Objective To investigate whether the bone harvested from Cloward discectomy with trephine could substitute for iliac-crest bone grafts in arthrodesis procedure. Methods We reviewed the 30 patients with cervical spondylotic myelopathy involving a single level, which had been managed with anterior trephination discectomy and arthrodesis by the bone chips harvested from within the trephine. The bone chips harvested with trephine were then trimed and implanted erectedly similar to Robinson arthrodesis procedure. All cases had been followed-up for an average of 4.75 years. The latest results were analyzed according to JOA score system and recovery rate. The fusion outcome were assessed by anteroposterior and flexion and extension lateral radiographs of the cervical spine. Results At the latest followed-up examination, clinical results were excellent in fifteen patients(50％ ), good in eleven(36.7％ ), fair in three(10％ ) and poor in one (3.3％ ). X-ray showed solid fusion in all, and no dislodgment of the grafts. However, the cervical curves had a little loss. There was no significant bone grafts subsidence. Conclusion In cervical anterior decompression the bone chips obtained in trephination could substitute for other type of bone grafts for arthrodesis. The postoperative outcomes were not affected by the loss of the cervical curves.

PURPOSE: The Large amounts of whole cow' s milk intake, just followed by prolonged breast milk feeding may induce a severe deficit of iron. We performed this study to investigate the severity of iron deficiency in these subjects. METHODS: Seventy-one subjects (12 to 48 months of age) were classified according to history of prolonged breast milk feeding and intake of large amounts of whole cow' s milk. Prolonged breast milk feeding and large amounts cow' s milk intake subjects were assigned as group A (n=15), the large amounts of cow's milk intake subjects as group B (n=15), the prolonged breast milk feeding subjects as group C (n=24) and the normal control subjects as Group D (n=17). The hematologic and iron status were evaluated and compared between each group. RESULTS: Although the mean of group A was lower than the mean of group B and C, the level of hemoglobin of group A was significantly lower than group D (P<0.01). The level of the ferritin of group A was significantly lower than group B, C (P<0.05, respectively) and group D (P<0.01). Of the 15 study subjects of group A, 14 (93.3%) had microcytic hypochromic anemia and 7 (46.7%) revealed that serum ferritin levels were at 1.0ng/dL, indicating severe deficit of storage iron. CONCLUSION: The intake of large amounts of whole cow' s milk, just followed by prolonged breast milk feeding induced iron deficiency anemia and a severe deficit of storage iron. It is necessary to inform parents to avoid irreversible recognition impairment and behavioral change.
Anemia, Hypochromic ; Anemia, Iron-Deficiency ; Breast* ; Ferritins ; Humans ; Iron* ; Milk* ; Milk, Human* ; Parents

Objective To explore the surgical strategies of thoracic spinal stenosis with dural ossification. Methods One-hundred and eight patients with thoracic spinal stenosis were treated. Dural ossification was found in 29 cases during operation from January 2004 to June 2008. There were 19 males and 10females, with an average age of 56.4 years (42-74 years). The course of disease was 13 months (2-48months). The lesion was located in T1-T4 in 4 cases, T5-T8 in 5 cases, and T9-T12 in 20 cases. All the patients were treated by posterior lamina resection. Both ossificated dural and ossificated yellow ligament were resected in 16 patients. Decompression was performed with partial ossification remaining on dural surface in 13 cases. JOA score was used to evaluate the outcomes 1, 3 and 12 months after operation. Results The average operation time was 140 min, and average bleeding was 300 ml. Dural incisions were repaired with a wound drainage in 11 cases. Seven cases appeared cerebrospinal fluid leakage which healed in 3-5 days.Dural incisions were not repaired without wound drainage in 5 cases. Cerebrospinal fluid leakage occurred in these cases healed in 5-7 days. Thirteen cases treated with floating method did not appear cerebrospinal fluid leakage. All patients did not undergo subarachnoid infection and the aggravation of original nervous system symptoms. According to JOA score, all patients were evaluated as excellent in 22 cases, good in 5 and fair in 2 cases, and excellent and good rate was 93%. Conclusion For thoracic spinal stenosis with dural ossification, resection of both ossificated dural and ossificated yellow ligament and complete decompression with partial ossification remaining on dural surface is safe and reliable. Dural ossification does not influence the prognosis, but increase operative difficulty and risk.

OBJECTIVETo study the anti-tumor effects of all-trans retinoic acid (ATRA) and mechanisms of its action.

METHODSHuman esophageal carcinoma cell line EC9706 cells were treated with ATRA at different concentration. The proliferation inhibition was examined by MTT assay. Morphological examination, TUNEL method and flow cytometry were used to detect the apoptosis and changes of cell cycle. Immunohistochemical method was used to detect the expression of apoptosis-related genes caspase-3 and bcl-2. The semi-quantification of protein expression was analyzed by pathological image analysis.

