Risk factors for delayed bleeding after intestinal polypectomy in children / 中国当代儿科杂志

OBJECTIVES@#To investigate the clinical characteristics and risk factors of delayed bleeding after intestinal polypectomy in children, and to provide a theoretical basis for clinical surgical intervention of intestinal polyps.@*METHODS@#A retrospective analysis was conducted on the clinical data of 2 456 children with intestinal polyps who underwent endoscopic high-frequency electrocoagulation loop resection in the Endoscopy Center of Children's Hospital Affiliated to Zhengzhou University from January 2014 to December 2021. According to the presence or absence of delayed bleeding after surgery, they were divided into bleeding group with 79 children and non-bleeding group with 2 377 children. A multivariate logistic regression analysis was used to investigate the risk factors for delayed bleeding. The receiver operating characteristic (ROC) curve was used to investigate the value of various indicators in predicting delayed bleeding.@*RESULTS@#Of all 2 456 children, 79 (3.22%) experienced delayed bleeding, among whom 5 children with severe delayed bleeding underwent emergency colonoscopy for hemostasis and 74 received conservative treatment, and successful hemostasis was achieved for all children. There were significant differences between the bleeding and non-bleeding groups in age, body mass index, constipation rate, location of lesion, time of endoscopic procedure, resection method (P<0.05). Children with a diameter of polyps of 6-10 mm and >20 mm were more likely to develop delayed bleeding after resection (P<0.05). The multivariate logistic regression analysis showed that endoscopic operation time, polyp diameter, and resection method were significantly associated with delayed bleeding (P<0.05). The ROC curve analysis showed that the endoscopic operation time, polyp diameter, and resection method had a good value in predicting delayed bleeding after intestinal polypectomy, with an area under the ROC curve of 0.706, 0.688, and 0.627, respectively.@*CONCLUSIONS@#Endoscopic high-frequency electrocoagulation loop resection has a lower incidence of delayed bleeding in children with intestinal polyps, and the endoscopic operation time, polyp diameter, and resection method are closely associated with the occurrence of postoperative delayed bleeding.

Blue Nevus Hidden within the Nevus of Ota / 中国医学科学杂志(英文版)

A 3-year-old boy presented with bluish patch and scattered blue spots on the left side of his face. After several sessions of laser treatment, the azury patch in the periorbital area became even darker. Histopathology showed many bipolar, pigment-laden dendritic cells scattered in the papillary and upper reticular dermis. Immunohistochemically, these cells were positive for S100, SOX-10, melan-A, P16, and HMB-45. The positive rate of Ki-67 was less than 5%. Finally, the lesion was diagnosed with nevus of Ota concurrent with common blue nevus. Therefore, for cases of the nevus of Ota with poor response to laser treatment, the possible coexisting diseases should be suspected.

Minimal Invasive Thoracoscopic Mitral Valve Surgery

ABSTRACT Introduction: The totally thoracoscopic approach for mitral valve (MV) disease is a minimally invasive method. We investigated the procedure's feasibility, safety and effectiveness when it was performed by an experienced operator. Methods: We retrospectively analysed 96 consecutive patients with MV disease treated between March 2016 and November 2019 by minimally invasive procedures. The procedures were performed on a femoral artery-vein bypass through two ports, including a main operation port and a thoracoscopic port. The clinical data of patients were collected, including preoperative cardiac function, operative data, postoperative complications, and follow-up. Results: A total of 96 patients (57 male patients; average age, 49.7±14.5 years; left ventricular ejection fraction, 65.6±7.7%) were enrolled in this study. No intraoperative conversion incision or death occurred. The cardiopulmonary bypass and aortic cross-clamp times were 163.8±50.6 minutes and 119.7±38.9 minutes, respectively. Postoperative chest tube drainage in the first 24 hours was 232.8±108.1 ml. The ventilation time and length of intensive care unit stay were 13.2±6.2 hours and 2.9±2.2 days, respectively. One patient died of disseminated intravascular coagulation and prosthesis thrombosis 3 days after the operation, fearing anticoagulant-related hemorrhage. The overall success rate of valve repair during 1-year follow-up was 97.9%. Conclusion: The totally thoracoscopic procedure on mitral valves by an experienced surgeon is technically feasible, safe, effective and worthy of widespread adoption in clinical practice.

