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In the context of the national strategy of promoting the research and development of food and drug homologous substances, it is necessary to study the regulatory model of food and drug homologous substances as food. Medicinal and food homologous substances are regulated as "Chinese medicinal materials" or "Chinese decoction pieces" in the drug category, and as "food and drug homologous substances", "agricultural products" or "traditional Chinese medicine healthy food" in the food category. Drug supervision focuses on quality, while food supervision focuses on safety, and it is worth exploring whether there is a blind spot in the supervision of food and drug substances completely based on the food concept. In this paper, Lonicerae Japonicae Flos, as drug and food homologous substance, is selected as the research object, and its quality regulation status is investigated by reviewing the relevant laws and regulations and standards on food, analyzing the quality information and test results of the samples, and analyzing the necessity of quality regulation when serving as food, in order to provide a basis and reference for the way food substances are regulated.
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We report a case of a female teenage with monogenic diabetes mellitus caused by glucokinase regulator (GCKR) gene mutation who presented with diabetic ketosis and misdiagnosed as type 1 diabetes. The patient was treated with insulin for 3 years since diagnosis. The islet function was well preserved, but polycystic ovary syndrome was developed. Whole-exome gene sequencing revealed a GCKR gene c. 69delG heterozygous mutation. After molecular diagnosis, the insulin dosage was gradually reduced to full cessation, and only metformin sustained-release tablets were taken to control blood glucose. It is necessary to regular evaluate islet function of patient with type 1 diabetes, and genetic test is of significance for accurate diagnosis and treatment.
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Strengthening the standard formulation and quality management of traditional Chinese medicine（TCM） dispensing granules is an important part of the strategic planning for the development of TCM in China. In order to examine the clinical application and overall quality control of the existing national standards for TCM dispensing granules， this study classified and summarized the varieties in the existing standards， analyzed their clinical applicability， and discussed the characteristics of the test methods for identification， content determination and specific chromatogram/fingerprint. It was found that the coverage of the existing standards was inadequate in terms of quantity， and it was even weaker in the aspects of therapeutic efficacy， herb family， processing method and preparation method of TCM dispensing granules. It was concluded that the characteristics of national standards in test methods were summarized as follows：guided by clinical application， based on the reference system， taking specific chromatogram as a breakthrough， so as to improve the overall quality control of TCM dispensing granules. It is suggested that the coverage of national standards should be subsequently expanded to meet the needs of market development. In order to enhance clinical applicability， the content of national quality standards should be increased， including increasing variety diversity to meet the needs of clinical application， raising the standard requirements to improve the clinical medication experience， and strengthening effectiveness research to highlight clinical efficacy. At the same time， the accessibility of regulatory inspection is enhanced， the rules for the management of varieties without national standards are promulgated to lay the foundation for the healthy and orderly development of TCM dispening granule industry.
