For the purpose of determining the time of death,the life history (the growth and development) and the sum of effective temperature of Lucilia Sericata were studied under the ordinary temperature. On the bases of the growth and development of the fly ,we have established three linear regression equations between the sum of effective temperature and the length of larvae or weigth pupa of Lucilia Sericata (K 1=2 0880+0 8014X 1、K 2=54 0917-2 8814X 2、K 3=133 2180-2 6312X 3).These linear regression equations provide a reliable,scientific method for estimating the time of death in forensic medicine practice.

OBJECTIVE:To evaluate the quality of the methodology of clinical research on Yinzhihuang injection in the treatment of icteruc virus hepatitis.METHODS:The methodology quality of77pertinent literatures was evaluated and analyzed according to the quality assessment criteria in the evaluation manual of Cochrane Reviewer's Handbook 4.2.2.RESULTS:Only 4 literatures were up to the related standards,2 of which were randomized controlled trials(RCT)and other 2 were semi-randomized controlled trials(CCT).All of the 4 studies were low quality(Grade C)researches,in which the biases on selectivity,practice,measurement and wastage were highly possible.CONCLUSION:More randomized controlled trials of high quality are needed to obtain reliable evidences on Yinzhihuang injection in the treatment of icteric virus hepatitis.

BACKGROUND:Previous studies have shown that basic fibroblast growth factor (bFGF) can enhance fat survival rate by promoting vessel regeneration of transplanted fat.However,there is no clear conclusion addressing its effects on adipocytes.OBJECTIVE:To investigate the effect of bFGF on the proliferation and differentiation of human preadipocytes.DESIGN,TIME AND SETTING:Cytological in vitro comparison observation was conducted at the Medical College of Chinese People's Armed Police Force from March 2006 to December 2007.MATERIALS:Totally 10 samples of adipose tissue from patients undergoing abdominal liposuction were used in this study,including 1 male and 9 females,aged 21-45 years.METHODS:The human preadipocytes were obtained from human abdominal fat particles by isolation,culture and natural purity.The experiment was divided into bFGF and control groups.Cells in the control group were incubated in DMEM.Cells in the bFGF group were incubated in DMEM supplemented with 100 ng/L bFGF.MAIN OUTCOME MEASURES:Morphology of cultured cells was studied to determine the growth curve at 0,3,6,9,12,15 days following culture by inverted phase contrast microscope.Fat aggregation was observed in cells using oil red O staining.Absorbance value was examined using enzyme-linked immunosorbent assay.RESULTS:The preadipocytes represented the spindle-like character with strong proliferation.During 1 to 15 days,the preadipocytes proliferated into monolayers.Some cells became single bubble cells with lipid droplets deposited,close to maturity.The cells in bFGF group had no significant differences with the control group in cell morphology,but the amount of cells in bFGF group was 44% more than the control group.Following oil red O staining,lipid droplet was found in the preadipocytes,showing dark red.Following 15 days of incubation,the concentration of lipid droplet reached a peak.The absorbanca of bFGF group was increased 300% compared with the control group (P ＜ 0.05).CONCLUSION:The bFGF not only promote the proliferation of human preadipocytes,but also induce the differentiation of preadipocytes into mature adipocytes.

Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and epidural adhesion.Methods Fifty-three cases of thoracic OLF from January 2003 to December 2009 were reviewed retrospectively.All patients were treated by the methods of en bloc resection of semi-facet and lamina.All patients were followed up for more than half an year,including 32 males and 21 females,aged from 43 to 73 years(average 54.7 years).The lesions located in upper thoracic for 18 patients,and in thoracolumbar for 35 patients.For multi-level or jumping OLF patients,the responsible levels were determined by combination of images and clinical symptoms.For multi-level OLF with ossification of posterior longitudinal ligament(OPLL)or thoracic kyphosis(＞50°),multi-level pedicle screw fixation and correction of kyphosis were performed.For dural adhesion patients,part of cerebrospinal fluid was released with a caudal incision of dural sac resulting in collapse and epidural arachnoid separation.Ossific and adhesion dura mater were removed with integrity of arachnoid.The surgical outcomes were evaluated with preoperative and postoperative thoracic Japanese Orthopaedic Association(JOA)score,Nurick grade and neurologic functional recovery ratio.Results Fifty-three cases were followed up for 6 months to 6 years,with an average of 18 months.The average preoperative JOA score was 4.3±2.3,which significantly increased to 8.3±1.8 after operation.Postoperative neurologic functional recovery rates were 11% to 80%(average 65.8%),including excellent in 18 cases,good in 20,fair in 10,and poor in 5.The excellent or good rate was 71.7%.The mean preoperative Nurick grade was 3.7(2-5 grade)and decreased to 2.3 grade after operation.Conclusion En bloc resection of semi-facet and lamina is a safe and effective method for treatment of thoracic OLF.For the patients with OPLL or kyphosis,pedicle screws fixation and kyphosis correction was beneficial for recovery of neurologic function of thoracic OLF patients.

