Objective To explore the value of 64-slice multi-detector computed tomography coronary angiography (64SCTA) in detecting the coronary artery plaque and to analyze the risk factors for unstable plaque. Methods A total of 112 inpatients who had been diagnosed as coronary artery disease by 64SCTA received catheter coronary angiography (CAG). The levels of serum endothelin-1 (ET-1), matrix metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) were measured. The effect of 64SCTA in detecting the coronary artery plaque was evaluated as compared with CAG. The patients were divided into the soft plaque group (n=51) and non-soft plaque group (n=61) according to the CT value of correctly detected plaque. The differences in the above detection indexes between two groups and the risk factors for soft plaque forming were analyzed. Results The 64SCTA had 87.4% sensitivity and 87.1% specificity in detecting coronary artery plaque, the positive predictive value was 82.2% and the negative predictive value was 91.0%. There were significant differences between soft plaque group and non-soft plaque group in the levels of MMP-9, IL-6, hs-CRP, the number of coronary lesions and the composition ratios of gender, diagnosis and diabetes. Logistic regression analysis showed that MMP-9>5.231 ng/L (P=0.0215, OR=2.33, 95%CI 1.13-4.79), hs-CRP>3.583 mg/L (P=0.0008, OR=4.32, 95%CI 1.84-10.15) and unstable angina pectoris (P=0. 0339, OR=4.33, 95% CI 1.12-16.77) were the risk factors for soft plaque formation. Conclusions 64SCTA has highervalue in detecting the coronary artery plaque, and is one of most reliable means in non-invasive methods. MMP-9, hs-CRP and unstable angina pectoris are independent risk factors of plaque instability.

Objective To investigate the changes of cellular immunity and humoral immunity in children with acute or critical illness. Methods Seventy-three critically ill children admitted to PICU of Chil-dren′s Hospital Affiliated to Fudan University during the period from April,2015 to September,2015 were the objects of study. Blood samples were collected within 48 hours after admition. The lymphocyte subpopulation was measured by flow cytometry,and the level of humoral immunity was measured by rate immune scatter turbidimetry,and the neutrophil function was measured by flow cytometry-DHR analysis. Twenty-three cases from 73 cases were detected the second time after admitted to hospital for seven days. Ten health children be-fore elective surgery were selected as control. Results (1) Compared with the control,the percentages of CD3 +T cells and CD8 +T cells were significantly decreased in critically ill children within 48 hours of admis-tion[(57. 43 ± 13. 46)%,(21. 26 ± 7. 87)% vs. (66. 24 ± 5. 27)%,(26. 82 ± 7. 63)%,P<0. 05]; At the same time,CD4 +T cells and NK cells had no significant change[(33. 42 ± 11. 29)%,(8. 83 ± 7. 77)% vs. (34. 89 ± 4. 94)% (11. 34 ± 5. 60)%,both P<0. 05]; While B cells were significantly increased[(31. 69 ±13. 83)% vs. (21. 08 ±7. 24)%,P<0. 05]. Neutrophil activation rate[(14. 32 ±14. 81)%] was signifi-cantly higher than the normal reference value ( 0 -10%) and the activation rate was more than 90% after stimulated by PMA. The plasma level of complement C3[(0. 88 ± 0. 31) g/L] was lower than that of the control group[(1. 19 ± 0. 18)g/L,P<0. 05]. (2) Compared with the first time,the percentages of CD3 +cells and CD4 + cells were increased after treated for one week in 23 patients[(61. 20 ± 13. 56)%,(36. 79 ± 9. 95)% vs. (56. 80 ± 13. 99)%,(32. 86 ± 10. 87)%,both P<0. 05]. No significant difference in neutrophil activation and activation rate after PMA stimulation was found compared with admition. IgA,IgM and comple-ment C3 were significantly increased[(0. 98 ± 0. 75) g/L,(1. 00 ± 0. 39) g/L,(1. 15 ± 0. 34) g/L vs. (0. 80 ± 0. 69) g/L,(0. 86 ± 0. 48) g/L,(0. 93 ± 0. 23) g/L,all P<0. 05]. Conclusion Immune disorders occur in critically ill children in the early stage of illness,the most obvious change is cellular immune response,and im-mune function starts to recover after one week.

