To compare clinical outcomes of transperitoneal and retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma (RCC) and to identify the indicators for each approach. Methods A total of 258 patients underwent transperitoneal(n=116) or retroperitoneal (n=142) laparoscopic radical nephrectomy for RCC. The operation time, blood loss during operation, fasting period after surgery and hospital stay were compared between the two groups. Results The operation time was 80-315 min(a mean of [167±66.8] min) for transperitoneal approach and 85-280 min(a mean of [152± 48.8] min) for retroperitoneal approach (P=0.034). The blood loss was 50-1,000 ml (a mean of [181±140.4] ml) for transperitoneal approach and 50-800 ml(a mean of [171±132.9] ml) for retroperitoneal approach(P=0.544). The fasting period of surgery was 1-5 d (a mean of [2.8±1.3] d) for transperitoneal approach and 1-5 d (a mean of [2.9±1.2] d) for retroperitoneal approach(P=0.801). The hospital stay was 3-9 d (a mean of [6.6±1.5] d) for transperitoneal approach and 3-8 d (a mean of [6.5±1.6] d) for retroperitoneal approach(P = 0. 477). Conclusion Transperitoneal and retroperitoneal approaches both can yield satisfactory surgical outcomes in laparoscopic radical nephrectomy. The transperitoneal approach is suitable for tumors with a larger size.

The teaching of the Fermentation Engineering Experiment in normal university must serve for the basic education,placing students' creative spirit and practical ability in the first place.Therefore,teaching reform of the Fermentation Engineering Experiment under the background of new curriculum reform of basic education should be studied from the curriculum content,teaching methodology,training pattern and as-sessment system,in order to cultivate the normal-university students' research ability,working attitude,crea-tive and teaching ability.

OBJECTIVETo describe the costs of medical care and utilization of health service of patients with HIV/AIDS.

METHODSPatients with human immunodeficiency virus (HIV)/AIDS treated in the Beijing You'an Hospital were interviewed retrospectively during December 1999. Data on demographic characteristics, disease process, and utilization of health service and costs of hospital-based medical care were collected.

RESULTSA total number of 29 patients with HIV/AIDS were interviewed, including 17 (58.62%) asymptomatic HIV infections and 12 AIDS patients. Asymptomatic HIV infections had a mean of 6 outpatient visits, 1.3 hospitalizations and 58.6 inpatient hospital days per person-year. AIDS patients made, on average, 7.8 outpatient visits, 2.1 hospitalizations and 200.2 inpatient hospital days per person-year. The outpatient and inpatient medical costs were 13,729 RMB and 4,745 RMB for asymptomatic HIV infections, and 15,053 RMB and 22,242 RMB for AIDS patients per person-year respectively. For those who took both outpatient and inpatient medical care, the medical care costs, including costs of outpatient care and those of inpatient care, were 16,248 RMB for asymptomatic HIV infections and 36,795 RMB for AIDS patients.

CONCLUSIONDemands for health services and costs for medical care were high among patients with HIV/AIDS. Further study on utilization of health services and cost of medical care for patient with HIV/AIDS in a wider geographic coverage are needed.

Acquired Immunodeficiency Syndrome ; economics ; Adolescent ; Adult ; Child ; China ; Female ; HIV Infections ; economics ; HIV-1 ; Health Care Costs ; Health Services ; economics ; utilization ; Hospital Charges ; Hospitalization ; economics ; Humans ; Male ; Middle Aged ; Retrospective Studies

AIMTo evaluate the effect of in vitro and in vivo treatment with mitomycin C (MMC) on activities of CYP2D1/2, CYP2C1 , and CYP1A2 in the liver of male rats.

METHODSUsing HPLC to determine the activities of the three isoenzymes in rat liver microsomes by detecting the specific metabolites of their substrates after treatment with inducers in vivo or inhibitors in vitro.

RESULTSIn vitro, MMC inhibited the activity of CYP2D1/2, CYP2C11, and CYP1A2 in dexamethasone-induced microsomes by (19 +/- 6)% (P < 0.05), (85 +/- 10)% (P < 0.01), and (36 +/- 6)% (P < 0.05), respectively, and decreased the activity of CYP1A2 in beta-naphthoflavone-induced microsomes by (58 +/- 6)% (P < 0.01). Rats were injected intraperitoneally with 20% of the LD50 of MMC for 3 or 6 d. The treatment showed no significant effect on microsomal activities of CYP2D1/2, CYP2C11 or CYP1A2.

CONCLUSIONMMC can inhibit the activities of CYP2D1/2, CYP2C11, and CYP1A2 in rat liver microsomes in vitro, but it showed no significant effect on the activities of the three isoenzymes in vivo.

Alcohol Oxidoreductases ; Animals ; Antibiotics, Antineoplastic ; pharmacology ; Aryl Hydrocarbon Hydroxylases ; metabolism ; Biotransformation ; Cytochrome P-450 CYP1A2 ; metabolism ; Cytochrome P450 Family 2 ; Male ; Microsomes, Liver ; enzymology ; Mitomycin ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Steroid 16-alpha-Hydroxylase ; metabolism

OBJECTIVESTo access the prevalence of HIV infection and the associated factors among urban MSM in China.

