BACKGROUND: Hypoxia-inducible factor 1α may mediate mammalian cells to adapt hypoxia environment.OBJECTIVE: To observe high altitude hypoxia on the ultrastructure of the lung tissue of hypoxia-inducible factor 1α expression.METHODS: Sprague-Dawley rats underwent high altitude hypoxia intervention for 1, 2, 3 and 30 days. Control group was set. Four high altitude hypoxia groups consisted of Golmud, Qinghai at the altitude of 2 700 m from 5-m above sea level of Xi'an consuming 1 day, Tanggula region at 5 000 m above sea level consuming 2 days, and Tibet Nagqu at 4 500 m above sea level consuming 3 and 30 days, respectively.RESULTS AND CONCLUSION: Light and electron microscopy showed that acute high altitude hypoxia 2 day group presented apparent high altitude pulmonary edema, while the 30 day group of acute high altitude hypoxia of high altitude pulmonary edema was significantly reduced, but hypoxia-inducible factor 1α mRNA expression was significantly increased (P < 0.01). Results demonstrate that hypoxia-inducible factor 1α mRNA expression increase in lung tissues after hypoxic acclimatization can help ameliorate high altitude pulmonary edema.

BACKGROUND: At present, MRI is the key method to examine the hippocampal sclerosis of the patients with epilepsy. The main results are the abnormal signals of hippocampus, in addition, other symbols of MRI can also suggest the hippocampal sclerosis.OBJECTIVE: To study the significance and value of the loss of visualization of digitations of hippocampal head in diagnosis of hippocampal sclerosis through the analysis of MRI on patients with temporal lobe epilepsy.DESIGN: Non-randomized, blind procedure(data selection, result evaluation), blank controlled and clinical experiment.SETTING: Departments of radiology in two universities.PARTICIPANTS: Between September 1996 and December 2002, 18 patients with temporal lobe epilepsy were selected from the Department of Radiology,Xinhua Hospital Affiliated to Shanghai Second Medical University. Meanwhile,patients with headache were diagnosed with MRI. Eighteen healthy people,whose ages were matched, were as control group.METHODS: Among 18 patients, MRI of 16 patients and 18 people in the control group were performed with a GE 1.5T Horizon MR unit and another 2with a GE 1.5T Signa whole body MR unit. With the double blind procedure, whether the digitations of hippocampal head of 72 hippocampal heads of 36 people in both patient and control groups exist or not was recorded by two radiologists with knowledge of hippocampal dissection but without knowing the condition of clinical operation. The results were divided into 3 levels:loss, poorly visible and existing, and hippocampal atrophy and abnormal signals were also recorded.MAIN OUTCOME MEASURES: Image condition of digitations of head,size of hippocampal head and changes of signal.RESULTS: Of 18 patients with hippocampal sclerosis, the abnormal findings included smooth and the loss of visualization of digitations of hippocampal heads seen in 16 patients, poorly visible of digitations of hippocampal head in one patient, and existence of digitations of hippocampal head in one patient. Hippocampal atrophy and high signals on T2-weighted images and fluid-attenuated inversion recovery imaging were seen in all patients. The sensitivity of loss of digitations of hippocampal heads for diagnosis of hippocampal sclerosis was 88.9% (16/18), and the specificity was 100%.CONCLUSSION: The loss of visualization of digitations of hippocampal head is a sensitive indicator for the diagnosis of hippocampal sclerosis. Atrophic changes of hippocampus combining with the increase of T2-weighted signal can definitely diagnose the hippocampal sclerosis.