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Objective To investigate the change in interleukin-33 (IL-33) in the peripheral blood of hepatocellular carcinoma (HCC) patients and the role and potential mechanism of IL-33 in regulating CD8 + T cell function in HCC patients. Methods A total of 44 HCC patients who attended Shaanxi Provincial People's Hospital from April 2019 to January 2020 and 20 healthy controls were enrolled. Peripheral blood was collected, and plasma and peripheral blood mononucleated cells (PBMCs) were isolated; ELISA was used to measure the plasma levels of IL-33 and its receptor ST2, and quantitative real-time PCR was used to measure the relative mRNA expression levels of IL-33 and ST2 in PBMCs. CD8 + T cells were purified and stimulated with recombinant IL-33; CCK-8 assay was used to assess cell proliferation, enzyme-linked immunospot assay was used to measure the secretion of perforin and granzyme B, and flow cytometry was used to measure the expression of PD-1, LAG-3, and CTLA-4; changes in cell proliferation, secretion of cytotoxic molecules, and immune checkpoint molecules after IL-33 stimulation were compared. CD8 + T cells were co-cultured with HepG2 cells; the expression of lactate dehydrogenase was measured to calculate the proportion of dead HepG2 cells induced by CD8 + T cells, and the change in the killing function of CD8 + T cells after IL-33 stimulation was compared. The t -test or the paired t -test was used for comparison of continuous data between two groups, and a Pearson correlation analysis was performed. Results Compared with the control group, the HCC group had significantly lower plasma level of IL-33 (269.80±63.08 pg/ml vs 339.50±64.43 pg/ml, t =4.072, P 0.05). The proportion of CD8 + T cells was not correlated with the plasma level of IL-33 or ST2 (both P > 0.05). Compared with the control group, the HCC group had significantly lower levels of perforin and granzyme B (both P 0.05), but it promoted the secretion of perforin and granzyme B ( P < 0.05). Compared with the control group, the HCC group had a significant reduction in the killing activity of CD8 + T cells ( P < 0.05), and stimulation with recombinant IL-33 enhanced the killing function of CD8 + T cells, which was mainly reflected in the increases in the proportion of dead HepG2 cells ( P < 0.05) and the secretion of IFNγ and TNFα ( P < 0.05). Conclusion There is a reduction in the plasma level of IL-33 in HCC patients. IL-33 can enhance the killing activity of CD8 + T cells by promoting the secretion of perforin and granzyme B, which provides a new target for the treatment of HCC.
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Objective:To evaluate the clinical features and follow-up effect of treatment for retinal capillary hemangioma (RCH) of myopic disc.Methods:Retrospective case series studies. A total of 14 patients (15 eyes) diagnosed with juxtapapillary RCH (JRCH) at Peking Union Medical College Hospital and followed up for more than 12 months from January 2007 to December 2019 were included. Among these patients, there were 7 males (7 eyes) and 7 females (8 eyes) with the average age of 29.8±12.7 years. There were 6 isolated JRCH cases, all of which were monocular patients, including 1 case with a single peripheral RCH; 8 cases with von Hippel-Lindau disease, including 5 cases of binocular RCH. Out of 15 eyes, 6 eyes were merged with peripheral RCH. Three eyes were simply observed, and 12 eyes were treated with photodynamic therapy (PDT) alone or PDT combined with other treatments. The average follow-up time was 55.2 months. Its clinical characteristics and long-term treatment effects were analyzed.Results:At the first visit, among the 15 eyes, 3 eyes had visual acuity <0.1, 5 eyes were 0.1-0.4, and 7 eyes were> 0.5. The endogenous and fixed exogenous JRCH were 12 (80%, 12/15) and 3 (20%, 3/15) eyes, respectively. The size of the tumor was 1/4 to 4 optic disc diameters (DD); the combined macular edema, epiretinal membrane, and macular hole were 11, 5, and 1 eyes, respectively. There were 3 eyes with tumor diameter less than 1 DD. The visual acuity at the first diagnosis was 0.6-1.0, and no treatment was given. The follow-up time was 12 months in 2 eyes and 120 months in 1 eye. At the last follow-up, his vision remained stable and the tumor did not enlarge. Six eyes with tumor diameter ranging from 1.0 to 2.5 DD, visual acuity was 0.06 to 0.6 at first diagnosis, accompanied by retinal exudation. 5 eyes were treated with PDT alone, and 1 eye was treated with PDT combined with anti-vascular endothelial growth factor drugs. The follow-up time was 12 to 84 months. At the last follow-up, the visual acuity improved or stabilized in 5 eyes and decreased in 1 eye. There were 6 eyes with peripheral RCH, including 4 eyes with retinal detachment, 2 eyes with epiretinal membrane, and 1 eye with vitreous hemorrhage. The visual acuity at the first visit was 0.02-0.6. All patients were treated with PDT combined with transpupillary thermotherapy, extrascleral drainage, and vitrectomy. The follow-up time was 12 to 132 months. At the last follow-up, all eyesight decreased.Conclusions:Visual decrease cause by JRCH often occurs at young adults. Bilateral JRCH are more common in patients with von Hippel-Lindau's disease. The tumor can cause retinal exudation, macular edema, epiretinal membrane and macular hole, resulting in gradual vision loss. PDT and/or combined anti-vascular endothelial growth factor drugs for medium sized JRCH with retinal exudation can maintain long-term vision stability. Patients with large JRCH or severe complications such as retinal detachment tend to have poor prognosis.
