Expressions of interleukin-6 (IL-6) and its receptor (gp80、gp130) in 8 patients with Graves' disease (GD) were compared with those in 8 euthyroid patients with nodular goiter or benign thyroid adenoma. The thyroid tissues of GD expressed significantly higher IL-6 mRNA, gp130 mRNA and IL-6 protein than those of the control group, suggesting that activated IL-6/gp130 signal pathway in the thyroid tissue may contribute to the pathogenesis of GD.

BACKGROUNDThe ideal post-gastrectomy reconstruction procedure should maintain the normal digestive function and restore intestinal transit to improve the patient quality of life. The aim of this study was to evaluate the effects of integral continual jejunal interposition after subtotal gastrectomy on the nutritional status, glucose levels, and gastric-intestinal motility.

METHODSThe study investigated the effects of the integral continual jejunal interposition, the Billroth I and Billroth II operations, and the isolated jejunal interposition following subtotal distal gastrectomy on the blood glucose, insulin, routine blood parameters, liver function, and myoelectrical activity in Beagle dogs.

RESULTSThe weights of the dogs decreased during the first post-operative weeks. Dogs in the integral continual jejunal interposition, Billroth I, and Billroth II groups gained significantly more weight by 8 weeks. The prognosis nutrition index of the dogs decreased in the first 2 post-operative weeks and increased significantly by 4 weeks in the integral continual jejunal interposition and Billroth I groups. The group with duodenal exclusion (Billroth II) had significantly higher glucose levels compared to the normal control group. The insulin curve was much higher in dogs that underwent the Billroth I, continual jejunal interposition, and isolated jejunal interposition than the Billroth II and normal groups. The frequencies of fasting and postprandial jejunal pacesetter potentials (PPs) were greater in the continual jejunal interposition and Billroth I groups than that in the isolated jejunal interposition and Billroth II groups. The percentage of aboral propagation of PPs was greater in the continual jejunal interposition group than the Billroth I, isolated jejunal interposition, and Billroth II groups.

CONCLUSIONContinual jejunal interposition after subtotal gastrectomy avoids jejunal transection, maintains the duodenal passage and food storage bags, and reduces the influence of blood glucose and insulin.

Animals ; Dogs ; Gastrectomy ; methods ; Gastroenterostomy ; methods ; Jejunum ; pathology ; surgery ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo evaluate the safety, feasibility and the long-term outcomes of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC).

METHODSThe clinical and follow-up data of 46 cases after LAG from June 2008 to December 2009 were analyzed, and compared with 85 cases after conventional open gastrectomy (OG) for advanced gastric cancer at the same period at our hospital. The surgical safety, postoperative recovery, complications, radical degree, survival rate were compared.

RESULTAs compared with OG group, operation time was longer in LATG group ((274 ± 78) min vs. ( 217 ± 41) min, t = 4.635, P = 0.000). Estimated blood loss in the LAG group ((254 ± 112) ml) was significantly less than in the OG group (t = 3.942, P = 0.000). Time to ambulation ((63 ± 16) hours), first flatus ((77 ± 20) hours), resumed liquid diet ((88 ± 15) hours), duration of analgesic medication ((53 ± 20) hours) and postoperative hospital stay ((11.1 ± 4.6) days) were significantly shorter in the LAG group (t = 5.549, 6.508, 9.436, 9.464 and 2.980 respectively, all P < 0.01). The distance of the proximal and distal resection margin were (5.7 ± 1.4) cm and (3.9 ± 1.5) cm in LAG group, (5.8 ± 1.1) cm and (4.7 ± 1.5) cm in OG group respectively, but the difference was not significant. The number of lymph node dissections was also similar, (30.5 ± 10.4) in LAG group and (32.6 ± 12.3) in OG group (t = 0.960, P = 0.339). The incidence of postoperative complications and mortality rate in LAG group (8.7% and 0 respectively) were also lower than in the OG group, with no statistically significant difference (P > 0.05). The mean follow-up was 31.0 months (range 6-48 months), and the cumulative survival of the 2 groups was similar (χ(2) = 1.594, P = 0.207).

CONCLUSIONSLaparoscopy-assisted gastrectomy for advanced gastric cancer is not significantly different with open surgery in surgical safety, radical degree, and survival rate. It is less traumatic and of fewer complications.

