Objective To investigate the role of plasma tissue factor (TF) and tissue factor pathway inhibitor-1 (TFPI-1) level and to observe the effect of extrinsic TFPI-1 on no-reflow (NR) in a rabbit model of ischemia/reperfusion. Methods Rabbits were randomized into four groups (n = 10 each): ischemic- reperfusion group (IR, subjected to 120 minutes of coronary artery occlusion and followed by 60 minutes of reperfusion); ischemic- reperfusion TFPI-1 group (100 ng/kg bolus and 1 ng · kg~(-1) · min~(-1) infusion during reperfusion) ; ischemic group (subjected to 180 minutes of coronary artery occlusion) and sham group. The NR area and ischemic area were determined by thioflavin S and Evan's blue staining in vivo. Plasma TF and TFPI-1 levels were measured before operation, before and at 120 minutes post coronary artery ligation, 10 and 60 minutes after reperfusion by ELISA. Results Plasma TF and TFPI-1 levels before and at 120 minutes post coronary artery ligation were similar among the four groups (all P > 0.05). At 10 and 60 minutes after reperfusion, the plasma TF levels in the IR group was significantly higher than those in ischemic group and sham group [10 minutes: (20.7 ±4. 1) pg/ml vs. (13.9 ±2. 2)pg/ml(P <0. 001), (20.7±4. l)pg/ml vs. (13.2±2.6) pg/ml(P<0. 001); 60 minutes; (15.8±2.6) pg/ml vs. (13.5± 1.6) pg/ml(P<0.05), (15.8 ±2.6) pg/ml vs. (12.1 ±0.7) pg/ml (P < 0. 001)] while the plasma TFPI-1 levels were similar among IR, ischemic and sham groups at 10 minutes after reperfusion and at 60 minutes after reperfusion (all P >0. 05). TFPI-1 level [(9.7 ± 1. 6) ng/ml] was significantly lower in the IR group than in the ischemic group [(11.6 ±1.6) ng/ml, P < 0. 05] and sham group [( 10. 1 ±1.3) ng/ml, P < 0. 01] . TF mRNA expression in the NR area in IR group was significantly up-regulated compared to the ischemic group (P<0. 05) and sham group (P <0. 001 ) while TFPI-1 mRNA expression was similar between IR group and ischemic group ( P > 0. 05 ) . NR severity in the ischemic-reperfusion TFPI-1 group was significantly attenuated compared to IR group (0. 39 ±0. 11 vs. 0.54±0.06, P<0.01). Conclusion Upregulated TF mRNA expression in the NR area and increased plasma TF level during reperfusion period, reduced plasma TFPI-1 level during reperfusion period as well as attenuated NR severity by extrinsic application of human rTFPI-1 in this model suggested an important role in the pathogenesis of the NR phenomenon.

Background Image clarity during near work is influenced by several factors,such as accommodative lag,pupil size and monochromatic aberrations.Since image clarity during extended reading at near distance has been cited as a possible inducement of myopia in childhood and a possible difference between myopic and emmetropic people throughout life,it is important to examine these factors in myopic and emmetropic myopic juvenile during reading at near distance. Objective The aim of this study was to investigate the relationships among wavefront aberrations,accommodative response and pupil size in early onset and progressive myopes eyes under the different reading status and explore the possible mechanism of the development of myopia as well. Methods Fiflyseven subjects aged from 12 to 16 years were enrolled and grouped as emmetropes,the onset of myopes and progressive myopes.Reading material were Chinese novels presented by rapid serial visual presentation at a distance of 25 cm. Accommodative response and pupil size were recorded by a Grand Seiko WV-500 autorefractor.The Image J software was used to calculate the pupil diameter.Wavefront aberrations were then measured with a WASCA wavefront analyzer. Results Aberrations and accommodative response showed large inter-subjeet variability.With accommodative stimulus of 4 diopter,the accommodative lag in the early-onset of myopes group and progressive myopes group were ( 1.72 ±0. 53) D and ( 1.74 ±0. 44) D, showing larger value in comparison with ( 0. 96 ±0. 55) D of emmetropes group( t＝4.25 ,t=4.47 ,P<0. 001). However,there were no significant differences in accommodative lag between the early-onset of myopes group and progressive myopes group( t = 0. 18, P>0. 05). The mean value of pupil diameter, total RMS value, high-order RMS value, spherical aberration and coma were all significantly reduced with the stimulus varied from 0 D to 4 D( P<0. 01). However,none of the pupil sizs,total RMS value,high-order RMS value,spherical aberration and coma had significant difference among different refractive groups( P>0. 05). Conclusion The early-onset of myopes and progressive myopes had larger accommodative lag. The lower sensitivity to defocus at near reading distance,inducing the larger accommodative lag and hyperopic defocus may be linked to the developing myopia.