Rule mining of acupoint and medication selection of acupoint application therapy for functional constipation / 中国针灸

OBJECTIVE@#To analyze the rules of acupoint and medication selection of acupoint application therapy for functional constipation (FC) by data mining technology.@*METHODS@#The clinical research literature regarding acupoint application therapy for FC from published to February 26, 2020 was searched in CNKI, VIP, Wanfang, SinoMed and PubMed. The prescriptions were extracted, and by using SPSS24.0 and SPSS Modeler14.0 software, the use of high-frequency acupoints and medication was summarized. The association rule analysis, cluster analysis and core prescription analysis of acupoints and medication were analyzed.@*RESULTS@#A total of 122 prescriptions of acupoint application therapy were included, involving 32 acupoints. The core prescription of acupoints was Tianshu (ST 25), Dachangshu (BL 25), Shenque (CV 8) and Guanyuan (CV 4). The high-frequency meridians mainly included conception vessel, @*CONCLUSION@#The use of local acupoint and regulating-

Effect of competence health cultivation on the prevention and control of inadvertent perioperative hypothermia

SUMMARY OBJECTIVE To explore the feasibility of health competence cultivation on the prevention and control of Inadvertent Perioperative Hypothermia (IPH). METHODS Patients with expected spinal surgery were divided into group A and group B by the random number method. Group B followed routine IPH management, and health training measures for performance and ability were implemented in Group A. The scores of the health competence questionnaire, the temperature at different times, IPH complications, and hospitalization for the two groups were observed and compared. RESULTS The main evaluation indexes, such as the health competence questionnaire score, temperature fluctuations, and IPH complications, during the perioperative period in group A were significantly better than those in group B (p < 0.05). The indexes of anesthesia, total hospital expenses, and health service satisfaction in group A were also significantly better than those in group B, which shows the advantages of cultivating health capabilities in both doctors and patients. CONCLUSION Through health competence cultivation and feasible health management measures, the medical staff can improve the quality of IPH prevention and management.

RESUMO OBJETIVO Explorar a viabilidade do cultivo da competência em saúde na prevenção e controle da hipotermia perioperativa inadvertida (IPH). MÉTODOS Pacientes com cirurgia espinhal marcada foram divididos em dois grupos, A e B, pelo método de números aleatórios. O grupo B foi conduzido com base na gestão rotineira para prevenção de IPH; já no grupo A, foram implementadas medidas de treinamento em competência de saúde. As pontuações do questionário sobre competência em saúde, a temperatura aferida em diferentes momentos, complicações relacionadas à IPH e hospitalização dos dois grupos foram observadas e comparadas. RESULTADOS Os principais índices de avaliação, como a pontuação do questionário sobre competência em saúde, a variação de temperatura e as complicações relacionadas à IPH durante o período perioperatório foram significativamente melhores no grupo A do que no grupo B (p<0,05). Os índices de anestesia, despesas hospitalares totais e satisfação com o serviço de saúde também foram significativamente melhores no grupo A do que no B, o que demonstra as vantagens do cultivo da competência de saúde tanto em médicos como em pacientes. CONCLUSÃO Por meio do cultivo de competências de saúde e de medidas viáveis de gestão da saúde, a equipe médica pode melhorar a qualidade da prevenção e gestão da IPH.

