AIM:To study the KIF21A gene mutation in a Han family with concomitant exotropia. ·METHODS: The genomic DNA of five family members was extracted from peripheral blood leukocytes and amplified with PCR. The PCR products were purified for DNA sequencing. DNA sequences were aligned with the human KIF21A gene sequences registered in GenBank. · RESULTS: Mutation analysis of all exons of the pedigree's KIF21A gene reveals no gene mutation in any of the families. ·CONCLUSION: Our study demonstrates that the KIF21A gene maybe is not virulence gene in this pedigree.

Objective To evaluate the clinical outcome of one-level posterior lumbar interbody fusion (PLIF) performed with microendoscopic approach.Methods A consecutive series of 56 patients who under went one-level PLIF procedure(24 cases performed with microendoseopic approach and 32 cases with tradition- al open approach)were studied from January 2005 to May 2006.The following data were compared between 2 groups with 12 to 27 months follow-up:estimated blood loss,postoperative drainage,transfusion needs,surgi- cal time,length of hospital stay,postoperative back pain by visual analogue scale,complications,and the clinical and radiographic results.Results The microendoscopic approach was found to have a significantly less blood loss,less postoperative drainage,less needs of transfusion,less postoperative back pain,shorter re- covery time and shorter length of hospital stay.However,the microendoscopic approach needed significantly longer surgical time.There was no significant difference between 2 groups in the aspects of the complications and the clinical and radiographic results.Conclusion The one-level PLIF performed with microendoscopic approach minimize estimated blood loss,length of hospital stay,postoperative back pain.It also shows the ex- cellent surgical efficacy of the microendoscopic approach for suitable patients.

Background With the changes of diet and living style,the diabetes has become the major diseases affecting human health.Diabetic cataract is a common complication of diabetes. Objective The present study was to investigate the difference of lens proteomics between diabetic cataract and age related cataract using two dimensional electrophoresis (2-DE) and mass spectrometry in order to postpone happening of diabetic cataract and offer the effective approach to the prevention and therapy of diabetic cataract. Methods The lenses were obtained from 8 diabetic patients and 12 age-related cataract patients during the surgery to extract the protein by lysis and centrifugation.The lens proteins were separated using immobilized pH gradients 2-DE.Image analysis was carried out using PDQuest Advanced-8.0.1 software package.Significant difference of the crystallines was identified by matrixassisted laser adsorption/ionization time of-flight-mass spectrometry (MALDI-TOF-MS) and peptide mass fingerprint combined with protein database. Results The maps of 2-DE showed that lens proteins of diabetic cataract and age related cataract were in the section of pH 5-9 with the relative molecular weight 14000-97000;while relative molecular weight of more abundant crystalline was localized at 20000-31000.About 3 differential protein spots were detected by image analysis software.Two crystallines,αB and βB1 crystallin,were identified using MALDI-TOF-MS.Conclusions Proteomic analysis of lens can be accomplished and the proteins can be well separated,moreover,differential proteins can be analyzed using 2-DE and mass spectrometry between diabetic cataract and age related cataract.These results indicate that αB and βB1 crystallin proteins accelerate the development of diabetic cataract.This technique offers a new avenue for clarity of lens proteins of diabetic cataract other than age related cataract.

