Introduction: Differences in systolic blood pressure reading between arms are common but could signal trouble if the discrepancy is significant. Early detection of aortic dissection could invariably determine patient’s survivability. Hence, a high index of suspicion with prompt diagnostic imaging is vital for accurate diagnosis. Case Presentation: A previously healthy 35-year-old lady was referred from district hospital for hypertensive cardiomyopathy complicated by acute pulmonary oedema. After being admitted to the Intensive Care Unit, the mean arterial pressure on the left arm was noted to be significant higher. On physical examination, both lower limbs were dusky in appearance because of poor perfusion. Investigations: Computed Tomography Angiography showed extensive arch and abdominal aorta dissection extending to the proximal common carotid artery. There was distal abdominal aorta thrombosis with partial left renal infarction. Echocardiogram showed global hypokinesia, presence of intimal flap, aortic regurgitation and mild pericardial effusion. Supine chest X-ray showed apparent cardiomegaly. Treatment: Repair of the ascending aortic dissection and suspension of the aortic valve by the cardiothoracic team on Day 2 of admission. The vascular team did bilateral high above knee amputation on Day 9 of admission. Outcome: Patient passed away on Day 10 of admission. Discussion: With the absence of classical features of aortic dissection, establishing the diagnosis can be challenging and requires both good clinical judgment and prompt radiological imaging, such that early treatment can be initiated. Conclusion: A high index of suspicion and good clinical judgment is needed in cases of significant blood pressure discrepancy between arms.
Blood Pressure

Aging ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Glutathione Peroxidase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Wistar ; Superoxide Dismutase ; metabolism ; Testis ; drug effects ; metabolism

Objective To compare the differences between Hertel exophthalmometry and CT on exophthalmos measurement,and explore its practical application value in forensic medicine.Methods Fifty-six normal individuals without eye injuries or diseases were selected as the control group.The absolute values of exophthalmos were measured in the standardized CT image workstation.The difference of binocular exophthalmos was compared in normal group.Forty-seven cases with unilateral orbital fracture were divided into injured eye group and normal eye group according to the presence of binocular orbital fractures.The differences of the absolute values of eophthalmos from the same eye and the relative values of eophthalmos between two eyes for same person measured by Hertel exophthalmometry and CT were analyzed.Results There was no statistical difference of exophthalmos between the normal eyes measured by CT method.In the normal eye group,the absolute value of exophthalmos measured by CT method was (16.66±5.41) rm,which was (16.16±4.45)mm when measured by the Hertel exophthalmometry method.There was no statistical difference between two groups (P＞0.05).In the injured eye group,there was statistical difference between the absolute values of exophthalmos measured by two measurement methods (P＜0.05).There was no statistical difference of the relative values of exophthalmos between the injured eyes and the normal eyes by two measurement methods (P＞0.05).Conclusion CT method has a good consistency with Hertel exophthalmometry,which can be applied into the practice of medicolegal expertise.

Objective To explore the effect of conbercept combined with operation on treatment of patients with neovascular glaucoma.Methods A total of 10 patients with neovascular glaucoma (10 eyes) were selected and randomly divided into experimental group and control group.The experimental group was treated with intravitreal injection of conbercept plus trabeculectomy and panretinal photocoagulation (PRP),while the control group was treated with atropine,glucocorticoid and panretinal photocoatulation.The pre-treatment and post-treatment visual acuity,intraocular pressure and vascular endothelial growth factor (VEGF) expression in serum and humor aqueous were compared.Results After treatment,the visual acuity improved significantly (P ＜ 0.05).The intraocular pressure of the experimental group and control group before treatment and after treatment decreased significantly (P ＜ 0.05).The expression level of the post-treatment VEGF in serum and humor aqueous in the experimental group and control group decreased significantly,and the level of VEGF experimental group was much more lower (P ＜ 0.05).Conclusion Application of conbercept combined with surgery can effectively improve the clinical symptoms and reduce intraocular pressure in patients with neovascular glaucoma.

