Objective To study the prevalence of dilated cardiomyopathy and the quasi-latent Keshan disease in villages of non-endemic areas of six Keshan disease endemic provinces in China,and to provide reference values for proposing a elimination standard of keshan disease.Methods County,township and village was selected as the study area by using multi-stage sampling in non-Keshan disease areas of Sichuan,Shanxi,Henan,Shandong and in Keshan disease areas of Chongqing and Yunnan.In each county two townships were selected and in each township one village was chosen.The residents of the villages sampled were surveyed by questionnaire,physical examination,electrocardiogram (ECG) and cardiac echocardiography.Suspected dilated cardiomyopathy patients had chest X-ray.Dilated cardiomyopathy patients were diagnosed according to the criteria proposed by 2006 World Health Organization/International Society and Federation of Cardiology (WHO/ISFC).Results The number of investigated villages was 126 and 54 139 people were surveyed by questionnaire and clinical examination.Ten patients with dilated cardiomyopathy were found,the prevalence was 18.47/100 000(10/54 139),and its 95％ confidence interval was 18.11/100 000-18.84/100 000.A total of 197 patients with quasi-latent Keshan disease were found,the prevalence was 363.88/100 000 (197/54 139),and its 95％ confidence interval was 362.27/100 000-365.49/ 100 000.The prevalence of male quasi-latent Keshan disease was 353.34/100 000(83/23 490) and of female was 372.07/100 000(114/30 639).The number of subjects with normal and abnormal ECG was 45 222 and 8917,respectively,and the rate of abnormal ECG was 16.47％.The highest rate of abnormal ECG was 38.28％ (1585/4141) in Chongqing.The lowest rate of abnormal ECG was 8.10％ (1175/14 507) in Yunnan.The highest detection rate of T wave and ST segment changes was 4.67％ (2528/54 139).In abnormal ECG indices,the detection rate of Henan,Shandong and Chongqing was higher,and all of them were higher than 10.0％.Conclusions We suggest that the reference baselines of dilated cardiomyopathy and quasi-latent Keshan disease in Keshan disease areas of the six provinces in the south of China be 18.47/100 000 and 363.88/100 000,respectively.

Pristimeim, as one major active chemical component of traditional Chinese medicine Celastrus aculeatus Men., has been reported to have pharmacological activities such as broad spectrum anti-tumor and anti-rheumatoid arthritis in recent years. In this article, we review the research articles of pristimerin on the characteristics and molecular mechanism of its pharmacological effects, aiming to make a reference for new drug development and clinical application.

OBJECTIVETo evaluate the protective effect of licoflavone on gastric mucosa in rats with chronic superficial gastritis and explore the possible mechanism.

METHODSSD rat models of chronic superficial gastritis was established by intragastric administration of 0.02% ammonia and long-term irregular diet. The rat models were then randomized into model group, vitacoenzyme group and 3 licoflavone groups of high, medium, and low doses. After 30 days of treatment, the gastric histopathology, mucosal lesions, scanning electron microscopy, mucin function production by the gastric mucosa epithelial cells, serum PGE(2) level and gastric microcirculation were assessed to evaluate the protective effect of licoflavone on gastric mucosa.

RESULTSCompared with normal control rats, the rat models of chronic superficial gastritis showed significantly higher gastric mucosal injury rate, histopathological scores and gastric mucin content. Licoflavone significantly ameliorated gastric pathology and increased serum PGE(2) level, enhanced acidic mucin secretion by the epithelial cells, and improved gastric microcirculation in the rat models.

CONCLUSIONLicoflavone feeding suppresses gastric mucosa injury, protects and restores the injured mucosa in rats with chronic superficial gastritis, and these effects are related with the up-regulation of serum PGE(2) level.

