Objective To study the effects of fetal lamb cardiac bypass on the fetal cardiac function.Methods Eight ewes at gestation of 120 to 140 days have nine fetus which were randomly divided into control group (n = 4) and fetal bypass group (n = 5). Control group underwent sham procedure that fetal stemotomy was performed.Bypass group underwent fetal cardiac bypass with cen- trifugal pump and placenta for 30 minutes.Fetal mean blood pressure,heart rate and bleed gas data were recorded before bypass,30 minutes during bypass,1 hour after cessation of bypass,2 hour after cessation of bypass.Tei index of two ventricles and pulse index of umbilical arteries were recorded with ultrasonography.Plasma troponin I was assayed.Ultrastructure of fetal myocardium was recorded,Results Fetal mean blood pressure and heart rate of two groups have no changes during the experiment time.The umbilical pulse index of bypass group elevated significantly compared with control group (P

Objective To investigate the renal function changes of the children with breast milk jaundice(BMJ) and effect of early interference treatment on renal function. Methods Serum bilirubin and urine - minim protein (?2-MG,?1-MG, Alb and IgG) of the 50 patients with BMJ were measured when they were in hospital within 12 hours and the last day separately , at the same time, 20 healthy newborns had been chosen to serve as control group. Results Compared with control group, the urine minim protein of treatment group increased with the rise of serum bilirubin. When serum bilirubin was 205.2 - 256.5 ?mol/L, urine ?2- MG had mild increasing (P

OBJECTIVETo summarize the electrocardiography and echocardiography features of patients with cardiac amyloidosis (CA) diagnosed by endo-myocardial biopsy (EMB).

METHODSA total of 20 consecutive patients [7 men, mean age (50 ± 12) years] referred for EMB because of clinical suspicion of CA from September 2006 to October 2009 were included in the study. Primary CA was diagnosed in 11 out of 20 patients (55%) by EMB and biomarkers examination. The electrocardiography and echocardiography features were analyzed.

RESULTSThe voltage of all the limb leads were low in the 11 CA patients [mean values of (0.33 - 0.51) mV], the incidence of low voltage and pseudo-infarction patterns were 45% and 45%, respectively. Concentric hypertrophy and normal left ventricular diameters were evidenced in all CA patients on echocardiography, left atrial enlargement (n = 10, 91%), granular/sparking appearance of the myocardium (n = 9, 82%) and moderate to large pericardial effusion (n = 7, 64%) as well as left ventricular systolic dysfunction (n = 8, 73%) were often presented in CA patients.

CONCLUSIONSThe diagnosis of primary CA should be considered in patients with unknown origin of heart failure, concentric hypertrophy and normal left ventricular diameters with granular/sparking appearance of the myocardium or pericardial effusion presented on echocardiography and low voltage of limb leads or pseudo-infarction pattern presented on electrocardiography. EMB and serum (urine) biomarkers examinations should be then performed to confirm or exclude the diagnosis of CA.

Adult ; Amyloidosis ; diagnostic imaging ; physiopathology ; Cardiomyopathies ; diagnostic imaging ; physiopathology ; Echocardiography ; Electrocardiography ; Female ; Humans ; Immunoglobulin Light-chain Amyloidosis ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo study the immune memory in vaccinees after the completion of a full schedule hepatitis B immunization.

METHODSOne thousand and two hundred one infants born in 1987 -1989 were immunized with 3 doses of plasma derived hepatitis B vaccine, while 2484 newborn babies during 1996-1999 were injected with 3 doses of the yeast recombinant hepatitis B vaccine. All of the infants under observation were tested for HBsAg, anti-HBs and anti-HBc, in 2005. Of 959 individuals negative for anti-HBs (< 10 mIU/ml), HBsAg and anti-HBc, 228 were immunized with plasma-derived vaccine and 731 with yeast recombinant vaccine after birth. All of them were detected for anti-HBs 15 days after a booster of 10 Ipg yeast recombinant vaccine. In addition, interleukin-2 (IL-2) was detected in 11 non-responders and 22 responders after boostering, using an enzyme-linked immunospot (ELISPOT). The anti-HBs levels of 190 individuals (91 with plasma derived vaccine and 99 with yeast recombinant vaccine) who had had quantitative data on their antibody status after the primary hepatitis B vaccination, were compared with that after the boostering.