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Objective:To explore the effect of SimMan 3G simulator based scenario simulation teaching method and case-based learning (CBL) in emergency medicine teaching.Methods:Sixty students from Batch 2013 eight-year program of clinical medicine were selected as subjects. They were randomly divided into an experimental group and a control group, with 30 students in each group. In the teaching of emergency medicine, the experimental group used the combination of scenario simulation with CBL teaching methods, and the control group used classic teaching methods. The test scores and the questionnaires satisfaction of the two groups were compared to evaluate the teaching effects. SPSS 17.0 was used for the statistical analysis, measurement data were compared between the groups by t test, and counting data were compared between groups by chi-square test.Results:The scores of the experimental group (94.24±1.13) were better than those of the control group (90.6±0.59), with significant differences ( t=12.85, P<0.05). The results of the questionnaires showed that the students of experimental group were more satisfied with the learning experience than those of the control group. Conclusion:The teaching method can improve the teaching effects, the students' emergency clinical thinking, skills, comprehensive analysis and judgment ability, team cooperation consciousness and leadership ability.
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Objective To investigate the neuroprotective effect of Benztropine on retinal ganglion cells (RGCs) death and optic nerve injury in rats model of non-arteritis anterior ischemic optic neuropathy (rNAION).Methods A total of 25 Sprague-Dawley rats were randomly divided into Benztropine treatment group (n=13)and PBS control group (n=12).The right eye was set as the experimental eye.rNAION model was established by using rose Bengal combined with laser photodynamic method.The rats in the Benztropine treatment group were received intraperitoneal injection with Benztropine 10 mg/kg (0.2 ml) daily for 3 weeks,while the rats in the PBS control group were received intraperitoneal injection with an equal volume of PBS.At 1,3 and 7 days after modeling,the retinal and optic disc conditions of the rats were observed by direct ophthalmoscopy.Retrograde labeling,fluorescence microscopy and transmission electron microscopy were used to observe the survival of RGCs and the damage of the optic nerve myelin and axon at 4 weeks after modeling.The RGCs density and survival rate of the two groups were compared by One-Way Anova.Results At 1 and 3 days after modeling,the optic disc edema was observed in the rats of rNAION model group.At 7 days after modeling,the optic disc edema decreased and the boundary was blurred compared with 3 days after modeling.After 4 weeks,the RGCs density in the PBS group was 308± 194/mm2 and the survival rate was 13.7％.The density of RGCs in the Benztropine group was 1173+868/mm2 and the survival rate was 47.6％.The differences of RGCs density and survival rate were significant between the two groups (F=7.552,8.184;P=0.015,0.012).Myelin disintegration,axon degeneration,onion-like body and gliosis were observed in the optic nerve sections of rNIAON in the PBS group,while the damage ofaxon and myelin structure in the Benztropine group was significantly less than that in the PBS group.Conclusions Benztropine group showed higher RGC survival rate,less damage ofaxon and myelin structure on rNAION model.This study explored the potential neuroprotective effect of Benztropine.
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Objective To study the effectiveness of scleral buckling without subretinal fluid drainage for macula-on rhegmatogenous retinal detachment (RRD),and to analyze the correlation between bestcorrected visual acuity (BCVA) and the height of foveal subretinal fluid as well as the thickness of central retina measured by optical coherence tomography.Methods The medical records of 27 patients (27 eyes)who underwent scleral buckling without subretinal fluid drainage for macula-on RRD were retrospectively analyzed.The BCVA,height of foveal subretinal fluid and central subfield thickness (CST) were evaluated preoperatively and 1 week,1 month,3 months,6 months and 12 months postoperatively.Results Postoperative BCVA of all eyes were improved significantly (P ＜ 0.05),and no significant improvement of BCVA was observed after 3 months postoperatively.After surgeries,the height of foveal subretinal fluid as well as the thickness of central foveal retina were correlated with the length of postoperative period significantly,respectively (P ＜ 0.05),but had no correlation with the improvement of postoperative BCVA (P ＞ 0.05).Conclusions Scleral buckling without subretinal fluid drainage for macula-off RRD improved the BCVA,especially in the first 3 months postoperatively.The postoperative alterations of subretinal fluid and central foveal retinal thickness had no correlation with BCVA.
