BACKGROUND: Migu tablet, a Chinese drug for kidney invigorating, is effective on preventing and treating osteoporosis, but the concrete mechanism of pharmacology is still not clear. Transforming growth factor-β1(TGF-β1) is an important cytokine, which can regulate bone resorption and formation.OBJECTIVE: To investigate the effect of kidney invigorating recipe on mRNA expression of TGF-β1 of osteoblast.DESIGN: A completely randomized controlled study was conducted.SETTING: Department of Traumatic Orthopedics, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: This experiment was conducted at the laboratory for bone metabolism of integration of Chinese and western medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from May 2003 to April 2004. Experimental rats: Totally 16 newborn SD rats of clean degree were involved. Experimental drug: Medical liquor of Migu tablet was prepared in the Department of Traumatic Orthopedics,Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. The subscription was mainly composed of Chinese herbs such as Herba Epimedii, Cortex Eucommiae, Semen Juglandis,Radix Rehmanniae, Radix Achyranthis Bidentatae. and so on. Positive control drug: which was recombinant basic fibroblastic growth factor (rbFGF), was purchased from Beijing Banding Company. Negative control group was subdivided into negative control of probe and antibody METHODS: 100,1 000,5 000,10 000 mg/L Chinese herb Migu tablet liquor for kidney invigorating and positive control drug 5 μg/L rbFGF were added into the osteoblasts of cranial bones of newly born SD rats separated and cultured in vitro. 24 hours later, nuclear acid molecular in situ hybridization of osteoblasts were analyzed by self-made digoxin-labeled TGF-β1 cDNA probe . The mean absorbance of positive particles representing the mRNA expression of TGF-β1. A total of 40 osteoblasts were randomly chosen from each group under 200-fold amplification. The average absorbance of hybridized particles of the cells was measured with TJTY-300 automatic image analyzer.MAIN OUTCOME MEASURES: mRNA expression of TGF-β1 in osteoblasts of each group.RESULTS: Automatic image analyzer showed that the TGF-β1 mRNA expressions of Migu liquor groups whose concentration were 5 000 mg/L and 10 000 mg/L were respectively 1.18 times and 1.30 times that of control group, with a significant difference. [The mean absorbance's of hybridized particles of the cells in the 5 000,10 000 mg/L Migu liquor groups and negative control were 0.213 67±0.015 00,0.237 03±0.021 73,0.181 27±0.015 28 ,respectively, P ＜ 0.05 and P ＜ 0.01].Although the mean absorbance ( 0.254 45±0.020 81)of the hybridized particles of the cells in the 5 μg/L recombinant rbFGF was higher than those of 5 000,10 000 mg/L Migu liquor groups, but there was no significant difference(P ＞ 0.05).CONCLUSION: Migu tablet for kidney invigorating can stimulate the secretion and synthesis of TGF-β1 in osteoblasts, thus promote bone formation and inhibit bone resorption.

Objective To study the relationship between gene mutation and clinical phenotype in patients with tuberous sclerosis complex (TSC).Methods The clinical data of 76 patients with TSC diagnosed in Guangdong 999 Brain Hospital were collected between May 2007 and May 2014 and then TSC gene mutation analysis was performed.Genotype-phenotype analyses for all the patients were also carried out.Results Fifty of the 76 (66％) patients were male,and 26 (34％) were female,in which 19 (31％) patients presented with cyst-like cortical tuber,69 (92％) with skin lesions,16 (30％) with renal lesions,50 (69％) with mental retardation and 39 still suffered seizures after a year.In this study,22 (29％) cases showed TSC1 gene mutation,31 (59％) presented TSC2 gene mutation,and 15 (20％)cases had no mutation identified.The mutation ratio of TSC1 ∶ TSC2 was approximately 3 ∶ 5,while the mutation ratio of TSC1 ∶ TSC2 was 1 ∶ 1 for familial TSC patients,and 1 ∶ 2 for sporadic TSC patients.Comparing to those with TSC1 gene mutation and no mutation identified,patients with TSC2 gene mutation exhibited statistical meaning on the aspects of the onset age of seizure (Z =1.688,P =0.007),seizure onset before l-year-old (x2 =10.584,P =0.001),epilepsy duration (x2 =4.996,P =0.025),spasms onset (x2 =10.111,P =0.001),cyst-like cortical tuber (x2 =9.182,P =0.002),skin lesions (x2 =9.016,P =0.003),as well as renal lesions (x2 =6.079,P =0.014).No apparent relation was found between genotype and intelligence outcome.Conclusions The patients with TSC2 gene mutations presented severer symptoms in seizure onset than those with TSC1 gene mutation and no mutation identified.The patients with TSC2 gene mutation were characterized by early onset of seizure,especially before 1-year-old,others like spasms onset,cyst-like cortical tuber,skin lesions,as well as renal lesions being more vulnerable.Therefore,more active treatment should be given to the patients with TSC2 gene mutation.