Background Currently,the recommendation when treating acute biliary or pancreatic disease during pregnancy is to perform endoscopic retrograde cholangiopancreatography (ERCP) without radiation exposure,either empirically (with no radiographic guidance) or with ultrasound guidance.However,few published studies compared these two ways.This study aimed to compare ultrasound-guided ERCP with the procedure without radiographic guidance in the treatment of acute pancreaticobiliary disease in pregnant patients.Methods The clinical data of 68 pregnant patients with acute pancreaticobiliary disease admitted to our hospital between January 2004 and May 2010 were reviewed retrospectively.ERCP was performed without radiographic guidance in 36 cases (group A) and with ultrasound guidance in 32 cases (group B).Data on the following variables were compared between the two groups:surgical success rate,rate of complete stone removal,time to resolution of clinical manifestations and laboratory indicators,length of hospital stay,complications,outcome and differences in efficacy of ERCP during different stages of pregnancy.Results In group A,the rates of surgical success and complete removal of stones were 69％ and 60％,respectively; the corresponding values were 91％ and 89％ in group B (P ＜0.05).Postoperatively,clinical manifestations improved rapidly in all patients; there was no statistically significant difference between the groups (P ＞0.05).Leukocyte counts and liver function had improved significantly after one week in all patients; they recovered more quickly in group B ((8.64±1.83)days vs.(14.57±3.74) days,(14.29±4.64) days vs.(20.00±5.40) days,P ＜0.01).The hospital stay was shorter in group B ((16.28±7.25) days vs.(28.00±6.83) days,P＜0.001).The complication rate was 14％ in group A and 3％ in group B (P ＜0.05).There were no significant differences between the two groups in the procedure's efficacy during different stages of pregnancy.Conclusions In the treatment of acute pancreaticobiliary disease during pregnancy,ultrasound-guided ERCP is safer and more effective than performing the procedure empirically without radiographic guidance when performed by experienced practitioners.Its more widespread use is recommended.

Objective To investigated the effects of combined arsenic trioxide(ATO) and resveratrol(Res)on the viability of NB4 human leukemia cells. Methods NB4 human leukemia cell was used in this experiment.Cells were cultured in ATO (0,0.1875,0.3750,0.7500, 1.1250, 1.5000,2.2500,3.0000,5.0000 μmol/L) and Res (0, 1.5625,3.1250,6.2500, 12.5000, 18.7500,25.0000,37.5000,50.0000 μmol/L). Cell viabilities were measured by MTT in different treatment groups. Half inhibitory concentration(IC50) was calculated. The ratio of concentration of ATO and Res 1.5∶ 18,1.5∶ 25,1.5∶ 35 was added to cells, and the combination index(CI) was calculated. The level of ROS in control, ATO( 1.5000 μmol/L), Res(25.0000 μmol/L) and ATO(0.9000 μmol/L) + Res( 12.5000μmol/L) groups was measured by chemiluminescence assay. Results ①ATO( ≥0.7500 μmol/L) reduced the viability of NB4 cells in a concentration-dependent manner(P ＜ 0.05 ), and IC50 was (1.78 ± 0.11 )μmol/L. ②)Res (≥18.7500 μ mol/L) dose-dependently decreased the viability of NB4 cells (P ＜ 0.05 ), and IC50 was ( 18.71 ±0.18)μ mol/L. ③Combination of ATO and Res showed an antagonistic effect on NB4 cells viability. ④The ROS in Res group( 1670.55 ± 13.97) was significantly lower than that in control group(2345.88 ± 14.48,P ＜ 0.05). The ROS in ATO group (3092.42 ± 94.84) was significantly higher than that in control group(P ＜ 0.05). The ROS in ATO + Res group (1860.27 ± 15.99) was significantly lower than that in ATO group(P ＜ 0.05). Conclusions NB4 cell survival rate can be decreased by ATO and Res. The combination of arsenic trioxide and Res presents an antagonistic effect on NB4 cell viability, in part by reducing intracellular ROS formation.

