Volume 87  ·   Issue 24  ·  2007

Leukemia is a heterogeneous disease, and the results of treatment vary greatly among patients due to different genetic characteristics. Therefore, determining the predictors of improving diagnosis level, improving treatment effect and implementing individualized treatment has been a hot spot in leukemia research.

Objective to investigate the feasibility and clinical application of interphase nuclear fluorescence in situ hybridization (FISH) in the detection of chromosomal aneuploidy in lung cancer printed specimens. Methods the chromosomal aneuploidy in 46 lung cancer printed specimens was detected by FISH technique. Results the chromosomal aneuploidy was detected in 46 lung cancer printed specimens. The main characteristics of chromosomal aneuploidy were the increase of chromosomes 7, 8 and 12 and the loss of chromosome 9. The total detection rates of chromosomal aneuploidy in chromosomes 7, 8, 9 and 12 were 67.4% (31/46), 60.9% (28/46), 28.3% (13/46) and 56.5% (26/31), respectively. Conclusion Interphase nuclear FISH can detect chromosomal aneuploidy in lung cancer printed specimens, and these changes are expected to be applied to early diagnosis and prognosis of lung cancer.

Objective to investigate the efficacy of anterior distraction reduction and intervertebral bone graft fusion in the treatment of bilateral dislocation of cervical spine. Methods Twenty-one patients with bilateral dislocation of cervical spine were treated with anterior distraction and lift and pry reduction, and intervertebral bone graft fusion and internal fixation. Results All 21 patients with dislocation achieved successful reduction, bone fusion was obtained after postoperative follow-up, and the spinal nerve function of 4 patients improved after operation. Conclusion Anterior distraction reduction is an effective treatment for bilateral dislocation of cervical spine.

Objective to investigate the effect of age on bone mineral density in patients with Cushing's syndrome (CS). Methods the bone mineral density of different age groups of CS patients was compared with that of normal women. A total of 57 female cases who had been hospitalized for CS and had bone mineral density examination from June 1996 to February 2004 were collected, and 49 normal females who had been examined at the same time were selected as normal control group.According to different age groups, the two groups were stratified and analyzed. There were 27 cases in CS group and 15 cases in control group aged 30-39 years; The bone density was compared between 16 cases in CS group and 20 cases in control group aged 40~49 years. Results the bone peak in lumbar vertebra and hip in normal control group appeared between 30~39 years old and 20~29 years old. The bone density in CS group was lower than that in normal control group, and the most significant in 20~29 years old group; The bone mineral density of lumbar vertebra and Wards triangle decreased most obviously. The younger the age of CS patients, the more significant the bone loss. Osteoporosis in CS patients accounted for 29.8% (17/57), osteopenia in 50.9% (29/57), and the incidence of fracture was 26.3% (15/57). The Z value of lumbar bone mineral density in CS patients with fracture was significantly lower than that in patients without fracture (P =0.003). Conclusion The bone mineral density in CS patients was significantly lower than that in normal women, and the bone mineral density in lumbar vertebra and Wards triangle decreased more significantly. The bone mineral density loss in young CS patients was more obvious than that in older patients, and fracture was more likely in those with low lumbar bone mineral density.

Objective to evaluate the application value of allogeneic acellular dermal matrix (ADMA) in the surgery of vesicovaginal fistula and anterior urethral stricture.Methods 4 patients with complicated vesicovaginal fistula and 5 patients with anterior urethral stricture.ADMA was used as tissue substitute.The vesicovaginal fistula was repaired by extraperitoneal transvesical approach.ADMA was placed between the vagina and bladder during the operation.The stenosis segment of anterior urethral stricture was removed and the urethra was replaced with ADMA. Results No surgical complications occurred in all the cases.Four patients with vesicovaginal fistula were followed up for 4~12 months without recurrence.Five patients with anterior urethral stricture.After removal of urinary catheter, 3 patients had smooth urination and 2 patients had intermittent urethral dilatation for 2 months.All patients had smooth urination and urinary flow rate reached the normal range at 3 months postoperative.No signs of stenosis were found on urethrography.Conclusion In partial lower uroplasty surgery such as vesicovaginal fistula and urethral stricture,ADMA was used to replace autologous tissue, and the surgical effect was definite. It is a safe, effective, minimally invasive and economical new method, especially avoiding the trauma caused by acquiring autologous tissues in the past.

