Objective To systematically evaluate the association between protein C and Legg -Calve -Perthes disease.Methods A literature research was performed through PubMed,Embase,Cochrane library,Web of Science,Chinese Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI)and Wan-fang Database from inception to February 201 6 on the association between protein C and Legg -Calve -Perthes disease.According to the Newcastle -Ottawa Scale(NOS)criteria,the quality of studies was evaluated and data were extracted.Meta -analysis was performed with Stata 1 1 .0 software.Results A total of 1 4 articles were included.Twelve articles on protein C and Legg -Calve -Perthes disease in the study group and the control group were compared.The results of Meta -analysis showed that there was no significant difference in protein C levels between the study group and the control group[odds radio(OR)=1 .41 ,95% confidence interval(CI)(0.87,2.28),P =0.1 47];five articles on protein C and the white race of Legg -Calve -Perthes disease between the study group and the control group were com-pared,The results of Meta -analysis showed that there was no significant difference in protein C levels between the whiteskin patients′group and the control group[OR =0.61 2,95%CI(1 .83,7.29),P =0.61 2];three articles on pro-tein C and the yellow race of Legg -Calve -Perthes disease between the study group and the control group were com-pared,and the results of Meta -analysis showed that there was no significant difference in protein C levels between the yellow skin patients group and the control group[OR =0.59,95%CI(0.05,6.72),P =0.080].Conclusion There is no significant correlation between protein C and Legg -Calve -Perthes disease.

OBJECTIVETo identify the genetic defects in patients with congenital atrial septal defects (ASD).

METHODSThe clinical data and blood samples from 180 unrelated subjects with congenital ASD were collected and evaluated. Two hundred healthy individuals served as controls. The coding exons and the flanking introns of GATA4 gene were amplified by polymerase chain reaction and sequenced using the di-deoxynucleotide chain termination approach. The acquired sequences were aligned with the sequences publicized in GenBank by the aid of programme BLAST to identify the sequence variations. Clustal W software was applied for analysis of the conservation of altered amino acids.

RESULTSTwo novel heterozygous missense GATA4 mutations were identified in 2 out of 180 ASD patients. Namely, the triplet substitutions of GTC for GGC at codon 21 and TCG for CCG at codon 87 were detected, predicting the conversions of glycine into valine at amino acid residue 21 (G21V) and proline into serine at amino acid residue 87 (P87S). None of the two mutations were detected in 200 healthy controls. Across-species alignment of GATA4 encoded protein sequences displayed that the mutated amino acids were highly conserved evolutionarily. Additionally, a single nucleotide polymorphism c.99G>T was observed. However, the polymorphic frequency distribution in ASD cases was similar with that in healthy controls (for genotype GT, χ(2) = 0.7556, P = 0.3847; for allele T, χ(2) = 0.7235, P = 0.3950).

CONCLUSIONSTwo novel mutations of GATA4 gene are identified in two unrelated ASD patients. This finding provides new insight into the molecular etiology responsible for ASD.

Case-Control Studies ; Child, Preschool ; DNA Mutational Analysis ; GATA4 Transcription Factor ; genetics ; Genome ; Heart Septal Defects, Atrial ; genetics ; Humans ; Mutation

Objective To determine the trend of emergency department (ED)mortality of a tertiary general hospital from 2004 to 2014 in order to find the factors that may impact on ED mortality.Methods Mortality in ED was estimated according to the ratio of ED visiting patients to ED deaths.And the data of all ED deaths in 2004,2009 and 2014 were collected.Variance analysis and chi-square test were used for data analysis.Results During the past decade,ED visiting patients was increased significantly by 38.0% in 2014,compared with those in 2004,and the mortality was also increased accordingly from 0.7% in 2004, to 0.9% in 2009,to 1.2% in 2014 (P <0.01).Finally,a total of 1,091 deaths occurred in these three years were included for further evaluation.There were no significant changes in average age and gender distribution,and the average age was 61.9 and the male /female ratio was 1.36∶1 during past decade.The number of adults under 40 years old (18 -39)increased from 7.5% in 2004,to 10.6% in 2009,to 14.4% in 2014 (P <0.05).Both the facilities were upgraded and the number of staffs in ED increased markedly.The cardiovascular illness,cerebrovascular diseases,and sudden death were the leading causes of ED death during past decade.The incidences of trauma and tumor remained unchanged.Average time consumed from onset of illness to arrival to ED didn’t vary significantly during past decade.The study showed no changes in use of ambulance,but remarkable increases in number of non-compliant patients or their family from 18.3% in 2004,to 25.6% in 2009,to 38.3% in 2014 (P <0.01).The percentage of patients in the night time was higher,but there were no significant changes in number of emergency patients in the night time and during holidays in the past decade,but the mean ED stay time increased obviously from 22.4 h in 2004 to 53.3 h in 2014 (P <0.05 ).Conclusions During the past decade,although ED facilities and number of staffs have been improved apparently,ED mortality rate still keeps on escalating. The increase in ED mortality rate may be related to the severely ill patients presenting to ED,the obvious decrease in compliance of patients and the prolonged ED stay time.