Objective To compare the body composition of diabetic and healthy subjects and to investigate the correlation between obesity and type 2 diabetes mellitus.Methods Body composition was analyzed in 80 type 2 diabetic patients (diabetes group) and 80 healthy subjects (control group) selected at random.They were measured for body fat mass,visceral fat area,sketedtal muscle mass,waist-hip ratio,the content of protein and mineral,etc.The blood glucose,blood fat,insulin resistance index (Homa-IR) and glycosylated hemoglobin(HbA1c) were also measured.Results The means of body fat mass((19.68 ± 6.78)kg),percent body fat ((29.87 ± 8.04) ％),obesity degree ((115.93 ± 15.94) ％),visceral fat area ((104.48 ± 36.19) cm2),Body mass index(BMI) ((24.85 ± 3.51) kg/m2),chest circumference ((94.06 ±7.86) cm),waist circumference ((85.18 ± 9.50) cm) and waist-hip ratio (0.90 ± 0.05) were significantly higher than the means of healthy subjects'weight control ((-4.08 ± 6.79) kg),body fat mass ((17.31 ± 5.55)kg),percent body fat ((27.38 ± 6.47)％),obesity degree((108.88 ± 13.80)％),visceral fat area ((85.44 ±44.04) cm2),BMI ((23.43 ± 3.10) kg/m2),chest circumference ((91.11 ± 7.52) cm),waist circumference ((80.79±8.17) cm) and waist-hip ratio (0.86 ± 0.05) (t=2.55,2.30,3.12,2.86,2.73,2.28,3.12 and 4.76 respectively;P ＜0.05),body mass control ((-7.01 ± 7.49) kg),obesity control ((-8.53 ± 6.66)kg),muscles control((1.52 ± 1.43) kg) were lower than control group:the body mass control((-4.08 ±6.79) kg),obesity control ((-6.39 ± 5.78) kg),muscles control ((2.31 ± 2.09) kg).The uric acid was negatively related to weight control and obesity control (r =-0.43,-0.42 ; P ＜ 0.01),and were positively related to visceral fat area,percent body fat,waist-hip ratio,BMI,obesity degree,chest circumference,waist circumference and body fat mass (r =0.32,0.31,0.40,0.36,0.36,0.31,0.42,0.42 ; P ＜ 0.05).The triglyceride was negatively related to weight control and obesity control (r =-0.44,-0.41 ;P ＜ 0.01),and were positive related to percent body fat,waist-hip ratio,BMI,obesity degree,chest circumference,waist circumference and body fat mass(r =0.27,0.35,0.46,0.46,0.35,0.42,0.42 ;P ＜ 0.05).Conclusion The body fat and fat distribution are significantly different between diabetic and healthy subjects.There may be some relationship between central obesity and diabetes.

Objective To study the distribution and drug resistance of pathogens in neonatal septicemia in order to provide clinical guidance for antibiotic usage.Methods This retrospective study analyzed blood culture and clinical data from 83 confirmed neonatal septicemia patients and the blood collection cultures were analyzed.Results A total of 84 strains were isolated from 83 cases of blood specimens,Gram positive bacteria,Gram negative bacteria and fungi were 38(45.2%),41(48.8%),5(6.0%),respectively.Gram positive bacteria was mainly coagulase negative staphylococcus and staphylococcus aureus,which were 13(15.5%) and 8(9.5%) respectively.Gram negative bacteria was mainly Escherichia coli and Klebsiella pneumonia,which were 25(29.8%) and 9(10.7%) respectively.Gram positive bacteria were found high resistance to penicillin G,amoxicillin clavulanate potassium,oxacillin and clindamycin,from 34.2% to 73.7%,but they were sensitive to vancomycin,teicoplanin and linezolid.Gram negative bacteria were found high resistance to ampicillin(82.9%),the constituent ratio of the extended spectrum βlactamases(ESBLs) was 34.1%,carbapenem resistant strains was not found.All fungi were sensitive to azoles.Conclusion Gram negative bacteria are the major pathogens in neonatal septicemia,with high infection rate of Escherichia coli and high constituent ratio of the ESBLs,and antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility results.

Objective To explore the significance and value of loss of digitations of hippocampal head in diagnosis of hippocampal sclerosis.Methods Eighteen patients with hippocampal sclerosis comfirmed by histopathological examination and 18 cases to be matched control group were examined by MRI . The digitations,atrophic change and abnormal signals of hippocampal head were evaluated retrospectively.Results Of 18 patients with hippocampal sclerosis, loss of digitations was seen in 16 cases, poorly visible in 1 case and exist in 1 case. The sclerotic hippocampal heads all had atrophic change and were hyperintensity on T_2-weighted and FLAIR MR imagings. No loss of digitations were seen in the opposite side of the hippocampal sclerosis and all hippocampal heads in control group.Conclusion The loss of digitations of hippocampal head is a sensitive indicator for the diagnosis of hippocampal sclerosis.