Purpose The one-step examination of myocardial perfusion imaging (MPI) combined with coronary artery calcium score (CACS) can obtain both coronary functional information and anatomical information simultaneously, this paper aims to evaluate the value of the one-step examination of MPI combined with CACS for detecting coronary artery disease (CAD). Materials and Methods 188 cases who underwent one-step examination of MPI combined with CACS and invasive coronary angiography (ICA) because of chest tightness, chest pain with suspected coronary artery disease were analyzed retrospectively, with the results of ICA used asgold standard, the diagnostic efficacy of MPI, CACS and one-step examination with combination of the two techniques for CAD was investigated. Results ①Pre-test probability of CAD was intermediate in 79.8%(150/188), and high in 20.2%(38/188) cases. Seventy-three cases were confirmed as CAD and 115 of 188 patients were negative according to ICA.②The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of CAD by MPI were 65.8%, 75.7%, 71.8%, 63.1%and 77.7%, respectively. ③ The CACS of CAD group was significantly higher than the non-CAD group (494.96±99.60 vs. 38.15±16.03, P<0.05). According to the features of the ROC curve, the best threshold for the diagnosis of CAD with CACS was 96.45, with CACS≥96.45 as the positive standard in diagnosis of CAD, the sensitivity, specificity, accuracy, PPV and NPV for the diagnosis of CAD by CACS were 60.3%, 93.9%, 80.8%, 86.3%and 78.8%, respectively. ④ The sensitivity of MPI combined with CACS were significantly higher than MPI (80.8% vs. 65.8%, P<0.05), while the specificity (71.3% vs.75.7%, P>0.05) and accuracy (75.0% vs. 71.8%, P>0.05) showed no statistically significant difference; the sensitivity of MPI combined with CACS were significantly higher than CACS (80.8%vs. 60.3%, P<0.05), while the specificity was lower than CACS (71.3%vs. 93.9%, P<0.05) and the accuracy showed no statistically significant difference (75.0%vs. 80.8%, P>0.05). Conclusion The one-step examination of MPI combined with CACS can reduce coronary heart disease misdiagnosis, improve the diagnostic sensitivity of CAD compared with the MPI or CACS, with high application value for the diagnosis of CAD, especially in moderate risk groups.

Objective To evaluate the additional value of CACS in detection of coronary artery disease (CAD) with MPI.Methods A total of 188 suspected CAD patients (128 males,60 females;average age (61.93±9.16) years) who underwent one-step examination of MPI combined with CACS from December 2012 to August 2014 were enrolled in this retrospective study.According to the gold standard of CAG,the diagnostic efficacy of MPI was calculated.ROC analysis was performed to determine the optimal CACS threshold for the detection of CAD.Mann-Whitney u test and x2 test were used for statistical analysis.Results (1) Seventy-three CAD cases were confirmed (≥ 50％ stenosis) among 188 patients.The sensitivity,specificity,accuracy for CAD diagnosis with MPI were 65.8％ (48/73),75.7％ (87/115),71.8％ (135/188),respectively.Twenty-five CAD patients had negative findings with MPI,including 2 with LM disease,4 with three-vessel disease (LAD±LCX±RCA,3-VD),3 with 2-VD,16 cases with 1-VD.Among them 13 cases (52.0％,13/25) had intermediate lesions of 1-VD (50％ ≤ stenosis＜70％).(2) The CACS of CAD group was significantly higher than that of non-CAD group (172.40(19.25,516.45) vs 0;z=-8.465,P＜0.001).According to the ROC analysis,95.1 was the optimal CACS cutoff to detect CAD patients.Combining MPI with CACS (at cutoff of 95.1) improved the sensitivity of MPI (80.8％,59/73;x2 =4.233,P＜0.05) for the detection of CAD,with no significant decrease in specificity and accuracy (71.3％,82/115;75.0％,141/188;x2 values:0.558 and 0.490,both P＞0.05).(3) Of the 25 CAD patients with negative MPI results,11(44.0％,11/25) showed abnormal CACS(CACS≥95.1),consisted of 2 cases of LM disease,4 cases of 3-VD,2 cases of 2-VD,3 cases of 1-VD.Diagnosis was corrected by CACS in 8/9 cases of severe CAD (LM CAD or multivessel disease) which were missed by MPI.Conclusion CACS could offer additional information for MPI in detection of suspected CAD patients,which can improve the sensitivity of MPI for diagnosing CAD,especially for severe CAD with LM lesions or multivessel CAD.