Objective To assess the relationship between the BMI and the brain DAT, and the influence of BMI on the brain SPECT imaging with 99Tcm-TRODAT-1. Methods MRI and 99Tcm-TRODAT-1SPECT imaging were performed in 31 healthy volunteers(16 males and 15 females), and then the three-dimensional reconstruction of SPECT images were completed. Based on the MRI images, right striatum (RST) and the left striatum (LST) were drawn as ROI on the 4 most clearly consecutive transverse slices.The cerebellum (CB) was taken as the background reference area and the corresponding uptake ratios of ST/CB, LST/CB and RST/CB were calculated. The Pearson correlation tests for radio-uptake ratios (ST/CB, LST/CB, RST/CB), BMI and age were performed, Then multiple linear regression analysis using ST/CB as dependent variable and BMI and age as independent variables was performed. SPSS 15.0 was used in data analysis. Results The ST imaging was symmetrical. The radioactivity was higher in the ST front area than that of the back area. The average uptake ratios of ST/CB, LST/CB, RST/CB were 1.71±0.16,1.70 ± 0. 16 and 1.72±0.17 respectively, in which the three ratios of the female were 1.74 ± 0. 18, 1.71±0. 19 and 1.76 ± 0. 19 respectively and those of the male were 1.68 t 0. 14, 1.68 ± 0. 13 and 1.69± 0.15respectively. ST/CB, LST/CB and RST/CB were negatively correlated with patients'BMI (r = -0. 53,-0.57,-0.47, all P＜0.05). The ST/CB was negatively correlated with patients' age(r=-0.39, P=0. 03). The multiple linear regression analysis showed that the BMI was significant independent variable (β=-0.53, t= -3.36, P=0. 002). Conclusions TheSTDAT,evel may decrease as patients' BMI and age increase. Females' DAT level is slightly higher than males'. For ST DAT imaging, age, gender and BMI should be all taken into consideration.

OBJECTIVESTo evaluate and analyze the role of posterior ligament complex (PLC) in determining therapeutic principle for traumatic thoracic-lumbar fracture.

METHODSFrom August 2005 to May 2008, 60 patients (38 male, 22 female) who suffered from the traumatic thoracic-lumbar fracture were carried out posterior operations. According to the Magerl traumatic thoracic-lumbar fracture classification system, these cases were classified to subtype A, B and C. The average age was 34 years (21 - 65 years). Magnetic resonance imaging (MRI) scan, which including both T1/T2 weight and fat-stir sequence, as well as the MRI negative film reading technique were used to evaluate the state of PLC. Furthermore, related physical or neurological examinations (such as severe skin bruising and sinking, broadening spinous process gap and tenderness, spinal cord or nerve root injury) and another X-ray or CT reconstruction films were taken to evaluate the the state of PLC synthetically. Above-mentioned results were compared with the final exploration results during operation and some parameters were analyzed.

RESULTSThe sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), misdiagnosis rate and rate of missed diagnosis of these sixty patients were 85.3%, 80.8%, 83.3%, 85.3%, 80.8%, 19.2%, 14.7% respectively. After 13 cases of thoracic-lumbar fracture-dislocation were eliminated, the sensitivity, specificity, accuracy, PPV, NPV, misdiagnosis rate and rate of missed diagnosis of remaining 47 cases were 81.0%, 80.8%, 80.9%, 77.3%, 84.0%, 19.2%, 19.0% respectively. There were 5 cases with MRI negative results before operation but positive results during operation. Contrarily, 5 cases with MRI positive results before operation but negative results during operation occurred.

CONCLUSIONSMRI is a main means for evaluating the state of PLC. Although the MRI fat-stir sequence as well as the MRI negative film reading technique are adopted, the state of PLC can not be estimated exactly before operation (especially for those unfracture dislocation cases). In order to estimate the state of PLC exactly, the related local physical examination and image technology as well as the location of the abnormal image signal in MRI film and time of injury must be analyzed synthetically.

Adult ; Aged ; Female ; Humans ; Ligaments ; pathology ; Lumbar Vertebrae ; injuries ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Fractures ; pathology ; surgery ; Thoracic Vertebrae ; injuries ; Young Adult

OBJECTIVETo evaluate the effect of combined use of implantation of (125)I seeds with regional arterial infusion chemotherapy on late-staged pancreatic carcinoma.

