Objective To investigate the effect of preoperative pravastatin preconditioning on myocardial ischemia-repedusion(I／R)injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Sixty ASA Ⅱ orⅢpatients of both sexes aged 18-64 yr undergoing cardiac valve replacement under CPB were randomly divided into 4 groups(n=15 each)：control group(group C)and 3 pravastatin groups receiving oral pravastatin 10，20 and 40 mg respectively every night for 7 days before operation(group P1-3).The number of patients receiving dopamine(≥5 μg·kg-1·min-1)and adrenaline was recorded from the termination of CPB to the end of operation，from the end of operation to 12 h after operation，during 12-24 h after operation and during 24-48 h after operation.Venous blood samples were taken from central venous line for measurement of plasme cTnI and CK-MB concentrations at 7 days before operation，before induction of anesthesia，at opening of the aorta and at 2，24 and 48 h after opening of aorta.Results The number of patients receiving dopamine and adrenaline was significantly less in group P3 than in group C(P<0.05).Plasma CK-MB and cTnI concentrations were significantly lower in group P3 than in group C(P<0.05).Conclusion Preconditioning with oral pravastatin(40mg／d for 7 consecutive days)can protect myocardium against I／R injury in patients undergoing cardiac valve replacement with CPB.

Adenocarcinoma ; diagnosis ; pathology ; surgery ; Adenocarcinoma, Mucinous ; diagnosis ; pathology ; surgery ; Adult ; Aged ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Cholecystectomy ; methods ; Female ; Follow-Up Studies ; Gallbladder Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Survival Rate

BackgroundThe morphological examination of macular disease is very important information for the early diagnosis.Spectral domain optical coherence tomography (SD-OCT) is a gold criteria in the diagnosis of macular diseases,but its clinical application is limited in the eyes with refractive medium opacity.The resolution ratio of conventional B-scan sonography is unsatisfactory.20 MHz B-scan sonography may be a new approach to maculopathy.ObjectiveThis study was to evaluate the clinical value of 20 MHz B-scan ultrasound by comparing morphological changes of different maculopathies observed by 20 MHz ultrasound and spectral-domain OCT.MethodsA prospective study was designed.51 eyes of 51 patients with macular diseases who were determined by Tianjin Medical University Eye Center were enrolled in this study.Spectral-domain OCT was used to image the macular area,and then the 20 MHz B-scan ultrasound was used to examine the same eye to assess the value of 20 MHz B-scan ultrasound diagnosis.The macular diseases were typed according to the OCT manifestation.The characteristics of 20 MHz ultrasound for the same maculopathy were analyzed.All the patients subscribe the informed consent before the study.ResultsIn 10 eyes with macular hole determined by spectral-domain OCT,shallow dome-shaped lesion with central hollow was exhibited on the ultrasound image.The macular edema,retinal neuroepithelium layer detachment and retinoschisis were found in 16 eyes,6 eyes and 4 eyes by spectral-domain OCT,but the 20 M Hz B-Scan ultrasound presented with the focal belt-shaped elevation with non-echo zone below.In contrast,in 15 eyes of retinal pigment epithelium detachment in OCT,spectral-domain OCT showed stronger and thicker belt-shaped echo.Conclusions20 MHz B-scan ultrasound has certain value in the diagnosis and differentiation for several common maculopathies.Although it is not accurate as OCT in recognizing diseases,it could play an important role in refractive media opacity eye.

Objective To investigate the amounts of endothelial progenitor cells(EPCs)in peripheral blood of patients with proliferative diabetic retinopathy(PDR).Methods Forty patients with PDR(PDR group),thirty patmnts with type 2 diabetes mellitus(DM)without DR(DM group),and twenty agematched normal subjects(control group)were enrolled in this study.Blood samples were treated bv repeated centrifugation and stained with monoclonal antibodies.At least 2 × 105 cells were analyzed bv flow cytometry.EPCs were identified by CD34 and CD133 antibody.The correlation between EPCs numbers and DR duration,glycosylated hemoglobin,serum lipids was analyzed.Results The number of EPCs in PDR,DM and control group were(49±12)、(35±11)、(90±25)cells/ml respectively,the difference was statistically significant(F=56.260,P=0.000).There was a positive correlation between EPCs numbers and DR duration(r=0.564,P＜0.05).However there was no correlation between EPCs numbers and glycosylated hemoglobin(r=-0.170,P>0.05)or triglyceride levels(r=0.261,P>0.05).Conclusions The number of EPCs in peripheral blood of PDR patients was decreased. EPCs might play an important role in the pathogenesis of PDR.

