Objective To assess the safety and efficacy of the new Cordis coronary stent in the Chinese population.Patients A total of 32 patients recieved 34 Cordis stents (target lesions of 32) from July to December 1995 in our hospital. Vessel distribution was 18 LAD (53%), 8 Lcx (23.5%) and 8 RCA (23.5%).Methods All cases were studies retrospectively. The coronary lesions were predilated with standard balloon angioplasty followed by implantation of Cordis stents. The reference diameter of the vessels and the minimal luminal diameters (both before and after stent implantation) were measured by quantitative angiography. All patients were followed up at mean peroid of 3 months with regards to their symptoms and angiographic follow-up at 6 month's time were carried out in 8 patients.Results Delivery success was achieved in all lesions except 1 unsuccessful delivery due to failure to negotiate an acute angle of a left main vessel to LAD. Average MLD post stenting was satisfactory (0.53±0.36 mm vs 3.32±0.34 mm) compared to reference diameter of 3.13±0.4 mm. There was 1 patient with complication of subacute stent thrombosis. Another patient died 5 weeks later from non-ischaemic end stage heart failure secondary to severe aortic regurgitation. Loop seperations occurred in 2 stents (5.8%) during deployment.Conclusions The Cordis stent implantation is efficacious with high angiographic success rate. The strong radiopacity facilitates precise positioning of the stent in the target lesions. Our experience in the Chinese population is favourable. Stent deformity was possible. For smaller stents of 3 mm, higher pressure of balloon inflation for deployment followed by adequate anticoagulation is recommended. Further studies are required to investigate the long term restenosis rate.

With the advent of modern surgical techniques, paediatric cataract has become much more manageable. Intraocular lens (IOL) implantation is the standard of care for patients over the age of 2 years. The use of IOL in young infants is still controversial. In addition, there are still unresolved issues, such as the minimum age at which IOL can be safely implanted, IOL power selection and IOL power calculation. The current trends in the management of the above challenges are discussed. Although numerous reports on the prevention and management of posterior capsule opacification have been published, there are ongoing intensive debates and research. Long-term postoperative complications like glaucoma and rhegmatogenous retinal detachment are problems that cannot be overemphasised and these issues are also reviewed.
Cataract ; congenital ; Cataract Extraction ; adverse effects ; methods ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Lens Implantation, Intraocular ; adverse effects ; methods ; Lenses, Intraocular ; Postoperative Complications ; prevention & control ; Refraction, Ocular

Aged ; Auditory Brain Stem Implantation ; instrumentation ; methods ; Female ; Humans ; Male ; Middle Aged ; Neurofibromatosis 2 ; diagnosis ; rehabilitation ; surgery ; Speech Perception ; Speech Therapy

Central sensitization is essential in maintaining chronic pain induced by chronic pancreatitis (CP), but cortical modulation of painful CP remains elusive. Here, we examined the role of the anterior cingulate cortex (ACC) in the pathogenesis of abdominal hyperalgesia in a rat model of CP induced by intraductal administration of trinitrobenzene sulfonic acid (TNBS). TNBS treatment resulted in long-term abdominal hyperalgesia and anxiety in rats. Morphological data indicated that painful CP induced a significant increase in FOS-expressing neurons in the nucleus tractus solitarii (NTS) and ACC, and some FOS-expressing neurons in the NTS projected to the ACC. In addition, a larger portion of ascending fibers from the NTS innervated pyramidal neurons, the neural subpopulation primarily expressing FOS under the condition of painful CP, rather than GABAergic neurons within the ACC. CP rats showed increased expression of vesicular glutamate transporter 1, and increased membrane trafficking and phosphorylation of the N-methyl-D-aspartate receptor (NMDAR) subunit NR2B and the α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) subunit GluR1 within the ACC. Microinjection of NMDAR and AMPAR antagonists into the ACC to block excitatory synaptic transmission significantly attenuated abdominal hyperalgesia in CP rats, which was similar to the analgesic effect of endomorphins injected into the ACC. Specifically inhibiting the excitability of ACC pyramidal cells via chemogenetics reduced both hyperalgesia and comorbid anxiety, whereas activating these neurons via optogenetics failed to aggravate hyperalgesia and anxiety in CP rats. Taken together, these findings provide neurocircuit, biochemical, and behavioral evidence for involvement of the ACC in hyperalgesia and anxiety in CP rats, as well as novel insights into the cortical modulation of painful CP, and highlights the ACC as a potential target for neuromodulatory interventions in the treatment of painful CP.
Animals ; Anxiety/etiology* ; Chronic Pain/etiology* ; GABAergic Neurons ; Gyrus Cinguli/metabolism* ; Hyperalgesia/metabolism* ; Pancreatitis, Chronic/pathology* ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate/metabolism* ; Trinitrobenzenesulfonic Acid/toxicity*