METHODSDuring operation, (125)I seeds were implanted into tumor parenchyma or operative beds for 7 patients with pathological diagnosis of late-staged pancreatic carcinoma, then chemotherapy pump was implanted into common hepatic artery or celiac artery through left gastric artery or right epigastric artery. Gemcitabine (1000 mg/m(2)) plus fluorouracil (500 mg/m(2)) was used for postoperative adjuvant chemotherapy once a week for 7 consecutive weeks.

RESULTSThe mean number of implanted (125)I seeds was 42 and the mean dose was 29.4 mCi. The mean follow-up time was 245 days. Rate of pain relief was 100%, metastasis foci was reduced in 2 cases. CA-19-9 Antigen level decreased to normal in all patients. Pancreatic fistula occurred in one case and was cured with conservative therapy.

CONCLUSIONSThe combination therapy is effective for late-staged pancreatic carcinoma, it brings symptom relief and improvement in quality of life.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Brachytherapy ; adverse effects ; methods ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Infusions, Intra-Arterial ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Pancreatic Neoplasms ; therapy ; Retrospective Studies ; Survival Analysis ; Treatment Outcome

OBJECTIVETo understand the risk factors of schistosomiasis transmission in the Three Gorges Reservoir Area (TGRA) and to provide evidence for the development of control strategy.

METHODSApproaches including epidemiology, immunology and field survey were applied to investigate the potential risk factors which would involve the importation of infectious resources live mobile and migrant population, and livestock in the reservoir area. Meanwhile, observation on survival and reproductive status of snail under simulation habitats was also carried out, using ecological methods on snails. Strategy in preventing the spread of snail as infectious resources was also provided.

RESULTS175 mobile people from schistosomaisis endemic area of were tested and one person showed immunology tests positive with indirect hemagglutination test (IHA) and circumoral precipitin test (COPT), with a positive rate of 0.57%. Through the two-year period under observation, data showed that the snails with ribbon/smooth shells could survive and reproduce under habitats of simulation.

CONCLUSIONSOnce the infectious resource of schistosomiasis was introduced into the TGRA, the area became a new schistosomiasis epidemic area in TGRA which called for countermeasures to be taken.

Animals ; China ; epidemiology ; Disease Reservoirs ; Humans ; Risk Factors ; Schistosomiasis japonica ; epidemiology ; prevention & control ; transmission ; Snails ; parasitology

OBJECTIVETo evaluate and analyze a therapeutic principle and strategy to treat the traumatic instability of sub-axial cervical spine as well as the prognosis assessment.

METHODSAccording to the Allen-Fergurson's classification, 83 patients who suffered from the traumatic instability of sub-axial cervical spine were performed operations depending on the patients's general health, the local pathological anatomy and neurological function, including both the decompression and reconstruction maneuvers through anterior, posterior or combined approach.

RESULTSThe average follow-up was 3 years and 9 months. The distraction-flexion and compression-flexion were the most frequent injury subtypes. There were 46, 28 and 9 operations through anterior, posterior or combined approach respectively. No operation through anterior-posterior-anterior approach occurred. The average scores of JOA, VAS and ASIA motor index improved from 11.2, 7.8 and 53.5 before operation, to 15.3, 2.6 and 67.8 at the final follow-up, respectively. After operation, there were different extent improvements of average radiologic parameter. Fusion was achieved in all patients and 12 complications occurred.

CONCLUSIONSAccording to both the patients's general health and the local pathological anatomy, individual therapeutic designing should be determined to treat the traumatic instability of sub-axial cervical spine.

Adolescent ; Adult ; Aged ; Cervical Vertebrae ; injuries ; surgery ; Decompression, Surgical ; methods ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Joint Instability ; etiology ; surgery ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Spinal Fusion ; methods ; Spinal Injuries ; complications

To analyze and identify the constituents in rat plasma after oral administration of the active fraction of Corydalis yanhusuo, a LC-MS/MS method was established. The constituents absorbed into blood, their original crude drugs and their metabolites were identified either by comparing the retention time and mass spectrometry data with that of reference compounds or by mass spectrometry analysis and retrieving the reference literatures. Nine species are the original form in Corydalis yanhusuo, moreover, some metabolites in blood identified as glucuronide were found. The constituents absorbed into blood and the possible metabolites which demonstrate to originate from the active fraction of Corydalis yanhusuo are responsible for the observed efficacy. Its serum pharmacochemistry should be subjected to complete investigation so as to illuminate the pharmacology and active mechanism of the active fraction of Corydalis yanhusuo.
Administration, Oral ; Alkaloids ; administration & dosage ; blood ; isolation & purification ; metabolism ; Animals ; Chromatography, High Pressure Liquid ; Corydalis ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; metabolism ; Glucuronides ; blood ; Male ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry