Objective To review the clinical characteristics of left ventricular pseudo-aneurysm (LVPA) in China mainland.Methods The China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP information and PubMed database were searched to extract information on clinical profile,diagnostic imaging,treatment and outcome of patients with LVPA from January 1986 to April 2012.Results Clinical data of 77 patients with LVPAs (including 5 coexistent with true aneurysm) were extracted from 65 articles.There were 56 males (72.7％) and 11 females (27.3％) with a median age of 48 years old(range 5 to 82).The most common etiology was myocardial infarction (40,51.9％).Breathlessness/dyspnea (44.6％),chest discomfort (41.9％) and chest pain (41.9％) were the most frequently reported symptoms,but asymptomatic patients accounted for 10.8％ of all.86.4％ of the patients had electrocardiographic abnormalities,most of which were nonspecific ST segment changes.No event of thromboembolism was reported.Transthoracic echocardiography was the most commonly used diagnostic imaging test,followed by angiography with which no complication was reported.19 cases of pseudo-aneurysms(24.7％)were reported to rupture and 15 patients(19.5％) died,mostly of cardiac tamponade and sudden death.Conclusions LVPA is a rare and life-threatening disorder.It lacks of specific clinical manifestations distinguishable from coronary disease or heart failure.Emergency surgery is warranted once it is identified.

Objective To test the reliability and validity of the brief International Classification of Functioning, Disability and Health (ICF) core sets for Chinese stroke patients using Rasch model analysis. Methods The body functions of 38 Chinese stroke patients were measured using the brief ICF core sets. The qualifiers of the 20items were measured by two raters and analyzed using FACETS statistical software. The intra-rater reliability and validity were tested by using the separation index and separation reliability and fit analysis. Results The brief ICF core sets had good internal consistency and reliability (person separation index = 6.02, person separation reliability = 0.94 ) with these Chinese patients. The raters showed significantly different strictness in rating, but their ratings had good internal self-consistency. The construct validity was good for the body functions of the ICF component ( separation index = 10.50, separation reliability = 0.80) , but misfitting and overfitting were found in items b117, b152and b755. Conclusion The body function of the brief ICF core sets has good reliability and validity for Chinese stroke patients. A many-facet Rasch measurement model can provide comprehensive information and has good application prospects for testing the reliability and validity of ICF core sets.

BACKGROUND:Ultrasound has been widely used in developmental hip dysplasia screening in infants and young children, but there are significant differences among different inspection findings, even in the reexamination by the same examiner. Therefore, the accuracy of ultrasound imaging in the diagnosis is of insufficient evidence.
OBJECTIVE:Through virtual reality three-dimensional reconstruction images showing the structure of acetabulum and femoral head space, to obtain a new parameter in order to enrich measurement standards of Graf ultrasonic diagnosis technology and to further improve the credibility of the diagnosis of developmental dysplasia of the hip.
METHODS:Ten fresh cadaver specimens of Chinese infants were selected, including five males and five females. Two-dimensional ultrasonic method was employed for hip screening, and at the same time, multi-slice spiral CT was used for three-dimensional reconstruction fol owed by volume reconstruction and fitting of surface reconstruction to display the anatomic structure around the hip and to simulate Graf’s two-dimensional ultrasound method to measure a andβangles on three-dimensional virtual reality images.
RESULTS AND CONCLUSION:As confirmed by three-dimensional reconstruction, Graf’s two-dimensional ultrasound could be used to measure a and angles, truly reflecting the development of bony and cartilaginous acetabulum. Graf’s two-dimensional ultrasound contributed to the proper evaluation of beonatal hip dysplasia, which can be used as a routine examination for developmental dysplasia of the hip. These indicate that to master Graf’s ultrasound technology and strictly grasp the evaluation standards for developmental dysplasia of the hip is the important guarantee for diagnosis of developmental dysplasia of the hip.