Asia-Pacific is one of the most densely populated regions of the world and is experiencing rapid economic changes and urbanization. Environmental pollution is a significant problem associated with the rapid modernization of many cities in South Asia. It is not surprising that the prevalences of asthma and allergies are increasing rapidly, although the underlying reasons remain largely unknown. Many studies from this region have documented the changing prevalence of allergic diseases in various parts of the world. However, the methodologies used were neither standardized nor validated, making the results difficult to evaluate. The International Study of Asthma and Allergies in Childhood (ISAAC) has provided a global epidemiology map of asthma and allergic diseases, as well as the trend of changes in the prevalence of these diseases. Allergic sensitization is extremely common in many Asian communities. However, the prevalence of allergic diseases remains relatively rare. The rapid urbanization in the region, which increases environmental pollution and can affect the rural environment, will likely increase the prevalence of asthma and allergies in Asia.
Asia ; Asian Continental Ancestry Group ; Asthma ; Environmental Pollution ; Humans ; Hypersensitivity ; Prevalence ; Social Change ; Urbanization

Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in immunocompetent patients. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Tibial osteomyelitis can also occur secondary to cutaneous mucormycosis but is rare. Limb salvage is typically successful after lower extremity cutaneous mucormycosis even when the bone is involved. Herein, we report two cases of lower extremity cutaneous mucormycosis in diabetic patients that presented as acute worsening of chronic pretibial ulcers. Despite aggressive antifungal therapy and surgical debridement, both ultimately required amputation. Such aggressive presentation has not been reported in the absence of major penetrating trauma, recent surgery, or burns.

INTRODUCTIONTraditional Chinese medicine (TCM) has been used as an alternative in treating children with atopic dermatitis (AD) but its efficacy and potential side effects are debatable. We recently used a TCM capsule (PentaHerbs) on 9 children and observed significant reductions in clinical scores of disease severity. However, there have been concerns that the therapeutic effects of many forms of TCM are due to the presence of corticosteroids. The purpose of this study was to evaluate if common corticosteroids are present in PentaHerbs capsules.

MATERIALS AND METHODSPentaHerbs powder was analysed with thin-layer chromatography, infra-red spectrophotometry and liquid chromatography mass spectrometry.

RESULTSHydrocortisone, prednisolone, fludrocortisone and dexamethasone were not detected in the PentaHerbs capsules.

CONCLUSIONCorticosteroids are not present in the 5 familiar herbs that were earlier shown to have efficacy on AD.

Child ; Chromatography, Thin Layer ; Dermatitis, Atopic ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Glucocorticoids ; analysis ; therapeutic use ; Humans ; Mass Spectrometry ; Pilot Projects ; Spectrophotometry, Infrared

OBJECTIVETo investigate the role of a potential diabetes-related mitochondrial region, which includes two previously reported mutations, 3243A-->G and 3316G-->A, in Chinese patients with adult-onset type 2 diabetes.

METHODSA total of 277 patients and 241 normal subjects were recruited for the study. Mitochondrial nt 3116 - 3353, which spans the 16S rRNA, tRNA(leu(UUR)) and the NADH dehydrogenase 1 gene, were detected using polymerase chain reaction (PCR), direct DNA sequencing, PCR-restriction fragment length polymorphism and allele-specific PCR. Variants were analyzed by two-tailed Fisher exact test. The function of the variants in 16S rRNA were predicted for minimal free energy secondary structures by RNA folding software mfold version 3.

RESULTSFour homoplasmic nucleotide substitutions were observed, 3200T-->C, 3206C-->T, 3290T-->C and 3316G-->A. Only the 3200T-->C mutation is present in the diabetic population and absent in the control population. No statistically significant associations were found between the other three variants and type 2 diabetes. The 3200T-->C and 3206C-->T nucleotide substitutions located in 16S rRNA are novel variants. The 3200T-->C caused a great alteration in the minimal free energy secondary structure model while the 3206C-->T altered normal 16S rRNA structure little.

CONCLUSIONSThe results suggest that the 3200T-->C mutation is linked to the development of type 2 diabetes, but that the other observed mutations are neutral. In contrast to the Japanese studies, the 3316G-->A does not appear to be related to type 2 diabetes.

