Objective To evaluate the prognostic value of iASPP for nasopharyngeal carcinoma (NPC).Methods One hundred and thirty patients with nasopharyngeal carcinoma were initially diagnosed and treated between January and December 2012 in Department of Radiation Oncology of the First Affiliated Hospital of Guangxi Medical University.The clinical staging was classified according to the cancer staging criteria 2009 AJCC/UICC.All patients were treated by IMRT.Cisplatin-based concurrent chemotherapy was given to patients with stages Ⅲ-ⅣB disease.Immunohistochemistry was used to detect the expression of iASPP in the carcinoma tissues,and the clinicopathological features were compared among the patients with different expressions of iASPP.Furthermore,the relationship between the expression of iASPP and the efficacy in patients was explored.Results Of 130 patients,positive expression of iASPP was observed in 86 patients (66.2％),and negative expression in 44 patients (33.8％).There was significant difference in the positive expression rate of iASPP among the patients with different N-stage and clinical stages(x2 =7.565,4.947,P ＜ 0.01).At three months after treatment,no significant difference was found in the response rate of tumor with different expression of iASPP.In univariate analysis,the expression of iASPP was significant predictor of 3 year-DMFS (x2 =4.335,P =0.037) and PFS (x2 =6.640,P =0.01).Furthermore,N-stage was significant predictor of 3y-DMFS (x2 =8.058,P =0.005),PFS (x2 =9.554,P =0.002) and OS (x2 =6.987,P =0.008),respectively.By using multivariate Cox analysis,the expression of iASPP and N-stage was independent prognostic factors for PFS (x2 =4.336,5.228,P ＜ 0.05),respectively.Conclusions Positive expression of iASPP may be a poor prognostic factor for NPC patients.

Adolescent ; Asthma ; blood ; drug therapy ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Interleukin-17 ; blood ; Male

Objective To study the respiratory and circulatory changes in elderly patients, and their relationship with pulmonary complications after thoracotomy. Methods 58 elderly patients either aged over 75 years, with major organ dysfunction or underwent highly invasive procedures (group 1). Respiratory and circulatory status, including arterial blood gas under room air, water balance, urine gravity, and hemodynamics monitoring through pulmonary artery catheter were documented. The results were compared with those from 56 young patient controls receiving thoracotomy in the same period (group 2). Results All 12 patients having pulmonary complications were from group 1 (group 1A). Ten of them presented on the 2nd or 3rd postoperative day with hypoxemia. The other 2 died of type II respiratory failure after severe infection. Preoperative pulmonary co-morbidity (P=0.026, Exp(B)=5.4) and obesity (P=0.043, Exp(B)=4.9) were identified as independent risk factors for pulmonary complications after thoracotomy in elderly patients. During the first 3 postoperative days, PaO_2 of group 1A was significantly lower than group 2 as well as the other elderly patients who did not develop pulmonary complications after surgery (Group 1B). PaCO_2 of group 1A and 1B were significantly lower than group 2. There were also significant differences between the three groups in water balance on the first postoperative day (group 1A +832ml, P=0.006 vs. group 1B +109ml, P=0.004 vs. group 2 -243ml ). Urine gravity in group 1A was also significantly higher than in group 2 in the first 3 postoperative days. Pulmonary artery catheter monitoring revealed increased cardiac output and decreased systemic vascular resistance, showing a hyperdynamic status, in elderly patients after surgery. Pulmonary vascular resistance was elevated in the same time. Conclusion Pulmonary co-morbidities commonly seen in elderly patients are responsible for pulmonary complications, the major cause of surgical mortality after thoracotomy. Hypoxemia in the early postoperative period is mainlycaused by relative volume overloading from trauma induced interstitial edema. Close monitoring of arterial blood gas under room air, water balance, and urine gravity after thoracotomy may identify elderly patients at risk of developing pulmonary complication and prompt timely intervention.

