OBJECTIVETo investigate the methylation status of zonula occludens-1 (ZO-1) gene promoter and its clinical significance in children with stage IV non-Hodgkin lymphoma (NHL) and to provide a basis for further etiological study and early diagnosis of this disease.

METHODSFifty-five children with a confirmed diagnosis of stage IV NHL (40 cases of T-NHL and 15 cases of B-NHL) were selected as the case group, and 20 children with diseases other than hematologic malignancies were selected as the control group. Bone marrow samples were collected from these subjects. Methylation-specific PCR (MS-PCR) was applied to evaluate the methylation status of ZO-1 gene promoter, and the integrated optical density (IOD) was determined. RT-PCR was used to measure the mRNA expression of ZO-1.

RESULTSMS-PCR showed that the methylated bands of ZO-1 gene promoter were found in 39 (70.9%) of 55 patients in the case group before treatment, while no ZO-1 gene promoter methylation was detected in the control group. With close tracking of 47 cases in the study group, consisting of 32 cases of T-NHL and 15 cases of B-NHL, the rates of ZO-1 gene promoter methylation prior to treatment were 72% and 67%, respectively, (P>0.572). The cases of T-NHL and B-NHL showed no significant changes in methylation rate in the early and middle phases of chemotherapy (P>0.05), but they showed significant changes in methylation rate in the late phase of chemotherapy (P<0.05). RT-PCR showed that the NHL cases carrying methylated ZO-1 gene had no mRNA expression of ZO-1, while all children in the control group had mRNA expression of ZO-1. There was no linear relationship between the total number of peripheral blood leukocytes and ZO-1 gene IOD (r=0.093, P=0.575); a positive correlation was found between the number of malignant cells in bone marrow and ZO-1 gene IOD (r=0.669, P<0.001).

CONCLUSIONSZO-1 gene shows a hypermethylation status in children with NHL, and the methylation level is positively correlated with the number of malignant cells in bone marrow. ZO-1 may be used as a novel molecular marker in early diagnosis, outcome assessment, prognostic evaluation, and detection of minimal residual disease.

Adolescent ; Child ; Child, Preschool ; DNA Methylation ; Female ; Humans ; Infant ; Lymphoma, Non-Hodgkin ; genetics ; Male ; Promoter Regions, Genetic ; Zonula Occludens-1 Protein ; genetics

Postoperative pancreatic leakage remains a persistent problem after pancreaticoduodenectomy.For patients with a soft and nonfibrotic pancreas,double binding continuous hemstitch suture is an optimal method for anastomosis.From January 2011 to June 2012,92 cases of periampullary carcinoma with a soft pancreas underwent pancreaticoduodenectomy,and then a modified technique of pancreaticogastrostomy was performed with 2 continuous hemstitch sutures placed in the mucosal and seromuscular layers of the posterior gastric wall,respectively.The median time for pancreaticogastrostomy was 12 minutes,and only 15 patients had postoperative complications.Two patients developed pancreatic leakage(1 grade A and 1 grade B)postoperatively.Pancreaticogastrostomy with double binding continuous hemstitch sutures is a simple and safe reconstruction procedure for patients with a soft and fragile pancreas who received pancreaticoduodenectomy.

