Novel mutations in the lipase H gene lead to secretion defects of LIPH in Chinese patients with autosomal recessive woolly hair/hypotrichosis (ARWH/HT).

Autosomal recessive woolly hair/hypotrichosis (ARWH/HT: OMIM #278150/604379) is a rare hereditary hair disease characterized by tightly curled hair at birth which can lead to sparse hair later in life. The mutations in both LIPH and LPAR6/P2RY5 are responsible for autosomal recessive woolly hair with or without hypotrichosis (ARWH/HT). To conduct clinical and genetic investigations in four patients from three unrelated Chinese Han families with ARWH/HT, we performed mutation screening of LIPH and LPAR6/P2RY5 gene and identified four mutations in LIPH: c.454G>A, c.614A>G, c.736T>A, c.742C>A. c.736T>A and c.742C>A mutations were reported in previous studies, and c.454G>A, c.614A>G were identified for the first time. We carried out functional studies of the two mutants with c.454G>A (p.Gly152Arg, G152R) or c.614A>G (p.His205Arg, H205R). Interestingly, both of them lead to secretion defects of LIPH, which are involved in the pathogenesis of ARWH/HT.

Simultaneous heart valve replacement surgery and abdominal subtotal hysterectomy: case report.

A middle-aged woman with rheumatic heart disease, mitral valve prolapse and incompletely closed mitral valve medium, patent foramen ovale, merge multiple uterine fibroids, and moderate blood loss anemia underwent mitral valve replacement surgery with total abdominal hysterectomy under general anesthesia and cardiopulmonary bypass condition. The surgery was successful, and postoperative bleeding, blood clots, heart failure, and other related complications did not occur. Heart valve replacement surgery with the surgical treatment of uterine fibroids effectively improves the safety of surgical treatment for patients as well as reduces the patient's medical expenses and risk of secondary surgery and trauma.

[Determination of seven perfluoroalkyl and polyfluoroalkyl substances in serum of pregnant women and evaluation of neonatal neurobehavior based on high performance liquid chromatography-tandem mass spectrometry].