Objectlve To detect the KChIP2 mRNA level in rheumatic heart disease patients with or without atrial fibrillation (AF) by real-time PCR.Methods Right atrial appendage samples from rheumatic heart disease patients with (n=17) or without AF (n=13) were obtained during cardiac surgery.Total RNA was extracted from the atrial tissues.and the KChIP2 and Kv4.3 mRNA were detected by SYBR Green I real-time PCR with the GAPDH as the house keeping gene.Result The ratio of KChIP2/GAPDH(0.1468 ±0.0452 VS.0.2200±0.0388,P＜0.01)and the ratio of Kv4.3/GAPDH(0.3946±0.1826 vs.0.5257±0.1427.P＜0.05)were significantly lower in AF patients compared to non-AF patients.Conclusion Down-regulated atrial KChIP2 and Kv4.3 mRNA expressions in rheumatic heart disease patients with chronic AF might be one of the molecular bases responsible for the down-regulation of the Ito current density of AF.

Objective To explore the effect of conbercept combined with operation on treatment of patients with neovascular glaucoma.Methods A total of 10 patients with neovascular glaucoma (10 eyes) were selected and randomly divided into experimental group and control group.The experimental group was treated with intravitreal injection of conbercept plus trabeculectomy and panretinal photocoagulation (PRP),while the control group was treated with atropine,glucocorticoid and panretinal photocoatulation.The pre-treatment and post-treatment visual acuity,intraocular pressure and vascular endothelial growth factor (VEGF) expression in serum and humor aqueous were compared.Results After treatment,the visual acuity improved significantly (P ＜ 0.05).The intraocular pressure of the experimental group and control group before treatment and after treatment decreased significantly (P ＜ 0.05).The expression level of the post-treatment VEGF in serum and humor aqueous in the experimental group and control group decreased significantly,and the level of VEGF experimental group was much more lower (P ＜ 0.05).Conclusion Application of conbercept combined with surgery can effectively improve the clinical symptoms and reduce intraocular pressure in patients with neovascular glaucoma.

To investigate the epidemiology of hand, foot, and mouth disease (HFMD) and the genetic characteristics of enterovirus A71 (EV-A71) in Linyi of Shandong Province, China during 2007-2012. The number of reported HFMD cases were obtained from the National Notifiable Disease Reporting System (NNDRS) were analyzed by descriptive epidemiology method; the VP1 region of EV-A71 isolated from HFMD patients in Linyi was amplified and sequenced. Finally, the genetic variability and phylogenecity of VP1 sequences of EV-A71 were analyzed by MEGA 5.0. The results showed that HFMD incidence was reported in each year from 2007 to 2012 in Linyi, and the highest incidence and mortality were reported in 2009, when there were total 14697 cases and 9 of death. The reported incidence was 140.28/100000, and the mortality was 0.086/100000. The peak incidence usually occurred between April and July, and the summit occurred in May. Scattered children accounted for 77.37%-92.00% of all cases. The peak age was 2.5 years during 2007-2009 and 1.5 years during 2010-2012. A total of 1365 laboratory-confirmed HFMD cases were reported in the 6 consecutive years, accounting for 2.98% of the gross number. Among these reports, the ratio of EV-A71 was 44.18%, and the ratio of coxsackievirus A16 (CVA16) was 46.59%. All EV-A71 strains isolated in Linyi during 2007-2012 belonged to the C4a evolutionary branch of C4 genotype. In conclusion, HFMD outbreaks occurred every year in Linyi during 2007-2012. Incidence varied significantly among different counties. The peak incidence in each year lasted from April to July. Most of the patients were children under 3 years of age, and scattered children took the highest proportion. Co-circulation of EV-A71 and CVA16 was the major cause of HFMD in each year. Since the first report of HFMD prevalence caused by EV-A71 (C4a) in 2007, the virus has been prevalent continuously in Linyi for 6 years.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Enterovirus ; classification ; genetics ; isolation & purification ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; virology ; Humans ; Infant ; Male ; Middle Aged ; Molecular Sequence Data ; Phylogeny ; Young Adult