With the promoting of medicine and health system reform,it provided new requirement for the price management of medical consumbles.Based on the current statns of medical consumbles price management in China,it studied the mechanism of pricing and reimbursement of Japan and Australia.To implement the price management mode of Chinese medical consumables through optimizing China medical service item package charging,playing the function of evidence-based evaluation and economic evaluation and establishing the supervision system of medical consumable prices.

Objective To study the clinical and imaging features of patients with bone metastases from breast cancer and identify the factors related to the incidence of bone metastases. Methods Three hundred and thirty-four patients with breast cancer were recruited into this study. Whole-body 99Tcm-methylene disphosphonate (MDP) bone scan, clinical staging, pathological, immunohistochemical and serological test results were analyzed retrospectively. χ2 test was used for statistical analysis. Results The incidence rate of bone metastases for patients with and without lymph node metastases was 71% (152/214) and 22. 5% (27/120), respectively (χ2 =72.80, P =0.000). The incidence rate of bone metastases from infiltrated non-specified and specified breast cancer was 69% (203/294) and 41.7% (5/12), respectively (χ2 =3. 97, P=0.046). Alkaline phosphatase (ALP) was elevated in 28.5% (51/179) and 14.9%(11/74) of patients with and without bone metastases, respectively (χ2 = 5. 25, P = 0.022 ). Carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 15-3, CA125, CA19-9 increased in 68.7% ( 123/179) and 27.0% (20/74) of patients with and without bone metastases, respectively (χ2 = 37. 03, P =0. 000). Conclusions The incidence of bone metastases from breast cancer is correlated to pathological types of primary tumor and lymph node metastases. Bone metastases occurs more frequently in patients with infiltrated, non-specified, primary cancer and with lymph node metastases. Serum ALP, CEA, CA15-3,CA125, CA19-9 might be the tumor makers for early diagnosis of bone metastases from breast cancer.

Objective To evaluate the value of transesophageal echocardiography (TEE) in transthoracic minimally invasive device closure of ventricular septal defect(VSD).Methods A total of 164 cases of VSD were recruited as candidates to receive transthoracic minimally invasive device closure between January 2007 and October 2010,including 138 perimembranous VSDs,3 muscular VSDs and 23 supracristal VSDs.Among these groups,85 male patients were included.Four-champer view,five-champer view,left ventricular long-axis view,short-axis view and right ventricular inflow view were detected to evaluate the availability of device closure.Results A total of 152 cases(92.7%)were successfully closed with a device.All the patients were followed up more than 3 months arranged with a standard protocol.No complete atrioventricular block (CAVB) or associated valvular complications were observed.Three of the five cases with traced residual shunt after device closure closed spontaneously.Conclusion TEE plays an important role in transthoracic minimally invasive device closure of ventricular septal defect,which has been proved by the good follow-up results without CAVB and associated valvular complications.