Objective to investigate the differences in hematopoietic reconstitution, immune reconstitution, efficacy and complications of autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of autoimmune diseases.Methods From 1999 to June 2006, 32 patients with severe autoimmune diseases underwent APBSCT.Among them, 27 were female and 5 were male, with a median age of 29 years (15-49 years). All patients were mobilized by cyclophosphamide (CTX) + granulocyte colony stimulating factor (rhGCSF) protocol, and CD34+ cells were sorted by CliniMACS cell sorter.The pretreatment protocol was CTX + TBI in 21 patients, and CTX + antithymocyte globulin (ATG) in 11 patients. Results The median time of granulocyte implantation was 11 days in CTX + TBI group and 9 days in CTX + ATG group, and the difference between the two groups was statistically significant (P =0.003). The median time of platelet implantation was 13 days and 8 days in the two groups, respectively, P =0.001 All patients were followed up for more than 12 months. Three cases (14.3%) in CTX + TBI group had recurrence, two cases (18.2%) in CTX + ATG group had recurrence, and the rest patients had stable condition; During transplantation, the incidence of bacterial infection in CTX + TBI group was 5/21 (23.8%), viral infection in 1 case (4.8%), radiation mumps in 4/21 (19%), bacterial infection in CTX + ATG group was 2/11 (18.2%), viral infection in 2 cases (18.2%), and serum disease reaction in 3/12 (25%). The infection in both groups was controlled quickly after antibiotic or antiviral treatment, and there were no fatal hemorrhagic complications caused by thrombocytopenia in both groups.

Objective to summarize the cytogenetic characteristics and clinical significance of patients with multiple myeloma (MM) in China.Methods The cytogenetic results of 100 patients with MM in our hospital were retrospectively analyzed.Results (1) The overall clonal sex chromosome aberration (CA) detection rate of patients was 17.2%; The detection rate of CA after subcloning was 37.0%; Among them, hypodiploid is the most common; The detection rate of chromosome 13 abnormality (C13A) was 6.0%, and the detection rate of fluorescence in situ hybridization (FISH) was 33.3%; The detection rate of chromosome 14 translocation and/or 14q32 abnormality was 6.0%; (2) Univariate analysis showed that clonal CA, non-hyperdiploid and C13A all significantly shortened the overall survival time (OS) and disease progression time (TTP) of patients; In multivariate analysis, only C13A has independent prognostic significance. Conclusion C13A, non-hyperdiploid, hyperdiploid, immunoglobulin heavy chain (IgH) translocation and other CA are reproducible in MM patients in China. Prognostic analysis shows that C13A is an independent prognostic poor factor.

Objective to investigate the relationship between the polymorphisms of α-adductin (ADD1) gene G460W and G protein β 3 subunit (GNB3) gene C825T and hypertension. Methods the polymerase chain reaction-restriction endonuclease fragment length polymorphism analysis (PCRRFLP) was used to genotype normotensive (495 cases) and hypertensive (256 cases) from Qingdao Port, Shandong Province. Results the polymorphisms and allele frequencies of ADD1 gene G460W and GNB3 gene C825T in hypertensive group and control group were in accordance with HardyWeinberg equilibrium. The frequency of individuals with WW genotype in hypertensive patients (35.2%) was higher than that in control group (27.4%), and the difference was statistically significant (x2=4.768, P =0.029, OR =1.43). There was no statistically significant difference in the frequencies of CC, CT, TT genotypes and C and T alleles of GNB3 gene between hypertensive group and control group (genotype, P =0.755; allele, P =0.561). Conclusion ADD1 gene

