Postural orthostatic tachycardia syndrome (POTS) is characterized by orthostatic intolerance, a presentation of autonomic dysfunction which is frequently observed in the patients with multiple sclerosis (MS). Nevertheless, to date, there have been a few studies focusing on POTS in MS patients and the underlying pathomechanism. We present a 28-year-old woman with relapsing-remitting opticspinal multiple sclerosis who also suffered POTS and discuss the possible pathomechanism of POTS in MS.

Objective To investigate the expression of human bone morphogenetic protein-7(hBMP-7)in rat bone malTOW stromal cells(BMSC)with a recombinant adenovirai vector carrying the hBMP-7 gene(Ad-hBMP-7) and study the effecta of Ad-hBMP-7 transfection on BMSC difierentiation.in order to explore the possibility for hBMP-7 gene therpy.Methods The rat BMSC cultured in vitro.They were divided into 3 groups:untreated group,Ad-hBMP-7 and Ad-GFP transduced treated group.The rat BMSC were transfected by Ad-hBMP-7 and Ad-GFP. The expression of hBMP-7 was detected by RT-PCR and Western blot analysis.and the alkaline phosphatage (ALP)activity of the BMSC was observed.ResulIs In the Ad-hBMP-7 transduced treated group.hBMP-7 mRNA expression wag manifested detected by RT-PCR(470 bp),Westem blot analysis demonstrated that these cells indeed produced the hBMP-7 protein(Mr.15×103);10 days after transduction treatment,most of the BMSC were had brown black particles stained positively by ALP activity.But in Ad-GFP transduced treated group and untreated group they did not.Conclusions Ad-hBMP-7 could efficiently transfect BMSC and promote the conversion to osteoblast.The expression of hBMP-7 in rat BMSC provides a basis for hBMP-7 gene therapv.

Objective To investigate the presence of occult brain tissue damage in patients with relapsing neuromyelitis optica(RNMO)and its possible mechanism by using diffusion tensor imaging (DTI).Methods DTI scans were performed in 16 patients with RNMO and 16 sex-and age-matched healthy controls.Histogram analysis of mean diffusivity (MD)and fractional anisotropy (FA)was performed in brain tissue (BT),white matter (WM)and gray matter (GM)to detect the presence of occult brain tissue damage in RNMO patients.Region of interest(ROI )analysis of MD and FA was also performed in 6 dedicated regions with or without direct connection with spinal cord or optic nerve to determine the relationship between occult brain tissue damage and the damage of spinal cord and optic nerve.Results Patients with RNMO had a significantly higher average MD of the BT[RNMO(0.95?0.02)? 10~(-3)mm~2/s,controls (0.91?0.03)?10~(-3)mm~2/s,t = 3.940,P

Objective To investigate the status of anxiety-depression and the relevant factors in puerpera be- fore delivery.Methods The emotion of anxiety and depression in puerpera before delivery was evaluated by self-rat- ing anxiety scale(SAS)and self-rating depression scale(SDS)which had satisfactory validity and reliability.Results The values of anxiety and depression in puerpera were higher than those of general crowd(P

ObjectiveTo investigate the quality of life (QOL) of the epilepsy patients and the factors affected the QOL.Methods200 cases were investigated using the Quality of Life in Epilepsy Inventory 10 (QOLEI-10) and the Washington Psychosocial Seizure Investigate (WPSI). 200 healthy persons were chosen as normal control group. ResultsThe QOL of the patient group were significantly poor as compared with that of normal control group(P<0.01). The factors that the patients always faced with were disability in the attack control, short in money, unemployment, restriction of movement, disability in intercommunication, psychological disorder (depress, strain, anxiety, dread, shame feel, cognitional dysfunction, etc.), as well as the difficult to get professional curtains, taking medicine improperly and side effects of the medicine. Conclusions The factors mentioned, which were usually neglected by many doctors, do affect the QOL of epilepsy patients, and hinder the epilepsy treatment effectively.