Objective To describe the prevalence of deliberate self-harm (DSH) and suicidal behaviors (SIB) as well as the relationship between them in a college student population.Methods A total of 4063 medical students were selected under the cluster sampling method in Anhui province.Data were analyzed by Pearson Chi-square and logistic regression.Results A total of 4063 ( 13.4％ )students reported that they had deliberately harmed themselves during the past 12 months.The acts of DSH with 1 and more than or equal to 2 times occurrence accounted for 3.7％ and 9.6％ among all the respondents.The act of DSH was significantly higher among boys than that among girls.Rates of suicide ideation,suicide plan,attempted suicide and SIB in the last year were 4.5％,1.4％,0.6％ and 4.9％,respectively.However no statistically significant difference was found in different sex.Students in the DSH group that with SIB were found to have lower positive coping levels (OR=0.5,95％CI:0.3-0.8),getting less support from fricnds (3-5 vs.less than or equal to 2:OR=0.6,95％CI:0.3-0.9;more than or equal to 6 vs.less than or equal to 2:OR=0A,95％CI:0.2-0.8),with higher negative coping levels (OR=2.1,95％CI:1.2-3.7),having more serious depressive symptoms (OR=2.9,95％ CI:1.6-5.2) and anxiety symptoms (OR=2.2,95％ CI:1.2-3.8),having more serious sleeping problems (OR=1.7,95％CI:1.1-2.8 ) and perceived fat (fat vs.moderate:OR=2.0,95％CI:1.1-3.6) than the DSH group without SIB.The rates of SIB in students with DSH behavior were significantly higher than those in students without those behaviors (OR=4.7,95％ CI:3.5-6.4).Psyehosocial variables could attenuate the relationship between the DSH status and suicidal events (OR=3.3,95％CI:2.4-4.5).The DSH frequency exhibited a curvilinear relationship to SIB (OR=3.1-10.0) and psychosocial variables also attenuated this relationship (OR=2.4-5.9).Conclusion It was well known that SIB was not a suicidal gesture but our findings suggested that the presence of DSH might trigger the suicidal attempts.

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Hypothalamus ; metabolism ; Male ; Physical Conditioning, Animal ; physiology ; Rats ; Rats, Sprague-Dawley

Objective The prognosis of traumatic brain injury is closely associated with the apoptosis of neural cells .This study investigated the anti-apoptosis effect of alpha lipoic acid (α-LA) and its possible mechanism in the mouse model of traumatic brain injury. Methods Seventy-two healthy male ICR mice were randomly divided into four groups of 18 each:sham operation +vehicle, sham operation +α-LA, trauma +vehicle, and trauma +α-LA.The model of traumatic brain injury was made by weight-dropping.The animals in the α-LA groups were treated with intragastric α-LA at 30 minutes after surgery, while those in the vehicle groups with oral dimethyl sulfoxide in corn oil .At 48 hours after treatment , brain samples were collected from the mice for determining brain edema , measuring the expressions of cytochrome c , Bcl-2-associated X protein ( Bax ) , and caspase-3 in the mitochondria and cytosol of the brain tissue by Western blot and immunohistochemistry respectively , and detecting the survival of the neurons and apoptosis of neural cells in the cortical area by Nissl staining and TUNEL , re-spectively. Results The brain water volume , caspase-3 expres-sion, and neural cell apoptosis were markedly higher while the neuron survival remarkably lower in the trauma +vehicle group than in the sham operation +vehicle and sham operation +α-LA groups ( P<0.01).Compared with the mice in the trauma +vehicle group, those in the trauma +α-LA group showed significantly reduced proportion of water in the brain tissue ([79.89 ±0.55] vs [81.71 ± 0.66]%, P<0.05), expression of caspase-3 ([58.40 ±7.31] vs [47.42 ±7.74]%, P<0.05), and apoptosis of neural cells ([59.63 ±8.61] vs [44.86 ±7.32]%, P <0.05), but increased survival rate of neurons ([44.45 ±10.56] vs [57.46 ± 11.01]%, P<0.05).The expression of cytochrome c in the mitochondria was remarkably decreased and that of Bax markedly in -creased in the trauma +vehicle than in the sham operation +vehicle and sham operation +α-LA groups (P<0.01). Conclusion Alpha lipoic acid has a protective effect against traumatic brain injury in mice , probably by inhibiting the apoptosis of neural cells through the mitochondrial pathway .