RESULTSAmong the individuals who received plasma derived vaccine 16-18 years ago, 79.82% of them showed the signs of immune memory after one booster, with a geometric mean titer (GMT)of 325.69 mIU/ml. Of the individuals who received the yeast recombinant vaccine 6-9 years ago, 95.62% showed immune memory after one booster,with its GMT of 745.18 mIU/ml. Anti-HBs levels induced by the booster were associated with that after the primary immunization. The positive rate of IL-2 was 40.91% in subjects with good immune memory. However, IL-2 was not detected in non-responders after the booster (P < 0.01).

CONCLUSIONMost of the individuals who had received a completed schedule of primary hepatitis B vaccination and seroconverted from anti-HBs positive to negative,showed the signs of having immune memory after the booster. Only a small proportion of the vaccinees had lost their immune memory during the long term follow-up period, suggesting that these individuals should receive a booster of hepatitis B vaccine in the highly endemic areas of hepatitis B. Hepatitis B virus; Immune memory; Booster immunization

Antibody Formation ; Hepatitis B ; immunology ; prevention & control ; Hepatitis B Vaccines ; administration & dosage ; immunology ; Humans ; Immunization, Secondary ; Immunologic Memory ; Infant ; Infant, Newborn ; Interleukin-2 ; blood

OBJECTIVETo evaluate the RT-PCR-ELISA method applied for testing live attenuated hepatitis A vaccine titer.

METHODSA solid phase hybridization-enzyme colorimetric detection method was used for detecting specific nucleic acid. Primer labeled with biotin was used to amplify viral gene fragment, then the product was quickly hybridized with the specific probe covalently coupled on DNA-binding microplate wells. Finally, peroxidase-labeled streptavidin was used in colorimetric detection. The results were judged by reading A value. Eleven batches of live attenuated hepatitis A vaccine titer were tested by this method. The results were compared with that of routine cell culture method (CCID50).

RESULTSThe sensitivity was similar to routine cell culture method (P>0.05). This method was convenient, fast and specific.

CONCLUSIONCCID50 method may be replaced by the RT-PCR-ELISA method in evaluating the titer of live attenuated hepatitis A vaccine.

Base Sequence ; DNA, Viral ; analysis ; Enzyme-Linked Immunosorbent Assay ; Genes, Viral ; Hepatitis A Vaccines ; Hepatitis A virus ; genetics ; Quality Control ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Vaccines, Attenuated

OBJECTIVETo compare the differences in the complete genome sequence between mumps epidemic strain and mumps vaccine strain S79 isolated in Zhejiang province.

METHODSA total of 4 mumps epidemic strains, which were separated from Zhejiang province during 2005 to 2010, named as ZJ05-1, ZJ06-3, ZJ08-1 and ZJ10-1 were selected in the study. The complete genome sequences were amplified using RT-PCR. The genetic differences between vaccine strain S79 and other genotype strains were compared; while the genetic-distance was calculated and the evolution was analyzed.

RESULTSThe biggest difference between the 4 epidemic strains and the vaccine strain S79 was found on the membrane associated protein gene; whose average nucleotide differential number was 42.5 +/- 3.0 and the average variant ratio was 13.6%; while the mean amino acid differential number was 12.8 +/- 1.5 and the average variant ratio was 22.4%. The smallest difference among the 4 epidemic strains and the vaccine strain was found in stromatin genes, whose average nucleotide differential number was 73.8 +/- 2.5 and the average variant ratio was 5.9%; while the mean amino acid differential number was 3.0 +/- 0.8 and the average variant ratio was 0.8%. The dn/ds value of the stromatin genes of the 4 epidemic strains reached the highest, as 0.6526; but without any positive pressure (dn/ds < 1, chi2 = 0.87, P > 0.05). There were mutations happened on the known antigen epitope, as 8th amino acid of membrane associated protein genes and on the 336th and 356th amino acid of hemagglutinin/neuraminidase proteins. Compared with the vaccine strain, the glycosylation sites of ZJ05-1, ZJ06-3, ZJ08-1 and ZJ10-1 increased 1, 1, 2 and 2 respectively. The complete amino acid sequence of all strains showed that there were 17 characteristic sites found on the genotype-F mumps strain. Within the complete genome, the genetic-distance between epidemic strains and vaccine strains in Zhejiang province (0.071) was significantly larger than the genetic-distance between strains in Yunnan province (0.013); the difference showing statistical significance (t = 4.14, P < 0.05). Except nucleocapsid protein genes, all the genes shared similar evolution tree.

