ObjectiveThis study aimed to analyze different transcripts specifically expressed by red blood cells in RhD-positive individuals， and to explore the mechanism of alternative splicing. MethodsErythroblasts from RhD-positive individuals were isolated and cultured in an in vitro erythroblast culture system. The fragment from exon 6 to 3’untranslated coding regions of RHD gene of RhD-positive individuals was amplified by reverse transcription polymerase chain reaction （RT-PCR） method. The PCR products were then sequenced by next-generation sequencing and the mRNA transcripts were analyzed. The maximum entropy values of 5’ splice site （ss） and 3’ ss of all exons of RHD gene were analyzed using bioinformatics. ResultsThe transcripts of the RHD gene were mainly normal full-length mRNA. In addition， eight other abnormal transcripts were also identified. According to the expression frequencies （high to low）， these transcripts were exon 7 deletion， exon 9 deletion， exons 8 and 9 deletion， exons 7-9 deletion， exons 7 and 9 deletion， exons 8-9 deletion and 170 bp insertion between exon 7 and 10， full-length with 170 bp insertion between exon 7 and 8， exon 9 deletion and 170 bp insertion between exon 7 and 8. The last three transcripts were novel. Bioinformatic analysis suggested that the abnormal splicing of exon 7 and exon 9 might be due to the decreased binding ability of 5’ss or 3’ss to the spliceosome. The intron 7 was expressed in mRNA， which might be related to the sequences conserved with 5’ss and 3’ss splicing. ConclusionThe alternative splicing patterns of RHD gene are very complicated， which leads to various transcripts at the mRNA level of the RHD gene from RhD-positive individuals.

BACKGROUNDResection of sacral chordomas is challenging. The anatomy is complex, and there are often no bony landmarks to guide the resection. Achieving adequate surgical margins is, therefore, difficult, and the recurrence rate is high. Use of computer navigation may allow optimal preoperative planning and improve precision in tumor resection. The purpose of this study was to evaluate the safety and feasibility of computer navigation-aided resection of sacral chordomas.

METHODSBetween 2007 and 2013, a total of 26 patients with sacral chordoma underwent computer navigation-aided surgery were included and followed for a minimum of 18 months. There were 21 primary cases and 5 recurrent cases, with a mean age of 55.8 years old (range: 35-84 years old). Tumors were located above the level of the S3 neural foramen in 23 patients and below the level of the S3 neural foramen in 3 patients. Three-dimensional images were reconstructed with a computed tomography-based navigation system combined with the magnetic resonance images using the navigation software. Tumors were resected via a posterior approach assisted by the computer navigation. Mean follow-up was 38.6 months (range: 18-84 months).

RESULTSMean operative time was 307 min. Mean intraoperative blood loss was 3065 ml. For computer navigation, the mean registration deviation during surgery was 1.7 mm. There were 18 wide resections, 4 marginal resections, and 4 intralesional resections. All patients were alive at the final follow-up, with 2 (7.7%) exhibiting tumor recurrence. The other 24 patients were tumor-free. The mean Musculoskeletal Tumor Society Score was 27.3 (range: 19-30).

CONCLUSIONSComputer-assisted navigation can be safely applied to the resection of the sacral chordomas, allowing execution of preoperative plans, and achieving good oncological outcomes. Nevertheless, this needs to be accomplished by surgeons with adequate experience and skill.

Adult ; Aged ; Aged, 80 and over ; Chordoma ; surgery ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Sacrum ; surgery ; Spinal Neoplasms ; surgery ; Surgery, Computer-Assisted ; methods ; Treatment Outcome

Objective To explore the risk factors of elderly people with pulmonary TB,and to provide the scientific evidence of prevention and interventions for tuberculosis among the old people in Nanchang City.Methods 1∶1 case control study was performed .A total of 390 pulmonary TB patients over 60 years old were selected as case group.One healthy person with the same gender and within 2 year age difference was selected to match each case.Interviews were carried out with a uniformly designed questionnaire.Logistic regression models were used for analysis.Results A total of 120 smear positive tuberculosis patients and 270 smear negative tuberculosis patients were investigated.And 72.82% male and 27.18% female of the 390 TB patients were investigated.Average age of patients was 70.34 ±7.75.Multivariate condition logistic regression analysis showed smoking(OR =2.359,95%CI:1.368 -4.068),contacting tuberculosis(OR =3.357,95%CI:1.854 -6.075),BMI 18.5 -24.9(OR =0.175,95%CI:0.056 -0.546),education (OR =0.110,95%CI:0.036 -0.332),annual average income (OR =0.475,95%CI:0.332 -0.681),per capita living space(OR =0.946,95%CI:0.920 -0.973)and drinking tea (OR =0.398,95%CI:0.268 -0.592)were the influencing factors(P <0.05).Conclusion Health education should be promoted auording to the risk factors,and patients manage ment should be streng thened.

