OBJECTIVETo study the prognostic and clinical relevance of histologic subtyping of thymoma according to the World Health Organization (WHO) classification.

METHODSThe clinicopathologic features of 108 patients with thymoma removed surgically were retrospectively reviewed. The histologic diagnosis of the tumors was made on the basis of 2004 WHO classification by two experienced pathologists. The correlation between Masaoka tumor stage, WHO histologic subtype, completeness of resection, presence of myasthenia gravis, other clinical parameters (including age, gender and tumor size) and survival was studied.

RESULTSAccording to WHO classification, there were 7 cases (6.5%) of type A thymoma, 19 cases (17.6%) of type AB thymoma, 23 cases (21.3%) of type B1 thymoma, 19 cases (17.6%) of type B2 thymoma, 27 cases (25.0%) of type B3 thymoma and 13 cases (12.0%) of type C thymoma. According to Masaoka tumor staging, 36 cases (33.3%) were in stage I, 34 cases (31.5%) in stage II, 27 cases (25.0%) in stage III and 11 cases (10.2%) in stage IV(a). The association between histologic subtype and Masaoka tumor stage was statistically significant (P = 0.000). The 5-year survival rates of type A, AB, B1, B2 and B3 thymoma cases were 100%, 100%, 93%, 83% and 43%, respectively; while the 10-year survival rates were 100%, 100%, 81%, 70% and 33%, respectively. The median survival time of type C thymoma was 62.5 months. Type B2 and B3 thymoma cases had an intermediate prognostic ranking in comparison with type C thymoma and other groups (P = 0.000). The 5-year survival rates of tumors in stage I, II and III were 100%, 77% and 54%, respectively; while the 10-year survival rates were 100%, 70% and 27%, respectively. The median survival time of patients in stage IV(a) was 14.0 months. Masaoka tumor stage was highly significant in predicting survival of patients (P = 0.000). On multivariate analysis, Masaoka tumor stage was an independent predictive factor for survival (P = 0.027). On the other hand, the WHO subtype (type A to B1 versus type B2 to B3 versus type C) and completeness of resection could predict the tumor-related survival.

CONCLUSIONSThe Masaoka tumor stage is the single most important prognostic factor of thymoma. The WHO histologic subtype and completeness of resection affect mainly the post-operative survival. The classification of thymoma may also reflect the clinical behavior of the tumor. Type A, AB and B1 thymomas belong to the low-risk group, while type B2 and B3 thymomas have an intermediate prognostic ranking. Type C thymoma carries the worst prognosis.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myasthenia Gravis ; etiology ; Prognosis ; Survival Analysis ; Thymoma ; classification ; complications ; diagnosis ; pathology ; Thymus Neoplasms ; classification ; complications ; diagnosis ; pathology ; World Health Organization

OBJECTIVETo select the effective siRNA which could inhibit the expression of DNA methyltransferase 1 (DNMT-1) in adenoid cystic carcinoma (ACC) and discuss the time-, and dose-dependent effect of RNA interference (RNAi).

METHODSFour pairs of siRNA were designed, synthesized and transfected through oligofectamine reagent into ACC cell lines ACC-2, ACC-3 and ACC-M. 24, 48 and 72 h after transfection, total RNA and protein were harvested respectively. mRNA and protein expression level of DNMT-1 were detected by real time PCR, RT-PCR and Western blot, and then the effective siRNA was subsequently selected. ACC-3 as also transfected by different concentration of siRNA and the dose-dependent effect of RNAi was discussed. Cy(3) labelled GAPDH siRNA was used as a positive control.

RESULTSTwo of 4 pairs of siRNA inhibited the mRNA expression of DNMT-1 in three ACC cell lines and the expression of DNMT-1 was downregulated by 67%, 86%, 92% and 76%, 76%, 86% respectively. The gene inhibition was detected at 24 h or 48 h after transfection, maintained only 1 - 2 days and showed direct relationship to the concentration of siRNA. The change of protein expression level of DNMT-1 was consistent to the changes of mRNA.

CONCLUSIONSThe effective siRNA which could inhibited the expression of DNMT-1 of ACC were achieved. The inhibition effect of RNAi was time-dependent and dose-dependent.

Carcinoma, Adenoid Cystic ; genetics ; metabolism ; Cell Line, Tumor ; DNA (Cytosine-5-)-Methyltransferases ; genetics ; metabolism ; DNA Methylation ; Genetic Vectors ; Humans ; RNA, Messenger ; genetics ; RNA, Small Interfering ; genetics ; Salivary Gland Neoplasms ; genetics ; metabolism ; Transfection

OBJECTIVETo investigate occupational health status of female workers in pharmaceutical industries and to propose the protective measures for the occupational health.

