Purpose: The aim of this study was to compare the efficacy of liver transplantation (LT) and liver resection (LR) for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) and to investigate risk factors affecting prognosis. Materials and Methods: A total of 94 HCC patients with PVTT type I (segmental PVTT) and PVTT type II (lobar PVTT) were involved and divided into LR (n=47) and LT groups (n=47). Recurrence-free survival (RFS) and overall survival (OS) were compared before and after inverse probability of treatment weighting (IPTW). Prognostic factors for RFS and OS were explored. Results: Two treatment groups were well-balanced using IPTW. In the entire cohort, LT provided a better prognosis than LR. Among patients with PVTT type I, RFS was better with LT (p=0.039); OS was not different significantly between LT and LR (p=0.093). In subgroup analysis of PVTT type I patients with α-fetoprotein (AFP) levels >200 ng/mL, LT elicited significantly longer median RFS (18.0 months vs. 2.1 months, p=0.022) and relatively longer median OS time (23.6 months vs. 9.8 months, p=0.065). Among patients with PVTT type II, no significant differences in RFS and OS were found between LT and LR (p=0.115 and 0.335, respectively). Multivariate analyses showed treatment allocation (LR), tumor size (>5 cm), AFP and aspartate aminotransferase (AST) levels to be risk factors of RFS and treatment allocation (LR), AFP and AST as risk factors for OS. Conclusion LT appeared to afford a better prognosis for HCC with PVTT type I than LR, especially in patients with AFP levels >200 ng/mL.

Aged ; China ; Forests ; Humans ; Life Style ; Pulmonary Disease, Chronic Obstructive ; therapy

OBJECTIVETo compare the safe duration of apnea and intubation time between face mask ventilation with air and 100% oxygen during induction of general anesthesia.

METHODSEighty adult patients with ASA class I or II without predicted difficult airways were scheduled for elective surgery under general anesthesia. The patients were randomized to receive anesthesia induction with preoxygenation [Group 1, n=40, fraction of inspired oxygen (FiO)=1] or without preoxygenation (Group2, n=40, FiO=0.21). Two experienced anesthesiologists performed the mask ventilation and tracheal intubation during induction, and the assistants adjusted the oxygen concentration and recorded the pulse oxygen saturation (SpO) and other variables. The cases where SpOdecreased to below 90% before accomplishment of intubation were considered unsuccessful, and mask ventilation with 100% oxygen was given. After tracheal intubation, mechanical ventilation was not initiated until the SpOdecreased to 90%. The number of unsuccessful cases, the safe duration of apnea and intubation time were recorded in the two groups.

RESULTSThere was no unsuccessful case in either groups. The safe duration of apnea was 469.5∓143.0 s in Group 1 and 63.6∓20.0 s in Group 2, and the intubation time was 34.4∓12.6 s and 32.8∓9.6 s, respectively. The safe duration of apnea was significantly longer than the intubation time in both groups (P<0.01). The intubation time and the number of cases with SpO≥90% before completion of tracheal intubation were similar between the two groups. The safe duration of apnea was significantly shorter in Group 2 than in Group 1 (P<0.01) and was correlated with the body mass index of the patients (P<0.05).

CONCLUSIONAnesthesia induction without preoxygenation can provide sufficient time for experienced anesthesiologists to complete tracheal intubation.

OBJECTIVETo investigate a potential relationship between Solute carrier family 30 (zinc transporter) member 8 (SLC30A8) rs13266634 variant and efficacy of rosiglitazone or repaglinide in treating newly diagnosed Chinese type 2 diabetes patients.

METHODSA total of 209 diabetic patients without any antihyperglycemic history were recruited and treated with repaglinide or rosiglitazone randomly for 48 weeks (104 and 105 patients, respectively). Anthropometric measurements and clinical laboratory tests were carried out before and after the treatment. An non-synonymous variant rs13266634 was genotyped by matrix-assisted laser desorption ionization-time of flight mass spectroscopy.