Aged ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Laparotomy ; Lymph Node Excision ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Stomach Neoplasms ; surgery ; Survival Rate ; Treatment Outcome

OBJECTIVETo establish a nasopharyngeal carcinoma (NPC) cell line CNE1-pLVTHM/BART7 with stable ebv-miR-BART7 overexpression.

METHODSThe recombinant lentivirus pLVTHM/BART7 expression plasmid was packaged into mature lentivirus by 293FT cells and used to infect CNE1 cells. Flow cytometry was employed for sorting the GFP(+) cells. The efficiency of ebv-miR-BART7 overexpression was determined using qRT-PCR.

RESULTSThe recombinant lentivirus plasmid pLVTHM/BART7 was successfully constructed and verified by PCR and sequencing. The expression of ebv-miR-BART7 in CNE1 cells infected with the lentivirus pLVTHM/BART7 was significantly increased as compared with the negative control and the blank control cells.

CONCLUSIONThe recombinant lentivirus vector pLVTHM/BART7 results in high and stable expression of ebv-miR-BART7 in infected CNE1 cells, which provides a useful cell model for further studies of the role of ebv-miR-BART7 in nasopharyngeal carcinoma.

Carcinoma ; Cell Line, Tumor ; Genetic Vectors ; Humans ; Lentivirus ; genetics ; MicroRNAs ; Nasopharyngeal Neoplasms ; genetics ; Plasmids

OBJECTIVETo investigate the eGFR as a risk factor for long-term (4-year) outcome in Chinese renal insufficiency patients after isolated coronary artery bypass grafting (CABG) at our institution.

METHODSFrom January 1999 to September 2003, 3371 consecutive patients who underwent isolated CABG were retrospectively reviewed. Of these patients, 549 (16.29%) patients were female, 1979 (58.71%) patients with hypertension, 866 (25.69%) patients with diabetes, 1130 (33.52%) patients with hyperlipidemia, 1011 (29.99%) patients with left main stenosis > 50%, and 1150 (34.11%) patients undergoing off-pump procedures. The mean age was (60 +/- 9) years old. Estimated GFR was calculated using the Cockcroft-Gault formula. The main outcomes were in-hospital mortality, in-hospital morbidity and long-term mortality. COX analysis was used in this study.

RESULTSThere were 649 patients with glomerular filtration rate estimates < 60 ml/(min.1.73 m(2)) and 2722 patients with glomerular filtration rate estimates > 60 ml/(min.1.73 m(2)). The in-hospital mortality and follow-up mortality was higher in the estimated glomerular filtration rate < 60 ml/(min.1.73 m(2)) group (2.77% vs. 0.77%, P < 0.01), (6.81% vs. 2.63%, P < 0.01). The COX analysis result confirmed eGFR < 60 ml/(min.1.73 m(2)), derived using the Cockcroft-Gault formula (HR: 1.948, 95%CI: 1.357 to 2.797, P < 0.01) was an independent risk factor for long-term mortality in patients after coronary artery bypass grafting surgery.

CONCLUSIONSThe estimated glomerular filtration rate < 60 ml/(min.1.73 m(2)) derived using the Cockcroft-Gault formula is an independent risk factor for long-term mortality in patients after coronary artery bypass grafting surgery.

Adult ; Aged ; Coronary Artery Bypass ; mortality ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Renal Insufficiency ; mortality ; physiopathology ; Retrospective Studies ; Risk Factors

BACKGROUNDMelanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. The description of the course of the tumors differs somewhat, but it is generally considered as a benign lesion. We investigated the clinicopathologic features, immunophenotypes, and ultrastructural features of 13 patients with nonpsammomatous melanotic schwannoma (NPMS).

METHODSTumor specimens of each patient were sectioned and stained with hematoxylin-eosin, Fontana-Masson, Prussian blue, and periodic acid-Schiff (PAS). Immunohistochemical markers such as S-100, Leu-7, HMB-45, Melan-A, CK, EMA, vimentin, GFAP, laminin, collagen IV and MIB-1 were detected with the Envision immunohistochemical staining method. Four of the cases were observed by electron microscopy.

