[Pilot study of the relationship between clinical classification of gallbladder cancer and prognosis: a retrospective multicenter clinical study].

Objectives: To propose a novel clinical classification system of gallbladder cancer, and to investigate the differences of clinicopathological characteristics and prognosis based on patients who underwent radical resection with different types of gallbladder cancer. Methods: The clinical data of 1 059 patients with gallbladder cancer underwent radical resection in 12 institutions in China from January 2013 to December 2017 were retrospectively collected and analyzed.There were 389 males and 670 females, aged (62.0±10.5)years(range:22-88 years).According to the location of tumor and the mode of invasion,the tumors were divided into peritoneal type, hepatic type, hepatic hilum type and mixed type, the surgical procedures were divided into regional radical resection and extended radical resection.The correlation between different types and T stage, N stage, vascular invasion, neural invasion, median survival time and surgical procedures were analyzed.Rates were compared by χ(2) test, survival analysis was carried by Kaplan-Meier and Log-rank test. Results: Regional radical resection was performed in 940 cases,including 81 cases in T1 stage,859 cases in T2-T4 stage,119 cases underwent extended radical resection;R0 resection was achieved in 990 cases(93.5%).The overall median survival time was 28 months.There were 81 patients in Tis-T1 stage and 978 patients in T2-T4 stage.The classification of gallbladder cancer in patients with T2-T4 stage: 345 cases(35.3%)of peritoneal type, 331 cases(33.8%) of hepatic type, 122 cases(12.5%) of hepatic hilum type and 180 cases(18.4%) of mixed type.T stage(χ(2)=288.60,P<0.01),N stage(χ(2)=68.10, P<0.01), vascular invasion(χ(2)=128.70, P<0.01)and neural invasion(χ(2)=54.30, P<0.01)were significantly correlated with the classification.The median survival time of peritoneal type,hepatic type,hepatic hilum type and mixed type was 48 months,21 months,16 months and 11 months,respectively(χ(2)=80.60,P<0.01).There was no significant difference in median survival time between regional radical resection and extended radical resection in the peritoneal type,hepatic type,hepatic hilum type and mixed type(all P>0.05). Conclusion: With application of new clinical classification, different types of gallbladder cancer are proved to be correlated with TNM stage, malignant biological behavior and prognosis, which will facilitate us in preoperative evaluation,surgical planning and prognosis evaluation.

[The investigation and analysis of the tinnitus in 1 596 cases of physical examinees].

Objective:To investigate and analyze the tinnitus' prevalence and its related systemic factors in health examination population in Dalian City. Method:The 1 596 people were chosen from the Physical Examination Center of our hospital from February 1, 2015 to April 1, 2015, the tinnitus questionnaire was performed, as well as Otolaryngology examination，the whole body check and blood test. We calculated the prevalence of tinnitus and analyzed the relationship of tinnitus with the gender,age,hypertension,hyperlipidemia, overweight, diabetes, renal dysfunction, anemia and other factors. Result:①The total prevalence of tinnitus is about 18.8%(300/1 596) in Dalian's health examination population, and it is increased gradually with age(P<0.01). The prevalence of female is 20.6% (175/848), which is higher than the male(16.7%,125/748)(P<0.05).②Analyzed with the single factor Logistic regression analysis：female(OR=1.30), age(OR=1.04), hypertension(OR=2.30),hyperlipidemia(OR=1.49), overweight(OR=1.45), and diabetes(OR=1.75) were independent related factors for tinnitus(P<0.05); and analyzed with multi factor Logistic regression analysis: female(OR=1.27,P＝0.085), age(OR=1.05,P＜0.01),overweight(OR=1.46,P＝0.007) were the main related factors.Conclusion:The prevalence of tinnitus is high in health examination population of Dalian；hypertension, hyperlipidemia and diabetes may be associated with tinnitus, all of female, overweight and age may be the mainly systemic factors.

Cloning and transcriptional expression of a novel gene during sex inversion of the rice field eel (Monopterus albus).

We performed annealing control primer (ACP)-based differential-display reverse transcription-polymerase chain reaction (DDRT-PCR) to isolate differentially expressed genes (DEGs) from the stage IV ovary and ovotestis of the rice field eel, Monopterus albus. Using 20 arbitrary ACP primers, 14 DEG expressed-sequence tags were identified and sequenced. The transcriptional expression of one DEG, G2, was significantly greater in the ovotestis than the stage IV ovary. To understand the role of G2 in sex inversion, G2 cDNA was cloned and semi-RT-PCR, real time PCR were performed during gonad development. The full-length G2 cDNA was 650 base pairs (bp) and it comprised a 5'-untranslated region (UTR) of 82 bp, a 3'-UTR of 121 bp and an open reading frame of 444 bp that encoded a 148-amino acid protein. The expression of G2 was weak during early ovarian development until the stage IV ovary, but expression increased significantly with gonad development. We speculate that G2 may play an important function during sex inversion and testis development in the rice field eel, but the full details of the function of this gene requires further research.

Clinical characteristics and risk factors of pericardial effusion complicating radiofrequency catheter ablation in Chinese Han patients with tachyarrhythmias.

