Objective To quantitatively evaluate the left ventricular systolic synchrony in patients with chronic renal failure (CRF) by real-time three-dimensional echocardiography (RT-3DE). Methods Thirty patients with CRF and twenty-five normal subjects were enrolled in this study.The M-mode ejection fraction (M-EF), left ventricular end diastolic internal diameter (LVIDd), interventricular septum diameter (IVSd), left ventricular posterior wall diameter (LVPWd) were obtained on two-dimension. The global and regional volume-time curves were obtained on three -dimensional. The end diastolic volume (LVEDV),end systolic volume (LVESV) and ejection fraction (LVEF) of left ventricule, the time to minimal systolic volume (Tmsv) of 16,12,6-segmental standard deviation (Tmsv16, 12, 6-SD), maximal difference (Tmsv16, 12, 6-Dif) were derived from Qlab software . The above parameters as a percentage of the cardiac cycle with different heart rates between patients were also calculated from the Qlab software, which were Tmsv16, 12, 6-SD% and Tmsv16, 12, 6-Dif %, rspectively. Results The indices of HR, LVIDd, IVSd, LVPWd and LVESV were significantly higher while LVEF was significantly lower in the CRF group than those of the control group (P<0.05 or P<0.01); The indices of systolic asynchrony of Tmsv16,12-SD%, Tmsv16,12-Dif, Tmsv16 ,12 ,6-SD/R-R%,Tmsv16,12,6-Dif/R-R% were significantly larger in the CRF group than those of the control group(P<0.05 or P<0.01). Conclusions RT-3DE provides a simple, intuitional and noninvasive approach to assess the systolic synchrony of all the LV segments simultaneously and LVEF in patients with chronic renal failure.

ObjectiveTo evaluate the effect of preoperative percutaneous transhepatic biliary drainage (PTBD) on postoperative outcomes after pancreaticoduodenectomy.MethodsThe clinical data of 115 patients undergoing pancreatoduodenectomy between 2001 and 2009 were retrospectively analyzed.The diagnosis of periampullary cancer or cancer of the pancreatic head was confirmed histologically.The preoperative total bilirubin level was more than 100 μmol/L and there was no concomitant cholangitis.Forty-two patients underwent PTBD (PTBD group),and 73 were not drained (early operation group).The following parameters were analyzed:wound infection,intra-abdominal abscess,intra-abdominal or gastrointestinal bleeding,biliary or pancreatic leakage,gastroparesis,morbidity and mortality.The length of hospital stay and cost were also assessed.ResultsThe perioperative mortality and morbidity were 2.38％/54.76％ in the PTBD group and 2.74％/50.68％ in the early operative group,respectively.There were no significantly differences between these two groups.Similar results were obtained in biliary leak,pancreatic leak,intra-abdominal infection,wound infection and gastroparesis.The length of hospital stay and cost were significantly less in the early operation group than the PTBD group.ConclusionsPTBD had no beneficial effects on postoperative outcomes following pancreaticoduodenectomy.For distal biliary obstruction,PTBD should not be carried out routinely.

Objective To investigate the effect of hydrogen sulfide(H2S)on gene expression of adenosine triphosphate(ATP)-sensitive K+ channel(KATP)of aortic smooth muscle cells(ASMC)in rat.Methods Male Sprague-Dawley(SD)rats were used in the study.The original generation cells were obtained by modified tissue piece inoculation.The passaged cells were used.The ASMC were divided into 2 groups:H2S group of different dosages and control group.The contents of sodium hydrosulfide in the culture media of H2S group were 10-5,10-4 and 10-3 mol/L respectively,and the same volume of normal saline was added to control group.Each group was treated for 24 hours.Morphology of the cells was observed by inverted microscope and identified by immunohistochemical method employing ?-smooth muscle-actin.The expressions of SUR2B and Kir6.1 were identified by immunohistochemical SP technology.The SUR2B mRNA and Kir6.1 mRNA levels were assayed by real time fluorescence relative quantitative polymerase chain reaction.Results The passaged cells developed typical growth pattern peak and valley and the 97th percent of the cells expressed the smooth muscle specific differentiation marker ?-smooth muscle-actin.SUR2B and Kir6.1 could be detected in ASMC by immunohistochemical technology.They were both located at cytoplasmic and cytomembrane but not in at nucleus.Compared with control group,SUR2B mRNA and Kir6.1 mRNA levels in H2S groups were higher than those in control group in a dosage-dependent mode.Conclusions H2S can increased the expression KATP channel SUR2B mRNA and Kir6.1 mRNA levels of ASMC.J Appl Clin Pediatr,2009,24(1):21-23

Objective To investigate the function of soluble stem cell factor receptor(s-kit)and stem cell factor(SCF) in chronic aplastic anemia(CAA).Methods ELISA assay was employed to determine the levels of s-kit and SCF in peripheral blood of CAA patients and umbilical cord blood.Results The levels of s-kit and SCF in peripheral blood of CAA patients are lower than those of normal group and umbilical cord blood group.Conclusions The decreased levels of s-kit and SCF show that s-kit and SCF may play a role in CAA mechanism.The raised levels of s-kit and SCF show that s-kit and SCF may be applied in the field of cord blood transplantation.

