Objective To investigate the genetic variants in the protein C (PC) and endothelial protein C receptor (EPCR) genes associated with the risk and outcome of acute respiratory distress syndrome (ARDS) patients in Chinese Han race.Methods Five tagSNPs (single nucleotide polymorphism,SNP) in the PC and EPCR genes were genotyped in patients with ARDS (n =275) and non-ARDS (n =337) in order to find the association between them in this case-control study.The SNPs were genotyped by SNPstream Beckman platform.Then,the correlation between the associated SNPs and plasma levels of activated protein C (APC) in patients with ARDS was investigated.The APC levels were measured using enzyme linked immunosorbent assay (ELISA) method.Results Association analysis rcvealed that two PC SNPs in perfect linkage disequilibrium,rs1799809 and rs1158867,were significantly associated with susceptibility to ARDS.T allele frequency of rs1799809 in ARDS patients was significantly higher than that in non-ARDS patients (OR =1.569,95％ CI:1.192-2.066).And the genotype frequencies of rs1799809 were also significantly different between these two groups (P =0.007).The association remained significant after adjustment for multiple comparisons.Haplotype consisting of three SNPs in the PC gene was also associated with susceptibility to ARDS.The frequency of haplotype CCC in the ARDS samples was significantly lower than that in the non-ARDS group (P ＜ 0.01).Moreover,ARDS patients canrying rs1799809 TT genotype showed lower serum levels of APC than patients with TC and CC genotypes (Padj =0.02).However,genotype and allele analyses of EPCR did not show any significant difference between ARDS and non-ARDS patients.Conclusions These findings indicated that common genetic variation in the PC gene was significantly associated with susceptibility to ARDS in Chinese Han race.The PC genetic variation influenced plasma concentration of APC in patients with ARDS.

AIM: To evaluate intraocular pressure (IOP) control and visual rehabilitation after placement of the Ex-press(R)miniature glaucoma shunt with adjunctive amniotic membrane transplantation (AMT) and mitomycin C (MMC) in patients with post-traumatic open-angle glaucoma during 2y of follow up.METHODS: This was an interventional,2-year,observational study.Eighteen eyes were prospectively observed (in 18 patients with traumatic secondary open-angle glaucoma) in which Ex-press miniature glaucoma filtration shunts were implanted with AMT and MMC.The outcome measures included intraocular pressure (IOP),best corrected visual acuity (BCVA),number of antiglaucoma medications,and complications.The progress of all patients was monitored for 24mo.RESULTS: Complete success (IOP <21 mmHg without glaucoma medications) was seen in 15 of the 17 (88.2%) eyes enrolled in the study at 24mo after the operation.IOP decreased from 36.9±4.8 mmHg preoperatively to 15.4±3.5 mmHg at 12mo and 15.5±3.5 mmHg at 24mo postoperatively.Early postoperative hypertension developed in two patients (11.1%) due to postoperative fibrosis.Most of the patients had improved postoperative BCVA values at the final follow-up visit compared to their preoperative measurements.Two patients (11.1%) developed transient hypotony.There were no complications such as hyphema,choroidal effusion,shallow anterior chamber,the device touching the iris,or extrusion of the device.CONCLUSION: The Ex-press miniature glaucoma filtration shunt with adjunctive AMT and MMC is effective and safe in cases of traumatic open-angle glaucoma.Surgical management is an appropriate surgical treatment in this series of cases.