Objective To analysis and determine the possibility of the Citellus undulatus infected with Yersinia pestis surviving the winter in an experimental study, and to provide scientific experimental basis for the study on the mechanism of Yersinia pestis preservation. Method In 2006,09 to 2007,04 and 2007,09 to 2008,04 in Xinjiang Wusu-Gurtu natural foci of plague, under natural conditions, the over the winter process of Citellus undulatus carrying the plague bacteria was simulated, and 178 Citellus undulatus were infected with Yersinia pestis (1×107 Bacteria/mouse) using artificial injection method. One hundred seventy-eight Citellus undulatus infected with Yersinia pestis were kept into a construction of the black (1-5 ℃) basement (2 meters under the ground) in the plague focus. In doing so, these Citellus undulatuses almost simultaneously stepped into hibernation. After waking up from hibernation in following year in April, the survived mice carrying the plague bacteria were observed. Results Sixty-eight mice survived among the 178 infected with Yersinia pestis after 6 months of hibernation (through October to the following year in April), and the remaining 110 were all dead without pulling through the hibernation period. The survival rate was 38.2% (68/178). The organ culture of Yersinia pestis of the 110 dead mice(Citellus undnlatus) were tested, 67 were negative(-), 43 positive(+), with a positive rate of 39.1%(43/110). Among the rats with positive plague bacteria, the congestive pulmonary edema and the pathological changes of the hemorrhagic inflammation of the heart, liver, spleen, kidney and injection site could be seen clearly; the plague-free mice were not found to have any pathological changes. The survived 68 mice over the winter were autopsied and observed after being fed up for 20 days. No any pathological changes were found among these mice, and culturing of Yersinia pestis of the heart, liver, spleen, lungs and the tissue of injection site of these mice were all negative (-). Conclusions Citellus undulatus can carry Yersinia pestis during hibernation, but some fail to carry the bacteria through the entire process of hibernation persistently. Yersinia pestis was negative in the survived mice at the end of hibernation. The results showed that Citellus undulatus can not carry Yersinia pestis over the winter.

OBJECTIVETo determine the molecular mechanisms involved in atrial fibrosis which occurs in patients with atrial fibrillation (AF) and to investigate their effects on the initiation and maintenance of AF.

METHODSThe right atrial tissue samples were taken from 73 patients with rheumatic heart disease who underwent heart valve replacement surgery. 34 patients had no history of AF (sinus rhythm group), 9 patients had paroxysmal AF and 30 patients had persistent AF. The mRNA content of collagen type I, collagen type III, MMP-2, TIMP-1, TIMP-2, TIMP-3 and TIMP-4 was measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and normalized to beta-actin or GAPDH.

RESULTSCompared to sinus rhythm group, the mRNA of collagen type I and MMP-2 increased significantly in the persistent AF group (all, P < 0.01), followed by the paroxysmal AF group (all, P < 0.05). The mRNA of collagen type III was slightly higher in both AF groups than in the sinus rhythm group, but the differences were not statistically significant (P > 0.05). The mRNA of TIMP-1, TIMP-2 and TIMP-3 was down-regulated in the persistent AF group (all, P < 0.01, respectively), however, the trends of reduction did not reach statistical significance in the paroxysmal AF group (P > 0.05). The mRNA of TIMP-4 remained compatible in each group. The mRNA of collagen type I was significantly correlated with left atrial dimension (r = 0.336, P = 0.004) and AF duration (r = 0.339, P = 0.003). The mRNA of MMP-2 was significantly correlated with the mRNA of TIMP-2 (r = -0.326, P = 0.006), the mRNA of collagen type I (r = 0.322, P = 0.006), left atrial dimension (r = 0.300, P = 0.011) and AF duration (r = 0.300, P = 0.010).

CONCLUSIONThe increased level of collagen type I associated with selective downregulation of TIMP-2 and upregulation of MMP-2 gene expression in atrium could be one of the molecular mechanisms of atrial fibrosis during atrial fibrillation, which correlates with the initiation and maintenance of AF.

