Objective To evaluate left atrial function by velocity vector imaging (VVI) in patients with rheumatic mitral stenosis(RMS). Methods Thirty eight patients with RMS and 42 normal controls were studied with VVI analysis software. Peak systolic strain (S), systolic strain rate(SRs), early diastolic strain rate(SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured,and also the SRa peak time delay(Td-SRa). Results Comparing to the controls group, the S, SRs and SRe of all segments were significantly lower(P<0.05). Except the base latero-aorta's SRa, the other segments' SRa were lower (P<0.05). In patients with atrial fibrillation(AF),56% segments had no SRa,and 18.6% had irregular low amplitude movement at late diastole, while 25.4% had discernible positive peak. The base and middle inferior SRa of patients with AF were lower (P<0.05 ) than those of the patients with sinus rhythm. While the Td-SRa of patients was longer than that of control group,especially what of the patients with AF. Conclusions The segmental and globe left atrial function of patients with RMS can be evaluated with VVI.

Objective To explore the application value of the diffusion-weighted imaging (DWI)and dynamic contrast-enhanced MRI in detection of peripheral zone of hepatic alveolar echinococcosis (HAE).Methods Twenty patients with HAE underwent abdominal plain scan,DWI and dynamic enhanced MRI.The ADC values and enhanced ratio of the central necrosis,solid component,peripheral zone and normal liver parenchyma were measured at a workstation,and further were analyzed and compared.Results 32 lesions were detected in 20 patients with HAE.Two groups were divided according to the lesion with central necrosis (group A)or not (group B).In group A, the ADC values of the solid part and normal liver parenchyma were (1.52±0.30)×10 -3 mm2/s and (1.22±0.30)×10 -3 mm2/s. Meanwhile,in group B those were (1.50±0.25)×10-3 mm2/s and (1.03±0.28)×10-3 mm2/s,exhibiting no statistical differences between the two groups.In group A and B,the ADC values of the peripheral zone of lesion were 1.34(1.10,1.61)×10 -3 mm2/s and 0.96 (0.86,1.22)×10 -3 mm2/s,exhibiting statistical differences (Z =2.867,P =0.004);meanwhile,the enhanced ratio were 1.70± 0.36 and 1.58±0.30,exhibiting no statistical difference.No correlation between ADC values and enhanced ratio was found in the peripheral zone.Conclusion DWI at 3.0T can display visually the HAE,and the ADC value may reflect the DWI features of periph-eral zone.The ADC values in combination with enhanced ratio may help for the diagnosis.

Objective To study the extraction process of Jiejiu Gankang granules by orthogonal test.Methods With the ethanol extraction rates of the medical materials like ginseng,radix salviae miltiorrhizae,the water extraction rates of the medical materials like hawthorn,and Tanshinone ⅡA as the parameters,the extract conditions of Jiejiu Gankang granules was optimized by orthogonal design.Results The optimal preparation process was as follows:the mixture of medical materials like ginseng and Schisandra chinensis was refluxed twice with total 10 times of 70% alcohol,2.0 hours for each time,and then the mixture of medical materials like hawthorn extracted twice with total 10 times of boiling water,2.0 hours for each time.Conclusion The optimal preparation process is reasonable and with high extraction rate of active components.

To explore the accuracy of simple selection method of Fengshi (GB 31). Through the study of the ancient and modern data,the analysis and integration of the acupuncture books,the comparison of the locations of Fengshi (GB 31) by doctors from all dynasties and the integration of modern anatomia, the modern simple selection method of Fengshi (GB 31) is definite, which is the same as the traditional way. It is believed that the simple selec tion method is in accord with the human-oriented thought of TCM. Treatment by acupoints should be based on the emerging nature and the individual difference of patients. Also, it is proposed that Fengshi (GB 31) should be located through the integration between the simple method and body surface anatomical mark.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians

