B7-1 Antigen ; genetics ; immunology ; Carcinoma, Hepatocellular ; genetics ; immunology ; Enterotoxins ; genetics ; immunology ; Genetic Vectors ; Humans ; Liver Neoplasms ; genetics ; immunology ; T-Lymphocytes ; immunology ; Transfection ; Tumor Cells, Cultured

Objective To study the trend of accidental death among children under 5 years of age.Methods A survey on accidental death among children was performed in Guangzhou to compare the data from the national monitoring program on the deaths under five in the same period during 2001-2010.Data on mortality and causes of injures were adjusted by missing reports.Results Mortality rates on injuries were decreasing annually from 2001 to 2010.Comparing with 2001,the magnitude of the drop in mortality among the 0,1-4 and under 5 year groups were 72.02％,77.17％ and 74.66％ respectively,with statistically significant differences (P＝0.000).During the 10 years of observation,data showed a dropping trend (P＝0.000) of the mortalitics on drowning,traffic accident,suffocation and falling,especially on drowning and suffocation.The main causes of death were suffocation in the 0 year group,drowning in the 1-2-year group,traffic accident and poisoning in the 3-year group,traffic accident and falling in the 4-year group.The accidental deaths happened in ‘C area’ which including Huadu,Conghua,Zengcheng,Panyu and Nansha,with the total proportion of accidental death in Guangzhou as 75.69％.Conclusion The mortality of accidental deaths among children under 5 years of age in Guangzhou had been decreasing during 2001-2010,mainly owing to the practice of intervention programs on drowning and suffocation,suggesting the necessity of integrating the health education programs on accidental injury with the healthcare management system in children in the country,focusing on the suburban and county levels where economy was relatively undeveloped or with more floating population.

OBJECTIVETo evaluate the clinical efficacy of high intensity focused ultrasound (HIFU) combined with endocrine therapy in the treatment of patients with prostate cancer.

METHODSTwenty patients with prostate cancer were treated with extracorporeal HIFU device( model FEP-BY01 ) and androgen ablation, of whom 15 received orchiectomy and 5 LHRH-a. Fourteen patients of the total number were given flutamide in addition to castration.

RESULTSThe mean follow-up was 13.5 months (ranging 6 to approximately 30). Before and after the treatment, the prostate volume, prostate specific antigen (PSA), international prostate symptom score (IPSS) and maximal flow rate (Qmax) of the patients were (36.4 +/- 16.2) ml and (20.6 +/- 11.8) ml (P < 0.05), (32.2 +/- 10.4) ng/ml and (2.4 +/- 0.8) ng/ml (P < 0.01), 20. 5 +/- 6.5 and 13.6 +/- 7.5 (P < 0.05), (10.6 +/- 6.3) ml/s and (14.2 +/- 4.6) ml/s (P < 0.05), respectively. Mild hematuria and pain were noted in 5 and 8 patients respectively, and 1 patient underwent internal urethrotomy with a cold knife because of urethral stricture. er, with minimal complications.

CONCLUSIONHIFU combined with endocrine therapy is effective in the treatment of prostate canc-

Aged ; Aged, 80 and over ; Antineoplastic Agents, Hormonal ; therapeutic use ; Combined Modality Therapy ; Flutamide ; therapeutic use ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; antagonists & inhibitors ; therapeutic use ; Humans ; Male ; Middle Aged ; Orchiectomy ; Prostatic Neoplasms ; therapy ; Treatment Outcome ; Ultrasound, High-Intensity Focused, Transrectal

BACKGROUNDRisk factors that contribute to younger patients with lung cancer are still relatively unknown. The aim of this study was to compare the clinical characteristics, histological types, stages at diagnosis, treatment modalities and survival rates between young and old patients with lung cancer.

METHODSThe study was designed as a retrospective review of all lung cancer patients admitted to the Third Affiliated Hospital of Harbin Medical University from 1998 to 2008. Survival analyses using univariate and multivariate approaches were performed to compare the survival rates between different age groups and to discover potential prognostic factors.