RESULTSNinety-one patients in repaglinide group and ninety-three patients in rosiglitazone group completed the study. Δ value of homeostasis model assessment of beta cell function (HOMA-B) and Δ value of fasting proinsulin levels were statistically significant between three genotype groups (P=0.0149 and 0.0246, respectively) after rosiglitazone treatment. However, no genotype association was observed in the repaglinide or rosiglitazone group with other parameters.

CONCLUSIONThe SLC30A8 variant was associated with the efficacy of insulin sensitizer monotherapy on insulin secretion in patients with newly diagnosed type 2 diabetes mellitus in Shanghai, China.

Carbamates ; therapeutic use ; Cation Transport Proteins ; genetics ; China ; Diabetes Mellitus, Type 2 ; drug therapy ; genetics ; Female ; Gene Frequency ; Humans ; Hypoglycemic Agents ; therapeutic use ; Male ; Middle Aged ; Piperidines ; therapeutic use ; Polymorphism, Single Nucleotide ; Thiazolidinediones ; therapeutic use ; Zinc Transporter 8

Objective To learn the present status of defluoridation water improvement project in Shanxi province in order to provide scientific basis for speeding up the prevention and control of endemic fluorosis.Methods According to "The National Technical Scheme for Endemic Disease Control" from 2005 to 2009, the investigation points were selected in the counties that implemented the measures of water improvement and defluoridation,the status of drinking water defluoridation Project was investigated, and the water fluoride levels were determined by fluoride selective ion electrode. Results The primary status was surveyed in 1658 water improvement and defluoridation projects in 51 counties. The resource of drinking water for water improvement and defluoridation projects was mostly ground water[accounting for 93.12% (1544/1658)]. Among 1658 water improvement and defluoridation projects 1405 projects worked well(accounting for 84.74%) and 190 projects intermittently worked (accounting for 11.46%). Sixty three projects abandoned (accounting for 3.80%), in Datong basin the abandoned projects accounted for 36.36% (12/33). Water fluoride content of 1595 water improvement and defluoridation projects had been determined, among them water fluoride content of 874 projects were above 1.0 mg/L (accounting for 54.80%). The situations of exceeded national standard in the five basins was different(H = 33.22,P ＜ 0.01). The rate of over national standard of fluoride levels in drinking water was 88.37%(38/43) in Datong basin. Therefore, in Datong basin water improvement should be strengthened. Conclusions In Shanxi province the water improvement and defluoridation projects are basically running normally. However, the qualified rate is lower for the water improvement and defluoridation projects. The water improvement status varies dramatically among areas.The situation is still grim in Shanxi province. Water improvement and defluoridation needs to be strengthened to improve the effect of prevention and control of the disease.