Objective To evaluate the long-term results of minimal incision osteotomy for hallux valgus.Methods From February 1996 to May 1999,372 cases(705 feet)with hallux valgus were treated with minimal incision osteotomy.Seventy-nine cases after surgery were followed up for more than 5 years,including 6 males(10 feet)and 73 females(140 feet)with an average age of 47 years(range,13-75 years).The average follow-up time was 7.5 years(range,5.3-13.2 years).The preoperative and postoperative hallux valgus angles(HVA),intermetatarsal angles(IMA),the tibial sesamoid position(TSP),American orthopedic foot and ankle society(AOFAS)score,range of movement of the first metatarsophalangeal joint,and lateral metatarsalgia etc.were observed and measured.And the clinic outcome were studied and evaluated.Results Based on Wen Jian-min's clinic curative effect evaluation criterion(2001),56 feet(37.3%)were excellent,88 feet(58.7%)good ,6 feet(4.0%)fair.The rate of excellent or good was 96.0%(144/150).The postoperative mean AOFAS score was 84.20±4.32 points(range,60-100 points).The mean HVA decreased from 33.28 to 12.31 degrees,the mean IMA from 11.75 to 6.80 degrees.The TSP was corrected from an average preoperative grade of 4.29 to a grade of 3.07 at final follow-up.There are no nonunion or delayed union of osteotomy,avascular necrosis of the 1st metatarsal head,infection,hallux varus.Four feet(2.7%)had numbness in the medial of the big toe.The 1st metatarsophalangeal joint range of motion decreased from 70.20 to 69.53 degrees.There were 97 feet(64.7%)with the 2-5 metatarsalgia before operation,and 35 feet(23.3%)disappeared,54 feet(36.0%)improved,8 feet(5.3%)aggravated after operation.Conclusion Minimal incision osteotomy technique is sound and reliable method to treat hallux valgus.The osteotomy technique is simple,and could provide satisfactory long-term results with lower complication rate.

OBJECTIVETo investigate long-term efficacy and safety of ambrisentan monotherapy in patients with pulmonary arterial hypertension (PAH).

METHODSPatients with PAH who received 2.5 mg or 5 mg of ambrisentan once daily between July 10, 2011 and August 30, 2012 for at least 6 months were enrolled. The efficacy endpoints were change in exercise capacity, World Health Organization (WHO) functional class and N-terminal pro-brain natriuretic peptide (NT-proBNP) level, echocardiographic parameters. The safety endpoint was the safety of long-term ambrisentan administration, as defined by the incidence and severity of adverse events.

RESULTSA total of 18 patients with PAH were enrolled. Mean age was (39 ± 17) years, 8 (55.6%) were female, and 11 (61.1%) patients were in WHO functional class III. The median duration of treatment was 17 months (range: 6-26 months). After treatment, the 6MWD was significantly increased[ (495 ± 97) m vs. (400 ± 91) m, P < 0.001], NT-proBNP was significantly reduced [308 (53-1 645) ng/L vs. 80(22-454) ng/L, P = 0.005], the systolic pulmonary artery was significantly decreased [(62 ± 30) mmHg vs. (82 ± 41) mmHg, P = 0.001] and left ventricular end diastolic diameter was significantly increased [(44 ± 6) mm vs. (40 ± 6) mm, P < 0.004] compared to pre-treatment. WHO functional class was improved compared with baseline in 11(61.1%) patients, stable in 7(38.9%) patients. No patient died during the treatment period. No patient was withdrawn from this study for safety reasons.

CONCLUSIONSLong-term treatment of ambrisentan can effectively improve the exercise capacity, reduce systolic pulmonary artery pressure and NT-proBNP in PAH patients. Ambrisentan is safe and well tolerated in Chinese PAH patients.

Adult ; Blood Pressure ; Female ; Humans ; Hypertension, Pulmonary ; drug therapy ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; metabolism ; Peptide Fragments ; metabolism ; Phenylpropionates ; therapeutic use ; Pyridazines ; therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the baseline clinical characteristics of patients with pulmonary arterial hypertension after operation for congenital heart disease (AO-CHD-PAH) in China.

METHODSA total of 122 consecutive patients diagnosed as AO-CHD-PAH in Shanghai Pulmonary Hospital from September 1, 2006 to August 31, 2011 were retrospective analyzed.

RESULTSSixty-seven percent patients were female. The median age at procedure and diagnosis were 14.8 and 24.8 years old, respectively. The median duration from procedure of CHD to diagnosis of PAH was 7.3 years. The most frequent initial symptom (109/122, 89.3%) attributed to PAH was dyspnea on exertion. The frequent sign was accentuation of second heart sound on pulmonary valve area (113/122, 92.6%).Incidence of WHO functional PAH classes I/II was 53.3% (65/122) and mean 6 minutes walk distance was limited to (408.4 ± 103.3) m. Borg dyspnea score was 2.0 (1.0, 3.0).Right heart catheterization demonstrated severe elevated mean pulmonary arterial pressure [(71.6 ± 24.2) mmHg, 1 mmHg = 0.133 kPa] and pulmonary vascular resistance index [(29.1 ± 16.0) Wood U·m(2)] in this patient cohort. Cardiac index was (2.7 ± 0.9) L·min(-1)·m(-2), 90.2% (110/122) patients received PAH-specific therapy. The majority of PAH-specific therapy was phosphodiesterase type 5 inhibitor, which is somehow different from PAH-specific therapy regimen of American-European developed countries.

