Objective To investigate the copy number changes on chromosome 3q26. 1 in urothelial carcinoma of the bladder, and to explore its potential clinical significance. Methods The microarray-based comparative genomic hybridization (Array-CGH) approach was used to analyze the genome-wide copy number changes of 35 tumor tissue samples of bladder cancer. To confirm the loss of a small fragment in 3q26. 1 detected by Array-CGH, real-time fluorescent quantitative polymerase chain reaction (real-time PCR) was performed with 57 frozen tumor tissue samples and 34 formalinfixed paraffin-embedded (FFPE) tumor tissue samples. The urine sediment cells collected from 15 healthy volunteers and 29 bladder cancer patients were checked as above. Results The Array-CGH data showed that the copy number loss of a small fragment in 3q26. 1 was detected in 77.1% (27/35)of the tumor tissue samples investigated. Real-time PCR analysis validated this loss of a small fragment of 3q26.1 with high frequencies in both 57 frozen tumor samples and 34 FFPE tumor samples.The percentage of samples exhibiting loss was 78.9% (45/57) and 100. 0% (34/34) respectively.Furthermore, the relative copy number of the 3q26.1 small fragment was significantly lower in the urinary sediment cells of the patients (median=0. 0020), comparing with that of healthy controls (median=0. 0030) (P＜0.01). Conclusions Loss of the small fragment in 3q26.1 could be a characteristic genetic change of urothelial carcinoma of the bladder. It may serve as a potential molecular marker for bladder cancer.

ObjectiveDouble-outlet right ventricle,which often associated with total anomalous pulmonary venous connection and complete endocardial cushion defects,has been considered a risk factor for biventricular repair procedure.To reviewed cases treated by biventricular repair for endocardial cushion defects with double outlet right ventricle.MethodsFrom July to November of 2009,6 patients (3 males and 3 females) aged from 7 to 24 (16.17±5.98) years and with endocardial cushion defects and double outlet right ventricle underwent operation of biventricular repair The duration of follow-up ranged from 10 days to 2 years(median,16 months).Endocardial cushion defects were repaired with a 2-patch technique.The artificial vascular patch was implanted to connect the ventricular septal defects and the aorta for draining the blood stream from the left ventricle to the aorta.The other patch was used to repair the ostium primum atrial septal defects.Right ventricular outflow tract obstructions was released and reconstructed by transplanting a bovine pericardium patch.If the size of pulmonary valve annulus was far more below the normal,a transannular pericardial patch was used.Rastelli procedure with a valved conduit between the right ventricle and the pulmonary artery would be performed if the obstruction in the right ventricular outfolw tract was severe.ResultsOne death occurred 2 days after the operation,resulting in a mortality rate of 16.6%.The case,a boy of 7 years old,had a mirror-image dextrocardia,complete endocardial cushion defect ( C type),anomalous pulmonary venous drainage and single atrium.In this case,the operation lasted for 8 hours,acute renal failure happened next day to the operation,the effect of CRRT was unsatisfied,and eventually cardiac arrest occurred as a result of hyperkalemia.The remaining cases had survived.Follow-up examinations showed that the systolic pressure gradients across the pulmonary valves decreased,with a range of 14 to 40 mm Hg,(23.9 ± 11.03) mm Hg.Mild mitral and tricuspid regurgiration were identified in 4 cases and moderate mitral regurgitation was identified in one case.The cardiac function in all patients was classified as NYHA class Ⅰ/Ⅱ,Conclusion Endocardial cushion defects with double outlet right ventricle can be corrected by means of biventricular repair procedure.The procedure was associated with a low mortality,The interim life quality of patients may be improved.The longterm outcomes should be further studied.

OBJECTIVETo assess the clinical effectiveness of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius.

METHODSAccording to Cochrane Systematic Review, Medline, Embase, Cochrane Li- brary, CNKI and CBM, randomised controlled trials (RCTs) of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius were searched for from 1966 to 2014. Data analysis was performed with the Cochrane Collaboration's RevMan 5.0 software.