RESULTSOf the 13 patients, 8 were male and 5 female, aged from 11 to 92 years (mean, 38.6 years). The tumor sites included the spinal nerve root (5 patients), cranial nerve (1), greater omentum (1), subcutaneous tissue (3), mesentery (1), bone (1) and mediastinum (1). Eleven patients were followed up for over 2 years, with a mean of 5.9 years. One patient (9.1%) with a primary tumor in the greater omentum developed another primary tumor of the same type in the subcutaneous tissue of the abdominal wall after the first operation. Local recurrence of the tumor was seen in 2 patients (18.2%). One patient (9.1%) showed the local recurrence and metastasis. Seven patients (63.6%) showed no evidence of the recurrence or metastasis. Grossly, all tumors were well-circumscribed and the gross findings were suggestive of melanin-containing tumors. The tumor was composed of spindled and epithelioid cells with abundant intracytoplasmic melanin pigments. Nuclei were round and contained delicate, evenly distributed chromatins as well as small, distinct nucleoli. In some areas, the nucleoli were large and prominent. Rare mitoses were seen in most lesions except the larger omentum lesion. The pigment was shown to be positive for the Fontana-Masson and negative for Prussian blue and PAS. Immunohistochemical staining for S-100, Leu-7, HMB-45, Melan-A, and vimentin were strongly positive. Linear immunoreactions of both laminin and collagen IV was detected in all patients. Ultrastructurally, numerous elongated tumor-cell processes, duplicated basement membrane and melanosomes were observed in all developmental stages.

CONCLUSIONSHistologically, melanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. Distinguishing between this tumor and malignant melanoma is of paramount importance in planning of management. Immunohistochemically, combined use of laminin and collagen IV is valuable in distinguishing melanotic schwannoma from malignant melanoma. Wide local resection and additional radiotherapy should be advocated. Further studies including cytogenetic or molecular biology are still required to better delineate melanotic schwannoma from malignant melanoma. Appropriate long-term follow-up is needed for all melanotic schwannomas.

Adult ; Aged ; Aged, 80 and over ; Child ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Male ; Microscopy, Electron ; Middle Aged ; Neurilemmoma ; chemistry ; mortality ; pathology ; ultrastructure ; Prognosis ; Soft Tissue Neoplasms ; chemistry ; mortality ; pathology ; ultrastructure

OBJECTIVETo improve Madigan prostatectomy (MPC) for a much satisfactory effect in open surgery.

METHODSA total of 52 patients with benign prostatic hyperplasia (BPH) were treated using MPC. The MPC procedure was modified by exposing anterior prostatic urethra near the bladder neck and conjunction with cystotomy. This modified procedure preserved prostatic urethra intact and could also deal with intracystic lesions at the same time.

RESULTSThe intact of prostatic urethra was kept completely or almost for 48 cases. The hemorrhage amount during modified procedure was a less. The mean operative time was 120 minutes. The 35 patients had been followed up for 1 - 12 months. The average Qmax was 18.9 ml/s. The cystourethrography revealed that the urethra and bladder neck were intact in 8 patients postoperatively. Furthermore, the prostatic urethra was obviously wider after modified MPC.

CONCLUSIONSThe modified MPC can reduce the urethra injury and enlarge the MPC indications. The modified technique is easy to perform with little complications and much more satisfactory clinical result. The modified MPC is highly recommended.

Aged ; Humans ; Male ; Middle Aged ; Prostatectomy ; methods ; Prostatic Hyperplasia ; surgery

OBJECTIVETo explore the risk factors on relapsing tuberculosis related to smear positive pulmonary tuberculosis which had been cured for five years.

METHODSPatients with smear positive pulmonary tuberculosis registered in 1995 from ten countries in Hubei province were studied and logistic regression was used for data analysis.

RESULTSThe 5-year relapse rate of smear positive pulmonary tuberculosis was 3.85 percent. Risk factors related to relapse would include being non-modeled county, negative smear after treated for three months, the class of retreatment, management of non-DOTS, method of chemotherapy and patients that did not get treated by the tuberculosis institute, with odds ratios of 0.15, 4.62, 3.68, 5.88 and 6.47, respectively.

CONCLUSIONEffect standard, regulation DOTS and the centralized management measure might have had effects on decreasing the relapse rate.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antitubercular Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; China ; epidemiology ; Contact Tracing ; Directly Observed Therapy ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Mycobacterium tuberculosis ; isolation & purification ; Odds Ratio ; Recurrence ; Risk Factors ; Sputum ; microbiology ; Tuberculosis, Pulmonary ; drug therapy ; microbiology

BACKGROUNDRenal transplants can improve the quality of life for recipients, but the quality of their sexual life might not be improved. This study was conducted to research the prevalence of erectile dysfunction (ED) and the influential factors in male renal transplant recipients (RTRs).

