Objective To observe the changes of systolic time interval after neonatal asphyxia and explore its relationship with clinical manifestation and prognosis. Methods Tow-dimensional and Doppler echocardiography were employed to detect tow - dimension parameters and left and right ventricular STI in 27 mild and 18 severe asphyxiated neonates as well as 14 normal controls and its relationship with clinical manifestation and prognosis was analyzed. Results There was no difference in cavity and thickness of heart and great arteries between normal and asphyxiated neonates. In acute stage mild and severe asphyxiated neonates had a shorter right ventricular ejection time (RVET) than normal neonates and a longer right ventricular prejection period (RPEP) was found in severe neonates than that in normal and mild asphyxiated neonates. Left ventricular preejection time (LPEP) was prolonged in comparison with normal neonates in acute stage and convalescence. There were more cases with increased RPEP/RVET in severe asphyxiaed group than those in mild and normal group in acute stage. The incidence of heart failure in acute stage and disability in late period was higher in cases with increased RPEP/RVET than that with normal RPEP/RVET. Conclusion Asphyxia has more severe damage to right ventricle than that to left ventricle. Cases with increased RPEP/RVET are prone to suffering from heart failure in acute stage and more likely to undergo disability in late period.

OBJECTIVETo investigate the best choice of operation opportunity and operation plan for limb fractures combined with severe craniocerebral trauma in children.

METHODSFrom January 2005 to July 2012,36 patients with limb fractures and severe craniocerebral trauma were received,including 24 males and 12 females aged from 1 to 13 years old (mean, 6.1 +/- 3.0). The time from injury to hospital was (18.0 +/- 15.0) h. Glasgow coma score were less than 8 with an average of 6.4 +/- 1.3. AIS-ISS score were 25.9 +/- 8.1. Thirteen patients were open fracture, 23 were closed fracture. Patients were divided into immediate operation group (21 patients) received fracture fixation with 24 h, the average time was (15.0 +/- 7.4) h, and delayed operation group (15 patients) received fracture fixation after 24 h, the average time was (165.4 +/- 114.6) h. All patients were treated by open reduction, and 33 cases by internal fixation, 3 cases were external fixation. Operative time, blood loss, fracture healing time and brain trauma,physical trauma, postoperative rehabilitation situation were observed and evaluated.

RESULTSAll patients were healed at stage I ,and no dead, aggravating of coma, disorders of breathing and circulation occurred during operation. Operative time,blood loss,healing time in immediate operation group was (44.5 +/- 25.3) min, (47.1 +/- 36.5) ml, (2.7 +/- 0.5) months, respectively; while in delayed operation group was (87.0 +/- 40.0) min, (112.7 +/- 67.5) ml, (3.8 +/- 1.2) months,respectively; and there were obvious differences between two groups. There was no siginificant meaning in Glasgow coma score and Fugl-Meyer motor function between immediate operation group (4.7 +/- 0.6, 97.9 +/- 2.7) and delayed operation group (4.7 +/- 0.5, 97.7 +/- 3.9) (t = 0.23, P > 0.05; t = 0.11, P > 0.05).

CONCLUSIONThe condition of limb fractures combined with severe craniocerebral trauma in children is seriously, comfortable surgical opportunity should according to particular case, and immediate operation can performed on the condition of stabled vital signs.

Adolescent ; Child ; Child, Preschool ; Craniocerebral Trauma ; surgery ; Extremities ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation ; Fracture Fixation, Internal ; Fractures, Open ; surgery ; Humans ; Infant ; Male

6.24 mmol/L) and sixty healthy persons in the health center of our hospital were investigated as hyperhpidemia group (Hyperlipidemias) and control group (Controls) respectively.Hyperlipidemias were given simvastatin 20 mg?d~(-1) for twelve weeks (Statins).Blood samples of ulnar vein were extracted from Statins at the end of twelve weeks as well as Controls and Hyperhpidemias at the beginning of the experiment. Blood serum,plasma and mononuclearcell were extracted and stored at a refrigerator of-80℃.The level of plasma angiotensinⅡwas detected by the method of radioimmunity.While the expression of RANTES mRNA and protein on mononuclearcell were assessed by real time reverse transcription polymerse chain reaction and Western blot respectively.Results①The plasma angiotensinⅡof Hyperlipidemias was higher than that of Controls [(92.13?22.03) vs (50.85?12.12),P

