A case of a middle-aged male who got a sudden death during sleep,It isfound after postmortem examination that the death is caused by congenitalcoronary-ventricular fistula.In the light of documents,the occurrence of thetissues,the mechanism of the sudden death and the clinical characteristics areanalysed and discussed.

Objective To explore the clinical significance of prenatal ultrasonic diagnosis of fetal nephrohydrosis and its prognosis.Methods Prenatal ultrasanography was performed on 9526 women at more than 20 weeks gestation,and 162 women whose anteroposterior diameter of the renal pelvis was≥8 mm were included in this study.The grade of fetal nephrohydrosis was classified according to Grignon grading method.The changes in fetal nephrohydrosis were observed regularly until delivery.Results(1)The incidence of fetal encephalic fluid and Grignon grade:there were 162 fetuses with fetal nephrohydrosis among 9526 fetuses,with an incidence of 1.7%.The numbers of fetuses with Grades 1 to 5 were 71,59,7,3 and 22,respectively.(2)The distribution in gestafional weeks of fetal nephrohydrosis:generally,fetal nephrohydrosis was first diagnosed at(33±5)weeks,and the maximum degree of nephrohydrosis was observed at(36±3)weeks.One hundred and ten fetuses with nephrohydrosis recovered during the process of gestation,at about(37±4)weeks.(3)Poor terminations of pregnancy:there were 40(25%)fetuses with poor terminations among totally 162 cases.Among these 40 fetuses,3(27%)were first diagnosed at 20 to 24 weeks within 11 fetuses,6(24%)were first diagnosed at 25 to 28 weeks within 20 fetuses,14(26%)were first diagnosed at 29 to 32 weeks within 53 fetuses,11(23%)were first diagnosed at 33 to 36 weeks within 48 fetuses,and 6(20%)were first diagnosed at 37 to 40 weeks within 30 fetuses,The results demonstrate that high grade of fetal nephrohydrosis according to Grignon grading method indicates a poorer prognosis of the fetus.(4)Follow-up results:there were 122(75%,122/162)live and healthy neonates in total,including 110 neonates whose nephrohydrosis recovered prior to birth and 12 neonates whose nephrohydrosis recovered within 1 week after birth.These neonates all developed well without any urinary sequela within the first 2 years.There were also 20(12%,20/162)hydronephrotic neonates who were still diagnosed as nephrohydrosis within 1 week after birth,including 11 fetuses graded below Grignon grade 3,whose nephrohydrosis recovered 3 to 12 months after birth and who developed well without any urinary symptoms.Conclusions The study demonstrates that hydronephrotic fetuses who are diagnosed at earlier gestational weeka and with higher grading have poore prognosis.The Grignon grading method can be used in the prenatal evaluation of fetal nephrohydrosis to predict the prognosis of the fetus.

Objective To investigate and discuss the feasibility and clinical outcome of the minimally invasive two-incision total hip arthroplasty. Methods From February to June 2004, 17 cases of the minimally invasive two-incision total hip arthroplasty were performed. There were 7 males and 10 females with an average age of 69 years from 58 to 75 years. Preoperative diagnosis of the patients included 5 of osteoarthritis, 4 of osteonecrosis and 8 of femoral neck fracture. The operations were performed with Versys cementless prosthesis and minimally invasive instruments provided by Zimmer Company. Operation time, blood loss, length of incisions, average postoperative hospitalization, and operation related complications were analyzed. Blood transfusion was performed while hemoglobin of the patients was less than 8 g. Results The patients were followed up from 6 to 12 months with an average of 8 months. The average operation time was 95 mins (85 to 170 mins). The average blood loss was 280 ml (190 to 450 ml) and blood transfusion was carried out in 4 cases of femoral neck fracture (average, 400 ml). The average length of anterior incision was 5.0 cm (4.6 to 6.5 cm) and that of posterior incision was 3.7 cm (3.0 to 4.2 cm). All the patients were ambulatory the day after surgery. 11 cases were discharged 5 days and 6 cases discharged 7 days after operation. Postoperative measurement on X-ray film showed that the average angles of abduction and anteversion of acetabular cup were 46?(43? to 55?) and 21?(17? to 23?) respectively. Proximal femoral split fracture occurred in one case, in which the fluoroscopy demonstrated the femoral component was stable and well positioned, and the patient walked without weight-wear for 2 months and was found with stable prosthesis evaluated at 3 and 6 months postoperatively. None of infection, dislocation or injury of vessel and nerve happened. Conclusion Anterior and posterior two-incision total hip arthroplasty has the advantages of muscle sparing, minimally invasive, less blood loss, rapid recovery; however, this technique is time consuming, special instruments and fluoroscopy are needed.

