BACKGROUND: Neural behavior is a sensitive parameter for predicting abnormal central nervous growth that is resulted from multiple factors. Therefore this study was designed to explore the influence of hypothermia and cigarette smoke exposure during pregnancy on neural behavioral growth of neonatal rats.OBJECTIVE: To study the influence of hypothermia and cigarette smoke exposure on neural behavioral growth of neonatal rats.DESIGN: Randomized case control study based on experimental animals. SETTING: Obstetric and Gynecological Department , Third Affiliated Hospital of Xinxiang Medical College; Cytobiological Department of Xinxiang Medical College.MATERIALS: Totally 270 healthy unpregnant SD rats were obtained, including 180 males with body mass of 190- 210 g, and 90 female rats with body mass of 225-275 g. Rats were raised with granulated feed and drinking water routinely in room of 25 ℃ with natural sunlight. Male and female rats in estrus were put in the same cage overnight in proportion of 2: 1, pregnancy was confirmed if vaginal bolt was observed the following morning. Totally 160 pregnant rats were obtained and randomly divided into 16 groups that were exposed to hyperthermia, cigarette smoke or their combination and by this way, earlier reflex, learning and memory of neonatal rats were observed after natural delivery,INTERVENTIONS: From the second day of pregnancy, rats in 37 ℃, 41 ℃,42 ℃ hyperthermia combining cigarette group received subcutaneous injection of 1 mL smoke hydrotrope every other day, while rats in 25 ℃ control group and 37 ℃, 41 ℃, 42 ℃ single hyperthemia groupwere given 2.0 mL double distilled water every day for totally 7 times. From the pregnancy of 10 days, pregnant rats were put into incubator, and rats anus temperature should be kept respectively at(37 ±0.5) ℃, (41 ±0.5)℃, (42 ±0.5)℃in the 37 ℃, 41 ℃, 42 ℃ of single hyperthemia groups and the temperature should last for 2.0 minutes; nats of 37 ℃, 41 ℃, 42 ℃hyperthemia combining cigarette group received the same treatment and were divided into four subgroups with the duration of 0. 5, 1.0, 1.5, 2.0 minutes respectively;rats in 25℃ control group were not exposed to hyperthermia. Rats were then singly raised from the pregnancy of 18 days for natural delivery. Pregnant days, number of neonatal rat and death rats were recorded, and visible malformation was observed. The average body masses of each cote of neonatal rats were measured every week. Time of eye-opening, ear-opening, hair-growing and teething were observed for assessing their physical growth. Reflex and sensory function of neonatal rats, such as planar tuning, spatial turning, visual orientation and auditory surprise was observed at 3, 7, 12, 16 days after birth respectively; The mean targeting time of each cote was used as reference for assessing their feflex. Y-lybirinth test was used for assessing learning and memory function of neonatal rats(30 days after birth).MAIN OUTCOME MEASURES: ① Main outcomes: Reflex and sensory, such as planar tuning, spatial turning, visual orientation and auditory surrise. ② Secondary outcomes: Influence of hyperthemia and cigarette exposure on learning memory function of neonatal rats.RESULTS: For hyperthermia group(41C and 42C), targeting time of neonatal rat physical growth(eye-opening, ear-opening, hair-growing and teething) and reflex sensory function(planar tuning, spatial turning, nvisual orientation and auditory surprise), as well as learning and memory(minute) were obviously delayed in contrast with those of the control group and 37 C group(χ2 = 11.34, P ＜0.01 ); meanwhile, longer hyperthermia exposure (1.5 minutes) combined with cigarette smoke had supplementary effect on the above neural behaviors, which was significantly different from that of single hyperthermia group(χ2=10.29, P＜0.01).CONCLUSION: Abnormal neural behavior of neonatal rats, such as growing retardation, learning and memory obstacle could be induced by the combination of longer hyperthemia exposure and cigarette smoke.

