Objective To evaluate the effect of high frequency oscillation ventilation (HFOV) and HFOV+ MgSO 4 on oxygenation, pulmonary and systemic arterial pressure, histologic alterations, and serum magnesium concentration in severe meconium aspiration syndrome(MAS) piglets with persistent pulmonary hypertension(PPH). Methods Newborn piglets were randomized to HFOV group( n =6), HFOV+MgSO 4 group( n =7) and control group( n =5). Piglets of HFOV group and HFOV+MgSO 4 group received an intratracheal a 20% suspension of human meconium. All piglets were given HFOV, Piglet of HFOV+MgSO 4 group was given MgSO 4 intravenously simultaneously. Cardiopulmonary functions, blood gases were monitored and serum magnesium concentration of piglets in HFOV+MgSO 4 group were measured by atomic absorption spectrophotometric assay. Results (1) HFOV and HFOV+ MgSO 4 treatment showed improved oxygenation in MAS model, PaO 2,a/APO 2 increased significantly and A-aDO 2?,Qs/Qt decreased significantly in HFOV group at 30 minute ( P

Objective To investigate the effects of different astragalosides(AST) and hydro-soluble astragali polysaccharide(APS) of Astragalus membranaceus on inducing erythroid differentiation of human leukaemic K562 cells.Methods APS and AST were extracted by alcohol or water from Astragalus membranaceus.K562 cells were treated with APS,AST and sodium butyrate(BA) respectively.The proportion of benzidine-positive cells was examined after 1-4 days culture.MTT assay was performed for evaluating the proliferation effects of APS,AST and BA on K562 cells.Results The percentages of benzidine-positive cells induced by APS,AST and BA were 13.2%,2.9% and 17.5%,respectively.The kinetic characteristics of K562 cells induced by different levels of APS(1,2,4,8mg/ml) indicated that 4 mg/ml APS was sufficient to induce K562 cells to turn to be benzidine-positive.The results suggested that APS,other than AST,could induce the K562 cells towards erythroid differentiation.Compared with BA,the percentage of benzidine-positive cells induced by APS was lower at 24h,48h and 72h(F=237.44,P=0.00),while the total number of benzidine-positive cells was higher at 96h(F=322.25,P=0.00).The results of MTT assay for Absorbance(A) showed that APS and AST had no inhibitory effects on growth of K562 cells(P=0.28,P=0.11),while BA showed an obvious inhibitory effect on K562 cells(P=0.00).Conclusion Astragalus membranaceus has pharmacological effects to induce the K562 cells towards erythroid differentiation,and its valuable constituents are contained in hydro-soluble astragali polysaccharide(APS).The induction of differentiation is most evident with a dosage of 4 mg/ml APS.The cell growth curve reveals that APS has no inhibitory effect on K562 cells.

Objective To study the clinical evaluation of gas exchange impairment in neonatal respiratory failure.Methods Blood gas, PaO2/PAO2, Qs/QT, PaO2/FiO2, A-aDO2 and RI of 53 newborn infants with respiratory failure in NICU of PUMCH from Jan. 1993 to Dec. 1997 were measured. Results These infants were divided into two groups according to PaO2/PAO2: moderate and severe respiratory failure. Qs/QT(11±3)%, PaO2/FiO2(183±113), A-aDO2(22.9±6.8)kPa, RI(2.5 ±0.8) in 21 neonates with moderate respiratory failure; Qs/QT(24±6)%, PaO2/FiO2 (82±30), A-aDO2 (49.3 ± 17.8)kPa,RI(7.6 ±3.4) in 32 neonates with severe respiratory failure(P＜0.001). These results in respiratory failure caused by different pathogenesis were different. In meconium aspiration and pneumothorax group there were the highestQs/QT(32±3)% ,A-aDO2 (69.8 ± 12.2)kPa,RI(9.2 ±2.9)and the lowest PaO2/FiO2 (77±39). Mortality of infants with high pulmonary shunt was high. Qs/QT(17±8)% in 38 survives and (24±6)% in 10 died neonates( P＜0.05). Conclusion The clinical evaluation using these indexes for newborn infants with respiratory failure is beneficial in recognizing pathogenesis,guiding therapy and evaluating prognosis.

Niacin, a broad-spectrum lipid-regulating agent, can significantly lower plasma triglyceride and raise the high density lipoprotein-cholesterol.Extended-release niacin added to statins monotherapy could further modify the lipid profile and reduce residual cardiovascular risk.This combination therapy provides a safe, effective and economical treatment for clinicians and may be superior to other drugs combined with statins.

Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of thoracic tuberculosis.Methods The study was retrospective,from September 2009 to September 2012,38 patients who underwent EBUS-TBNA were finally diagnosed of thoracic tuberculosis,with enlarged hilar or mediastinal Iymph nodes on chest enhanced computed tomography(≥ 1.0 cm).Patients in whom EBUS TBNA was nondiagnostic subsequently underwent surgical biopsy.All the patients had a minimum of 6 months clinical and radiologic follow-up.Results EBUS-TBNA was performed on a total of 88 lymph node stations in 38 patients.Of the enlarged lymph nodes,60(68.18％) were located in the mediastinal region and the remaining 28 (31.82 ％) around the hilum or interlobar area.Of the 38 patients,EBUS-TBNA achieved definitive diagnosis in 34 patients(89.47％).EBUS was well tolerated by all of the patients with no complications.Conclusion EBUS-TBNA is a safe procedure with a high yield for the diagnoses of thoracic tuberculosis.

Objective To investigate the epidemiologic factors associated with the age of natural menopause and menopausal symptoms in a large population at age of 40 to 65 years in Jiangsu Province.Methods From May 2010 to Oct.2011,a total of 20 275 women (40 to 65 years) attending health examination in Jiangsu Province were enrolled in this cross-sectional study.A structured questionnaire was used to collect data of demographics,menopausal status,chronic diseases,reproductive history.Also the menopausal symptoms were evaluated by Kupperman menopause index (KMI).Cox proportional hazards regression model and Logistic regression were performed to identify risk factors for earlier age of natural menopause and menopausal symptoms,respectively.Results The overall median age at natural menopause in Jiangsu women was 50 years.Lower educational level,poor economic status,lower body mass index (BMI),age at menarche less than 14 years,nulliparity and smoking were associated with earlier onset of natural menopause (P ＜ 0.05).The most frequently symptoms in perimenopausal women were fatigue (46.84％,1880/4014),insomnia (44.67％,1793/4014) and muscle/joint pain (43.80％,1758/ 4014),while sexual problems (57.06％,3463/6070),muscle/joint pain (53.30％,3235/6070) and insomnia (51.03％,3097/6070) were predominant symptoms in postmenopausal women.After adjusting for confounding factors,it was revealed that women with poor educational background,low income,divorce,higher BMI,higher parity,and smoking presented positive correlation with menopausal symptoms (P ＜ 0.05).Conclusions The study suggested that an estimate of median age at natural menopause were 50 years in Jiangsu women.The main factors contributing to earlier onset of menopause and menopausal symptoms were lower educational level,poor economic status,and smoking.Moreover,there were different menopausal symptoms between perimenopausal and postmenopausal women,which provided the important insights for physicians to prevent and treat menopause symptoms in their clinical practice.

Objective To report the spectrum of electron transfer flavoprotein dehydrogenase (ETFDH)gene mutations in 20 Chinese RR-LsM families.Methods Twenty-four RR-LSM patients in the First Hospital of Peking University from January 2003 to May 2010 were collected and the clinical characteristics were analyzed.These patients came from 20 families in North Mainland China.Sixteen families had 1 patient each.and the other 4 families had 2 patients.ETFDH gene analysis was performed in all patients,11 family members and 100 healthy controls.Results The mean onset age was(27.9±9.9)years.The main symptoms were limb weakness(21,87.5%),dysmasesia(15,62.5%),neck weakness (14,58.3%)and myalgia(14,58.3%).Eighteen patients had high level of acyleamitine.Fifteen of 17patients had glutaric aciduria.Seventeen ETFDH mutations,including 13 missense mutations,2 splice mutations,and 2 nonsense mutations,were identified in 19 families:c.998A>G,c.1450T>C,c.1703T>C,c.1717C>T,c.821G>A,c.643G>A,c.251C>T,c.1763A>T,c.IVS7+2T>C and c.IVS6+1G>A were Hovel mutations which were not found in 100 healthy controls.Nine families had the mutation of c.770A>G(P.Y257C)and 5 families had the mutation of c.1227A>C(P.L409F).Conclusions The numerous novel mutations in ETFDH gene indicate that Chinese RR-LSM might have special mutation pattern.c.770A>G(P.Y257C)and c.1227A>C(p.L409F)may be hot spot mutations in North Mainland China.

