OBJECTIVETo investigate the ability of the model for end-stage liver disease (MELD) score combined with serum sodium measurements to effectively evaluate the prognosis of patients with decompensated liver cirrhosis.

METHODSA total of 212 patients with decompensated cirrhosis were retrospectively analyzed. Each patient's MELD scores, and sodium-based MELD scores (MELD-Na, MELDNa, and MESO) were calculated at three-month intervals. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare the predictive abilities of the four scores for 3-, 6- and 12-month mortality. Kaplan-Meier survival curves were created using the best cut-off values for each score identified by the ROC.

RESULTSAmong the 212 patients, 46 died within three months, 56 died within six months, and 87 died within 12 months. The MELD, MELD-Na, MELDNa and MESO scores were significantly different between patients who survived and those who died within three and 12 months (P less than 0.01). The AUCs for the four separate scores were all more than 0.8 at the 3- and 6-month time points; however, the AUCs of MELDNa (3-month: 0.846; 6-month: 0.869) and MESO (0.831; 0.850) were significantly better than those of MELD (0.812; 0.841) (P less than 0.05). At the 12-month time point, the AUCs of MELD, MELD-Na, MELDNa, and MESO were not significantly different (0.774, 0.775, 0.786, and 0.777, respectively). Survival curves showed that all the scores were able to clearly discriminate the patients who survived from those who died within 12 months (P=0.000).

CONCLUSIONThe MELD score and its sodium-based variants (MELD-Na, MELDNa, and MESO) can precisely predict mortality of patients with decompensated cirrhosis for short and intermediate periods. The MELDNa and MESO scores are superior for predicting 3- and 6-month survival.

Adult ; Aged ; Aged, 80 and over ; End Stage Liver Disease ; blood ; mortality ; Female ; Humans ; Liver Cirrhosis ; blood ; mortality ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Sodium ; blood

OBJECTIVETo investigate the expression of Toll-like receptors (TLRs) in thymus of myasthenia gravis (MG) patients and the relationship with clinical features.

METHODSThymic specimens of 36 patients received extended thymectomy for MG were divided into three groups by pathological type: 13 thymoma tissues (thymoma group) and 13 thymic tissues adjacent to thymomas (parathymoma group) from 13 cases of MG patients with thymomas, and 23 thymic tissues from MG patients without thymomas (MG nonthymoma group). Twenty-one normal thymic specimens from cardiac surgery were used as controls. The levels of TLR2-4 mRNA were examined by RT-PCR, then the levels of TLR4 mRNA were assayed by real time RT-PCR and their relationship with clinical features were analyzed.

RESULTSThe levels of TLR4 mRNA among the different groups had significant differences, while there was no difference in TLR2 and TLR3 levels. The real time RT-PCR showed that the level of TLR4 mRNA in nonthymoma group was significantly higher than that in control group(0.8544+/- 0.1200 vs 0.6851+/- 0.1524, P=0.018). And so is parathymoma group compared with the thymoma group (0.8214+/- 0.1019 vs 0.7101+/- 0.0916, P=0.005). No significant difference of TLR4 mRNA level was found between the parathymoma and nonthymoma groups. Nevertheless, the expression of TLR4 in both groups was increased compared with control group. The levels of TLR4 mRNA had positive correlation with Osserman type(R=0.609; P=0.004) .

CONCLUSIONTLR4 may play a key role in the pathogenesis of MG. It was the thymic tissues adjacent to thymomas but not thymomas themselves participated in the onset of MG.

Adolescent ; Adult ; Female ; Gene Expression Regulation ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Thymus Gland ; metabolism ; Toll-Like Receptor 2 ; genetics ; Toll-Like Receptor 3 ; genetics ; Toll-Like Receptor 4 ; genetics ; Toll-Like Receptors ; genetics ; Young Adult

To achieve fast and accurate analysis of weak current signal of nanopore-based single molecule detection, we designed a real-time adaptive threshold data processing algorithm with data buffering technique and finite impulse response filtering. The system, which is designed based on the data processing algorithm, could realize real-time recognition and analysis of nanopore events during the data recording process. In order to verify the performance of the system, the ideal signals with different noise level (20-100 pA) and recording bandwidth (3 - 100 kHz) was generated. The results showed that the system was stable to analyze the generated signals even at high noise. In addition, the system was also suitable for the data recording conditions of low bandwidth and high sampling rate (250 kHz). The proposed nanopore data processing system was further applied in the Aerolysin nanopore experiment for the detection of poly(dA) 4 molecules. The results showed that the data processing system could be applied in real nanopore recording system with high accuracy and speed.