Adolescent ; Adult ; Atrial Fibrillation ; metabolism ; pathology ; Collagen Type I ; genetics ; Female ; Fibrosis ; Humans ; Male ; Matrix Metalloproteinase 2 ; genetics ; Middle Aged ; Myocardium ; pathology ; RNA, Messenger ; analysis ; Tissue Inhibitor of Metalloproteinase-2 ; genetics ; Tissue Inhibitor of Metalloproteinases ; genetics

Objective To investigate the clinical features of pneumocystis carinii pneumonia (PCP)in patients with autoimmune diseases.Methods The data from 12 patients with autoimmune diseases who were hospitalized in Peking Union Medical College Hospital because of developing PCP were retrospectively reviewed.Clinical characteristics and T cell subsets in the peripheral blood were analyzed.Results The main clinical manifestations of these 12 patients were fever(12/12),cough(9/ 12),expectoration(9/12)and obvious dyspnea(12/12),which were progressive.Blood gas analysis presented with typeⅠrespiratory failure.Bilateral interstitial and alveolar infiltrates were observed in chest X-ray film.The counts of peripheral blood lymphocytes(0.44?0.31)?10~9/L,CD4~+ T-lymphocytes (0.120?0.079)?10~9/L and CD8~+ T-lymphocytes were(0.248?0.252)?10~9/L decreased significantly and the CD4/CD8 ratio reversed,which were significantly different from those of healthy person(P

Objective To evaluate the efficacy of MR angiogrphy(MRA) for detecting cerebral vasospasm after subarachnoid hemorrage(SAH) and compare it with spiral CT angiography(CTA).Methods Ten patients with SAH under MRA and CTA studies were performed within 24 hours after MRA,which was performed 5 to 10 days after SAH.Maximum intensity projection(MIP) images were produced for MRA and CTA studies.Five arterial locations were examined for spasm:the suprasellar internal carotid artery(ICA),the M1 and M2 segments of the middle cerebral artery(MCA),the A1 and A2 segments of the anterior cerebral artery(ACA).Vasospasm was cate- gorized as none,mild(50 % reduction).Results The overall correlation between MRA and CTA was 82 %(r=0.76),but it was better for proximal than distal lo- cations vessels.Agreement between MRA and CTA was greater for no spasm(89%) and severe spasm(100%)(r= 0.85～0.91)than for mild(56%)or moderate(67%)spasm(r=0.21～0.51).Conclusion MRA is highly accu- rate in the detecting no spasm or severe cerebral vasospasm in proximal arterial locations vessels;it is less accurate in detecting mild and moderate spasm in distal locations vessels.

OBJECTIVETo investigate the role and significance of cardiac mast cells and Toll-like receptor 4 (TLR4) in the development and progression of viral myocarditis (VMC).

METHODSForty-eight Balb/c mice were randomly divided into a control group (n=24) and a model group (n=24). Coxsackievirus B3 was intraperitoneally injected into the model group mice to establish a VMC model. In each group, cardiac tissues were collected from 8 mice at 7, 14 and 28 days after the model was established. The cardiac tissues were stained with hematoxylin and eosin as well as Masson trichrome to observe pathological changes in cardiac tissues. The number and degranulation of cardiac mast cells at each time point were measured and evaluated by toluidine blue staining and transmission electron microscopy. The mRNA and protein expression of TLR4 in cardiac tissues was measured by RT-PCR and immunohistochemistry. In the model group, the correlation between number of cardiac mast cells and mRNA expression of TLR4 at all time points was analyzed.

RESULTSThe model group had significantly higher pathological scores of cardiac tissues than the control group at all time points (P<0.05). The myocardial collagen volume fraction in the model group at 28 days was significantly higher than in the control group at all time points and higher than in the model group at 7 and 14 days (P<0.05). At each time point, the model group had a significantly increased number of mast cells (P<0.05), and significantly increased mRNA and protein expression of TLR4 (P<0.05) compared with the control group. In the model group, the number of cardiac mast cells was positively correlated with the mRNA expression of TLR4 at all time points (R²=0.877, P<0.05).

CONCLUSIONSMice with VMC have significantly increased numbers of cardiac mast cells and expression of TLR4 compared with control mice at all time points, suggesting that mast cells and TLR4 may play important roles in the inflammatory response and fibrosis of VMC.

Animals ; Coxsackievirus Infections ; immunology ; Enterovirus B, Human ; Female ; Mast Cells ; physiology ; Mice ; Mice, Inbred BALB C ; Myocarditis ; immunology ; Myocytes, Cardiac ; pathology ; Toll-Like Receptor 4 ; analysis ; genetics ; physiology