Perfluoroalkyl and polyfluoroalkyl substances (PFASs) have been extensively used as synthetic fluorine-containing compounds in various consumer products, including surfactants, cookware, lubricants, clothing, and food packaging, since the 1950s. Evidence has shown that PFASs cross the placental barrier and interfere with fetal thyroid hormone homeostasis, which is crucial for fetal growth and neurobehavioral development in children aged 2-9 years. However, no epidemiological data on the association between prenatal PFAS exposure and neonatal neurobehavioral development are available. In this study, we explored the association between prenatal PFAS exposure and neonatal neurobehavioral development based on the Ezhou cohort study. Blood samples (10 mL) were collected during the third trimester of pregnancy (28-36 weeks) at the Ezhou maternal and child health hospital. The blood specimens were centrifuged at 4000 r/min for 15 min immediately after collection, separated, stored at -80 ℃. The samples were analyzed for seven PFASs, namely, perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroheptanesulfonic acid (PFHpS), and perfluorooctane sulfonamide (PFOSA). The PFASs were separated using a C18 column (100 mm×2.1 mm, 1.7 µm) at an oven temperature of 40 ℃, injection volume of 10 µL, and flow rate of 0.4 mL/min via gradient elution with methanol and ammonium acetate aqueous solution. The instrument was operated in negative electrospray ionization mode with multiple reaction monitoring. The correlation coefficients (r2), limits of detection (LODs) and quantification (LOQs), and spiked recoveries of the seven PFASs were 0.993-0.999, 0.006-0.020 ng/mL, 0.020-0.066 ng/mL, and 84.6%-116.8%, respectively. Neonatal behavioral neurological assessment (NBNA) was used to evaluate newborn cognitive development 72 h after birth; this tool consisted of five clusters, including behavior (six items), passive muscle tone (four items), active muscle tone (four items), primitive reflexes (three items), and general assessment (three items). Each item was rated on a three-point scale (0, 1, or 2), with the 20 items having a maximum score of 40. A total of 379 mother-newborn pairs were included in the analysis. The PFASs with the highest exposure levels was PFOA, with median levels of 19.4 ng/mL. Linear regression models were used to test the effects of ln-converted PFAS levels in newborns. After adjusting for confounding factors, the linear regression model showed that PFOS exposure during pregnancy was associated with decreased active muscle tone(ß(95% CI): 0.36(-0.64, 0.08)) and general assessment(ß(95% CI): 0.34(-0.61, 0.07)) in all newborns. Furthermore, PFNA exposure was associated with decreased passive muscle tone(ß(95% CI): 0.38(-0.74, 0.01)) and total NBNA(ß(95% CI): 0.37(-0.68, 0.06)). PFDA exposure was associated with decreased behavior(ß(95% CI): 0.28(-0.54, 0.01)), while PFHxS exposure was associated with elevated total NBNA(ß(95% CI): 0.27(0.05-0.48)). Gender stratification analysis showed that PFOS exposure during pregnancy was associated with decreased active muscle tone(ß(95% CI): 0.54(-0.73, 0.35)) and general assessment(ß(95% CI): 0.50(-0.88, 0.13)), PFNA exposure during pregnancy was associated with decreased passive muscle tone(ß(95% CI): 0.67(-1.2, 0.14)) and total NBNA(ß(95% CI): 0.45(-0.91, 0.01)), PFDA exposure during pregnancy was associated with decreased behavior(ß(95% CI): 0.44(-0.71, 0.17)), PFHxS exposure was associated with elevated total NBNA(ß(95% CI): 0.41(0.02-0.80)) in male newborns, and PFOA exposure was associated with decreased general assessment(ß(95% CI): -0.27(-0.51, 0.02)), and PFDA exposure was associated with elevated behavior(ß(95% CI): 0.46(0.40-0.52)) in female newborns. The proposed method separates and detects various PFASs without the need for cumbersome pretreatment processes, and has the advantages of low LODs, satisfactory recoveries, and accurate precision. Thus, it allows for the simultaneous analysis of trace PFASs in microserum samples from pregnant women. Our results also showed that prenatal PFAS exposure can lead to neurobehavioral disorders in offspring, with male newborns showing greater sensitivity than female newborns.

A new c.1845A→T of oncostatin M receptor-ß mutation and slightly enhanced oncostatin M receptor-ß expression in a Chinese family with primary localized cutaneous amyloidosis.

Primary localized cutaneous amyloidosis (PLCA) is a chronic itching skin disease with amyloid material deposited in the upper dermis. PLCA is more common in Southeast Asia and South America, where up to 10% of cases may be familial. Mutations of OSMR or IL31RA have been identified in PLCA. Here we detected a new OSMR mutation in a lichenoid PLCA family from north China. This is the first report of PLCA with gene mutation on the Chinese mainland. A heterozygous 1845A→T was found in exon 13 of the proband, causing p.Lys615Asn substitution, which was not found in screening 100 ethnically matched healthy controls. The particular mutated amino acid is well conserved throughout various evolutionary lineages, located within the second fibronectin III-like domain of oncostatin M receptor ß subunit (OSMRß), and in close vicinity to a previously reported mutation, p.Gly618Ala. Immunohistochemistry showed slightly enhanced OSMRß expression in the lesion of the proband. This study extends the knowledge of PLCA gene mutation and further supports the pathogenic role of OSMRß in PLCA.

Pulmonary alveolar proteinosis complicated with tuberculosis: A case report.