Animals ; Chronic Disease ; Dinoprostone ; blood ; Epithelial Cells ; secretion ; Female ; Flavones ; pharmacology ; Gastric Mucosa ; drug effects ; pathology ; Gastritis ; pathology ; Male ; Microcirculation ; Mucins ; secretion ; Rats ; Rats, Sprague-Dawley

Objective To systematically evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in perioperative management of pancreatectomy.Methods Literatures were researched using CNKI,Wanfang database,VIP database,PubMed,Cochrane Library,Embase from January 1990 to March 2018 with the key words including "快速康复外科,加速康复外科,胰腺切除术,胰十二指肠切除术,惠普而术,ERAS,enhanced recovery,fast track,pancreatic surgery,pancreatectomy,Whipple,pancreatoduodenectomy,pancreatoduodenal resection".The cohort study about ERAS in elective pancreatic surgery or pancreaticoduodenectomy were received and enrolled.The patients using ERAS in perioperative management and using traditional perioperative management were respectively allocated into the ERAS group and control group.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Count data were described as odds ratio (OR) and 95％ confidence interval (CI).Weighted Mean Difference (WMD) was used as a consolidated statistics for measurement data that were measured using the same tool,and standardized mean difference (SMD) was used as a consolidated statistics for measurement data that were measured using the different tools.The heterogeneity of the studied was analyzed using the I2 test.Results Nineteen retrospective cohort studies were enrolled in the Meta analysis,and total sample size was 3 699 patients,including 1 823 in the ERAS group and 1 876 in the control group.The results of Meta analysis showed that there were statistically significant differences in the time of postoperative nasogastric tube removal,time for postoperative solid diet intake,time of postoperative defecation recovery,incidence of postoperative overall complications,incidence of postoperative delayed gastric emptying,incidence of postoperative intra-abdominal infection,duration of postoperative hospital stay and hospital expenses between ERAS group and control group (WMD=-1.70,-3.61,-0.86,OR =0.65,0.60,0.70,WMD=-4.64,SMD=-0.48,95％CI:-2.97--0.42,-4.70--2.53,-1.01--0.71,0.52-0.81,0.45-0.80,0.54-0.91,-5.91--3.38,-0.77--0.18,P ＜ 0.05).There was no statistically significant difference in the operation time,volume of intraoperative blood loss,incidence of postoperative pancreatic fistula,incidence of postoperative wound infection,readmission rate,reoperation rate and mortality between ERAS group and control group (WMD=-9.73,-14.39,OR=0.85,0.72,1.05,0.81,0.74,95％CI:-34.24-14.78,-116.96-88.17,0.72-1.01,0.46-1.14,0.83-1.32,0.58-1.13,0.53-1.02,P＞0.05).The results of subgroup analysis showed that heterogeneity of data was from eastern and western countries.Conclusion ERAS in the perioperative management of pancreatectomy is safe and feasible,it can also promote postoperative recovery of patients and reduce incidence of complications and financial burden.

Background: Epidermal growth factor receptor (EGFR) mutations, including a known exon 19 deletion (19 del) and exon 21 L858R point mutation (L858R mutation), are strong predictors of the response to EGFR tyrosine kinase inhibi?tor (EGFR?TKI) treatment in lung adenocarcinoma. However, whether patients carrying EGFR 19 del and L858R muta?tions exhibit different responsiveness to EGFR?TKIs and what are the potential mechanism for this difference remain controversial. This study aimed to investigate the clinical outcomes of EGFR?TKI treatment in patients with EGFR 19 del and L858R mutations and explore the genetic heterogeneity of tumors with the two mutation subtypes. Methods: Of 1127 patients with advanced lung adenocarcinoma harboring EGFR 19 del or L858R mutations, 532 received EGFR?TKI treatment and were included in this study. EGFR 19 del and L858R mutations were detected by using denaturing high?performance liquid chromatography (DHPLC). T790M mutation, which is a common resistant mutation on exon 20 of EGFR, was detected by amplification refractory mutation system (ARMS). Next?generation sequencing (NGS) was used to explore the genetic heterogeneity of tumors with EGFR 19 del and L858R mutations. Results: Of the 532 patients, 319 (60.0%) had EGFR 19 del, and 213 (40.0%) had L858R mutations. The patients with EGFR 19 del presented a significantly higher overall response rate (ORR) for EGFR?TKI treatment (55.2% vs. 43.7%, P = 0.017) and had a longer progression?free survival (PFS) after first?line EGFR?TKI treatment (14.4 vs. 11.4 months,P= 0.034) compared with those with L858R mutations. However, no statistically significant difference in overall survival (OS) was observed between the two groups of patients. T790M mutation status was analyzed in 88 patients before EGFR?TKI treatment and 134 after EGFR?TKI treatment, and there was no significant difference in the co?exist?ence of T790M mutation with EGFR 19 del and L858R mutations before EGFR?TKI treatment (5.6% vs. 8.8%, P = 0.554)or after treatment (24.4% vs. 35.4%, P= 0.176). In addition, 24 patients with EGFR 19 del and 19 with L858R mutations were analyzed by NGS, and no significant difference in the presence of multiple somatic mutations was observed between the two genotypes. Conclusions: Patients with EGFR 19 del exhibit longer PFS and higher ORR compared with those with L858R muta?tions. Whether the heterogeneity of tumors with EGFR 19 del and L858R mutations contribute to a therapeutic response difference needs further investigation.