Objective To study the effect of CO2 pneumoperitoneum on the anti-apoptotic capability of gallbladder carcinoma cell line (GBC-SD).Methods The CO2 pneumoperitoneum was established in vitro.After GBC-SD cells were exposed to CO2 pneumoperitoneum at 12 mmHg for 1,2,3,4 h,the expressions of survivin mRNA was examined by RT-PCR.The untreated GBC-SD cells served as control.Results Under a pressure of 12 mmHg,the expressions of survivn had an increasing tendency with the exposure time.Conclusions Under certain pressure and within certain exposure time,CO2 pneumoperitoneum could improve anti-apoptotic capability of GBC-SD cells,which may be one of the mechanisms of the promoting effect of carbon dioxide pneumoperitoneum on malignant cell growth.

Red cell isoenzymes EsD and PGM and serum Hp are of genetic polymorphism which is inheritedsccording to the Law of Meqdelian Segregation. The distribution of their gene frequencies varies withraces. In this paper,the phenotype frequencies of the EsD,PGM and Hp have been investigated by theemthod of mixed starch/agarose gel electrophoresis and polyacrylamide gel electrophoresis among fivenationalities in Inner Mongolia, namely Creqen, Ewenki, Dawuor, Northeast Mongolian and Buryat.The gene Oroqen,Ewenki,Dawuor,Northeast Mongolian and Buryat. The gene frequencies were alsocalculated. The phenotype frequencies of EsD,PGM and Hp are compared not only among the five nationalities but with those reported by other countries.

Objective To develop and compare the methods for determining the carrier status in the 18 deleted families of Duchenne and Becker muscular dystrophy. Methods Deletion analysis of the probands was performed by multiplex polymerase chain reaction (PCR) to amplify 9 dystrophin exons described by Chamberlain. Polymorphism linkage analysis was made on DNA with PCR amplification using primers of intragenic short tandem repeat sequences (STR44, STR45, STR49 and STR50), primers of 5′ end (5′DYS II) and primers of 3′end (MZ18, MZ19) in the members of the families. Gene dosage analysis was performed and DQ value was calculated. Results Both of deletions of exons and STR allelic fragments adjacent to the deleted exons were determined in the probands. STR allelic fragments of 6 pairs of heterozygotes, 2 pairs of homozygotes and 11 hemizygotes were detected at those loci in all of the female relatives. 13 female relatives in deleted families were assayed with gene dosage analysis. In 9 /13 female relatives DQ value was in the range of single copy and carrier status was ascertained.Conclusion Repeat sequence polymorphism as well as gene dosage analysis can potentially be used in carrier detection in the deleted families of Duchenne and Becker muscular dystrophy.

BACKGROUND: Optical mapping technique is a novel electrophysiological detection method in which voltage-sensitivity dye is medium and silicon photoelectrical diode transforming technology is characteristic, used for analyzing the spatial-temporal distribution of membrane potential in complex neural system.OBJECTIVE: To observe the spatial-temporal changes of brainstem auditory electro-stimulation evoked potential by using optical mapping technology, so as to probe into the influence of γ-Aminobutyric acid (GABA) and γ-GABA receptor antagonist-bicuculline (BMI) on auditory evoked potential.DESIGN: Randomized controlled study.SETTING: Aging Medicine Research Institute of Military General Hospital and E.T.N Department of Japanese Kansai Medical University.MATERIALS:This study was conducted at E.T.N Department of Japanese Kansai Medical University from May to November 2002. Totally 100 ddy/ddy rats, with age of 0-5 days, clear grade, either gender were selected.METHODS: All rats were put to death after cryo-anaesthetized, and brainstem was cut into slices under frozen state so as to remain activity.One side of brainstem slice was connected with the residual end of untraumatic auditory nerve, and slices were put on organic glass plate with the bottom covered with siliac gel and fixed by tungsten filament of 30 μm wide. The residual end of untraumatic auditory nerve was stimulated by tungsten electrode, meanwhile the evoke potentials were recorded at cochlea nuclei and vestibule nuclei. In control group slices were incubated in artificial CSF for 20 minutes, which added with 50 μmol/L γ-GABA in experimental group for observing the influence of γ-GABA on brainstem auditory evoked signals; or alternatively incubated with 50 μmol/L g-GABA and 200 μmol/L for 20 minutes for observing the influence of BMI on brainstem auditory evoked signals. Stimulation was positive rectangle-shape impulse with electric current of 5 mA and frequency of 0.1 Hz, lasting period of 5 ms, the onset time of electric stimulation was set at 89.9 ms.Brain stem slices were stained with electric-sensitivity dye of NK3041 and 16×16 pixel silicon photoelectrical diode device was used to record the auditory nerve stimulation evoked optical signals.fluence of γ-GABA and BMI on optical signals.RESULTS: Totally 100 ddy/ddy rats enrolled in this study and 56 died Character of brainstem auditory electrical-stimulation evoked optical signals: Spatial-temporal changes of auditory evoked optical signals were recorded. The latency of optical signals was (4.63±1.01) ms cochlea nuclei and (6.00±0.89) ms at vestibule nuclei of the same side. Each optical sigual can be divided into two parts: Quick peak-potential and slow long-term potential. The onset phage of quick potential displayed pre-synaptic property, while later phage displayed post-synaptic property; the slow long-term reaction due to γ-GABA and BMI administration: 50 μmol/L γ-GABA was added into the perfusion fluid so as to reduce the amplitude of auditory evoked brainstem neuronal signals in maximum degree, the onset latency of quick potential did not prolonged, but amplitude slightly descended; while the latency and amplitude of later phage were obviously reduced. But such changes could be partly resumed due to the 200 μmol/L dicentrine administration.CONCLUSION: Auditory electro-stimulation evoked potentials can be detected by using multiple-site optical mapping system, which displaying spatial-temporal property. γ-GABA can obviously attenuate the amplitude of auditory electro-stimulation evoked brainstem signals, but such effect can be partly but not completely attenuated by γ-GABA A receptor antagonist-BMI, which implying that besides γ-GABA A receptor, such inhibition of γ-GABA energetic neurons on auditory electro-stimulation evoked potentials can be achieved by other γ-GABA subtype receptors.