METHODSA cross-sectional survey was conducted in three renal transplantation centers. Structured questionnaires were administrated by trained interviewers to 824 male renal transplant patients, who had active sexual lives in the last 6 months.

RESULTSComplaints of ED were reported by 75.5% of the 809 RTRs (age range 19 - 75 years, mean age (45 +/- 10) years), whose questionnaires were completed. Mild, moderate and severe ED were reported at 53.6%, 8.3% and 13.6%, respectively. The mean age and the graft duration were significantly higher in male RTRs with ED compared to potent graft recipients (P = 0.00 and 0.04, respectively). The prevalence of ED increased with the increase in age. It was 60.7%, 65.8%, 75.2%, 87.5% and 92.2% in patients with age below 30 years, 31 - 40 years, 41 - 50 years, 51 - 60 years and over 60 years, respectively (P = 0.000). Moreover, the severity of ED increased with aging. The percentage of moderate and severe cases of ED increased from 6.7% in patients below 40 years to 28.9% in those over 40 years (P = 0.000). The prevalence of ED in the RTR who had no occupation was higher than in those who were holding a position (P = 0.001). The prevalence of ED decreased with the increase in the education level. The prevalence of ED was 94.3%, 86.4%, 74.0% and 67.8% in men with elementary school or lower, middle school, high school, and college or higher degrees, respectively (P = 0.000). Patients, whose distal end of arteria iliaca interna was interrupted and underwent iterative transplantation, worried transplanted kidney function was impacted by sexual life, and received cyclosporine (CsA)-based immunosuppressive regimens, were more likely to have ED (P = 0.000, 0.001, 0.000, 0.000, respectively). After Logistic regression analysis, only five factors, age, education level, interruption of arteria iliaca interna distal end, worrying transplanted kidney function impacted by sexual life and CsA-based immunosuppressive regimens sustained their significance.

CONCLUSIONSRenal transplant has varying effects on erectile function. ED is highly prevalent among RTRs and its influential factors are multiple. Age, education level, interruption of arteria iliaca interna distal end, worrying transplanted kidney function impacted by sexual life, CsA-based immunosuppressive regimens are the main influential factors of ED in male RTRs.

Adult ; Aged ; Cross-Sectional Studies ; Cyclosporine ; therapeutic use ; Erectile Dysfunction ; epidemiology ; etiology ; Humans ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Prevalence

OBJECTIVETo compare the predictive value of glomerular filtration rate (GFR) estimated by the Cockcroft-Gault formula or the modification of diet in renal disease (MDRD) equation and serum creatinine for in-hospital and long-term mortality post coronary artery bypass graft surgery (CABG).

METHODSClinical data of 5559 consecutive patients undergoing isolated CABG were retrospectively analyzed. The main outcomes were in-hospital mortality and long-term mortality. Estimated GFR was calculated by the Cockcroft-Gault formula and MDRD equation respectively. Receiver-operating characteristic curves and Cox's analysis were used for the comparison.

RESULTSFollow-up was complete in 5485 patients (97.6%). Analysis of receiver-operating characteristic curves showed that GFR estimated by the Cockcroft-Gault formula had a maximal accuracy for predicting in-hospital mortality (area under the curve: 0.755, P < 0.01). Multivariate logistic analysis and the Cox's analysis results indicated estimated GFR < 60 mlxmin(-1)x1.73 m(-2) base on the Cockcroft-Gault formula was an independent risk factor for in-hospital and long-term mortality (hazard ratio 4.51 for in-hospital mortality, P < 0.01; hazard ratio 1.54 for long-term mortality, P < 0.01), both Cockcroft-Gault formula and MDRD equation were superior to serum creatinine for predicting in-hospital and long-term mortality post CABG.

CONCLUSIONGFR estimated by the Cockcroft-Gault formula was superior to GFR estimated by the MDRD equation for predicting in-hospital mortality, and estimated GFR was superior to serum creatinine for predicting in-hospital and long-term mortality.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cause of Death ; Coronary Artery Bypass ; Creatinine ; blood ; Female ; Glomerular Filtration Rate ; Hospital Mortality ; Humans ; Kidney Function Tests ; methods ; Male ; Middle Aged ; Postoperative Period ; Predictive Value of Tests ; ROC Curve ; Renal Insufficiency ; diagnosis ; etiology ; mortality ; Retrospective Studies ; Risk Factors ; Young Adult