OBJECTIVETo construct the eukaryotic expression vectors of human cyclin D1 gene and express them in poorly differentiated nasopharyngeal carcinoma cells (CNE-2Z cells).

METHODSThe full-length cyclin D1 was cloned from CNE-2Z cells by RT-PCR. The cDNA fragments were inserted into pIRES2-EGFP plasmids and pEGFP-C2 plasmids and confirmed by restriction enzyme digestion, PCR and sequencing. The recombinant vectors were transfected into CNE-2Z cells via Lipofectamine 2000, and the expression of cyclin D1 in the cells was examined by immunofluorescence and Western blotting.

RESULTSAgarose gel electrophoresis showed a 918 bp band of the RT-PCR products, which matched the expected size. Restriction enzyme digestion, PCR and sequencing demonstrated successful construction of the recombinant vectors. CNE-2Z cells transfected with the recombinant vectors expressed cyclin D1 protein or cyclin D1-GFP protein as were verified by immunofluorescence and Western blotting.

CONCLUSIONWe have cloned cyclin D1 gene and constructed its eukaryotic expression vectors that can be expressed in nasopharyngeal carcinoma cells, which may facilitate the study of the role of cyclin D1 in the development of nasopharyngeal carcinoma.

Cell Line, Tumor ; Cloning, Molecular ; Cyclin D1 ; biosynthesis ; genetics ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Humans ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Plasmids ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection

OBJECTIVETo study high altitude environment affecting on worker's health

METHODSUsing the cohort study, the altitude reaction was investigated and the WBC, RBC, Hb and oxygenation indexes were measured on workers in several periods, namely, acclimatization period, initially arrived high altitude and resident 90 days.

RESULTSThe 83.3% of men had altitude reactions with different kinds at initially arrived high altitude. The headache was the most. The rate of abnormal blood pressure increased with altitude and resident time (P < 0.01). The rate of 90 day's group was 41.7%. The rise of diastole pressure was obvious (P < 0.01). As the beginning of arrived highland, the increase of WBC, RBC were significant (P < 0.01). The increase of Hb appeared only in 90 day's group. The level of malondialdehyde (MDA) obviously increased during acclimatization period and increased with altitude and resident time (P < 0.01). The activity of catalase (CAT), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) increased significantly in 90 day's group [(222.36 +/- 36.52) x 10(3) U/L, (158.49 +/- 14.42) U/L, (45.74 +/- 8.31) NU/ml respectively] (P < 0.01).

CONCLUSIONThe high altitude environment may result in the abnormal blood pressure, the rise of diastolic pressure was important. It lead to the increase of WBC, RBC, Hb. It initiated activity of oxygenation reaction. The symptoms of headache, dizziness, loss of appetite and insomnia appeared as working in high altitude environment.

Acclimatization ; physiology ; Adult ; Altitude ; Altitude Sickness ; blood ; Blood Pressure ; physiology ; Cohort Studies ; Erythrocyte Count ; Health Occupations ; Humans ; Leukocyte Count ; Middle Aged

OBJECTIVETo evaluate the clinical value of radial endorectal ultrasound (ERUS) in the assessment of preoperative staging of rectal carcinoma.