RESULTSATRA inhibited the proliferation of EC9706 cells moderately. Apoptosis in EC9706 cells was induced by ATRA treatment. The morphology of EC9706 cells showed changes such as nuclear chromatin condensation and fragmentation. Sub-G1 peak was found by flow cytometry. The maximal apoptosis rate was 32.6%. The expression of caspase-3 gene was enhanced. The expression of bcl-2 gene was decreased. All these effects were presented in a dose-dependent and time-depend manner.

CONCLUSIONApoptosis is one of the key mechanisms of ATRA action on EC9706 cells.

Antineoplastic Agents ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Esophageal Neoplasms ; metabolism ; pathology ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Tretinoin ; administration & dosage ; pharmacology

PURPOSE: We observed the prevalence rate of microalbuminuria(MA) and its relationship with the various clinical factors in children and adolescents with type 1 diabetes mellitus(DM). METHODS: Seventy two children and adolescents(26 males and 46 females, 17.1+/-3.0 years) were included. MA was defined as 24 hour urine microalbumin >30mg/day(20microgram/min). Subjects were classified into three groups(normoalbuminuria, transient MA, or persistent MA). Additionally, sub jects were classified into another three groups according to age at diagnosis(<5, 5-11, or >11 years), arbitrarily. Clinical characteristics were analyzed between these groups and prevalence rates of MA by age and by duration of diabetes were analyzed. RESULTS: Of the 72 patients, 42(58.3%), 11(15.3%), and 19(26.4%) patients were included in nor moalbuminuric, transient MA, and persistent MA group, respectively. The mean level of HbA1c in persistent MA group was greater than those of other groups(P<0.01). The prevalence rates of diabetic retinopathy(27.8%) and neuropathy(16.7%) in the persistent MA group were higher than those in other groups(P<0.05). The cumulative incidence for developing persistent MA was 1.4% at 13 years, 4.7% at 15 years, and 20.7% at 18 years of age. The cumulative incidence for developing persistent MA was 3.4% after 6 years, 15.6% after 7 years, and 17.8% after 8 years. In patients who were diagnosed before 11 years of age, the appearance of persistent MA was delayed until pubertal age, whereas those who were diagnosed after 11 years of age developed persistent MA earlier after diagnosis. CONCLUSION: These data suggest that screening for MA should be performed in children and adolescents who have had diabetes for more than 5 years, or have entered into puberty, especially those with poor metabolic control.
Adolescent* ; Child* ; Diabetes Mellitus, Type 1* ; Diagnosis ; Female ; Humans ; Incidence ; Male ; Mass Screening ; Prevalence ; Puberty

OBJECTIVETo study the clinical characteristics and outcomes of the hereditary medullary thyroid carcinoma (HMTC) and the sporadic medullary thyroid carcinoma (SMTC).

METHODSThe clinical data of 78 patients with medullary thyroid carcinoma who underwent surgery in our hospital between July 1980 and May 2011 were retrospectively analyzed.

RESULTSOf these 78 patients, there were 23 HMTC cases and 55 SMTC cases. The HMTC group was significantly younger age of onset [(36.4±13.5) years vs. (46.6±11.2) years, P<0.01] and a lower pre/post-operative serum calcitonin levels [(850.4±110.20) ng/L vs. (1450.4±118.3) ng/L, P<0.01 and (410.8±133.2) ng/L vs. (1585.4±129.5) ng/L, P<0.01] than the SMTC group. In addition, the mean tumor diameter was also significantly smaller in the HMTC group (14.3 mm vs. 21.0 mm in SMTC group, P<0.05). Tumor multifocality was seen in a significantly higher proportion of HMTC cases compared with the SMTC cases (56.6% vs. 29.1%, P<0.05). The overall 10-year survival was 100% in HMTC group and 80.2% in SMTC group (P<0.05).

CONCLUSIONHMTC has a better prognosis than SMTC.

Adolescent ; Adult ; Age of Onset ; Aged ; Carcinoma, Medullary ; classification ; genetics ; pathology ; Carcinoma, Neuroendocrine ; Female ; Genetic Diseases, Inborn ; pathology ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; classification ; genetics ; pathology ; Young Adult

OBJECTIVETo describe and analyze epidemiological characteristics of babies with neural tube defects (NTD) by sex and birth outcome in a high-prevalence and a low-prevalence areas of China.

METHODSBirth defects surveillance data collected from 1992 through 1994, as a part of the Sino-American cooperative project on NTD prevention, were used to classify NTD as four categories, i.e., anencephaly, encephalocele, high-level and low-level spina bifida according to the sites of lesion (high vs. low level lesion were cervicothoracic and lumbosacral, respectively). Each category was sub-classified, according to single or compound defect, as isolated external defects (including those with NTD only) or multiple external defects (including those with NTD and another major external birth defects that is not the sequence of a defect such as cleft lip with or without cleft palate). The rates of anencephalus, encephalocele, high- and low-level spina bifida (SB) in males and females and their sex ratios were calculated, adjusted for urban and rural areas, season, category and birth outcome by sex and sites of lesions (high vs. low).