Objective to evaluate the effect of quantitative tissue velocity imaging (QTVI) on cardiac function and its value in the diagnosis of left heart failure. Methods 30 patients with left heart failure and 32 normal subjects were examined by routine echocardiography, and the left ventricular ejection fraction (LVEF) was calculated by simplified biplanar Simpson method; The peak systolic velocity (Vs) and maximum systolic displacement (Ds) at 6 sites of mitral annulus of left ventricular wall were measured by QTVI technique.The mean Vs and mean Ds of 6 sites of mitral annulus in the heart failure group were compared with the normal control group and the heart failure group before and after treatment, and the correlation between the mean Vs, mean Ds and LVEF was analyzed to explore the evaluation effect of QTVI technique on cardiac function and its diagnostic value in left ventricular systolic heart failure.Results The mean Vs of 6 sites of mitral annulus in the heart failure group was significantly lower than that in the normal control group [(2.8±0.6) cm/s vs (6.4±0.9) cm/s, P<0.01], and the mean Vs and mean Ds were significantly higher in the heart failure group after treatment than that before treatment [(3.5±1.1) cm/svs (2.8±0.6) cm/s, P<0.01]; The mean Ds at 6 sites of mitral annulus was significantly lower in the heart failure group than in the normal control group [(5.2±1.5) mmvs (11.6±1.5) mm,P<0.01], and the mean vs at 6 sites of mitral annulus was significantly higher in the heart failure group than before treatment [(6.5±2.0) mm vs (5.2±1.5) mm,P<0.01]. The mean vs at 6 sites of mitral annulus and mean Ds were significantly positively correlated with LVEF (r 0.87, 0.89, respectively, P<0.01). The area under the operating characteristic curve of subjects diagnosed with left heart failure was 0.95. Taking 4.42cm/s as the boundary value, the sensitivity, specificity and accuracy of the mean vs at 6 sites of mitral annulus in diagnosing left heart failure were 97.5%, 90.2% and 95.1%. The area under the operating characteristic curve of subjects diagnosed with left heart failure was 0.96. Taking 8.49mm as the boundary value, the sensitivity and specificity of the mean Ds at 6 sites of mitral annulus in diagnosing left heart failure were 97.5%, 87.8% and accurate

Objective to investigate the clinicopathological characteristics and surgical treatment effect of primary splenic tumors. Methods 43 cases of primary splenic tumors admitted to the Cancer Hospital of Chinese Academy of Medical Sciences from February 1972 to March 2006 were retrospectively analyzed. According to their clinicopathological characteristics, the treatment process and survival rate were statistically analyzed. Results 48.8% (21 cases) of 43 cases were found by physical examination. 42 cases underwent surgical resection and 1 case underwent tumor biopsy. 16 cases were benign, including 15 cases of splenic hemangioma and 1 case of splenic lymphangioma; There were 24 cases of malignant tumor, including 16 cases of splenic lymphoma and 8 cases of splenic angiosarcoma. Most of the patients with lymphoma survived for a long time, the 3-year survival rate was 88.7%, and the average survival time of splenic angiosarcoma was 10.4 months. Conclusion the primary splenic tumor lacks specific symptoms, B-ultrasound and CT are the first choice of examination, and surgical resection is the main treatment.

Objective to investigate the incidence of asymptomatic recurrence, the type of recurrent atrial tachyarrhythmia and its predictive factors of atrial fibrillation (atrial fibrillation) after peripulmonary vein isolation (CPVI). Methods 48 consecutive patients with atrial fibrillation treated with CPVI were followed up by Holter for 48 h. The follow-up time was 1, 3 and 6 months after operation, respectively. Multivariate Logistic regression analysis was performed to determine the predictive factors of asymptomatic recurrence, such as age, sex, type of atrial fibrillation, whether or not there was organic heart disease, left atrial anterior-posterior diameter, left ventricular ejection fraction, operation time, and postoperative heart rate variability. Results Among 48 patients, 42 patients were followed up with complete data, including 26 males and 16 females, with an average age of 58 ± 14 years. 25 patients had paroxysmal atrial fibrillation before operation and 17 cases had non-paroxysmal atrial fibrillation. The incidence of asymptomatic recurrence in paroxysmal atrial fibrillation group at 1, 3 and 6 months after operation was 8%, 12% and 8%, respectively. The asymptomatic recurrence rate of non-paroxysmal atrial fibrillation group at 6 months was significantly higher than that of paroxysmal atrial fibrillation group (P<0.05). Atrial fibrillation was the most common type of asymptomatic recurrence after CPVI, while atrial tachycardia was the more common type of symptomatic recurrence after CPVI. Conclusion Some patients have asymptomatic recurrence of atrial fibrillation after CPVI. Non-paroxysmal atrial fibrillation, left atrial enlargement and the increase of standard deviation of normal R-R interval are independent predictors of asymptomatic recurrence after CPVI.

