Objective To compare and evaluate the efficacy of diagnosis and excision for appropriately selected breast multi-focal lesions and solitary lesion by ultrasound-guided vacuum-assisted biopsy (UGVAB). Methods Among 392 appropriately selected patients, 187 patients with multi-focal lesions and 205 patients with solitary lesion were treated by the 8-gauge UGVAB from May 2007 to June 2009. All lesions were removed as completely as possible. The patients with benign pathology underwent physical and ultrasound examinations at one week and 6 months after procedure. Results During the procedure, only three patients had vasovagal syncope and twenty others complained of other intraoperative discomfort. An accurate pathological diagnosis was obtained in all lesions. There was no apparent false-negative result among the 696 lesions with benign pathology at a follow-up of 6 months after procedure. The rates of malignant or premalignant pathology, postoperative complications and residual lesions in patients with multi-focal lesions were higher than those in patients with solitary lesion. If each lesion was considered as a subject of study, there was no significant difference between the two groups. Conclusion UGVAB is an effective method for diagnosis and excision of appropriately selected breast multi-focal lesions and can be used routinely.

Objective To observe the Pin1 expression pattern in skin and to establish an inducible skin specific Pin1 overexpression mouse model. Methods The mouse Pin1 gene was cloned into modified vector pTRE2 with C?terminal Myc tag. The linearized pTRE2?Pin1 DNA was micro?injected into one?cell embryos followed by implantation into foster mice to produce TRE?Pin1 transgenic mice. Results TRE?Pin1 transgenic founder mice were successfully created. These mice were crossed with transgenic tool mice K14?rtTA to create epithelial specific double transgenic progenies. Pin1 gene was induced by incorporating doxycycline into drinking water of the mice. Pin1 protein overexpression in the skin was con?firmed by Western blot and immunohistochemistry. The endogenous Pin1 protein was predominantly expressed in epidermal cells in the skin. Conclusions The inducible skin specific Pin1 overexpression mouse model is successfully established which may serve as a useful model for further study of Pin1 functions in the skin.

Objective To study the synergistic effects of Mitomycin C in photodynamic therapy for colonic carcinoma. Methods The colon carcinoma cell line SW800 was assigned to be treated with 002 ?g/ml Mitomycin C, or 2 ?g/ml PSD-007 (photosensitizer), or Mitomycin C and PSD-007 (PSD+MC group).The cells without any special treatment served as control. Fluorescence spectrophotometer and MTT assay were used to detect the content of intracellular photosensitizer and survival rate of SW700 cells under photodynamic therapy. The obtained data was analyzed with SPLM statistical software. Results After PSD was added for 4, 8, 16 and 24 h, intracellular PSD level of PSD+MC group increased significantly as compared with that of PSD group. The intracellular PSD contents of PSD group, PSD+MC group had a strong and negative correlation with cell survival rate respectively after photodynamic therapy, but the cell survival rate curve shifted to the left obviously. The best killing effects on SW700 cells of photodynamic therapy could be obtained when the SW700 cells had been exposed to photosensitizer for 8-16 h. Conclusion There is insignificant influence of lowconcentration of Mitomycin C alone on cell survival rate. The better synergistic effect of Mitomycin C on killing the colon carcimoma cells can be achieved by enhancing the intracellular content of photosensitizer for 6-8 h before photodynamic therapy.

Objective To explore the relationship between the expression of CD44v6,P16 protein and the invasion and metastasis in gastric carcinoma and to investigate the correlation between the expression of CD44v6 and P16 protein.Methods Immunohistochemical methods were used to detect the expression of CD44v6 and P16 protein in 110 cases of gastric carcinoma.Results In 110 cases of gastric carcinoma,the expression of CD44v6 and P16 protein were 72.7%(80/110)and 47.3%(52/110)respectively. The high level expression of CD44v6 protein and low level expression of P16 protein were positively correlated with the TNM staging,serosa infiltration,lympho node and liver metastasis of gastric carcinoma(P

