Objective To explore the genetic impact of three newly discovered single nueleotide polymorphism (SNP) sites of the transforming growth factor (TGF)-β1 gene on the susceptibility of the chronic hepatitis B virus (HBV) infection. Methods Genome DNA was extracted from the peripheral blood samples of 115 cases suffering from the chronic HBV infection (74 chronic hepatitis B, 41 cirrhosis) as well as 41 healthy volunteers. Thereafter, genotyping of rs2241715, rs2241716 and rs4803455 sites of the TGF-β1 gene was performed by genotype-specific polymerase chain reaction (PCR) analysis. The data were analyzed by the ehi square test and Fisher exact test. Results There was a significant difference of rs2241715 genotypes and allele frequencies between healthy volunteers and patients with chronic hepatitis B and cirrhosis (χ2 = 11.419, P＜0.01 and χ2 = 6.218, χ2 = 5.961,P＜0.05,respectively). Interestingly, the risk relative of subjects with T/T genotype suffered from chronic hepatitis B (OR = 2. 974, 95% CI = 1.209 - 7. 314, P = 0.018) and cirrhosis (OR = 3.228, 95%CI=1.201-8.675, P=0.020) was dramatically higher than that in patients with T/G or G/G genotypes. Conclusion The TGF-β1 rs2241715 T/T genotype appears to be associated with the chronic HBV infection.

Objective To observe the clinical curative effect of selective bronchial arterial embolization for severe hemoptysis.Methods Thirty-eight hospitalized patients with severe hemoptysis was enrolled in this study.Of which 31 patients were recurrent hemoptysis,27 patients were with bronchiectasis,4 patients were with bronchial lung cysts,4 patients had unknown causes,3 patients were with tuberculosis.All patients were diagnosed by chest imaging examination,fiber bronchoscopy,bronchial arteriography,and they were all treated by selective bronchial arterial embolization.Results The most times of embolization was 3,and bronchial arterial imaging were performed for vascular malformation.After having bronchial arterial embolization,35 patients were immediately released of bleeding.Postoperative 24 h,8 patients had hemoptysis again,of which 1 case was performed with conservative treatment and subsequently had pneumonectomy,5 patients had effective conservative treatment,2 cases were performed embolization again after failed conservative treatments.Hemoptysis completely disappeared within 1 week.The total effective rate was 97.4％(37/38).Patients were followed up for 1 year,of which 13 patients relapsed again,11 patients'annual and each time's quantity of hemoptysis reduced 50％.Two patients had pneumonectomy after a number of embolization.The total effective rate was 94.7％ (36/38).After treatment,3 patients had mild chest pain in short time,2 patients had shoulder pain,3 patients had chest tightness,and 3 patients had subcutaneous passive congestion.After being treated for short-term,these symptoms disappeared eventually.Conclusion Selective bronchial arterial embolization for the treatment of acute or recurrent severe hemoptysis is very effective,and can avoid the risk of surgery.It is effective for recurrent cases and worthy of clinical application.

Objective To investigate the effect of astaxanthin on the peripheral blood endothelial progenitor cells (EPCs) apop-tosis induced by oxidative stress in vitro and to explore its underlying mechanism .Methods Human peripheral blood EPCs were in vitro cultured and divided into the control group ,model group with 100 μmol/L tert-butyl hydroperoxide(tBHP) and the astaxan-thin plus tBHP group(with 0 .10 ,1 .00 ,10 .00 nmol/L astaxanthin pretreatment for 24 h ,then adding the final concentration of 100μmol/L tBHP for 6 h continuous culture) .The cell viability was measured by the MTT method .The level of reactive oxygen spe-cies (ROS) was determined by the DCFH-DA method .The changes of mitochondrial membrane potential(MMP) and the apoptosis ratio were detected by the JC-1 method and the DAPI method ,respectively .Results Compared with control group ,100μmol/L tB-HP could obviously caused the apoptosis of EPCs(P<0 .05) ,while astaxanthin could decrease tBHP induced apoptosis ,which man-ifested by the decrease of the apoptosis ratio (P<0 .05) and MMP increase .Conclusion Astaxanthin has the protective effect on the apoptosis of EPCs ,its mechanism may be related with the protection of the mitochondrial function .