Three hundred and ninety five patients with bronchial asthma were randomly divided into 4 groups:patients in group A received inhaled beclomethasone dipropionate(BDP)100μg and Zhichuan decoction;patients in group B were given inhaled BDP 200μg;patients in group C took Zhichuan decoction only;patients in group D were given inhaled BDP 100 μg.Methacholine airway reactivity,pulmonary ventilation function,serum acidophilia cationic protein and symptom score were determined before and after treatment.All above indicators were significantly improved in groups A and B,which suggests that Zhichuan decoction could reduce hormone dosage in control of airway chronic inflammation,reduction of airway reactivity and improvement of pulmonary ventilation function of patients with bronchial asthma.

OBJECTIVETo observe the clinical efficacy differences among warming-promotion acupuncture, regular acupuncture and psychological care for post-earthquake depression.

METHODSNinety cases of post-earthquake depression in Gansu province were randomly divided into a warming-promotion acupuncture group, a regular acupuncture group and a care group, 30 cases in each one. The psychological treatment was applied in the care group; the regular acupuncture at Baihui (GV 20), Sishencong (EX-HN 1)), Fengchi (GB 20), Shenmen (HT 7), Yang-lingquan (GB 34), Taichong (LR 3) and Sanyinjiao (SP 6) was used in the regular acupuncture group; based on the treatment of regular acupuncture group, the warming-promotion acupuncture was applied in the warming-promotion acupuncture group, once a day. Ten days were taken as one course with an interval of two days between two courses. Totally 3 treatment courses were completed. The Hamilton depression (HAMD) scale before and after treatment in each group was observed while the efficacy was analyzed.

RESULTSAll three treatments were effective for depression. The total cured rate was 86.67% (26/30) in the warming-promotion acupuncture group, which was obviously superior to 50.00% (15/30) in the regular acupuncture group (P < 0.01) and 33.33% (10/30) in the care group (P < 0.001). After the treatment, the score of HAMD was all reduced in three groups, in which the effect in warming-promotion acupuncture group was superior to that in the regular acupuncture group and care group (9.02 +/- 2.37 vs 10.73 +/- 2.28 and 11.05 +/- 2.01, P < 0.05, P < 0.01).

CONCLUSIONThe warming-promotion acupuncture has positive effect on post-earthquake depression, which has special effect and is worthy of clinical generalization and application.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Aged ; Child ; Depression ; therapy ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Needles ; Young Adult

AIM:To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasocular operation.METHODS:Seven cases of endoscopic nasal surgery with intraoperative image-guidance were retropectively reviewed,including 3 cases of optic nerve injury;3 cases of foreign object of optic behind the eyeball;1 case of retrobulbar tumor(angeioma).RESULTS:The preoperative preparatory time would take 15 minutes,including coordination,head holder localization,conventional instrument registration.In our cases,the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.3mm.The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures.No complication occurred.CONCLUSION:Nasal endoscope combined with imageguidance systems provides accurate anatomical localization of anterior skull base with enlarged operation field.It is possible for surgeons to observe important anatomical structures during endoscopic surgery.It could increase the effectiveness and decrease surgical complications,especially in complicated cases.

Objective To synthesize a quantum dot (QD) to recognize glioma cells for imaging and photodynamic therapy. Methods By one-pot aqueous approach, near infrared-emitting CdTe was produced. After detection of its physicochemical characterizations, RGD was conjugated. Emission images were observed with confocal microscopy. To test its toxicity, CdTe-RGD with various concentrations was separately added into U251 and 3T3 cells for incubation in dark circulation. To test its photodynamic effect, U251 and 3T3 cells were then irradiated for 5 ~ 60 min using 632.8 nm laser. Results The QD (Φ = 3.75 nm, PL peak wavelength =700 nm, PLQY=20%) achieved was a spherical crystal with excellent monodispersity. Under confocal microscope , U251 cells were visualized but 3T3 cells not. In dark circulation, the survival rates of both U251 and 3T3 cells were above 85%. After laser irradiation, the survival rate of U251 cells decreased to (37 ± 1.6)%with the increasing of irradiation time and CdTe-RGD concentration. Conclusion With good physicochemical characterization and low toxicity, CdTe-RGD could be applied in biomedical imaging and photodynamic therapy of gliomas.

