Adolescent ; Bone Screws ; Child ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male

Objective To analyze the correlation between miR-31 and ESCC in expression of miR-31 in the plasma of ESCC in Xinjiang Kazak and Han nationality patients. Methods The plasma samples were collected respectively from patients with ESCC in 20 cases and healthy subjects in 20 cases. The relatively expression of miR-31 was detected by real-time Q-PCR. Results The expression of miR-31 with ESCC were higher than those of the normal control group, which related to the degree of tumor differentiation in Kazak ESCC patients (P < 0.01); the levels of miR-31 relative expression in Kazak were higher than that of Han (P = 0.008, P = 0.027). Conclusion miR-31 may be involved in the occurrence of ESCC in Han and Kazak nationality. miR-31 might be another risk factor in high incidence of ESCC in Kazak than Han nationality.

AIMTo determine the relationship between C3435T mutation in exon 26 of the human multidrug resistant 1 gene and cyclosporine (CsA) pharmacokinetic (PK) parameters among healthy Chinese volunteers by nonlinear mixed effect model (NONMEM).

METHODSTwenty healthy subjects were given orally a single dose of 500 mg CsA in microemulsion solution. Blood CsA concentrations were measured with HPLC and the genotype for the C3435T polymorphism of MDR1 gene was determined with the PCR and restriction fragment length polymorphism. The results were further confirmed by sequencing. NONMEM was performed to assess the effect of genotype on CsA PK profile.

RESULTSMDR1 C3435T genotype was identified as the best predictor of CsA systemic exposure. The relative bioavailability of CsA was 40% higher in subjects who carried at least one 3435C allele compared to that of TT type individuals in the study population.

CONCLUSIONThe MDR1 C3435T genotype offers a potential basis of mechanism to explain inter-subject differences in CsA oral bioavailability.

Administration, Oral ; Adult ; Biological Availability ; Cyclosporine ; administration & dosage ; pharmacokinetics ; Exons ; Genes, MDR ; genetics ; Genetics, Population ; Genotype ; Humans ; Male ; Mouth ; metabolism ; Polymorphism, Genetic

OBJECTIVETo explore the clinical characteristics, diagnosis and surgical treatment of adult congenital bronchoesophageal fistula.

METHODSEleven cases of adult congenital bronchoesophageal fistula that were diagnosed and surgically treated between May 1990 and August 2010 had been reviewed. There were 7 male and 4 female patients, ranging in age from 28 to 66 years (mean 48.7 years). The chief clinical presentation included coughing and sputum in 10 cases, recurrent bouts of coughing after drinking liquid food in 6 cases, hemoptysis in 6 cases, low fever in 4 cases, chest pain in 3 cases. The duration of symptoms before diagnosis ranged from 5 to 36 years (mean 16.8 years). The diagnosis of bronchoesophageal fistula was confirmed most by esophagography. Associated diseased lung was resected in all patients (lobectomy in 10 cases and pneumonectomy in 1 case). The operation included right thoracotomy in 7 cases and left thoracotomy in 4 cases. The fistula was completely resected in 10 cases. The tract was simply divided and the end was sutured in 1 case.

RESULTSThe postoperative course was uneventful in 10 patients who were discharged from hospital 10 to 18 d after operation. One patient suffered from esophageal fistula and received second operation. Regular follow-up was conducted on all 11 patients, proving that 3-year survival rate was 11/11 and 5-year survival rate was 9/11.

CONCLUSIONPersistence of congenital bronchoesophageal fistula into adulthood is rare. The main symptom is nonspecific coughing and bouts of coughing after drinking liquid food. The most useful diagnostic method is the esophagography. Even though it is benign disease, life-threatening complications might occur and it must be treated surgically as soon as the diagnosis is established.

Adult ; Aged ; Bronchial Fistula ; congenital ; diagnosis ; surgery ; Esophagoscopy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Thoracotomy

AIMTo investigate the chemical constituents of the rhizomes of Anemarrhena asphodeloides Bunge.

METHODSThe compounds were separated by means of solvent extraction, chromatography on absorbent resin SP825 and silica gel C18 repeatedly, and their structures were elucidated on the basis of chemical methods and spectral analyses (FAB-MS, 1H NMR, 13C NMR, 1H-1H COSY).