Relationship between genetic polymorphisms of IL-10 promoter and antituberculosis drug-induced liver injury / 中华疾病控制杂志

@# Objective To investigate the relationship between interleukin 10 (IL-10) -592 (rs1800872) and -819 (rs1800871) promoter genetic polymorphisms and the susceptibility of antituberculosis drug-induced liver injury (ADLI). Methods A case-control study was conducted. Epidemiology survey data and peripheral blood samples were obtained from the patients. Two IL-10 gene polymorphisms (-592 A/C and 819 C/T) were genotyped with PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) in Chinese Han ADLI subjects (n=180) and sex matched by frequency matching in control subjects (n=180). Results No significant differences in genotypes of IL-10 -592 site and IL-10 -819 site between ADLI group and that of the control group were noticed (all P>0.05). The mutant alleles -592 C of IL-10 gene polymorphism was significantly higher in ADLI subjects compared to controls, and in dominant model, the frequency of CC+AC genotype was 1.62 higher among the cases than controls (all P<0.05). Significant difference in allele -819 C/T between the ADLI group and the control group were not found (P=0.190). The polymorphisms at -819 C/T and -592 A/C variants of IL-10 gene were found to be good linkage disequilibrium. The CC haplotype represent genetic risk factor (OR=1.37, 95% CI: 1.02-1.85) and CA haplotype represent genetic protect factor (OR=0.49, 95% CI: 0.34-0.70) for ADLI in the subjects. Conclusions The polymorphisms in IL-10 gene -592 A/C and -819 C/T are associated with ADLI.

Clinical and genetic features of early-onset progressive encephalopathy associated with NAXE gene mutations / 中国当代儿科杂志

Early-onset progressive encephalopathy is a lethal encephalopathy caused by NAXE gene mutations. This paper reports the clinical and genetic features of a patient with early-onset progressive encephalopathy. A 4-year-old boy admitted to the hospital had repeated walking instability and limb weakness for 2 years. The patient and his elder brother (already dead) had clinical onset at 2 years of age. Both of them showed symptoms such as strabismus, ataxia, reduced muscle tone, delayed development, and repeated respiratory failure after infection. The NAXE gene of the patient showed new compound heterozygous mutations, i.e., c.255 (exon 2) A>T from his mother and c.361 (exon 3) G>A from his father. The NAXE gene encodes an epimerase that is essential for the repair of cellular metabolites of NADHX and NADPHX. This disease is associated with a deficiency of the mitochondrial NAD(P)HX repair system. Patients usually have rapid disease progression. They are also quite likely to have respiratory failure immediately after infection.

The status and influencing factors of caring behaviors perceived by elderly residents in nursing homes in Zhengzhou / 中华护理杂志

Objective To investigate the level and influencing factors of caring behaviors perceived by elderly residents in nursing homes in Zhengzhou.Methods Totally 366 elderly residents from 20 nursing homes in Zhengzhou were investigated with a demographic data questionnaire,Short Portable Mental Status Questionnaire (SPMSQ),Barthel Index Scale (BI),and Elderly Residents-Perceived Caring Behaviors Inventory.Results The total score of caring behaviors needs was (110.99±10.09),the mean score was (3.96±0.36),the dimension score of meeting the emotion needs was the highest(4.39±0.61),the dimension score of giving confidence and hope demand was the lowest (3.56±0.58).Multiple logistic regression showed that occupation before retirement,living pattern,the type of medical insurance,ADL,satisfaction of nursing service and length of residence were the major influencing factors (P＜0.05).Conclusion The elderly in nursing homes have a high demand for caring behaviors.The nursing staff should consider the specific situation of them and do regular assessment,to provide safe,professional and holistic caring behaviors from different perspectives so as to improve their quality of life.