Acupuncture Therapy ; Adult ; Fasciitis ; therapy ; Female ; Humans ; Male ; Scapula ; injuries ; Young Adult

Acupuncture Therapy ; Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; complications ; Humans ; Infant ; Male ; Paraplegia ; etiology ; therapy

BACKGROUND: Amnion has been widely used in ophthalmology. Numerous studies have suggested that amnion transplantation did not induce acute immunologic rejection. These indicated that amnion transplantation can be used as a safe material for repair of dural defects.OBJECTIVE: To study the probability of freeze-dried amniotic membrane (FDAM) as a dural substitue. METHODS: Each of the guinea pigs underwent bilateral parietal craniectomy behind the coronal suture and beside the midline to expose the dura. On the right side, a piece of dura mater was removed. The dural defect was covered with a piece of FDAM. The exposed dura on the left was cut and sutured itself as control. The animals in each group were sacrificed at 15, 30, 60 and 90 days after operation, respectively. The implants were harvested and stained with hematoxylin-eosin, and histologically analyzed. RESULTS AND CONCLUSION: After operation, the behavior of all guinea pigs remained completely normal. The wound healing was achieved in all cases. No wound infection, subcutaneous effusion or cerebrospinal fluid (CSF) leakage occurred. The graft was degraded gradually and covered with a sheet of connective tissue. Dural defects repaired with FDAM showed no adhesions to the brain surface. 15 days after operation, plenty of scattered fibroblasts appeared in the dural substitute. 30 days alter dural graft implantation, parts of the implant disappeared; meanwhile the hyperplasia of fibrous connective tissue took place in the center part of the dural substitute, without the infiltration of inflammatory cells. 60 days after implantation, a majority of the dural graft was degraded, substituted by fibrous connective tissue which was of hyperplasia and low-grade degeneration, surrounded by a small quantity of giant cells. 90 days after operation, colloidal degeneration happened in the dural substitute, surrounded by ossification tissue and the degenerated fibrous connective tissue. The inflammatory cells were not discovered. The animal experiment proves FDAM to be a safe and applicable dural substitute.

OBJECTIVETo study the changes of biomarkers in cerebrospinal fluid (CSF) in cerebral amyloid angiopathy (CAA) dementia and Alzheimer(')s disease.

METHODSLevels of amyloid protein β (Aβ42, Aβ40) and phosphorylated Tau-protein (P-tau) in CSF and ratio of Aβ42/Aβ40 were tested in 5 cases with CAA dementia and 20 cases with Alzheimer's disease collected at Peking Union Medical College Hospital from December 2001 to March 2011.

RESULTSThe levels of Aβ42, Aβ40, and P-tau in CSF and ratio of Aβ42/Aβ40 were (660.4 ± 265.2) ng/L, (7111.0 ± 1033.4) ng/L, (71.8 ± 51.5) ng/L, and 0.077 ± 0.033, respectively in CAA dementia and (663.6 ± 365.6) ng/L, (5115.0 ± 2931.1) ng/L, (47.7 ± 38.8) ng/L, and 0.192 ± 0.140, respectively in Alzheimer's disease patients. There were no statistically significant differences between CAA dementia and Alzheimer's disease in terms of these CSF biomarkers (all P>0.05).

CONCLUSIONMeasurements of CSF biomarkers may not be helpful in differential diagnosis of CAA and Alzheimer's disease.

Aged ; Aged, 80 and over ; Amyloid beta-Peptides ; cerebrospinal fluid ; Apolipoproteins E ; genetics ; Biomarkers ; cerebrospinal fluid ; Cerebral Amyloid Angiopathy ; cerebrospinal fluid ; Dementia ; cerebrospinal fluid ; Humans ; Male ; tau Proteins ; cerebrospinal fluid