Objective to block the expression of heparinase in gastric cancer cell line SGC7901 by RNA interference (RNAi) technique and to observe its effect on the invasive ability of tumor cells. Methods Small interfering RNA (siRNA) was synthesized by transcription in vitro and transfected with liposome; Combined with reverse transcription (RT) -PCR, Western blot was used to detect the expression of heparinase mRNA and protein; The invasion ability of gastric cancer cell lines after heparinase RNAi was evaluated by in vitro invasion assay. Results the heparinase siRNA molecule could specifically inhibit heparinase mRNA in SGC7901 cells, and the inhibition rate was (70±6) %; The invasion inhibition rate of SGC7901 cells after heparinase RNAi was (61±36) %. Conclusion the siRNA molecule targeting heparinase gene can specifically inhibit the protein expression level and reduce the invasion ability of tumor cells. Heparinase is a key molecule to promote the invasion and metastasis of gastric cancer cells, and can provide a new strategy for inhibiting the invasion and metastasis of gastric cancer.

Objective to investigate the effect of local interference of phosphatidylinositol-3 kinase (PI3K) p110 β subunit on neointimal hyperplasia of transplanted vessels. Methods the rat model of jugular vein branch-carotid artery interposition was divided into 6 groups: Group 1: 25% Pluronic F-127, Group 2: pU6-Pik3cb-shRNA-1, Group 3: pU6-Pik3cb-shRNA-2, Group 4: 1/2 (shRNA 1+ shRNA 2), Group 5: pGenesil-1 plasmid mismatched shRNA, Group 6: wortmannin positive control group. PI3K p110 β subunit mRNA and its downstream effector molecules phosphorylated Akt and mTOR were determined by fluorescence quantitative PCR and Western blot 3 days after surgery. Results the transfection efficiency of smooth muscle cells and endothelial cells in Pluronic F-127 plasmid sustained-release system was 60%, and the transfection efficiency of PI3CB mRNA and its downstream effector molecules phosphorylated Akt and mTOR was more than 90%.

Objective to investigate the changes of transcription factors in the proximal outflow tract of connexin 43 (Cx43) knockout mice embryo, and to investigate the reasons of abnormal development of the proximal outflow tract of Cx43 knockout mice embryo from the molecular level. Methods Cx43 knockout, Cx43 heterozygous and Cx43 wild type mice embryo heart proximal outflow tract with gestational age of 13.5 d and 14.5 d were used as the research objects. And transcribed into cRNA in vitro, biotin-labeled and fragmented at the same time; After the hybridization signal was scanned, the gene expression was analyzed by relevant bioinformation software.Some transcription factors related to cardiac development were verified by real-time quantitative reverse transcription (RT) PCR. Results Compared with Cx43 wild type group, 6 genes with different expression in Cx43 knockout group were transcription factors related to cardiac development. Three genes: Sox11, Foxp1 and Tbx20 were verified by real-time quantitative RT-PCR. At 13.5 days of gestational age, the expression levels of Sox11 and Foxp1 in Cx43 knockout mouse embryos were significantly lower than those in Cx43 wild type group (4.76±0.19 vs 5.34±0.25, 5.08±0.28 vs 5.64±0.15, all P<0.01); The expression levels of Sox11, Foxp1 and Tbx20 were significantly lower in the knockout group than in the Cx43 wild-type group (4.71±0.27 vs 5.00±0.19, 5.25±0.31 vs 5.77±0.16, 7.05±0.17 vs 7.43±0.25, all P<0.05). The change trend was basically consistent with the results of gene chip. Conclusion The abnormal expression of cardiac-specific transcription factors Foxp1, Sox11 and Tbx20 may be related to the abnormal development of outflow tract in Cx43 knockout mice.

Methods pCR3.1/GR plasmid expressing gastrin receptor (CCK-2R) was transfected into colon cancer cell line Colo320 by liposome transfection, and the positive clone expressing CCK-2R was screened from G418. The positive clone was identified by reverse transcription PCR and immunoblotting, and it was successfully named Colo320WT. Colo320WT cells were treated with 1×10-8 mol/L gastrin at a time gradient of 0, 1, 6, 12, 48 and 48 h, and with gastrin receptor antagonists L365,260 for 30 min, followed by 1×10-8 mol/L gastrin for 12 h. The expression of phosphorylated adhesion kinase (FAK) Tyr397 and total FAK in Colo320WT cells was detected by immunoblotting. The localized expression of phosphorylated FAKTyr397 in Pseudopod was observed by confocal microscopy. The formation of FAK-Src-p130Cas-Dock180 signal complex was detected by immunoprecipitation. Rac activity was determined by Pull-down. Results With the prolongation of gastrin intervention, the expression of phosphorylated FAKTyr397 increased and reached the maximum at 12 h, but had no obvious effect on total FAK. The ratio of phosphorylated FAKTyr397/FAK was 2.82%, 9.28%, 22.62%, 38.59%, 28.41% and 14.94%, respectively. The ratio of phosphorylated FAKTyr397/FAK was 7.21% after L365 and 260 blockade. The phosphorylated FAKTyr397 also increased and reached the maximum at 12 h. The signal complex of FAK, Src, p130Cas and Dock180 was formed by immunoprecipitation under gastrin intervention. Promote localization of phosphorylated FAKTyr397 in lamellar pseudopods, enable FAK-Src-p130Cas-Dock180 signaling complex formation, and activate Rac.