RESULTSThis research included 3320 patients with primary lung cancer, of whom 626 (18.8%) were 45 years old or younger at the time of diagnosis. The percentage of smokers and the male to female ratios between the young and old patient groups were 51.27% vs. 70.6% (P < 0.001) and 1.99 vs. 2.13 (P = 0.4801), respectively. The young patient group had a higher incidence of adenocarcinoma and fewer surgeries. The 1-year, 3-year and 5-year survival rates in the young patient group were generally lower than those of the old patient group, with significant differences (P = 0.0232). The clinical stage of the tumor was a prognostic factor for both non-small cell lung cancer patients (P < 0.0001) and small cell lung cancer patients (P = 0.0002). Symptoms, diagnostic method, histology, smoking, treatment modality and body mass index were shown to have significant relationships with the survival of lung cancer patients (P < 0.05).

CONCLUSIONSPatients with lung cancer who are younger than 45 years old might have a significantly poorer prognosis than that of older patients. Symptoms, diagnosis method, histology, smoking, treatment modality and body mass index can be independent prognostic factors for lung cancer.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Female ; Humans ; Lung Neoplasms ; epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Smoking ; Survival Rate ; Young Adult

Objective To clarify the genetic characteristics of human immunodeficiency virus (HIV) circulated in the population of men who have sex with men (MSM) in Zhengzhou,Henan and to analyze its relationship with HIV-1 prevailing in the paid blood donors (PBDs).Methods Thirty-one MSM who were confirmed as HIV positive individuals in 2010 together with 41 HIV-positive former PBDs were enrolled in the study.Information on related epidemiological characteristics and their plasma were collected.RT-PCR was used to amplify HIV-1 full length gag (1584 bp),pol (3147 bp) genes and partial env gene (C2V3 segment,558 bp) followed by sequencing on those subjects.Online software available at LosAlamos HIV Database was used to identify the HIV subtypes based on the findings of the sequences.Phylogenetic tree was used to identify thc possible relationship of transmission.Results Fifty-three full length gag,38 full length pol and 48 partial env (C2V3) genes were collected from 72 participants.Among the 31 HIV ( + )MSM individuals,14 CRF01_AE strains,5 CRF07BC_ strains and 12 subiype B ( 1 subtype B and 11B' ) strains were identified respectively.All of the 41 strains identified from former PBDs were infected by B' strains.The CRF01_AE strains identified in MSM showed a close relationship to those identified from both Hebei and Liaoning provinces.The CRF07 BC strains showed a close relationship with those from Shijiazhuang and Beijing cities.Among the 12 subtype B strains,8 sequences grouped into 1 cluster with 1 sequence from the former PBDs.Two sequences grouped with 02HNseq4 suggested that B' had been prevailed in the MSM population might come from the former PBDs and were closely related to the strains identified in the MSM population.Conclusion Complicated genetic background and multiple introductions of HIV in the MS population in Zhengzhou,were found.This was also the first report which noticed that the subtype B epidemic among Zhengzhou MSM was mainly originated from the B' among the former PBDs.

OBJECTIVETo investigate the tumor-associated antigen CA125 expression in the serum and cervical and vaginal secretions in women during normal reproductive period, and explore the clinical value of detecting tumor markers in the cervical and vaginal secretions.

METHODSA total of 145 women in reproductive period were divided into 3 age groups (20-29 years, 30-39 years, and over 40 years), and their CA125 levels in cervical secretion, vaginal secretion and serum were detected by automatic electro-chemiluminescent immunoassay.

RESULTSCA125 levels in the cervical secretion, vaginal secretion and serum showed no significant difference between the 3 age groups (P>0.05). In each group, CA125 levels differed significantly between the cervical secretion, vaginal secretion and serum (P<0.001). In the 145 women, the average CA125 level was 497.82 - or + 75.29 U/ml in the cervical secretion, 114.66 - or + 26.40 U/ml in vaginal secretion and 18.06 - or + 3.35 U/ml in serum, showing significant differences between them (P<0.001).

CONCLUSIONCA125 expression level is significantly higher in the cervical and vaginal secretions than in the serum in women in normal reproductive period, and its levels in cervical and vaginal secretions can be more sensitive and convenient for early detection of related diseases.

Adult ; Biomarkers ; analysis ; CA-125 Antigen ; blood ; metabolism ; Cervix Mucus ; metabolism ; Female ; Humans ; Middle Aged ; Vagina ; secretion ; Young Adult

OBJECTIVETo make preimplantation genetic diagnosis (PGD) for female translocation carriers by analyzing first polar bodies (1PBs) with whole chromosome painting probe (WCP).