BACKGROUND: Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by the accumulation of phospholipoproteinaceous material in the alveoli. Cases of PAP complicated with tuberculosis are much more complex and have rarely been well recorded. CASE SUMMARY: We describe a 21-year-old Han Chinese patient with suspicious lung infection associated with mild restrictive ventilatory dysfunction and diffusion reduction. High resolution computed tomography revealed a "crazy-paving" appearance and multiple pulmonary miliary nodules around the bronchi. Bronchoalveolar lavage demonstrated a small amount of periodic acid-Schiff positive proteinaceous materials. A serological test for the presence of a Mycobacterium tuberculosis antibody and an interferon-gamma release assay were both positive. The patient received a standard course of first-line anti-tuberculosis treatment after diagnostic bronchoalveolar lavage. To date, clinical remission has been achieved and maintained for five years. CONCLUSION: In summary, the diagnosis of PAP complicated with tuberculosis was supported by a combination of clinical manifestations, imaging, pulmonary function, laboratory examinations, bronchoalveolar lavage, etc. This case highlighted that diagnostic bronchoalveolar lavage in combination with anti-tuberculosis treatment is a safe and effective option for mild PAP patients with tuberculosis.

Effectiveness and safety of bevacizumab for unresectable non-small-cell lung cancer: a meta-analysis.

BACKGROUND: Non-small-cell lung cancer (NSCLC) accounts for more than 85% of all cases of lung cancer. The 5-year survival of patients presenting with advanced stage NSCLC is less than 15%, indicating that additional treatment options are needed. Bevacizumab is a recombinant humanized version of the murine anti-human vascular endothelial growth factor (VEGF) monoclonal antibody with a high binding specificity for VEGF. OBJECTIVE: The aim of this meta-analysis was to evaluate the effectiveness and safety of bevacizumab in patients with unresectable non-small-cell lung cancer (NSCLC) on the basis of evidence-based methodology. METHODS: The electronic database PubMed was searched to identify randomized, controlled trials (RCTs) of bevacizumab for the treatment of unresectable NSCLC. Other databases such as the Cochrane Library Trials Register, the WHO Trial Registration, the National Cancer Institute, ClinicalTrials.gov, the European Organization for Research and Treatment of Cancer, the Southwest Oncology Group, the Eastern Cooperative Oncology Group, the European Society of Clinical Oncology and the American Society of Clinical Oncology were also searched. The meta-analysis was performed using Reviewer Manager Version 5.0 software provided by the Cochrane Collaboration. Outcome measures were overall survival rates, progression-free survival, tumour response rate, incidence of severe adverse events (SAEs) and treatment-related death. RESULTS: Four eligible studies that included 2101 patients were found; in these studies, bevacizumab was administered to 1237 patients. Neither high-dose (15 mg/kg) nor low-dose (7.5 mg/kg) bevacizumab increased 1-year overall survival rates compared with patients not treated with bevacizumab. However, high-dose bevacizumab, rather than low-dose, increased 2-year overall survival rate (risk ratio [RR] = 1.24; 95% confidence interval [CI] 1.04, 1.49) and tumour response rate (RR = 1.69; 95% CI 1.21, 2.35) compared with patients not treated with bevacizumab. Progression-free survival was also significantly improved in both the low- (hazard ratio [HR] = 0.76; 95% CI 0.64, 0.90) and high-dose groups (HR = 0.73; 95% CI 0.65, 0.81). There was a clear and significant increase in the rate of treatment-related death in the high-dose group (RR = 2.07; 95% CI 1.19, 3.59) compared with patients not treated with bevacizumab. No significant differences were noted in the rate of treatment-related death in the low-dose group or in the incidences of SAE in the low- or high-dose groups compared with patients not treated with bevacizumab. Neutropenia was easily induced in both the low- and high-dose bevacizumab groups. Patients who received high-dose bevacizumab tended to experience hypertension, neutropenia, haemoptysis, rash and headache more frequently than patients not treated with bevacizumab. CONCLUSIONS: Low-dose bevacizumab may significantly improve progression-free survival in patients with unresectable NSCLC, whereas high-dose bevacizumab may increase 2-year overall survival rates, prolong progression-free survival and improve tumour response rate but at the cost of higher treatment-related death. Larger well designed RCTs should be carried out in the future to clarify the role of bevacizumab in the treatment of NSCLC.

[Preparation and spectrum properties of cellulose nanoparticles].