ObjectiveTo evaluate the retinal function with central serous chorioretinopathy (CSC) and the fellow eyes (mf-ERG).MethodsTwenty patients (40 eyes) with unilateral CSC, diagnosed by fluorescein angiography, were examined on each eye of the patients by mf-ERG multifocal electroretinography. The patients aged from 31 to 53 (13 men, 7 women; mean age, 41 years), and the CSC eyes had visual acuities of 0.2 to 0.8. None of the patients had significant abnormality in the fellow eyes with visual acuities of 0.8 to 1.5. Twenty-four healthy people (29 normal eyes with visual acuities of 1.0 and more and without any retinal diseases) were studied simultaneously as the normal control. The stimulus matrix of 61 hexagonal elements were grouped into 5 concentric rings from the fovea outward to 30? of the degree of visual field. The first-order responses of mf-ERG were recorded. The first negative wave (N 1-wave) and positive wave (P-wave) of the mf-ERG were measured. Amplitude intensities and latechies for the two configurations were calculated and compared.ResultsCompared with the control eyes, the responses were not only depressed severely in P 1- and N 1-wave amplitude intensities in the ring 1~3 in the CSC eyes with CSC (P0.05). There were no significant differences in N 1- and P 1-wave latencies in 5 concentric rings among the control eyes, the fellow eyes or the CSC eyes.ConclusionsCSC is a kind of macular disease involving both eyes. It may cause the decrease of retinal function in macular area of CSC eyes and also influence the retinal function in macular area of the fellow eyes. mf-ERG is a sensitive way in examining visual function.

Objective To investigate the X-ray and clinic manifestations of hereditary multiple osteochondroma(HMO).Methods Five patients with HMO clinically and pathologically confirmed and 63 persons in their pedigree were studied.Results Of 63 cases inquired in this study,there were 21 patients with hereditary multiple exostosis,including 16 men and 5 women.In 5 cases confirmed pathologically,4 patients had hereditary history of pedigree and the members of three generation in 1 patient with HMO had no the history of pedigree.Conclusion HMO has the remarkable sex difference and the typical inherited trend including the location of exostosis.HMO has inherited character of skipping generation.

Objective To explore the clinical application of DKK-1,TFF3 and CA72-4 detection in the diagnosis and treatment of gastric cancer.Methods Seventy-five cases(gastric cancer group) of gastric cancer admitted to our hospital from January 2013 to May 2015 were selected.Seventy cases of benign gastric disease(benign gastric disease group) and 70 persons undergoing the physical examination(healthy control group) were selected as the research subjects.The concentration of CA72-4 in each group was detected by the electrochemiluminescence analyzer.The serum DKK-1 and TFF3 levels in each group were detected by enzyme linked immunosorbent assay(ELISA).The receiver operating characteristic(ROC) curve was drawn for evaluating the diagnostic efficiency of each index in each group.The sensitivity,specificity,positive predictive rate and negative predictive rate of 3 indicators for diagnosing gastric cancer before operation were compared.The concentration change of various indexes after gastric cancer radical resection were compared..Results The concentrations of DKK-1,TFF3 and CA72-4 in the gastric cancer group were significantly higher than those in the benign gastric disease group and healthy control group,the difference was statistically significant(P<0.05).The area under ROC curve of DKK-1,TFF3 and CA72-4 were 0.876(95%CI 0.803-0.950),0.944 4(95%CI 0.894-0.975) and 0.818(95%CI 0.726-0.884) respectively.The sensitivity of CA72-4 was 78.6% and the specificity was 84.3%,the sensitivity of DKK-1 was 93.6% and the specificity was 87.1%,the sensitivity and specificity of TFF3 was 92.4% and 90.1% respectively.The concentrations of DKK-1,TFF3 and CA72-4 after radical resection in the gastric cancer group were significantly reduced,the difference was statistically significant compared with before treatment(P<0.05).Conclusion The detection of DKK-1,TFF3 and CA72-4 has a certain clinical value for the diagnosis of gastric cancer.The combined detection of these 3 indicators is conducive to improve the specificity and sensitivity of gastric cancer diagnosis.