CONCLUSIONThere were significant differences found in the genes between mumps epidemic strain and mumps vaccine in Zhejiang province.

Amino Acid Sequence ; China ; epidemiology ; Genome, Viral ; Genotype ; Humans ; Molecular Sequence Data ; Mumps ; epidemiology ; genetics ; virology ; Mumps Vaccine ; Mumps virus ; classification ; genetics ; isolation & purification ; Viral Proteins ; genetics

OBJECTIVE: To analyze the utilization of hospital service and its related influencing factors among patients with occupational pneumoconiosis. METHODS: A total of 178 patients with occupational pneumoconiosis were selected as the study subjects using the convenience sampling method. The utilization of hospital service and health-related quality of life of patients with pneumoconiosis and its complications were investigated using the Questionnaire on Pneumoconiosis Patients′ Medical Consultation Behavior and its Influencing Factors and the European Quality of Life Inventory.RESULTS: The one-year hospitalization rate of patients with pneumoconiosis was 57.3%(102/178), and 88.2% of the patients were hospitalized once a year. The median number of hospitalization time in a year was 20.0 days. Visual health scale(VAS) score was(58±15) points. The multiple logistic regression analysis results showed that the utilization of hospital service among patients with employment injury insurance and fund reimbursement provided by the local governmentwere higher than those without employment injury insurancea nd without fund reimbursement provided by the local government(all P<0.05). The utilization of hospital service of patients with problems in usual activities and those unable to perform usual activities were higher than those without any problems(P<0.05). The utilization hospital service of patients with VAS scores <60 was higher than those with VAS scores of 60-<75(P<0.05). CONCLUSION: The patients with pneumoconiosis have a relatively overall high level of utilization of hospital service. The employment injury insurance, fund reimbursement provided by the local government, VAS score, and status of physical health are important influencing factors of utilization of hospital service.

OBJECTIVETo assess the medical community's awareness and practice regarding delirium in the intensive care unit (ICU).

METHODSOne hundred and ten predesigned questionnaires were distributed to ICU practitioners in the affiliated hospitals of Zhejiang University.

RESULTSA total of 105 valid questionnaires were collected. Totally, 55.3% of the clinicians considered that delirium was common in the ICU. Delirium was believed to be a significant or serious problem by 70.5% of respondents, and under-diagnosis was acknowledged by 56.2% of the respondents. The incidence of ICU delirium is even more under-estimated by the pediatric doctors compared with their counterparts in adult ICU (P less than 0.05). Primary disease of the brain (agreed by 82.1% of the respondents) was believed to be the most common risk factor for delirium. None of the ICU professionals screened delirium or used a specific tool for delirium assessment routinely. The vast majority (92.4%) of respondents had little knowledge on the diagnosis and the standard treatment of delirium.

CONCLUSIONSAlthough delirium is considered as a serious problem by a majority of the surveyed ICU professionals, it is still under-recognized in routine critical care practice. Data from this survey show a disconnection between the perceived significance of delirium and the current practices of monitoring and treatment in ICU in China.

Attitude of Health Personnel ; Delirium ; diagnosis ; epidemiology ; therapy ; Humans ; Incidence ; Intensive Care Units ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo understand the prevalence of HBV core promoter mutant (T1762 A1764 mutant) isolated from asymptomatic carriers from areas with higher and lower incidence of hepatocellular carcinoma (HCC) in Guangxi.