RESULTSSix steroidal saponins were isolated from the rhizomes of Anemarrhena asphodeloides Bunge. They were identified as (25S)-26-O-beta-D-glucopyranosyl-22-hydroxy-5beta-furostane-2beta, 3beta, 26-triol-3-O-beta-D-glucopyranosyl-(1 --> 2)-beta-D-galactopyranoside (timosaponin N, 1), timosaponin E1 (2), (25S)-26-O-beta-D-glucopyranosyl-22-methoxy-5beta-furostane-2beta, 3beta, 26-triol-3-O-beta-D-glucopyranosyl-(1 --> 2)-beta-D-galactopyranoside (timosaponin O, 3) , timosaponin E2 (4), (25R) -26-O-beta-D-glucopyranosyl-22-hydroxy-5alpha-furostane-2alpha, 3beta, 26-triol-3-O-beta-D-glucopyranosyl-(1 --> 2)-[beta-D-xylpyranosyl-(1 --> 3)]-beta-D-glucopyranosyl-(1 --> 4)-beta-D-galactopyranoside (purpureagitosid, 5) and marcogenin-3-O-beta-D-glucopyranosyl-(1 --> 2)-beta-D-galactopyranoside (6).

CONCLUSIONCompound 1 and compound 3 are new compounds, and compound 5 was isolated from the rhizomes of Anemarrhena asphodeloides Bunge for the first time.

Anemarrhena ; chemistry ; Molecular Conformation ; Molecular Structure ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Saponins ; chemistry ; isolation & purification

OBJECTIVETo evaluate the correlation between single nucleotide polymorphisms (SNP) in the promoter of ataxia-telangiectasia mutated (ATM) gene and the susceptibility of nasopharyngeal carcinoma in Cantonese.

METHODSA total of 176 NPC Cantonese NPC patients and 202 age-matched healthy controls were enrolled in this study. G/A genotyping of the SNP locus rs189037 in the promoter of ATM gene was performed by PCR and direct sequencing of the PCR products.

RESULTSThe genotype frequency of heterozygote G/A was 50% (88/176) and 47.5% (96/202), and that of the homozygote variant A/A was 15.3% (27/176) and 18.3% (37/202) in NPC patients and healthy individuals, respectively. Statistics analysis revealed no evident correlations of the G/A and A/A genotypes to the clinical phenotypes of NPC in either NPC group or healthy control group (OR7equals;1.022, 95%CIequals;0.668-1.564 for G/A+A/A). Analysis after stratification by age and gender found no such correlations either.

CONCLUSIONThe genotype frequencies of SNP locus rs189037 in the promoter of ATM gene are similar between NPC patients and healthy subjects, suggesting that rs189037 is not related to the genetic susceptibility of NPC in Cantonese.

Adult ; Asian Continental Ancestry Group ; genetics ; Ataxia Telangiectasia Mutated Proteins ; Base Sequence ; Carcinoma ; genetics ; Case-Control Studies ; Cell Cycle Proteins ; genetics ; DNA-Binding Proteins ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Nasopharyngeal Neoplasms ; genetics ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Protein-Serine-Threonine Kinases ; genetics ; Tumor Suppressor Proteins ; genetics

OBJECTIVETo explore the value of partial atrium or large blood vessel resection for the treatment of locally advanced lung cancer.

METHODSThirty-five patients with locally advanced lung cancer (T(4)N(0)-N(2)M(0)) underwent lobectomy or pneumonectomy combined with intrapericardial vascular management or partial resection of the atrium. Of the 35 patients , 15 underwent left pneumonectomy combined with partial resection of the left atrium, 3 had pneumonectomy and partial resection of pulmonary artery trunk, 11 received right pneumonectomy and partial resection of the left atrium, 3 had middle and lower lobectomies and partial resection of the left atrium, and 3 underwent right upper lobectomy, partial resection of the superior vena cava and replacement of artificial blood vessel.

RESULTSNo death occurred in the 35 patients. Postoperative arrhythmia occurred in 4 cases and respiratory failure in 2 cases. The 1, 2, 3 and 4 year survival rates of the patients were 79.2% (19/24), 53.3% (8/15), 46.2% (6/13) and 36.4% (4/11), respectively. Pathologically, 27 patients had squamous carcinoma, 3 had adenocarcinoma, 3 had adenosquamous carcinoma and 2 had large cell carcinoma. In TNM staging, 6 were in T(4)N(0)M(0), 11 in T(4)N(1)M(0) and 18 in T(4)N(2)M(0).