A 28-year-old woman was admitted to hospital due to subcutaneous ecchymosis for nearly 2 years and purple lines on the skin with intrauterine pregnancy for more than 5 months. The patient had obvious skin ecchymosis at the infusion site without inducement 2 years ago (2004). Purple lines were found in the lower abdomen since September 2005, which gradually increased and widened, and a few purple lines appeared around the breast and under the armpit.

Objective to establish a rat model of neurogenic bladder caused by lumbar intervertebral disc herniation and evaluate the urodynamics.Methods Twenty male Wistar rats were randomly divided into two groups, 15 in the operation group and 5 in the sham operation group.Flat head screws were placed into the L6-S1 intervertebral disc of rats to establish a rat model of lumbar intervertebral disc herniation.Electron X-ray radiography and combined behavior score (CBS) were performed postoperatively, and all rats were subjected to suprapubic cystostomy at 4 weeks postoperatively, and cystometry in awake state was performed 3 days after the fistula.Results Postoperative electron X-ray radiography confirmed that the screws were placed into the L6-S1 intervertebral disc; During the observation time, the CBS scores of the operation group were significantly higher than those of the sham operation group (all P<0.05), and the CBS scores of each group remained basically unchanged after 1 week after operation; Compared with the sham operation group, the spontaneous bladder contraction frequency (t =4.425, P =0.000), the maximum bladder capacity (t =5.141, P =0.002) and the bladder compliance (t =2.891, P =0.011) were higher in the operation group. The neurogenic bladder model of lumbar disc herniation in rats was successfully established by urodynamic examination. Conclusion A reliable model of neurogenic bladder caused by lumbar disc herniation in rats can be obtained by screw insertion into the intervertebral disc, which can be confirmed by electron X-ray, CBS score and urodynamic examination.

Objective to compare the sensitivity and specificity of the traditional rapid plasma reactin test (RPR) with the recombinant Treponema pallidum antigen-based rapid syphilis test. Methods 249 outpatients from STD centers were selected and their venous blood was collected after signing the informed consent form. The serum were collected for Treponema pallidum hemagglutination test (TPHA), RPR test and recombinant antigen enzyme-linked immunosorbent assay and the results were compared. Results Based on the results of TPHA, the serum sensitivity and specificity of the recombinant antigen enzyme-linked immunosorbent assay were 100% and 98.4%. The serum sensitivity and specificity of the RPR test were 65.1% and 98.4%. Conclusion Compared with the RPR test, the recombinant Treponema pallidum antigen-based assay has higher sensitivity.

AIDS is still a major disease of mankind, which threatens the life and health of people in all countries. The research on AIDS is deepening, and its treatment has entered the era of highly active antiretroviral therapy (HAART), and some results have been achieved.

On March 6, 2007, the editor-in-chief of the British Medical Journal (BMJ), one of the world's famous comprehensive medical journals, came to Beijing and gave a lecture on writing and publishing medical papers at China Union Medical University. The editor of BMJ emphasized that the prerequisite for producing high-quality papers is to have high-quality medical scientific research. Comparing with the common problems in medical research and paper publication in China, especially in clinical therapeutic research, we think it is necessary to learn advanced ideas from BMJ, which has a history of 160 years. Now talk about some views on how to improve the level of medical clinical research in China.

Crouzon syndrome is an autosomal dominant hereditary disease characterized by craniosynostosis and maxillofacial dysplasia, about 1/3 of which is sporadic. It is also known as craniofacial dysostosis, hereditary craniofacial dysplasia, cranio-orbital-facial dysplasia, etc. It is rare to see patients in otolaryngology department, and one case was admitted to our department on February 22, 2006. The report is as follows.