BACKGROUNDThe microemboli produced during spontaneous plaque rupture and ulceration and during coronary intervention will reduce coronary reserve and cause cardiac dysfunction. It is though that inflammation caused by the microinfarction induced by the microembolization may play an essential role. It is known that the activation of p38 mitogen-activated protein kinases (MAPK) in both infected and non-infected inflammation in myocardium may cause a contractile dysfunction. But the relation between the activation of p38 MAPK and microembolization is still unknown.

METHODSSprague-Dawley rats were randomly divided into three groups: Sham group, coronary microembolization (CME) group and SB203580 group (n = 10 per group). CME rats were produced by injection of 42 µm microspheres into the left ventricle with occlusion of the ascending aorta. SB203580, a p38 MAPK inhibitor, was injected into the femoral vein after the injection of microspheres to make the SB203580 group. Left ventricular ejection fraction (LVEF) was determined by echocardiography. The protein concentration of P38 MAPK in the myocardium was assessed by Western blotting. The relative expression of mRNA for tumor necrosis factor (TNF)-α was assessed by the technique of semi-quantitative polymerase chain reaction amplification.

RESULTSLVEF was depressed at three hours up to 12 hours in the CME group. Increased p38 MAPK activity and TNF-α mRNA expression were observed in the CME group. The administration of SB203580 partly inhibited p38 MAPK activity, but did not fully depress the TNF-α expression, and partly preserved cardiac contractile function.

CONCLUSIONSp38 MAPK is significantly activated by CME and the inhibition of p38 MAPK can partly depress the TNF-α expression and preserve cardiac contractile function.

Animals ; Blotting, Western ; Coronary Disease ; drug therapy ; etiology ; metabolism ; Echocardiography ; Embolism ; complications ; Imidazoles ; pharmacology ; therapeutic use ; Immunohistochemistry ; Microcirculation ; drug effects ; Myocardial Contraction ; drug effects ; physiology ; Myocardium ; metabolism ; Pyridines ; pharmacology ; therapeutic use ; Random Allocation ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha ; genetics ; p38 Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; metabolism

Objective To evaluate the clinical efficacy of detachable balloons,detachable coils and intracranial covered stents in management of intracranial giant aneurysms.Methods From April 1998 to March 2006,20 patients with a giant or very large aneurysm were treated by parent artery occlusion(PAO), coils embolization and covered stent,in which 9 aneurysms were treated by PAO,8 by coils embolization and 3 by covered stent at initial management.Two recurrent aneurysms treated by coils embolization were performed by covered stent.Follow-up 9-83 months,mean 41.1?25.3 months.Immediate postprocedural angiographic outcomes were categorized as complete occlusion(100%),subtotal occlusion(95%-99%),and incomplete occlusion(＜95%)of the aneurysms;and follow-up angiographic outcomes were categorized as stable, thrombosis,and recanalization.Clinical outcomes were graded according to a modified Glasgow Outcome Scale (GOS).Results Endovascular treatment was technically feasible in all aneurysms without procedural-related complications.Immediate postprocedural angiograms showed complete occlusion was achieved in 11 aneurysms, subtotal occlusion in 7 and incomplete occlusion in 2.One patient with incomplete occlusion died on the seventh day with a rebleeding.The final angiographic findings in nineteen survival patients confirmed a complete occlusion in 15 aneurysms,subtotal occlusion in 3 and incomplete occlusion in 1,in which 10 parent arteries were successfully preserved.No rebleeding occurred during the follow-up period.The clinical evaluation performed at final follow-up in 19 patients revealed that the symptoms disappeared in 11 patients and improved in 8 in the modified GOS.Conclusions Treatment of giant intracranial aneurysms with coiling was associated with a low complete occlusion rate and a high recanalization rate.Treatment with endovascular parent artery occlusion remains practical,but this technique may result in damage to the parent artery and cause cerebral ischemic events.The use of an intracranial covered stent proved to be a relatively simple and safe procedure and maintained the pateney of the parent artery.