RESULTSTotally 391 patients of 6 RCTs and 2 retrospective cohort studys were included and divided into volar plate group (187 cases) and radial column plate group (204 cases). Meta-analysis result showed: compared with radial column plate group, volar plate group had significant difference in recovery of wrist function [SMD = 0.74, 95% CI (0.47, 1.01), P < 0.00001], Gartland-Werley scores [SMD = -1.39, 95% CI (-2.24, -0.53), P = 0.001], postoperative neural in- jury [OR = 3.67, 95% CI (1.37, 9.84), P = 0.01 1 and postoperative wrist pain [OR = 0.32, 95% CI (0.13, 0.74), P = 0.008]. But no significant difference was identified in DASH scores [SMD = -0.36, 95% CI (-0.97, 0.26), P = 0.25], radiographic result assess- ment [SMD = -0.18, 95% CI (-0.53, 0.16), P = 0.3], postoperative grip strength [SMD = 0.71, 95% CI (-0.12, 1.54),P = 0.09], postoperative tendinous damage [OR = 0.31, 95% CI (0.10, 0.98), P = 0.05] and carpal tunnel syndrome [OR = 0.96, 95% CI (0.63, 1.48), P = 0.87].

CONCLUSIONCompared with radial column plate internal fixation, volar approach plate fixation for treat- ment of distal radius intra-articular fracture has advantage of recovery of joint functionand. However, the volar approach plate fix- ation was associated with a higher risk of long-term complications than the radial column approach plate fixation.

Bone Plates ; Fracture Fixation, Internal ; methods ; Humans ; Radius Fractures ; surgery

OBJECTIVETo investigate the species of Ligularia distributed in the northwestern China and their medicinal uses in the local area.

METHODField investigation, specimen collection, taxonomic study and datum check were adopted.

RESULTThere are 29 species and 1 varieties of Ligularia distributed in the northwestern China, and 18 species of them had been used as folk medicines with the function of resolving phlegm, relieving cough, clearing heat and toxins.

CONCLUSIONThe northwestern China is abundant in medicinal resource of Ligularia.

Anti-Asthmatic Agents ; isolation & purification ; pharmacology ; Antitussive Agents ; isolation & purification ; pharmacology ; Asteraceae ; chemistry ; classification ; China ; Conservation of Natural Resources ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Ecosystem ; Humans ; Hypnotics and Sedatives ; isolation & purification ; pharmacology ; Pharmacognosy ; Plants, Medicinal ; chemistry ; classification

ObjectiveTo assess the efficacy and safety of Xuebijing injection for the treatment of severe acute pancreatitis (SAP).Methods An extensive search of related literatures from the Cochrane Library, EMBASE, China Biology Medicine (CBM), CNKI, VIP and Wanfang data up to March 2014 was performed. Randomized controlled trials (RCTs) regarding Xuebijing injection for the treatment of SAP were collected regardless of languages. Jadad scale was taken for quality evaluation of the included studies by two researchers. The patients in control group were given conventional treatment, and those of the Xuebijing group were given Xuebijing injection on the top of conventional treatment. The Cochrane Collaboration RevMan 5.2 software was used for data analysis regarding the effect of Xuebijing injection on the mortality, incidence of complication, effective rate, the length of stay in hospital, and the safety of the drug in patients with SAP.Results A total of 15 published reports meeting the inclusion criteria were enrolled. The methodological quality of the trials was low. Meta analysis showed that the mortality in Xuebijing group was significantly lower [odds ratio (OR) = 0.37, 95% confidence interval (95%CI) =0.17 - 0.77,P = 0.008], and the incidence of complication was also significantly decreased (OR = 0.26, 95%CI =0.14 - 0.45,P< 0.000 01) as compared with those of control group. The effective rate in Xuebijing group was significantly higher than that of the control group [relative risk (RR) = 0.85, 95%CI = 0.80-0.91,P< 0.000 01]. The length of stay in hospital in Xuebijing group was significantly shorter than that of the control group [mean difference (MD) = -5.28, 95%CI = -6.69 to -3.86,P< 0.000 01]. Adverse reactions of Xuebijing injection were reported in 2 studies. The adverse reaction in one study was headache and nausea, which were relieved by adjusting the speed of intravenous infusion, and mild rash was reported in another case, and it disappeared after the withdrawal of Xuebijing. Conclusions The currently available evidence shows that Xuebijing injection may have some therapeutic effect on SAP. Because of the low methodological quality of the included trials, multi-center and high-quality RCTs with large sample sizes are needed to provide stronger evidence.