OBJECTIVETo study the inhibitory effects of Panax Notoginseng Saponins(PNS) on apoptosis induced by hypoxia/hypoglycemia and reoxygenation in cultured rat hippocampal neurons.

METHODApoptosis were measured by flow cytometry, intracellular free calcium concentration([Ca2+]i) was measured with confocal laser scanning microscopy, morphological changes and neuronal necrosis were observed with fluorescence microscope, and meanwhile the leakage of lactic dehydrogenase(LDH) was measured.

RESULTHypoxia/hypoglycemia cultures for 5 hours and reoxygenation induced neuronal apoptosis and necrosis, and significantly increased neuronal [Ca2+]i and the leakage of LDH. The effects were increased with the extending time of reoxygenation. PNS has could significantly decrease the percentage of neuronal apoptosis and necrosis, and reduce neuronal [Ca2+]i and the leakage of LDH.

CONCLUSIONPNS has inhibitory effect on neuronal apoptosis. This effect might be related to its effect of decreasing intracellular free calcium concentration.

Animals ; Apoptosis ; drug effects ; Calcium ; metabolism ; Cell Hypoxia ; Cells, Cultured ; Fetus ; Ginsenosides ; isolation & purification ; pharmacology ; Hippocampus ; cytology ; Hypoglycemia ; pathology ; L-Lactate Dehydrogenase ; metabolism ; Neurons ; cytology ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar

OBJECTIVETo present a new method for reduction of the prominent malar complex by using the curved osteotomy through intraoral incision.

METHODSAccording to the anatomical characteristics of the malar complex, a new curved osteotomy was designed for reduction of the prominent malar complex. This method, that made malar arch move toward backside, inside and upside, lowered the whole malar complex and gain better contour of malar area.

RESULTSFrom 2001 to 2003, 41 patients were treated with the intraoral curved osteotomy [for reduction of the prominent malar complex. All patients obtained good results.

CONCLUSIONSThrough the intraoral approach, the curved osteotomy method could lower the whole prominent malar complex and get better contour of malar area.Intraoral curved osteotomy for reduction of the prominent malar complex could be an ideal method with better face contour, simpler technique, and fewer complications.

Adult ; Female ; Humans ; Male ; Middle Aged ; Mouth ; surgery ; Osteotomy ; methods ; Reconstructive Surgical Procedures ; methods ; Young Adult ; Zygoma ; surgery

OBJECTIVETo compare the treatment outcomes, complications and histopathologic features between conventional parotidectomy and functional regional parotidectomy in the treatment for pleomorphic adenoma of parotid gland and to provide clinical, and pathological evidence for determining the safe surgical margin.

METHODSOf 109 patients, 60 patients received conventional parotidectomy and 49 patients received functional regional parotidectomy. The rates of tumor recurrence and complications were compared between the groups of patients.

RESULTSThere was no significant difference in the incidence of tumor recurrence, the facial paralysis and sialosyrinx between two groups. The rates of Frey's syndrome, numbness of auricular region, and facial asymmetry were 30.0%, 61.7%, and 38.3% in the patients with conventional parotidectomy respectively, while the rates were 6.1%, 30.6%, and 8.2% in the patients with functional regional parotidectomy, with significant statistically difference, respectively (P < 0.05). Of 109 patients, 33 with incomplete capsule, 29 with capsule penetration, 25 with pseudopodia, and 13 with satellite nodules. There was no significant difference in the depth of tumor infiltration between two groups of patients. For the tumor smaller than 2 cm, the depth of infiltration in conventional group was from 0.061 to 1.122 mm, functional group was from 0.442 to 3.127 mm (Z = -1.093, P = 0.057); for the tumors between 2 - 4 cm, the depth in conventional group was from 0.081 to 7.908 mm, functional group was from 0.082 to 6.632 mm (Z = -0.214, P = 0.831); for the tumor larger than 4 cm, the depth of infiltration was from 0.340 to 8.476 mm.

CONCLUSIONSCompared with conventional parotidectomy, functional regional parotidectomy has good outcomes and less complications. The surgical margins of pleomorphic adenomas of the parotid gland should be determined by the size of tumor. The 1 cm-surgical margins are safe for the tumors less than 4 cm, and the tumors more than 4 cm should be treated with superficial parotidectomy.

Adenoma, Pleomorphic ; pathology ; surgery ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Parotid Neoplasms ; pathology ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

Adult ; Fatty Liver ; diagnosis ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Waist-Hip Ratio

OBJECTIVETo analyze the epidemiologic characteristics of severe acute respiratory syndrome (SARS) and to evaluate the effectiveness on its major control measures in Tianjn.

