Objective To investigate the clinical value of the decfion of percentage of pulmonary perfusion defect score (PPDS％) in patients with pulmonary embolism (PE).Methods A retrospective study was carried out on PPDs％ data of patients(n =36) with clinical confirmed PE.The patients were divided into three levels:low (PPDS％ ＜30％),medial (30％ ≤PPDS％ ＜50％) and high (PPDS％ ≥50％) risk groups,according to the standard of PPDs％ diagnosis.the PPDS％ and the incidence rate of the clinical adverse events were compared in mild,moderate and severe risk PE.The therapeutic results were compared with the PPDS％ changes.Results The mild,moderate and severe risk patients with PE were 15 cases,13 cases and 8 cases respectively,according to the standard of PPDS％ diagnosis.16 cases,12 cases and 8 cases respectively,according to the standard of 2008 ESC APE diagnosis and treatment guidelines.The uniform rate was 94.4％ for two methods,the uniform rate was 100.0％ in which high risk of PE.The PPDS％ of PE was (46.2 ± 4.6) ％ before treatment.The data was significantly higher than that post treatment (31.6％ ± 1.8％) (t =17.38,P ＜ 0.01).The scores of low,medial and high risk patients were (25.9 ± 3.9) ％,(45.6 ± 4.3) ％ and (58.4 ± 4.9) ％ (t =6.18,P ＜ 0.01),respectively.The mild,moderate and severe risk PE according to the PPDS％ standard with clinical adverse events for were 1 cases (6.5％),3 cases (23.0％) and 5 cases (62.5 ％) respectively,with a significant difference (x2 =8.71,P ＜ 0.05).Conclusion PPDS％ could be used as an important reference index for risk stratification of diagnosis,evaluating therapeutic efficiency and predicting the prognosis in patients with PE.

Objective To evaluate the clinical value of the upper extremital artery supply and vein running back in the patients after peripheral vascular surgery by Na99mTcO4 trace imaging(TTI).Methods SPECT static imaging was performed on 36 patients after peripheral vascular surgery in vein injecting Na99mTcO4 740 MBq 5min.The radioactivity uptake of operated limb(finger)/normal limb(finger) ratio(T/NT) was analyzed using region of interest analysis.0,Ⅰ,Ⅱand Ⅲ scales were classified according to their radionuclide distribution and T/NT,were divided into A,B,C and D group,respectively.Localy warming and anticontrctive therapy were only given in A and B group for 30min,routine therapy in C group,and raising operated limb (finger) and reductive pressure treatment in D group.Then,exploratory surgery was performed on 0 scales and Ⅲ scales of TTI again.Results A,B,C and D group were 11,7,13 and 5 patients,their T/NT was (0.142 ± 0.058),(0.384 ± 0.046),(0.794 ± 0.072) and (1.12 ±0.076),respectvely,and there were significant differences among the groups(t =2.33a,4.33b,6.90b,2.59a,5.73b,2.12a,aP ＜ 0.05,b P ＜ 0.O1) ;TTI again showed:there were 7 cases of 0 scales (arterial thrombosis was confirmed by exploratory surgery) and 4 cases of Ⅰ scales in A group,3 cases of Ⅰ scales and 4 cases of Ⅱ scales in B group,all 13 cases of Ⅱ scales in C group,4 cases of Ⅱ scales and 1 case of Ⅲ scales(vein thrombosis was confirmed by exploratory surgery) in D group.Conclusion TTI could play an important role in economical,simple and notraumatic diagnosing the extremital artery supply and vein running back in the patients after peripheral vascular surgery.