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Objective To observe the effect of ultrasound-guided transversus abdominis plane block combined with diclofenac sodium suppository in anus on postoperative analgesia and early recov-ery after laparoscopic hysterectomy.Methods Sixty-six patients of laparoscopic hysterectomy,aged 40-60 years,were randomly divided into group T and group D,33 cases in each group.Group T used ultrasound-guided bilateral transversus abdominis plane (TAP)block after surgery.Group D used TAP block and diclofenac sodium suppositories in anus.All patients received PCIA.Postoperative 24 h sufentanil dosage out of analgesia pump and the effective press times were recorded.The incidence of dysphoria,nausea and vomit within postoperative 24 h,the time of first out-of-bed activity,the time of first anal exhaust and the time of removing urine tube were measured.The plasma concentra-tion of interleukin-6(IL-6),C reactive protein (CRP)and cortisol (Cor)were recorded at the follow-ing four time points:before anesthesia,just postoperative moment,8 and 12 h after surgery. Results Compared with group T,the sufentanil dosage [(18.6±3.2)μg vs (40.8±5.1)μg]and the effective press times [(9.3±2.2)times vs (20.4±3.5)times]were fewer in group D (P<0.05).The incidence of dysphoria,and nausea and vomit were less in group D compared with group T (P<0.05).The IL-6,CRP and Cor of group D at 12 h were lower than those of group T (P<0.05). But the times of first out-of-bed activity,anal exhaust and removing urine tube in two groups were not significantly different.Conclusion Transversus abdominis plane block combined with diclofenac sodium suppositories in anus can provide safe and effective postoperative analgesia for laparoscopic hysterectomy,and promote the early fast recovery.
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Objective To compare the fast blood flow density (FBFD) of intermediate choroid between endogenous Cushing syndrome (ECS) patients and healthy control subjects.Methods Thirteen eyes of 7 eligible ECS patients (ECS group) and 13 eyes of 7 gender,age,axial length matched healthy volunteers (control group) were enrolled in this study.For each subject,macular radial scan with swept source optical coherence tomography (SS-OCT) was performed and subfoveal choroidal thickness (SCT) was measured.Then 3.0 mm× 3.0 mm macular scan with SS-OCT angiography was performed,and selected blood flow image at intermediate choroid level or 1/2 SCT beneath Bruch membrane.The grayscale images were then binarized for the analysis of FBFD.Results The SCT in ECS group was (394.7±77.7) μm,which was significantly thicker than (332.1 ± 68.1) μm in control group (t=2.923,P=0.008).The FBFD of intermediate choroid in ECS group were (76.35± 14.46)％,which were significantly greater than (63.57± 13.42)％ in control group (t=2.775,P=0.01).Conclusion ECS patients had increased FBFD at intermediate choroid level compared with healthy controls.
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Objective To observe the clinical effect of edaravone combine with clopidogrel on patients with acute cerebral infarction . Methods Eighty cases diagnosed with acute cerebral infarction from February 2014 to February 2015 were randomly divided into observation group and control group with 40 cases in each group.Control group received basic treatment of clopidogrel, observation group received edaravone on the basis of control group.The serum levels of superoxide dismutase ( SOD ) and malondialdehyde ( MDA ) between two groups were compared post-treatment. Results The serum SOD levels in observation group on 7th and 14th day post-treatment [(89.37 ±6.07, 99.14 ±11.24)U/mL]were significantly higher than those in control group [(71.26 ±7.43,80.01 ±12.02)U/mL](P<0.05).The serum MDA levels in observation group on 7th and 14th day post-treatment [(5.23 ±0.81, 3.42 ±0.48)nmol/mL]were significantly higher than those in control group[(7.16 ±1.01,5.24 ±0.71) nmol/mL](P<0.05).Conclusion Edaravone combined with clopidogrel has the exact effect in treatment of patients with acute cerebral infarction.