Manipulating cellulose molecules in nanosize range to create excellent nano materials is the frontier of cellulose science. Cellulose nanoparticles, a kind of renewable biomaterial, have become the research focus home and aboard. It is of great importance to develop a simple, green, low energy-consuming, rapid and efficient method to prepare cellulose nanoparticles. In the present paper, cellulose nanoparticles (CNP) which enjoy good dispersity and nanosize were prepared by alkaline hydrolysis in a simple and feasible way, with microcrystalline cellulose (MCC) as the raw material. Moreover, the size and morphology, crystal structure and spectrum properties of the cellulose nanoparticles were analyzed by means of transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD) and Fourier transform infrared spectrometry (FTIR). TEM images demonstrate that the prepared samples are in quasi-sphere shapes with good dispersity and with size about 20-40 nm. The SEM images of the samples show that the purified cellulose nanoparticles can be obtained after dialysis treatment to remove salt particles. The XRD results show that the microcrystalline cellulose and cellulose nanoparticles almost have the same diffraction peaks in cellulose I crystal form. Because of the damage of amorphous region of MCC by alkaline hydrolysis, the crystallinity of produced samples increases by up to 79.71%. The grain size was calculated with Scherrer's formula, and the average size is about 3-6 nm. Furthermore, the FTIR spectra suggest that the characteristic peaks on the graphs of cellulose nanoparticles have no significant change compared to natural cellulose, which indicates that the sample remains as the basic chemical groups of cellulose. The results show that preparing cellulose nanoparticles (CNP) by alkaline hydrolysis enjoys the ease to operate and can produce high yield, and therefore the study offers a new approach to obtaining cellulose nanoparticles with nanosize and good dispersion.

[A study on the haplotype of the solute carrier family 11 member 1 gene in Tibetan patients with pulmonary tuberculosis in China].

OBJECTIVE: To investigate the association of the haplotype of the solute carrier family 11 member 1 (SLC11A1) gene with susceptibility to pulmonary tuberculosis in Tibetans. METHODS: Four polymorphisms of the SLC11A1 gene [5' (GT)n, INT4, D53N, and 3' UTR] were investigated by denaturalization high performance liquid chromatography and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 140 patients (the patient group) and 139 PPD-positive healthy controls (the control group) of the Tibetan nationality from June 2004 until January 2005. The relationship between the haplotype and susceptibility to pulmonary tuberculosis in these patients was studied by chi2 test, and the linkage disequilibrium as well as the haplotype were analyzed by the SHESIS software. RESULTS: The haplotype frequencies of 5'(GT)9/INT4 G, 3'UTR TGTG/D543N G, 3'UTR TGTG del/D543N A were 64.8% (181/280), 76.6% (215/280), 12.0% (34/280) among the patients and 78.1% (217/276), 84.4% (235/276), 6.4% (18/276) among the controls. 5' (GT)9/INT4 G, 3'UTR TGTG/D543N G haplotypes rendered a lower risk (chi2 = 11.026, P<0.01, chi2 = 6.547, P<0.05, respectively), but 3'UTR TGTG del/D543N A haplotype a higher risk (chi2 = 6.547, P<0.05) for tuberculosis. CONCLUSIONS: 5' (GT)9/INT4 G, 3'UTR TGTG/D543N G and 3'UTR TGTG del/D543N A haplotypes of the SLC11A1 gene may be associated with the susceptibility of the Tibetan population to pulmonary tuberculosis.

Is the delivery mode a critical factor for the microbial communities in the meconium?