Objective To evaluate the value of interstitial magnetic resonance lymphography (MRL) to identify the sentinel lymph node (SLN) of breast cancer.Methods Totally 58 patients with invasive breast cancer were consecutive collected.15 mL of Gd-DTPA and 2 mL of mepivacain hydrochloride 2% were mixed and 0.5 mL of them was injected into the outside of the subareolar breast tissue.MRI was performed with Siemens 3.0 T Magnetom Trio MRI instrument using volumetric interpolated breath-hold examination sequence.Axillary lymph flow was tracked on maximum intensity projection (MIP) and sentinel lymph nodes were identified by interstitial MRL as M-SLN.All M-SLN were marked by a method of surface capsule localization.During surgery, methylene blue was used as tracer and SLNs stained by it were detected and excised by following the blue lymphatic vessels,these were designated as D-SLN.The numbers of SLNs detected by interstitial MRL and stained by methylene blue during operation were compared by paired samples rank-sum test and the correlation was analyzed by Spearman rank correlation test.Assessing the sensitivity, specificity and accuracy of interstitial MRL for diagnosing M-SLN.Results A total of 75 M-SLNs (average 1.60 ± 0.52) were identified by interstitial MRL.During operation, all M-SLNs were easily resected under the guidance of skin marker.91 D-SLNs (average 1.94±0.63) were stained by methylene blue, which was significant more than those of the M-SLNs.There was a strong correlation (Spearman's rank correlation coefficient 0.69,P<0.001) between the SLNs identified by these two methods.Interstitial MRL in diagnosing D-SLN metastasis of breast cancer had a sensitivity of 95.8%,specificity of 88.9%,and accuracy of 93.3%.Conclusion Interstitial MRL can accurately identify the axillary sentinel lymph node and guide the biopsy.It may have great clinical value in the future.

Objective To investigate the median effective dose (ED50) of cisatracurium priming accelerating the onset of neuromuscular block in patients of different genders. Methods Ninety ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing elective abdominal operation under general anesthesia were divided into 2 groups ( n = 45 each): male group (group M) and female group (group F). Neuromuscular block was monitored with accelerograph F (TOF-Watch SX). A single twitch stimulation of ulnar nerve was used to monitor neuromuscular function.Anesthesia was induced with midazolam 0.04 mg/kg and fentanyl 1 μg/kg. Accelerograph F was opened after the patients lost consciousness. The priming dose of cisatracurium was injected intravenously, then fentanyl 5 μg/kg and propofol 2 mg/kg were injected intravenously 3 min later and the left dose of cisatracurium for intubation was injected intravenously 4 min later. Tracheal intubation was performed when the ratio of the single twitch stimulation value to control value (T/Tc). decreased to 10%. Anesthesia was maintained with iv infusion of propofol and remifentanil and inhalation of isoflurane. The priming dose of cisatracurium was determined by up-and-down sequential trial. The initial priming dose was set at 5 μg/kg. The ratio of two successive doses was 1.2. T/Tc, time to 90% block, onset time, maximal neuromuscular block and clinical duration were recorded 4 min after the administration of the priming dose. The ED50 and 95% confidence interval (CI) of cisatracurium priming required to accelerate the onset were caculated. Results Time to 90% block was significantly longer-in group M than in group F (P ＜0.05). No significant difference was found in the other parameters among the groups. The ED50 and 95% CI of cisatracurium priming required to accelerate the onset were 21.36 μg/kg (95% CI 20.52-22.23 μg/kg)in group M and 14.53 μg/kg (95% CI 13.77-15.33 μg/kg) in group F. The ED50 was significantly higher in group M than in group F ( P ＜ 0.05). Conclusion The ED50 of cisatracurium priming accelerating thd onset is 21.36 and 14.53 μg/kg in male and female respectively and it is significantly higher in male than in female.

Objective To investigate the risk factors of complication rate after colorectal cancer operation.Methods This study recruited a total of 254 non-emergency colorectal cancer patients admitted to our hospital between December 2005 and December 2006,and then evaluated the effects of life style,preoperative factors and intraoperative factors on postoperative complications.Results Single factor analysis showed that the postoperative complication rate was not significantly affected by gender,age,obesity,palliative/curative resection,anesthesia style as well as preoperative drinking or smoking history.Preoperative complications(P=0.001),tumor stage and operation time(P=0.025) affected the postoperative complicatin rate.Multi-factor logistic regression analysis showed that preoperative complications were the only risk factor of postoperative complications [P=0.001,OR=5.871,(95% CI 2.958-11.651)].Conclusion Old age as such does not represent a contraindication for surgical treatment.Preoperative complications,operation time and tumor stage significantly affect the postoperative complication rate.Preoperative complications are the strongest risk factor of all.Therefore,reasonable perioperative managements and shortening operation time are the key to reducing postoperative complications.

Objective To determine the prevalence and the risk factors for childhood obesity in Changsha and Shenzhen, China.Methods A case-control study was conducted in 209 obese children (the cases) identified in the investigation on childhood obesity in 6 288 children aged 6 to 9 years in Changsha and Shenzhen in China and 209 children with normal weight (the controls). The cases and controls were matched by gender, age, and school. Adjusted odds ratio (aOR) and 95% confidence intervals (CI) for the risk factors were measured.Results The prevalence rate of overweight and obese children was 9.28% and 3.30% in Changsha, and 12.17% and 4.22% in Shenzhen, respectively. The rate of overweight children is significantly higher in Shenzhen than in Changsha. No statistical difference was observed in the rate of obesity between the children in both cities. Paternal obesity (OR 1.78, 95% CI 1.01 to 3.16), maternal weight gain during pregnancy ≥15.0 kg (OR 5.22, 95% CI 2.78 to 9.80), birth weight ≥4.00 kg (OR 2.55, 95% CI 1.24 to 5.26), unhealthy snacks ≥1 per week (OR 3.94, 95% CI 1.11 to 13.99), and watching television ≥2 hours per day(OR 2.35, 95% CI 1.01 to 5.47) were associated with childhood obesity when potential confounding factors were adjusted by multi-variable logistic regression analysis. Conclusion Paternal obesity, gestational weight gain, high birth weight, and unhealthy life-style are important risk factors for obesity in urban children in south China.