Objective To explore the long-term effect of endemic arsenism on oxidative stress and immune function, and to provide scientific basis for prevention and treatment of the disease in the areas. Methods In 2009, Using cluster sampling and typical investigation, the cross-sectional study was completed. The patient groups and the internal control group were selected in the arsenism areas after 5 years quality improvement of drinking water(Silizhuang village, Daying village and Gucheng village in Shanyin county, Gucheng city, Shanxi province) and they were divided into mild, moderate, severe case and internal control groups, respectively. The external control group was selected in a non-arsenism area(Yangzhuang village in Heshengbu city). The Oxidative stress indicators were determined and analyzed [serum superoxide dismutase (SOD) activity was determined with xanthine oxidase method, glutathione peroxidase(GSH-Px) activity was determined with 2-thio-2-nitrobenzoic acid method, and mmuuity malondisldohyde(MDA) levels was determined with thiobarbituric acid method]. The immune function was determined and analyzed [immunoglobulin G (IgG) was determined with radioimmunoassay method, and serum lysozyme was determined with turbidimetric method]. Results A total of 252 people were surveyed, in which the external control group, the internal control group, mild, moderate and severe patient groups were 56, 57, 49,44 and 46, respectively. Serum SOD activities were (72.19 ± 11.75), (66.96 ± 12.02), (49.79±11.07), (48.54 ±10.56) and (47.68 ± 10.68)kU/L, respectively. The difference of serum SOD activities between the groups was statistically significant(F = 52.42, P ＜ 0.01 ). Serum SOD activities in the external control group were significantly higher than other groups (all P ＜ 0.05). The value in the internal control group was significantly higher than the 3patient groups (all P ＜ 0.05). There were no significant differences between the case groups (P ＞ 0.05). Serum GSH-Px activities of the five groups were (197.41 ± 38.54), (195.02 ± 31.93), (187.26 ± 28.22), (187.24 ± 25.40),(186.88 ± 21.84)U/mg, respectively, and the difference between the groups was not significant(H = 4.21, P ＞0.05). Serum MDA levels of the five groups were (4.51 ± 2.14), (5.88 ± 2.00), (6.44 ± 2.83), (5.89 ± 2.57),(5.88 ± 2.40)μ mol/L, respectively, and the difference between the groups was statistically significant(F = 3.36,P ＜ 0.05). The external control group was significantly lower than other groups(all P ＜ 0.05). No significant difference was observed between other groups(all P ＞ 0.05). Serum IgG levels were(11.16 ± 2.08), (8.15 ± 1.44), (8.77 ±2.54), (9.19 ± 1.97), (8.44 ± 2.52)g/L, respectively, and the difference between the groups was statistically significant(H = 52.92, P ＜ 0.01 ). The external control group was significantly higher than other groups(all P ＜0.05). No significant difference was observed between other groups(all P ＞ 0.05). Serum lysozyme levels were (13.57 ± 5.16), (10.05 ± 3.96), (8.78 ± 3.35), (8.72 ± 3.76), (9.38 ± 4.26)mg/L, respectively, and the difference between the groups was statistically significant (H = 35.00, P ＜ 0.01 ). The external control group was significantly higher than other groups(all P ＜ 0.05). No significant difference was observed between other groups(all P ＞ 0.05). Conclusions The effect of arsenic on the body's oxidative stress response and immune function persists after 5 years of drinking low arsenic water. In addition to intensify arsenic removal from drinking water, it should also strengthen the monitoring of population's health in the diseased areas.

Objective To become aware of the present distribution of drinking water source with high fluoride in endemic fluorosis disease areas in Shanxi Province, and to provide the evidence for making scientific and effective tactics in prevention and control. Methods According to "The National Technical Scheme for Endemic Disease Control" in the year 2004 to 2006, the investigation points were selected in 60 counties at 8 cities of Shanxi Province. The fluoride levels of water were determined by fluoride selective ion electrode. Results The fluoride content of water was determined in 2990 villages in 60 counties. Water fluorides content of 1658 villages were above 1.00 mg/L, accounted for 55.45%(1658/2990). The highest water fluoride content was 9.72 mg/L. Villages with high fluoride water in Taiyuan, Datong, Xinding, Linfen, Yuncheng basins accounted for 89.63% (1486/1658) among villages with high fluoride in Shanxi Province. In Shanxi Province the villages with high fluoride water were mainly distributed over 5 basins and scattered on the other areas. The distribution of drinking water source with high fluoride were different in 5 basins(H=316.10, P<0.05). The Water fluorides content in Datong basin(2.32 mg/L) was significantly higher than that of the other basins (P<0.05) and the ratio of drinking water fluoride levels under the national standard was 81.16%(336/414) in Datong basin. Conclusions Drinking water source with high fluoride are widespread distributed in Shanxi Province and mainly distributed in 5 basins. The situation of drinking water fluoride levels under the national standard is serious. The task of prevention and control for endemic fluorosis is still arduous. Therefore, we should strength water improving to raise the effect of prevention and treatment.

