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Objective To explore the effect of multiplex methylation specific PCR for early diagnosis of nasopharyngeal carcinoma. Methods The methylation status of 18 genes were verified by MSP from 35 early nasopharyngeal carcinoma andmultiplex-MSP was established through the optimized working condition for rapid detection of several genes′ methylation status. Results The methylation rate of 12 genes exceeds 50%. The methylation specific products in only one group (Segment U) did reach the expected results while those from the other three groups were consistent with the MSP′s. Conclusion Multiplex-MSP is an efficient and low-cost method, and it can produce ideal experimental results similar to those by the MSP and DNA microarrays.
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Objective To investigate the clinical characteristics of patients with polyarteritis nodosa (PAN),and to improve the understanding of the disease.Methods The data of 65 consecutive PAN patients admitted to Peking Union Medical College Hospital from October 2001 to March 2013 were analyzed.Patients were divided into two groups based on hapatitis B surface antigen (HBsAg) status.Chi-square test,Fisher exact probability,t test and Mann-Whitney test were used for statistical analysis.Results The male/female ratio of patients with PAN was 1.3/1,and the average age was (37.6±1.6) years old.Fever (in 40 cases,62％) was the most frequent manifestation.Skin was involved in 51 cases (79％),urologic involvement in 44 cases (68％),peripheral nervous system involvement in 22 cases (34％) and gastrointestinal involvement in 21 cases (32％).Forty-six (71％) patients had high-sensitivity C reactive protein (hs-CRP) elevation and 11 (17％) patients had eosinophil count elevation.The most common vascular involvements were limb arteries in 22 cases (34％),renal artery in 19 cases (29％),and gastrointestinal artery in 17 cases (26％).Patients with negative HBsAg had more frequent arthralgia or arthritis(41％ vs 9％,x2=4.00,P＜0.05),more indicators of poor prognosis (30％ vs 0,P＜0.05) and more glucocorticoid pulse therapy (30％ vs 0,P＜0.05) when compared with patients with positive HBsAg.Conclusion Clinical manifestations of PAN are complex.Young patients with fever of unknown origin,rash,weight loss,myalgias,accompanied by symptoms of multi-organ damage including urologic,peripheral nervous system,gastrointestinal involvement and negative autoantibodies should be highly suspected for the diagnosis of PAN.For the treatment of patients with positive HBsAg,special attention should be paid to maintain the delicate balance between controlling the organ damage caused by PAN and prevention of hepatitis B virus (HBV) infection reactivation.
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Objective To investigate the frequence and clinical characteristics of peripheral neuropathy (PN) of patients with systemic lupus erythematosus (SLE) in China.Methods The data of 67 consecutive PN related with SLE (SLE-PN) patients admitted to Peking Union Medical College Hospital (PUMCH) during January 1995 to August 2011 were retrospectively analyzed.At the same time,a total of 201 cases were randomly selected as controls from 4447 SLE patients without SLE-PN in PUMCH during the same period.Chi-square test,t test and Mann-Whitney test were used for statistical analysis.Results The prevalence of SLE-PN in SLE patients was 1.5％(67/4514).Seventy-two cases of PN were discovered in 67 patients.Polyneuropathy was the most frequent presentation and was diagnosed in 45 cases(62.5％),mononeuropathy in 9 cases (12.5％),myasthenia gravis in 8 cases (11.1％),cranial neuropathy in 7 cases (9.7％),autonomic disorder in 2 cases (2.8％) and acute inflammatory demyelinating polyradiculoneuropathy in 1 case (1.4％).No plexopathy was diagnosed.No symptoms were observed in 5 cases (6.9％) PN.There were differences between SLE patients with and without SLE-PN in age[(37±14) years vs (32±14) years,P＜0.05],fever(65.7％ vs 47.8％,P＜0.05),myositis (17.9％ vs 5.0％,P＜0.01),skin and mucous involvement of skin and mucous (80.6％ vs 59.7％,P＜0.01),central nervous system involvement (38.8％ vs 19.9％,P＜0.01),gastrointestinal involvement (6.0％ vs 18.4％,P＜0.05),anti-Sm antibody positivity (34.4％ vs 18.6％,P＜0.05),anti-RNP antibody positivity (46.9％ vs 29.9％,P＜0.05),elevation of IgG (52.4％ vs 30.1％,P＜0.01),and SLEDAI score [12.0(9.0) vs 9.5(10.8),P＜0.05].Conclusion SLE-PN is not rare in patients with SLE.SLE patients with peripheral neuropathy tend to have more active disease.Multidisciplinary collaboration and comprehensive treatment can help to relieve pain and improve the quality of life.