OBJECTIVEThe major cause of congenital adrenal hyperplasia (CAH) is 21-hydroxylase deficiency, which accounts for 90% - 95% of all cases in most populations. This study was conducted to characterize the molecular basis of the 21-hydroxylase deficiency and to obtain the spectrum of the CYP21 gene mutations in a group of Chinese patients, and analyze the relationship of genotype and phenotype.

METHODSTo detect the distribution of gene mutations in Chinese population samples from 52 patients with 21-hydroxylase deficiency from 51 families were collected, including two parents samples in 30 patients and one parents sample in 10 patients. Blood samples were obtained for extraction of peripheral blood lymphocytes. Polymerase chain reaction (PCR) followed by nesed PCR were used to study the 21-hydroxylase gene (CYP21) mutations. The primary PCR amplified two overlapping CYP21-specific DNA fragments, The product of the nested PCR which used products from the primary PCR was analysed by restriction fragment length polymorphism (RFLP) or amplification-created restriction site (ACRS). All patients were studied by 6 mutations, including P30L, I2g (intron 2 nt 656 c/a-->g splice mutation), E3Delta8nt (exon 3 codon111-codon113 8 bp deletion), I172N, V281L and Q318X.

RESULTSThrough analysis of 52 patients with 21-hydroxylase deficiency, in 5 patients no mutations were detected, in 17 patients only one mutated allele could be characterized, two different mutations were identified in 21 patients, three mutations were detected in 2 patients. Totally, in 73% of alleles the genotypes could be detected. The most common mutation was I2g, which present on 31% affected alleles, then followed by I172N, Q318X, V281L, P30L, E3Delta8nt, accounting for 23%, 14%, 9%, 3%, 2% of all identified mutations respectively, which included multiple mutations accounting for 6%. The most frequent molecular defects of the salt-wasting form were the I2g (45.7%), Q318X (26%). Of the simple virilizing form, the dominant mutations were I172N (40.7%) and I2g (18.5%).

CONCLUSIONSix different mutations were examined in this study, and the detected mutations accounted for 73% affected alleles, in which I2g and I172N were the most common mutations (accounting for 54%). Correlation between genotypes and phenotypes was compatible with the reported data. Two rounds of PCR followed by RFLP or ACRS analysis may provide important information for genetic counseling and for prenatal diagnosis.

Adrenal Hyperplasia, Congenital ; diagnosis ; enzymology ; genetics ; Child ; Child, Preschool ; China ; Family Health ; Female ; Gene Frequency ; Genotype ; Humans ; Infant ; Male ; Phenotype ; Point Mutation ; genetics ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Steroid 21-Hydroxylase ; genetics ; metabolism

OBJECTIVETo establish a rapid method of detecting CYP21 gene mutations.

METHODSFifty Chinese patients with 21-hydroxylase deficiency and some of their families were investigated. Blood samples were obtained for extraction of peripheral blood lymphocytes. A search for restriction sites discriminating between the morbid and the normal in CYP21 gene was made by the computer program DNAssist. PCR-based amplication-created restriction site(PCR-ACRS) was performed at I172N and R356W which are not natural recognition sequence. In addition, I172N and R356W were analysed in five families which conform to the applicability of PCR-ACRS.

RESULTSIn 50 identified 21-hydroxylase deficient Chinese patients, 21 were found to have I172 N (3 were homozygote, 18 were heterozygote); 8 were found to have R356W, all of them were heterozygote. By analysing the families, the findings were consistent with the characteristics of autosomal recessive genetic deficiency.

CONCLUSIONAnalysis of CYP21 gene point mutations using PCR-ACRS is relatively simple, accurate and feasible.

Adrenal Hyperplasia, Congenital ; enzymology ; genetics ; China ; DNA ; genetics ; metabolism ; DNA Mutational Analysis ; methods ; Deoxyribonucleases, Type II Site-Specific ; metabolism ; Female ; Humans ; Male ; Mutation ; Polymerase Chain Reaction ; methods ; Reproducibility of Results ; Sensitivity and Specificity ; Steroid 21-Hydroxylase ; genetics ; metabolism