0.05).Conclusions Transcatheter intervention of VSD with large sack both thin-waist-big-side occluder or symmetrical occluder showed satisfactory result.Attention should be paid in the indications of these 2 types of occluders.

There is a broad and urgent need for the clinical application of anticancer nanomedicine in tumor therapy, but the complex biological barrier in solid tumors has always been the main obstacle to infiltrating nanomedicine into the tumor. The traditional design of nanomedicine based on enhanced permeability and retention (EPR) effect still has some limitations in tumor permeability, it is urgent to find other design theories. Therefore, this review summarizes two novel strategies, active transcytosis and immune cell-mediated tumor penetration, for promoting tumor penetration of anticancer nanomedicine.

Objective To evaluate transthoracic echocardiographic guidance for closure of atrial septal defects with Amplatzer occlusion device in the adults Methods Thirty patients with atrial septal defects were occluded by use of Amplatzer septal occluder The mean age was (32 3?14 7) years (ranging from 13-65 years) Transthoracic echocardiography was undertaken for guidance for closure before and in the procedure of intervention Transthoracic echocardiography was done immediately, one month and three month respectively after intervention to evaluate the treatment efficiency Results Twenty four patients were treated successfully directly by guidance of transthoracic echocardiography during the period of closure, the total effectiveness was 80%. Five patients needed to have transesophageal echocardiography before closure to select indication and another one patient was treated successfully by adding transesophageal echocardiography for guidance in the procedure There was no significant complication that occurred during the procedures, and there was no emergency surgical case Trivial to small residual shunts were found in 2 cases (6 7%) immediately after the procedure No residual shunts were found in the one month follow up, and all patients had no displacement and recanalization in the one month follow up Conclusion Transthoracic echocardiography can guide most of atrial septal defect patients for closure of atrial septal defects with the Amplatzer occlusion device

Objective To analyze the clinical features of acute leukemia(AL) with positive mixed lineage leukemia(MLL)fusion gene in children,and explore their treatment protocols,prognosis factors,and so on.Methods Clinical features,treatment protocols,and prognosis factors were studied retrospectively among 51 AL patients with MLL fusion gene.MLL fusion gene was detected by morphology immunology,cytogenetics,molecul arbiology and reverse transcrption polymerase chain reaction(RT-PCR).Results Fifty-one AL patients with MLL fusion gene positive,included 37 cases of acute lymphoblastic leukemia(ALL) and 14 cases of acute myelocytic leukemia(AML).Forty-two patients exhibited abnormal clonal chromosome 11.MLL fusion gene rearrangements and MLL fusion gene partial tandem duplication were found among 36 cases and 15 cases,respectively.Thirty-two cases who received regular chemotherapy were followed up.Twenty-four cases including 19 cases of ALL and 5 cases of AML had achieved complete remission(CR).Six cases including 5 cases of ALL and 1 cases of AML had achieved more than 2 years CR.Sixteen cases were alive update including 12 cases of ALL and 4 cases of AML.Ten cases of positive MLL fusion gene were turning negative.Up to now,6 cases relapsed and 6 cases were dead.Conclusions The incidence of AL children with positive MLL fusion gene is low.It has some features,such as,high replapse rate and poor prognosis.A few patients sensitive to chemotherapies can achieve CR.They live with constant negative MLL fusion gene.

Child ; Humans ; Middle Ear Ventilation ; Otitis Media ; Otitis Media with Effusion ; surgery ; Recurrence

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Leukemia, Myeloid ; pathology ; physiopathology ; Male

The traditional Chinese medicine (TCM) theory of "treating heart and brain diseases with same methods (Nao Xin Tong Zhi: NXTZ)" has great significance to the treatment of cardiovascular and cerebrovascular diseases. It has been proven effective by a great deal of clinical researches. However, the underlying mechanism for this theory is still unclear. To provide insights into the potential mechanism of "NXTZ", this study attempts to deeply investigate the mechanism from two representative cardiovascular and cerebrovascular diseases, coronary heart disease (CHD) and cerebral apoplexy. First, various data resources were integrated to obtain different types of biomedical entities including drugs, targets, pathways and diseases. Then, three different approaches including text mining, biological network and enrichment analysis were utilized to recognize the potential common features between CHD and cerebral apoplexy, and the corresponding functions of drugs which could treat both diseases, thus unveiling the mechanism of NXTZ.
Brain ; drug effects ; Coronary Artery Disease ; drug therapy ; genetics ; metabolism ; Databases, Bibliographic ; Drugs, Chinese Herbal ; therapeutic use ; Heart ; drug effects ; Humans ; Stroke ; drug therapy ; genetics ; metabolism