Objective: To observe the effects of acupoint thread-embedding therapy and low-carbohydrate diet therapy on obese patients with food addiction. Methods: Sixty-five eligible patients were randomized into a thread-embedding group of 33 cases and a diet group of 32 cases to respectively receive 12-week treatment. Before treatment, after treatment and at 6-month follow-up, the two groups were observed and compared in terms of body mass (BM), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body mass index (BMI), body fat rate (BFR), basal metabolic rate (BMR) and Yale food addiction scale version 2.0 (YFAS 2.0). Results: At the end of treatment, there were no significant differences in the general efficacy, and the improvements in BM, BMI, WC, HC, WHR and BFR between the thread-embedding group and diet group (all P>0.05). At follow-up, the thread-embedding group showed more significant improvements in all the aforementioned indicators compared with the diet group except HC (all P<0.05). At the end of treatment and follow-up, BMR and YFSA 2.0 had more significant improvements in the thread-embedding group than in the diet group (all P<0.05). Conclusion: Acupoint thread-embedding therapy can produce significant efficacy in treating obese patients with food addiction; it can improve the food addiction state and work better in maintaining the efficacy compared with low-carbohydrate diet therapy.

In this study, ultra performance liquid chromatography-quadrupole-time of flight mass spectrometer-MS^E (UPLC-Q-TOF-MS^E) combined with UNIFI analysis platform was used to rapidly analyze and identify the metabolites of hederagenins 3-O-α-L-rhamnosyl-(1→2)-[β-D-glucopyranosyl-(1→4)]-α-L-arabopyranoside (Pulsatilla saponin D) and oleanolic acid 3-O-α-L-rhamnosyl-(1→2)-[β-D-glucopyranosyl-(1→4)]-α-L-arabopyranoside (Pulsatilla saponin B₇) and hederagenins 3-O-α-L-rhamnosyl-(1→2)-α-L-arabopyranoside (Pulsatilla saponin BD) in plasma and colonic tissue of normal and ulcerative colitis (UC) rats. The database and analysis methods were established based on the precise molecular weight of compounds, retention time, neutral loss and reported data, and then the final data were obtained by comparing with the blank control group, combining with the deviation and the cracking rule of the compound. The results showed that the glucoses, hydroxylation and dehydroxylation, methylation and demethylation, dehydrogenation, decarboxylation and hydrolysis of saponin D, B₇ and BD occurred in the plasma and colon tissues of normal and UC model rats. This study will clarify the metabolic transformation of Pulsatilla saponins D, B₇ and BD in rats, determine the prototype components and their metabolites that enter the body, and whether colon injury will affect their metabolism in vivo, so as to explore the possible anti-colitis effective components in the prototype or metabolites of Pulsatilla saponins D, B₇ and BD. This experiment was approved by Animal Ethics Committee of Jiangxi Science and Technology Normal University (approval number: Y202227).

OBJECTIVETo investigate the distribution, phenotype and development of pericytes in infantile hemangioma.

METHODSFifty-two infantile hemangioma samples were included in our study. alpha-SMA was used as the marker antigen to observe the distribution of pericytes. Transmission electron microscope and TUNEL method were used to analyze the apoptosis of pericytes.

RESULTSIn the early and middle proliferating stage, there existed many pericytes in hemangioma; Pericytes together with endothelial cells generated vasculogenesis. In the late proliferating stage, many pericytes became apoptotic. In the early involuting stage, there were only a few of pericytes around the microvessels; After that, the microvessels became obstruction progressively and pericytes disappeared finally.

CONCLUSIONSThe pericyte is one of the major constitutive cells of hemangioma. The vasculogenesis, development and disappearance of microvessels undertaken by pericytes and endothelial cells lead to the pathologic evolution of infantile hemangioma.

Child ; Child, Preschool ; Female ; Hemangioma ; pathology ; Humans ; Infant ; Male ; Microcirculation ; Neovascularization, Pathologic ; pathology ; Pericytes ; pathology

OBJECTIVETo investigate the expression of Fas/FasL in infantile hemangiomas and discuss the role of Fas/FasL in the pathologic evolution of infantile hemangioma.

METHODThe EnVision immunohistochemical stain and RT-PCR technique was used to examine the expression of Fas/FasL protein and mRNA in the infantile hemangiomas.