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We developed a novel method for the rapid determination of lysozyme using a new fluorogenic substrate that consists of a cationic aluminum phthalocyanine ( tetra ( trimethylammonio ) aluminum phthalocyanine, TTMAAlPc ) , and an anionic mucopolysaccharide ( heparin, HP ) . We found that fluorescence from the cationic aluminum phthalocyanine, a red-region fluorescence probe, was quenched significantly in acidic media in the presence of low concentrations of anionic mucopolysaccharide heparin ( HP) bearing anionic sulfonic acid groups, because of induced aggregation. The practically non-fluorescent substrate degraded into small molecular fragments upon the hydrolysis of lysozyme, and thus the phthalocyanine molecules aggregated in HP were released, resulting in significant fluorescence recovery in the reaction system. This phenomenon forms the foundation of the proposed method. The reaction mechanism was determined using fluorescence spectroscopy and fluorescence anisotropy techniques. Factors that affected the determination were investigated. Under optimal conditions, the linear range was 0. 2-2 mg/L, and the detection limit was 0. 015 mg/L. The developed method is easy to operate and has good selectivity and sensitivity. This method was used in the analysis of practical samples of lysozyme, and the results were in agreement with those determined by a conventional turbidimetric method.
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OBJECTIVE@#To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) on ureteral injury repair via renal artery transplantation.@*METHODS@#The left ureteral obstruction model was set up in 49 Balb/c mice by micro vascular clamp. The microscopic vascular clamp was taken out to lift the left ureteral obstruction after 10 days. The mice were randomly divided into an experimental group (n=25) and a control group (n=24). Balb/c mice BMSCs transfected by luciferase (Luc) were transplanted immediately through the renal artery after removing the microscopic vascular clamp from the experimental group; while mice in the control group was closed the incision after the microscopic vascular clamp was removed immediately and without BMSCs transplant. Magnetic resonance imaging (MRI) was used to scan the experimental mice. By measuring the left renal pelvis volume of the experimental mice at different time points and comparing the left ureter recanalization rate after removing left ureteral obstruction of the experimental group and the control group, we evaluated the repair effect of BMSCs on ureteral injury.@*RESULTS@#The volume of the left renal pelvis in experimental mice became bigger obviously after the left ureter was obstructed (P<0.01). The left renal pelvis volume of the experimental group and the control group had no statistical significance 10 days after the left ureteral obstruction was set up (P=0.693). In the experimental group, the left ureter recanalization rate was higher than that in the control group, after removing the left ureteral obstruction (P=0.012).@*CONCLUSION@#Transplantation through the renal artery can promote the restoration of ureteral injury in mice.
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Animales , Ratones , Trasplante de Células Madre Hematopoyéticas , Métodos , Células Madre Hematopoyéticas , Biología Celular , Ratones Endogámicos BALB C , Arteria Renal , Obstrucción Ureteral , TerapéuticaRESUMEN
In this study, we explored the rationality of processing methods and mechanism of Aconiti Lateralis Radix (Fuzi) through comparing the chemical contents of diester alkaloids (DAs) and monoester alkaloids (MAs) in the raw material of Fuzi and its processed products. The results showed that the toxicity potency of MAs is at least lower than 1/64 to 1/180 of the toxicity potency of DAs. The contents of DAs in processed Fuzi decreased to 1/76.5 to 1/38.3 of the value of raw Fuzi. The contents of MAs in processed Fuzi significantly increased by 4.6 to 5.2 fold or basically the same as that of the raw Fuzi. The values of MAs/DAs of processed Fuzi were enhanced by 30 to 390 fold of the raw Fuzi. It was found that the contents of DAs were insignificantly different between "Wu dan fu pian" (steaming or stir-frying without Danba) and "Dan fu pian" (steaming or stir-frying with Danba). The result suggested that the abilities of "eliminating toxicity" of different processing methods were equivalent at all. In contrast, the contents of MAs contained in "Wu dan fu pian" were of 5.3 to 8.7 fold higher than the values in "Dan fu pian". This result suggested the processing method by steaming or stir-frying without Danba might have better effect for "conserving property" than the method processed with Danba stipulated by China Pharmacopoeia. We believe that the new processing method without Danba can be recommended in further application due to it offers a simple procedure and it will not introduce inorganic impurities in the products.