ObjectiveTo investigate long-term effect on radiofrequency heat-coagulation (RF)endometrial ablation in treatment of anovulatory dysfunctional uterine bleeding (DUB). MethodsFrom Jul.2001 to Nov. 2009, 1 196 patients with DUB who were failed by medical treatment( including 127 patients with dysmenorrheal) were enrolled into this study in Jinan Millitary General HospitaL Those patients were divided into two groups according to age:427 patients at age of or more than 45 years (average age 48 years) in Group A who were treated by RF procedure for amenorrhea;769 patients at age of less than 45 years old (average 37 years) in group B were treated by RF for controlling excessive menstrual bleeding. All the patients had the results of menstrual score (pictorial blood loss assessment chart, PBAC), hemoglobin (Hb) ,endometrial curettage pathology and hysteroscopy examination immediately after RF procedure; Some patients still had another endometrial curettage pathology and clinical results in 6 months after RF. The mean follow-up time was 72 months ( range:6 to 100 months). The evaluation criterion for RF treatment was to use optimal and significant effect measurements. For group A, the optimal treatment effect (cure) was defined as bleeding cessation and achieving amenorrhea that continued for more than 12 months after treatment. For group B, the optimal treatment effect (cure) was also defined as bleeding cessation and resuming normal menstruation which continued for more than 12 months after treatment. Significant treatment effect was defined as irregular, minor bleeding, but PBAC score less than 100 within 12 months. If patient symptoms and PBAC scores did not change compared with those before treatment, the treatment was defined as failure. For dysmenorrhea, the optimal treatment effect was disappearance for more than 12 months, the significant treatment effect was remission, and treatment failure was not changed from the pre-treatment baseline. The effective rate was the sum of that of the optimal and significant effect. One hundred and twentyfive patients with DUB treated by agents at the same time were chosen as control group. Results( 1 ) The recent and long-term effective rates for bleeding cessation by RF: the total recent effective rates within 1 months were 94. 82％ ( 1134/1196), including 96. 5％ (412/427) in group A and 93.9％ (722/769) in group B. The total curative rates for dysmenorrheal were 82. 7％ ( 105/127 ), including 86. 4％ ( 38/44 ) in group A and 80. 7％ ( 67/83 ) in group B. Pathology examination after hysteroscopy immediately after RF showed a completely and whole destroyed endometrium in group A, and a little rested endometrium in group B. The long-term effect rates for bleeding cessation by RF after 12, 24 and 36 months were 92. 55％ (969/1047), 93.9％ (866/922) and 93.7％ (609/650), respectively. PBAC and Hb in group A and group B within 12, 24, 36 and more than 36 months were improved significantly ( P ＜ 0. 05 ). (2) Complications : the major complication was irregular minor bleeding in 1 to 2 months after treatment, the rate was 8.03％ (96/ 1196). The second one was menorrhea in 3 months after RF, the rate was 5. 18％ (62/1 196 ). This condition was corrected by the second RF. No hysterectomy was performed on those patients. Conclusion RF is the safe, efficient and minimal invasive procedure in treatment for DUB. The mechanism of keeping longterm curative effect and preventing recurrence is due to endonetrium inactivation and fibrosis by thermocoagulation.

Objective To evaluate and analyze the clinical effect of comprehensive rehabilitation therapy after arthroscopic rotator cuff repair using suture-bridge technique for full-thickness rotator cuff tears.Methods Forty-one patients (20 males,21 females; mean age 52.2 years) with full-thickness rotator cuff tears were treated with arthroscopic rotator cuff repair using suture-bridge technique between June 2010 and January 2012 in our hospital.After arthroscopic rotator cuff repair,the patients were randomly assigned to a treatment group (21 patients) or a control group (20 patients).The treatment group received systematic rehabilitation therapy including rehabilitation education,physical modalities treatment and rehabilitative training additionally,while the control group only accepted the routine rehabilitation therapy including stretching and muscle strength training.The outcome was evaluated at 6 months after surgery,by employing visual analogae scale (VAS),the range of motion (ROM) testing of shoulder joint flexion and rotation,the rating scale of University of California at Los Angeles (UCLA),and the shoulder index of American shoulder and elbow surgeons (ASES).Results The mean follow-up period was 15.6 months (8-24 months).Prior to intervention,there was no significant difference in any parameter between the two groups (P ＞ 0.05).Six months later,all scores of assessments changed:in treatment group VAS (1.7 ± 1.5),ROM [flexion (168.3±31.3)°,rotation (47.2±11.2)°],UCLA(30.7 ±4.13) and ASES (85.1 ±15.67); in control group VAS(3.8±2.2),ROM[flexion (121.2 ±53.6)°,rotation (32.9 ±14.9)°],UCLA(18.3 ±4.94) and ASES (36.4 ± 17.70).Significant changes occurred in both groups in all the parameters after treatment when compare to baseline (P ＜ 0.05).Conclusions Comprehensive rehabilitation therapy is an effective approach for improving motor ability of the shoulder in patients after arthroscopic rotator cuff repair with suture-bridge technique for their full-thickness rotator cuff tears.