METHODA total of 2816 female workers from 19 pharmaceutical industries in Shandong and Gansu provinces were investigated by a questionnaire.

RESULTS73.1% of female workers exposed to occupational hazards, mainly to toxic chemicals. 63.2% of them suffered from dysmenorrhea; 38.5% of them have reproductive system diseases, i.e. mammary gland hyperplasia (44.1%), cervical erosion (26.5%), uterine annex inflammation (24.2%); 17.1% of them suffered from accidental work injuries; 34.7% of them complained about low back pain, and 29.7% of them perceived hearing loss. 94.9% of female workers hoped to get the occupational health and labor protection knowledge and skills.

CONCLUSIONStrengthening the supervision of labor protection for female workers, including technical measures occupational hazards control and health-related knowledge, and improving the occupational health status of female workers should be conducted.

Adolescent ; Adult ; China ; Drug Industry ; Female ; Health Status ; Humans ; Middle Aged ; Occupational Exposure ; statistics & numerical data ; Occupational Health ; statistics & numerical data ; Young Adult

BACKGROUNDFood composition and style is changing dramatically now, which causes inappropriate secretion of hormones from brain, gastrointestinal and endo-pancreas, may be related to unbalance of glucose in blood. The aim of this study was to explore the fast response of C-peptide, glucagon-like peptide-1 (GLP-1), ghrelin and endomorphin-1 (EM-1) to the eastern and western style meals in patients with type 2 diabetes mellitus.

METHODSThe study enrolled 57 patients with type 2 diabetes (20 men and 37 women, mean age (67.05 ± 8.26) years). Eastern style meal (meal A) and western style meal (meal B) were designed to produce the fullness effect. C-peptide, GLP-1, ghrelin and EM-1 were assessed before (0 hour) and after (2 hours) each diet.

RESULTSThe delta (2h - 0h) of C- peptide in meal A was significantly lower than that in meal B (P = 0.0004). C-peptide, GLP-1, ghrelin and EM-1 were obviously higher before meal B than those before meal A (P < 0.0001, < 0.0001, = 0.001, = 0.0004 respectively). Blood glucose 2 hours and 3 hours after meal B were higher than those after meal A (P = 0.0005, 0.0079 respectively). Correlations between GLP-1 and ghrelin were strongly positive before both meals and 2 hours after both meals and also in relation to the delta of meal A and meal B (r(A0h) = 0.7836, r(B0h) = 0.9368, r(A2h) = 0.7615, r(B2h) = 0.9409, r(A(2h-0h)) = 0.7531, r((2h-0h))B = 0.9980, respectively, P < 0.0001).

CONCLUSIONWestern style meal (high fat and protein food) could make more response of C-peptide than eastern style meal, and could stimulate more gut hormones (GLP-1, ghrelin) and brain peptide (EM-1) at the first phase of digestion.

Aged ; C-Peptide ; blood ; Diabetes Mellitus, Type 2 ; blood ; Diet ; Fasting ; blood ; Female ; Ghrelin ; blood ; Glucagon-Like Peptide 1 ; blood ; Humans ; Male ; Middle Aged ; Oligopeptides ; blood ; Postprandial Period

Objective To investigate the effect of combined narrow band ultraviolet B ( NB-UVB) and tacrolimus on the changes in the level of tyrosinase and interleukin -10 ( IL -10 ) in Guinea pig with vitiligo. Methods Animal models with vitiligo were built first .And then all the animal models were randomly divided into six groups of eight according to the principle of weight balance: normal group , model group , control group(2 times per a day), medication alone group (0.03% tacrolimus ointment skin smear , 2 times per a day ) , light alone group ( white spot area use NB -UVB irradiation , once every other a day ) , combination group(topical tacrolimus combination NB -UVB irradiation, frequency , method and time same to medication alone group and light alone group ). Colorimetric method and ELISA method were used to detect the changes in the level of tyrosinase in serum and IL -10 in skin tissue homogenates and serum respectively , before and after the administration and irradi-ate.Results No significant changes in the level of tyrosinase in serum were observed before and after combined administration of NB -UVB and tacrolimus in animal models with vitiligo .While IL-10 contents in skin tissue homogenates and serum were significantly higher than that before administration , and the difference was statistically significant (P<0.01).Conclusion Combined treatment of NB-UVB and tacrolimus can significantly improve the level of IL -10 in skin tissue homogenates and serum for animal models with vitiligo .