METHODSParticipants were recruited using respondent driven sampling and snowball sampling method in Beijing, Harbin, Zhengzhou and Chengdu city. A face-to-face questionnaire was administrated to collect relevant demographic and ethological data; 5 ml venous blood sample was taken from each subject to measure HIV antibody in serum (samples were first screened by colloidal gold, latex chromatographic and double-antigen sandwich ELISA method, positive samples were further confirmed by immunoblotting method). The characteristics of HIV infection was described and the risk factors were analyzed.

RESULTSA total of 1864 MSM were recruited and the prevalence of HIV was 6.7% (125/1864). It was 9.5% (24/252) among MSM older than 39 years and it was 1.9% (2/105) among those less than 20 years old. The prevalence was 8.4% (31/371) among MSM with junior level education and was 4.8% (41/858) among those with college level education. It was 10.3% (35/340) among MSM with sexual partner old than him for over 10 years while it was 5.0% (58/1168) among those having sexual partner within 10 years older. The prevalence of HIV infection was 8.9% (61/695) among MSM with unprotected receptive anal sex and it was 5.5% (64/1169) among those without unprotected receptive anal sex. The risk factors independently associated with HIV infection included being older than 39 years (OR = 6.5, 95%CI: 1.5 - 28.7), with junior or lower level education (OR = 1.8, 95%CI: 1.2 - 2.7), having sexual partner older than himself for over 10 years (OR = 2.1, 95%CI: 1.3 - 3.3) and having unprotected receptive anal intercourse (OR = 1.6, 95%CI: 1.1 - 2.4).

CONCLUSIONMSM had a high rate of HIV infection. Older age, lower level education, having older sexual partner and unprotected receptive anal intercourse were related to HIV infection.

Adult ; China ; epidemiology ; HIV Infections ; epidemiology ; Homosexuality, Male ; Humans ; Male ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo characterize the meningococcal strains isolated from cases and close contacts with meningococcal disease associated with an outbreak in a jail in May 2010 by investigating the national distribution of hyperinvasive ST-4821 serogroup C clone associated with this outbreak.

METHODSThe cases were described based on the clinical symptoms and laboratory results. Pharyngeal swabs were cultured for N. meningitidis from men in the jail. Meningococcal isolates were identified by serogrouping, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), respectively. Four hundred and sixteen serogroup C N. meningitidis strains were collected from 27 provinces between 2003 and 2010 for a nationwide survey and analyzed by PFGE and MLST.

RESULTSThree persons in a jail system were infected with invasive N. meningitidis serogroup C. All isolates tested had matching PFGE patterns and belonged to the multilocus sequence type (ST) 4821 clonal complex. All 47 N. meningitidis strains were identified from the pharyngeal swabs of 166 peoples in the jail, and 26 of them belonged to ST-4821 serogroup C clone, and 90.14% (375/416) serogroup C strains identified in the nationwide survey belonged to the ST-4821 complex. The ST-4821 serogroup C clone was spread nationwide, distributed in 24 provinces, especially in eastern provinces between 2003 and 2010.

CONCLUSIONEndemic transmission and carriage rate of ST-4821 serogroup C clone are high in this jail system. The ST-4821 serogroup C clone is spreading in China and nationwide distributed despite the existence of some effective vaccines.

Carrier State ; China ; epidemiology ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Meningitis, Meningococcal ; epidemiology ; microbiology ; Neisseria meningitidis ; genetics ; isolation & purification ; Pharynx ; microbiology ; Prisons

To study the program of evaluating mothers and infants after 6 months of cord blood donation, from June 1998 to February 2004, all mothers after 6 months of cord blood donation were followed-up by phone calls or letters to report on the health condition. The results showed that when 3 195 mothers were visited by phone calls, 18 mothers declined to answer. 392 letter were send to those who could not be found by phone, 15 of whom wrote back. The average time to talk with each mother was approximately 12 minutes. Follow-up on the baby donors showed two cases with chromosome abnormality, one with hypothyroidism, one with neutropenia, one with albinism and 5 dead with unclear reasons. The cord blood components from all these abnormal donors found were discarded. In conclusion, the programs to evaluate mother and baby after 6 months of cord blood donation seems important in quality control of the components stored in cord blood bank.
Adult ; Blood Banks ; Blood Donors ; China ; Female ; Fetal Blood ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Quality Assurance, Health Care ; methods ; statistics & numerical data ; Surveys and Questionnaires ; Time Factors