METHODSWCP was used in fluorescence in situ hybridization (FISH) analysis of 1PBs for four female Robertsonian carriers presented for PGD with 45 XX, der(13;14)(q10;q10) karyotype. All the patients underwent ovarian stimulation and during 6 h after oocyte retrieval 1PBs were biopsied and WCP were used in FISH. On day 3 after fertilization embryos diagnosed as normal or balanced were transferred.

RESULTSA total of 61 oocytes were collected in 4 PGD cycles. Of the 54 matured oocytes, 50 were biopsied and 45 were fixed successfully. Results were obtained in 40 1PBs. Overall, 74.1% (40/54) oocytes were diagnosed. The fertilization rate and good embryo rate were 64.8% (35/54) and 65.7% (23/35) respectively. Two clinical pregnancies were obtained. One patient delivered a normal female baby with karyotype 46, XX in June 2006. For another patient, the fetus spontaneously aborted at 9th week of pregnancy with karyotype of 45, X confirmed by amniotic villus diagnosis.

CONCLUSIONWCP can differentiate normal, balanced and unbalanced oocytes accurately and can be used as an efficient PGD method for female carriers of translocation.

Adult ; Chromosome Painting ; methods ; Female ; Heterozygote ; Humans ; In Situ Hybridization, Fluorescence ; Oocytes ; metabolism ; Pregnancy ; Preimplantation Diagnosis ; methods ; Translocation, Genetic ; genetics

BACKGROUNDTracheostomy should be considered to replace endotracheal intubation in patients requiring prolonged mechanical ventilation (MV). However, the optimal timing for tracheostomy is still a topic of debate. The present study aimed to investigate whether early percutaneous dilational tracheostomy (PDT) can reduce duration of MV, and to further verify whether early PDT can reduce sedative use, shorten intensive care unit (ICU) stay, decrease the incidence of ventilator associated pneumonia (VAP), and increase successful weaning and ICU discharge rate.

METHODSA prospective, randomized controlled trial was carried out in a surgical ICU from July 2008 to June 2011 in adult patients anticipated requiring prolonged MV via endotracheal intubation. Patients meeting the inclusion criteria were randomly assigned to the early PDT group or the late PDT group on day 3 of MV. The patients in the early PDT group were tracheostomized with PDT on day 3 of MV. The patients in the late PDT group were tracheostomized with PDT on day 15 of MV if they still needed MV. The primary endpoint was ventilator-free days at day 28 after randomization. The secondary endpoints were sedation-free days, ICU-free days, successful weaning and ICU discharge rate, and incidence of VAP at day 28 after randomization. The cumulative 60-day incidence of death after randomization was also analyzed.

RESULTSTotal 119 patients were randomized to either the early PDT group (n = 58) or the late PDT group (n = 61). The ventilator-free days was significantly increased in the early PDT group than in the late PDT group ((9.57 ± 5.64) vs. (7.38 ± 6.17) days, P < 0.05). The sedation-free days and ICU-free days were also significantly increased in the early PDT group than in the late PDT group (20.84 ± 2.35 vs. 17.05 ± 2.30 days, P < 0.05; and 8.0 (interquartile range (IQR): 5.0 - 12.0) vs. 3.0 (IQR: 0 - 12.0) days, P < 0.001 respectively). The successful weaning and ICU discharge rate was significantly higher in early PDT group than in late PDT group (74.1% vs. 55.7%, P < 0.05; and 67.2% vs. 47.5%, P < 0.05 respectively). VAP was observed in 17 patients (29.3%) in early PDT group and in 30 patients (49.2%) in late PDT group (P < 0.05). There was no significant difference between the two groups in the cumulative 60-day incidence of death after randomization (P = 0.949).

CONCLUSIONSThe early PDT resulted in more ventilator-free, sedation-free, and ICU-free days, higher successful weaning and ICU discharge rate, and lower incidence of VAP, but did not change the cumulative 60-day incidence of death in the patients' anticipated requiring prolonged mechanical ventilation.