Objective To explore the common causes of epilepsy and the etiologic characteristics in different age groups of patients with epilepsy.Methods A retrospective survey was made in 5572 epilepsy patients in Epileptic Center of Guangdong 999 Brain Hospital from January 2003 to December 2009.According to the diagnostic criteria published in 2005 from ILAE,all the diagnoses of 5572 cases were made by epileptic specialists.Based on history,cranial MRI or CT and pathologic data,causes of epilepsy were classified into idiopathic,symptomatic and cryptogenic epilepsy.The cases of symptomatic epilepsy were further arranged into different categories in different age grades,such as head trauma,perinatal injuries,infection in central nervous system, cerebral vascular disease, brain tumor, disorders of cortical development,neurocutaneous syndrome and others.The cases with febrile seizures and family history were collected,and positive ratio of febrile seizures and family history were contrasted in different categories of cases by Kruskal-Wallis test ( nonparametric test ).Results In 5572 cases,66 were idiopathic,2834 symptomatic,2672 cryptogenic,and the ratio of these causes was 1％,51％,48％ respectively.Among 2834 cases of symptomatic epilepsy,822 were head trauma,497 were perinatal injuries,360 were infection in central nervous system,249 were brain tumor,150 were cerebral vascular disease,135 were disorders of cortical development,62 were neurocutaneous syndrome and 559 were others. In brief,head trauma,perinatal injuries,infection in central nervous system,brain tumor and cerebral vascular disease were top 5 causes of symptomatic epilepsy. Hippocampal sclerosis was found in 744 cases in those of eryptogenic epilepsy.The importance of febrile seizures( idiopathic:15.2％ ( 10/66 ),symptomatic:6.5％ ( 185/2834 ),cryptogenic:9.4％ ( 250/2672 ) ; x2 =181.393,P =0.000 ) and family history ( idiopathic:83.3％ ( 55/66 ),symptomatic:1.1％ (31/2834),cryptogenic:0.4％ (12/2672) ; x2 =68.354,P =0.000) was statistically different in different causes of epilepsy.Febrile seizures was the most frequent in cases with hippocampal sclerosis than those with other causes,and family history was the most frequent in neurocutaneous syndrome in symptomatic cases.Perinatal injurics was thc first causc in cases of infancy and childhood,head trauma was the top one in those of juvenile and adulthood,and cerebral vascular disease was the main cause in senile cases. Conclusions In the whole epileptic cases of 5572, 1％ was idiopathic,51％ was symptomatic,and 48％ cryptogenic. The main causes of them were head trauma,perinatal injuries,infection in central nervous system,brain tumor,and cerebral vascular disease.