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Objective To compare the outcome of proximal femoral nail antirotation (PFNA)and third generation of Gamma nail (TGN) in the treatment of femoral intertrochanteric fracture in the elderly. Methods From January 2007 to June 2008, the patients with intertrochanteric fractures were divided into PFNA group ( n = 55 ) and TGN group ( n = 52 ) randomly. The two treatment groups were comparable in aspect of general data. The clinical data of surgical trauma, complications and postoperative function of the two groups were compared in our study. Results The mean operation time was (66.6 ± 15.4) min in PFNA group and (73. 1 ± 20.8 ) min in TGN group (P ＞ 0. 05 ). The mean intraoperative blood loss differed significantly, (219.5 ± 107.5 ) ml in PFNA group compared with (269.0 ±123.9) ml in TGN group ( P ＜ 0. 05 ). The mean fluoroscopy time was ( 2.97 ± 1.14 ) min in PFNA group and (3.43 ± 1.18) min in TGN group (P＜0.05). Unilateral femoral shaft splits at the distal end of the nail was observed intra-operatively in four patients of the PFNA group and in one of the TGN group,with no statistical difference between two groups. Of all, 91 patients ( n =46 in the PFNA group and n =45 in the TGN group) were followed up for a duration of ( 17.5 ±3.69) months. There was one re-fracture and one implant failure during the follow up period in PFNA group, which was not found in TGN group. Fiftyone patients recovered to normal activity status, including 27 in the PFNA group and 24 in the TGN group,with no statistical differences. Conclusions Intertrochanteric fracture can be treated successfully with PFNA and TGN. There is no significant difference in complications and functional outcome between the two groups. However, PFNA takes advantages of less blood loss, less operative time and less fluoroscopy time over TGN.
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Objective To investigate the effect of medical rescue of the Maritime Medical Team (Corps) for mass sick and wounded in maritime disaster so as to improve the medical rescue capacity for maritime disasters.Method The construction of maritime medical teams (corps) constituted with various numbers of 10, 15,50 and 120 team members, and the development of algorithm in practice were reviewed. In 68 maritime disasters from January 2003 to December 2009, 937 wounded were rescued by first-aid at sea. The patients were classified and given cardiopulmonary cerebral resuscitation, emergency operation, complication prevention, comprehensive treatment for seawater immersion wound and rapidly referred to hospitals. Results Of 937 patients, 872 survived (93%) and 65 died (7%). Of the dead, 16 died in one hour (25%), 43 died in 24 hours after injury (66%),andofthem, 61died of trauma (94% ) , 2 died of drowning and 1 died of poisoning. Conclusions Besides a good command of the features of mass sick and wounded, organization and program, treatment strategies and measures, the timely and effective assignment for on-site first aid at sea and safe transfer were very important for medical rescue of mass patients in maritime disaster. After the practice of maritime medical team (corps) in medical rescue during maritime disaster, the rapid response capability, cooperation and the quality of rescue were improved, and the experience of medical service of marine medical team (corps) was enriched.
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From July 2006 to November 2008,16 patients with unstable intertrochanteric fractures were treated with cemented bipolar hemiprosthesis arthroplasty, including 5 males and 11 females, at a mean age of 84 years (range, 78-92 years) in the First Affiliated Hospital of Soochow University. Of them, 15 patients were followed with mean time of 14 months. The cemented bipolar hemiprosthesis was purchased from Beijing Montagne. The patients received 5-7 days of antibiotics following arthroplasty in addition to medicine of anticoagulation and analgesia. 1 case died of pulmonary heart disease 10 months after the operation and 3 cases had heterotopic ossification. There was no prosthesis loosening or dislocation. According to Harris hip scores, 3 cases were rated as excellent, 9 good, 3 fair, and 0 poor; the excellent and good rate was 80%. Results show that cemented bipolar hemiprosthesis arthroplasty is effective in treating elderly unstable intertrochanteric fractures, but operation indications require more attention.
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[Objective]To observe the expressional variability and correlation of cox-2 and p53 protein between osteosarcoma and osteochondroma and explore their clinical significance.[Method]Sixty Specimens divided into 2 groups were taken from the department of pathology,Third Hospital of Hebei Medical University during 1998~2004.Among them,40(24 male and 16 female)aged 8~38(18.68?6.47)at time of therapy were from cases of osteosarcoma excision;20(13 male and 7 female)aged 9~27(17.95?4.77)from benign lesion of bone(osteochondroma)operation.Immunohistochemistry staining(Streptavidin-Peroxidasc,S-P method)was performed to detect the expressions of cox-2 protein and p53 protein in 40 cases of osteosarcoma.The criteria of positive expression was that brown granule was found in cytoplasm(cox-2)or in nucleus(p53).The percentage of cox-2 or p53 positive expression in five high power fields was cunted randomly in each case.Positive(-):positive oncocytes account 50%.Software SAS v6.12 was used in data analysis.The difference of cox-2 and p53 expressions between osteosarcoma and osteochondroma was analyzed with Chi-square Test.Spearman method was used,with the standard ?=0.05,to analyze the relationship between cox-2 and p53 expression among osteosarcoma.[Result]The positive rate of cox-2 and p53 expressions were 67.5% and 55.0% in osteosarcoma,there was noticeable distinction between osteosarcoma and osteochondroma,most of them was high.There was a positive correlation between them,rs=0.58,P