Objective To investigate the changes in the number of skin melanin after combined treatment of narrow band ultraviolet B ( NB-UVB) and tacrolimus ointment in animal models with vitiligo. Methods Animal models with vitiligo were built first.And then all the animal models were randomly divided into six groups of eight according to the principle of weight balance:normal group,model group,control group ( where vaseline was used in the shed white spot areas in the back of animal model, these two methods were implemented 2 times per day ), medication alone group(0.03%tacrolimus ointment skin smear,these two methods were implemented 2 times per day), light alone group(white spot area use NB-UVB irradiation, these two methods were irradiation once every other day ) , combination group ( topical tacrolimus combination NB-UVB irradiation,frequency,method and time same to medication a-lone group and light alone group).The differences of the number of mela-nin in the skin tissue before and after medication were checked and com-pared and irradiation by histopathology.Results The effect of the com-bined group on skin melanin express was significantly different compared with model group ( P<0.01 ) .Conclusion Combination of NB -UVB and tacrolimus ointment has a significant effect on vitiligo treatment.

OBJECTIVETo analyze the clinical characteristics of severely and critically ill children with 2009 influenza A (H1N1) infection.

METHODClinical data of 150 cases with 2009 influenza A (H1N1) virus infection confirmed with the use of a real-time polymerase-chain-reaction assay on nasopharyngeal swab specimens were analyzed.

RESULTAmong 150 severely and critically ill children with 2009 influenza A (H1N1) virus infection, 103 were male, 47 were female; the median age was 5 years, 81(55%) were 5 years of age or older; 21 (14%) had underlying chronic diseases. The most common presenting symptoms were fever (95%), cough (89%), vomiting (23%), wheezing (19%), abdominal pain (16%), lethargy (7%), seizures (6%), myalgia (6%), and diarrhea (6%). The common laboratory abnormalities were increased or decreased white blood cells counts (40%), elevated of CRP (33%), LDH (29%), CK (25%) and AST (19%). Clinical complications included pneumonia (65%), encephalopathy (12%), myocarditis (5%), encephalitis (1%) and myositis (1%). All patients had received antibiotics before admission or on admission; 73% of patients had received oseltamivir treatment, 23% of patients had received corticosteroids; 32 (21%) were admitted to an ICU, 13 patients were intubated and mechanically ventilated. Fourteen patients with dyspnea who were irresponsive to the treatment experienced bronchoalveolar lavage with flexible bronchoscopy, and the branching bronchial casts were removed in 5 patients. Totally 145 (97%) patients were discharged, five (3%) died, three previously healthy patients died from severe encephalopathy, one patient died from ARDS, one previously healthy patient died from secondary fungal meningitis.

CONCLUSIONSeverely and critically ill children with 2009 influenza A (H1N1) virus infection may occur mainly in older children without underlying chronic disease. The clinical spectrum and laboratory abnormality of the patients can have a wide range. Neurologic complications may be common and severe encephalopathy can lead to death in previously healthy children. Early use of bronchoalveolar lavage with flexible bronchoscopy may reduce death associated with pulmonary complications.

Child ; Child, Hospitalized ; Child, Preschool ; China ; epidemiology ; Critical Care ; Critical Illness ; Female ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; diagnosis ; drug therapy ; epidemiology ; pathology ; Male

BACKGROUNDLaparoscopic dismembered pyeloplasty is technically feasible for ureteropelvic junction (UPJ) obstruction although it is still challenged by its technical difficulty and time-consuming. In this study, we compared the initial results of retroperitoneal laparoscopic pyeloplasty versus a combined laparoscopic dissection and open reconstruction through a small incision in the treatment of UPJ obstruction.

METHODSSixty-four patients with primary UPJ obstruction underwent pyeloplasty: 32 patients underwent laparoscopic procedure and 32 patients underwent open assisted laparoscopic surgery including two steps, ie, laparoscopic dissection of the UPJ transperitoneally and then pyeloplasty via an extended small incision. The demographic data and intraoperative, postoperative and follow-up conditions of patients were compared between the two groups.

RESULTSPreoperative data were comparable in the patients of the two groups. The operative time was shorter (60.9 minutes vs 157.7 minutes, P < 0.0001) and the complication rate was lower (9.4% vs 31.3%, P < 0.05) in the open assisted group than in the laparoscopic group. The estimated blood loss (42.3 ml vs 47.8 ml), time to have normal diet (37.6 hours vs 33.8 hours), and hospital stay (6.7 days vs 6.2 days) were equivalent. The operative success rate was 97% for the open assisted group and 91% for the laparoscopic group.

CONCLUSIONSThe procedure of combined small incision with laparoscopy for UPJ obstruction is technically easy, and the results are promising. It can be used as an alternative to conventional procedures.