ObjectiveTo investigate the characteristic of pathology in Chinese patients with Nonaka myopathy.MethodsThirteen patients (7 males and 6 females) diagnosed with Nonaka myopathy in our laboratory from January 2002 to March 2011 were included in this study.Their mean age was 39.5 years old and the mean duration of illness was 4.15 years.The most common symptoms were weakness of raising feet with sparing of quadriceps femoris muscles in the early stage of disease.One patient presented the initial symptoms of upper limb weakness. Muscles biopsies were obtained from all these 13 patients. Histology study including immunohistochemical (IHC) staining with antibody against amyloid 3,phosphorylated tau protein,ubiquitin,glucose-regulated protein of molecular weight 78 000(GRP78),calnexin,caspase-12and Bax were performed.Skeletal muscle samples from 3 chronic fatigue syndrome patients,2 myofibrillar myopathy patients were used for control in the IHC staining. All coding exons of uridinediphospho-N-acetylglucosamine 2-epimerase gene were directly sequenced in genomic DNA from these patients.Results The main pathological changes of tibialis anterior muscle in 12 cases were muscle dystrophy with rimmed vacuoles.The rimmed vacuoles were positive for anti-β-amyloid,tau protein and ubiquitin in IHC studies.In the atrophy fibers,IHC showed the increased expression of endoplasmic reticulum stress related proteins GRP78 and calnexin,and apoptosis proteins of caspase-12 and Bax.ConclusionsThere is accumulation of abnormal proteins in muscle fibers in Chinese patients with Nonaka myopahty.These proteins may stimulate endoplasmic reticulum stress and apoptosis,which may be a mechanism responsible for muscle damage.

Objective To investigate the genetic association between the inducible nitric oxide synthase (NOS) 2A gene and stroke with a history of coronary artery disease ( CAD). Methods 708 patients with stroke and 235 healthy controls were recruited in this study, and the stroke group was delaminated into 2 subgroups according to the history of CAD. SNP rs28944190, an A to C base change located in intron 22 of the gene, was used as a genetic marker. PCR-based restriction fragment length polymorphism analysis was applied to genotype rs28944190 (Hac Ⅲ site). Results The x2 test showed no association between patients with stroke and healthy controls. Of 708 patients, 94 had a history of CAD and the frequency of allele C of rs28944190 was significantly higher in patients with a history of CAD than those without (23.9% vs 16.6%, x2 =5.629, df= 1, P =0.018, OR = 1.580, 95% CI 1.083—2.306), especially in male patients (x2 = 8. 592, df= 1, P = 0. 003, OR = 1. 983, 95% CI 1. 255—3. 134). The frequency of genotype AA + AC of rs28944190 was significantly higher in patients with a history of CAD than those without such a history (47.9% vs 30. 8%, x2 = 10. 761, df= 1, P = 0. 001, OR = 2. 065, 95% CI 1.34—3.19), especially in male patients (x2 = 15. 762, df= 1, P =0. 000, OR =2. 985, 95% CI 1.74—5. 12). Conclusion The present study suggests that the NOS2A gene is unlikely to contribute to the etiology of stroke.

Objective To analyze the dynamic evolution of brain MRI in patients with mitochondrial myopathy,encephalopathy,lactic acidosis,and stroke-like episodes (MELAS) syndrome.Methods A retrospective study was performed on 58 MELAS cases with pathologically and (or) molecularly confirmed diagnosis.MRI were repeated within 60 days after the onset of stroke-like episodes (SLE) and the evolution changes of cerebral lesions were accessed.Brain atrophy index (BAI) was calculated in the remission stage from 31 patients with MELAS,and the correlation between BAI,age and disease duration was analyzed.Results The proportion of lesions expansion,migration and shrink within 30 days after the onset of SLE was 64.1％ (25/39),10.2％ (4/39),17.9％ (7/39),respectively,and 13％ (3/23),21.7％ (5/23),56.5％ (13/23),between 30-60 days after the onset of SLE respectively.In the recovery stage of SLE,the BAI in 31 patients with MELAS was 15.2％ ±2.8％.The correlation coefficient between BAI and the age,total disease course and duration of encephalopathy was 0.329 (P =0.043),0.405 (P =0.012) and 0.649 (P =0.000).Conclusions Brain atrophy in the studied MELAS patients gradually develops and strokelike lesions shrink with progression of the disease.However,the migration of lesions is persistent.