Objective To study the expression of secondary lymphoid-tissue chemokine (SLC)、 CCR7 and its correlation with clinical pathology and lymphangiogenesis in pancreatic adenocarcinoma (PAC). Methods The tissue specimens including PAC, the cancerous peripheral tissues, the normal pancreatic tissues and peripheral lymph nodes were obtained from 30 patients with PAC. The expressions of SLC and CCR7 in these tissues were assayed by immunohistochemical staining and reverse transcription polymerase chain reaction (RT-PCR). MIND marked by VEGFR-3 was detected by morphometric analysis, and the relationship between MLND and clinical pathology of PAC was analyzed. Results In all the specimens, the positive rates of SLC protein in PAC, the cancerous peripheral tissues, the normal pancreatic tissues and peripheral lymph nodes were respectively 16. 7%, 43. 3%, 76. 7% and 46. 6%. The positive rates of CCR7 protein in PAC, the cancerous peripheral tissues, the normal pancreatic tissues and peripheral lymph nodes were respectively 76. 7%, 66. 7%, 30. 0% and 70. 0%. The results of RT-PCR and fluorescence quantitative real-time PCR indicated that the expression levels of CCR7 mRNA in PAC tissues, the cancerous peripheral tissues and peripheral lymph nodes were higher than that in the normal pancreatic tissues ( P <0. 01 ). There was no significant correlation between the expression of SLC protein with MLVD of PAC ( P > 0. 05 ). There was 23 specimens that the CCR7 protein was positive, and among these specimens the MIND was higher than that in negative group of CCR7 protein (P = 0.004). Conclusions The expression of SLC was not related to lymphatic metastasis and TNM stages of PAC. The expression of CCR7 was significantly associated with lymphatic metastasis and TNM stages of PAC, and the high expression of CCR7 in PAC tissues was significantly associated with lymphangiogenesis of PAC.

Objective To evaluate the mechanical characteristics of systolic left ventricular(LV) transmural torsion in different LV electro-mechanical patterns using speckle tracking imaging. Methods Five open-chest canine models were employed for the acquirement of the basal, apical short-axis and four-chamber views of LV during baseline(BASE) and right atrial appendage(RAA), right ventricular apical (RVA), left ventricular lateral wall (LVL) and left ventrieular apical (LVA) pacing. Subendocardial (subend),subepicardial(subepi) and bulk rotation angle(RA) and segmental angle excursion(AE) at basal and apical level were analyzed using a dedicated workstation. LV torsion at different layers and bulk and global LV ejection fraction (EF) were calculated. Results ① There were no significant difference of transmural torsion and RA at basal and apical level between BASE and RAA pacing (P>0.05);② LV torsion of subend, subepi and bulk during RVA pacing were lower than those during RAA pacing(P0.05);LV torsion of subend and bulk during LVA pacing were lower than those during RAA pacing(P0.05);LV RA of subend,subepi and bulk at basal level during RVA and LVA pacing were lower than those during RAA pacing (P<0.05); ③ For normal electro-mechanical pattern, LV torsion of subend were significant higher than that of subepi(P<0.05), there only were a higher tendency for all pacing models (P>0.05); ④AE of segments near the pacing site decreased during different ventricle paeings (P<0.05); ⑤At BASE and during RAA pacing, LV bulk and subepi torsion were positively correlated to EF; RA of subend,subepi and bulk at basal level were positively correlated to EF. Conclusions LV transmual torsion are significantly depressed during RVA and LVA pacing. There is a spatial co-relationship between LV EF and torsion and rotation of bulk and subepi at basal level in normal LV electro-mechanical patterns.

Objeetive To evaluate the changes of left ventricular(LV) global and segmental volume, LV outlet pressure and their co-relationship, and to access LV global and segmental systolic function and mechanical asynchrony in different LV electro-mechanical patterns using full volume three-dimensional echocardiography(3DE). Methods Nineteen open-chest canine models were employed for the acquirement of LV full volume dynamic 3DE imaging during right atrial appendage (RAA), right ventricular apical (RVA), LV lateral wall(LVL) and LV apical(LVA). LV outlet end-systolic pressure(ESP) was recorded simultaneously. End-systolic volume (ESV), end-diastolic volume (EDV), global and segmental ejection fraction(EF) and systolic dyssynchrony index(SDI) of LV were measured and calculated using a dedicated workstation. The average ascending rate of LV pressure during systole(+ dp/dt) and the average descending systolic pressure(ESP), + dp/dt and - dp/dt during RVA pacing were lower than those during RAA pacing (P <0.05). SDI during RVA pacing was higher than that during RAA pacing(P<0.05). ESP, + dp/dtand - dp/dt during LVL and LVA pacing were lower than those during RAA pacing (P <0.05). There and LVA pacing was higher than that during RVA pacing (P <0.05),SD1 during LVL pacing was lower than that during RVA pacing (P <0.05), there was no significant difference of SDI between RVA and LVA and LVL pacing. Segmental EF of septum and apex during LVI. pacing were higher than those during LVA pacing (P <0.05). @Segmental EF of anterior and post septum and all apical segments (except lateral wall) during RVA pacing were lower than those during RAA pacing (P <0.05). Segmental EF of lateral and anterior wall during I.VI. pacing were lower than those during RAA pacing (P <0.05). Segmental EF of anterior wall and anterior septum during LVA pacing were lower than those during RAA parameters. Conclusions The global and minority segmental systolic function of LV during RAA pacing could be reduced compared with normal sinus rhythm. All the ventricular pacing worsen LV systolic and diastolic function compared with RAA pacing. LV systolic function during LVL pacing was superior to RVA pacing. During ventricular pacing,the systolic function at nearby segments of the pacing site was depressed.

