PURPOSE: Laparoscopic cholecystectomy (LC) has been accepted as one of the best methods for treatment of patients with gallbladder (GB) disease. Diagnosis of malignant gallbladder disease by radiologic finding is possible; however, some cases can be diagnosed incidentally as cancer of the gallbladder after a LC. Prognosis of GB cancer is very poor; however, a complete recovery can be achieved with early detection and resection. This study was performed in order to determine incidence and clinical features of incidentally detected GB cancer after LC. METHODS: A retrospective analysis of 10 Patients diagnosed as GB polyp prior to surgery, but diagnosed incidentally as GB cancer after LC from January 2002 to February 2011 was conducted. RESULTS: Of 124 cases of GB polyp, 10 patients were diagnosed as incidental GB cancer, with incidence rate of approximately 8%. Mean age was 60.9. Mean diameter of polyps was 1.1 cm, with six cases of pedunculated polyps, and four cases of sessile polyps. GB stones were diagnosed by radiologic study prior to surgery in four patients. Four patients had pT1a tumors (limited to mucosa) and six patients had pT2 (invaded perimuscular tissue) or pT3 (perforated serosa, direct invasion into liver). CONCLUSION: Malignancy potential of GB polyps was 8%. Surgeons should be aware of the possibility of malignancy and frozen section biopsy should be performed for examination of suspected GB tissue. If needed, radical cholecystectomy should be performed.
Biopsy ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Frozen Sections ; Gallbladder ; Gallbladder Diseases ; Gallbladder Neoplasms ; Humans ; Incidence ; Polyps ; Prognosis ; Retrospective Studies ; Serous Membrane

OBJECTIVE: To evaluate the application of MSCT and post-processing images to fractures of nasal bone in forensic identification. METHODS: 134 cases were examined by thin slice scanning with MSCT and all of the data were sent to workstation for MPR and SSD. The result of MSCT was compared with that of X-ray. RESULTS: There are 55 (41.04%) cases of linear fracture, 46 (34.33%) cases of comminuted fracture, 27 (20.15%) cases of depressed fracture and 6 (4.48%) cases of no fracture in this sample. With X-ray or CR, 48 (35.82%) cases were misdiagnosed or underdiagnosed. 133 (99.25%) cases were confirmed by MSCT. Significance difference was found between X-ray and MSCT (chi2= 45.0816, P<0.001). CONCLUSION MSCT and post-processing images might be the chief evidence for nasal fractures in forensic identification.
Adolescent ; Adult ; Chromatography, Thin Layer ; Female ; Forensic Medicine/methods* ; Fractures, Comminuted/diagnostic imaging* ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Nasal Bone/injuries* ; Skull Fractures/diagnostic imaging* ; Tomography, Spiral Computed/methods* ; Young Adult

Hemodynamics changes in pregnant women,cardiac output increases by 50％,increasing the burden of cardiovascular system.It leads to further aggravation of original cardiovascular diseases during pregnancy,and non-pregnancy potential cardiovascular diseases will show up.Advanced age,obesity and diabetes etc.are risk factors of cardiovascular diseases,and they are more common in pregnant women than those non-pregnant,thus incidence rate of cardiovascular diseases increase in pregnant women consequently,making 1％～4％pregnancy more compli-cated than the normal pregnancy,which is also an important reason leading to pregnant woman death and adverse outcomes such as premature birth and stillbirth.Treatment during pregnancy should consider impact of fetus,there-fore its more complicated and difficult for clinical treatment of cardiovascular diseases during pregnancy.The pres-ent article mainly elaborates influence of cardiovascular diseases on pregnancy,including gestational hypertension,gestational diabetes and perinatal cardiomyopathy.

OBJECTIVETo identify the distribution and differentiation of ABL kinase domain mutation in the Chinese Han nationality imatinib resistant chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+)ALL).

METHODSBone marrow or peripheral blood samples of 112 imatinib resistant CML patients and 21 Ph(+)ALL patients were obtained from the first affiliated hospital of Soochow university according to local law. Total RNA was extracted from the mononuclear cells using a TRIzol reagent. ABL kinase domain (KD) mutation was detected by direct sequencing.

