-guided fine needle aspiration biopsy have greatly facilitated the detection of papillary thyroid microcarcinoma (PTMC).Currently, the occurrence, development and pathological features of PTMC are not clearly understood.Therefore, no consensus on the diagnosis and treatment has been reached.Patients with PTMC are suggested to be closely observed and periodically examined with ultrasonography in some countries such as Japan, and these patients are to be operated when the tumor enlarged or new lymphatic metastasis are found.Operation is the first choice in the European and American countries, and the long-term survival rates of these patients are nearly 100％.For the PTMC patients with the risk factors such as thyroid capsule invasion, lymphatic metastasis,multi-focal lesion, higher degree of malignancy, thyroid stimulating hormone suppression therapy was given after operation, which may reduce the local recurrence rate.In China, we should hold well thelimitation and choose the best way for different patients according to the personalized principle in clinical practice.

Objective To investigate the value of RDW for predicting death risk in the patients with acute pancreatitis (AP) and its correlation with the Ret parameters.Methods A total of 164 patients with AP in the emergency surgery of Second Xiangya Hospital of Central South University from March 2015 to May 2015 were selected ,including 151 survival cases and 13 death cases , and other 175 healthy people were selected as the control group.The venous blood was collected for detecting whole blood RDW and Ret parameters by using the Sysmex XN-1000 automatic blood analyzer.The inter-group comparison was performed by Mann-Whitney U and Kruskal-Wallis H tests ;the diagnostic value of RDW for AP death risk was evaluated by receiver operating charac-teristic(ROC) curve and area under curve(AUC).Results The RDW level in the AP death group was[15.7% (14.1% -21.8% )] , which was significantly higher than that of AP survive group [13.3% (12.7% -14.5% )] ,the difference was statistically significant (Z=40.02 ,P<0.05);AUC of RDW ROC curve for diagnosing death risk was 0.835(95% CI:0.786-0.951);With the cutoff val-ue of RDW for diagnosing the AP death risk as ≥14.5% ,the sensitivity was 71.43% (95% CI:41.90% -91.60% )and specificity was 89.40% (95% CI:83.40% -93.80% );the RDW level of AP patients was positively correlated with Ret% ,IFR ,MFR and HFR(r=0.376 ,0.502 ,0.468 ,0.475 ,P<0.01) ,and was negatively correlated with LFR (r= -0.502 ,P<0.01).Conclusion The RDW level is a good indicator for early predicting AP death risk ,its elevated degree is closely correlated with Ret generation.

BACKGROUND: Deficit of nivalenol (NIV) and selenium (Se) is related with kashin-beck disease (KBD) to certain extent. Hyaluronic acid (HA) metabolism affects directly the polymerization of proteoglycans (PG) and normal structure and function of cartilage. The integration with HA receptor on surface of cartilage tissue is the key link in HA metabolism. Being the main receptor of HA on chondrocytic membrane, CD44 expression impacts directly HA metabolism, further affects cartilage matrix metabolism, which is extremely important to maintaining the structure and function of cartilage matrix.OBJECTIVE: To probe into the injury and protection of related etiology of KBD to target tissue cells and the mechanism on degenerative necrosis of chondrocytes.DESIGN: Randomized controlled observation was designed.SETTING: Department of Genetics and Molecular-Biology of Medical College of Xi' an Jiaotong University.MATERIALS: The experiment was performed in Key Laboratory Room on Ministry of Education associated with Environment and Disease of Xian Jiaotong University from October 2002 to July 2004. One New Zealand pedigree young rabbit aged 30 days was employed and its humerus, femurs and tibia were cut out in surgery.METHODS: With cell culture, the model of bone tissue was reconstructed in vitro, in which, NIV of various concentrations, KBD suspicious infectious agent and Se, the protective factor were added. HA receptor CD44 on chondrocytic membrane and soluble CD44 in cell culture solution were determined.MAIN OUTCOME MEASURES: ① Microscopic observation of adhesion molecule CD44 on chondrocytic surface. ② Soluble CD44 in chongrocytic culture solution.RESULTS: ① Microscopic observation of adhesion molecule CD44 on chondrocytic surface: CD expression in chondrocytic membrane was decreased with increasing of NIV concentration and it was in tendency of increasing with Se added. ② Soluble CD44 in chongrocytic culture solution:The concentration of soluble CD44 in cell culture solution was decreased gradually following the increased concentration of NIV, but it was increased in high concentration group and such tendency did not alter when Se added. Except blank control and Se control, significant difference was presented among groups (P ＜ 0.05).CONCLUSION: NIV disturbs adhesion molecule CD44 expression on chondrocytic surface and further induces metabolic disturbance of cartilage extracellular matrix. Se supplementation can resist the injury of NIV to chondrocytes, but its action is limited.