Pancreaticoduodenectomy (PD) is the most effective treatment for patients with pancreatic head or periampullary lesions. Two major strategies exist: pylorus-preserving pancreaticoduodenectomy (PPPD) and pylorus-resecting pancreaticoduodenectomy (PRPD). However, it is yet unclear regarding the morbidity after PPPD and PRPD. This study analyzed the morbidity after PPPD and PRPD to determine the optimal surgical treatment of masses in the pancreatic head or periampullary region. A systematic search of databases identifying randomized controlled trials (RCTs) from the Cochrane Library, PubMed, EMBASE and Web of Science was performed. Outcome was compared by postoperative morbidity including overall morbidity, pancreatic fistulas, wound infections, postoperative bleeding, biliary leakage, ascites and delayed gastric emptying (DGE) rate between PPPD and PRPD. The DGE rate in the PRPD subgroups (conventional PD [CPD] and subtotal stomach-preserving PD [SSPPD], respectively) was also analyzed. The results showed that 9 RCTs including 722 participants were included for meta-analysis. Among these RCTs, 7 manuscripts described PRPD as CPD, and 2 manuscripts described PRPD as SSPPD. There were no significant differences in the overall morbidity, pancreatic fistulas, wound infections, postoperative bleeding, or biliary leakage between PPPD and PRPD. There was a lower rate of DGE with PRPD than that with PPPD (RR=2.15, P=0.03, 95% CI, 1.09-4.23). Further subgroup analysis indicated a comparable DGE rate for the CPD but a lower DGE rate for the SSPPD group than the PPPD group. However, the result did not indicate any difference between CPD and SSPPD regarding the DGE rate (P=0.92). It is suggested that PPPD is comparable to PRPD in overall morbidity, pancreatic fistulas, wound infections, postoperative bleeding and biliary leakage. The current data are not sufficient to draw a conclusion regarding which surgical procedure is associated with a lower postoperative DGE rate. Our conclusions were limited by the available data. Further evaluations of RCTs are needed.
Adult ; Aged ; Aged, 80 and over ; Humans ; Middle Aged ; Morbidity ; Pancreaticoduodenectomy ; adverse effects ; methods ; Pylorus ; surgery

HIV/AIDS patients in high prevalence areas with different routes of infection (sexually transmitted 878 cases, 527 cases of intravenous drug user, paid blood donor 652 cases) were choosen for traditional Chinese medicine (TCM) syndrome investigation for one-year clinical follow-up. This paper primarily concluded the nature, location and pathogenesis of AIDS diseases. Deficiency of Yang and Yin, combining deficiency of Qi are the basic deficiency syndromes, while stagnation of dampness, toxic fire are the excess syndromes; the disease location of HIV infector is spleen, main syndrome is deficiency of spleen Qi; the disease location of AIDS patient is kidney, main syndrome is deficiency of spleen and kidney Yang. The pathogenic development tendency is from deficiency of Qi to combining stagnation of dampness and toxic fire, finally to deficiency of Qi and Yin, deficiency of Yang.
Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; HIV Infections ; diagnosis ; etiology ; transmission ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Young Adult

OBJECTIVETo explore the clinical and pathological features of liver injury in adults with acquired rubella.

METHODSThirty-six adult patients with acquired rubella (AAR) were enrolled in this study, the liver functions were dynamically analyzed, liver biopsy was done in two patients.

RESULTSLiver injury was found in 77.8% of the 36 patients, with slight elevation of ALT and/or AST. The highest incidence and the most serious liver injury occurred in the period of 6-10d after vanishing of the rashes. Viral inclusion bodies were found in the liver specimen, with complete histological architecture but slight inflammation. The mean hospitalization days of AAR accompanied with liver injury and without liver injury were 18.2 days, 7.8 days, respectively (u=3.596>1.96, P<0.05).

CONCLUSIONHigh incidence of liver injury is observed in the adult patients with acquired rubella occurred in recent years, usually exhibited by mild liver injury with slight elevation of ALT. The elevation of AST or jaundice may indicate more serious liver injury, and these patients should be given active treatment to prevent acute liver failure. Liver injury may prolong the course of rubella patients.

Adolescent ; Adult ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Bilirubin ; blood ; Biopsy, Needle ; Female ; Humans ; Liver ; pathology ; Liver Diseases ; blood ; epidemiology ; etiology ; pathology ; Liver Function Tests ; Male ; Mitochondria, Liver ; pathology ; Prognosis ; Rubella ; complications ; Severity of Illness Index ; Young Adult

OBJECTIVETo observe the primary clinical result of digital template as navigation to the upper cervical pedicle instrumentation.

METHODSCT scan of upper cervical vertebrae was performed. 3-D model of upper cervical vertebrae was reconstructed by software Amira 3.1 and was preserved in STL format. Then 3-D model was run in software UG Imageware 12.0, the best pedicle channel was extracted according to the reverse engineering principle. A virtual navigational template was established according to he lamina anatomic trait, and the best pedicle channel. The virtual vertebrae and navigational template were manufactured using rapid prototyping. The navigational template was sterilized and used intra operative to assist with the placement of pedicle screw. The Accuracy of screw placement was confirmed with postoperative X-ray and CT scanning.

