To explore the clinicopathological characteristics of parathyroid crisis.The data of 3 cases from our hospital and 125 cases reported domestically were retrospectively analyzed.All 3 cases were male.And their disease course was 3 months to 10 years.The serum calcium ranged from 3.72 to 5.19 mmol/l.Among 177 retrieved cases,125 had complete basic data.The male/female ratio was 1∶ 1.17,average age (46 ± 14) (15-75) years and average serum calcium (4.30 ± 0.58) (3.75-7.28) mmol/L.There was no difference between genders or benign and malignant pathological types.Among 117 eases with pathological diagnosis,the most common type was adenoma (74.4％).The ratio of parathyroid carcinoma was higher in males than that in females (33.3％ vs.11.7％).Misdiagnosis rate was 25.0％ upon initial presentations.Case fatality rate stood at 9.4％ (17/180) and half of them died preoperatively.

To analyze the correlation between fragmented QRS complexes( fQRS) and inflammation in 136 patients with acute coronary syndromes(ACS). Patients with fQRS had increased hs-CRP levels (P<0.01) in comparison to patients with non-fragmented QRS. The higher hs-CRP levels was,the more the number of leads in the fQRS on ECG was(P<0.01). When we performed multiple logistic regression analysis, fQRS was found to be related to in-creased hs-CRP levels [ OR:1.507 , 95% CI:1.172~1.936 , P<0.01 ] . fQRS was independently related to in-creased hs-CRP. fQRS that may result as an end effect of inflammation at cellular level can represent increased car-diac risk in patients with ACS.

The risk of stroke increases significantly after transient ischemic attack (TIA). TIA is an independent risk factor for cerebral infarction. This article review s the advances in prediction models of stroke risk after TIA in order to conduct rapid and accurate risk assessment and stratification in patients w ith TIA and develop timely reasonable treatment strategies, thereby reducing the risk of stroke.

Objective To investigate the routine ultrasound and contrast-enhanced ultrasound (CEUS) features of hepatic nodules in Budd-Chiari syndrome(BCS) after portacaval anastomosis.Methods Routine ultrasonography and CEUS were performed in 18 BCS patients with hepatic nodules after portacaval anastomosis.Results Appearance after portosystemic anastomosis,multiplicity,small size,presence of peripheral rim and hypervascularization were important ultrasound imaging features of hepatic regenerative nodules in patients with BCS.Nodules showedquick wash-in and slow wash-out pattern in CEUS.Sixteen cases showed center-to-periphery enhancement pattern in arterial phase and hyper-enhancement in portal phase and late phase.Two cases showed periphery-to-center enhancement pattern in arterial phase and periphery enhancement in portal phase and late phase.Conclusions Hepatic regenerative have different features on routine ultrasound and CEUS in patients with BCS after portacaval anastomosis,which are useful for differential diagnosis.

AIM: To investigate the frequency of P459H(CCC→CAC) in exon 10 of CYP21 gene among normal population.METHODS: The exons 3-10 of CYP21 gene were amplified with polymerase chain reaction(PCR).The PCR round products were digested by restriction enzyme Pst I to confirm that CYP21 gene was specifically amplified.PCR-based amplification-created restriction site(PCR-ACRS) was performed using the first round PCR products as template.After the second PCR products were digested by restriction enzyme Fsp I,10% polyacrylamide gel electrophoresis was used to screen the frequency of P459H in exon 10.RESULTS: The codon 459 in exon 10 of CYP21 gene was all CCC among 100 normal cases tested.CONCLUSION: P459H(CCC →CAC) of CYP21 gene might be a novel point mutation causing CAH.Furthermore,PCR-ACRS was a fast and safe method for gene mutation screening.

AIM:To determine four bioactive components in Tongda Granule ( Radix Paeoniae alba,Flos Carthami,Radix Scutellariale,etc. ),namely hydroxy safflower yellow A,peoniflorin,ferulic acid,and baicalin. METHODS:The isolation was performed on an Alltech Apollo C18 (250 mm ? 4. 6 mm,5 ?m) with the mobile phase consisting of methanol-0. 2% (w)phosphoric acid for gradient elution. The flow rate was 1. 0 mL/min and the column temperature was set at 30 ℃. RESULTS:This method was successfully applied to determining four bio-active components in Tongda Granule. The standard curves were linear over the ranges of 5. 20 -104 mg/L for hydroxy safflower yellow A(r =0. 999 1),25. 6 -512 mg/L for peoniflorin (r =0. 999 6),7. 72 -154. 4 mg/L for ferulic acid (r =0. 999 5),32. 5 -650 mg/L for baicalin (r = 0. 999 5),respectively. The average recoveries were 101. 1% ,99. 6% ,98. 9% and 101. 9% ,RSD were 2. 3% ,1. 8% ,2. 6% and 1. 3% ,respectively. CONCLUSION:The method is simple and can be used as a quality control method for Tongda Granule.