BACKGROUND:Studies have confirmed that the nano-hydroxyapatite/chitosan/alginate composite materials have a certain flexibility and strength and possess a bioactivity similar to human bone.
OBJECTIVE:To explore the effect of the nano-hydroxyapatite/chitosan/alginate composite materials on the repair of rabbit mandible defects.
METHODS:Bilateral mandibular defect models of 10 mm × 5 mm × 5 mm were made in 18 healthy New Zealand white rabbits. Then, the rabbits were divided into two groups:experimental group was implanted with nano-hydroxyapatite/chitosan/alginate composite material, and control group was implanted with hydroxyapatite/chitosan composite. At 4, 8 and 12 weeks after implantation, cone-beam CT was applied to observe implant degradation, cal us growth and bone connection in the defect area;new bone formation was observed by hematoxylin-eosin staining.
RESULTS AND CONCLUSION:The gray values of the bone density in the experimental group and control group gradual y increased with time, and there were remarkably significant differences between the two groups at different time points (P<0.01). At the same time point, the experimental group was superior to the control group in gross observation, cone-beam CT observation, gray value of CT and histological observation (P<0.05). At 4-8 weeks after implantation, the implant materials in the two groups were gradual y degraded with a blurred junction between the defect and bone tissue, and a smal amount of new bone formed tightly integrated to the recipient bone tissue, in which the experimental group was more significant. And during 8 to 12 weeks, the degradation of implanted materials in the two groups was basical y complete, and the implant began to merge with the recipient bone tissue, with further generation of new bone tissue and gradual repair of bone defect area, in which, the experimental group was more obvious. Results show that the nano-hydroxyapatite/chitosan/alginate can repair bone defects effectively, and promote the new bone formation.

Objective:This article discusses the status of the health behaviors of rural people with diabetes, to explore effect of doctors’ home-visiting on the behavior of patients with diabetes in rural areas, and to promote chronic disease management and public health service equalization in rural areas . Methods:Junan, Liangshan, and Pingyin counties in Shandong province were sampled using a multi-stage stratified sampling method, and data was collected from 401 questionnaires issued to people with diabetes. A chi-square test and multivariate logistic regression were used to analyze the determinants. Results:Only 52. 0% of diabetes patients received home-visiting from doctors in the surveyed rural areas. Doctors’ visiting works on medication behavior on time and appropriate exercise of patients with diabetes in rural areas was statistically significant, but did not work on measuring blood glucose and periodic review and other health-related behaviors. Conclusion:The rate of doctor home-visiting is low, and the effect is not obvious. More attention should be paid to the content and quality of doctors’ home visiting, and strong policies should support and guide it. According to the characteristics of the rural and patients behavior changing, it is necessary to take flexi-ble modes of health service, improve the diabetes management in rural areas, and promote the equalization of public health service.

Purpose To compare the therapeutic effects of CO2 laser resection and traditional split laryngeal surgery on the early laryn-geal cancer, and to examine relationship between the expression of p27 and PTEN and clinical prognosis in early laryngeal squamous cell carcinoma. Methods 85 patients who underwent CO2 laser resection surgery and 46 patients who underwent split laryngeal surger-y were selected and the occurrence rates after surgery were observed. SP immunohistochemical method was uesd to detect the expression of p27 and PTEN in tumor resection marginal and their surgical margine tissues. Clinical data were collected and all patients were fol-lowed up. Results In the more than two-year follow-up study, 14 of 85 patients in CO2 laser treatment group ( recurrent group) pres-ented with local recurrence and the recurrence rate was 16. 5%, while 6 of 46 patients in split laryngeal surgery group presented with local recurrence and the recurrent rate was 13. 0%. There was no statistical significance in recurrence rate between the two groups ( P> 0. 05). 10 of all the none recurrent patients did not follow the doctor’s advice to quit smoking after the operation, while 12 in the recurrent patients did not, the difference between the two groups was statistically significant (P<0. 01). The positive rate of p27 and PTEN in laryngeal carcinoma tissues and the cancer adjacent tissues ( negative surgical margin tissues ) was 43. 5% ( 57/131 ) , 80. 2% (105/131) and 48. 9% (64/131), 83. 2% (109/131), respectively, with a significant difference (P<0. 01). The positive rate of p27 and PTEN in laryngeal carcinoma tissues of the recurrent group and non recurrent group was 20. 0% (4/20), 47. 7% (53/111) and 10. 0% (2/20), 55. 9% (62/111), respectively, with a significant difference (P<0. 05). While the positive rate of p27 and PTEN in tumor resection marginal tissues of the recurrence group and non recurrence group was 50. 0% ( 10/20 ) , 85. 6% ( 95/111) and 40. 0% (8/20), 91. 0% (101/111), the difference was also statistically significant (P<0. 01). Conclusions There was no statistically significant difference in tumor recurrence rate between CO2 laser surgery and traditional split laryngeal surgery. Postoper-ative recurrence is closely related to resume smoking. The recurrence rate of p27 and/or PTEN negative patients was higher than that of the opposite ones which should be followed up closely after treatment.