Methylation of GSTP1 promoter region in hepatocellular injury induced by isoniazid / 国际药学研究杂志

Objective To investigate the relationship between methylation of CpG island in glutathione S-transferase P1(GSTP1) promoter region and injury induced by isoniazid in HL-7702 cells.Methods HL-7702 cells were divided into the control group and three isoniazid groups(200,400,800 mg/L).Colorimetric method was used to detect the activity level of lactate dehydrogenase in the medium of HL-7702 cells;the mRNA expression of GSTP1,DNA methyltransferases 1(DNMT1),DNMT3a and DNMT3b were de?tected by real-time fluorescence quantitative PCR;the protein expression levels of DNMT1,DNMT3a and DNMT3b were detected by enzyme-linked immunosorbent assay;the methylation of the CpG island in the GSTP1 promoter region was determined by the bisulfite sequencing PCR.Results The activity level of lactate dehydrogenase in supernatants of the HL-7702 cells in isoniazid group(400, 800 mg/L)was higher than that in the control group(P<0.01).Compared with the control group,the mRNA expression of DNMT 1、3a、3b and GSTP1 were elevated in 400 and 800 mg/L isoniazid groups(P<0.05,P<0.01).The proteins expression of DNMT1 and 3a in the 400 and 800 mg/L isoniazid groups were higher than that in the control group(P<0.05,P<0.01),and the protein expression of DNMT 3b in the 800 mg/L isoniazid groups were higher than that in the control group(P<0.01).The methylation level of CpG is?land in GSTP1 promoter region of three isoniazid groups were decreased.Conclusion The CpG island in the promoter of GSTP1 has hypomethylation in hepatocyte cells damaged by isoniazid.

Effect of dimethyl fumarate on rats with chronic pancreatitis

OBJECTIVE@#To discuss the effect of dimethyl fumarate (DMF) on rats with l-arginine induced chronic pancreatitis (CP).@*METHODS@#Male Wistar rats were given DMF treatment (25 mg/kg) by oral lavage method; then Wistar rats were given the intraperitoneal injection of l-arginine for 5 times (250 mg/100 kg, twice per time, each interval of 1 h) for building of CP model. Rats were divided into control group, CP group, DMF group and CP + DMF group. Rats in CP + DMF group were given the oral intragastric administration of DMF (25 mg/kg), while rats in control group and CP group were given the equal volume of normal saline. The weight of rats was evaluated and the intraperitoneal glucose tolerance test was performed (IPGTT, 2 g/kg). The islet of rats was isolated and then flow cytometry was employed to evaluate the quality and activity of islets. Meanwhile, the histology of non-endocrine tissues and levels of myeloperoxidase (MPO) and malondialdehyde (MDA) were detected.@*RESULTS@#Compared with control group, the weight of rats in CP group was significantly reduced at week 2, 4 and 6; the blood glucose significantly increased, AUC increased, the histopathological scores of pancreatic atrophy, acinar injury, edema and cellular infiltration increased, levels of MDA and MPO increased, the islet equivalent and islet activity decreased at 0, 30, 60, 120 and 180 min. Compared with CP group, the weight of rats in CP + DMF group significantly increased at week 2, 4 and 6; the blood glucose significantly decreased, AUC decreased, the histopathological scores of pancreatic atrophy, acinar injury, edema and cellular infiltration decreased, levels of MDA and MPO decreased, the islet equivalent and islet activity increased at 0, 30, 60, 120 and 180 min.@*CONCLUSIONS@#DMF treatment can improve CP induced by l-arginine and islet function in rats.