Objective To evaluate the application value of three‐dimensional ultrasonography OmniView technology in diagnosis of fetal cleft lip/palate . Methods Three‐dimensional volume data was acquired from 100 normal singleton fetuses and 18 cleft lip/palate fetuses ,and was analysed by OmniView technology . Two‐dimensional ultrasonography and three‐dimensional OmniView technology were compared in the displaying rate of different planes of the lip and palate and the diagnosis accordance rate of cleft lip/palate.Results ①ThedisplayingrateofthelipandpalateofOmniViewtechnologywashigherthanthatof two‐dimensional ultrasonography ( the displaying rates were 64% -88% and 30% -65% ,respectively , P <0 .05) . Further more ,the curved plane tiled imaging of palate was successfully reconstructed by OmniView technology ,displaying the nonplanar panorama of the palate . ② There was no significant difference in diagnosis accordance rate of fetal cleft lip/palate between two‐dimensional ultrasonography and OmniView technology( the accordance rate was 89% -94% and 78% -100% ,respectively , P >0 .05) . Conclusions Three‐dimentional ultrasonography OmniView technology can improve the displaying rate of the hard and soft palate .The application of this technology in the fetuses who has a high risk of cleft palate may be beneficial to the diagnosis of cleft palate .

Objective:To analyze the factors affecting lymph node failure pattern after radiotherapy/chemotherapy in esophageal squamous cell carcinoma without initial clinical metastasis. Methods:A total of 263 patients, who were diagnosed as thoracic esopha-geal carcinoma from January 2002 to December 2009, were included in this retrospective study. Factors affecting lymph node failure pattern with general clinical data and tumor local factors were analyzed. Results:Among the 263 esophageal cancer cases, 31 (11.8%) had lymph node metastasis after treatment, including 18 cases of simple lymph node metastasis and 13 other cases of lymph node metas-tasis with esophageal and other organ metastasis or recurrence. The numbers of cases for lymph node metastasis in the upper, middle, and lower thoracic esophagus were 11 (13.3%), 13 (10.1%), and 7 (13.7%), respectively. Univariate analysis showed that recent cura-tive effect, length of tumor on X-rays, maximum tumor diameter, and tumor volume were the significant factors associated with lymph node metastasis (χ2=7.597, 9.717, 5.361, and 4.815;P=0.006, 0.002, 0.021, and 0.028). Logistic regression analysis results showed that recent curative effect and length of tumor on X-rays were independent significant factors (P=0.004 and 0.026). Conclusion:Recent cu-rative effect and length of tumor on X-rays were the significant factors associated with lymph node failure pattern after radiotherapy/chemotherapy in esophageal squamous cell carcinoma without initial clinical metastasis.

Objective: to select the optimal acupuncture therapeutic projects on cerebral infarction-related motor dysfunction of lower limbs. Methods: to optimize the combination projects on 4 factors and 3 levels affecting the acupuncture effect on cerebral infarction by using orthogonal design targeting on patients with cerebral infarction-related motor dysfunction of lower limbs, and Fugl-Meyer score of limb motor function was taken as indexes. Results: The relatively optimal Fugl-Meyer score of lower limb function can be obtained within 3-day duration of cerebral infarction. Conclusions: As far as the considered factors and levels are concerned, the previously mentioned project is the optimal acupuncture therapeutic project for cerebral infarction-related motor dysfunction of lower limbs.