In the present study, a newly synthesized benzofuran lignan 4-formyl-2-(4-hydroxy-3methoxyphenyl)-5-(2-methoxycarbonyethyl)-7-methoxy-benzo [b] furan (ERJT-12) was tested for its antiproliferative activity on human tumor cells. The related mechanisms were also investigated. In vitro growth inhibitory effects of ERJT-12 on various cancer cell lines were determined by MTT assay. Cell cycle distribution and apoptosis were detected by flow cytometry. The integrity of DNA was assessed by agarose gel electrophoresis. Activation of Caspase-3/7 and Caspase-6 was measured by colorimetric assay. The expressions of cell cycle proteins cell divide cycle 25c (Cdc25c), cyclin dependent kinase 1 (CDK1), CyclinB1 and apoptosis-related proteins Bax and Bcl-2 were detected by Western blotting. MTT assay showed that ERJT-12 inhibited the proliferation of several cancer cell lines including multidrug resistant cells. MCF-7 cells were markedly arrested at gap2/mitosis (G2/M) phase after treatment with ERJT-12 and progressed into apoptosis. The increased activities of Caspase-3/7 and Caspase-6 in MCF-7 cells were observed. The expression of CyclinB1 was down-regulated. The activities of Cdc25c and CDK1 protein were suppressed and Bcl-2 protein was phosphorylated. ERJT-12 displays potent antiproliferative activity towards cancer cells through suppressing cell cycle proteins, arresting cell cycle at G2/M phase and inducing apoptosis. It might be a novel candidate for cancer therapy.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Benzofurans ; pharmacology ; CDC2 Protein Kinase ; metabolism ; Caspase 3 ; metabolism ; Caspase 6 ; metabolism ; Caspase 7 ; metabolism ; Cell Cycle Proteins ; metabolism ; Cell Division ; drug effects ; Cell Line, Tumor ; Cyclin B ; metabolism ; Cyclin B1 ; G2 Phase ; drug effects ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; bcl-2-Associated X Protein ; metabolism ; cdc25 Phosphatases ; metabolism

OBJECTIVETo summarize the clinical study of modified total aortic arch replacement and stent elephant trunk technique treatment to patients with DeBakey I thoracic aortic dissection.

METHODSFrom January 2006 to October 2010, 101 cases of DeBakey I aortic dissection were treated by modified total arch replacement and stent elephant trunk technique, in which emergency surgery for 73 cases. There were 76 male and 25 female patients, aged from 21 to 77 years with a mean of (49 ± 8) years. Intraoperative ascending aortic replacement in 31 cases, Bentall procedure in 29 cases, Wheat procedure in 7 cases, David procedure in 34 cases. At the same time stent elephant trunk in the left subclavian artery corresponding position was windowed to rebuild the blood supply. Deep hypothermic circulatory arrest cerebral protection was completed by bilateral antegrade cerebral perfusion.

RESULTSThe mean cardiopulmonary bypass time was (212 ± 40) min, mean myocardial occlusion time was (95 ± 16) min, mean circulatory arrest time was (42 ± 8) min. Operative mortality was 1 case and hospital mortality was 5 case, which died of septicemia, acute renal failure and hemiplegia complicated with multiple organ failure. Compared with selective cerebral perfusion, the incidence of postoperative cerebral vascular accident and transient neurological dysfunction decreased. Seventy-six cases received aorta CTA before discharged, the closure rate of descending thoracic aortic dissection false lumen was 78.9%. Seventy-one patients were followed up for 5 to 49 months, 50 cases was reviewed by CTA, of which closure rate of descending thoracic aortic dissection false lumen was 88.0%, no late death and re-surgery.

CONCLUSIONSThe modified total aortic arch replacement and stent elephant trunk technique treatment for patients with DeBakey I thoracic aortic dissection was safe and effective, with less postoperative complications.

Adult ; Aged ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Young Adult

OBJECTIVESThis study try to subclassify breast cancer into different prognostic subgroups according to immunohistochemical algorithm and discuss the relationship between subtypes and biological and clinical behavior and prognosis.

METHODSOne hundred and twenty-eight cases of infiltrative ductal carcinoma were studied using immunohistochemical staining with an antibody panel of ER, PR, HER2 and CK5/6 and subclassified referring to previous reports, and the 9 cases of HER2 positive subtype were tested using FISH.

RESULTSThe expression of ER, PR, HER2, and CK5/6 was detected in 67%, 45%, 27% and 27% cases, respectively. All cases were subclassified into five subgroups, with luminal A (55%), luminal B (20%), HER2 positive (7%), basal-like (10%) and unclassified cases (8%). Nine HER2 positive cases all showed amplification of HER2 gene. It was demonstrated that the luminal A group was associated with the best prognosis but the basal-like group worst by univariate analysis. Multivariate analysis demonstrated that both the clinical stage and immunohistochemical subtypes of tumor were related to overall survival. Menses status were different among these subtypes.

CONCLUSIONAccording to the expression of ER, PR, HER2 and CK5/6, infiltrative ductal carcinoma could be subclassified into five subgroups with different biological features and outcome, having a role in evaluating the prognosis and guiding the clinical treatment.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; classification ; metabolism ; pathology ; Carcinoma, Basal Cell ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; classification ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Middle Aged ; Neoplasm Staging ; Prognosis ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Survival Rate ; Tumor Burden