CONCLUSIONSPAH-specific therapy rate is satisfactory for pulmonary arterial hypertension after operation for congenital heart disease in China and phosphodiesterase type 5 inhibitors are predominant PAH-specific medication in China.

Adolescent ; Adult ; Child ; China ; Female ; Heart Defects, Congenital ; surgery ; Humans ; Hypertension, Pulmonary ; etiology ; Male ; Postoperative Complications ; Retrospective Studies ; Young Adult

OBJECTIVETo compare the clinical characteristics and survival on Chinese patients with idiopathic pulmonary arterial hypertension (IPAH) and familiar pulmonary arterial hypertension (FPAH) during conventional therapy era and targeted therapy era.

METHODSIPAH and FPAH patients who were referred between Jan 1999 and Oct 2004 in Fuwai Hospital were defined as conventional therapy era group (before 2005 no PAH-specific drug was available in China). All patients in this group were followed up till Jun 2005. IPAH and FPAH patients who were referred between Sep 2006 and Aug 2011 were defined as targeted therapy era group (new PAH-specific drugs were available in China since 2006) were analyzed. All patients in this group were followed up till Dec 2013. The primary endpoints were death and therapy medicine.

RESULTSSeventy-two patients were enrolled in conventional therapy era group, 375 were enrolled in targeted therapy era group. The mean age was (35.9 ± 12.2) years and (34.5 ± 17.4) years respectively (P = 0.67), and women was predominant in both groups. There was no difference in WHO functional class and hemodynamic data between the two groups. About 90.3% patients were treated by calcium-channel blockers (CCB) in conventional therapy era group. In targeted therapy era group, almost all patients were treated by at least one PAH-specific drug, only 3.2% patients who had a positive response to acute pulmonary vasodilator testing were treated by CCB. The median survival time was 30.4 months in conventional therapy era group and 66.2 months in targeted therapy era group. The 1-, 2-, 3- and 5- year survival rates of IPAH and FPAH patients were 68.0%, 56.9%, 38.9% and 20.8% in conventional therapy era group, and 89.3%, 78.1%, 68.2% and 53.7% in targeted therapy era group respectively (P < 0.000 1).

CONCLUSIONCompared with conventional therapy era, the survival rate of Chinese IPAH and FPAH patients is significantly improved in targeted therapy era.

Adult ; Aged ; China ; epidemiology ; Familial Primary Pulmonary Hypertension ; epidemiology ; therapy ; Female ; Follow-Up Studies ; Humans ; Hypertension, Pulmonary ; epidemiology ; therapy ; Male ; Middle Aged ; Survival Rate ; Young Adult

AIM: To observe the effects of rapamycin pregnancy intervention on cognitive function of autism model in rat offspring. METHODS: Fourteen pregnant rats were randomly divided into normal group (n = 3), model group (n = 4), rapamycin (RAPA) control group (n =3) and intervention group (n = 4). The model group and intervention group were i.p. injected with sodium valproate 600 mg/kg at embryonic day (E) 12.5 to establish autism model in rat offspring. RAPA control group and intervention group were i.g. given RAPA 4 mg/kg every day from the 13th day of gestation until the offspring rats were weaned at 23 days. After the birth of the above four groups of pregnant rats, 15, 27, 21 and 26 offspring male rats were selected to conduct behavioral tests to identify the model. Then, paw withdrawal mechanical threshold (PWMT), tail flick latency (TFL) evoked under different light intensity and learning and memory function of offspring rats were further detected. RESULTS: Rat offspring in the model group had lower growth and development indexes and exploratory behavior ability, but stronger repetitive stereotyped behavior compared with the normal group (P < 0.05), while the indexes between the intervention group and model group were reversed (P < 0.05). The model group had higher PWMT than normal group (P < 0.01) and the PWMT of intervention group was lower than that of model group (P < 0.01). The TFLs of rats in 4 groups showed a timed dose-response relationship (TDRR, P < 0.01), that is, TFLs were shortened with the increase of light intensity. The TDRR curve of model group shifted to right compared with normal group (P < 0.01) and intervention group shifted to left compared with model group (P < 0.01). At the light intensity of Focus 34, 51 and 76, the TFLs of model group were longer than those of normal group (P < 0.01) and intervention group had shorter TFLs compared with model group (P<0.01). In spatial probing trial of Morris water maze test, the platform crossover number in model group was less than that in normal group (P<0.01) and that in intervention group was more than model group (P < 0.05). CONCLUSION: RAPA intervention during pregnancy may alleviate behavior disorder, pain tolerance and memory function of autism model in rat offspring to some extent.