RESULTS(1) In the early and middle proliferating stage, a number of infantile hemangioma cells expressed Fas. In the late proliferating stage, the number of positive cells increased obviously and the expression of Fas mRNA was reaching the strongest level. In the early regressing stage the Fas still existed in some cells and after that the expression decreased quickly. (2) Up to the middle proliferating stage, there were a few of FasL(+) cells foound. In the late proliferating stage, the number of FasL(+) cells increased significantly. From the early regressing stage, the number of FasL(+) cells decreased rapidly and disappeared.

CONCLUSIONThere may exist significant correlation between the expression of Fas/FasL and the development of the infantile hemangioma cells. The apoptosis of the infantile hemangioma cells mediated by Fas/ FasL may be the major reason of the spontaneous involution of infantile hemangioma.

Apoptosis ; Child ; Child, Preschool ; Fas Ligand Protein ; metabolism ; Hemangioma ; metabolism ; pathology ; Humans ; Hyperplasia ; Infant ; RNA, Messenger ; metabolism ; Signal Transduction ; fas Receptor ; metabolism

OBJECTIVETo study the effect of basic fibroblast growth factor (bFGF) on the gene expression of decorin by periodontal ligament fibroblasts (PLFs) in culture, and discuss the effect of bFGF in periodontal regeneration.

METHODSHuman PLFs were cultured and stimulated by exogenous bFGF. Gene expression of decorin was assessed by semi-quantitive RT-PCR.

RESULTSThe mRNA expression of decorin was suppressed by bFGF and the effect was dose-dependent. When the dose of bFGF increased, the inhibitive effect decreased.

CONCLUSIONDecorin has many biological effects. The inhibitive effect may be one of important factors which participate in the healing process of periodontitis, and provide partly theoretical basis of bFGF in periodontal regeneration.

Decorin ; Fibroblast Growth Factor 2 ; Fibroblasts ; Humans ; Periodontal Ligament ; RNA, Messenger ; Regeneration

OBJECTIVETo study the expression and significance of structural proteins, VEGF and Ang-1 in cavernous venous malformations of the body surface.

METHODSTissue samples came from 25 cases of cavernous venous malformations, 12 cases of normal moderate veins and 12 cases of normal small veins. Envision immunohistochemical stain was used to investigate the expression of IV collagen, fibronectin, laminin, VEGF and Ang-1. The results were analyzed semi-quantitatively.

RESULTSThe distribution of structural proteins in cavernous venous malformations is similar to moderate and small veins, but the expression in venous malformations is less obviously. VEGF expression in cavernous venous malformations and small veins is stronger obviously than moderate veins. Ang-1 expression in small veins is stronger remarkably than cavernous venous malformations and moderate veins.

CONCLUSIONThe abnormal expression of structural proteins may be an important factor in etiopathology and progress of cavernous venous malformations. There is disturbance of blood vessel remodelling in the sinusoid of cavernous venous malformations, with which the less expression of Ang-1 may be related.

Angiopoietin-1 ; metabolism ; Collagen Type IV ; metabolism ; Fibronectins ; analysis ; Hemangioma, Cavernous ; metabolism ; Humans ; Laminin ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Veins ; abnormalities ; metabolism

OBJECTIVETo investigate the clinical pathology of cavernous venous malformations of the body surface.

METHODSTissue samples of cavernous venous malformations from 42 cases were stained with hematoxylin and eosin to observe the pathologic structure. The clinical manifestations and case history were summarized accordingly.

RESULTSThere was no distribution difference of the malformation in sex and body sides, but with obvious difference in anatomic sites. The malformation occurred most frequently at the head and neck, more frequently at extremities and least frequently at the trunk. According to pathologic structure, cavernous venous malformations of the body surface can be divided into three types: the cellular, the canaliform and the mixed.