Objective To explore the protection and mechanism of hydrogen sulfide (H2S) preconditioning against injury induced by cisplatin in human marrow mesenchymal stem cells (HMMSCs).Methods HMMSCs were treated by cisplatin at 0,5,10,20,40,60,80 mg/L concentrations for 24 h respectively and were exposed to cisplatin at 20 mg/L concentrations for 0,6,12,24,36,48 h respectively.HMMSCs were pretreated with NaHS at 0,0.4,0.6,0.8,1.0 mmol/L respectively for 30 min before exposed to cisplatin at 20 mg/L concentrations for 24 h.HMMSCs were treated by U0126 or combined with human epidermal growth factor (HEGF) together for 30 min before they were preconditioned with NaHS for 30 min.The cell survival rate,cell apoptosis rate,the expression of p-ERK1/2 and t-ERK1/2 were recorded.Results The cell survival rate decreased to 71.72％±2.72％,59.41％±5.44％,50.37％±4.55％,38.97％±2.92％,30.11％±4.64％ and 21.71％±5.35％ respectively after cells were treated with cisplatin at 5,10,20,40,60,80 mg/L concentrations respectively,and the differences were statistically significant compared with 0 mg/L group.The cell viability fell to 70.30％±6.20％,61.63％±2.70％,51.29％±3.13％,38.72％±3.66％ and 27.57％±2.32％ after HMMSCs were treated with cisplatin at 20 mg/L for 6,12,24,36,48 h respectively,and the differences were statistically significant compared with 0 h group.The cell viability increased to 65.99％±2.67％,72.93％±5.44％,75.10％±4.71％ and 76.56％± 5.25％ when HMMSCs got pretreatment of NaHS,and the differences had statistical significance compared with cisplatin group.The cell apoptotic rate decreased from 35.29％±2.77％ to 18.62％±0.97％ when HMMSCs were pretreated with NaHS at 0.6 mmo/L.Treatment of HMMSCs with cisplatin at 20 mg/L for 24 h reduced p-ERK1/2 expression.The pretreatment of NaHS could inhibit the inhibitory action to the expression of p-ERK1/2 induced by cisplatin.Pretreatment with U0126 or HEGF inhibited or promoted the protection and the upregulated expression ofp-ERK1/2 caused by NaHS pretreatment.Conclusion The preconditioning of H2S can protect cell damage caused by cisplatin via activating the ERK1/2 pathway of HMMSCs.

Objective To investigate the expression of proinsulin, insulin, C-peptide in insulinoma and normal pancreas and their roles. Methods Thirty-eight cases of insulinoma and 20 cases of normal pancreas from Sep. 2006 to Dec. 2009 in our hospital were selected. Immunohistochemistry was used to determine the expression of proinsulin, insulin, C-peptide. Results Proinsulin, insulin, C-peptide was expressed in insulinoma and normal pancreas. Proinsulin, C-peptide were strongly expressed in 100%insulinoma, while they were weekly expressed in 55% ～60% normal pancreas; insulin was expressed as + + +in 79% insulinoma, while it was expressed as + + + + in 85% normal pancreas. Proinsulin, C-peptide positive cell accounted for 80% ～ 100% of 38 insulinoma, and insulin positive cell accounted for 50% ～ 70%,the proinsulin/insulin ratio ＞ 1 accounted for 78.9%; while the corresponding values were 20% ～ 80%, 60% ～90%, 10.0% in normal pancreas, and the difference was statistically significant ( P ＜ 0.05 ). Conclusions The proinsulin/insulin ratio ＞ 1 is 78.9% in insulinoma, and detection of proinsulin may help to diagnose insulinoma.

Objective To evaluate the long-term efficacy and safety of donepezil in treating patients with Alzheimer's disease(AD).Methods Totally 86 patients with AD were randomly divided into control group(n =43)and treatment group(n =43).The control grou,p received conventional therapy with aniracetam,nimoldipine and ginkgo tablet,while the study group was administrated with donepezil(10 mg/d)on the basis of conventional therapy.The improvements of recognitive ability,mental state,activities of daily life were graded by mini-mental state examination (MMSE),Alzheimer's disease assessment scale-cog(ADAS-cog),activity of daily living(ADL)and global deterioration scale(GDS).The scores were compared between the groups before the treatment and 3,6,12,18,24,30,36,42,48,54,60,66 and 72 months after the treatment,respectively.Results The scores of MMSE,ADAS-cog and GDS after 3 months and ADL score after 6 months (t=2.361,-2.198,-1.790,-2.420,P＜0.05 or P＜0.01)were improved in treatment group than in control group with the best effects at 12 months(all P＜0.01)and the scores continued to decrease after 36 months.At 72 months,the score improvements in treatment group were 7.5 for MMSE,20.3 for ADAS-cog,19.5 for ADL,and 1.4 for GDS as compared with control group(all P ＜0.01).In contrast to pretreatment,there were statistically significant differences in the scores of MMSE,ADAS-cog and GDS at 3,6,12,18 and 24 months,and in the score of ADL at 6,12,18,24 and 30 months after treatment(P＜0.05 or P＜0.01).The differences in the scores of ADAS-cog and GDS after 24 months as well as MMSE and ADL after 30 months were not found(P＞0.05)between pre-treatment and post-treatment.Conclusions Donepezil might be long term effective and safe in slowing down the recognitive and overall function deterioration of AD.