Objective To analyze the relationship of the lateral angulation with the incision level after anterior approach operation for thoracolumbar fractures by evaluating the Cobb' s angle at different approach levels.Methods A retrospective study was done on 154 patients with thoracolumbar fractures treated consecutively with anterior operation from May 2004 to January 2008.The preoperative,postoperative and follow-up angle of coronal Cobb and the postoperative angle between screws and endplates on the anteroposterior radiograph were measured.According to the relationship between the injury vertebrae and the incision level,the patients were divided into two groups,ie,incision level ≥2 vertebrae group and incision level ≤ 1 vertebra group.Results All patients were followed up for 6-47 months(mean 37 months),which showed significant postoperative lateral angulation(P ＜ 0.01)especially at follow-up (P ＞ 0.05).The coronal Cobb' s angle showed insignificant difference before operation between two groups but it was increased after operation and during the follow-up(P ＜0.01).The screws A or B were more parallel to the endplate in two groups(P ＜ 0.01),while the parallel of the screws C or D to the endplate showed no statistical difference(P ＞ 0.05).Conclusions Compared with the operation with incision level ≥2 vertebrae,the operation with incision level ≤ 1 vertebra can more easily induce postoperative lateral angulation and exert a significant impact on implantation orientation of the vertebral screws A and B,which may indirectly lead to postoperative lateral angulation.

Endoscopy ; methods ; Humans ; Intestinal Diseases ; diagnosis ; diagnostic imaging ; Intestine, Small ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods

Objective To explore the value of MR dynamic contrast-enhancement in diagnosis and differential diagnosis of infiltrating ductal carcinoma of breast at 3.0T MR magneton.Methods 17 cases of breast infiltrating ductal carcinoma underwent plain MRI and MR dynamic contrast-enhanced scan using 3.0T MR scanners with dedicated breast coil.All cases were confirmed by surgery and pathology.MRI signal intensity,morphology and hemodynamic characteristics of lesions were analysed.Results 17 breast infiltrating ductal carcinomas in 17 cases all appeared as masses,low(8/17)or equal(9/17)signal intensity on T_1WI,high(14/17)or equal(3/17)signal intensity on T_2WI.On morphology,the lesions were irregular and lobulated in shape(82.4%,14/17);undefinite margins(12/17)or non-smooth margins(15/17),glitch sign or astral sign(7/17);the lesions showed non-uniform marked enhancement(10/17)or ring enhancement(5/17)after intravenous administration of contrast agent.82.4%(14/17)of the lesions,the blood vessels could be seen gathering around the lesions on the maximum intensity projection(MIP)image.On hemodynamics,the early enhanced ratio for all cases was over 90%;88.2%(15/17)of the lesions,peak enhancement was less than three minutes;the time-signal intensity curve of the lesions appeared as type Ⅱ was 35.3%(6/17)and type Ⅲ was 58.8%(10/17)mostly.Conclusion Dynamic contrast-enhanced MRI manifestations of breast infiltrating ductal carcinoma are of certain characteristics,which may contribute to the diagnosis and differential diagnosis.