RESULTSOf the 112 imatinib resistant CML patients, 54.46%(61 cases) had ABL KD mutation. Twenty-three mutants were identified in 20 amino acid sites and 23.21% (26 cases) ABL KD mutations were in P-loop region. ABL KD mutations were also detected in 71.43% (15 cases) imatinib resistant Ph(+)ALL patients, with 10 mutations in 8 amino acid sites. The most frequent mutation was T315I (28.57%), followed by E255K/V (19.05%) and Y253F/H (14.29%). The frequency of T315I was much higher in imatinib resistant Ph(+) ALL than that in imatinib resistant CML (P = 0.001). Ph(+)ALL with additional chromosomal aberrations also had a higher rate of ABL KD mutation than that of CML (P = 0.010). Ph(+)ALL gained ABL KD mutation faster than CML (P < 0.010).

CONCLUSIONChinese imatinib resistant CML and Ph(+)ALL patients had different characteristics in ABL KD mutation. The rate of ABL KD mutation in Ph(+)ALL with additional chromosomal aberrations was much higher than that of CML with additional chromosomal aberrations.

Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; Benzamides ; pharmacology ; Chromosome Aberrations ; Drug Resistance, Neoplasm ; genetics ; Female ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Middle Aged ; Mutation ; Philadelphia Chromosome ; Piperazines ; pharmacology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Protein-Tyrosine Kinases ; genetics ; Proto-Oncogene Proteins c-abl ; genetics ; Pyrimidines ; pharmacology ; Young Adult

OBJECTIVETo observe the effects of Stragalus membranaceus injection on nitric oxide and endothelin levels of intestinal mucosa in reperfusion injury after hemorrhage shock.

METHOD32 SD rats were randomly divided into four groups: normal group, model group, low dosage group, (treated with Astragalus membranaceus 10 g x kg(-1)); high dosage group (treated with Astragalus membranaceus 20 g x kg(-1)). Models of hemorrhagic shock for 60 minutes and reperfusion for 90 minutes were created. The animals were administrated 3 mL therapeutic solution before reperfusion. At the end of study, intestinal pathology was observed, and the concentration of lactic acid (LD), nitric oxide (NO), endothelin (ET) of intestinal mucosa were detected.

RESULTThe intestinal pathology showed that intestinal mucosa epithelial cells damage in model group was severe, in low dosage group was medium, in high dosage group was slight, and no obvious damage was found in normal group. The concentration of LD and NO of small intestine mucous membrane in model group and low dosage group were significantly higher than those in high dosage group and normal group (P < 0.05), but there were no significant differences between high dosage group and normal group (P > 0.05). The concentration of ET of small intestine mucous membrane in model group was the highest of the four groups (P < 0.05). The concentration of ET in low dosage group was significantly higher than that in high dosage group and normal group (P < 0.05), but there were no significant differences between high dosage group and normal group (P > 0.05).

CONCLUSIONStragalus membranaceus injection can reduce small intestine mucous damage by protecting endothelium function in injury after hemorrhage shock-reperfusion.

Animals ; Astragalus membranaceus ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Endothelins ; metabolism ; Ileum ; metabolism ; pathology ; Injections, Intravenous ; Intestinal Mucosa ; metabolism ; pathology ; Lactic Acid ; metabolism ; Male ; Nitric Oxide ; metabolism ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; etiology ; metabolism ; pathology ; Shock, Hemorrhagic ; complications

Purpose:To summarize our experience in related donor renal transplantation. Methods:Analyzedand reviewed the clinical date of 7 cases related donor renal transplantation in our center. Results:All 7 patientsrecovered smoothly from the operation. 1 of 7 had rejection. 6 of 7 had their transplanted kidney funtioned well,and 1 case died of liver function failuer. Conclusions:The advantage of related transplantation was less rejectionoccoured and much longer graft survive time obtained. But a care operation in the harvesting of donor graft wasneeded.