Objective To investigate the expression of serum angiopoietin-2 (Ang-2 ) and its clinical significance in patients with chronic heart failure (CHF).Methods The levels of serum Ang-2,N-terminal pro-B-type natriuretic peptide (NT-proBNP)and left ventricular ejection fraction (LVEF)were detected in 1 1 3 patients with CHF,who were divided into four groups according to New York Heart Association (NYHA:class Ⅰ,n=3 2;Ⅱ,n=30;Ⅲ,n=26;Ⅳ,n=25).Another 20 healthy volunteers for physical check-up were chosen as the control group.Results With the change of cardiac function (from Ⅰ to Ⅳ),the levels of plasma Ang-2 and NT-proBNP were increased significantly (P<0.05 ).The level of serum Ang-2 was positively correlated with NT-proBNP (r=0.774,P<0.001),but negatively correlated with left ventricular ejection fraction (r=-0.725,P<0.001).Conclusion The level of serum Ang-2 has a significant correlation with the severity of heart failure.Ang-2 is expected to be used to predict and evaluate the severity of CHF.

To study and analyze prevalence condition of hypertension and complicated cardiovascular risk factors in north Fujian rural area .Methods : By cluster sampling , an epidemiological questionnaire and physical ex‐amination were performed among 1784 residents using standardized survey method , who were ≥35 years from six towns and eight villages in north Fujian rural area from Jun 2013 to Mar 2014. Hypertension was diagnosed accord‐ing to The 2010 Chinese Guideline for the Prevention and Treatment of Hypertension , multivariate Logistic regres‐sion was used to analyze independent risk factors for hypertension in these subjects .Results : Prevalence rate of hy‐ pertension was 17.43% (31／1784 ) in north Fujian rural area .After population standardization , it＇s 23. 21%(18.66% in men and 16. 13% in women) , there was no significant difference in prevalence rate of hypertension be‐tween men and women in any age layer , P＞0. 05 all.Multivariate Logistic regression analysis indicated that age , overweight (BMI≥24 kg／m2 ) , high triglyceride and fasting blood glucose were independent risk factors for hyper‐tension in north Fujian rural area (OR＝1.107－2.096 , P＜0. 05 or ＜0. 01).Conclusion : Prevalence rate of hyper‐tension is high in north Fujian rural area , age , overweight , smoking , high triglyceride and fasting blood glucose are the main risk factors .

OBJECTIVETo review the efficacy of total anomalous pulmonary venous connection (TAPVC) repair and to conclude the factors impacting the peri-operative death rate.

METHODSThe clinical data of 145 infants under 1 year old who underwent the TAPVC repair from January 2001 to July 2008 was analyzed. There were 94 male and 51 female patients. The mean age when the repair was performed was (7 ± 3) months, and the average weight was (6.3 ± 1.6) kg. As to the pulmonary connection type, 77 patients were supracardiac (53.1%), 47 patients were cardiac (32.4%), 9 patients were intracardiac (6.2%), and the remaining 12 patients were mixed (8.3%). Pre-surgery echocardiography showed that 21 patients had pulmonary venous obstruction (12 patients were supracardiac type, 3 patients were cardiac type, 3 patients were intracardiac type, and 3 patients were mixed type).