Objective To investigate the relationship between the patient-based questionnaires and the computed tomography (CT) staging in patients with chronic rhinosinusitis (CRS). Methods Quantitative data of 121 preoperative recruits with CRS were collected by using the Lund-Mackay CT staging system, a visual analogue scale ( VAS), sino-nasal outcome test-20 ( SNOT-20), and the medical outcome study short-form 36 items (SF-36). The patients were classified into several subgroups according to whether CRS was associated with nasal polyps (NP) or not, sex, duration of disease, and educational background.Correlation between the patient-based questionnaires and the CT staging were analyzed in the total cohort patients and subgroups. Results In the total cohort patients, there were significant correlations between SNOT-20 and SF-36 ( r = -0. 561, P ＜ 0. 01 ), SNOT-20 and VAS ( r = 0. 743, P ＜ 0. 0l ), and SF-36 and VAS ( r = - 0. 504, P ＜ 0. 01 ), however, the CT staging did not correlate with the patient-based questionnaires (P ＞ 0. 05 ). Significant but weak correlations were found between the CT staging and the patient-based questionnaires in the C RS with NP subgroup (CT vs SNOT-20, r = 0. 318, P = 0. 005; CT vs SF-36, r = - 0. 358, P = 0. 002; CT vs VAS, r = 0. 358, P = 0. 002). Compared between CRS with NP and without NP subgroup, there were statistic differences on the Lund-Mackay CT stage and the SNOT-20 and VAS scores (t value was 3.249, -2.409, -2.957, respectively, all P＜0.05). Conclusions The patient-based questionnaires correlate well with each other, but CT staging correlated significantly but weakly with the patient-based questionnaires only in the CRS with NP subgroup. Nasal polyps do not appear to be responsible for the adverse effects of CRS on quality of life.

Objective To investigate the clillicoradiologic characteristics of MarchiafavaBignami disease (MBD). Methods The clinical and neuroimaging findings, including lesion morphorogy, distribution, signal intensity/density in 7 MBD patients were retmspectiVely analyzed.Diffusion-weighted imaging(DWI)was performed in 5 cases.Of the 7 cases,4 underwent both CT and MRI,2 only CT and 1 MRI. Results with extensive iso-or slightly hypo-intensity on T1-weighted images and hyper-intensity on T2-weighted images, 5 patients were manifested as acute onset, in which white matter (WM) was symmetrically involved in bilateral periventricular and frontal subconical regions. Punctate or linear hypo-intensity on FLAIR images was found in the atrophied corpus callosum in 1 case presented as chronic type, with scattered patchy hyper-intensity in periventricular WM and frontal subcortical WM. DWI showed markedly hyper-intensity with diffusion restriction in 2 cases in acute phase with apparent diffusion coefficient(ADC)values(0.52～0.55)×10-3 mm2/s.Brain atrophy was found in all the 7 patients. Conclusions The MRI features of MBD are characteristic and may be associated with the clinical spectrum and prognosis.

Objective To investigate the process of electrical activities when human brain deals with the facial sexual information. Methods Forty healthy college students in March 2005 were selected from Southern Medical University. All subjects participating in the experiment vohmtarily were right-handed with normal or corrected sight and never suffered from family history of mental disorder. 360 pictures of real human face (balf females and half males) strange to all participants, were used as the stimulus presented once one by one in randomized order on the screen with a stimulus duration of 800 ms and a stimulus onset asynchrony (SOA) of 1200 ms. Half subjects were asked to press the left button of a game-pad immediately after female face presentation and the right for male, the other half reversed. Event-related electroencephalogram (EEG) was recorded by 19 channels of international 10-20 system with linked earlobes as reference. EEG epochs from 100 ms before to 800 ms after stimulus were amplified by means of an ERPs system developed in our lab, digitized with sampling frequency of 1000 Hz, bandwidth of [0.1, 30] Hz and a notch of 50 Hz. Electrode impedance was less than 5 kΩ. Trial contaminated with ocular, muscular or any other type of artifacts were inspected visually and rejected. Each 60 stimuli of the same gender faces worked as an overlaying unit (the real overlay number was about 45-50 with bad epochs rejected). Three female and 3 male subjects were excluded owing to the bad ERP record quality and thus 34x6 epochs came from the rest ones. Results (1) The possible difference trend (but P>0.05) between male and female facial stimuli appeared at the frontal area in 40-100 ms after stimuli; (2) The significant difference between male and female appeared at the occipital in 140-160 ms after stimuli (P<0.05); (3) The significant difference between male and female appeared at the large frontal and occipital area in 200-260 ms after stimuli (P<0.05); (4) The significant difference between male and female appeared at the large central parietal in 280-300 ms after stimuli (P<0.05); (5) The significant difference or trend between male and female appeared at several areas in different time after 360 ms. Conclusion In different stage, different brain areas are activated for the facial sexual feature processing. Thus, our brain works as a network.