Effect of dimethyl fumarate on rats with chronic pancreatitis

Objective: To discuss the effect of dimethyl fumarate (DMF) on rats with l-arginine induced chronic pancreatitis (CP). Methods: Male Wistar rats were given DMF treatment (25 mg/kg) by oral lavage method; then Wistar rats were given the intraperitoneal injection of l-arginine for 5 times (250 mg/100 kg, twice per time, each interval of 1 h) for building of CP model. Rats were divided into control group, CP group, DMF group and CP + DMF group. Rats in CP + DMF group were given the oral intragastric administration of DMF (25 mg/kg), while rats in control group and CP group were given the equal volume of normal saline. The weight of rats was evaluated and the intraperitoneal glucose tolerance test was performed (IPGTT, 2 g/kg). The islet of rats was isolated and then flow cytometry was employed to evaluate the quality and activity of islets. Meanwhile, the histology of non-endocrine tissues and levels of myeloperoxidase (MPO) and malondialdehyde (MDA) were detected. Results: Compared with control group, the weight of rats in CP group was significantly reduced at week 2, 4 and 6; the blood glucose significantly increased, AUC increased, the histopathological scores of pancreatic atrophy, acinar injury, edema and cellular infiltration increased, levels of MDA and MPO increased, the islet equivalent and islet activity decreased at 0, 30, 60, 120 and 180 min. Compared with CP group, the weight of rats in CP + DMF group significantly increased at week 2, 4 and 6; the blood glucose significantly decreased, AUC decreased, the histopathological scores of pancreatic atrophy, acinar injury, edema and cellular infiltration decreased, levels of MDA and MPO decreased, the islet equivalent and islet activity increased at 0, 30, 60, 120 and 180 min. Conclusions: DMF treatment can improve CP induced by l-arginine and islet function in rats.

Vagus Nerve Stimulation for Pediatric and Adult Patients with Pharmaco-resistant Epilepsy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Over past two decades, vagus nerve stimulation (VNS) has been widely used and reported to alleviate seizure frequency worldwide, however, so far, only hundreds of patients with pharmaco-resistant epilepsy (PRE) have been treated with VNS in mainland China. The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.</p><p><b>METHODS</b>We retrospectively assessed the clinical outcome of 94 patients with PRE, who were treated with VNS at Beijing Fengtai Hospital and Beijing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients. The clinical data analysis was retrospectively examined.</p><p><b>RESULTS</b>Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve. At last follow-up, we found McHugh classifications of Class I in 33 patients (35.1%), Class II in 27 patients (28.7%), Class III in 20 patients (21.3%), Class IV in 3 patients (3.2%), and Class V in 11 patients (11.7%). Notably, 8 (8.5%) patients were seizure-free while ≥50% seizure frequency reduction occurred in as many as 60 patients (63.8%). Furthermore, with regard to the modified Engel classification, 12 patients (12.8%) were classified as Class I, 11 patients (11.7%) were classified as Class II, 37 patients (39.4%) were classified as Class III, 34 patients (36.2%) were classified as Class IV. We also found that the factors of gender or age are not associated with clinical outcome.</p><p><b>CONCLUSIONS</b>This comparative study confirmed that VNS is a safe, well-tolerated, and effective treatment for Chinese PRE patients. VNS reduced the seizure frequency regardless of age or gender of studied patients.</p>

High Physical Activity is Associated with an Improved Lipid Profile and Resting Heart Rate among Healthy Middle-aged Chinese People / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the effects of physical activity (PA) on dyslipidemia and elevated resting heart rate (RHR) in a large-scale cross-sectional study in China.</p><p><b>METHODS</b>We recruited community-based individuals who were 40-60 years old using a cluster sampling method. The PA levels of the participants were classified as low, moderate, or high, using the International Physical Activity Questionnaire. Dyslipidemia was defined as the detection of abnormalities in lipid indicators, and 4 lipid parameters were evaluated using fasting blood samples. Multivariate logistic regression analyses were used to evaluate the associations of PA with dyslipidemia and RHR.</p><p><b>RESULTS</b>A total of 10,321 participants (38.88% men) were included in this study. The percentages of individuals with high, moderate, and low PA levels were 46.5%, 43.9%, and 9.6%, respectively. In both men and women, high PA provided odds ratios of 0.88 [95% confidence interval (CI): 0.83, 0.94] for dyslipidemia and 0.82 (95% CI: 0.73, 0.92) for elevated RHR, compared to participants with low PA.</p><p><b>CONCLUSION</b>Our data suggested that substantial health benefits (related to dyslipidemia and elevated RHR) occurred at higher intensity PA, with greater energy consumption, in middle-aged Chinese people, and particularly in men.</p>