Adult ; Arteriovenous Malformations ; therapy ; Embolization, Therapeutic ; methods ; Enbucrilate ; therapeutic use ; Female ; Humans ; Kidney ; blood supply ; Male ; Middle Aged

The study purpose was to explore whether dichloromethylene diphosphonate (Cl(2)MDP)-loaded gelatin particles can induce the depletion of macrophage in reticuloendothelial system of liver and spleen or can depress the immunity of macrophage in SD rat models of immune thrombocytopenic purpura (ITP) to treat the ITP rats. New Zealand rabbits were immunized with platelets of SD rats to prepare rabbit anti-rat platelet serum, and the serum was intravenously injected into SD rats to produce the ITP model. In experimental ITP models, 150 microl of anti-platelet serum was intravenously injected into SD rats per 24 hours. The platelet counts maintained pathological level and were persistently less than 50 x 10(9)/L in the models during experiment process. The MTT test of macrophage RAW264.7 was carried out by means of Cl(2)MDP-loaded gelatin particles in vitro. After intravenous injection of a group dose of Cl(2)MDP-gelatin particles, the platelet counts of the rats were measured at the time of 4 hours, 24 hours, 48 hours, 72 hours and 96 hours, respectively, and bleeding times were detected in 24 hours. The results showed that Cl(2)MDP-loaded gelatin particles increased the platelet counts of ITP models to mean of 180 x 10(9)/L, a physiological level in 24 hours after injection, and kept this platelet level through whole process of 120 hours. Furthermore, rats pre-treated with Cl(2)MDP-loaded gelatin particles avoided the decrease of platelet counts significantly when they were injected anti-platelet serum. It is concluded that Cl(2)MDP-loaded gelatin particles restrain multiplication of macrophage RAW264.7, and promptly, effectively restore platelet counts of ITP models to physiological level in a dose dependent manner. So, the targeting therapy of drug-loaded gelatin particles offers a new idea and approach to treat ITP, and this strategy is worthy of further studies.
Animals ; Clodronic Acid ; administration & dosage ; Drug Carriers ; Drug Delivery Systems ; Gelatin ; administration & dosage ; Liver ; cytology ; drug effects ; Macrophages ; drug effects ; physiology ; Particle Size ; Purpura, Thrombocytopenic, Idiopathic ; therapy ; Rabbits ; Rats ; Rats, Sprague-Dawley ; Spleen ; cytology ; drug effects

The aim of the present study is to investigate the expression of a novel estrogen receptor, G protein-coupled receptor 30 (GPR30) and its correlation with matrix metalloproteinases-9 (MMP-9) in epithelial ovarian cancer (EOC). Ovary tissues were obtained from 39 female patients, including 30 cases of EOC and 9 cases of benign ovarian tumor. Four normal ovary tissues were used as control. Immunohistochemical staining was used to detect the expressions of GPR30 and MMP-9. Chi square test, Fisher's exact test and Spearman's rank correlation analysis were used for statistical analysis. The results showed that GPR30 overexpression rate in EOC cases was significantly higher than those in benign ovarian tumor and normal ovary cases. Whereas MMP-9 overexpression rate in EOC cases was significantly higher than that in normal ovary cases, without any difference to that in benign ovarian tumor cases. To demonstrate the relationship between GPR30 and clinicopathological variables of EOC, we further analyzed the pathology type, FIGO stage and age of patients sampled in our study. The analysis showed there were significant differences of GPR30 overexpression rate among various pathology types and different FIGO stages (P<0.05), and no significant difference of both GPR30 and MMP-9 among three age groups (P>0.05). Moreover, GPR30 expression was positively correlated with MMP-9 (r(s)=1.000, P=0.002). These results suggest that GPR30 may be involved in the invasion and metastasis of EOC, being a potential index of EOC early diagnosis and malignancy grade prediction.
Adult ; Aged ; Biomarkers ; metabolism ; Cystadenocarcinoma, Serous ; metabolism ; Female ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Neoplasms, Glandular and Epithelial ; metabolism ; Ovarian Neoplasms ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, G-Protein-Coupled ; metabolism ; Young Adult