Objective:To explore the role of sympathetic adrenal medulla system,vascular endothelial function and renin-angiotensin-aldosterone system (RAAS)in the pathogenesis of hypertension caused by obstructive sleep apnea hypopnea syndrome (OSAHS).Methods:A total of 42 OSAHS patients with hypertension (OSAHS + hypertension group)were selected,and they received continuous positive airway pressure (CPAP)treatment for six months.An-other 50 OSAHS patients without hypertension and no received CPAP treatment were regarded as pure OSAHS group.Levels of norepinephrine (NE),24h urine vanillyl mandalic acid (VMA),nitric oxide (NO),endothelin-1 (ET-1),angiotensin Ⅱ (AngII)and aldosterone before and after treatment were compared in OSAHS + hyperten-sion group,and they were compared with those of pure OSAHS group.Results:① Compared with pure OSAHS group and before treatment in OSAHS + hypertension group,there were significant rise in levels of NE [(3.0± 1.4)ng/ml vs.(4.1± 1.7)ng/ml,(3.7 ± 1.5)ng/ml],ET-1 [(56.7 ± 12.6)pg/ml vs.(66.3 ± 14.7)pg/ml, (63.2±13.8)pg/ml],AngⅡ [(38.2±6.7)pg/ml vs.(45.7±8.5)pg/ml,(42.1 ±7.6)pg/ml]and aldosterone [(148±12)ng/L vs.(162±16)ng/L,(154±15)ng/L],and significant reduction in NO level [(63.7±11.8)μmol/L vs.(56.2 ±8.4)μmol/L,(59.1 ±9.3)μmol/L]after treatment in OSAHS + hypertension group,P <0.05 or <0.01,but there was no significant difference in 24h urine VMA level,P >0.05 both;②Compared with before treatment,there were significant reductions in levels of NE,ET-1 and AngII after treatment in OSAHS +hypertension group (P <0.05 or <0.01),but there were no significant difference in levels of 24h urine VMA,NO and aldosterone,P >0.05 all.Conclusion:Sympathetic adrenal medulla system,renin-angiotensin-aldosterone sys-tem and vascular endothelial function may be involved in incidence of hypertension in OSAHS patients.

OBJECTIVETo investigate the kinetic expression and alteration of nuclear transcription factor-kappa B (NF-kappaB) and its gene in hepatocellular carcinoma (HCC) development.

METHODSA hepatoma model was established with N-(2-fluorenyl) acetamide (2-FAA) using male SD rats. Morphological changes and dynamic alterations of NF-kappaB and NF-kappaB mRNA of the rat livers at different stages of HCC development were observed by pathological examinations. The liver specimens from HCC patients were collected by self-control method. The expression of NF-kappaB was quantitatively analyzed by ELISA.

RESULTSHepatocytes showed vacuole-like denaturation, atypical hyperplasia, and transformation into highly differentiated cancerous hepatocytes with increasing tendencies of liver NF-kappaB and NF-kappaB mRNA expressions. The NF-kappaB positive material was granule-like and stained brown, with dot-nest-like staining localized in the nuclei and cytoplasm of HCC cells, but only in the cytoplasm of the cells of park cancer tissues. Its expression in HCC cells was stronger than that in their surrounding tissues (chi2 = 13.1, P less than 0.01). No positive relationship was found between NF-kappaB expression and histological grades, the number of tumors, or size of the tumors.

CONCLUSIONThe expression of NF-kappaB and its gene are associated with the development of HCC. To inhibit the expression may be useful to HCC therapy.

Adult ; Aged ; Animals ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Female ; Humans ; Liver Neoplasms, Experimental ; metabolism ; pathology ; Male ; Middle Aged ; NF-kappa B ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore the low-risk indicators of early cervical cancer.