The association between mutations in the reverse transcriptase domain of hepatitis B virus polymerase gene with tumorigenesis of hepatocellular carcinoma / 肿瘤

Objective: To explore the relationship between the mutations in the reverse transcriptase (RT) domain of hepatitis B virus polymerase (HBV-P) gene and the occurrence and development of hepatocellular carcinoma (HCC). Methods: In this case-control study, the serum samples from 202 HCC patients and 202 chronic hepatitis B virus (CHB) carriers matching for age and gender were collected. The sequence of the RT domain of HBV-P gene was determined by direct sequencing following PCR amplification. The relationship between the mutations in the RT domain of HBV-P gene and the occurrence and development of HCC was analyzed. Results: The T895A, A904T and C955T mutations in the RT domain of HBV-P gene were all significantly associated with HCC compared to non-HCC controls (P = 0.034, 47.5% vs 37.1%; P = 0.011, 5.4% vs 1.0%; P = 0.030, 5.4% vs 1.5%). Furthermore, the Logistic multivariate analysis showed that T895A was an independent risk factor for HCC [odds ratio (OR) = 2.230, 95% confidence interval (CI): 1.230-4.044, P = 0.008]. A904T or C955T increased the risk of HCC occurrence either (OR = 6.523, 95% CI: 0.838-50.733; OR = 2.904, 95% CI: 0.599-14.093), but it did not reach statistical significance. The mutation rate of combined mutation occurrence either in A904 or C955T was 9.4% in HCC group and 2.5% in non-HCC controls (P = 0.003). The adjusted OR was 4.145 (95% CI: 1.170-14.681), demonstrating its significant association with HCC (P = 0.028). Conclusion: The mutations in the RT domain of HBV-P gene are associated with the tumorigenesis of HCC. Copyright © 2014 by TUMOR.

Expression of RHBDD1 gene in patients with chronic myeloid leukemia and its clinical significance / 中国实验血液学杂志

This study was aimed to investigate the expression of RHBDD1 gene in patients with chronic myeloid leukemia (CML) and explore its clinical significance. The relative expression levels of RHBDD1 in bone marrow mononuclear cells of healthy controls and CML patients were detected by using real time PCR. The results showed that the expression level of RHBDD1 in CML patients was significantly higher than that in healthy controls. The expression level of RHBDD1 in CML patients with negative BCR/ABL p210 was remarkably higher than that in patients with positive BCR/ABL p210. In patients ≥ 50 years old RHBDD1 expression was lower than the patients < 50 years old. There were no significant relation of RHBDD1 expression with sex of patients. It is concluded that RHBDD1 gene may be involved in the pathogenesis and progression of CML, particularly reflects in the pathogenesis of the patients with negative BCR/ABL p210.

Effect of erythromycin on electrical activity and gastric emptying of the intrathoracic stomach after esophagectomy for esophageal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of erythromycin on electrical activity and emptying of the intrathoracic stomach after esophagectomy for esophageal cancer.</p><p><b>METHODS</b>Thirty patients undergoing esophagectomy for cancer and esophagogastrostomy above the aortic arch were divided into the study group (n=15) and the control group (n=15). Electrogastrography and radionuclide gastric emptying were examined for these patients before and 1, 3, 6, 12 months after surgery. Patients in the study group received erythromycin (0.25 g tid po) for 1 week before examination.</p><p><b>RESULTS</b>The wave amplitude (Uv), dominant frequency (CPM) and percentage of normal slow wave (%) of electrogastrogram decreased after surgery and returned to normal at the first postoperative month in the study group and the 12th postoperative month in the control group (P>0.05). Gastric emptying was significantly delayed after esophagectomy, and returned to normal one year after operation in the study group (P>0.05). However, gastric emptying remained abnormal in the control group (P<0.01).</p><p><b>CONCLUSIONS</b>Erythromycin improves electrical activity and emptying of the stomach after esophagectomy for cancer. Gastric emptying recovery later than the recovery of electrical activity, which may be related to gastric ischemia and edema.</p>

