The 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR) catalyzes the conversion of HMG-CoA to mevalonate in mavalonic acid pathway, which is the first committed step for isoprenoid biosynthesis in plants. However, it still remains unclear whether HGMR gene plays a role in the isoprenoid biosynthesis in Dendrobium officinale, an endangered epiphytic orchid species. In the present study, a HMGR encoding gene, designed as DoHMGR1 (GenBank accession JX272632), was identified from D. officinale using the reverse transcription polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE) methods, for the first time. The full length cDNA of DoHMGR1 was 2 071 bp in length and encoded a 562-aa protein with a molecular weight of 59.73 kD and an isoelectric point (pI) of 6.18. The deduced DoHMGR1 protein, like other HMGR proteins, constituted four conserved domains (63-561, 147-551, 268-383 and 124-541) and two transmembrane motifs (42-64 and 85-107). Multiple sequence alignment and phylogenetic analyses demonstrated that DoHMGR1 had high identity (67%-89%) to a number of HMGR genes from various plants and was closely related to Vanda hybrid cultivar, rice and maize monocots. Real time quantitative PCR (qPCR) analysis revealed that DoHMGR1 was expressed in the three included organs. The transcripts were the most abundant in the roots with 2.13 fold over that in the leaves, followed by that in the stems with 1.98 fold. Molecular characterization of DoHMGR1 will be useful for further functional elucidation of the gene involving in isoprenoid biosynthesis pathway in D. officinale.
Base Sequence ; Cloning, Molecular ; DNA, Complementary ; genetics ; Dendrobium ; enzymology ; genetics ; Gene Expression Regulation, Plant ; Hydroxymethylglutaryl CoA Reductases ; genetics ; metabolism ; Molecular Weight ; Phylogeny ; Plant Leaves ; enzymology ; genetics ; Plant Roots ; enzymology ; genetics ; Plant Stems ; enzymology ; genetics ; Plants, Medicinal ; enzymology ; genetics ; Sequence Alignment ; Sequence Homology, Amino Acid

Objective To investigate the clinical significance of generalized epilepsy with febrile seizures plus(GEFS+ ). Methods The data of one family with GEFS+ were retrospectively analyzed by studying clinical manifestations, physical examinations, electroencephalogram(EEG), 24 hours dynamic EEG monitoring, et al. Some of the patients were examined by CT. Results Ⅳ 12, her chief complaints when admitted to hospital were frequent spasm for 3 days. She began to appear febrile seizures (FS) from 8 months after birth, and frequent generalized tonic - clonic FS appeared during that time. There were 36 people in 5 generations of the family including 14 patients (8 males and 6 females) ,aged from 4 years and 5 months to 82 years. FS presented in 8 cases (Ⅱ 2, Ⅲ1, Ⅲ4, Ⅲ6, Ⅳ1, Ⅳ11, Ⅳ17, Ⅴ2),febrile seizures plus(FS +) in 4 cases ( Ⅳ2, Ⅳ12, Ⅳ13, Ⅳ14), ES + and absence seizures in 1 case ( Ⅴ1 ), uncertain type in 1 case (Ⅰ2). The results of EEG indicated that 12 cases were normal and 4 cases with FS+ and 1 case with absence seizures had epileptic discharges. Apart form Ⅳ13, Ⅳ14 who were treated with magnesium valproate, the dosage for the other patients decreased, or medicine terminated or without medicine, and all the patients had no recurrence of seizures. The intelligence, movement development and neurological examinations of the family were all normal. Head CT scan of 3 cases were normal. Conclusions GEFS+ is autosomal dominant inheritance disease with conspicuous genetic heterogeneity and phenotypic heterogeneity. The apprehension of GEFS+ plays an important role in diagnosis and differential diagnosis of epilepsy in childhood.

Objective To analyse the follow-up of one family with generalized epilepsies with febrile seizures plus (GEFS +).Methods We conducted a family with GEFS + by sexs,ages, seizure manifestation,electroencephalogram (EEG),and so on.Results There were 36 people in 5 generations of the family in all,including 14 patients(8 cases were male and 16 cases were female).Their ages were from 4 years and 5 months to 8 years.There were 8 cases febrile seizures (FS),4 cases with FS + and 1 case with FS + and absence seizures in 13 patients except 1 case without adequate knowledge.The Results of ECG indicted that 12 cases were normaland 4 cases with FS + and 1 case with absence seizures had epileptic discharges.Conclusions GEFS + is a common kind of inherited epilepsic syndrome and occur in childhood.So it is greatly important for epileptic children to know GEFS +