RESULTSAll patients underwent two-ventricle anatomy correction (the cases of complex malformations had been excluded). Peri-operative mortality was 11.7% (17/145). Because of the significant improvement in the surgical techniques, anesthesiology, cardiopulmonary bypass and the management of ICU in January 2006, the population was divided into two groups: A (before January 2006) and B (after January 2006). Peri-operative mortality decreased from 19.0% in group A to 6.2% in group B(P = 0.020). After analysis, it was determined that the factors impacting mortality were which group the patient belongs to, whether he/she had preoperative pulmonary vein obstruction and how big the atril septel connection was. The operative technique to keep the anastomotic aperture adequate and prophylaxis pulmonary hypertensive episodes contributed to the improvement on the mortality rate. There had been no case of repeating the surgery because of pulmonary venous obstruction during peri-operative care period.

CONCLUSIONSImprovements of the surgical technique as well as the treatment in preoperative and postoperative have led to the reduction of the mortality. Preoperative pulmonary vein obstruction is still an important factor that contributes to early mortality.

Female ; Humans ; Infant ; Male ; Pulmonary Veins ; abnormalities ; surgery ; Retrospective Studies ; Treatment Outcome ; Vascular Diseases ; congenital ; surgery

OBJECTIVETo study the chemical constituents of radix and rhizome of Ligularia sagitta.

METHODIsolation and purification were carried out on the column chromatography of silica gel and sephadex LH -20. The structures were identified by spectral analysis.

RESULTSeven terpenoid compounds were isolated from the radix and rhizome of L. sagitta. Five of them are sesquiterpenoids, the structures were determined as 7alpha-hydroxy-9(10) -ene-1, 8-dioxo-6, 7-dihydrofuranoeremophilane (1), 1p, 10P3-epoxy-6beta, 8 beta-dihydroxy-eremophil7 (11) -en-12, 8alpha-olide (2) , 1-oxo-9-desoxycacalol (3), benzofuranoeremophil-l-ene (4) and bakkenolide (5); other two compounds belong to triterpenoid. 3p, 16P3-dihydroxy-12-oleanen-28-al (6) and lupeol (7).

CONCLUSIONCompoundsl-3 and 6 were: isolated from L. sagitta for the first time, and compounds 3 and 6 were obtained from Ligularia for the first time.

4-Butyrolactone ; analogs & derivatives ; chemistry ; isolation & purification ; Asteraceae ; chemistry ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Sesquiterpenes ; chemistry ; isolation & purification ; Terpenes ; chemistry ; isolation & purification

BACKGROUNDWhite blood cell count is an important index to the outcome of patients. In hospital, leukopenia is accompanied by high mortality, morbidity and treatment costs. However, in infectious diseases, the reasons responsible for leucopenia was not well elucidated. We investigated patients with gastrointestinal fistula to find risk factors for leukopenia.

METHODSA prospective case control investigation was carried out in the Gastrointestinal Fistula Center, General Surgical Institute of Jinling Hospital. Cases included gastrointestinal fistula patients with leukopenia (n = 98) and controls composed of gastrointestinal fistula patients with normal white blood cell count (n = 78). The two groups were compared for risk factors of leucopenia by statistical analysis.

RESULTSFactors associated with an increased risk for leukopenia included bacterial infection (25.5%) and hypoalbuminaemia (61.2%). Multivariable Logistic regression analysis identified bacterial infection (80%), urinary catheter (70%) and central vein catheter (60%) as the independent determinants for mortality in cases.

CONCLUSIONSIn patients with gastrointestinal fistula, two independent factors for leukopenia and three significant predictors of mortality were elucidated. We suggest that clinicians give patients more supportive management and apply prevention strategies to treat and prevent leukopenia.

Adult ; Aged ; Bacterial Infections ; complications ; Case-Control Studies ; Catheterization, Central Venous ; adverse effects ; Female ; Gastric Fistula ; complications ; Humans ; Intestinal Fistula ; complications ; Leukopenia ; etiology ; mortality ; Logistic Models ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Urinary Catheterization ; adverse effects