Aim To observe the effect of endomorphin-1 (EM-1 )on TLR2 and TLR4 expressions of dendritic cells (DC)from human peripheral blood.Methods Monocytes isolated from human peripheral blood mono-nuclear cells were cultured in medium containing re-combinant human interleukin-4 and recombinant hu-man granulocyte macrophage colony stimulating factor. After six days of culture,the immature dendritic cells (imDC ) were divided into four groups,the control group (BLA group),EM-1 group,LPS group and LPS+EM-1 group.After 2 days of culture,the expres-sions of TLR2 and TLR4 were determined by fluores-cence activated cell sorter(FACS).The expressions of TLR2 and TLR4 at mRNA level in DC were detected by RT-PCR.Results The FACS results showed that the expressions of TLR2 and TLR4 in imDC were high-er,and their expressions were decreased with the mat-uration of DC.Compared with BLA group,the expres-sions of TLR2 and TLR4 in DC were down-regulated in EM-1 group (P<0.05 ).Compared with LPS group, TLR2,TLR4 on DC surface were significantly lower in LPS +EM-1 group (P <0.01 ). RT-PCR results showed that compared with BLA group,EM-1 interven-tion induced TLR2 mRNA expression was down-regula-ted significantly (P<0.01),there were no significant changes of TLR4 mRNA expression (P>0.05 ).mR-NA expressions of TLR2 and TLR4 on DC in LPS +EM-1 group were lower than those in LPS group (P<0.05 ).Conclusions EM-1 enables the down-regula-tion of the expressions of TLR2 and TLR4 on DC sur-face,the effects of EM-1 on immune function may be associated with TLR2 and TLR4 expressions on DC surface.

Objective To evaluate the diagnostic and therapeutic role in bladder pain syndrome/interstitial cystitis (BPS/IC) of random bladder biopsy and hydrodistention with cystoscopy under anesthesia.Methods A retrospective review of cases in our BPS/IC center was performed from 2005 to 2010. One hundred and nineteen patients were included who are diagnosed as the bladder pain syndrome/interstitial cystitis (BPS/IC).There were 32 male patients,aged 47 to 64 years,and 56 years on average; 87 female cases,aged 23 to 67 years,49 years on average.Patients with bladder pain symptoms underwent a thorough evaluation which include voiding diary,pelvic pain、urgency and frequency questionnaire,urine culture,cytology,acid fast bacilli and upper tract imaging.Cystoscopy and random bladder biopsy had been undertaken with general anesthesia.Before and after hydrodistention with cystoscopy,the patients daily frequency of urination,the maximum urine volume,pain scores,symptom scores,QOL score were observed to understand whether there are significant improvement. Results One hundred and nineteen BPS/IC cases underwent random bladder biopsy and hydrodistention with cystoscopy under anesthesia,and finally 102 cases were confirmed of IC; 17 cases were not IC. Eight patients who were previously diagnosed as BPS/IC were found bladder transitional cell carcinoma as the cause of bladder pain symptoms( including 4 cases carcinoma in situ,1 case Low grade non-invasive bladder cancer,3 cases High grade invasive bladder cancers),and 4 of whom had no hematuria. Mean time from the occurrence of BPS to diagnosis of transitional cell carcinoma was 10.8 months. Three patients previously diagnosed as BPS/IC were found tuberculous cystitis as the cause of symptoms,and one eosinophilic cystitis,three chemical cystitis,two radiation cystitis were also detected.Before hydrodistention with cystoscopy under anesthesia,the daily frequency of urination in 102 cases diagnosed for IC patients was 42.1 ±5.6; the maximum urine volume was 141.0 ± 8.3 ml; pain score 7.6 ± 3.0; O'Leary-Sant questionnaire symptom score was 27.7 ± 4.2; QOL score was 7.6 ± 2.4.After hydrodistention with cystoscopy under anesthesia,the daily frequency of urination in 102 IC patients was 23.3 ± 3.4,and the maximum urine volume was 352.0 ± 1.7 ml ; pain score was 3.3 ± 4.3 ; O'Leary-Sant questionnaire symptom score was 12.5 ± 7.3 ; QOL score was 3.2 ± 5.1. Before and after hydrodistention with cystoscope under anesthesia,all of the daily frequency of urination,the maximum urine volume,pain scores,symptom scores,QOL score in 102 IC patients were significant improved (P ＜ 0.05 ). Conclusions BPS/IC remains a diagnosis of exclusion.Random bladder biopsy and hydrodistention with cystoscopy under anesthesia play an important diagnostic and therapeutic role in BPS/IC.