In this work,a tetrahedral DNA nanostructure(TDN)functionalized rotational paper-based analytical device(RPAD)was constructed for rapid and highly sensitive detection of aflatoxin B1(AFB1)using exonucleaseⅠ(ExoⅠ)and G-quadruplex(G4)dimer.Herein,a single-stranded DNA,containing both of the G4 dimer sequence and AFB1 recognition sequence,was used as the recognition probe(G4 dimer probe).TDN was used to precisely regulate the orientation and distribution density of G4 dimer probe to improve the recognition efficiency of the system.ExoⅠas a single stranded DNA specific nuclease was introduced for effective amplification of the detection signal.G4 dimer was employed to enhance the fluorescence signal of thioflavin T(ThT).In the absence of AFB1,the G4 dimer structure of G4 dimer probe could specifically bind with ThT to generate dramatic fluorescence enhancement.However,in the presence of AFB1,AFB1 could specifically bind with G4 dimer probe,resulting in the dissociation of G4 dimer probe from TDN and further be digested by ExoⅠ.At the same time,the released AFB1 could bind to G4 dimer probe on the TDN again by this way to generate signal amplification.After this cycle,the amount of aptamer on the TDN was decreased,accompanied by the reduction of G4 dimer on TDN.In this case,the fluorescence intensity of the system was reduced.The designed RPAD showed a good linear response in AFB1 concentration range of 0.0001-500 ng/mL and the limit of detection was 0.1 pg/mL.Moreover,the proposed strategy was successfully applied to detection of AFB1 in peanut and wine.The developed TDN/G4 dimer/ExoⅠstrategy improved the specificity and sensitivity of the system significantly.

OBJECTIVETo evaluate the prevalence of TET2 gene mutation in acute myeloid leukemia (AML) patients, and analyze their clinical characteristics and prognosis.

METHODSPolymerase chain reaction (PCR) and direct sequencing were used to sequence exon 3 to 11 of TET2 gene.

RESULTSAmong 96 AML patients, TET2 gene mutation was detected in 13 (13.54%) patients (95%CI 6.70% - 20.38%). The median age was 54 years in mutated group and 41 years in unmutated group (P = 0.010). Mutated and unmutated patients did not significantly differ in gender, white blood cells (WBC) count at diagnosis, platelet count, PB and BM blast percentage and chromosome karyotype, excepting for hemoglobin level 84 (70 - 108) g/L in mutated group versus 70 (55 - 87) g/L in unmutated group (P = 0.032). TET2 gene mutation had no significant correlation with C-KIT, FLT3, JAK2V617F mutations, but did with NPM1 mutation. TET2 mutated patients had lower CR1 rate and 2-year overall survival than unmutated in non-M(3) patients (P < 0.05).

CONCLUSIONSTET2 gene mutation is more prevalent in older AML patients and has a certain correlation with clinical characteristics and outcome. It may be a molecular marker for poor prognosis in AML.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; DNA Mutational Analysis ; DNA-Binding Proteins ; genetics ; Exons ; Female ; Humans ; Karyotype ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Proto-Oncogene Proteins ; genetics ; Young Adult