Aged ; Aged, 80 and over ; Critical Illness ; Female ; Humans ; Male ; Middle Aged ; Respiration, Artificial ; Time Factors ; Tracheostomy ; methods

BACKGROUNDThis study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain (LBP), after 5 years of follow-up.

METHODSFrom September 2004 to November 2006, 172 patients underwent percutaneous nucleoplasty for chronic LBP in our department. Forty-one of these patients were followed up for a mean period of 67 months. Nucleoplasty was performed at L3/4 in 1 patient; L4/5 in 25 patients; L5/S1 in 2 patients; L3/4 and L4/5 in 2 patients; L4/5 and L5/S1 in 7 patients; and L3/4, L4/5, and L5/S1 in 4 patients. Patients were assessed preoperatively and at 1 week, 1 year, 3 years, and 5 years postoperatively. Pain was graded using a 10-cm Visual Analogue Scale (VAS) and the percentage reduction in pain score was calculated at each postoperative time point. The Oswestry Disability Index (ODI) was used to assess disability-related to lumbar spine degeneration, and patient satisfaction was assessed using the modified MacNab criteria.

RESULTSThere were significant differences among the preoperative, 1-week postoperative, and 3-year postoperative VAS and ODI scores, but not between the 3- and 5-year postoperative scores. There were no significant differences in age, sex, or preoperative symptoms between patients with effective and ineffective treatment, but there were significant differences in the number of levels treated, Pfirrmann grade of intervertebral disc degeneration, and provocative discography findings between these two groups. Excellent or good patient satisfaction was achieved in 87.9% of patients after 1 week, 72.4% after 1 year, 67.7% after 3 years, and 63.4% at the last follow-up.

CONCLUSIONSAlthough previously published short- and medium-term outcomes after percutaneous nucleoplasty appeared to be satisfactory, our long-term follow-up results show a significant decline in patient satisfaction over time. Percutaneous nucleoplasty is a safe and simple technique, with therapeutic effectiveness for the treatment of chronic LBP in selected patients. The technique is minimally invasive and can be used as part of a stepwise treatment plan for chronic LBP.

Adolescent ; Adult ; Diskectomy, Percutaneous ; methods ; Female ; Humans ; Low Back Pain ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the clinical significance of prostate-specific antigen (PSA) screening in early detection of prostate cancer in Chinese men.

METHODSPSA screening was performed in 8562 asymptomatic men who had been enrolled for health checkup and all were > or = 50 years old. Prostate biopsy was recommended for those with a serum PSA level > or = 4.0 ng/ml. The pathological and clinical features of the patients with prostate cancer detected by the PSA screening were compared with that of 82 clinically diagnosed prostate cancer patients during the same period.

RESULTSOf the 8562 asymptomatic men, 719 had PSA levels > or = 4.0 ng/ml and biopsy was performed in 295 of them. Fifty-eight prostate cancers were detected. The biopsy rate was 41.0% and positive detection rate was 19.7%. The overall age distribution in the screening group and the clinical groups was not significantly different (P = 0.176). However, 41.4% (24/58) of the patients in screening group were > 75 years old, and significantly more than that in the clinical group (25.6%, P = 0.0491). The proportion of the patients with PSA levels > or = 20 ng/ml in the screening group was significantly less than that in the patients of the clinical group (44.8% vs. 75.6%, P = 0.0002). Whether in the patients whose age was > 75 years old (P < 0.05) or < or = 75 years old (P = 0.0002), the patients in the screening group had significantly lower Gleason scores < 7 (60.3% vs. 34.1%, P = 0.002), more T1 or T2 tumor (87.9% vs. 26.8%, P < 0.0001) and more chance to receive radical prostatectomy (50.0% vs. 18.3%, P < 0.0001) than the patients in the clinical group did. However, the distributions of PSA levels at diagnosis and biopsy Gleason scores were not significantly different between the above mentioned two groups (P > 0.05).

CONCLUSIONProstate-specific antigen (PSA) screening is useful for early detection of prostate cancer in Chinese men aged > or = 50 years. The patients detected by PSA screening usually show a lower PSA level, Gleason scores and early clinical stage disease, and have more chance for radical prostatectomy than the clinically diagnosed patients.

Aged ; Aged, 80 and over ; Biopsy ; Early Detection of Cancer ; methods ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; diagnosis ; pathology