Objective To understand the situation of iodine deficiency disorders of Cangzhou city, Hebei province, in order to provide the scientific basis for prevention and control of iodine deficiency disorders. Methods From 2007 to 2009, dynamic monitoring of iodine deficiency disorders was carried out in low iodized salt coverage places Hejian city and Xian county. Nine towns were randomly chosen in each county, 4 administrative villages were randomly selected in each town, 8 household salts were tested in each village. Every year, 1 - 3 copies of residents water samples were collected for determination of iodine; more than 100 students age 8 - 10 years old were checked the situation of goiter and urinary iodine, more than 40 students selected were measured iodine content of salt from their home; more than 50 women of childbearing age 18 - 40 years were tested of urinary iodine. Thyroid was examined with palpation; water iodine and urine iodine concentration were measured with arsenic-Ce catalytic spectrophotometry; salt iodine was detected by direct titration. Results From 2007 to 2009,median household salt iodine were 4.3,15.9,3.6,18.4,4.6,11.7 mg/kg in Hejian city and Xian county, respectively,iodized salt accounted for 34.03% (98/288), 78.82% (227/288), 29.86% (86/288), 84.72% (244/288), 37.15%(107/288),49.31% (142/288), respectively, the consuming rate of iodized salt were 27.08% (78/288),36.46%( 105/288 ), 28.13% (81/288 ), 49.31% ( 142/288 ), 37.15 % ( 107/288 ), 30.90% ( 89/288 ), respectively. Ten samples of drinking water were tested, water iodine were 5.5 - 34.4 μg/L. From 2007 to 2009, the goiter rate of students aged 8 - 10 years old was below 5%, the median of urinary iodine were 138.1,176.6,112.0 μg/L, ＜ 100 μg/L ratio were 31.6% ( 65/206 ), 25.0% ( 52/208 ) and 44.4% (91/205 ). The median of urinary iodine of child-bearing age women were 167.3,164.2,78.1 μg/L, ＜ 100 μg/L ratio were 28.7%(29/101 ), 19.2%(20/104) and 60.0%(60/100).Conclusions In areas with low coverage of iodized salt, iodine nutrition level are affected, the child-bearing age

Objective To describe the clinical manifestation of the chronic atlantoaxial rotatory dislocation (AARD) with C1,2 lateral facets locked,and explore the effect of the operation combined with anterior retropharyngeal approach and posterior approach.Methods Data of 8 patients with chronic AARD with C1,2 lateral facet locked who had undergone open reduction with the anterior retropharyngeal approach and C 1,2 transpedicular screw fixation with autologous iliac bone graft from Oct.2010 to Jun.2013 were retrospectively analyzed.There were 4 males and 4 females with an average age of 31 years old (range,11-57 years old).The intervals from onset to diagnosis were from 29 to 180 days and the mean time was 70.6 days.5 cases were chronic AARD with right C1,2 lateral facets locked and 3 with left C1,2 lateral facets locked.Reduction was failed to obtain by traction for two to four weeks.Subsequently,after open reduction with the anterior retropharyngeal approach,the patients were performed C 1,2 transpedicular screw fixation with autologous iliac bone graft for one stage or two.Results 1 patient underwent open reduction with the anterior retropharyngeal approach in stage one and C1,2 transpedicular screw fixation in stage two because of an overall severe condition,and the other patients did anterior and posterior operation in one stage.The average operation time was 205 min (range,160-260 min).The mean blood loss was 210 ml (range,100-300 ml).There were no operation complications except one young girl reflected pain in autologous iliac donated area,and pain relieved when taking non-steroidal anti-inflammatory by oral for one week.All patients had been followed up for a mean period of 14.8 months (range,5-37 months).Three-dimensional computed tomography revealed C1,2 arthrodesis bone graft fusion from two to four months and the average was 3.1 months.Neither recurrence of symptoms nor dislocation was observed at the latest follow-up.Conclusion Open reduction through the anterior retropharyngeal approach with C1,2 transpedicular screw fixation is an effective treatment strategy for chronical AARD with C1,2 lateral facets locked,which reduces surgical complications with less operation difficulty.