AIM: To observe the expression of corticotropin releasing hormone (CRH) within the paraventricular nucleus of hypothalamus (PVN) and to explore the relationship between the activated CRH-containing neurons and sympathetic activity in rats with heart failure (HF).METHODS: Healthy male Sprague-Dawley (SD) rats were subjected to coronary artery ligation to induce HF, and chronic intracerebroventricular (ICV) infusion was performed by osmotic pump for 4 weeks.The rats in sham group and HF group were given vehicle (VEH;artificial cerebrospinal fluid 0.25 μL/h).The rats in HF plus treatment group were treated with CRH competitive inhibitor αh-CRH (15 mg/h).Meanwhile, the Lewis rats and Fischer 344 rats for control study also underwent coronary ligation to induce HF or sham surgery.After 4 weeks, left ventricular end-diastolic pressure (LVEDP) and maximum positive/negative change in pressure over time (±dp/dtmax) were determined.The right ventricular-to-body weight (RV/BW) and lung-to-body weight (lung/BW) ratios were calculated.The renal sympathetic nerve activity (RSNA) was recorded and the plasma norepinephrine (NE) level was measured.The expression of CRH in the PVN combined with the plasma adrenocorticotrophic hormone (ACTH) levels were measured.RESULTS: Compared with the sham-SD rats, the HF-SD rats had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased), accompanied by decreased ±dp/dtmax and increased RSNA, plasma NE, LVEDP, lung/BW and RV/BW.However, ICV treatment with αh-CRH attenuated these changes in the HF-SD rats (P<0.05).Compared with the sham-Fisher 344 rats, the HF-Fisher 344 rats also had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased).In addition, they had significantly increased RSNA and plasma NE level, higher LVEDP, RV/BW and lung/BW, and lower ±dp/dtmax (P<0.05).Compared with the SHAM-Lewis rats, the HF-Lewis rats had not significantly changed in the above parameters.CONCLUSION: In CHF, the CRH-containing neurons in PVN are activated, thus aggravating cardiac function by increasing sympathoexcitation.

The apoplexy was first formally proposed by Zhang Zhongjing in TCM.After extensive study of the medical researchers,its on causes,pathogenesis,diagnosis and treatment and prescription were developed.The cause and pathogenesis covered three stages:The period of exopathic wind,endogenous wind and combination of internal and external wind.The knowledge of the cause and the pathogenesis of the apoplexy during Jing,Yuan and Ming dynasty focused on endogenous wind.The article reviews the medical researchers' understanding of the apoplexy's pathogenic rule from the review on classical literatures of this period.

AIM:To observe the neuroprotection effects exogenous adrenomedullin(AM) against hypoxic-ischemia reperfusion damage(HIRBD) in neonatal rat models.METHODS:Forty neonatal rats were randomly divided into Control Group(n=8,with sham operation),Hypoxic-ischemia Reperfusion(HIR) Group and Intervention Group(n=8,wth intraperitoneal AM injection 0,6 and 12 h after making model).All rats were decapitated at 48 hours after reperfusion,and the cerebral slices were made at the 2 mm level in front of the interaural line.The pathobiological changes of brain tissue were observed by the method of HE dye in light microscope,and the levels of nitrogen monoxide synthase(NOS),glutathion(GSH) and myeloperoxidase(MPO) in neonatal rats cerebral tissue were determined by using chromatometry.RESULTS:Hypoxic-ischemia reperfusion could induce obviously cerebral pathological change which could be improved by AM.The brain tissue levels of cNOS and GSH in AM 0 and 6 h Group were significantly higher than those of HIR Group(P