Objective To study the applications and outcomes of using autogeneic cartilage in hearing recon-struction surgery in patients with chronic otitis media or cholesteatoma .Methods A total of 165 patients (173 ears) in whom autogeneic cartilage was used were analyzed retrospectively .Forty -three patients (48 ears) had simple tympanic membrane perforations ,61 patients (61 ears) had cholesteatomas including 12 retraction pockets ,23 pa-tients (23 ears) had tympanoscleroses and 38 patients (41 ears) had otitis media with granulations .The cartilage grafts were used for tympanic perforation reparing in 133 patients (139 ears) ,for ossiculoplasty in 102 patients (104 ears) ,for attic reconstruction in 31 patients (31 ears) and for canal wall reconstruction of external auditory canal in 3 patients (3 ears) .The auditory outcome (0 .5 ,1 ,2 ,and 4 kHz pure tone average hearing threshold ,the average air-bone gap) and local architecture status were followed up for 1 year after surgery .Results In 133 patients (139 ears) with tympanic perforation ,the rate of successful repair of a tympanic membrame perforation in one -stage was 97 .84% with perforation repair in 136 ears and postoperative perforation in 3 ears .In 102 patients (104 ears) of os-siculoplasty ,there was no ossicular prostheses prolapse .In 31 patients (31 ears) of attic reconstruction ,no local graft shift or collapse was found .In 3 patients (3 ears) of external auditory canal repair ,no canal wall collapse occurred . In myringoplasty group (43 patients ,48 ears) ,preoperative and postoperative air -bone gap (ABG) was 23 .8 ± 3 .1 dB and 11 .6 ± 8 .7 dB ,respectively .In cholesteatoma group (61 patients ,61 ears ) ,preoperative and postoperative ABG were 39 .2 ± 24 .7 dB and 19 .0 ± 12 .1 dB ,respectively .In tympanosclerosis group (23 patients ,23 ears) ,pre-operative and postoperative ABG were 31 .2 ± 12 .4 dB and 19 .8 ± 11 .2 dB ,respectively .In otitis media with granu-lation group (38 patients ,41 ears) ,preoperative and postoperative ABG were 41 .6 ± 9 .9 dB and 15 .3 ± 13 .4 dB ,re-spectively .Conclusion Autogeneic cartilage is very valuable in hearing reconstruction surgery ,especially in compli-cated tympanic perforation ,combination with ossiculoplasty prostheses ,or reconstruction of mastoid cavity or exter-nal call wall defect .

Objective To observe the expressions of efflux pump gene cluster adeAB in acinetobacter baumannii isolated from the burn patients and the expression changes of its upstream regulatory genes adeR and adeS and determine the influence of those genes on drug resistance of acinetobacter baumannii.Methods Nine drug-resistant strains and nine sensitive strains of acinetobacter baumannii isolated from the burn patients treated between June 2012 and March 2013 were used.After strain identification using 16SrDNA sequencing,acinetobacter baumannii standard strain ATCC19606 was employed as the control.mRNA expressions of efllux pump genes adeA and adeB and their upstream regulatory genes adeR and adeS were detected by real-time quantitative PCR.Results (1) adeA and adeB genes presented higher expressions in drug-resistant strains (3.71 ±0.95,76.16 ± 8.75) than in sensitive strains (0.92 ± 0.94,0.72 ± 0.78) (F =38.71,663.65 respectively,both P ＜ 0.05).(2) adeS and adeR genes showed higher expressions in drug resistant strains (18.02 ± 6.71,3.02 ± 2.69) than in sensitive strains (1.64±1.51,0.76±0.61) (F =51.04,5.57 respectively,bothP＜0.05).Conclusions The over-expression of efflux pump gene cluster adeAB induced by the expression alteration of its upstream regulatory genes adeR and adeS is closely associated with the drug resistance of acinetobacter baumannii in the burn patient.Besides,the regulatory genes may depend on adeS to sense the nosocomial environment condition,activate or inactivate adeR and hence regulate efflux pump expression.

Objective To investigate the influence of abaI expression on acinetobacter baumannii biofilm formation.Methods Acinetobacter baumannii strain S isolated from bums patients was collected for the study,while the standard strain ATCC19606 was served as the control.At 6,24 and 48 hours,the gene expressions of abaI,pgaA,pgaB and pgaC were detected by real-time fluorescent quantitative PT-PCR,secretion of N-acyl-homoserine lactones (AHLs) by biological sensor and biofilm formation by MTT method.Results (1) Gene expressions of abaI,pgaA,pgaB and pgaC at 6 hours were 8.63 ±5.93,1.98 ± 1.93,1.01 ± 1.32 and 2.67 ± 3.46 respectively,which showed a quick increase at 24 hours (22.81 ± 17.60,5.13 ± 4.32,5.66 ± 3.97,11.97 ± 7.75 respectively),followed by a rapid decline in 48 hours (3.43 ± 0.88,1.30 ± 0.24,3.01 ± 3.00,3.02 ± 3.29 respectively).Gene expressions of pgaB and pgaC at 6 hours and that of pgaA and pgaC at 48 hours revealed statistically significant differences from those at 24 hours (P ＜ 0.05).(2) AHLs showed a level of 18.49 ± 11.03 at 6 hours,reached a peak of 52.23 ± 15.95 at 24 hours,then descended to 5.53 ± 0.94 at 48 hours.AHLs level at 24 hours showed statistically significant difference from that at 6 hours and 48 hours (P ＜ 0.05).(3)Biofilm formation at 24 hours and 48 hours was 2.83 ±0.44 and 2.71 ±0.15 respectively,far higher than that at 6 hours (0.49 ± 0.11,P ＜ 0.05).(4) In the correlation analysis among AHLs,biofilm formation and gene abaI,pgaA,pgaB and pgaC expressions,significant positive correlation was found between abaI and pgaA and between AHLs and pgaC expression (P ＜ 0.05).Conclusion Acinetobacter baumannii may regulate gene expressions of pgaA and pgaC responsible for biofilm formation to adjust to the external environment by means of changing abaI gene expression and AHLs secretion.