Background A virtual reality simulator provides a novel training model for improving surgical skills in a variety of fields.They can simulate a variety of surgical scenarios to improve the overall skills required for endoscopic operations,and also record the operative process of trainees in real-time and allow for objective evaluation.At present,some simulators for transurethral resection of the prostate (TURP) are available.The utility of virtual reality simulators in training of transurethral prostatectomy was investigated.Methods Thirty-eight urologists were randomly selected to take part in a simulation based training of TURP using the TURPSimTM system.Pre and post-training global rate scale (GRS) scores and objective parameters recorded by the simulator were assessed.Then,questionnaires were filled out.Results Compared with baseline levels,the GRS scores of trainees increased (18.0±4.0 vs.12.4±4.2,P＜0.001),while the rate of capsule resection (26.3％±0.6％ vs.21.2％±0.4％,P ＜0.001),amount of blood loss ((125.8±86.3) ml vs.(83.7±41.6) ml,P ＜0.001),external sphincter injury (3.6±2.9 vs.2.0±2.0,P ＜0.001)decreased significantly after training.Most trainees were satisfied with the simulator based training and believed that the simulator accurately mimicked actual surgical procedures and could help improve their surgical skills.Conclusions As a new method of training on transurethral prostatectomy skills,training of TURP using a virtual simulator can help urologists improve their surgical skills and safety.Therefore,the application of the TURPSimTM system in education and training of urologic surgery is warranted.

Objective To evaluate the efficacy of argon surper-cryosurgery system (ASSS) in the treatment of huge hepatic multi-nidus carcinoma at advanced stage in cases of which conventional surgery is impossible. Methods Twenty-two patients with huge hepatic multi-nidus carcinoma at advanced stage, incurable with conventional surgery, were treated by ASSS in combination with entire or reduced-size excision. In terms of combined treatment, 1 patient received reduced-size operation and portal vein chemotherapeutic pump, 2 with entire excision and portal vein chemotherapeutic pump, 1 with entire excision and liver artery chemotherapeutic pump, 3 with only liver artery chemotherapeutic pump, and 6 with portal vein chemotherapeutic pump. Nine patients were simply treated by ASSS. Results The surgical procedures went smoothly in all cases and the complications, such as bleeding at the puncture aperturae, thorax effusion, bile leakage and liver cataphora, were successfully managed. The follow-up study was performed and all patients surived with the longest survival of 11 months up till now. Conclusions ASSS offers a new treatment method for huge hepatic multi-nidus carcinoma at advanced stage, but the indications must be carefully observed, and the surgical skills and prevention of complication are of great importance.

Objective To evaluate the efficacy of argon surper-cryosurgery system (ASSS) in the treatment of huge hepatic multi-nidus carcinoma at advanced stage in cases of which conventional surgery is impossible. Methods Twenty-two patients with huge hepatic multi-nidus carcinoma at advanced stage, incurable with conventional surgery, were treated by ASSS in combination with entire or reduced-size excision. In terms of combined treatment, 1 patient received reduced-size operation and portal vein chemotherapeutic pump, 2 with entire excision and portal vein chemotherapeutic pump, 1 with entire excision and liver artery chemotherapeutic pump, 3 with only liver artery chemotherapeutic pump, and 6 with portal vein chemotherapeutic pump. Nine patients were simply treated by ASSS. Results The surgical procedures went smoothly in all cases and the complications, such as bleeding at the puncture aperturae, thorax effusion, bile leakage and liver cataphora, were successfully managed. The follow-up study was performed and all patients surived with the longest survival of 11 months up till now. Conclusions ASSS offers a new treatment method for huge hepatic multi-nidus carcinoma at advanced stage, but the indications must be carefully observed, and the surgical skills and prevention of complication are of great importance.

BACKGROUNDThe need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC Mentor(TM) is designed to train the user in percutaneous renal collecting system access puncture. This study aimed to validate the use of this kind of simulator, in percutaneous renal access training.

METHODSTwenty-one urologists were enrolled as trainees to learn a fluoroscopy-guided percutaneous renal accessing technique. An assigned percutaneous renal access procedure was immediately performed on the PERC Mentor(TM) after watching instruction video and an analog operation. Objective parameters were recorded by the simulator and subjective global rating scale (GRS) score were determined. Simulation training followed and consisted of 2 hours daily training sessions for 2 consecutive days. Twenty-four hours after the training session, trainees were evaluated performing the same procedure. The post-training evaluation was compared to the evaluation of the initial attempt.

RESULTSDuring the initial attempt, none of the trainees could complete the appointed procedure due to the lack of experience in fluoroscopy-guided percutaneous renal access. After the short-term training, all trainees were able to independently complete the procedure. Of the 21 trainees, 10 had primitive experience in ultrasound-guided percutaneous nephrolithotomy. Trainees were thus categorized into the group of primitive experience and inexperience. The total operating time and amount of contrast material used were significantly lower in the group of primitive experience versus the inexperience group (P = 0.03 and 0.02, respectively).