Objective To investigate the value of Habib 4X in hepatic resection. Methods The clinical outcome of 21 patients with liver disease who received liver resection at the Tianjin Third Central Hospital from November 2009 to April 2010 were retrospectively evaluated. All the operations were carried out by using Habib 4X. Results All patients received hepatectomy, including right hepatectomy in three patients, left hepatectomy in one patient, multiple segmentectomy in nine patients, single segmentectomy in seven patients and partial liver resection in one patient. All tumors were reseeted completely. The mean operation time was (50±25) minutes and the mean blood loss was(129±117)ml. No patient was transferred to ICU. Three patients were complicated with bile leakage, one with lymphatic leakage and four with pleural effusion, and they were cured by non-surgical treatment. There were no patients with postoperative hemorrhage, incision infection or hepatic failure. No mortality was observed. The mean postoperative hospital stay was(19±14)days. Conclusions Radiofrequency energy was applied along the margins of the tumor to create zones of necrosis before resection with a scalpel, offering hepatobiliary surgeons an additional method for performing liver resections with minimal blood loss, low morbidity and mortality rates. As for malignant tumors, minor or major liver resection assisted by Habib 4X is safe, and it can reduce the chance of positive incisal margin.

Objective To study the value of transcatheter arterial chemoembolization (TACE)in combination with portal vein chemotherapy (PVC) after resection of hepatocellular carcinoma to prolong survival. Methods From January 2000 to July 2007, 168 patients with hepatocellular carcinoma (HCC) underwent tumor resection in our hospital. After operation, TACE in combination with PVC was performed in 48 patients (combined group), TACE alone in 26 (TACE group), PVC alone in 50 (PVC group) and none of the above in 44 (control group). All the patients were followed up for 17-96 months. The 1-, 3-and 5-year survival rates were compared among the 4 groups. Results Accumulative 1-, 3-and 5-year survival rates were higher in the combined and TACE groups than in PVC and control groups. Conclusion After resection of HCC, combined use of TACE and PVC is the same as TACE in prolonging patient survival. However, it is better than PVC alone and non-surgical procedure.

BACKGROUNDHereditary nonpolyposis colorectal cancer (HNPPC) is one of the most common genetic syndrome related with mutation of human mismatch repair genes. This study was to evaluate the clinical significance of suspected hereditary nonpolyposis colorectal cancer (sHNPCC) criteria I and the clinical and genetic features of International Collaborative Group-HNPCC (ICG-HNPCC) and sHNPCC families.

METHODSTwenty-nine ICG-HNPCC families fulfilling the Amsterdam criteria and 34 sHNPCC families fulfilling the sHNPCC criteria I were collected. PCR-SSCP and DNA sequencing analysis were employed to screen the germline mutations of the hMLH1 and hMSH2 genes in these families.

RESULTSThe ICG group had more colorectal cancer (CRC) patients per family than did the suspected group (P < 0.05). No statistical difference was observed in Lynch classification and familial tumor spectrum. In both groups of families, colorectal cancer was the most frequent malignancy, and carcinomas of the stomach, pancreas and uterus were the three most common extracolonic malignancies. Mutation screening showed that ICG-HNPCC and sHNPCC families had a similar mutation rate (31.0% vs 29.4%, P > 0.05), mutation type, and mutation distribution. Comparison of the families with and without mutation showed no significant difference in CRC patients per family, Lynch classification, and tumor spectrum.

CONCLUSIONSICG-HNPCC and sHNPCC families that have similar clinical manifestations and genetic basis indicate a similar nature for cancer development. The application of sHNPCC criteria I will facilitate clinical diagnosis and treatment of small families.