CONCLUSIONThe cause of distribution difference in anatomic sites remains unclear. Internal hemorrhage and infection may account for the increased growth and ache of the lesion. The different pathologic structure of the malformation may cause different clinical manifestations.

Adolescent ; Adult ; Aged ; Arteriovenous Malformations ; complications ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infection ; etiology ; Male ; Middle Aged ; Pain ; etiology ; Sex Factors ; Skin ; blood supply ; pathology ; Veins ; abnormalities

ObjectiveTo assess the value of passive leg raising (PLR) test in predicting fluid responsiveness in patients with sepsis-induced cardiac dysfunction.Methods A prospective observational cohort study was conducted. Thirty-eight patients under mechanical ventilation suffering from sepsis-induced cardiac dysfunction admitted to Department of Surgical Intensive Care Unit of First Affiliated Hospital of Sun Yat-Sen University from September 2013 to July 2014 were enrolled. The patients were studied in four phases: before PLR (semi-recumbent position with the trunk in 45°), PLR (the lower limbs were raised to a 45° angle while the trunk was in a supine position), before volume expansion (VE, return to the semi-recumbent position), and VE with infusing of 250 mL 5% albumin within 30 minutes. Hemodynamic parameters were recorded in every phase. The patients were classified into two groups according to their response to VE: responders (at least a 15% increase in stroke volume,ΔSVVE≥15%), and non-responders. The correlations among all changes in hemodynamic parameters were analyzed by linear correlation analysis, and the receiver operating characteristic curve (ROC) was plotted to assess the value of hemodynamic parameters before and after PLR in predicting fluid responsiveness.Results Of 38 patients, 25 patients were responders, and 13 non-responders. There was no significant difference in the baseline and hemodynamic parameters at semi-recumbent position between the two groups. The changes in SV and cardiac output (CO) after PLR (ΔSVPLR andΔCOPLR) were significantly higher in responders than those of non-responders [ΔSVPLR: (14.7±5.7)%vs. (6.4±5.3)%,t = 4.304,P = 0.000;ΔCOPLR: (11.2±7.5)% vs. (3.4±2.3)%,t = 3.454,P = 0.001], but there was no significant difference in the changes in systolic blood pressure, mean arterial pressure, pulse pressure, and heart rate after PLR (ΔSBPPLR,ΔMAPPLR,ΔPPPLR andΔHRPLR) between two groups.ΔSVVE in responders was significantly higher than that of the non-responders [(20.8±5.5) % vs. (5.0±3.7) %,t = 8.347,P = 0.000]. It was shown by correlation analysis thatΔSVPLR was positively correlated withΔSVVE (r = 0.593,P = 0.000),ΔCOPLR was positively correlated withΔSVVE (r = 0.494,P = 0.002). The area under ROC curve (AUC) ofΔSVPLR≥8.1% for predicting fluid responsiveness was 0.860±0.062 (P = 0.000), with sensitivity of 92.0% and specificity of 70.0%; the AUC ofΔCOPLR≥5.6% for predicting fluid responsiveness was 0.840±0.070 (P = 0.000), with sensitivity of 84.0%and specificity of 76.9%; the AUC ofΔMAPPLR≥6.9% for predicting fluid responsiveness was 0.662±0.089, with sensitivity of 68.0% and specificity of 76.9%; the AUC ofΔSBPPLR≥6.4% for predicting fluid responsiveness was 0.628±0.098, with sensitivity of 76.0% and specificity of 61.5%; the AUC ofΔPPPLR≥6.2% for predicting fluid responsiveness was 0.502±0.094, with sensitivity of 56.0% and specificity of 53.8%; the AUC ofΔHRPLR≥-1.7%for predicting fluid responsiveness was 0.457±0.100, with sensitivity of 56.0% and specificity of 46.2%.Conclusion In patients with sepsis-induced cardiac dysfunction, changes in SV and CO induced by PLR are accurate indices for predicting fluid responsiveness, but the changes in HR, MAP, SBP and PP cannot predict the fluid responsiveness.