OBJECTIVE:To investigate the clinical efficacy and safety of alprostadil in the treatment of heart failure in pa-tients with normal left ventricular ejection fraction (LVEF). METHODS:120 patients diagnosed as heart farlture with normal LVEF were divided into observation group and control group by radom number table method,with 60 cases in each group. Control group was given symptomatic treatment;observation group was additionally treated with Alprostadil dried emulsion for injection 10μg,bid,on the basis of control group. Both groups received treatment for 5 d. The cardiac function indexes,serum inflammatory factors and oxidative stress indexes were observed in 2 groups before and after treatment,and the occurrence of ADR was com-pared between 2 groups. RESULTS:Before treatment,there was no statistical significance in cardiac function indexes,serum in-flammatory factors and oxidative stress indexes between 2 groups (P>0.05). After treatment,above indexes of 2 groups were all improved significantly,and the observation group was significantly better than the control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Alprostadil can improve cardiac function of patients with heart failure of normal LVEF,improve serum inflammatory factors and oxidative stress level with good safety.

Objective To investigate the changes of gamma-aminobutyric acid (GABA) in the anterior cingulate cortex of perimenopausal women with depression.Methods Forty perimenopausal women as the experimental group and ten healthy women as the control group were recruited and followed up for 18 to 24 months.The proton magnetic resonance spectroscopy (1H-MRS) was used to acquire the concentrations of GABA in the anterior cingulate cortex.The experimental group was examined before and after menopause.The control group was examined before into the group and after out of the group.The experimental group after menopause was further divided into the anxiety group and the depression group according to the Classification and Diagnostic Criteria of Mental Disorders in China-Third Edition (CCMD-3), 14-item Hamilton Anxiety Scale (HAMA-14) and 17-item Hamilton Depression Scale (HAMD-17).The data of three groups were compared respectively.Results The results showed that the concentrations of GABA after menopause in both of the anxiety group and depression group were significantly lower (P<0.05) than those before menopause, and were also significantly lower (P<0.05) than those in the control group.The concentrations of GABA after menopause in the depression group were significantly lower(P<0.05) than those in the anxiety group.Conclusion The changes of GABA in the anterior cingulate cortex are related with the pathophysiology mechanism of perimenopausal depression and the symptoms of perimenopausal depression.

OBJECTIVETo classify the patients with cleft lip and palate who need orthognathic surgery and to propose the corresponding operations.

METHODSFrom January 2005 to May 2015, 121 patients with cleft lip and palate diagnosed as maxillary retrusion were treated by orthognathic surgery. Inclusion criteriar: (1) male aged over 16, female aged over 14; (2) diagnosed as non-syndromic cleft lip and palate without systemic disease and other genetic diseases; (3) without previous orthodontic and orthognathic treatment; (4) having no other craniofacial malformation. Maxillary features and repaired types were recorded.

RESULTS93 patients were included and divided into two categories depended on the dental crowding. Class I: the teeth quantity and bone quantity is coordinated, space analysis ≤ 4 mm (mild dental crowding). The forward distance of maxillary less than 6 mm was defined as Class I a (36 cases) more than 6 mm as Class I b (28 cases). Class II: the teeth quantity and bone quantity is not coordinated, space analysis > 4 mm ( moderate or severe dental crowding). After the simulation of distraction osteogenesis, the anterior crossbite was corrected defined as Class II a (23 cases), not corrected defined as Class II b (6 cases). Class I a were corrected by conventional orthognathic surgery. While Class I b were corrected by Le Fort I maxillary advancement using distraction osteogenesis. Class II a were repaired just by anterior maxillary distraction. While Class II b need to combine conventional orthognathic surgery with anterior maxillary distraction. All the patients were satisfied with the treatment effect.

CONCLUSIONSThe patients of cleft lip and palate with maxillary retrusion who need orthognathic surgery can be classified as the method mentioned above, and then choose the appropriate operations.

Adolescent ; Adult ; Cleft Lip ; complications ; Cleft Palate ; complications ; Female ; Humans ; Male ; Maxilla ; Osteogenesis, Distraction ; Osteotomy, Le Fort ; Retrognathia ; classification ; surgery