BACKGROUND: The clinical features and risk factors of pericardial effusion complicating radiofrequency catheter ablation (RFCA) in a large sample of Chinese Han patients with tachyarrhythmias have rarely been reported. METHODS: We summarized the clinical characteristics and analyzed the risk factors of pericardial effusion complicating RFCA in 1,756 Chinese Han patients with tachyarrhythmias. RESULTS: There were 27 patients with pericardial effusion after RFCA. Of these patients, 10 developed cardiac tamponade; the symptoms of 9 patients were relieved after pericardiocentesis and drainage, while 1 patient was discharged after emergency surgical repair. The rate of pericardial effusion in patients with atrial fibrillation was significantly higher than in those with other tachyarrhythmias (P < 0.001). The proportion of female patients, hypertension, diabetes mellitus, coronary heart disease, age, left atrial size, and length of hospitalization in the pericardial effusion group was significantly increased compared with the non-pericardial effusion group (P < 0.01). Multivariate logistic regression analysis showed that female sex and atrial fibrillation were independent risk factors of complications by pericardial effusion after RFCA in patients with tachyarrhythmias. Age and left atrial size in female patients and those with atrial fibrillation were significantly higher than in male patients and patients without atrial fibrillation. CONCLUSION: Pericardial effusion complicating RFCA is not rare in patients with tachyarrhythmias, and it tends to develop into cardiac tamponade. Emergency pericardiocentesis and drainage are the most effective therapy. Female sex and atrial fibrillation may be independent risk factors of pericardial effusion after RFCA in patients with tachyarrhythmias.

Risk factors and prognosis of invasive fungal infections in allogeneic stem cell transplantation recipients: a single-institution experience.

OBJECTIVE: Invasive fungal infections (IFI) are frequent complications of allogeneic hematopoietic stem cell transplantation (SCT) and major causes of a poor prognosis. Analysis of risk factors and prognosis of IFI are important for the control of IFI. PATIENTS AND METHODS: We retrospectively reviewed the medical records of all allogeneic SCT recipients from January 2000 to December 2007. For the homogeneity of analysis, only 286 patients with no history of IFI were included. RESULTS: Fifty-five cases of IFI were identified, corresponding to cumulative incidence of 19.8%. Different overall survival rates were recorded in patients with or without IFI (20.3% vs. 55.3%, P=0.004). Multivariate analysis identified 2 risk factors of IFI: use of high-dose steroid and cytomegalovirus infections, and risk stratification can classify the patients into 3 subgroups with different incidences of IFI (9.2%, 25.4%, and 34.1%, P=0.0007). Further analysis confirmed use of steroid as a risk factor of inferior prognosis in IFI cases (0 vs. 57.1%, P<0.0001), which was due to higher rates of IFI-related mortality (64.7% vs. 23.9%, P=0.018). CONCLUSION: Post-transplant IFI was an unfavorable prognostic factor of the SCT recipients, and risk stratification can identify patients with high risk of IFI. Use of steroid played an important role in the pathogenesis as well as prognosis of IFI.

Identification of the pathological prion protein allotypes in scrapie-infected heterozygous bank voles (Clethrionomys glareolus) by high-performance liquid chromatography-mass spectrometry.

Cerebral formation of the pathological isoform of the prion protein (PrP) is a crucial molecular event in prion diseases. The bank vole (Clethrionomys glareolus) is a rodent species highly susceptible to natural scrapie. The PrP gene of bank vole is polymorphic (Met/Ile) at codon 109. Here we show that homozygous 109Met/Met voles have incubation times shorter than heterozygous 109Met/Ile voles after experimental challenge with three different scrapie isolates. An HPLC-MS/MS method was optimized and applied to investigate whether in heterozygous animals both PrP allotypes are able to undergo pathological conversion. The results demonstrate that both allotypes of the prion protein participate to pathological deposition.

Mutation of the PRNP gene at codon 211 in familial Creutzfeldt-Jakob disease.

Creutzfeldt-Jakob disease (CJD) belongs to a group of chronic, progressive, neurodegenerative disorders that may be hereditary, infectious, or sporadic. Hereditary CJDs are associated with mutations in the PRNP gene on chromosome 20p12-pter. We report a family in which four patients developed classical clinical signs of CJD, including severe cognitive decline, cerebellar signs, myoclonic jerks, and synchronic periodic discharges on electroencephalogram. The E211Q mutation has been identified in family members, but not in 97 sporadic CJD patients referred to the Italian registry of CJD nor in 205 healthy normal subjects, suggesting a pathogenic role for this mutation.

Prion protein glycotype analysis in familial and sporadic Creutzfeldt-Jakob disease patients.

Creutzfeldt-Jakob disease (CJD) and other transmissible spongiform encephalopathies (TSEs) are characterised by the accumulation of a pathological conformer of PrP, named PrPsc. Molecular weight and glycosylation of the protease-resistant core of PrPsc (PrP27-30) are heterogeneous in different forms of TSEs. We analysed PrP27-30 glycotypes in a large number of TSE-affected patients: 50 sporadic CJD (sCJD), 1 iatrogenic CJD, 1 Gerstmann-Sträussler-Scheinker syndrome (GSS) with the Pro102Leu mutation of PrP, 3 familial CJD (fCJD) with the Glu200Lys mutation and, for the first time, 7 fCJD with the Val210ll3e mutation. All patients were screened for the polymorphic codon 129 of the PrP gene. PrP27-30 deglycosylation and PrPsc immunohistochemistry were performed in selected cases. We found that two PrP27-30 glycotypes (type 1A and type 2A) are produced in sCJD. Type 1A is more frequently associated with methionine than valine in position 129. Type 1A is also formed in Val210lle fCJD. In Glu200Lys fCJD and GSS patients, we found that PrP27-30 has the same mobility of type 1 but different glycosylation ratios (type 1B). Our findings indicate that the polymorphic residue 129 of PrP has a leading role in determining the proteinase degradation site of PrPsc while mutant residues 102 or 200 influence only the glycosylation pattern.