Adolescent ; Adult ; Child ; Female ; Humans ; Kidney Pelvis ; surgery ; Laparoscopy ; methods ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Retroperitoneal Space ; Ureteral Obstruction ; surgery ; Urologic Surgical Procedures

OBJECTIVETo examine the distribution of fluorouracil in gastric cancer (CA), lymph node (LN), normal gastric mucosa (NG), peritoneum (PE), greater omentum (GO) and lesser omentum (LO) by preoperative intraperitoneal chemotherapy with Co-fluorouracil liposome (Co 5-Fu), and offer an experimental basis for clinic practice.

METHODSNinety-six gastric cancer patients were divided into four groups: Co 5-Fu i.v. injection group (Co 5-Fu i.v.), Co 5-Fu intraperitoneal perfusion group (Co 5-Fu i.p.), 5-Fu i.v. injection group (5-Fu i.v.) and intraperitoneal perfusion group (5-Fu i.p.) given on day-2, day-1 and 60 minutes before operation. Fluorouracil concentration in all tissues collected during operation were examined by high performance liquid chromatography (HPLC).

RESULTSThe fluorouracil concentration in the tissues in Co 5-Fu i.p. group was significantly higher than that in Co 5-Fu i.v. or 5-Fu i.p. group (P < 0.05 or P < 0.01), and that in 5-Fu i.p. group was greatly higher than that at 5-Fu i.v. group (P < 0.01). In Co 5-Fu i.p. group, the concentration of drug in LN, CA, PE, NG, GO and LO decreased gradually with the former 3 tissues significantly higher than the latter 3 tissues (P < 0.01), and adjacent lymph node was the highest. In Co 5-Fu i.v. group, the ranking was LN, CA, NG, PE, GO and LO with the former 3 tissues significantly higher than the latter 3 tissues (P < 0.01) and showing tumor tissues higher than the other tissues (P < 0.01). In 5-Fu i.p. group, the ranking was PE, LN, CA, NG, GO and LO with the former 2 tissues significantly higher than the latter tissues (P < 0.01).

CONCLUSIONCo 5-Fu possesses drug targeting, slow release and long effect in gastric cancer tissues and adjacent lymph nodes. Preoperative chemotherapy with Co 5-Fu i.p. is more advantageous than 5-Fu given i.v. or 5-Fu i.p.

Aged ; Antimetabolites, Antineoplastic ; administration & dosage ; pharmacokinetics ; Female ; Fluorouracil ; administration & dosage ; pharmacokinetics ; Gastric Mucosa ; metabolism ; Humans ; Infusions, Parenteral ; Injections, Intravenous ; Liposomes ; Lymph Nodes ; metabolism ; Male ; Middle Aged ; Omentum ; metabolism ; Panax ; chemistry ; Peritoneum ; metabolism ; Polysaccharides ; administration & dosage ; isolation & purification ; pharmacokinetics ; Preoperative Care ; Stomach Neoplasms ; drug therapy ; metabolism ; pathology

AIMTo investigate the effects of ramipril on myocardial ischemia/reperfusion injury in diabetic rats, and to explore its mechanism according to the observation on myocardial ultrastructure.

METHODSStreptozotocin induced diabetic rats were divided randomly into three groups (n = 16): ischemia/reperfusion (I/R), ischemic preconditioning (IPC) and ramipril (RAM) group. Rats in RAM group were administered by RAM(1 mg x kg(-1) x d(-1)) orally for 4 weeks, the others were administered by normal saline. Then all rats were subjected to myocardial ischemia/ reperfusion injury. Rats in IPC group were preconditioned before ischemia. The ECG and the infarct size were examined. The changes of myocardial morphology were examined by light and electron microscopes.

RESULTSCompared with I/R group, the elevation of ST segment and the incidence of ventricular tachycardia and ventricular fibrillation during ischemia were significantly decreased, the infarct size at the end of reperfusion was remarkably reduced, the myocardial morphology were significantly improved, special structure of myofilaments and mitochondria remained clearly, blood vessels were unobstructed, injury of endothelium were decreased in PC and RAM groups.

CONCLUSIONRamipril administered for 4 weeks induces myocardial protection in diabetic rats, which is similar to that of IPC. The mechanism may be involved in protection of cardiocytes and mitochondria, and improvement of endothelial function.

Animals ; Cardiotonic Agents ; pharmacology ; Diabetes Mellitus, Experimental ; complications ; Ischemic Preconditioning, Myocardial ; methods ; Myocardial Reperfusion Injury ; pathology ; prevention & control ; Myocardium ; ultrastructure ; Ramipril ; pharmacology ; Rats