Objective: To explore the mediating effect of hemoglobin (Hb) and hematocrit (HCT) on the association between alcohol consumption and blood pressure, and provide evidence for the prevention and control of alcohol-attributed hypertension. Methods: 1 091 male (age >50 years old) participants with drinking habit were selected from the Guangzhou biobank cohort study (GBCS). Mediation analysis was used to evaluate the mediating effect of Hb and HCT on the association of alcohol consumption (unit/day) with systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure(PP) and mean arterial pressure (MAP). Results: After adjusting for age, body mass index, education level, personal annual income, smoking, occupation and physical activity, the associations of alcohol consumption with SBP, DBP, PP and MAP were partly mediated by Hb, the proportion of mediating effect was 11.8% (95%CI 4.8%-24.7%), 15.3% (95%CI 6.5%-32.0%), 8.4% (95%CI 2.2%-22.5%) and 13.5% (95%CI 5.9%-27.5%), respectively. The associations of alcohol consumption with SBP, DBP, and MAP were also partly mediated by HCT, the proportion of mediating effect was 6.3% (95%CI 1.0%-16.0%), 8.7% (95%CI 1.4%-21.4%), and 7.5% (95%CI 1.0%-18.6%), respectively. Conclusion There is a significant mediating effect of Hb and HCT on the association between alcohol consumption and blood pressure. Besides efforts on alcohol control, the potential effects of alcohol-induced increase on Hb and HCT, which might also increase the blood pressure, need to be considered to achieve optimal monitoring and prevention of alcohol-related hypertension.

OBJECTIVETo investigate the endovascular treatments for the ruptured aneurysms located at anterior communicating artery complex (ACoAC).

METHODSThe data of patients with ruptured ACoAC aneurysms treated in Department of Neurosurgery, First Affiliated Hospital to Fourth Military Medical University from May 2013 to December 2014 was retrospectively analyzed. Sixty-six cases were recruited including 50 male and 16 female patients. The patients aged from 31 to 69 years old, averaging (51±8) years. The Hunt-Hess grade at admission were 13 cases with grade Ⅰ, 36 cases with grade Ⅱ, 11 cases with grade Ⅲ, and 6 cases with grade Ⅳ. The most diameter of aneurysms sac: 14 cases less than or equal to 3 mm, 36 cases more than 3 mm but less than or equal to 7 mm, and 16 cases more than 7 mm. The height diameter/neck width ratio: 8 cases with absolute wide neck, 50 cases with relatively wide neck, and 8 cases with narrow neck. There were 28 cases underwent single micro-catheter embolization, 18 cases underwent double micro-catheters embolization, 14 cases underwent stent-assisted embolization and 6 cases underwent balloon-assisted embolization. The patients were followed up for 6 to 12 months and evaluated by modified Rankin score (mRS) and digital subtraction angiography (DSA). The ratio of total embolization, recurrence rate, and time from operation to reexamination of four groups managed by different endovascular treatment were compared by χ(2) test or F test.

RESULTSSixty cases were totally embolized, 3 cases subtotally embolized, 3 cases incompletely embolized. Mild hemiparalysis and aphasia occurred in 2 cases, and 1 case died of infarction induced by subarachnoid haemorrhage. The mRS at six months after operation were 0 in 31 cases, 1 in 22 cases, 2 in 8 cases, 3 in 2 cases, 4 in 2 cases, 6 in 1 case. All the included cases reexamined the DSA at averaging (7.5±1.0) month post-operatively and 4 cases recurred. There were not significant differences of the ratio of total embolization, recurrence rate, time from operation to reexamination among four groups (all P>0.05).

CONCLUSIONThe endovascular treatment maybe an ideal management for ruptured ACoAC aneurysms.

Adult ; Aged ; Aneurysm, Ruptured ; therapy ; Catheters ; Embolization, Therapeutic ; Female ; Humans ; Intracranial Aneurysm ; therapy ; Male ; Middle Aged ; Postoperative Period ; Recurrence ; Retrospective Studies ; Stents ; Treatment Outcome

Objective To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population.Methods Based on the Guangzhou Biobank Cohort Study (GBCS),28 736 residents aged ≥50 years were included in Guangzhou.Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population.Adjustments on age,smoking,alcohol consumption,physical activity,education level,occupation,district of residence and body mass index etc.,were made.Results The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women,with the prevalence rates of diabetes as 13.1％ and 13.7％ in men and women,respectively.Compared to those with stable body weight,the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend ＜0.01).Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83,95％ CI:1.99-4.02) and women (OR=3.13,95％CI:2.47-3.96).Compared to those who reached the highest weight at age 20,those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes,with OR being 5.32 (95％CI:1.92-14.8) in men and 3.41 (95％CI:2.49-4.67) in women,respectively.Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women.Conclusion Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population.The detrimental effect of obesity on diabetes might become significantly visible in the next decades.

The teaching of radiology in standardized residency training needs a large number of case data to strengthen the subjective understanding and awareness of residents. The database built by residency training bases can meet the needs of teaching to a certain extent, but the conditions of training bases vary across regions, which makes it difficult to achieve homogeneity in the teaching of radiology. This article discusses the application of Eurorad database in the teaching of radiology in standardized residency training. This database is free of charge, reliable, and comprehensive and provides a large number of free reliable cases and images for teaching, covering both common and rare diseases. Moreover, it can also be used to cultivate the English ability and comprehensive quality of residents and help to establish a hierarchical training system for radiology and non-radiology residents, thereby promoting the improvement in the quality of standardized residency training. This article shows the potential value of Eurorad database in the teaching of radiology in standardized residency training, and comparative studies are needed in the future to further prove its effectiveness.