Objective To compare the safety and recent efficacy between transcatheter and surgical closure of secondum atrial septal defect over 50 years of age. Methods Retrospective analysis was done on 66 patients over 50 years of age who underwent transcatheter (30 cases) and surgical (36 cases) closure of secondum atrial septal defect.The median age was 60.8?7.1 years old in the transcatheter closure group and (57.5?6.3) years old in the surgical closure group( P=0.04).The median sizes of atrial septal defect in the transcatheter and the surgical closure group were 24.9?7.2 mm and 30.4?11.0 mm respectively (P=0.02). We compared the recent efficacy、 complications and prognosis between two groups. Results The instant procedural success rate was 93.3% for the transcatheter closure group and 100% for the surgical group (P=0.85). 2 procedures in the transcatheter closure group failed, 1 patient (2.6%) in the surgical group died during hospitalization and 9 patients (25.0%) underwent Devage tricuspid annuloplasty. Newly onset atrial arrhythmias occurred in 3.3% in the transcatheter closure group and 22.2% in the surgical closure group (P=0.03). After the procedures, right atrial and ventricular dimensions were decreased from 38.0?9.0 mm to 35.2?10.1 mm and from 44.2?8.6 mm to 36.2?9.0 mm in the transcatheter closure group whereas in the surgial group, the atrial and ventricular sizes fell from 44.1?8.2 mm to 38.2?9.5 mm and 49.0?10.2 mm to 37.1?11.0 mm respectively (P

Objective To analyze the efficacy and experience of coil embolization in patients with pulmonary arteriovenous malformations(PAMV). Methods Seven patients (2 males and 5 females, age range from 11 to 52 years; mean age 31 years) were admitted including 4 single saccular, 2 multiple saccular, 1 diffuse capillary pulmonary arteriovenous malformations. Results Coil embolization of pulmonary arteries was successful in all 7 patients. The mean arterial oxygen saturation rate increased from 87% to 96% in patients with saccular PAMV. Transient chest pain occurred in a case of diffuse capillary PAMV during the procedure, after undergoing multiple coil embolization, the arterial oxygen saturation rate increased from 79% to 87%. All patients were followed up for 6 months to 5 years, arterial oxygen saturation declined slightly,and mild to moderate tricuspid regurgitation was found by echocardiography only in the patient with diffuse capillary PAMV.Conclusion Coil embolization is an effective and safe method of treatment for saccular PAMV. But it is only a palliative therapy for diffuse capillary PAMV.

Objective To investigate the association between the ATP-binding cassette transporter A1(ABCA1)gene polymorphisms and plasma high density lipoprotein cholesterol(HDL-C)level in Chinese general population.Methods M883I,R1587K and R219K polymorphisms of the ABCA1 gene were detected by polymerase chain reaction-restriction fragment length polymorphism technique in 376 unrelated Chinese healthy subjects.Results In the study population,the subjects with the KK1587 genotype had markedly lower HDL-C levels than those with RR1587 and RK1587 genotypes(P

Objective To elucidate the efficacy and safety of transcatheter closure of secondary atrial septal defect (ASD) with Amplatzer septal occluder (ASO) in people over 50 years of age. Methods Retrospective comparison of 41 patients (14 males, 27 females) with ASD over 50 years of age ranging from 50 to 75(mean age 55.5?7.6, elder group) was conducted with 132 patients younger than 50 years(control group). After diagnosis of ASDs and evaluation of pulmonary artery systolic pressure and right atrial and ventricular dimensions by transthoracic echocardiography (TTE), all patients underwent transesophageal echocardiography (TEE) for complete assessment of ASD size, margins and anatomic relationship of the defect before closure of ASD. Each case was treated with ASO through the percutaneous transcatheter procedure under fluoroscopy and TTE or TEE. Early follow up(3 months) by echo was taken after the intervention. Results There was no difference of mean defect diameter measured by TEE and the balloon-stretched defect diameter of the ASDs between 2 groups. Pulmonary artery pressures in elder group were higher than those in younger group(P

Objective: To investigate the in vitro efficiency of two kinds of polylatic acid (PLA) immunomicrospheres: M1(hAFP158~166)and M2(hAFP218~226) in specific inducement of CTL and the cytotoxicity of CTL against hepatocellular carcinoma cells. Methods: Pripheral blood monocytes (PBMC) of HLA-A2+ healthy volunteers stimulated in vitro by peptide-loading microspheres were taken as effectors. The experiments were divided into three groups: control group, hAFP+ tumor cells group, and hAFP- tumor cells group. The specific cytolysis of target cells was assessed by 51Cr-release assay. Results: Both M1 and M2 induced proliferation of HLA-A2+ PBMC, forming visible clones. The effector cells induced by M1 and M2 both had an cytolysis rate over 75% for hAFP+ tumor cells, which was significantly higher than that for hAFP- tumor cells (P0.05). Conclusion: The two kinds of microspheres can both induce specific CTL in vitro, which can effectively kill hAFP+ tumor cells.