ObjectiveTo investigate the relationship between liver stiffness and hepatocellular carcinoma (HCC) risk in chronic heptatitis B patients with negative α-fetoprotein (AFP) tests. MethodsFrom September 2012 to August 2014, this study enrolled a total of 82 HBV-relative native HCC patients as the case group. During the same period, a total of 253 chronic hepatitis B patients were also include in this study as the control group. These 253 patients were followed up for six months. All of the two groups were AFP-negative. Liver stiffness was measured in all patients by transient elastography device Fibroscan?. Logistic regression was applied to assess the risk of HCC incidence, and stratum-specific likelihood ratios (SSLR) was calculated.ResultsThe age, liver stiffness measurements and plasma albumin of patients in case group were 53 years old (44-61), 12.00 kPa (7.50-20.75), 43.14 g/L (39.50-46.75) respectively. The age, liver stiffness measurements and plasma albumin of patients in control group were 45 years old (38-56), 8.40 kPa (5.40-13.50), 46.40 g/L (43.75-48.50) respectively. The variables were compared between two groups with unpaired studentt test, and the results were statistically significant (t=4.33, 3.56,
-4.48,P=0.00, 0.00, 0.00). The patients in case group were older, and had higher liver stiffness measurements and lower plasma albumin than that of the patients in control group. Logistic regression analysis showed that HCC incidence was associated with age,male-gender and liver stiffness, and the odds ratios (OR) was 1.053, 2.432, 6.803 respectively. When liver stiffness was<10 kPa, 10.1-15 kPa, 15.1-25 kPa,>25 kPa, SSLR for HCC presence was 0.67, 1.02,1.44, 3.98 respectively.ConclusionsLiver stiffness measured by transient elastography is useful in predicting the risk of HCC incidence in AFP-negative chronic heptatitis B patients. Clinicians needed to carry out close follow-up and appropriate intervention for these patients.

OBJECTIVE Through researching the ABR threshold, the cochlear morphology and miR-96 expression in the cochlear of BALB/c mice at different month's age, to find out if the miR-96 can regulate the age related hearing loss of BALB/c mice.METHODS ABR testing, AO/PI staining and scanning electron microscope were used to observe the ABR threshold and cochlear morphology of the BALB/c mice at the ages of 3 months, 6 months, 12 months and 18 months. Real-time PCR was used to detect the expression of miR-96 in the cochlea of BALB/c mice at the ages of 3 months, 6 months, 12 months and 18 months.RESULTS The ABR thresholds of BALB/c mice were (18.5±8.3), (45.8±7.8), and (85.6±15.6) dB SPL separately at the age of 3, 6 and 12 months. At the age of 18 months, no response was observed in the ABR testing with 120 dB SPL acoustic stimulation. In the AO/PI staining, we found that the outer hair cells was apparently lost since the age of 6 months and the loss of hair cells aggravated as the month's age increased. At the age of 12 months, no outer hair cells was left, inner hair cells was lost apparently too. With the scanning electron microscope, we found the changes of deficiency, lodging, fusion, shortening and inversion in the hair cell cilia. And these changes were aggravated as the month's ages increased. At the age of 3 months, the relative expression of miR-96 (2-△CT) was 0.0225±0.0073. The relative expression of miR-96 (2-△CT) in the cochlea were 0.0162±0.0048, 0.0116±0.0048, and 0.0050±0.0014 at the age of 6 months, 12 months and 18 months separately, comparing with the relative expression of miR-96 at the age of 3 months, the differences were significant(P<0.05).CONCLUSION The hearing loss, hair cells loss, and cilia damage aggravated as the month's age increased, but the miR-96 expression in the cochlea decreased. Which suggest that miR-96 might play an important role in the age related hearing loss.

Objective To investigate the clinic effect of Linezolid for community acquired methicillin resistant staphylococcus aureus (MRS A) pneumonia. Methods The clinic data of the patient- were collected from the First Affiliated Hospital of Sun Yat-Sen University, in addition, the body temperature and white blood cell counts were obtained as the index of treatment. Results It was proved that Linezolid was effective in treating community acquired MRSA pneumonia and showed well tolerance with few adverse events. Conclusion Linezolid demonstrated good clinical and antibacterial activity but very few adverse reactions in elderly patients with community acquired MRSA pneumonia.