Adaptor Proteins, Signal Transducing ; Carrier Proteins ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; DNA-Binding Proteins ; genetics ; Humans ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; Mutation ; Neoplasm Proteins ; genetics ; Nuclear Proteins ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Proto-Oncogene Proteins ; genetics

Aim To study inhibitory effect of 5-fluorouracil encapsulated by galactosylceramide liposomes (5-Fu-GCL)on 5-Fu-resistent HepG_2 cells and its mechanisms. Methods Inhibitory effect of 5-Fu-GCL on established model of 5-Fu-resistant HepG_2 cells was assessed with MTT assay in vitro. The concentration-time course of 5-Fu-GCL in intracellular fluid was detected with high performance liquid chromatography (HPLC). Thymidylic acid synthase (TS) expression was observed with immunohistochemical method,and NO content was determined with chemical method. Results Obvious inhibitory effects of 5-Fu-GCL (75,150,300,600,1200?mol?L-1) on 5-Fu-resistant HepG_2 cells were observed with IC_ 50 of 158.6 ?mol?L-1,far lower than that of free 5-Fu (400.9 ?mol?L-1). 5-Fu-GCL (300 ?mol?L-1) inhibited 5-Fu-resistant HepG_2 cells in a time-dependent manner,and the inhibitory effect of 5-Fu-GCL was stronger than that of free 5-Fu during 12～48 h. Compared with free 5-Fu,5-Fu-GCL (300 ?mol?L-1) increased the content of intracellular fluid in 5-Fu-resistant HepG_2 cells. 5-Fu-GCL(62.5,300,1200 ?mol?L-1) not only inhibited the expression of TS,but also increased the production of NO in 5-Fu-resistant HepG_2 cells,and these effects of 5-Fu-GCL(300,1200 ?mol?L-1) were stronger than those of free 5-Fu. Conclusion 5-Fu-GCL has inhibitory effect on 5-Fu-resistant HepG_2 cells. The effect may be related to the increased concentration of 5-Fu-GCL in intracellular fluid,inhibited expression of TS and increased production of NO.

To improve the efficiency of halophilic actinobacteria screening and carry out the rapid selection of targeted strains, we tested 34 strains of Streptomonospora by PCR-single strand conformation polymorphism analysis (PCR-SSCP) based on genus-specific primers for the PCR identification. This approach employs PCR with two pairs of primers located in the 16S rRNA sequence flanking two variable region, then build clustering tree according as SSCP data. Synchronously, we sequenced all the 16S rRNA partial sequences for these strains to verify them. The results showed that the PCR-SSCP analysis was an efficient, easy-to-handle and economic method for rapid selection of halophilic actinobacteria resources.

Objective To investigate the association between ten single nucleotide polymorphism (SNP) in the peroxisome proliferator-aetivated receptor (PPAR) α/δ/γ and essential hypertension (EH).Methods Participants were recruited within the framework of a cohort populations survey from the PMMJS (Prevention of Multiple Metabolic Disorders and MS in Jiangsu Province) which was conducted in the urban community of Jiangsu province from 1999 to 2007.Eight handred and twenty subjects (551 non-hypertensive subjects,269 hypertensive subjects) were randomly selected but were not related to each other.Ten SN P ( rs 135539,rs1800206,rs4253778 of PPAR αt; rs2016520,rs9794 of PPARδ ; rs10865710,rs1805192,rs4684847,rs709158 and rs3856806 of PPARγ ) were selected from the HapMap database.x2 test was used to determine whether the whole population was in H-W genetic equilibrium.SHEsis software was used to examine the relations of SNP and linkage equilibrium.Logistic regression model was used to examine the association between ten SNP in the PPAR and EH.Results Difference on the distribution of four SNP genotypes including rs1800206,rs9794,rsl0865710 and rs4684847 between high blood pressure and non-high blood pressure group,high systolic blood pressure(SBP) and normal SBP group,high diastolic blood pressure(DBP) and normal DBP group was significant (P＜0.05).After adjusting factors as age,sex,body mass index,fasting plasma glucose,high density lipoprotein cholesterol-C,high-fat diet and compared with wildtype gene carriers,the OR(95％ CI) of objects with rs1800206 V allele appeared in high blood pressure,high SBP and high DBP were 0.60 (0A1-0.89),0.57 (0.37-0.88) and 0.61 (0.39-0.96),respectively.The OR(95％CI) of objects with G allele of rs9794 were 0.63 (0.46-0.87),0.51 (0.36-0.73) and 0.68(0.47-1.01).The OR (95％CI) of objects with G allele of rs10865710 were 1.62 (1.19-2.20),1.59(1.14-2.22) and 1.53 ( 1.07-2.18),respectively.While the OR (95％ CI) of objects with rs4684847 T allele were 1.42 ( 1.04-1.94),1.38 (1.03-1.92) and 1.37 ( 1.00-1.88),respectively.Conclusion The four SNPs including rs1800206 of PPARα,rs9794 of PPARδ and rs4684847,rs10865710 of PPARγ influenced high blood pressure,high SBP and high DBP to different degrees.