Objective To explore the clinical efficacy of laparoscopic inguinal hernia repair (LIHR) in elderly patients.Methods The retrospective cohort study was adopted.The clinical data of 3 203 patients with inguinal hernias (3 847 sides) who were adnitted to the Ruijin Hospital of Shanghai Jiaotong University School of Medicine between January 2001 and December 2013 were collected.Of 3 203 patients,979 (1 107 sides) with age ＜ 60 years and 2 224 (2 740 sides) with age ≥ 60 years were respectively allocated into the under 60 years group and 60 years or older group.The surgical procedures including transabdominal preperitoneal (TAPP) approach,total extraperitoneal (TEP) approach and intraperitoneal onlay mesh (IPOM) approach were selected and performed by doctors in the same team.There were light-weight and heavy-weight patches.Observation indicators included (1) overall operation situations,(2) surgical comparison between the 2 groups,(3)comparison of postoperative indicators between the 2 groups,(4) follow-up.Follow-up using telephone interview and outpatient examination was performed to detect the recovery time of non-restricted activity,recurrence of hernia and complications.Measurement data with normal distribution were represented as ~ ± s and comparison between groups was done by the t test.Comparisons of count data were analyzed using the chi-square test or Fisher exact probability.Ranked data were compared by the nonparametric rank sum test.Results (1) Overall operation situations:3 203 patients with inguinal hernias (3 847 sides) underwent LIHR,including 1 475 (1 677 sides) using TAPP approach,1 718 (2 154 sides) using TEP approach and 10 (16 sides) using IPOM approach (6 using TAPP and IOPM approaches in each side).The light-weight patch was used in 2 206 sides and heavy-weight patch was used in 1 641 sides.Operation time was (31 ± 12) minutes in all 3 203 patients,(27 ±9)minutes in 2 559 patients with unilateral hernia and (44 ± 12)minutes in 644 patients with bilateral hernia,respectively.Duration of postoperative hospital stay was (1.5 ± 1.2) days.(2) Surgical comparison between the 2 groups:TAPP approach,TEP approach,IPOM approach,light-weight patch and heavy-weight patch were performed to 567,538,2,751,356 sides in the under 60 years group and 1 110,1 616,14,1 455,1 285 sides in the 60 years or older group,respectively,with statistically significant differences in above indicators between the 2 groups (X2 =37.976,70.022,P ＜ 0.05).Operation time in unilateral hernia and bilateral hernia and total operation time were (27 ± 9)minutes,(42 ± 10)minutes,(29 ± 10)minutes in the under 60 years group and (27 ± 10)minutes,(44 ± 12)minutes,(3 1 ± 13)minutes in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (t =-0.106,-1.768,-4.445,P ＞ 0.05).(3) Comparison of postoperative indicators between the 2 groups:the pain score at postoperative day 1 and duration of postoperative hospital stay were 2.4 ± 1.1,(1.5 ± 1.1) days in the under 60 years group and 2.3 ± 1.0,(1.5 ± 1.3) days in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (t =1.419,-0.126,P ＞0.05).(4) Follow-up:all the patients were followed up for 23-60 months,with a median time of 43 months.Cases with non-restricted activity recovery at postoperative week 2 and 4 were 973,978 in the under 60 years group and 2 208,2 222 in the 60 years or older group,respectively,showing no statistically significant difference between the 2 groups (X2=0.113,P ＞0.05).The recurrence of hernia,severe complications,serum tumescence,paresthesia and enteroparalysis were detected in 1,0,49,5,1 sides in the under 60 years group and 11,3,132,16,2 sides in the 60 years or older group,respectively,with no statistically significant difference between the 2 groups (x2=1.556,0.269,0.254,P ＞ 0.05).The urinary retention in the under 60 years group and 60 years or older group was respectively detected in 6 and 44 sides,showing a statistically significant difference between 2 groups (x2=6.956,P ＜ 0.05).Conclusion LIHR is safe and effective in elderly patients,and it can achieve good clinical efficacy under selecting reasonable operation procedures and patches.