BACKGROUND: Mothers are the primary source of bacteria for newborns, but it is unclear whether mother-to-newborn transmission occurs prior to, during or after birth. Similarly, the effect of the delivery mode on neonatal microorganisms has been the focus of controversy. METHODS: Healthy maternal and neonatal pairs that underwent vaginal birth and caesarean section were enrolled in this study. Meconium, placenta, membrane and amniotic fluid samples for newborns and vaginal, rectal and oral samples for mothers were collected. All samples were amplified and sequenced by a 16S rRNA gene primer set targeting bacteria and archaea. FINDINGS: A total of 550 samples from 36 mother-neonate pairs with vaginal births and 42 mother-neonate pairs with caesarean sections were included in this study. The negative controls showed that the data analysis in this study was not affected by contamination. There was a high diversity of microbial communities in the pregnancy environment of the foetus. Meconium samples could be divided into three distinct types that were not influenced by the delivery method. INTERPRETATION: The distribution patterns of bacterial communities in the meconium, placenta, and foetal membranes were highly similar and had nothing to do with the mode of delivery. For approximately half of the placental microorganisms, the same sequence could be found in the vaginal, rectal, and oral samples of the mother.

Mycophenolate mofetil and triptolide alleviating airway inflammation in asthmatic model mice partly by inhibiting bone marrow eosinophilopoiesis.

The bone marrow eosinophilopoiesis makes a major contribution to the chronic airway inflammation in asthmatic animals and patients. Some anti-asthmatic medicines alleviated the asthmatic airway inflammation by inhibiting the bone marrow eosinophilopoiesis. Immunosuppressive agents have been commonly used in patients with glucocorticoid refractory asthma and have been proved to be effective. However, the research on the effect of the immunosuppressive agents on the bone marrow eosinophilopoiesis has seldom been reported. The purpose of the study was to explore the effect of mycophenolate mofetil (MMF) and triptolide (TP) on the bone marrow eosinophilopoiesis and to further investigate the mechanisms of the immunosuppressive agents involved in the anti-asthmatic effect. Balb/c mice were sensitized and challenged by OVA to establish the asthmatic model, and respectively administered orally with sterile saline, MMF, and TP once daily for 2 weeks. Airway inflammation, and inflammatory mediators IL-5 and eotaxin in the peripheral blood and bone marrow were measured by histology and ELISA. Immunocytochemistry combined with in situ hybridization technique and Western blot analysis was performed to estimate the amount of CD34+ IL-5R mRNA+ cells and IL-5R expression in the bone marrow. The count of new produced eosinophils in the bone marrow was detected by anti-BrdU immunocytochemistry. We found that MMF and TP attenuated OVA-induced eosinophil (EOS) recruitment in bronchoalveolar lavage fluid (BALF), inflammatory mediator expression of IL-5 and eotaxin in the peripheral blood, inflammatory cells expressing eotaxin in the lung tissues and the number of new produced EOS in the bone marrow. Also, MMF abated the migration of CD34+ cells from the bone marrow to the peripheral blood, which was associated with a decreased eotaxin expression in the bone marrow and a decreased CCR3 expression on bone marrow cells. While, MMF or TP failed to decrease the amount of CD34+ IL-5R mRNA+ cells (EOS progenitors), and IL-5R expression in the bone marrow of asthmatic model mice. These results demonstrated that MMF and TP reduce the eosinophilopoiesis of the bone marrow; this is associated with a decrease of IL-5 produced by T cells, which contribute to alleviate the allergic airway inflammation in asthma. In addition, MMF decreased the CD34+ cells migration from the bone marrow to the peripheral blood by the reduction of the level of eotaxin in the bone marrow and the expression of CCR3 on the bone marrow cells.