Objective To study the correlation of ~(18)F-fluorodeoxyglucose (FDG) PET/CT with pathological changes of the VX2 rabbit tumors after treatment of Ar-He knife,and to explore the evolution of the Ar-He knife curative effect for VX2 rabbit tumors.Methods Thirty-six Japanese white rabbits had successfully been implanted with VX2 tumors in thighs.Four weeks later,the rabbits with VX2 tumors were imaged with FDG PET/CT before they were treated with Ar-He cryoablation.The rabbits were evenly and randomly divided into 6 groups (6 rabbits in each group) and imaged with FDG PET/CT respectively on the first day,third day,seventh day,fourteenth day,thirtieth day and sixtieth day after cryoablation.The rabbits in each group were sacriftced after post-treatment FDG PET/CT imaging for pathology and immunohistochemistry studies.The standardized uptake value (SUV) of tumor regions were calculated and compared with pathology and immunohistochemistry findings in the cryoablative area in each group.Paired-samples t-test and bivariate correlation analysis were evaluated by statistical software SPSS 16.0.Results After ArHe cryoablation,pathological changes of "necrosis-inflammatory response→organization" were found.On CT imaging,the tumors enlarged during 3-14 d after treatment and then shrank gradually.On FDG PET imaging,the maximum SUV (SUV_(max)) dropped dramatically on the first day after the operation(from 2.54±1.12 to 0.67±0.12),and increased slightly on the third day (1.71±0.82),and then continually dropped to 0.51±0.32 (60 d afterthe operation).The differences of SUV_(max) between pre-and after cryoablationin each stage were significant,respectively (t=5.471,8.716,11.388,5.713,7.144 and 7.213,all P＜0.05).The size and SUV_(max) of the targeting area did not correlate with each other(r=0.259,P=0.675).The change of the MVD closely correlated with SUV_(max)(r=0.865,P=0.032).Conclusion FDG PET/CT can reveal the pathological change of tumor tissue after Ar-He cryoablation therapy and therefore may be a potential tool for evaluating the curative effect of this treatment modality.

Objective To study the dosimetric impact of different angle fields in intensitymodulated radiotherapy (IMRT) and the feasibility of beam angle optimization (BAO) for multiple intracranial metastases.Methods In total,11 patients with multiple intracranial metastases were included in these analyses.Two treatment techniques were designed for each patient:the 7 equal spaced fields (BAF group) IMRT,and 7 fields by beam angle optimization (BAO group) IMRT.The dose distribution in the target,the dose to the organs at risk and normal brain tissues,and total MU in two groups were compared to explore the dosimetric differences.Results In comparison to the BAF group,the BAO group reduced the maximum dose to left and right lenses by an average of 45％,37％ (t =-5.707,-4.438,P ＜ 0.05);the mean dose to the left and right eyes were reduced by an average of 42.6％,44.5％ (t =-4.380,-5.638,P ＜0.05);the maximum dose to the right eyes were reduced by an average of 32.5％ (t =-2.518,P ＜ 0.05).The maximum dose of the right optic nerve and the mean dose of normal brain tissue were reduced by an average of 23％ and 3％ (t =-3.105,-3.437,P ＜0.05),respectively.For the target dose,conformity and homogeneity in PTV,no statistical differences were observed between the two groups (P ＞ 0.05).The BAO group reduced the maximum dose of the brainstem and the optic chiasm,as well as the number of MU,however,the differences were not statistically significant (P ＞ 0.05).Conclusions In comparison to the BAF group,the BAO group shows a similar target dose and reduces the dose for the organs at risk.For multiple intracranial metastases,IMRT protocols with BAO are feasible and beneficial.