Effects of different altitudes on cardiac hemodynamics and electrocardiogram of healthy male adults / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To detect the changes of cardiovascular system at different altitudes, so as to prevent and predict the susceptibility to acute mountain sickness.</p><p><b>METHODS</b>The test was performed with noninvasive cardiovascular monitor and electrocardiogram in healthy male Chinese members of the 25th and 26th expeditions to the antarctic kunlun station at different altitudes (40 m, 3 650 m and 4 300 m).</p><p><b>RESULTS</b>Compared with 40 m, from 3 650 m to 4 300 m, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI) significantly increased (P < 0.05); cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke index (SI), velocity index (VI), acceleration index (ACI), left ventricular ejection time (LVET) significantly decreased (P < 0.05) and pre-ejection period(PEP) decreased with no significance (P > 0.05).</p><p><b>CONCLUSION</b>SVR significantly increased but contractile and blood-pumping function of left ventricular decreased inversely associated with the Q-Tc interval, as the altitude is increasing.</p>

Antireflux anastomosis following resection of esophageal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the antireflux effects of a modified Nissen fundoplication following esophagectomy for cancer.</p><p><b>METHODS</b>From March 2006 to March 2007, 70 patients with esophageal cancer were divided into two groups randomly. Esophagogastrostomy with a stapler only was perform in 35 patients as controls (group C), and a modified Nissen fundoplication was added after esophagogastrostomy with stapler in the other 35 patients as observed group (group O). There were 48 male and 22 female, ranging in age from 47 to 77 years (mean 60.1 years). The operative morbidity and mortality were recorded. Fourty-nine patients were followed at 3 months after surgery, and the questionnaire of life quality (EORTC QLQ C-30) was conducted in 24 patients in group C and 25 patients in group O. Thirty patients were examined with esophageal manometry, 24 h pH monitoring and gastroscopy. There were 16 patients in group C and 14 patients in group O.</p><p><b>RESULTS</b>There was no significant difference in postoperative morbidity between the two groups (P > 0.05). However, the scores of heart burn and regurgitation in the group O were less than in group C (P = 0.041 and 0.034 respectively), but there was no difference in scores of dysphagia between the two groups (P = 0.677). The pressure at the anastomotic site was higher than that in the stomach in group O (P = 0.032), but not in group C (P = 0.448). DeMeester score in group O was 53 ± 46, compared to 140 ± 103 in group C (P = 0.043). The score of esophagitis was 0.9 ± 0.8 in group O, which was lower than 1.6 ± 1.0 in group C (P = 0.041).</p><p><b>CONCLUSIONS</b>Addition of modified Nissen fundoplication after esophagectomy and esophagogastrostomy for cancer significantly increases the pressure at the anastomotic site, thus reduces the extent of gastroesophageal reflux, which leads to the reduction of the extent of reflux esophagitis and the improvement of the quality of life.</p>