Objective To establish a simple,easily-producible and practical cardiopulmonary cerebral resuscitation model in rabbits.Method Cardiac ventricular fibrillation was induced in 27 New Zealand rabbits by alternating electric current.The rabbits were randomly divided into three groups according to the duration of untreated cardiac arrest(CA):CA-8 min group(n = 9),CA-5 min group(n = 9)and CA-3 min group(n = 9).All animals received cardiopulmonary resuscitation(CPR)until return of spontaneous circulation(ROSC).The sample of vein blood was collected for the measurement troponin I level at 4 hours after ROSC.The animals were sacrificed at 72 hours after ROSC,hippocampus were removed and fixed in 3%formalin,and coronal sections were analyzed by TUNEL staining and N1SSLE staining.The other two animals without ventricular fibrillation or CPR served as sham-operated group.One-way ANOVA or Mann-Whitney rank was used to determine the statistical significance among the three groups.R×C test was used for ROSC,LSD test for multiple comparisons,and t test for comparisons of means between two independent samples.A two-tailed value of P＜0.05 was considered statistically significant.Results There were no differences in rate of ROSC among groups.No animals survived until 72 hours after ROSC in CA-8 min group and CA-5 min group,while three animals in CA-3 min group survived.In group CA-8 min,CA-5 min and CA-3 min,the survival time of animals after ROSC were(1.67 ± 2.55)h,(37.78 ± 30.27)h,(12.0 ± 14.97)h,respectively.There were significant differences in the survival time of animals after ROSC and troponin I level after ROSC 4 h between CA-3 min group and the other two groups(P＜0.05).Compared with animals in CA-3 min group,sham-operated animals(n = 2)did not have neuronal degeneration or TUNEL positive cells in the hippocampus CA1 area.Conclusions CPR initiated as soon as 3 min after CA can give longer survival tome to the rabbits.The rabbits have neuronal degeneration and apoptosis in the hippocampus CA1 area at 72 hours after ROSC.It may be an ideal animal model for investigation on CPCR.

Objective: To analyze the relationship between inflammatory factors and relevant risk factors in patients of essential hypertension (EH) combining acute coronary syndrome (ACS) with its clinical significance. Methods: Our research included 3 groups: EH group, n=79 patients with standard criteria, EH+ACS group, n=85 and Control group, n=48 normal subjects. Blood levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), tryptase (TPS) and relevant clinical, biochemical parameters were measured; risk factors for cardiovascular disease were examined and the relationship between above parameters, risk factors and ACS occurrence in EH patients was studied by Logistic regression analysis. Results: The OR values were all greater than 1 in fibrinogen (Fbg), high-sensitivity C-reactive protein (hs-CRP), TPS, atherosclerotic plaque, Lp-PLA2 and EH grading. Fbg was the most significant independent risk factor (OR=22.242, 95% CI 6.458-76.609, P<0.0001), the standardized partial regression coefficient b'as absolute value (b') was 1.079 which was the highestone in above 6 variables with the strongest impact for ACS occurrence in EH patients. Conclusion: Fbg, hs-CRP, TPS, atherosclerotic plaque and EH grading were the independent risk factors for ACS occurrence in EH patients; Fbg was the highest risk factor for ACS occurrence with the strongest impact, which provided a new direction for ACS prevention and treatment.

OBJECTIVE To investigate a better surgical treatment for chronic otitis media.METHODS 106 patients with chronic otitis media were collected from hospital. We assessed effectss of ossicular chain reconstruction without incision of mastoid (method 1) and ossicular chain reconstruction with incision of mastoid (method 2).We compared therapeutic effect, complication, and surgical treatment between these two groups. Furthermore, we performed stratification analysis by normal or abnormal function of stapes, Eustachian and tendon of tensor tympani, using logistic regression model. RESULTS The improvement of hearing by method 1 and 2 were 85.71%, 68.00% (P=0.0296). The recovery rate of drying ear were 92.86%, 88.00% (P=0.3931). The proportion of continued tinnitus were 10.71%, 18.00% (P=2827). There were 85.71% and 36.00% samples with numeric pain score from 1 to 3 (P<0.0001). There were 89.29%, 24.00% samples with operation hour <2.0 hour (P<0.0001). For those patients with normal function of stapes, Eustachian and tendon of tensor tympani, the OR of method 1 were 2.91, 3.08 and 3.33 For those patients with abnormal function, the OR was 3.27, 2.89 and 1.33. CONCLUSION Ossicular chain reconstruction without incision of mastoid is a suitable surgical treatment for chronic chronic otitis media,it could improve hearing more effectively with entire debridement of the focus and shorter operation time.