Age of Onset ; Aged ; Alleles ; Base Sequence ; DNA Mutational Analysis ; DNA, Mitochondrial ; chemistry ; genetics ; Diabetes Mellitus, Type 2 ; genetics ; Humans ; Middle Aged ; Models, Molecular ; Nucleic Acid Conformation ; Point Mutation ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 16S ; chemistry ; genetics

OBJECTIVETo explore the biological characteristics of mesenchymal stem cells (MSC) derived from umbilical cord blood (UCB) and their supporting capacities in ex vivo expansion of hematopoietic stem/progenitor cells (HSPCs).

METHODSLow-density mononuclear cells (MNCs) from UCB were cultured in IMDM containing 20% FBS to form confluent adherent cells through 15 passages. Some cytokines in the conditioned medium were determined with ELISA. UCB-derived adherent cells were displayed with antibodies and analyzed with flow cytometry. The supporting capacity of UCB-derived adherent cells for ex vivo expansion of CD34(+) cells was assayed by co-culture in a two step culture. UCB-derived adherent cells were induced for chondrogenic differentiation with chondrogenic medium, and the induced cells were analyzed for the type II pro-collagen gene expression with RT-PCR.

RESULTSThe mean number of adherent fibroblast like colonies derived from UCB was (3.5 +/- 0.7)/10(6) MNCs. UCB-derived MSCs could survive for at least 15 passages of expansion. In their undifferentiated status, UCB-derived MSCs were CD13(+), CD29(+), CD90(+), CD105(+), CD166(+), SH2(+), SH3(+), SH4(+), CD45(-), CD34(-), and CD14(-). Stem cell factor (SCF), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) could be detected in the supernatant of the cultures. The MSCs cultured in chondrogenic media could differentiate into chondrogenic cells and express type II pro-collagen mRNA. UCB-derived MSCs could support the proliferation and differentiation of UCB CD34(+) cells in vitro.

CONCLUSIONUCB-derived MSCs are similar to those derived from adult bone marrow and can support the proliferation of hematopoietic stem/progenitor cells.

Antigens, CD34 ; metabolism ; Cell Adhesion ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Coculture Techniques ; Collagen Type II ; genetics ; Cytokines ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Fetal Blood ; cytology ; Gene Expression ; Hematopoietic Stem Cells ; cytology ; metabolism ; Humans ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo determine the risk factors involved in the typhoon episodes and to put forward and evaluate the intervention measures.

METHODSWe defined a confirmed injury case as: 'a person with fall,scalpel and stab, collision, drowning, injuries and trauma due to flying debris and building collapse, asphyxiation due to entrapment in collapsed buildings by typhoon from 0 am,August 12 to 6 pm, August 14 2004' and a death case as: 'a person with fall, scalpel and stab, collision, drowning, injuries and trauma due to flying debris and building collapse, asphyxiation due to entrapment in collapsed buildings by typhoon from 0 am, August 12 to 12 am, August 18 2004'. We investigated all hospitalized injured cases in ten hospitals and telephoned to those who were not hospitalized and the cases of death. We did case-control study with 1 pair versus 2 cases. 74 cases were selected in ten hospitals. The controls were neighbors of the controls matched by occupation, sex, village, and within 5 years of age without injury in this typhoon. We asked the cases and the controls on their alertness regarding typhoon and what actions taken when typhoon arrived.

RESULTSThere were 392 injury cases in all ten hospitals and 50 death cases. The attack rate of injury was 27.3 per 100 000. The fatal rate was 11.3% with the death rate 3.1 per 100 000. We investigated 209 injury cases and 31 death cases. The number of cases who were injured from 1 to 6 hours before typhoon landing accounted for 64.6% (155) of all cases. The peak of epidemic curve was 4 hours before the landing of typhoon. Data on the analysis of 74 cases and 148 controls revealed that 42% (31) of the cases were outside their homes before and during typhoon compared to 15% (22) of the controls (OR = 3.9, 95% CI: 1.9-7.7). Compared with 20% (30) control persons (OR = 17,95% CI: 4.2-68). 28% (21) cases did not receive the alert of typhoon before it arrived compared with 18% (27) control persons (OR = 3.3, 95% CI:1.3-8.6). 53% (39) of the cases did not pay attention to the alert of typhoon before typhoon arrived.

CONCLUSIONStaying outdoor, not receiving or did not take seriously about the alert of typhoon seemed to be the risk factors of injury by the typhoon episode, suggesting that the government should increase the emergency preparedness and to raise the awareness on risks associated with typhoon.

Cause of Death ; China ; epidemiology ; Cyclonic Storms ; Hospitalization ; Humans ; Risk Factors ; Wounds and Injuries ; epidemiology ; mortality