Objective To establish the platelet antigen panel for identifying the specificity of platelet antibodies which cause platelet transfusion refractoriness and neonatal alloimmune thrombocytopenia and provide evidence for clinical therapy and platelet genotyping research.Methods Based on the frequency distribution of human platelet alloantigen (HPA)-1 to HPA-16 gene in China, the frequencies of HPA-1 to HPA-6,HPA-15 alleles in blood group O donors were genotyped by the polymerase chain reaction with sequence-specific primers (PCR-SSP) method, and suitable donors were chosen to establish platelet-specific antigen panel.Using the established platelet-specific antigen panel, the specificity of platelet antibodies caused by alloimmune reaction was identified by using simplified sensitized erythrocyte platelet serology assay (SEPSA).Results Eleven ptatelet donors with blood group O were chosen to establish platelet-specific antigen panel which can identify specificity of HPA-1 to HPA-6, HPA-15 antibodies.One case of HPA-4b (Penb) and two cases of HPA-15a (Govb) platelet specific antibodies were detected in 1 120 samples.Conclusion Identifying the specific platelet antibodies using platelet specific antigen panel has profound significance on increasing the safety and effectiveness of clinical platelet transfusion and prevention of neonatal alloimmune thrombocytopenia.

Objective To explore the reasons why patients with Keshan disesse complicated with hypertension and their interaction in Fuyu County, Heilongjiang Province. Methods Fifty-three patients with Keshan disease were investigated in January, April and July in 2007. Blood pressure was measured and the risk factors of hypertension were investigated. According to the diagnostic criteria of hypertension, patients were divided into hypertension group and non-hypertension group, and then the risk factors of hypertension, as well as the course of Keshan disease, were compared between the two groups. The risk factors include age, gender, family history of hypertension, salt intake in diet, smoking, drinking and obesity. Results The age of hypertension group[(57.83±8.89)years] was significantly higher than that of non-hypertension group [(51.53 ± 9.43)years, t = 2.3630, P < 0.05) ;while the course of Keshan disease in non-hypertension group [(31.63 ± 8.66)years] was notably longer than that in hypertension group [(25.08±11.41)years, t = 2.0224, P < 0.05] ;No statistically significant difference in gender, family history of hypertension, salt intake in diet, smoking, drinking and obesity was observed between the two groups(χ2 = 0.0072,0.1779,0.0029,0.1555,0.119,0.7679, all P > 0.05). Conclusions Age might be an important factor in patients with Keshan disease accompanied by hypertension, and the role of other risk factors of hypertension should not be overlooked;whether Keshan disease and hypertension can affect each other needs further investigation.

Objective To explore the correlation between plantar pressure and walking function in hemiplegic stroke patients.Methods Thirty hemiplegic patients with stroke (a hemiplegic group) and thirty age-matched healthy persons (a control group) were recruited.Gait and balance function training and assessment system (model:AL-600) were used to quantify the walking velocity,peak plantar pressure at heel-strike and push-off periods and displacement of center of pressure (DCOP) of all subjects during walking.The asymmetry of gait was calculated.Two independent sample t-test were used to compare the walking velocity,peak plantar pressure and DCOP for the two groups.Pearson correlation coefficients were applied to analyze the correlation between the walking velocity and peak plantar pressure and DCOP.Results The walking velocity,the peak plantar pressure at heel-strike and push-off periods and DCOP of the hemiplegic group were significantly lower than the control group.In the hemiplegic group,the asymmetry of peak plantar pressure and DCOPx significantly increased,while that of DCOPy became bigger without significant difference.Moreover,the walking capacity of the hemiplegic group was positively correlated with the peak plantar pressure and DCOP.Conclusion Among hemiplegic stroke patients,both the peak plantar pressure at heel-strike and push-off periods lower in a way.Their capacity of weight transfer decreases,which is closely related to their walking velocity.