Objective To explore the risk factors in elderly type 2 diabetes mellitus with cerebral infarction. Methods Retrospective investigarion was performed on 148 elderly hospitalized patients with type 2 diabetes.The patients were classified based on the presence or absence of cerebral infarction and compared with 60 controls.Logis- tic regression analysis was used to reveal the risk factors for cerebral infarction.Results The levels of systolic blood pressure(SBP),body mass index (BMI),fasting blood glucose (FBG),total cholesterol (TC),triglyceride (TG) and plasma fibrinogen(Fg) were higher in the patients with cerebral infarction[141.15?17.46)mmHg,(23.81?3.53)kg/m~2,(8.82?2.81)mmol/L,(5.69?1.15)mmol/L,(2.08?0.75)mmol/L and (4.08?0.65)g/L] than those without cerebral infarction[(129.78?14.65) mmHg,(22.18?3.22)kg/m~2,(7.06?1.72 )mmol/L,(5.09?1.12)mmol/L,(1.62?0.43)mmol/L and (3.48?0.58)g/L].The logistic analysis showed COUR,SBP,FBG, TC,TG and Fg were the independent risk factors for cerebral infarction.Conclusion Early intervention of the inde- pendent risk factors including SBP,FBG,TC,TG and Fg in elderly patients with type 2 diabetes was important for reduction and postponement of cerebral infarction.

Objective To establish a real-time fluorescence quantitative methylation assay to investigate the methylation status of GSH-sulphur-transferase P1(GSTP1) gene promoter region in hepatocellular carcinoma(HCC) and to investigate whether which can be used as the early diagnostic indicator of HCC .Methods Ninety-five serum samples were collected from 40 patients with HCC ,30 patients with liver cirrhosis and 25 individuals with healthy physical examination as controls .The methylation level of GSTP1 gene in these serum samples were quantitatively determined by using the real-time fluorescence quantitative methylated spe-cific PCR technique .The receiver-operation characteristic(ROC) curves were adopted to evaluate its diagnostic value for HCC .Re-sults The methylation quantitative level of GSTP1 gene in HCC serum was significantly higher than that in the healthy controls (P<0 .05) .The ROC curve analysis demonstrated that the methylation quantitative analysis of GSTP1 gene could efficiently distin-guish HCC and cirrhosis from healthy controls (AUC=0 .8641) .With the methylation rate of 2% as the critical value for diagno-sing HCC ,its diagnostic specificity was 87 .5% ,the sensitivity was 69 .6% ;the combination detection of serum GSTP1 gene methy-lation and serum AFP could increase the detection rate of HCC to 75% .Conclusion The real-time fluorescence quantitative methyl-ation assay can accurately quantify the methylation level of serum GSTP1 gene ,which has certain application value for the early di-agnosis of HCC .

BACKGROUND:A variety of embryonic stem cells induction and differentiation systems have been established so far, while the research that promotes embryonic stem cells to differentiate into hematopoietic stem cells is stil at an initial stage, and the induction efficiency needs to be improved.
OBJECTIVE:To active the Wnt/β-catenin signal pathway in mouse embryonic stem cells with exogenous win3a as an inducer, and then to observe whether the activation of this pathway wil promote the directional differentiation of embryonic stem cells into hematopoietic progenitor cells.
METHODS:The ES-E14TG2a mouse stem cells were cultured with the exogenous wnt3a (100 μg/L) for 21 days, the content ofβ-catenin was tested by cellimmunofluorescence and western blot, and expression of Wnt downstream target gene was detected by quantitative reverse transcription PCR to determine the activation of Wnt/β-catenin signal pathway. Single-layer adherent culture method was used to induce the directional differentiate of above-mentioned cells into hematopoietic stem cells, and detection of hematopoietic development associated surface marker CD34+/Sca-1+was achieved by flow cytometry;meanwhile, the expression of hematopoietic associated gene was measured by quantitative reverse transcription PCR.
RESULTS AND CONCLUSION:We found thatβ-catenin accumulated in ES-E14TG2a mouse stem cells after cultured with wnt3a (100 μg/L) for 21 days;the expressions of Wnt downstream target genes such as Pitx2, Frizzled, Sox17 and Oct4 showed the different degrees in increase, meaning the activation of Wnt/β-catenin signal pathway. Furthermore, during the time that we used single-layer adherent culture method to induce hematopoietic stem cells, the CD34+/Sca-1+cells accounted for 20.2%of total cells at day 14, and control cells only accounted for 11.9%. Again, expression quantity of hematopoietic associated gene BMP4, FLK2 and CD34 increased while Smad5 was suppressed significantly. Our data suggest that sustaining action by wnt3a wil active Wnt/β-catenin signal pathway, and also promote the directional differentiation of ES-E14TG2a mouse stem cells into hematopoietic progenitor cells.