Objective To assess the left ventricular (LV) systolic synchrony by phase analysis of gated myocardial perfusion imaging (GMPI) with SPECT/CT in patients with old myocardial infarction (OMI) and further to identify independent predictors for LV dyssynchrony.Methods Seventy-six OMI patients and seventy-four healthy volunteers (control group) underwent resting GMPI from October 2010 to September 2013 in our hospital were included in this study.The left ventricular systolic synchrony parameters including phase histogram bandwidth (BW) and phase standard deviation (SD) were obtained by Cedars-Sinai quantitative gated SPECT (QGS) phase analysis technique,and LV cardiac function was also measured.The extent of myocardial perfusion defect was analyzed by the Quantitative Perfusion SPECT (QPS) software.The value of BW and SD were compared between OMI and the control groups,between LVEF ≤ 35％ and LVEF ＞ 35％ groups in OMI patients.Dyssynchrony was defined when the BW exceeded the abnormality threshold derived from a normal control group (threshold =x-± 2s for normal BW).Results (1) TheBW ((91.3±58.6)°vs.(37.2 ±11.7)°) and SD ((27.3 ±20.8)° vs.(11.8± 5.4) °) were significantly higher and the LVEF was significantly lower in OMI group than in the normal controlgroup (all P ＜0.01).In addition,BW ((136.0 ± 52.9)° vs.(51.0 ± 24.0)°) and SD ((38.7 ± 21.3) ° vs.(17.1 ± 14.0)°) were significantly higher in patients with LVEF ≤ 35％ than in patients with LVEF ＞ 35％ (all P ＜ 0.001).(2) Dyssynchrony (BW ＞ 60.6°) prevalence was 57.9％ (44/76) in OMI patients.Compared with the synchrony group,LVEF was significantly lower,while the left ventricular end-diastolic volume,end-systolic volume,summed motion score,summed thickening score and extent were significantly higher in dyssynchrony group (all P ＜ 0.001).(3) Additionally,dyssynchrony prevalence was significantly higher in patients with LVEF≤35％ compared with patients with LVEF ＞ 35％ (91.7％ (33/36) vs.27.5％ (11/40),P ＜0.001).(4) Pearson correlation analysis showed that LVEF was negatively correlated with BW (r =-0.807,P ＜ 0.001).(5) Multivariate logistic regression analysis revealed that the extent of myocardial perfusion defect was an independent predictor for dyssynchrony in OMI patients (OR =1.076,95％ CI:1.015-1.141,P =0.015).Conclusions GMPI phase analysis can reliably reflect left ventricular systolic synchrony.The left ventricular systolic dyssynchrony in OMI patients is significantly increased.Left ventricular dyssynchrony is closely related to LVEF.The extent of myocardial perfusion defect (Extent) is an independent predictor for left ventricular systolic dyssynchrony in OMI patients

Objective To observe the clinical efficacy of Yinlian Gargle in the treatment of acute radiation-induced oropharyngeal mucositis after nasopharyngeal carcinoma radiotherapy.Methods Thirty-two patients with nasopharyngeal carcinoma,who had received first radiation,were randomly split into two groups:the trial group(19 cases)and the control group(13 cases).After all groups were treated with radiotherapy and chemotherapy,the control group was given rinse treatment with saline whereas the trial group was given Yinlian Gargle.The incidence of severe acute radiation-induced oropharyngeal mucositis,the duration and intensity of oropharyngeal discomfort and pain(NRS score),quality of life(QOL-NPC score),duration and intensity of radiation-induced side effects(SE-QOL-NPC score)and symptoms of dry mouth(SE1 score)were monitored before and after intervention in two groups.Results The incidence of grade Ⅲ or above radiation-induced oropharyngeal mucositis until the sixth week of radiotherapy in the trial group was considerably lower than that in the control group(P＜0.001),while the incidence of grade I or above radiation-induced oropharyngeal mucositis at 1 month after radiotherapy in the trial group was obviously lower than that in the control group(P＜0.001).The NRS score of pharyngeal discomfort of the trial group was lower than that of the control group starting from the second week of radiotherapy(P＜0.05).The NRS score of oral and oropharyngeal pain was lower than that of the control group starting from the fourth week of radiotherapy(P＜0.05).The SE1 score of the trial group was higher than that of the control group starting from the fifth week of radiotherapy(P＜0.05).After one month of the completion of the radiotherapy,the NRS score of pharyngeal discomfort and the NRS score of oral and oropharyngeal pain in the trial group were lower than those of the control group(P＜0.001).The QOL-NPC score,SE-QOL-NPC score,and SE1 score were all higher than those in the control group(P = 0.05 or P＜0.05).Conclusion Patients with nasopharyngeal cancer can greatly reduce their risk of developing severe acute radiation-induced oropharyngeal mucositis,effectively delay and relieve related symptoms,and enhance quality of life by consistently using Yinlian Gargle during radiotherapy.Additionally,a month after the completion of radiotherapy,it still has positive therapeutic effects on acute radiation-induced oropharyngeal mucositis.