Objective To study the relationships among postpartum depression,dysfunctional attitudes and automatic thoughts.Methods 274 cases of postpartum women were estimated at fifth or sixth week after delivery by Edinburgh Postnatal Depression Scale (EPDS),Dysfunctional Attitudes Scales (DAS),Automatic Thoughts Questionnaire(ATQ) and some other forms designed by ourselves.Results ①The prevalence of postpartum depression was 18.20％.②The impact of culture degree on postpartum depression was statistically significant(x2 =12.37,P ＜ 0.05).③Compared with normal subjects,the postpartum depression group had significantly higher total score of ATQ (48.98 ± 12.35 vs 79.29 ± 23.90),total scores of DAS (118.92 ± 20.03 vs 148.03 ± 28.47),attraction or repulsion (13.82 ± 4.33 vs 18.01 ± 6.38),perfection (14.53 ± 5.91 vs 19.21 ± 5.23),compulsion(13.09 ± 3.61 vs 19.36 ± 4.98),seeking applause (14.97 ± 4.06 vs 18.78 ± 5.59),dependence (14.30 ±4.12 vs 19.23 ± 5.43),autonomous attitude(16.54 ± 3.67 vs 21.51 ± 4.81),cognition philosophy (12.32 ± 3.79 vs 18.16 ± 3.43),the difference was all statistically significant (P ＜ 0.01).④There was a significant positive correlation in postpartum depression and total scores of ATQ,total scores of DAS,attraction or repulsion,perfection,compulsion,seeking applause,dependence,cognition philosophy (the Pearson correlation was respectively:0.658,0.432,0.187,0.432,0.481,0.304,0.458,0.459,P ＜ 0.01).⑤Through stepwise regression analysis,automatic thoughts,cognition philosophy,compulsion,perfection and dysfunctional attitudes might play considerable role to predict the occurrence of postpartum depression.Conclusion Automatic thoughts,dysfunctional attitudes can predict postpartum depression to some extent.

Objective To summarize the imaging features of intra-pancreatic accessory spleen (IPAS)with multidetector computed tomography (MDCT) and improve the awareness and correct diagnosis of IPAS.Methods MDCT images of seven consecutive patients with surgically and pathologically confirmed IPAS were reviewed retrospectively.The investigated features included the location,size,shape,margin,density,and enhancement of the lesions.Results Four patients were male and three were female with a mean age of 49 years old.All the lesions were located at the dorsal side of parenchyma under the capsule of pancreatic tail.Three lesions were in round-like shape,and 4 in oval shape and all were well-defined.All the lesions were mass-like without necrosis and calcification.The maximum diameter of lesion ranged from 0.9 ～ 1.8 cm with a mean value of 1.4 cm.Compared with pancreatic parenchyma,the density of lesions were homogeneous on unenhanced CT,in arterial phase,slightly increased heterogeneous density was observed in 3 patients,slightly increased homogeneous density was observed in 4 patients.All the lesions appeared as slightly increased homogeneous density in portal phase.The CT value in unenhanced phase ranged from 50 ～ 61 Hu with a mean number of 55 Hu; and it ranged from 80 ～ 110 Hu with a mean number of 97 Hu in arterial phase; and the corresponding value was from 99 ～ 120 Hu with a mean number of 102 Hu in portal phase.Among the three patients underwent MDCT angiography,neither artery nor vein was compressed or invaded,and there was no vessel connected with lesions.Conclusions IPAS has some MDCT characteristics.For small solid mass in pancreatic tail,if the density and enhancement pattern is similar to that of spleen,the diagnosis of IPAS should be considered.

OBJECTIVE:To study the improvement effects of polydatin on renal fibrosis in rats and its mechanism. METH-ODS:50 rats was were randomly divided into sham operation group,model group,positive group(benazepril,5 mg/kg)and poly-datin high-dose and low-dose groups(100,50 mg/kg),with 10 rats in each group. Except for sham operation group,renal fibrosis model was induced by unilateral ureter obstruction. After modeling,administration groups were given relevant medicine intragastri-cally,and sham operation group and model group were given 0.5%sodium carboxymethyl cellulose solution once a day for consec-utive 4 weeks. The pathological change of renal tissue was scored. 24 h urinary protein and serum levels of urea nitrogen and creati-nine were determined,and the content of hydroxyproline,mRAN expression of TGF-β1 and FN were detected in renal tissue. RE-SULTS:Compared with sham operation group,pathological score,24 h urinary protein,serum levels of urea nitrogen and creati-nine,the content of hydroxyproline in renal tissue,mRNA expression of TGF-β1 and FN were all increased significantly (P<0.01). Compared with model group,24 h urinary protein,serum levels of urea nitrogen and creatinine and mRNA expression of FN in renal tissue decreased significantly in administation groups;the pathology scores,the content of hydroxyproline in renal tis-sue and mRNA expression of TGF-β1 of positive group and polydatin high-dose group were all decreased significantly(P<0.05 or P<0.01). CONCLUSIONS:Polydatin can prevent kidney fibrosis induced by unilateral ureteral obstruction,the mechanism of which may be associated with the mRNA expression down-regulation of TGF-β1 and FN in renal tissue.

Objective To evaluate CT scanning in diagnosing pancreatic lymphoma.Methods CT findings in 6 patients with pathologically-proved pancreatic lymphoma were retrospectively analyzed.Results There was no characteristic in findings of pancreatic lymphoma. The main findings were diffusely enlarged masses in the head and body of pancreatic. The masses were composed of irregular lesions in pancreatic, porta hepatis and retroperitoneal space.Conclusion CT can show pancreatic lymphoma lesions and enlarged lymph nodes in abdominal cavity or retroperitoneum are accompanied as well as, and can find the in jury of other object.