Increased expression of human calcium-activated chloride channel 1 is correlated with mucus overproduction in the airways of Chinese patients with chronic obstructive pulmonary disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is usually complicated with mucus overproduction in airway. Recently the increased expression of the human calcium-activated chloride channel 1 (CaCC(1)) was found to play an important role in mucus overproduction in the asthmatic airways. To investigate the relationship of CaCC(1) and mucus overproduction in the airway of Chinese patients with COPD, the expressions of CaCC(1), MUC5AC and mucus in bronchial tissues were examined. METHODS: Bronchial tissues were obtained from fiberoptic bronchoscopy and bronchial biopsy in West China Hospital from April to July in 2004. Twenty-five patients were diagnosed as the patients with COPD overproduction, and other 20 were the control subjects. The expressions of CaCC(1), MUC5AC and mucin in bronchial tissues were detected by reverse transcriptase-polymerase chain reaction (RT-PCR), in situ hybridization with digoxigenin (DIG)-labeled RNA probe, immunohistochemical and alcian blue-periodic acid Schiff (AB-PAS) staining, respectively. RESULTS: Compared with the control group, the stronger expressions of CaCC(1) were further detected throughout the bronchial tissues from patients with COPD (P < 0.01). Furthermore, the stronger expressions of the CaCC(1) mRNA were related to the severity of airflow obstruction. Samples from COPD showed a stronger staining for MUC5AC than those in control subjects (P < 0.01) and AB-PAS staining revealed more mucins in COPD patients' submucosal gland comparing with that in control subjects (P < 0.01). Expression levels of the CaCC(1) mRNA were respectively negatively correlated with the patients' forced expiratory volume in one second (FEV(1))/forced vital capacity (FVC) data, FEV(1)% predicted data, V(50)% predicted data, V(25)% predicted data (r = -0.43, r = -0.43, r = -0.35, r = -0.36, P < 0.01, P < 0.01, P < 0.05, P < 0.05). While the expression levels of the CaCC(1) mRNA were well correlated with the expression levels of the MUC5AC mRNA of airway epithelium and the PAS-AB stained area of submucosal glands (r = 0.39, r = 0.46, P < 0.05, P < 0.01). Expression levels of the MUC5AC mRNA were negatively correlated with the patients' FEV(1)/FVC data (P = 0.01), FEV(1)% pred data (P = 0.01), V(50)% predicted data, V(25)% predicted data (r = -0.53, r = -0.53, r = -0.48, r = -0.43, P < 0.01, P < 0.01, P < 0.01, P < 0.01). While the expression levels of the MUC5AC mRNA were well correlated with the positively PAS-AB stained area of submucosal gland (P < 0.05), and the correlation coefficients were 0.43. CONCLUSION: These results suggest that the stronger gene expression of CaCC(1) exists, complicated with mucus overproduction in the airway of Chinese patients with COPD.

Genetic instability of BRCA1 gene at locus D17S855 is related to clinicopathological behaviors of gastric cancer from Chinese population.

AIM: To investigate genetic instability of gene BRCA1 at locus D17S855, and their relationship with clinicopathological characteristics of gastric cancer in Chinese population. METHODS: Microsatellite instability (MSI) and loss of heterozygosity (LOH) of gene BRCA1 at locus D17S855 were compared between 37 samples of gastric cancer and corresponding non-cancerous gastric tissue. RESULTS: MSI at locus D17S855 was positive in 7 of 37 samples of gastric cancer (18.95%). MSI had a close relationship with TNM staging but no relation with lymph node metastasis, histological type or tumor differentiation. MSI positive frequency in TNM I + II (31.58%, 6/19) was much higher than that in TNM III + IV (5.56%, 1/18), (P < 0.05). LOH positive rate was 18.92% (7/37). LOH had no relationship to histological type, tumor differentiation or lymph node metastasis, but LOH positive rate in TNM III + IV was 33.33% (6/18), much higher than that in TNM I + II ( 5.26%, 1/19), (P < 0.05). BRCA1 protein was expressed in 14 of 37 samples of gastric cancer. The positive rates of BRCA1 protein in TNM I + II and TNM III + IV were 57.89% and 16.67%, respectively, (P < 0.05). The positive rate of BRCA1 protein was 77.78% in high differentiation samples, 30.77% in middle differentiation and 12.50% in lower differentiation samples, (P < 0.05). CONCLUSION: MSI of BRCA1 gene could be used as a molecular marker in early phases of sporadic gastric cancer in Chinese population. LOH occurs at later period of gastric cancer, therefore, it could be used as prognostic factor.

[Structural and property characteristics of Chinese fir wood charcoal prepared under various conditions].