RESULTSThe digital navigational template had been established and used in the 3 cases, the good trajectory of cervical pedicle had been showed by the CT scan of post operation. There were not complications of related pedicle screw insertion.

CONCLUSIONSA novel method of upper cervical pedicle location using Reverse Engineering and rapid prototyping has been developed; the navigational template is found to be highly accuracy and has great expectation.

Adult ; Bone Screws ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Computer Simulation ; Female ; Humans ; Imaging, Three-Dimensional ; Middle Aged ; Models, Anatomic ; Neuronavigation ; Spinal Fusion ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

Objecfive To find out the suitable therapy for the patient of desmoid tumour in head and neck.Methods Foay-four patients with desmoid tumours of the head and neck treated at Cancer Hospital of Fudan University between 1987 and 2002 were identified from inpatient tumour database.Patients were classified into three groups:operation group(15 cases);operation+radiation group(12 cases);radiation group(17 cases).All patients were prospectively follwed.Clinieopathologic features and treatment modalities were evaluated.Results In the group of operation,four of operation group had recurrences 26.7%(4/15).In the group of radiation,three of radiation group had recurrences 17.6% (3/17).And the recurrence of operation+tradiation group Was 23.5%(4/17).No patient died of their disease.Conclusion For desmoid tumors of the head neck,operation+radiation was recommended,and the benefits of radiation therapy were demonstrated.

OBJECTIVETo identify polymorphisms of the serotonin transporter(5-HTT) gene and to find out whether there was relationship between any such polymorphisms and sleep apnea syndrome (SAS).

METHODSFor two polymorphisms of 5-HTT target DNA gene was amplified using polymerase chain reaction (PCR) and 6% non-denaturing polyacrylamide gels electrophoresis. The frequencies of the different forms of the genotypes and alleles of 5-HTT gene were analyzed in 104 patients with SAS and 150 healthy controls.

RESULTSThe frequencies of the S or L alleles and the S/S, S/L or L/L genotypes in promoter region of 5-HTT gene in SAS group were not significantly different to those in healthy controls (P > 0.05). However, the frequencies of 10/10, 12/10 genotypes of 5-HTT-VNTR in SAS patients were significantly higher than those in healthy control subjects (P < 0.05). Moreover, the frequency of the allele 10 of 5-HTT-VNTR in SAS patients was significantly higher than that in healthy controls (P<0.01).

CONCLUSIONThe allele 10 of 5-HTT-VNTR might be a susceptible factor in the pathogenesis of SAS.

Adult ; Aged ; Alleles ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Male ; Middle Aged ; Minisatellite Repeats ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Promoter Regions, Genetic ; genetics ; Serotonin Plasma Membrane Transport Proteins ; genetics ; Sleep Apnea Syndromes ; genetics ; Young Adult

OBJECTIVETo explore the dynamic postburn changes in rat hepatic function and the effects of hyperoxic Ringer's solution resuscitation on the function.

METHODSOne hundred and ninety Wistar rats of both sexes with body weight of 250 - 300 g were employed as the model and were divided into 6 groups as A, B, C, D, E and F groups as follows: normal control (A, n = 10), early resuscitation with Ringer's solution (B, n = 40), delayed resuscitation with Ringer's solution (C, n = 30), early resuscitation with hyperoxic Ringer's solution (D, n = 40), delayed hyperoxic Ringer's solution resuscitation (E, n = 30) and burn control (F, n = 40). Blood samples were drawn from the injured rats under anesthesia at 6, 12, 24 and 48 postburn hours (PBHs), and the serum contents of ALT, AST and MDA in these blood samples were determined. Hepatic tissue samples were also harvested at the same time and served histologically.

RESULTSThe plasma ALT level at 6 PBH in all groups was higher than that in A group (P < 0.05). There was significant difference of plasma ALT levels between hyperoxic Ringer's solution treatment group an other treatment groups (P < 0.05). And there was evident difference of plasma ALT levels between hyperoxic Ringer's solution treatment groups and other treatment groups (P < 0.05). The dynamic change in plasma AST was almost similar to that of ALT. The plasma MDA level was increased obviously after injury, especially in F group (highest level). Furthermore, the MDA level in C group was higher than that in B group. The plasma MDA levels in D and E groups were evidently lower than that in all other groups (P < 0.05). It was revealed by histological examination that there were different degrees of degeneration an necrosis of hepatocytes during early postburn stage, but less so in D group.

CONCLUSIONFluid resuscitation during early postburn stage with hyperoxic Ringer's solution could inhibit the production of oxygen free radicals and blunt lipid peroxidation, and it could also enhance the host tolerance to hypoxia and prevent hepatocytes from injury, thus hepatic function was protected.

Animals ; Burns ; metabolism ; therapy ; Fluid Therapy ; Hepatocytes ; drug effects ; pathology ; Isotonic Solutions ; therapeutic use ; Liver ; metabolism ; pathology ; Oxygen ; administration & dosage ; Rats ; Rats, Wistar ; Shock, Traumatic ; metabolism ; therapy