METHODSThe medical records of 201 patients undergoing radical surgery between March 2000 and April 2011 for staging Ia2,Ib1 (tumor diameter≤2cm) cervix cancer were retrospectively reviewed, with particular focus on the pathological findings [parametrial involvement, positive margin, positive pelvic lymph node, and lymph vascular space invasion (LVSI)], treatment, and outcomes.

RESULTSThe operation duration ranged 75-330min (mean:188.87 min) and the intra-operative blood loss was approximately 100-2500 ml (mean: 583.33 ml). Pathology showed the rate of parametrial spread, positive margins, lymph node metastasis, LVSI was 0, 6.97%, 12.44%, and 17.41%. Based on the pathologic findings, the patients were classified as two groups: group A had 147 patients(73.13%) with no neoplasm or tumor diameter ≤2 cm,while group B had 54 patients (26.87%) with tumor diameter > 2 cm. The incidence of ≥ 1/2 cervical stromal invasion, LVSI, positive lymph node, underlying section of uterus involvement, and low tumor differentiation in group A and B were 20.14% vs. 85.19% (p = 0.000), 13.61% vs. 27.78%(p = 0.019), 9.52% vs. 20.37% (p=0.039), 4.82% vs. 14.81% (p=0.008), and 35.37% vs. 44.44% (p=0.025), respectively, with significant differences. Among the 163 patients who were followed up for more than 3 months, 10(6.13%) developed recurrence whereas no patient died.

CONCLUSIONSPathologic parametrial involvement in clinical stage 1a2 and 1b1 cervical cancer is uncommon. Tumor size and cervical stromal invasion can be used to identify low-risk population that are worthy of consideration for studies of less radical surgery performed in conjunction with pelvic lymphadenectomy.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors ; Uterine Cervical Neoplasms ; pathology ; surgery

OBJECTIVETo observe the evolution and differentiation of hepatic oval cells after transplanted into the spleens of homogenous rats, providing experimental data for treating hepatic failure with hepatic stem cells.

METHODSA two-step perfusion procedure was used to separate hepatic parenchymal cells from nonparenchymal cells. Then the suspension of nonparenchymal cells was centrifuged in Percoll gradients. The isolated cells were cultured, identified, and then transplanted into the spleens of homogenous rats undergone 2/3 hepatectomy.

RESULTSThe obtained cells were various in size with ovoid nuclei and inadequate cytoplasm. After 12 hours' culture, they revealed the characteristics of epithelial cells. Both the freshly isolated and cultured cells showed positive staining for cytokeratin 19 (CK19), OV6, alpha fetal protein (AFP), but negative for leucocyte common antigen (LCA). After intraspleenic transplantation into homogenous rats undergone partial hepatectomy, hepatic oval cells were differentiated into liver tissue-like structure including hepatocyte cords and bile ducts, and formed hepaticized spleen. But this kind of structure was not observed in the controls.

CONCLUSIONThe isolated rat hepatic oval cells show the biological characteristics of hepatic stem cells and can differentiate into hepatocytes and biliary epithelial cells under appropriate circumstances.

Animals ; Antigens, Differentiation ; analysis ; Cell Differentiation ; Cell Separation ; Cell Transplantation ; pathology ; Cells, Cultured ; Hepatectomy ; methods ; Hepatocytes ; drug effects ; physiology ; ultrastructure ; Liver ; cytology ; growth & development ; Liver Transplantation ; methods ; Male ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Spleen ; surgery ; Stem Cells ; drug effects ; physiology ; ultrastructure

Objective To summarize our experience on the food safety for residents and disaster relief workers in Li county after Wenchuan earthquake in Sichuan province.Methods A comprehensive survey was conducted to assess the current food hygiene status.According to the survey results,we had integrated the local forces and strengthened the food hygiene surveillance and quality detection focusing on the crucial procedures.Besides,effective health educations were applied to advocate the rational dietary after earthquake.Results There was no any food safety incident in the county,and the hygiene awareness of local residents has been improved.Conclusion Powerful organization,focused management and multi-collaboration are the important elements to accomplish the food safety control after earthquake.