Objective To investigate the clinical features of moyamoya disease complicated with Graves′disease and the efficacy of extra-and intra-cranial revascularization. Methods The clinical data of 4 patients with moyamoya disease complicated with Graves′disease were analyzed retrospectively. Among them,three were females and one was a male. Their mean age was 32 ± 7 years. After medical treatment, their thyroid function was normal. The patients were treated with superficial temporal artery-middle cerebral artery bypass grafting. Results (1) Three patients showed cerebral infarction and one showed frequent transient ischemic attack. DSA confirmed that 2 patients had unilateral moyamoya disease and 2 had bilateral moyamoya disease. Head MRI revealed brain infarcts. (2) The thyroid function was normal after drug treat-ment,the symptoms of moyamoya disease were stable in 3 cases. One patient had high metabolic symptoms, such as high fever and accelerated heart rate within one week after procedure. The patients were followedup for 6 to 18 months,one was good,3 were excellent,and there was no recurrence of Graves′disease. Postoperative head MRI revealed that the 4 patients did not have new brain infarcts. MRA showed that the arterial filling in cerebral sulci in the ischemic lesion areas was obviously improved compared with that before procedure. Retrograde filling of the ipsilateral middle cerebral artery M2-M3 segment was observed in 2 patients. Postoperative single photon emission computed tomography perfusion imaging revealed that the ischemic perfusion lesions on the operated sides were obviously improved compared with those before procedure. Conclusion When complicated with Graves′ disease,the symptoms of moyamoya disease will aggravate. It manifests as acute and chronic cerebral ischemia. After controlling the symptoms of hyperthyroidism,most cerebral ischemic symptoms can be alleviated. Superficial temporal artery-middle cerebral artery bypass grafting may establish an effective collateral circulation and improve the clinical symptoms.

Objective To investigate the effect of ligustrazine on the expression of platelet-derived growth factor-?(PDGF-?) receptor and extracellular signal regulated kinase(ERK1/2) induced by angiotensin Ⅱ(AngⅡ) in cardiac myocytes,and explore the mechanism of therapeutic.Methods Cultured cardiac myocytes of neonatal rats were treated with 10-7 mol/L AngⅡ as Ang Ⅱ group,10-7 mol/L AngⅡ plus 10 mg/L ligustrazine as ligustrazine group,the normally cultured neonatal rat cardiac myocytes as control group.Protein synthesis was measured by -leucine incorporation,and the expression of PDGF-? receptor and ERK1/2 was detected by Western blot.SPSS 11.0 software was used to analyze the data.Results There were significant differences among 3 groups(F=20.71 P

Objective To study the role of imbalance between transcription factors GATA-3 and T-bet expressions in causing acute lung injury after resuscitation in cardiac arrest model of swine.Methods Mter swine model of electrically induced cardiac arrest was established for 8 minutes,animals were resuscitated to get restoration of spontaneous circulation (ROSC).The swine with ROSC were randomly assigned to be sacrificed at 12 and 24 h after ROSC (n =8 in each group).CD3 +,CD4+ and CD8 + lymphocyte subsets were determined by flow cytometry,and the levels of serum IL-4,TNF-α,and IFN-γ were measured by using ELLSA.The protein levels and expressions of GATA-3/T-bet mRNA were detected in lung tissue by western blotting and quantitative real-time PCR device,respectively.Results Pulmonary function was significantly impaired after ROSC.CD4 + lymphocyte subsets (28.4 ± 2.3) ％,(24.1 ± 1.6) ％ and CD4 +/CD8 + (1.7 ±0.9),(1.5 ± 1.0) were significantly lower in the post-ROSC group compared with the sham-operated group (48.4±2.9)％,(51.1±5.4)％ (2.5±1.3),(2.7±1.1) (P＜0.05) at 12 h and 24 h after ROSC.The levels of serum IL-4 and TNF-α were markedly increased,while IFN-γ and IFN-γ/IL-4 were significantly decreased in the post-ROSC group compared with the sham-operated group (P ＜0.05) at 2-12 h after ROSC.Protein level and expression of GATA-3 mRNA in lung tissue were markedly increased,while those of T-bet were significantly reduced in the post-ROSC group compared with the sham-operated group (P ＜0.05) at 12 and 24 h after ROSC.Conclusions The lung immune dysfunction induced by imbalance between transcription factors GATA-3 mRNA and T-bet mRNA expressions may complicate in the process of post-resuscitation lung injury in a porcine model of cardiac arrest.