Objective To establish the rabbit model of main portal vein VX2 tumor thrombus by using orthotopic implantation and to observe its radiological and pathological features.Methods 24 New Zealand white rabbits were randomly divided into study group (n=16) and control group (n=8).In study group,VX2 tumor tissue fragments were fixed on the inner wall of the main portal vein by using a surgical approach.In control group, autologous muscle fragments were fixed on the inner wall of the main portal vein in the same way.CT examinations were performed in both group on 7 days, 14 days, 21 days and 28 days after the procedure.At each observation point,3 rabbits of the study group were inspected by using digital subtraction angiography (DSA),and then sacrificed for histologic examination.Meanwhile,1 rabbit of the control group was sacrificed for histologic examination after CT scanning.The survival time of the remaining rabbits were recorded.Results Among 16 rabbits of the study group, successful implantations were achieved in 15 rabbits (93.8%).Tumor thrombus formed in the main portal vein successfully for all these 15 rabbits.The mean survival time of the remaining 3 rabbits in the study group was (39.3±2.1) days.The imaging characteristic of tumor thrombus could be demonstrated by CT and DSA examinations.Tumor thrombus and the inner neovascularization were confirmed by histological examination.Conclusion It is feasible to establish an animal model of main portal vein tumor thrombus by orthotopic implantation.The radiological and pathological features of animal model are similar to hepatocellular carcinoma patients with portal vein tumor thrombus.

Subclinical hypothyroidism during pregnancy is associated with some adverse outcomes during maternal pregnancy.The present study investigated thyroid function parameters measured by electroehemiluminescence (ECL) immunoassays in subclinical hypothyroid women treated with levothyroxine (L-T4) during pregnancy.The results showed that in evaluating thyroid function with ECL immunoassays during replacement with L-T4,determination of serum TT4 appears to have a closer correlation with TSH and may better reflect the effìcacy of treatment.

Objective To study the levothyroxine doses and related factors in the treatment of pregnant women with subclinical hypothyroidism (SCH).Methods Fifty-six pregnant women with SCH (diagnosed before 12 weeks of gestation) were recruited and divided into 2 groups according to the baseline TSH levels,SCH group 1 (2.5 mIU/L ≤ TSH ≤ 5.0 mIU/L,n =24) and SCH group 2 (TSH＞5.0 mIU/L,n =32).Thyroid autoantibodies [thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)] were detected.All the subjects were treated with levothyroxine and the doses were adjusted according to the TSH level.The therapeutic target was to keep the TSH levels under control,0.3 to 2.5 mIU/L for the first trimester and 0.3 to 3.0 mIU/L for the second and third trimesters.Results There was a positive correlation between the levothyroxine doses and baseline TSH levels (r =0.533,P＜0.01) in pregnant women with SCH.A significant difference in the levothyroxine doses between SCH group 1 and SCH group 2 was found [(0.583 ± 0.341) vs (0.961 ± 0.405) μg/kg,t =-3.695,P＜ 0.01].The levothyroxine doses in SCH group 2 were 64.84％ higher than those in group 1.There was a significant difference in the levothyroxine doses between thyroid autoantibody negative and positive subjects [(0.680 ± 0.370) vs (0.918 ±0.440) μg/kg,t =-2.197,P =0.032].The levothyroxine doses in thyroid autoantibody positive subjects were 35 ％ higher than those in the negative subjects.In addition,there was a significant difference in the levothyroxine doses between subjects with negative and positive thyroid autoantibody [(0.421 ± 0.192) vs (0.720 ± 0.385)μg/kg,t =-2.331,P =0.029] in SCH group 1.While in SCH group 2,the difference did not reach statistical significance.Conclusion The baseline TSH levels and status of thyroid autoantibodies may affect the levothyroxine dosage in pregnant women with SCH.

Objective To detect the relationship between apical rotation and apical myocardial structure.Methods To observe the change of apical rotation,14 mongrel dogs were heated at apexes,and half and three quarter of apical wall thicknesses were destroyed according to their corresponding heating time.Ultrasonic tissue Doppler imaging was used to record the velocities of apical rotation.Computer programming was applied to calculate apical rotation according to the formulas of apical rotation calculation.Apical rotations were compared between before apical heating,half and three quarter of apical wall thicknesses destruction,respectively.Results Compared with the apical rotation before heating,apical rotation after half of apical wall destroyed decreased [(5.2±3.1)°vs (12.4±2.9)°,P＜0.001];but after three quarter of apical wall destroyed,the apical rotation increased [(7.3±3.6)°vs (5.2±3.1)°P＜0.01].Conclusions Outer part of apical myocardium was outer layer myocardium of which the damage leads to the decrease of apical rotation;inner part of apical myocardium was inner layer myocardium of which the damage leads to the increase of apical rotation to some extent.