Objective To investigate the variations of the expression and activity of phosphatidyl inositol-3 kinase(PI-3K)in the adipose tissue of pregnant women with gestational diabetes mellitus(GDM)and to explore its relationship with insulin resistance(IR)in these women.Methods The expression of PI-3K p85aprotein and mRNA in adipose tissue were detected by Western blot and Semi quantitative reverse transcription polymerase chain reaction(RT-PCR)in 20 GDM women(GDM group)and 20 normal pregnant women(normal group).The activity of PI-3K was determined by ELISA and IR index was calculated using homeostasis model assessment(HOMA)according to the results of fasting insulin(FINS)and fasting plasma glucose(FPG),which measured by oxidase assay and immunoradioassay,respectively.Results The expressions of PI-3K p85αmRNA and PI-3K p85a protein were markedly increased in the adipose tissue of GDM group than in the normal group(mRNA:0.83±0.03 vs 0.53±0.07,P＜0.01;protein:0.93±0.04 vs 0.71±0.06,P＜0.01).However,the PI-3K activity in the GDM groups was significantly down-regulated compared with the normal group(1.7±0.6 vs 5.2±0.5,P＜0.01).The levels of FPG and FINS (HOMA-IR)in the GDM group were all significantly higher than the normal group[FPG:(5.8±0.2)mmol/L vs(4.7±0.3)mmol/L;FINS:(14.8±0.2)mmol/L vs(11.2±0.3)mmol/L;HOMA-IR:1.3±0.4 vs 0.9±0.3,a11 P＜0.01]. Conclusions The decreased activity of PI-3K in the adipose tissue may be one of the molecular mechanisms for IR in GDM.

Adult ; Delivery of Health Care ; Female ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Occupational Health

Objective To investigate the expression and tyrosine phosphorylation of insulin receptor substrate-1 (IRS-1) and in the adipose tissue of patients with gestational diabetes mellitus (GDM), and to explore molecular mechanisms of insulin resistance in GDM. Methods The serum and adipose tissue were sampled from patients with GDM (GDM group, n = 20) and normal pregnant women (control group, n = 20). Fasting plasma glucose was measured by glucose oxidase assay. The expressions of IRS-1 protein and mRNA were determined by Western blot and semi-quantitative RT-PCR. The tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation. Results Compared with control group, in GDM group, the expression of IRS-1 mRNA was markedly decreased (0.61 ±0.06 vs 1.12 ± 0.17, P < 0.01), the expression of IRS-1 protein was significantly decreased (0.57 ±0.08 vs O. 83 ±0.07, P <0.01) and tyrosine phosphorylation was significantly reduced (0.23 ± O. 06 vs O. 62 ±0.04, P < 0.01) in the adipose tissue. Conclusion The decline of protein expression and tyrosine phosphorylation of IRS-1 in the adipose tissue of gestational diabetes appears to be one of the moleculemechanisms of insulin resistance in patients with GDM.

Adult ; Female ; Humans ; Leiomyoma ; complications ; Lung Neoplasms ; complications ; Uterine Neoplasms ; complications

Objective To investigate the association between essential hypertension(EH)and nonalcoholic fatty liver(NAFL).Methods Four hundred and nine patients of EH underwent liver uhrasonographic examina- tion during 2006-2007 year were enrolled.Patients were categorized as MS(n=312)or non-MS(n=97)ac- cording to the criteria by CDA.Body mass index(BMI),blood pressure,the profiles of blood lipid,liver func- tion,renal function,plasma sugar were determined.Results 1)The prevalence of fatty liver in EH+MS group (66.0%)was significantly higher than that of EH without MS group(41.2%,P

Objective To study the significance of the sample S/Co ratio when using a domestic reagent for anti-hepatitis C virus(HCV)antibody detection and to explore the procedure and standard of anti-HCV antibody diagnosis by using this domestic reagent.Methods Anti-HCV antibody was detected in 295 000 blood donors by a domestic anti-HCV reagent with enzyme-linked immunosorbent assay(ELISA)method and the reactive samples were tested again by ortho anti-HCV antibody reagent.The samples which anti-HCV antibodies were determined as positive by ortho anti-HCV rea- gent were examined by recombinant immunoblot assay(RIBA)reagent and 106 samples of them were also tested for HCV RNA.Results Six hundred and eighty-one samples were reactive in 295 000 samples screened by the domestic ELISA reagent,the reactive ratio was 0.23 %.Among the reactive samples screened by the domestic ELISA reagent,367 samples were determined as positive by ortho anti-HCV reagent while 66.2% of them showed a S/Co ratio≥3.8.The consistency rate between positive results determined by the domestic reagent and RIBA reagent respectively was 53.8%.For the samples showing S/Co ratio≥3.8 by ortho anti-HCV reagent,94.2% had a S/Co ratio≥8.0 when using the domestic ELISA reagent,while the percentage of samples showing S/Co ratio