Objective To confirm whether in post-resuscitation myocardial dysfunction involved in myocyte apoptosis mechanism in porcine model of cardiac arrest and apoptosis index varied from different modalities of cardiopulmonary resuscitation or not.Methods A total of 22 WZSP inbred small swine were randomly (random number) divided into sham operation group (SHAM) (n =6),defibrillation first group (DF,n =8) and chest compression first group (CF,n =8).Eight minutes after ventricular fibrillation was set up,standard CPR was carried out subsequently after defibrillation in porcine models of cardiac arrest in DF group and defibrillation after standard CPR in CF group,and hemodynamics were monitored.Twentyfour hours after restoration of spontaneous circulation (ROSC),animals were sacrificed,and myocardial specimens were examined with electron microscopy,Western blot,quantitative RT-PCR,and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay.The experimental data were analyzed by SPSS 17.0.Student's t test was employed for comparisons between two groups.Differences within groups at different time intervals were compared with repeated measures ANOVA.A two-tailed value of P ＜ 0.05 was considered statistically significant.Results Myocardial function was significantly impaired after ROSC.Levels of Bcl-2,Bax and caspase-3 protein was markedly increased in the CF and DF groups than those in the SHAM group (P ＜ 0.05) at 24 h after ROSC,while Bcl-2/Bax was significantly reduced in the CF and DF group compared with the SHAM group (P ＜ 0.05),and much more apoptotic cells were observed in cardiac arrest animals in comparison with sham-operation animals (P ＜ 0.05).Six hours after ROSC,hemodynamic indicators improved significantly in group DF than those in group CF,but Bcl-2,Bax and caspase-3 protein levels and apoptotic index were not significantly different bewteen the DF group and CF group (P ＞ 0.05).Conclusions Caspase-3-mediated apoptosis might be one of the main pathological mechanisms of postresuscitation myocardial injury in a porcine model of cardiac arrest,but there was no statistically significant difference in apoptosis index between two resuscitation modalities,showing no one modality was superior over another.

Objective To investigate the application value of identification of the scalp surface locations of cerebral ischemia lesions before direct revascularization for moyamoya disease and to design surgical approaches according to this by using the fusion of single photon emission computed tomography ( SPECT) cerebral perfusion imaging with CT imaging. Methods The clinical data of 13 adult patients with ischemic-type moyamoya disease underwent superficial temporal artery-middle cerebral artery bypass surgery were analyzed retrospectively. SPECT cerebral perfusion imaging was fused with CT imaging of the same machine before procedure. The lesions of ischemia were located on the cortical surface. The surgical approaches were designed at the center of the ischemic lesions. The patients were followed up for 6 to 12 months after procedure. The improvement of clinical symptoms and cerebral perfusion of the patients were observed after operation. Results One patient had perioperative cerebral hyperperfusion syndrome,and the others did not have any perioperative complications. At one-month follow-up, the improvement of symptoms in 4 patients were excellent,in 5 were good,in 4 were fair,and none was poor. At 6 to 12 month follow-up,the improvement of symptoms in 9 patients were excellent,in 4 were good,and none was poor. The postoperative visual SPECT cerebral perfusion imaging analysis suggested that the cerebral perfusion was improved significantly as compared with before procedure in all patients. Quantitative analysis:There was significant difference in target ischemic lesions between preoperative Fb and postoperative Fb ([2. 13±1. 06]% vs. [4. 13±2. 09]%;P<0. 05). There was significant difference between preoperative Fb and Fe ([2. 46±1. 97]% vs. [2. 13±1. 06]%;P<0. 05). The postoperative BFCR was [67. 57±3. 78]%( >50%) , which indicated that the efficacy of the procedure was remarkable. The superficial temporal arteries fed to brain of the patients were observed after procedure by using the head CT angiography. The postoperative head MRI reexamination showed no new infarcts occurred at 6 months. Conclusion Combine SPECT cerebral perfusion imaging with CT imaging to design surgical approach for superficial temporal artery-middle cerebral artery bypass surgery may improve the efficacy and reduce the risks of operation.

Objective To investigate the imaging characteristics of both intra- and extrathoracic sarcoidosis on 18F-FDG PET/CT.Methods From 2007 Aug.to 2009 Nov.,22 patients( 10 males,12 females) with sarcoidosis,confirmed by pathological study and clinical follow-up,underwent 18 F-FDG PET/CT imaging.The imaging patterns of intrathoracic and extrathoracic lesions were analyzed.The patterns were classified as the typical or atypical ( symmetrical or asymmetrical FDG accumulation and enlargement of hilar lymph nodes) based on PET and CT separately.Nonparametric McNemar test,independent t-test and Fisher exact test were applied for statistical analysis.Results For typical pattern vs atypical pattem identification,PET was significantly different from CT ( 18 and 4 vs 12 and 10,P =0.031 ).In those with atypical pattern demonstrated by CT alone at hilar region,PET showed either symmetrical or asymmetrical accumulation of FDG.Except for mediastinal lymph nodes involvement,lung parenchyma was the second common site ( 19/22,86.4％ ),followed by lymph nodes at abdomen and (or) pelvis ( 12/22,54.5％ ).Conclusion The imaging characteristics of both intra- and extrathoracic sarcoidosis on 18F-FDG PET/CT may be helpful for the diagnosis of atypical sarcoidosis on CT image alone.

