The severity of mitral regurgitation (MR) and tricuspid regurgitation (TR) was evaluated semiquantitatively by Doppler color flow imaging. The maximum MR area/body surface area (MRA/BSA) correlated significantly to the severity of angiographyic changes (tau=0.897). The maximum TR area/body surface area (TRA/BSA) also correlated significantly to the severity in angiography (tau=0.874). The cutoff values were 0.5, 2, 4, and 8cm²/m² for MRA/BSA and 1, 2.5, 5, and 10cm²/m² for TRA/BSA. Fourteen children (mean age 4.2 years) underwent repair of partial atrioventricular septal defects (P-AVSD) from 1985 to 1992. The cleft in the anterior leaflet was closed in the mitral valve; other procedures such as annuloplasty were not performed. They have been followed for periods from 7 months to 7 years and 5 months (mean 4 years); they were examined by echo cardiography and the Holter electrical cardiogram at the end of the period. MR had reduced to grade 0-II in all cases. No patients were given any medication, and all remained in NYHA Functional Class I. Paroxysmal supraventricular tachycardia developed in only one patient. We concluded that no annuloplasty in mitral valve is needed in children suffering from P-AVSD.

BACKGROUNDTo study the molecular biology of Xinjiang hemorrhagic fever (XHF) viruses, to explore its relationship with other Crimean-Congo hemorrhagic fever viruses, analyzing the epidemic origin and the tendency of geographic distribution of XHF.

METHODSThe S partial segment from the patient and tick samples collected in 2001 and 2002 was tested by RT-PCR, the positive samples were sequenced directly. The nucleotide homology of S partial segment as well as the whole segments were analyzed and the phylogenetic tree of S and M gene segments was drawn by computer.

RESULTSAll compared sequences of S partial segments from the patient and tick samples showed a high homology of nucleotide sequences. Phylogenetic tree divided all the analyzed viruses into three groups; Europe, African and Asian group. The Asian group can be divided further into another two branches: the middle Asian branch and the Chinese branch. All the Chinese isolates were clustered into one single group and was easy to be discriminated from the other isolates. The dividing of M segments seemed not completely related to the geographic origin of the viruses.

CONCLUSIONM segment classification was not consistent to the geographic distribution of the viruses. S segments analysis showed the close relationship of genetic background between the patient isolates and the tick isolates. Besides, all the Chinese isolates have the common evolution route and the gene structure characteristics displayed the regional distribution pattern.

Animals ; China ; epidemiology ; Genetic Variation ; Hemorrhagic Fever Virus, Crimean-Congo ; classification ; genetics ; isolation & purification ; Hemorrhagic Fever, Crimean ; epidemiology ; virology ; Humans ; Molecular Epidemiology ; Phylogeny ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA ; Ticks ; virology ; Viral Proteins ; genetics

BACKGROUND: Maintenance of instrumental activities of daily living (IADL) and social role (SR) is crucial to keep independent life because the decline in SR and IADL was a significant predictor of dependence in basic ADL in later. The independent effect of physical and cultural leisure activities and their effect modification on the IADL remains unknown. METHODS: We prospectively observed 3241 elderly with intact IADL at baseline for 5 years. Higher level functional capacity such as IADL and SR was assessed using the Tokyo Metropolitan Institute of Gerontology Index of competence (TMIG index). RESULTS: The mean age of the participants was 72.3 years (standard deviation 5.1), and 46.9% were male, and 90.9% of them received a follow-up assessment. Of the participants, 10.4% developed an IADL decline. Engagement in leisure physical activity was associated with a significantly lower risk of IADL decline (adjusted risk ratio, 0.73; 95% confidence interval [CI], 0.60 to 0.89), and cultural leisure activity was also associated with lower risk of IADL decline (adjusted risk ratio, 0.77; 95% CI, 0.63 to 0.95) independent of potential confounders. We also found significant and positive interaction between physical and cultural leisure activities at risk for IADL decline (P = 0.024) and SR decline (P = 0.004). CONCLUSIONS We found an independent association of physical and cultural leisure activities with a lower risk for functional decline in IADL and SR with positive interaction. Combined engagement in physical and cultural activities may effectively prevent from IADL decline and SR decline.