Objective To analyze the intratumoral and peritumoral microvessel density (MVD) and microlymphatic vessel density (MLVD) in pancreatic cancer and record the expression of vascular endothelial growth factor(VEGF)-C and VEGF-D. And to explore the significance of VEGF-C and VEGF-D during the lymphatic metastasis and development of pancreatic cancer. Methods The expression of VEGF-C and VEGF-D, VEGF-R3, CD34 were assayed by immunohistochemical staining in 30 cases of pancreatic cancer tissues. Results The positive rates of VEGF-C and VEGF-D protein in the central portion of tumors (30% and 16.7%) were significantly lower than those in the marginal portion (73.3% and 56.7%), P <0.01. The group with high expression of VEGF-C and VEGF-D in the marginal portion had significantly higher incidences of lymph node metastasis, lymphatic invasion and venous invasion( P <0. 01 ). MLVD in both of the VEGF-C and VEGF-D positive groups was higher than that in the negative groups( P <0. 01 ), and the lymph node me-tastasis increased. MVD in VEGF-C positive group was significantly higher than that in the negative group. MVD had no significant difference between VEGF-D positive and negative group ( P =0. 07). Conclusions The expression of VEGF-C and VEGF-D in the marginal portion of tumor is significantly correlated with lym-phatic metastasis in pancreatic cancer patients, and may induce lymphangiogenesis. VEGF-C may play an im-portant role in the regulation of angiogenesis and lymphangiogenesis in pancreatic cancer, and VEGF- D maybe only participate in the regulation of lymphangiogenesis.

Objective To investigate the assciation between hypertriglyceridemia and insulin resistance in type 2 diabetes (T2DM).Methods One hundred and forty-nine T2DM patients were divided into hypertriglyceridemia (n =88) and normal-triglyceridemia (n =61) groups according to triglyceridemia levels,waist circumference (WC),waist to height ratio (WHtR),fasting blood-glucose (FPG),glycosylated hemoglobin (HbA1 c),uric acid (UA),total cholesterol (TC),fasting insulin (FINS) and homeostatic model assessment for insulin resistance (HOMA-IR) levels were measured and compared between the two groups.Results Compared with the normal-triglyceridemia group,The levels of WC,WHtR,UA,TC,FINS and HOMA-IR of patients in the thypertri-glyceridemia group were significantly higher (Hypertriglyceridemia group:WC(89.51 ±10.31) cm,WHtR 0.55 ±0.06,UA(316.95 ±88.50) μmol/L,TC(5.74 ± 1.72) mmol/L,FINS (8.63 ± 4.91) μU/L,HOMA-IR 4.48 ± 3.14 ; Normal-triglyceridemia group:WC (86.31 ± 7.98) cm,WHtR 0.53 ± 0.05,Uric(275.48 ± 88.36) μmol/L,TC (5.15 ± 1.13) mmol/L,FINS (6.20 ± 3.89) μU/L,HOMA-IR 3.38 ± 2.76; t value were 2.133,2.315,2.815,2.349,2.364,2.221 ; P ＜ 0.05) ; HOMA-IR correlated positively with WC (r =0.233,P ＜ 0.01),WHtR(r =0.268,P ＜ 0.01),BMI (r =0.161,P ＜ 0.05),FPG(r=0.442,P ＜0.01),AST(r=0.169,P ＜0.0S),UA (r =0.907,P ＜0.01),TG(r =0.220,P ＜0.01)and FINS(r =0.907,P ＜0.01).Conclusion T2DM with hypertriglyceridemia increased insulin resistance.