This study was aimed to investigate the distribution and implication of tap1 (transporter associated with antigen processing) and tap2 loci allelic and genotypic frequencies. The distribution of tap1 and tap2 loci allelic and genotypic frequencies in 339 random samples of healthy Chinese Hans was analyzed by TaqMan PCR. Several genetic information about power of discrimination, cumulative DP, polymorphism information content, expected heterozygosity and observed heterozygosity were calculated. The results indicated that 5 tap1 alleles (tap1*0101, 020101, 020102, 0301 and 0401) and 4 tap2 alleles (tap2*0101, 0102, 0103 and 0201) were detected in all samples. 8 tap1 genotypes were found which account for 53.3% of the theoretic genotype and 6 tap2 genotypes were found which account for 60% of the theoretic genotype. The genotyping results of tap1 and tap2 both conform to the Hardy-Weinberg expectations (p > 0.05). Tap1*0101 (79.79%) and tap2*0101 (82.74%) are the most common alleles in Chinese Hans. It is concluded that tap1*0101 and tap2*0101 are most common alleles in Chinese Hans, tap1 and tap2 loci carry some power of individual discrimination and polymorphism information content. These two locl can be used for the research in the fields of human genetics, linkage analysis of genetic disease genes, paternity test and individual identification and so on.
ATP-Binding Cassette Sub-Family B Member 2 ; ATP-Binding Cassette Transporters ; genetics ; ATP-Binding Cassette, Sub-Family B, Member 3 ; Alleles ; Asian Continental Ancestry Group ; genetics ; Gene Frequency ; Genotype ; Haplotypes ; Humans

OBJECTIVETo investigate the clinical effects of close reduction and percutaneous minimally invasive fixation in the treatment of proximal humerus fractures.

METHODSFrom April 2008 to March 2010, 28 patients with proximal humerus fracture were treated with close reduction and percutaneous minimally invasive fixation. There were 21 males and 7 females, ranging in age from 22 to 78 years,with an average of 42.6 years. The mean time from suffering injuries to the operation was 1.7 d. Nineteen cases caused by falling down, 9 cases by traffic accident. The main clinical manifestation was swelling, pain and limited mobility of shoulders. According to Neer classification, two part fractures were in 17 cases and three part fractures in 11 cases. The locking proximal humerus plate was used to minimally fixation through deltoid muscle under acromion. The operating time,volume of blood loss, the length of incision and Constant-Murley assessment were applied to evaluate the therapeutic effects.

RESULTSThe mean operating time was 40 min, the mean blood loss was 110 ml, and the mean length of incision was about 5.6 cm. The postoperative X-ray showed excellent reduction and the plate and screws were successfully place. Twenty-eight patients were followed up for 6 to 24 months (averaged 14.2 months). The healing time ranged from 6 to 8 weeks and all incision was primarily healed. There were no cases with necrosis head humerus, 24 cases without omalgia, and 4 cases with o-malgia occasionally. All the patients can complete the daily life. The mean score of Constant-Murley assessment was 91.0 +/- 5.8, 24 cases got an excellent result, 3 good and 1 fair.

CONCLUSIONClose reduction and percutaneous minimally invasive fixation, not only can reduce surgical invasive, but also guarantee the early function activities. It has the advantages of less invasive, fixed well and less damage of blood circulation.

Adult ; Aged ; Female ; Fracture Healing ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Shoulder Fractures ; physiopathology ; surgery

OBJECTIVETo study the chemical constituents of Pseudostellaria heterophylla.

METHODThe compounds were isolated by silica gel and Sephadex LH-20 column chromatography and purified by recrystallization. Their structures were elucidated on the basis of physicochemical properties and spectral analysis.

RESULTSeven compounds were identified as 2-minalin (1) , 3-furfuryl pyrrole-2-carboxylate (2), ursolic acid (3), acacetin (4), luteolin (5), acacetin 7-O-beta-D-glucopyranosyl (6-->1)-alpha-L-rhamnopyranoside (6).

CONCLUSIONAmong them, compounds 3-6 were isolated from the plant for the first time.

Caryophyllaceae ; chemistry ; Chromatography, Gel ; Flavones ; chemistry ; isolation & purification ; Luteolin ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Triterpenes ; chemistry ; isolation & purification