Objective To study the influence of hemodialysis on inflammatory state and immune function by analyzing the change of serum protein components in uremic patients before and after hemodialysis.Methods 75 cases of uremic patients confirmed by the Nephrology from October 2013 to May 2014 were selected as the observation group,and 15 healthy volun-teers at the same time as the control group.Then the serum protein electrophoresis pattern of observation group beford the first hemodialysis,after the first hemodialysis,after one month’s treatment and control group were compared with each oth-er.Results In the observation group before and after the first hemodialysis,the ALB levels were lower,α1 and α2 globulin levels were higher than those in control group.There was a statistically significant between the observation group before and after the first hemodialysis and control group (P <0.001).After the first hemodialysis,there were differences inα1 globulin levels compared with before the first hemodialysis (P <0.01).ALB was no significant difference after one month’s hemodi-alysis compared with before the first hemodialysis,andα1,α2 globulin were significantly reduced and the difference was sta-tistically significant (P <0.001),ALB was lower than the control group and was statistically significant (P <0.001).After one month’s hemodialysis,the levels ofγglobulin were higher than those in control group,before the first hemodialysis and after the first hemodialysis.There were significant differences (P <0.001 or P <0.01).Conclusion Regular and effective hemodialysis can improve inflammatory state and immune function of uremic patients.

AIM: To establish recombination plasmid pEGFP-NGB and to investigate the expression of pEGFP-NGB in culture neuroglia cells. METHODS: The NGB cds was isolated by using RT-PCR method with total RNA extracted from fetal Kunming mouse brain, then the NGB cds was cloned into the eukaryotic expression vector pEGFP-C1 of EGFP reported green fluorescence protein. The expression vector of recombinant plasmid pEGFP-NGB was successfully constructed. GeneJamer transfection reagent was used to transfer recombinant plasmid pEGFP-NGB into culture neuroglial cells. The mRNA and protein expression of pEGFP-NGB in culture neuroglial cells were investigated. RESULTS: The positive clone sequencing was consistent with the sequence of Genbank. The NGB mRNA and protein expression of pEGFP-NGB in culture neuroglial cells were detected at high levels. The high expression of green fluorescence protein was observed by fluorescence microscope in culture neuroglial cells. CONCLUSION: The expression vector of recombinant plasmid pEGFP-NGB was successfully constructed and green fluorescence protein was expressed in cultured neuroglial cells.

OBJECTIVEThis paper is to explore the relationships between the occurrence of structural birth defects and environmental risk factors on birth defects.

METHODSA survey was conducted by using a population-based case control study. A total number of 388 structural birth defects, which were detected after 28 weeks' gestational age to 7th day after birth in various hospitals were recruited in Wuxi from 2002 to 2004. The control group consisted of 1607 normal live births born in the same period. Multiple logistic regression model was used to analyze relationships between environmental risk factors and occurrence of structural birth defects after controlling women's education level and childbearing age.

RESULTSAmong those factors which affected birth defects, the exposure to toxic substances in working environment was the highest risk factor, with OR value as 5.37 (95 % CI : 3.60-7.99). Suffering from reproductive tract infections, high fever during first trimester gestation, and taking potential teratogenic drugs such as hypnotics and anti-convulsion drug agents, might significantly increase the risk of structural birth defects, with OR values (95% CI) as 3.38 (1.33-8.56), 3.57 (1.73-7.37) and 2.75 (1.57-4.83) respectively. However, the correlation between oral contraceptives intake within six months before pregnancy and risk of birth defects had no statistical significance. In addition, pollution of the residential environment, staying up all night and raising pets at home, had relatively lower association with birth defects, with OR values (95% CI) as 2.28 (1.75-2.98), 1.96 (1.21-3.18) and 2.50 (1.66-3.76) respectively, yet with a higher proportion of exposure to those factors in pregnant women. There was a significant increase in occurrence risks of birth defects with increase in the number of exposure to environmental risk factors. OR values for having one, two, three kinds of environmental risk factors were 1.60, 4.32 and 10.23 respectively.

CONCLUSIONThe common structural birth defects were affected by a number of environmental risk factors. There was also a dose-response relationship between the number of environmental risk factors and occurrence risks of structural birth defects noticed in our study.

Air Pollution ; adverse effects ; Case-Control Studies ; Congenital Abnormalities ; etiology ; Female ; Humans ; Logistic Models ; Maternal Exposure ; adverse effects ; Pregnancy ; Risk Assessment ; Risk Factors