Objective To investigate the efficacy and safety of endovascular treatment for subclavian steal syndrome (SSS). Methods During the period from April 2004 to Feb. 2013 at authors’ hospital, a total of 12 patients with SSS, including subclavian artery stenosis (n = 7) and occlusion (n = 5), underwent endovascular treatment. Percutaneous transluminal angioplasty (PTA) was carried out in 4 cases and stent implantation in 8 cases. The clinical data were retrospectively analyzed. Results Technical success rate was 100%(12/12). The diseased side/healthy side blood pressure ratio increased from preoperative (0.46 ± 0.28) to postoperative (0.89 ± 0.32), and the difference was statistically significant (P < 0.05). After the treatment, the clinical symptoms were improved in different degrees in all patients. During the follow - up period lasting for (16.7 ± 7.9) months, restenosis occurred in one case with left SSS thirteen months after PTA, and the condition was improved after stenting angioplasty. Another patient with severe subclavian artery stenosis developed peripheral micro- vascular thrombosis of the diseased limb in 23 days after PTA, which was relieved after medication to improve microcirculation and vasodilation. No severe complications such as stroke occurred. Conclusion For subclavian artery steal syndrome, endovascular management is a minimally invasive, safe and effective treatment. It can significantly relieve the clinical symptoms due to vertebral- basilar artery insufficiency caused by subclavian steal syndrome, and improve limb weakness, low body temperature, etc. Therefore, this technique should be recommended in clinical practice.

OBJECTIVEThe aim of this study was to explore the influencing factors of prognosis for recurrent and metastatic esophageal carcinoma, and to provide reference for clinical treatment for these patients.

METHODSThe clinicopathological and follow-up data of 247 patients with recurrent and metastatic esophageal squamous cell carcinoma after radical resection were retrospectively reviewed, combined with analysis of prognostic factors in these patients. Kaplan-Meier method was used to analyze the survival, difference between groups was compared by Log rank test, and Cox model was used for multivariate analysis.

RESULTSAmong the 247 recurrent and metastatic patients, locoregional recurrence was in 139 patients (56.3%), distant metastasis in 60 patients (24.3%), and combined recurrence in 48 patients (19.4%). The survival time was 1 to 42 months in the 247 patients, and the median survival time was 10 months. The 1-, 3- and 5-year survival rate after recurrence and metastasis was 26.4%, 6.3% and 2.4%, respectively. Univariate analysis indicated that regional lymph node metastasis of the primary tumor, distant lymph node metastasis, clinical staging, interval between operation and recurrence, recurrent and metastatic patterns, and treatment methods after recurrence and metastasis were influencing factors of prognosis (all P<0.05). Cox multivariate analysis indicated that clinical staging of the primary tumor, interval between operation and recurrence, recurrent and metastatic patterns, and treatment methods after recurrence and metastasis were independent factors influencing prognosis (all P<0.05).

CONCLUSIONSThe prognosis of patients with recurrent and metastatic esophageal carcinoma is poor, and it is affected by many factors. Comprehensive treatment is effective in prolonging the survival time of the patients.

Carcinoma ; Carcinoma, Squamous Cell ; diagnosis ; Esophageal Neoplasms ; diagnosis ; Esophagectomy ; Humans ; Lymphatic Metastasis ; Neoplasm Recurrence, Local ; diagnosis ; Neoplasms, Second Primary ; Prognosis ; Retrospective Studies ; Survival Rate

Objective: To explore the mechanism and influencing factors of mirror-image artifact of color blood flow (MACBF) due to longitudinal strong echo big interface (LSEBI). Methods: Fifty suspicious patients with MACBF beside the main pulmonary artery and/or the left pulmonary artery undergoing echocardiography examination from November 2018 to April 2019 in Shengjing Hospital of China Medical University were chosen as the subjects. Image characteristics of the MACBF were observed, and mechanism and influence factors of the MACBF were explored with Doppler imaging principle. Results: Of all the subjects with MACBF, 36 subjects occurred only on the left side of the main pulmonary artery, 14 subjects occurred on both the left side of the main pulmonary artery and the left pulmonary artery. The LSEBI was found between the real color blood flow (RCBF) and the MACBF, there was a mirror relationship between the RCBF and the MACBF. The LSEBI on the left of the main pulmonary artery and the left pulmonary artery were the interface of the left lung and pleural. The signal strength of MACBF enhanced as the distance between the blood flow and the LSEBI got closer or the gain of the color blood flow got bigger. Conclusions MACBF may caused by LSEBI beside vessel. The formation of MACBF and its signal strength are influenced by the distance between blood flow and LSEBI and the gain of the color blood flow.