Relationship between the polymorphisms of UGT1A6 genes and anti-tuberculosis drug induced hepatic-injury / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the polymorphisms of UGT1A6 genes and anti-tuberculosis drug induced hepatic-injury (ADIH).</p><p><b>METHODS</b>202 cases and 239 controls were collected and a case-control study was conducted. Information on related risk factors of tuberculosis was collected. The genotypes of UGT1A6-19T/G, UGT1A6-308C/A and UGT1A6-541A/G genetic polymorphisms were detected by polymerase chain reaction and restriction fragment length polymorphism technique (PCR-RFLP) in patients received anti-tuberculosis therapy. The Hha I, Dpn II and Nsi I enzyme were employed. Univariate and multivariate conditional logistic analyses were conducted using SPSS13.0 for windows software.</p><p><b></b>RESULTS</p><p><b>RESULTS</b>The allele frequency of gene UGT1A6-19T/T, UGT1A6-19T/G, UGT1A6-19G/G, GT1A6-308C/C, UGT1A6-308C/A, UGT1A6-308A/A, UGT1A6-541AA, UGT1A6-541A/G and UGT1A6-541G/G in ADIH group were 51.5%, 39.6%, 8.9%, 52.0%, 40.6%, 7.4%, 57.9%, 33.7%, 8.4% and 71.1%, 25.5%, 3.3%, 79.1%, 19.2%, 1.7%, 79.5%, 19.2%, 1.3% in control group, respectively. Univariate analysis demonstrated that the frequency of UGT1A6-19T/G, UGT1A6-308C/A and UGT1A6-541A/G genotype in cases were significantly higher than that in controls (P less than 0.05).</p><p><b>CONCLUSION</b>A positive association is found between UGT1A6 genotype and the occurrence of ADIH. The synergetic effect is proved on susceptibility to pulmonary tuberculosis between UGT1A6 mutant genotypes.</p>

Association of TNF-alpha-238G/A and 308 G/A gene polymorphisms with pulmonary tuberculosis among patients with coal worker's pneumoconiosis / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>Tumor necrosis factor-alpha (TNF-alpha) may play an important role in host's immune response to mycobacterium tuberculosis (M. tuberculosis) infection. This study was to investigate the association of TNF-alpha gene polymorphism with pulmonary tuberculosis (TB) among patients with coal worker's pneumoconiosis (CWP).</p><p><b>METHODS</b>A case-control study was conducted in 113 patients with confirmed CWP complicated with pulmonary TB and 113 non-TB controls with CWP. They were matched in gender, age, job, and stage of pneumoconiosis. All participants were interviewed with questionnaires and their blood specimens were collected for genetic determination with informed consent. The TNF-alpha gene polymorphism was determined with polymerase chain reaction of restriction fragment length polymorphism (PCR-RFLP). Frequency of genotypes was assessed for Hardy-Weinberg equilibrium by chi-square test or Fisher's exact probability. Factors influencing the association of individual susceptibility with pulmonary TB were evaluated with logistic regression analysis. Gene-environment interaction was evaluated by a multiplicative model with combined OR. All data were analyzed using SAS version 8.2 software.</p><p><b>RESULTS</b>No significant difference in frequency of the TNF-alpha-308 genotype was found between CWP complicated with pulmonary TB and non-TB controls (chi2 = 5.44, P = 0.07). But difference in frequency of the TNF-alpha-308 A allele was identified between them (chi2 = 5.14, P = 0.02). No significant difference in frequencies of the TNF-alpha-238 genotype and allele (P = 0.23 and P = 0.09, respectively) was found between cases and controls either, with combined (GG and AA) OR of 3.96 (95% confidence interval of 1.30-12.09) at the -308 locus of the TNF-alpha gene, as compared to combination of the TNF-alpha-238 GG and TNF-alpha-308 GG genotypes. Multivariate-adjusted odds ratio of the TNF-alpha-238 GG and TNF-alpha-308 GA genotypes was 1.98 (95% CI of 1.06-3.71) for risk for pulmonary TB in patients with CWP. There was a synergic interaction between the TNF-alpha-308 GG genotype and body mass index (OR = 4.92), as well as an interaction between the TNF-alpha-308 GG genotype and history of BCG immunization or history of TB exposure. And, the interaction of the TNF-alpha-238 GG genotype and history of BCG immunization or TB exposure with risk for pulmonary TB in them was also indicated.</p><p><b>CONCLUSIONS</b>TNF-alpha-308 A allele is associated with an elevated risk for pulmonary TB, whereas TNF-alpha-238 A allele was otherwise.</p>