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Objective To observe the difference between skeletal age of hand and wrist and chronological age and explore the reliability of CHN radiographic atlas method to assess the skeletal age of hand and wrist in children and adolescent.Methods Total 1397 healthy children (666 boys,731 girls;age range,1.0-18.0 years old) with hand and wrist injury from 2007 to 2011 were selected.Forty groups (n =20 for boys and girls,respectively) were classified according to CHN radiographic atlas method.The radiographs of hand and wrist were assessed by CHN radiographic atlas method,the relations between skeletal age and chronological age were investigated by using Wilcoxon signed ranks test.Results According to the CHN radiographic atlas method,the difference in 1.0 to 3.9 years old,7.0 to 7.9 years old and 9.0 to 15.9 years old boy groups between skeletal age and the chronological age had statistical significance (P ＜0.05) ; the difference in 1.0 to 2.9 years old,8.0 to 11.9 years old,12.6 to 14.9 years old,and 17.0 to 18.0 years old girl groups between skeletal age and the chronological age had statistical significance (P ＜ 0.05).Besides,these skeletal age was higher than the chronological age.Conclusions Skeletal age assessed by the CHN radiographic atlas method in a majority of age groups was higher than chronological age.It should be cautious to estimate the contemporary Chinese children skeletal age of hand and wrist when using the CHN radiographic atlas method.
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Objective To introduce experience of using the new AO anterolateral distal tibia locking com-pression plate (LCP) for treatment of Pilon fractures. Methods Between February and August of 2009,8 closed Pi-lon fractures were treated by open reduction and internal fixation. The distal fibula was fixed with a one-third tubular plate or an recontruction plate via a straight incision posterior to the fibular crest. The distal tibia was approched by a straight incision over the ankle joint, and the fracture was stabilized using an anterolateral distal tibia LCP. Regular follow up was made to observe and evaluate the preliminary clinical outcomes. Results Seven of the 8 patients were availabe for follow up for 3 ～ 6 months (average 4.5 months). All incisions obtained primary healing, though one ex-perienced mild superficial inflammation,and none developed deep infections. Based on the Burwell and Charnley radi-ographic criteria,anatomical reduction was obtained in 5 cases,good in 1 ,and fair in 1. Among the 5 cases exceeding 5 months postsurgery,4 were evaluated as excellent and 1 us good according to Tometta' s clinically based criteria for Pilon fractures. Conclusion With good surgical timing,internal fixation with anterolateral LCP for Pilon fractures is reliable and warrants less complications.
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Substantia nigra is the largest nuclei in midbrain, which is divided into a compact part and a reticular part. Recent studies have shown that the changes of iron content in reticular part of substantia nigra results in the changes of substantia nigra echogenicity. The substantia nigra detected by transcranial Doppler, according to its echo changes, may provide help for the susceptibility of Parkinson's disease, latency and early diagnosis, as well as for the differential diagnosis of multiple system atrophy and vascular parkinsonism.