Objective To observe the surface structures of cardiovascular endothelial cells in situ with atomic force microscope (AFM). Methods Fresh aorta and aortic valve were dissected from 10 healthy male New Zealand white rabbits. Before fixed in 1% formaldehyde, the fresh tissues were washed in the buffer phosphate solution. Under general microscope, the fixed aorta or valve was spread on the double side stick tape which had already been stuck on the glass slide. The intima of aorta or the aorta side of valve was towards upside. Then the specimen was dried under 37 degrees centigrade in an attemperator and was washed with pure water. After dried again, the specimen was loaded on the platform ofNanoScope llla AFM and was scanned in tapping mode with the scanning speed of 0.5 HZ. Results The surface structures of endothelial cell on the fixed and dried tissue could be obsserved clearly in situ with AFM. Aortic endothclial cells were large, branched and arranged sparsely and parallel to the direction of blood flow, whereas endothelial cells on aorta valve surface were small, less branched and arranged intensively and vertical to the direction of blood flow. When the scanning range was dwindled, granular ultra-structures could be observed on the surface of endothelial cells, and, as the scanning range was dwindled further, fissure and convolution could be seen on the surface of granules from aortic endothelial cells. Centre cavity and surrounding swelling volcano-like structure could be seen on the surface of granules from endothelial cells of aortic valve. Conclusions It's feasible to observe the surface ultra-structures of cardiovascular endothelial cells in situ with AFM and morphological information provided by A FM might be of clinical value in future histopathological diagnosis.

BACKGROUNDThe lung functional status could be displayed on lung perfusion images. With the images, the radiotherapy plans of lung cancer could be guided to more optimized. This study aimed to assess quantitatively the impact of incorporating functional lung imaging into 3-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiation therapy (IMRT) planning for non-small cell lung cancer (NSCLC).

METHODSTen patients with NSCLC who had undergone radiotherapy were included in this study. Before radiotherapy, each patient underwent CT simulation and lung perfusion imaging with single photon emission computed tomography (SPECT). The SPECT images were registered with simulation planning CT and used to contour functional lung (lung-F) and non-functional lung (lung-NF). Two 3DCRT plans and two IMRT plans were designed and compared in each patient: two anatomic plans using simulation CT alone and two functional plans using SPECT-CT in addition to the simulation CT. Dosimetric parameters of the four types of plans were compared in terms of tumor coverage and avoidance of normal tissues. Total radiation dose was set at 66 Gy (2 Gy x 33 fractions).

RESULTSIn incorporating perfusion information in 3DCRT and IMRT planning, the reductions on average in the mean doses to the functional lung in the functional plan were 168 cGy and 89 cGy, respectively, compared with those in the anatomic plans. The median reductions in the percentage of volume irradiated with > 5 Gy, > 10 Gy, > 20 Gy, > 30 Gy and > 40 Gy for functional lung in the functional plans were 6.50%, 10.21%, 14.02%, 22.30% and 23.46% in 3DCRT planning, respectively, and 3.05%, 15.52%, 14.16%, 4.87%, and 3.33% in IMRT planning, respectively. No greater degree of sparing of the functional lung was achieved in functional IMRT than in 3DCRT.

CONCLUSIONFunction-guided 3DCRT and IMRT plannings both appear to be effective in preserving functional lung in NSCLC patients.

Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; pathology ; radiotherapy ; Humans ; Radiography ; Radiotherapy, Conformal ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, Emission-Computed, Single-Photon ; methods

Adolescent ; Antibodies, Viral ; Child ; Diagnosis, Differential ; Female ; Fever ; Humans ; Infant ; Male ; SARS Virus ; immunology ; Severe Acute Respiratory Syndrome ; diagnosis ; virology

Objective To explore the efficacy and safety of HAA regimen (homoharringtonine,cytarabine and aclarubicin) in the treatment of 150 newly diagnosed adult acute myeloid leukemia (AML).Methods All patients entered the study from May 1999 to June 2008 were treated with HAA regimen. Coxsurvival analysis was used to estimate the survival rate and differences between M1/M2 and M4/M5 were compared with 2-sided log-rank test. Results Out of the 150 patients, 121 (81%) achieved complete remission (CR). After the first course, CR rate was 68%. The CR rates of 97%, 84% and 38% were achieved in patients with favorable, intermediate and unfavorable cytogenetics, respectively. For the patients with CR, the median follow-up time was 16.5 ( 1.5-100.5 ) months, and the estimated 3-year survival rate was 45%. The estimated 3-year relapse free survival rate was 52% for the 121 patients with CR.Conclusions HAA regimen may be an efficacious and safe regimen with a good toleration in the induction therapy for newly diagnosed AML, and a high CR rate could be achieved with only one or two courses.