By techniques of one-step and two-step carbonization, and capped and uncapped carbonization, the pyrolysis on the thinning wood of Chinese fir, one of the fastest growing tree species in south China, was carried out. With special focus on the variation of Raman spectra and X-ray diffraction analysis of carbonized materials under different carbonization conditions, comprehensive analyses of charcoals were conducted. Results show that, with temperature rising, the graphite-like microcrystal and carbon atoms at the edge of graphite-like microcrystal increase rapidly. As a result, the hexagon carbon plane structure in carbonized material keeps growing. Moreover, the experiments reveal that carbonization condition has great effects on the property and structure of carbonized material, and 700 degrees C is the critical temperature at which the qualitative change of carbonized material occurs. Furthermore, formation and growth of graphite-like microcrystal in carbonized material, two-step method is more beneficial than one-step method, uncapped container carbonization method is better than the capped one, and using air as atmosphere gas is better than using N2. Samples with longer holding time in the process of carbonization enjoy higher graphitization extent.

[Study on the association of two polymorphisms of the vitamin D receptor (VDR) gene with the susceptibility to pulmonary tuberculosis (PTB) in Chinese Tibetans].

OBJECTIVE: To investigate the relationship between Fok I and Taq I polymorphisms of the VDR gene and the susceptibility of PTB in Chinese Tibetans. METHODS: Two polymorphisms of the VDR gene were typed by PCR-RFLP among 140 patients and 139 healthy controls who had been sensitized to tuberculosis. The relationship among two polymorphisms and the susceptibility of PTB were studied, and cases were grouped according to the genotypes. RESULTS: The genotype FF, Ff, ff were observed in 60, 56 and 24 cases among tuberculosis group while in 70, 60 and 9 cases among control group. A significant increase of VDR genotype ff (mutant homozygotes) was observed in the PTB patients when compared to controls (P < 0.05, OR 3.111, 95% confidence interval 1.343-7.207). The genotype of TT were in 137 cases, Tt in 3 cases among patients while TT in 134 cases , Tt in 5 cases among controls. No significant difference in these genotype frequencies was observed between two groups (P > 0.05, OR 1.704, 95% confidence interval 0.399-7.272). Two polymorphisms didn't show linkage disequilibrium and D' is 0.475. CONCLUSION: The Fok I polymorphism of VDR gene might be associated with PTB in Chinese Tibetan population, but no evidences supported that the Taq I polymorphism were associated with PTB in Chinese Tibetan. The two polymorphisms didn't show linkage disequilibrium.

Early diagnosis and treatment of severe acute cholangitis.

AIM: To investigate the diagnostic standard for early identification of severe acute cholangitis in order to lower the incidence of morbidity and mortality rate. METHODS: A diagnostic standard was proposed in this study as follows:documented biliary duct obstruction by ultrasound or computerized tomography or other imaging tools with the manifestation of systemic inflammatory response syndrome (SIRS). The surgical procedures included emergency common bile duct exploration with T tube insertion or cholecystostomy with secondary common bile duct exploration. And incidence of postoperative multiple organ dysfunction syndrome (MODS), duration of systemic inflammatory response and hospital mortality were analyzed. RESULTS: Fourty-three patients conforming to the diagnostic standard described above were employed in this study. 1 patient was admitted in acutely ill condition and complicated with acute relapse of chronic bronchitis, cholecystostomy procedure was performed but the patient was complicated with postoperative acute lung injury which was treated by assisted mechanical ventilation for 5 d; 2 wk later, two-stage common bile duct Exploration and T tube insertion were performed. The remaining 42 patients underwent primary common bile duct exploration and T tube insertion, 1 developed acute lung injury and recovered 3 d later, 2 patients developed acute renal dysfunction, 1 of which recovered 2 d later and the other died on d 4. For all patients, the postoperative systemic inflammatory response persisted for 2 to 8 d with median of 3 d. CONCLUSION: Early diagnosis of severe acute cholangitis can be made using this diagnostic standard, further development of systemic inflammatory response could be prevented and incidence of MODS as well as hospital mortality decreased.