RESULTSTotally, 784 NTD cases were identified from 326 874 recorded births (including live births, stillbirths and fetal deaths with a gestation age of at least 20 weeks). The prevalence rates of anencephalus (1.30 per 1 000 female births) and high-level SB (3.99) in females were higher than those (0.66 and 1.66 per 1 000 male births) in males in the high-prevalence northern regions; with adjusted prevalence rates of females 1.8 - 2.1 times greater than those of males. In the low-prevalence southern regions, the prevalence of high- (0.32 per 1 000 female births) and low-level SB (0.21) in female were higher than those in males, with high- and low-level SB rate of 0.10 and 0.09 per 1 000 male births), with adjusted rates for females of 1.3 - 1.6 times higher than in males. Isolated NTD accounted for more than 80% of all NTD cases, and the prevalence of isolated NTD in females (2.57) was higher than that in males (1.40).

CONCLUSIONSThe sex differences in NTD existed between north and south, in accordance with the phenotype of NTD. It suggested that proportion of high level SB and anencephalus in females could increase as the prevalence of NTD going up, anencephaly, high- and low-level SB had the different genetic and environmental background.

China ; epidemiology ; Female ; Humans ; Infant, Newborn ; Male ; Neural Tube Defects ; epidemiology ; Prevalence ; Sex Distribution

OBJECTIVETo verify the obtained immunogenic membrane antigens candidate of pancreatic cancer in the performed research.

METHODSPancreatic cancer cell line SW1990 membrane protein underwent immunoblot with serum IgG purified from clinically collected sera of 66 pancreatic cancer patients. Number 3 and number 8 positive dots of immunoblot were identified by MALDI-TOF mass spectrometry and peptide mass fingerprinting matching. The candidate membrane antigens were further validated in cell lines by RT-PCR, real-time PCR and Western blot, and their different expression level of gene and protein in pancreatic cancer cell lines were contrastly studied.

RESULTSNumber 3 and number 8 positive dots were identified as: voltage-dependent anion channel (VDAC3) and catechol-o-methyltransferase (COMT). RT-PCR, real-time PCR and Western blot showed that gene and protein of VDAC3 and COMT were expressed in the pancreatic cancer cell line SW1990, AsPc and P3 respectively.

CONCLUSIONVDAC3 and COMT might be the candidate immunogenic membrane antigens of human pancreatic cancer, and their gene and protein are differently expressed in the pancreatic cancer cell line SW1990, AsPc and P3.

Antigens, Neoplasm ; analysis ; Cell Line, Tumor ; Humans ; Pancreatic Neoplasms ; immunology ; Proteomics

OBJECTIVETo validate those obtained immunogenic membrane antigens candidate of human pancreatic cancer in the performed research.

METHODSIn the pre-studies, serum IgG purified from clinically collected sera of pancreatic cancer patients underwent immunoblot with human pancreatic cancer cell line SW1990 membrane protein, totally obtained 9 positive protein spots. Number 5 and 6 positive dots of immunoblot were identified by matrix-assisted laser desorption/ionization-time of flight mass spectrometry and peptide mass fingerprinting matching. The candidate membrane antigens were further validated in cell lines by RT-PCR and real-time PCR. RNA of human normal pancreatic tissue and pancreatic cancer tissue was extracted respectively, different gene expression level of prohibitin 2 was studied by real-time PCR.

RESULTSNumber 5 and 6 positive dots were identified as prohibitin 2 and prohibitin. RT-PCR and real-time PCR all showed that gene of prohibitin 2 and prohibitin were expressed in the human pancreatic cancer cell line SW1990, AsPc and P3 respectively, especially in P3 cell with highest expression (t = 7.442, P < 0.01). In addition, gene expression level of prohibitin 2 was significant higher in human pancreatic cancer than that of normal pancreatic tissue (t = 0.893, P < 0.01).

CONCLUSIONSProhibitin 2 and prohibitin are both differently expressed in the pancreatic cancer cell line SW1990, AsPc and P3. Prohibitin 2 is obvious highly expressed in human pancreatic cancer tissue. Prohibitin 2 and prohibitin might be the candidate immunogenic membrane antigens of human pancreatic cancer.

Antigens, Neoplasm ; genetics ; metabolism ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; Humans ; Membrane Proteins ; genetics ; metabolism ; Pancreatic Neoplasms ; genetics ; immunology ; metabolism ; Proteomics ; methods ; Repressor Proteins ; genetics ; metabolism