CONCLUSIONPneumonectomy or lobectomy combined with intrapericardial vascular management or partial resection of the atrium can enhance the possibility of radical resection of locally advanced lung cancer and increase the long term survival rate.

Aged ; Female ; Heart Atria ; surgery ; Humans ; Lung Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Vena Cava, Superior ; surgery

Objective To explore the dosage and injection method of concanavalin A(Con A) for inducing Wistar rats into the acute hepatic injury model. Methods (1)According to the dosage of Con A, 42 Wistar rats were randomly divided into groups A, B, C, D, E, N, 7 rats in each group. Group N was given tail intravenous injection of normal saline as normal control group. Groups A, B, C, D, E were given intravenous injection of 4, 8, 16, 30, 40 mg/kg of Con A respectively. At the 8th hour after modeling, the levels of alanine transaminase(ALT), aspartate aminotransferase(AST), albumin(ALB), interleukin(IL)-2 , IL-10, interferon (IFN)-γ, and tumor necrosis factor(TNF)-αwere detected. And HE staining was used to observe the pathological feature of hepatic tissue. (2)According to the injection method of Con A, 21 Wistar rats were randomly divided into normal control group, intraperitoneal injection group and tail intravenous injection group, 7 rats in each group. The dosage of Con A for the rats in intraperitoneal injection group and tail intravenous injection group was 16 mg/kg. At the 8th hour after modeling, the levels of serum ALT, AST, and ALB were determined. Results The number of abnormal deaths in various dose Con A groups at the end of each experiment was 0 in groups A, B, C, and 2 in group D, and 7 in group E. A small amount of spotty necrosis, inflammatory cell infiltration, and hepatic lobule with almost integrity of structure were found in groups A, B, while obvious bridging-like necrosis was seen in groups C, D. Serum ALT, AST, and ALB levels in intraperitoneal injection group had no statistically significant difference as compared with the normal control group. Conclusion Tail intravenous injection of 16 mg/kg of Con A can be used to induce an acute immunological liver injury rat model successfully.

Objective To sort out the main subjects of China's medical insurance fund supervision and their change process in different periods,to provide a basis for deepening the reform of the medical insurance fund regulation sys-tem.Methods Social network analysis method is used to quantify the national-level policies and tap the core subjects of China's medical insurance fund supervision.Results A total of 63 policies were included,and 195 regulatory sub-ject codes were obtained.The main regulatory subjects during the embryonic period of medical insurance fund super-vision were mainly insurance operators and relied on medical insurance fund supervision organizations.The main regu-latory subjects during the exploration period were mainly the insurance administration and the insurance agency and began to pay attention to social participation.The main regulatory subjects in the development period were mainly the Healthcare Security Administration and its handling agencies,with the collaboration of relevant departments.The participation of social subjects is obvious,and third-party professional institutions become important subjects.Con-clusion The supervisory subjects of China's medical insurance fund have embodied the logic of change from decen-tralization of responsibilities to centralized and unified functions,from multi-regulation to integrated multi-sectoral linkage,and from government-led to the introduction of social and market forces.The participation of multiple sub-jects is the development trend of medical insurance fund supervision in the future,and the capacity of collaborative governance of medical insurance fund supervision should be continuously improved.

Digital supervision of the medical insurance fund is the process of using digital information technology to map real-world medical scenarios and activities into the digital world,in which the medical insurance fund is super-vised and managed.The objectives of digital supervision include not only ensuring the safe and rational use of the medical insurance fund,but also promoting the quality of medical services,safeguarding the public's rights and interests,ensuring the long-term sustainability of the medical insurance system,and promoting social equity and stability at multiple levels.Based on the theory of Public Value theory,it interprets and explores the model and critical path of digital supervision of China's medical insurance fund from the three dimensions of Public Value Proposition,Autho-rizing Environment,and Operational Capacity,which concludes that the key to digital supervision of medical insurance funds lies in the search for consistency and balance between the three of real-world value objectives.Digital regulation should be oriented towards public value creation and return to value rationality;strengthen institutional design and build a pluralistic governance pattern for digital regulation;and strengthen core capacity building to make up for the shortcomings of digital regulatory capacity.The public value of digital supervision should be created from three as-pects:concept optimization,support and guarantee,and capacity improvement.The public value of digital supervision should be created from three aspects:concept optimization,support and guarantee,and capacity improvement.