Objective To investigate the changes of left atrial(LA) segmental strains by using threedimension speckle tracking imaging(3D-STI),and to investigate the feasibility of 3D-STI for assessment of LA myocardial strains in healthy adults.Methods A total of 60 healthy subjects were enrolled.Apical fullvolume images were acquired in all subjects and then were analyzed by off-line 3D-STI analysis software.The software divided LA into 16 segments automatically,they were six walls (anterior,anterior-septal,posterior-septal,inferior,anterior-lateral,posterior-lateral) in basal and middle levels,and four walls (anterior,septal,inferior,lateral) in roof level.The peak longitudinal strain (PALS),peak circumferential strain(PACS),peak area strain(PAAS),the time to peak longitudinal strain(TPLS),the time to peak circumferential strain(TPCS) and the time to peak area strain(TPAS) of left atrial by 3D-STI were obtained and compared.Results ①Compared with the four walls in roof level and anterior-lateral,posterior-lateral walls in middle level,PALS of corresponding walls in basal level were significantly increased (P ＜0.05).PALS of posterior-septal,inferior and posterior-lateral walls in middle level were significantly increased than septal,inferior,and lateral walls of roof level (P ＜0.05).PACS and PAAS of all walls in roof level were significantly increased,as compared with that of corresponding walls in middle and basal levels,and the PACS of posterior-septal wall in basal level were lower than that in middle level(P ＜0.05).②There were no significant differences in PALS,PACS,PAAS between different walls within one level(P ＜0.05).③TPLS,TPCS,TPAS of septal wall were significantly lower than that of lateral wall.TPLS of anterior wall,TPCS and TPAS of inferior wall were significantly lower than that of lateral wall(P ＜0.05).Conclusions 3D-STI is a feasible skill to assess LA myocardial strains in healthy subjects.

Objective To compare the value of contrast-enhanced ultrasound(CEUS) and contrastenhanced CT(CECT) for the differential diagnosis of the benign and malignant hepatic nodules in BuddChiari syndrome(BCS).Methods Thirty-nine BCS patients with hepatic nodules underwent CEUS and CECT examination separately,through which the perfusion characters of the nodules in different phases were observed.With the pathological result as the golden standard,the sensitivity,specificity and accuracy of CEUS and CECT were compared on diagnosing benign regenerative nodules and hepatocellular carcinoma (HCC) in BCS.Results Of the 66 hepatic lesions in 39 patients,21 were hepatocellular carcinoma(HCC),and the other 45 were regenerative nodules.The sensitivity,specificity and accuracy of CEUS and CECT were 81％,91％,88％ and 71％,84％,80％ respectively.Thus the diagnostic efficiency difference between CEUS and CECT had no statistic significance(P ＞0.05).Conclusions The differential diagnoses of the benign and malignant hepatic nodules in BCS on CEUS and CECT have high consistency.Due to the convenience and safety of CEUS,it can be used as first-line method.

Objective To investigate the cytokine spectrum and henlatopoiesis-supportive function of umbilical cord derived mesdnchymal stem cells(UC-MSC),and compare with those of normal adult bone marrow derived mesenchymal stem cells(BM-MSC).Methods The mRNA of cytokine production of UC-MSC and BM-MSC were determined by reverse transcriptasc polymerase chain reaction(RT-PCR)analysis.To evaluate hematopoiesis supporting activity,cord blood(CB)CD+34 cells were co-cultured with UC-MSC or BM-MSC.Colony-forming cells(CFC)were determined after 5 weeks of culture.Results RT-PCR assay showed that UC-MSC had a cytokine spectrum very similar to that of BM-MSC.including expression of the mRNA ofstem cell factor,leukemia inhibitor factor,macrophage colony stimulating factor,Flt3-ligand,interleukin-6,vascular endothelial growth factor and stromal derived factor-1.but UC-MCS additionally expressed mRNA of granulocyte macrophage and granulocyte colony-stimulating factors.After co-culture with CD+34 cord blood cells for 5 weeks,no significant difference in CFC was observed between the CD+34 cells/UC-MSC and CD+34 cells/BM-MSC co-cultures (P＞0.05). Conclusion The cytokine spectrum and hematopoiesis-supponive function of UC-MSC ale similar with that of BM-MSC.

Mutations P459H and R483W detected in CYP21A2 gene in two Chinese patients with simple virilizing 21-hydroxylase deficiency were studied.Plasmid vectors containing P459H and R483W were constructed and transfected into COS-7 cells.The converting rate of progesterone to 11-desoxycortisone was calculated.P459H reduce 21-hydroxylase activity to 6.8%,while the residual enzyme activity of R483W was only 2.9%.