Objective In this randomized,open-label,multicenter,angiographic trial,we compared the efficacy and safety of tenecteplase(TNK-tPA)with alteplase(rt-PA)in Chinese patients with acute myocardial infarction.Method Patients with acute ST-elevation myocardial infarction and pain to hospital time within 6 hours from October 2002,to March 2004 were randomly assigned a body weight adjusted bolus of TNK-tPA(0.53 ms/kg over more than 10 s,n=58) or front loaded rt-PA(≤100 mg,n=52).Coronary angeography was performed at 90 min after initiating study drugs.All patients received aspirin and heparin(target activated partial thromboplastin time:50-70 s).The primary end point of the trial was the rate of TIMI grade 3 flow at 90 minutes.Other end points included the rate of TIMI grade 2/3 flow at 90 minutes,all cause mortality at 30 days,the moderate/severe hemorrhage without intracranial hemorrhage(ICH) and ICH within 30 days.Results TIMI grade 3 flow at 90 minutes(68.4%vs.66.7%,P=1.00),TIMI grade 2 or 3 at 90 minutes(89.5%vs.80.4%,P=0.278).total mortality at 30 days(13.8%vs.9.6%,P=0.565),the rate of moderate/severe hemorrhage(8.6%vs.5.8%,P=0.72)and incidence of ICH(3.5%vs.1.9%.P=1.00)were all similar in TNK-tPA treated patients compared to rt-PA treated patients.Conclusion The efficacy of single-bolus,weight-adjusted TNK-tPA fibrinolytic regimen is equivalent to front-loaded alteplase in terms of the rates of TIMI grade 3 flow,TIMI 2 or 3 flow.Incidences of moderate/severe hemorrhage,ICH and 30-days mortality were similar in TNK-tPA and rt-PA treated patients.

OBJECTIVETo explore the level and feature of neonate deformity in water arsenic exposure areas, as to finding out an evidence for the study and prevention of the arsenic exposure.

METHODSThe birth situation of neonate was surveyed from 1998 to 2004 in water arsenic exposure areas according to cross-sectional survey. The results were classified in accordance with ICD-10 and common surveillance of china. The population of Shanyin County served as the common people and the data were analyzed by SPSS 11.5 for windows.

RESULTSThe neonates surveyed were 2467 cases. There were 49 neonates deformity found in this investigation, giving a neonate deformity rate of 198.62 per 10,000 cases, which was shown significantly higher in water arsenic exposure areas than in the normal (U = 3.23, P < 0.01), with types of nervous system deformity, limbs deformity and congenital heart disease as in system classification. There was no significant difference of deformity rate in different sex neonates (chi2 = 0.32, P > 0.05).

CONCLUSIONThe drinking high-arsenic water over a long period of time should be a risk factor of neonate deformity. Prevention and treatment of endemic arsenic exposure should be urgently needed.

Arsenic ; analysis ; Arsenic Poisoning ; complications ; epidemiology ; Congenital Abnormalities ; epidemiology ; etiology ; Cross-Sectional Studies ; Environmental Exposure ; analysis ; Female ; Humans ; Infant, Newborn ; Male ; Water ; analysis ; Water Pollutants, Chemical ; analysis ; Water Supply ; analysis

Objective To analyze the primary risk factors of patients with first ST elevation acute myocardial infarction(FSTEMI) in Beijing and Shenyang area between 2004 -2005. The Attributable risk percentage (ARP) and population attributable risk percentage (PARP) of every risk factor were determined. Method A total of 426 consecutive FSTEMI patients and 426 gender and age matched healthy controls were included in this 1:1 matched case-control study. Result Multivariate logistic regression analysis showed that following 8 primary risk factors were associated with FSTEMI : heavy smoking ( OR = 3. 170), diabetes (OR =2.835), positive family history (OR =2.243), lack of soybeans intake (OR = 2. 243), higher psychological stress ( OR = 2. 138 ), lack of fish intake ( OR = 1. 740), lower education level (OR = 1. 572) and recent adverse life events ( < 6 months before FSTEMI, OR = 1. 515). The ARP are 71.53% ,58.33% ,54. 05% ,40. 81% ,56. 85% ,41.53% ,48. 62% ,54. 00% ;the PARP are 38.79%, 10. 40%, 4. 69%, 33. 72%, 36. 03%, 24. 96%, 29. 56%, 14. 83%, respectively. Conclusion In this patient cohort, the harmful risk factors responsible for the development of FSTEMI in Beijing and Shenyang areas during 2004- 2005 are heavy smoking, higher psychological stress, lack of soybeans intake, lower education level, lack of fish intake, recent adverse life events, diabetes and positive family history.