METHODSA nested polymerase chain reaction (nPCR) was used for amplification of HBV DNA core promoter in sera, and then HBV DNA nPCR products were sequenced by direct sequencing.

RESULTSThe results show that 50.6% (39/77) of all HBV asymptomatic carriers were positive for HBV DNA HBV DNA positive rates of the samples from HCC higher incidence area, Longan County, and from lower incidence area, Guilin city were 55.6% (20/36) and 46.3% (19/41), respectively. HBV core promoter mutants could be seen in 35% in Longan positive samples and 47.4% in Guilin. The common mutations in both regions were all double mutations (nt 1,762 A-->T; nt 1,764 G-->A), accounting for 25% and 21%, respectively. The difference of the double mutant between Longan County and Guilin city was not significant (P>0.05).

CONCLUSIONSThese data implicated that the prevalence of HBV core promoter mutant isolated from asymptomatic carriers may not be correlated with the incidence of HCC in Guangxi.

Adolescent ; Adult ; Carcinoma, Hepatocellular ; virology ; Carrier State ; virology ; DNA, Viral ; genetics ; Female ; Hepatitis B ; virology ; Hepatitis B Core Antigens ; genetics ; Hepatitis B virus ; genetics ; Humans ; Liver Neoplasms ; virology ; Male ; Middle Aged ; Point Mutation ; Promoter Regions, Genetic ; genetics

BACKGROUNDAlthough endomyocardial biopsy (EMB) plays a crucial role in the final diagnosis in patients with heart failure of unknown etiology, the invasive nature of this technique limits its clinical application in China. The purpose of this study was to evaluate the clinical application of EMB in diagnosing cardiomyopathy with unexplained etiologies in China.

METHODSFifty-three consecutive patients (38 males, age 14 - 67 years, median 43 years) were included in the study who were initially diagnosed as unexplained cardiomyopathy and under EMB biopsy in Peking Union Medical College Hospital from 2006 to 2009. The patients were clinically divided into four groups: dilated, hypertrophic, restrictive and unclassified cardiomyopathy. Biopsies were performed via right internal jugular vein with the use of the bioptome under fluoroscopic guidance. Three to five endomyocardial samples were taken from each patient for light microscopy examination and one sample for electron microscopy was taken if necessary. For each patient, an initial clinical diagnosis, an EMB diagnosis and a final diagnosis prior to discharge were established. All the data were compared and analyzed for the evaluation of clinical utility of EMB in China.

RESULTSIn 26 patients initially diagnosed with restrictive cardiomyopathy (RCM), the etiology of the condition was finally diagnosed using EMB in 15; including 13 amyloidosis and two eosinophilic myocarditis. We employed EMB in 19 patients clinically diagnosed as dilated cardiomyopathy and detected viral myocarditis in one patient, cardiac involvement due to polymyositis in four and doxorubicin-induced cardiomyopathy in one. In five patients with severe left ventricle hypertrophy undergoing EMB, one patient was diagnosed as autophagic vacuolar cardiomyopathy and one as mitochondrial disease. In the remaining three patients with unclassified cardiomyopathy, EMB revealed infiltration of eosinophils as the cause of atrial ventricular block in one patient. Final diagnoses were made in 24 of the total 53 patients (45%) based on the combination of EMB and clinical data. Transient atrial ventricular block in a patient with prior complete left bundle branch block was the only complication occurred during the procedures.

CONCLUSIONThe clinical application of EMB is safe. The combination of EMB and clinical data produced a better understanding of the mechanisms behind the clinically diagnosed cardiomyopathy in China.

Adolescent ; Adult ; Aged ; Biopsy ; methods ; Cardiomyopathies ; classification ; diagnosis ; pathology ; Cardiomyopathy, Dilated ; diagnosis ; pathology ; Cardiomyopathy, Hypertrophic ; diagnosis ; pathology ; Cardiomyopathy, Restrictive ; diagnosis ; pathology ; Female ; Humans ; Male ; Middle Aged ; Myocardium ; pathology ; Young Adult