Objective:To investigate the changes and correlation of Insulin-line growth factor-1(IGF-1)and bone mineral density(BMD)in Graves disease(GD).Methods:The serum IGF-1 levels were determined by radioimmunoprecipitation assay(RIA) in 30 cases of females GD patients before and after successful therapy,the BMD were measured by dual-energy X-ray absorptiometry,the sex and ege were matched with the normal of the control group.Results:The levels of serum IGF-1(165 4?40 0) ?g/L markedly increase and the BMD(0 770?0 081)g/cm 2 markedly descend in GD group.There were significantly different from normal controls[IGF-1(92.5?25.1)?g/L、BMD(0.877?0.069)g/cm 2]( P0.05 ).Conclusion:IGF-1 probably play an important role in the pathogenesis and bone metabolism of GD.

With the rapid development of medical genetics,online Medelian inheritance in man (OMIM) manifests a more and more important role in medical genetics teaching.Using the educational form combining ‘ classroom teaching,review writing and seminar’,‘ Query and use of OMIM ’was introduced into the education of medical genetics.Reality practice revealed that this educational practice maintained advanced and timely status of knowledge and deeply activated self-studying and independent thinking ability of students.

Objective To observe the effects of 131I treatment on circulating granulocyte colonystimulating factor (G-CSF) and leucocyte levels of patients with Graves' disease (GD).Methods Enzyme-linked immunosorbent assay (ELISA),coulter three assortments,and radioimmunoassay were used to test the levels of circulating G-CSF,leucocytes and thyroid hormones of 65 incipient and untreated GD patients,all females,aged 21 -50,43 with normal leucocyte level and 22 with leucopenia before and after 131I treatment.Thirty age-matched healthy female subjects were used as controls.Results Before 131I treatment,the serous G-CSF level of the GD patients with normal leucocyte level was (28.4 ± 11.7)μg/L,significantly higher than that of the control [ ( 18.3 ± 6.98) μg/L,t =2.376,P ＜ 0.05 ].The serous G-CSF level of the GD patients with leucopenia was (40.1 ± 13.8 ) μg/L,significantly higher than that of the patients with normal leucocyte level ( t =2.788,P ＜ 0.01 ) and that of the control ( t =3.672,P＜0.01 ).180 d after the initiation of 131 I treatment,the G-CSF level of the patients with normal leucocyte level was (18.9 ± 8.32) μg/L,not significantly different from that of the normal controls,however,the G-CSF level of the GD patients with leucopenia was (25.7 ± 11.5) μg/L,still significantly higher than that of the normal control (t =2.103,P ＜ 0.05).The serous G-CSF level was negatively correlated with the titer of leucocyte ( r =- 0.38,P ＜ 0.05 ),however,not significantly correlated with such clinical parameters,as free triiodothyronine (FT3),free thyroxine (FT4) and thyrotropin-stimulating hormone (TSH).Conclusions Abnormal increment of G-CSF is observed in the GD patients,which may be related to the decrease of leucocyte.Effectively suppressing the auto-immune status in the GD patients,131I treatment is a safe and reliable therapy for GD patients with leucopenia and should be used as early as possible.

Based on MOOC teaching mode and the combination of flipped classroom teaching theory,the role of internship practice is integrated into medical education and the combination of MOOC teaching and traditional teaching mode in medical humanities curriculum is explored in practice applications.This paper analyzed the cur-rent situation of medical humanities curriculum teaching operation under current situation; based on the teaching concept of MOOC,introduced the reform of teaching form and teaching method in blending teaching mode,and ex-plored the practical application and practical thinking of blending teaching mode.This mode not only plays a lead-ing role of teachers teaching,but also fully embodies the subjective status of students'learning,exercises the students'ability of thinking in practice at the same time,and is an effective mode to improve medical humanities curriculum teaching.

Hypoxia-inducible transcription factor-1alpha (HIF-1alpha) is a "master" gene in the cell hypoxia response network. HIF-1alpha plays the key role on VEGF-dependent angiogenesis during tumor development. In this study, the siRNA expressive vector targeting HIF-1alpha was constructed. HepG2 cells were tranfected with an HIF-1alpha siRNA vector and exposed to a normoxic or hypoxic environment. mRNA and protein levels of HIF-1alpha and VEGF were detected by RT-PCR and Western blot at different cell culture environment. The mRNA and protein expression of HIF-1alpha was inhibited by RNA interference. The obvious decreases of mRNA and protein of VEGF was induced by HIF-1alpha gene knock-down. Our study indicated that HIF-1alpha regulated the expression of VEGF and hence promoted angiogenesis in liver cancer under hypoxic environment. The expression of VEGF was downregulated via HIF-1alpha gene knock-down. These results suggest that HIF-1alpha may be used as a good target gene for anti-angiogenesis in liver tumors.
Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Down-Regulation ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; Liver Neoplasms ; metabolism ; pathology ; RNA Interference ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Vascular Endothelial Growth Factor A ; metabolism