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Objective To evaluate one-stage arthroscopic reconstruction of anterior crueiate ligament (ACL)and posterior cruciate ligament(PCL)using Achilles tendon-bone allografts. Methods From July 2000 to February 2005.we treated 15 patients(11 males and 4 females)whose ACL and PCL were ruptured at one knee but the eontralateral knee was intact.Their associated meniscus injuries were treated arthroscopically according to established procedures prior to ligament reconstruction.Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees at one stage.Reconstruction of both ligaments was performed at subacute or chronic phase(>3 to 8 weeks)in 12 casses,and at acute phase in 3 cases(<3 weeks).All knees were graded pre-and postoperatively using the International Knee Documentation Committee(IKDC)and Lysholm scoring systems.At follow-up,functions were evaluated for all patients and compared with those of the contralateral healthy knee. Results All patients were followed up for a minimum of 3 years(mean,38 months).Preoperatively,the IKDC ratings showed all the injured knees were severely abnormal.At final postoperative f0Uow-up,9 knees received a normal rating,5 a nearly normal one and 1 an abnormal one.The differences in Lysholm score were statistically significant (t=15.660,P<0.05)between pre-and postoperative analyses.The most noticeable postoperative complication was a short localized fever coupled with arthroedema in 1 case. Conclusions Achilles tendon-bone allograft offers an alternative for simultaneous arthroseopic reconstruction of ACL and PCL.However,problems inherent in allograft tissues entail further investigation to ensure future application.
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To investigate the potential role of somatic mitochondrial DNA [mtDNA] mutations in tumorigenesis, the occurrence of mutations in mtDNA of breast carcinoma was studied. We chose to focus on the D-Loop [displacement loop] control region, which contains the L-strand [light strand] promoter, an mtTF1 binding site and the mt3 H-strand [heavy strand] control element. Previous studies had suggested that, this region contains an age-dependent mutation hotspot, i.e. T414G transversion. We postulated that if a similar phenomenon occurred in breast tissues, then tissue genotyping at the mtDNA locus might serve as a means of determining the cumulative mutation burden within the tissue independent of a persons chronological age. To test the hypothesis that mutation frequency in mtDNA in human breast tissues 1] correlate with case versus control status and 2] correlate with age and presumably exposure, we sequenced breast tumors and normal adjacent tissues along with matched blood from 40 cancer cases and normal tissues and matched blood from 23 women without cancer. Unlike predicted, we found no evidence of T414G mutation, even in older women. We observed 7 other homoplasmic mutations in this region with a higher frequency in tissue samples from cancer cases than those in controls. Most of these mutations were T to C or C to T transitions, but one represented a differential length of CA repeats. No age dependency was observed in the occurrence of these mutations. While many mutations detected in tumors were also present in normal adjacent tissues, the mutation profiles were different in breast tissues and peripheral lymphocytes. These observations suggest that mutations in the D-loop region of the mtDNA in human breast tissues are not an age-dependent phenomenon, but rather reflect genomic instability in tumorigenesis
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Objective To explore the cause and the interventional treatment of restenosis after percutaneous transhepatic biliary stent.Methods 20 patients with biliary restenosis after percutaneous transhepatic biliary stent placement were collected.According to drainage volume from biliary tract and degree of amelioration of jaundice,post-operation hepatic function,blood,urine and stool routines,ultrasound,CT scan and cholangiography were performed to determine the nature and location of biliary restenosis,and then all cases underwent recanalization with intervention method by the exteriorized drainage tube approach.The China-made nickel-titanium alloy stents with diameter of 10 mm and length ranged from 40 mm to 80 mm were used.Results The biliary restenosis occurred in mid-inferior segment of common bile duct in 9 patients, common hepatic duct in 7 patients and hepatic porta in 4 patients. As regarding the causes of restenosis included tumor compression in 9 cases, angulation in upper segment of stent in 3 cases, obstruction in stent by bile, food or clot in 4 cases, cholangitic stenosis in 2 cases and granulation proliferation in 2 cases.The obstruction in all cases was relived by extraction through drainage tube, drug irrigation,dredging by wire, balloon dialtion or stent replacement, so that the total survival rate was beyond 6 months.Conclusion After percutaneous transhepatic biliary stent placement in treating the malignant biliary obstruction,the rate of biliary restenosis is still high,which should be attached importance to.