Objective To explore the thoughts and medication rules of the contemporary inheritors of Lingnan LUO's Gynecology in differentiating and treating menopausal syndromes based on data mining technology.Methods The medical records of menopausal syndrome differentiated and treated by the contemporary inheritors of Lingnan LUO's Gynecology in clinic were collected.The Ancient and Modern Medical Records Cloud Platform(V2.3.5)was used to perform frequency statistics,association rule analysis,cluster analysis and complex network analysis of the data of medical records.Results A total of 191 medical records and 191 prescriptions were finally included,involving 160 kinds of Chinese medicinals.The statistics of four-examination information and syndrome types showed that the pathogenesis of menopausal syndrome was characterized by deficiency of the origin,which resulted in the dysfunction of healthy qi and the disturbance of the pivot,and then multiple viscera were involved;among the syndrome types,liver and kidney yin deficiency syndrome was the most common type.There were 26 high-frequency Chinese medicinals with the frequency being or over 40 times,and the top 5 Chinese medicinals were Lilii Bulbus,Codonopsis Radix,Corni Fructus,Paeoniae Radix Alba,and Rehmanniae Radix Praeparata.Most of the medicines were sweet in flavor and mild in nature,and had the meridian tropism of the liver,heart,kidney and spleen meridians.A total of 15 pairs of high-confidence drug combinations were obtained after association rule analysis.Cluster analysis of high-frequency Chinese medicinals yielded 5 core drug combinations.The complex network analysis revealed the core prescription which was composed of Rehmanniae Radix Praeparata,Corni Fructus,Cuscutae Semen,Lilii Bulbus,Ziziphi Spinosae Semen,Salviae Miltiorrhizae Radix et Rhizoma,and Margaritifera Concha.The association rule analysis showed that the drug pairs with high frequency of use were Ligustri Lucidi Fructus-Corni Fructus,Ligustri Lucidi Fructus-Salviae Miltiorrhizae Radix et Rhizoma.Conclusion For the treatment of menopausal syndrome,the contemporary inheritors of Lingnan LUO's Gynecology take the therapy of nourishing liver and kidney as the key,and also adopt the therapies of nourishing the heart and calming the mind,benefiting qi and invigorating the spleen,and harmonizing the pivot.The medicines prescribed by the inheritors mostly are sweet-light and mild tonics,and their prescription and medication rules are consistent with Professor LUO Yuan-Kai's academic thoughts.

OBJECTIVETo assess the prevalence of several tyrosine kinases (TKs) gene mutations including c-Kit, FLT3 and JAK2 V617F in core binding factor related acute myeloid leukemia (CBF-AML), and analyze their impact on clinical characteristics and prognosis.

METHODSMutations of c-Kit, FLT3-ITD and FLT3-TKD were detected by genomic DNA PCR and sequencing, and JAK2 V617F mutation screening by allele-specific PCR in 58 newly diagnosed CBF-AML patients [28 AML with inv(16) and 30 with t(8;21)], and analyze the patients clinical characteristics and prognoses.

RESULTSc-Kit aberrations were detected in 32.8% cases, including 6 cases mutated in exon 8 (mutKIT8) and 13 mutated in exon 17 (mutKIT17). MutKIT8 was more prominent in inv(16) than in t(8;21) patients (21.4% vs 0, P = 0.009). Only 2 cases had FLT3-ITD and 7 (12.1%) FLT3-TKD mutations. The result of JAK2 V617F mutation screenings in these CBF-AML patients was negative. The frequency of receptor tyrosine kinases(RTK) mutations was 46.6% and only one case had two kinds of missense mutations (mutKIT8 & TKD(+)). Median age of onset was higher for mutKIT17 than for wide-type c-Kit (wtKIT) patients (55 vs 31, P = 0.003). c-Kit mutations were significantly associated with decreased overall survival (OS) and continuous complete remission (CCR) rates (P = 0.053, and 0.048 respectively), and so did more for exon17 mutated patients reduced (P = 0.005, and 0.013 respectively). FLT3-TKD mutation showed no effects on prognosis of CBF-AML patients.

CONCLUSIONSRTK mutations are common in patients with CBF-AML. c-Kit mutations frequently and JAK2V617F mutation rarely appear in CBF-AML. c-Kit mutations, especially mutKIT17 confers higher relapse risk and poorer prognosis.

Adolescent ; Adult ; Aged ; Core Binding Factors ; DNA Mutational Analysis ; Female ; Humans ; Janus Kinase 2 ; genetics ; Leukemia, Myeloid, Acute ; diagnosis ; etiology ; genetics ; Male ; Middle Aged ; Mutation ; Prognosis ; Protein-Tyrosine Kinases ; genetics ; Proto-Oncogene Proteins c-kit ; genetics ; Young Adult ; fms-Like Tyrosine Kinase 3 ; genetics