Objective To establish an animal model of neurogenic pulmonary edema (NPE),and to study the role of catecholamine and beta receptors in the occurrence of NPE. Methods The NPE model was established by injecting fibrinogen and thrombin into the cerebellum medullary pool of the rabbits. Twenty-four rabbits were divided into the control group,the saline group and the experimental group by random num-ber table. In the control group,only cerebellar medullary cistern puncture was carried out,and no drug was in-jected. Cerebrospinal fluid was drew out and the same amount of saline was injected into the cerebellum me-dullary pool in the saline group. Fibrinogen and thrombin were injected into the cerebellum medullary pool in the experimental group. The animals were intubated by tracheotomy,the femoral artery and the internal jugu-lar vein were dissected and connected with the PiCCO instrument to detect the blood pressure,heart rate,and respiratory rate before puncture and at 1 min,10 min,30 min after puncture. Serum samples were collected for the determination of epinephrine,norepinephrine,acetylcholine,endothelin-1,cardiac troponin I,brain natri-uretic peptide and neuropeptide Y levels before puncture and at 1 min,10 min after puncture. The rabbits weresacrificed at 3 hours after successful modeling,the pathological examination of lung was performed. Myocar-dial samples were taken to detect adrenergic beta receptors mRNA. Results (1)The heart rate,respiratory rate and mean arterial pressure at 1 min and 10 min after puncture in experimental group were significantly higher than those in control group and saline group. (2) The pathological examination of the rabbits′ lungs in experimental group found that the lung tissue was swollen and dark red in appearance with large areas of con-gestion. Under the microscope,the lung tissue was edema,bleeding,and inflammatory cells were infiltrated in the alveolar cavity,which was consistent with characteristics of NPE. (3)There was no difference in epineph-rine and norepinephrine concentration in all groups before the cerebellar medullary pool puncture. The concen-tration of epinephrine and norepinephrine at 1 min after puncture time were (200. 0 ± 251. 7)μg/ L,(448. 9 ± 356. 7)μg/ L in the experimental group,whcih were significantly higher than those of control group[(15. 4 ± 3. 4)μg/ L,(15. 9 ± 9. 7)μg/ L] and saline group[(17. 1 ± 3. 8) μg/ L,(29. 6 ± 18. 4) μg/ L] (P < 0. 05). The concentration of epinephrine and norepinephrine at 10 min after puncture were (397. 0 ± 797. 7)μg/ L, (221. 4 ± 173. 7)μg/ L in the experimental group,whcih were significantly higher than those of control group [(23. 3 ± 6. 4) μg/ L,(18. 8 ± 3. 9) μg/ L] and saline group[(16. 7 ± 9. 1) μg/ L,(20. 3 ± 6. 5) μg/ L] (P < 0. 05). (4)There was no significant difference in the levels of serum neuropeptide Y,acetylcholine and endothelin-1 among the three groups. (5)The mRNA of adrenergic beta-1 receptor in the experimental group was 0. 37 ± 0. 12,which was significantly lower than those in the control group (0. 54 ± 0. 13) and saline group (0. 56 ± 0. 14) (P < 0. 05). There was no significant difference in adrenergic beta-3 receptor mRNA among the three groups. Conclusion The NPE animal model was constructed by injecting fibrinogen and thrombin into the cerebellum medullary pool of the rabbits. Catecholamine and beta-1 receptor play a role in the occurrence of NPE rabbit model. There is no significant correlation between neuropeptide Y,acetylcholine,en-dothelin-1 and the occurrence of NPE in rabbits.

OBJECTIVE: To determine the clinical value of transoral endoscopic adenoidectomy for the pediatric sinusitis. METHOD: Patients with chronic sinusitis and adenoid hypertrophy were divided into two group by undertaken with or without adenoidectomy, the operation group with 43 cases and the control group with 40 cases. Evaluation was performed in pretherapy and after 3 months therapy. Evaluation index included symptom scale for nasal obstruction and rhinorrhea, endoscopy score and CT score for chronic sinusitis. RESULT: There was a positive correlation (0.38) between the adenoid size and the symptom of nasal obstruction (P < 0.01). But there were no correlation between the adenoid size and the other index scores (P > 0.05). Whether in the operation group or the control group, all index scores in pretherapy were higher than in post-therapy (P < 0.05). After 3 month therapy, all index scores in the operation group were lower than the control group (P < 0.01). The decreased amplitude of all index scores in the the operation group were higher than the control group (P < 0.01). CONCLUSION Adenoidectomy combined with topical nasal treatment is one effective method for the pediatric sinusitis. Adenoidectomy play an important role in the treatment of pediatric rhinosinusitis.
Adenoidectomy ; methods ; Adolescent ; Child ; Endoscopy ; Female ; Humans ; Male ; Sinusitis ; surgery ; Treatment Outcome