METHODSAdopting two case reports 1 and 2, designed by the Tianjin Centers for Disease Control and Prevention to develop a unified case-tracing table including the map of the distribution of close contacts to SARS patients. With those methods, investigation on patients and their close contacts at hospital wards, families, communities and institutions of the patients were carried out.

RESULTSFrom April 13 through May 8, 2003, there were 175 SARS cases including imported ones, were identified with an incidence rate of 1.9 cases per 100,000. Among them, 14 died with a fatality of 8.0%. The whole process of epidemic in Tianjin was less than one month with the following features: (1) 93.7% of the total SARS cases in Tianjin were directly or indirectly transmitted by a super-spreader. (2) 68.6% of the total SARS patients were concentrated in 3 hospitals A, B and C which was menifastated in 'clustering'. Through study on the rest of the SARS patients, results showed that 16.8% of them were transmitted through family close contact and 2.3% due to contact to colleagues. However, 12.6% of the patients were not able to show evidence that they had any contact to a diagnosed SARS patient. At the early stage of the epidemic, a number of medical practitioners were infected, taking up 38.2% of the total SARS cases. Among the total number of 1 975 medical workers who participated in the SARS medical cares and treatments, 3.4% of them got infected. During the outbreak, all index cases and chains of transmission seemed to be clear, with only 3 patients not able to be traced for the source of infection, taking up 2% of the total SARS patients in Tianjin. Among the 10 index cases, only the super spreader and another one index case transmitted the virus to their contacts but the rest of index cases did not cause any secondary infection.

CONCLUSIONThough SARS is clinically severe and can be spreaded quickly, the epidemic can be under control within a short period of time if chains of SARS transmission are broken down and effective measures as isolation and quarantine against patients as well as underscoring awareness among the publics in a scientific way, being carried out.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Contact Tracing ; Cross Infection ; transmission ; Disease Outbreaks ; Family Health ; Female ; Humans ; Incidence ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; epidemiology ; mortality ; transmission ; Surveys and Questionnaires

AIM:To explore the effects of neuraminidase 3 (NEU3) on the viability, invasion and apoptosis of human prostate cancer DU145 cells and the molecular mechanism.METHODS:The human prostate cancer DU145 cells were divided into blank control group and treatment group.The cells in treatment group were treated with either neuraminidase inhibitor DANA, or NEU3 small interfering RNA (siRNA) to knock down the expression of NEU3.The cell viability was measured by CCK-8 assay.The cell invasion ability was detected by Transwell assay.The effects of the treatments on the mRNA level of Bcl-2 were detected by q PCR.The effects of the treatments on the protein levels of matrix metalloproteinase 2 (MMP2) and apoptotic inhibitory protein Bcl-2 were determined by Western blot.Apoptosis of the cells was analyzed by flow cytometry.RESULTS:The protein level of NEU3 and the apoptotic rate in DANA group were not significantly different from those in blank control group.The viability of DANA-treated DU145 cells was increased, and the invasion ability, MMP2 protein level, and Bcl-2 mRNA and protein levels were all decreased in these cells, compared with blank control group.On the other hand, the levels of NEU3 protein and Bcl-2 mRNA and protein in NEU3 siRNA group were significantly decreased compared with blank control group, while the viability and apoptotic rate of the cells with NEU3 siRNA transfection were increased (P<0.05).However, the protein expression of MMP2 and the invasion ability of the cells were not significantly changed after NEU3 siRNA treatment.CONCLUSION:The inhibition of NEU3 in enzyme activity and expression decreases the viability, and enhances the apoptosis of human prostate cancer DU145 cells.However, it has no obvious effect on the invasion ability of DU145 cells.

OBJECTIVE: To explore the laparoscopic partial gastrectomy and the indications. METHODS: Eighteen patients who underwent laparoscopic partial gastrectomy from August 2005 to May 2006 were analyzed retrospectively. RESULTS: Sixteen patients (including 6 with gastric cancer, 9 with duodenal ulcer, and 1 with gastric multiple polyps) underwent laparoscopic partial gastrectomy. The other two patients underwent an open surgical procedure (1 patient with the tumor size large than 6 cm, and the other patient with bleeding after loosening one clip). The rate of intraoperative subcutaneous emphysema was 5.88% (1/17), and no death occurred. The operation time was (285+/-30)min on average, the estimated blood loss was (130+/-50)mL, and the hospitalization was (11+/-4)d. One case of obstruction of distal loop happened after the surgery, and the rate was 6.25% (1/16). The patients were followed up for 1 approximately 9 months postoperatively. Trocar puncture-site metastases occurred in one patient. CONCLUSION Laparoscopic partial gastrectomy is safe and feasible with skillful laparoscopic technique and with restricted indications, and the surgical outcome may be similar to that of the open surgery.
Adult ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Stomach Diseases ; surgery