METHODSOne hundred and ten patients with rectal cancer underwent preoperative endorectal ultrasound (ERUS) examination in our hospital from February 2010 to September 2011. ERUS was performed using a Hitachi 900, Hitachi HI Vision Preirus US scanner, with a 5 - 10 MHz rigid rotating radial transducer and a focal length of 2 - 5 cm. The size, shape, echo pattern, infiltration depth, degree of circumferential involvement, extra-rectal invasion of the lesions and lymph node involvement were observed. The results of ERUS staging were compared with histopathological findings of the surgical specimens.

RESULTSThe accuracy of ERUS for T staging was 91.4%. The accuracy of ERUS in diagnosing stage T1, T2, T3, T4 cancers was 92.7%, 88.2%, 88.2% and 96.4%, respectively. The sensitivity of ERUS in diagnosing stage T1, T2, T3, T4 cancers was 92.3%, 72.7%, 85.4% and 71.4%, respectively. The specificity of ERUS in diagnosing stage T1, T2, T3, T4 cancer was 92.9%, 92.0%, 90.3% and 100.0%, respectively. Comparing the consistency of preoperative T-staging and postoperative pathological results, the Kappa value was 0.75, with a considerable consistency. The sensitivity, specificity, and accuracy of ERUS in the assessment of lymph node metastasis were 74.2%, 89.9% and 85.5%, respectively. Comparing the consistency of preoperative N-staging and postoperative pathological results, the Kappa value was 0.64, with a considerable consistency.

CONCLUSIONSERUS is a practical and accurate tool in assessment of preoperative staging of rectal tumors in regard to tumor invasion depth (T) and regional lymph node status (N), with advantages of simple operation, less pain, and high accuracy.

Adult ; Aged ; Endosonography ; methods ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Preoperative Period ; Rectal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Rectum ; diagnostic imaging ; pathology ; surgery

OBJECTIVESTo review the preliminary clinical experience with high-field-strength intraoperative magnetic resonance imaging (iMRI) suite with neuronavigation system in the pituitary adenoma operation with transsphenoidal approach.

METHODSFrom March 2009 to December 2010, 31 patients [range, 29 - 76 years, mean age (47 ± 11) years]of pituitary adenoma were operated with transsphenoidal approach and intraoperatively with a movable 1.5 T high-field-strength iMRI suite in combination with neuronavigation system. Tumor size was 1.8 - 7.3 cm, mean (3.5 ± 1.2) cm. Twenty-five cases were non-functional pituitary adenoma, 4 cases were prolactin-secreting pituitary adenoma, 2 cases were growth hormone-secreting pituitary adenoma. Thirty patients' resection with transnasal transsphenoidal approach were performed, one patient with transoral transsphenoidal approach was performed.

RESULTSIn 12 cases of 30 patients who planed to totally remove tumor, iMRI had revealed residual lesions and resulted in the change of the surgical strategy, 2 invasive cavernous sinus cases no further resection of the tumor because of internal carotid artery encasement, the other 10 cases resected further, eventually. Finally, 8 cases were totally removed. The ratio of total removal tumor was enhanced to 86.7% (26/30) from 60.0% (18/30). There was no perioperative mortality.

CONCLUSIONSHigh-field-strength iMRI suite with neuronavigation system provides valuable information of tumor resection that allows intraoperative modification of the surgical strategy. It could be very helpful to maximize the resection of the pituitary adenoma and minimize the injury to neurological function.

Adenoma ; surgery ; Adult ; Aged ; Cavernous Sinus ; surgery ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Neuronavigation ; methods ; Pituitary Neoplasms ; surgery

Primary Sj?gren′s syndrome(pSS)is a chronic autoimmune disease which is characterized by exocrine gland dam-age.Studies have found that pSS is associated with a variety of autoantibodies,including anti-Ro/SSA,-La/SSB,-M3R,-α-fodrin,-AD-AMTS13,-NA-14,-IFN-γ,-REG Iα,-MDM2.In this paper,we reviewed the progress of autoantibodies in the diagnosis,disease prediction and pathogenesis of pSS in recent years,so as to provide new ideas for pSS clinical and scientific research.