[Biological behavior of cardial cancer and its effect on surgical management].

OBJECTIVE: To study the biological behavior of cardial cancer and its influence on surgical management. METHODS: Complete clinicopathologic data of 46 cases with cardial cancer undergoing radical gastrectomy was investigated retrospectively. The relationships between tumor Borrmann type, depth of invasion, growth pattern, lymph node metastasis and 5-year survival rate postoperative were analyzed. RESULTS: Of 46 cases, Borrmann type III, Type IV and Type II was 76% (35/46), 18% (8/46) and 6% (3/46) respectively; 5-year survival rate was 40% (14/35), 0 (0/8) and 100% (3/3) respectively. In respect of the depth of invasion, pT(2) was 31% (14/46) cases with 71% (10/14) lymph node metastasis; and 5-year survival rate was 64% (9/14). pT(3) was 15% (7/46) cases with 86% (6/7) lymph node metastasis; and 5-year survival rate was 57% (4/7). And pT(4) was 54% (25/46) cases with 92% (23/25) lymph node metastasis; and 5-year survival rate was 12% (3/25). The growth pattern in 87% (40/46) cases was infiltrative; and 5-year survival rate was 28% (11/40); the growth pattern in 13% (6/46) cases was expansive; and 5-year survival rate was 100% (6/6). CONCLUSION: D(2)(+) radical total gastrectomy should be performed on the developed cardial cancer, and if necessary, resection of body and tail of pancreas should be chosen.

Mutation detection of type II hair cortex keratin gene KRT86 in a Chinese Han family with congenital monilethrix.

BACKGROUND: Monilethrix is an autosomal dominant hair disorder characterized clinically by alopecia and follicular papules. In this study, we collected a Han monilethrix family to detect the mutations in patients and investigated the correlation between the genotype and phenotype of monilethrix. METHODS: In this study, we identified a Chinese family with monilethrix through light microscopic and scanning electron microscopic (SEM) examination. Genomic DNA from peripheral blood samples was prepared. DNA samples from controls and monilethrix patients were subject to polymerase chain reaction (PCR) amplification. Two pairs of primers were used to amplify the seventh exon of KRT86. Mutation screening of the PCR products was detected using direct sequencing. RESULTS: Light microscopic examination showed a regular alternate enlargement and narrow area. SEM examination showed that part of the cuticle of the nodules shed and disappeared gradually in the narrow area with granular protrusions on the surface similar to the erosion-like structure. Parallel longitudinal ridge and groovepattern appeared, and the ridges varied in width, like dead wood. A heterozygous transversion mutation c.1204G > A (p.E402K) in the seventh exon of KRT86 was identified in both patients. CONCLUSIONS: The mutation of extron 7 of KRT86 identified plays a major role in the pathogenesis of this pedigree with monilethrix, and is a mutation hot spot of KRT86. Further research is needed to explore the relationship between the phenotype and the mutation of the type II hair keratin gene KRT86 of monilethrix.

Novel deletion mutation of TRPS1 gene in a Chinese patient of trichorhinophalangeal syndrome type I.

Tricho-rhino-phalangeal syndrome (TRPS) is a rare autosomal dominant disorder. Deletion or mutation of the TRPS1 gene leads to the tricho-rhino-phalangeal syndromes type I or type III. In this article, we describe a Chinese patient affected with type I TRPS and showing prominent pilar, rhinal and phalangeal abnormalities. Mutational screening and sequence analysis of TRPS1 gene revealed a previously unidentified four-base-pair deletion of nucleotides 1783-1786 (c.1783_1786delACTT). The mutation causes a frame shift after codon 593, introducing a premature stop codon after 637 residues in the gene sequence. This deletion is an unquestionable loss-of-function mutation, deleting all the functionally important parts of the protein. Our novel discovery indicates that sparse hair and metacarpal defects of tricho-rhino-phalangeal syndromes in this patient are due to this TRPS1 mutation. And this data further supports the critical role of TRPS1 gene in hair and partial skeleton morphogenesis.