CONCLUSIONSThe training on the virtual reality simulator, PERC Mentor(TM), can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently. This virtual reality simulator may become an important training and evaluation tool in teaching fluoroscopy-guided percutaneous renal access.

Adult ; Computer Simulation ; Computer-Assisted Instruction ; Fluoroscopy ; Humans ; Male ; Middle Aged ; Urologic Surgical Procedures ; education ; Urology ; education ; User-Computer Interface

OBJECTIVETo screen for the differential protein peaks of renal cell carcinoma (RCC) using magnetic beads-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS).

METHODSSerum proteins were profiled by magnetic beads (WCX) from 62 RCC patients and 37 patients with benign renal space-occupying lesions. Protein peaks were identified by MALDI-TOF-MS. Data were analyzed with Biomarker Wizard 3.1 and Biomarker Patterns Software 5.0. Diagnostic model for RCC was constructed based on 47 RCC cases and 26 patients with benign renal space-occupying lesions. The remaining 26 cases were evaluated with blind method.

RESULTSSeven differential protein peaks related to RCC were identified (Pβ0.05). The diagnostic model for RCC constructed by the differential protein peaks (m/z 2945.35, 15340.8, 6984.51, and 5819.23) generated excellent separation between the RCC and control groups, with a sensitivity of 83.0% and the specificity of 84.6%. As validated by blind method, the model had a sensitivity of 80.0% and a specificity of 81.8%.

CONCLUSIONDifferential protein peaks for RCC can be identified in serum by magnetic beads-based MALDI-TOF-MS, which is also valuable for the establishment of a RCC diagnostic model with a high sensitivity and specificity.

Adult ; Aged ; Biomarkers, Tumor ; blood ; Blood Proteins ; analysis ; Carcinoma, Renal Cell ; blood ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Proteomics ; methods ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods

BACKGROUNDA virtual reality simulator provides a novel training model for improving surgical skills in a variety of fields. They can simulate a variety of surgical scenarios to improve the overall skills required for endoscopic operations, and also record the operative process of trainees in real-time and allow for objective evaluation. At present, some simulators for transurethral resection of the prostate (TURP) are available. The utility of virtual reality simulators in training of transurethral prostatectomy was investigated.

METHODSThirty-eight urologists were randomly selected to take part in a simulation based training of TURP using the TURPSim(TM) system. Pre and post-training global rate scale (GRS) scores and objective parameters recorded by the simulator were assessed. Then, questionnaires were filled out.

RESULTSCompared with baseline levels, the GRS scores of trainees increased (18.0 ± 4.0 vs. 12.4 ± 4.2, P < 0.001), while the rate of capsule resection (26.3% ± 0.6% vs. 21.2% ± 0.4%, P < 0.001), amount of blood loss ((125.8 ± 86.3) ml vs. (83.7 ± 41.6) ml, P < 0.001), external sphincter injury (3.6 ± 2.9 vs. 2.0 ± 2.0, P < 0.001) decreased significantly after training. Most trainees were satisfied with the simulator based training and believed that the simulator accurately mimicked actual surgical procedures and could help improve their surgical skills.

CONCLUSIONSAs a new method of training on transurethral prostatectomy skills, training of TURP using a virtual simulator can help urologists improve their surgical skills and safety. Therefore, the application of the TURPSim(TM) system in education and training of urologic surgery is warranted.

Adult ; Computer Simulation ; Humans ; Male ; Transurethral Resection of Prostate ; education ; Urologic Surgical Procedures ; education ; Urology ; education

BACKGROUNDVirtual reality (VR) has been recognized as a useful modality in the training of surgical skills. With respect to basic endoscopic skill training of urology, we sought to investigate the effectiveness of the UroMentor(TM) virtual reality simulator (VRS) in the skill acquisition of flexible cystoscopy.

METHODSUrologists familiar with rigid cystoscopy procedures were selected to take part in a virtual training course of flexible cystoscopy. Changes in total operating time, frequency of injury, number of digital markers inside the bladder, and the global rating scale (GRS) scores were assessed following eight repeated training sessions on the UroMentor(TM).

RESULTSEighteen urologists voluntarily took part in the study. Total operating time was significantly lower after eight sessions of training by comparison ((111 ± 10) seconds and (511 ± 67) seconds, respectively; P < 0.001). Additionally, the frequency of injury decreased with training from (12 ± 2) times to (5 ± 1) times (P < 0.001), while the number of digital markers observed increased from 9 ± 0 to 10 ± 1 (P = 0.005). Finally, training with the UroMentor(TM) resulted in a GRS increase from (1.3 ± 0.2) points to (3.9 ± 0.2) points (P < 0.001).

CONCLUSIONthe VRS UroMentor(TM) can improve urologists' ability to perform flexible cystoscopy and could be used as an effective training tool for trainees.

Clinical Competence ; Computer Simulation ; Cystoscopy ; education ; Humans ; Urology ; education