ObjectiveTo recognize the features of genitourinary dysfunction in multiple system atrophy (MSA) and the importance of videourodynamics.Methods5 cases of MSA were reviewed.ResultsGenitourinary dysfunction in MSA included voiding problem, nocturnal urinary frequency, urgency, impotence and so on. The characteristic appearance of videourodynamics was that postvoiding volume more than 100 ml, detrusor-external sphincter dyssynergia (DESD) and open bladder neck at the start of bladder filling. The abnormal sphincter electromyography comprised of abnormal spontaneous activity, motor unit potentials (MUPs) more than 13 ms, polyphasic potentials more than 60%. MRI showed brain atrophy and the "hot cross bun" signal in the pontocerebellar degeneration.ConclusionMSA is a disorder characterized by progressive neuronal atrophy at certain sites of the central nervous system that control the urogenital function. MSA-related urological symptoms are analogous with symptoms of bladder outlet obstruction. It is necessary to take some reasonable investigations for avoiding misdiagnosis and unnecessary surgery.

Fatty Acids ; metabolism ; Humans ; Myocardial Ischemia ; diagnostic imaging ; metabolism ; Tomography, Emission-Computed, Single-Photon

ObjectiveTo assess the safety of intramyocardium injection of sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) to rescue chronic heart failure beagles. MethodsThe heart failure beagles were assessed with myocardium enzymology, cAMP content of myocardium, myocardial oxygen consumption, arrhythmia, systemic inflammation factors, and the function of liver and kidney after SERCA2a gene transferred. ResultsThere were no increase of cAMP content, no more arrhythmia, myocardial oxygen consumption, no apparente systemic inflammation, and no injures to hepatic and renal function. ConclusionOverexpression of SERCA2a by intramyocardium injection is relatively safe.

Objective To analyze the direct and indirect effects of influencing factors on suicide ideation among college students based on the structural equation model. Methods 1505 college students were investigated with ASLEC, Simplified Coping Style Questionnaire, SSRS, QSA and BDI. Results Incidence rate of college students' suicidal ideations during the past year was 6.67%. The goodness of fit for the structural equation model was satisfactory and 3 major indices( x2/df = 2.23, GFI = 0. 982, RMSEA = 0. 029 ) had met corresponding requirements. The depression was directly influencing factor on suicide ideation, while four factors including passive coping style, social support, positive coping style and suicide attitude, had indirect impacts. Negative life event not only directly affected suicide ideation, but also had indirect effects. According to the percentages of their contribution, the risk factors were ranked as follows:depression (41.08%), negativity life event (35.35%) and passive coping style (6.05%). Similarly, the top protective factor was: social support ( 11.94% ), followed by positive coping style (4.94%) and suicide attitude (0.63%). Conclusion Depression is an important risk factor of suicide,and has a direct impact. So, not only strengthen the mental health of college students, but also train students to face up the difficulties with a positive style, and make the college students get social supports sufficiently.

Objective To improve the effect of clinical diagnosis and treatment of acetabular fracture with a femoral nerve injury by analyzing the causes of femoral nerve injury following acetabular fractures.Methods From January 1996 to November 2004,146 cases of acetabular fractures were treated operatively.Six cases of them were complicated with femoral nerve injury.The causes of femoral nerve injury were analyzed on the basis of clinical manifestations,CT scan and 3-dimensional reconstruc- tion.All the cases were classified according to Letournel and Judet classification.Three cases had hema- toma compression (2 cases with double column fractures and 1 with transverse-posterior wall fractures);2 cases had femoral nerve injury caused by fracture fragments (1 case with anterior wall fracture following anterior hip dislocation,the another with old fracture of anterior column combined with fracture of superior ramus of pubis);and one case had anterior column fracture combined with fracture of wing of ilium,and the femoral nerve was injured by traction in operation.Clearance of hematoma,nerve tract decompression and epineuria solution were performed in 5 cases,and 1 case was treated conservatively.Results The average follow-up period was 1.8 years(ranging from 1 to 3 years).The muscle power of quadriceps fem- oris recovered from 1-2 grade before operation to 4-5 grade after operation in 5 cases.The function of ex- tensor knee and gait was normal.The function of sensory completely recovered in 4 cases.One case was followed up for 2 years,which showed the patient still suffered from hypoesthesia in the lower 2/3 of the thigh and the medial of the leg.One ease of traction injury was followed up for 1.2 years,showing the muscle power recovered to normal,but still presented with sensory disability.Conclusion Acetabular fractures associated with femoral nerve injury are rare.For complex acetabular fractures and severe trau- ma,attention should be given to the possibility of femoral nerve injury.Fragment stabbing and compres- sion of hematoma around iliopsoas muscle are the common causes of femoral nerve injury following ace- tabular fractures.Iatrogenic injury should not be ignored.

Objective To analyze the impact of multiple factors on the incidence of pneumothorax associated with CT-guided transthoracic needle aspiration biopsy.Methods The sign of pneumothorax after 162 cases(lesion diameter from 1cm to 6cm)CT-guided transthoracic needle aspiration biopsy was observed and its relationship with multivariate factors were analyzed by multivariate logistic regression model.Results Thirty-two cases presented pneumothorax accounting for 19.8%.Single variate analysis showed that the sign of pneumothorax ralated to intercurrent COPD,distance from lesion and chest wall,needle dwelling time and lesion diameter.67 patients of intercurrent COPD with postoperative pneumothorax occurred in 22 cases (32.8%);With respect to those having lesions close to the chest wall(48 cases),and the cases with the distance between the chest wall and lesions less than 2cm(55 cases)and greater than 2cm(59 cases), the postoperative pneumothorax occurred in 0,14(25.5%),18(30.5%)cases respectively;For those patients with needle in the chest residence time of less than 10 minutes(82 cases),10—20 minutes (51 cases),more than 20 minutes(28 cases)after the occurrence of pneumothorax were 8(9.6%), 10(19.6%),14(50%)cases respectively;In contrast,those with lesion diameter less than 2 cm (65 cases),2—4cm(52 cases),more than 4cm(45 cases)were 19(29.2%),8(15.4%) and 5(11.1%)respectively.The multivariate logistic regression analysis showed that the prior three factors were risk factors of pneumothorax(OR=4.652,4.030,2.855 respectively).Conclusions To avoid the pneumothorax,caution must be taken with respect to CT-guided transthoracic needle aspiration biopsy, patients with intercurrent COPD,long distance between lesion and chest wall,and smaller lesion diameter. For operation the needle dwell time within thorax should be minimized.

Objective The aim of this study was to investigate the clinical significance of CDKN1C positive expression in bone marrow in patients with myelodysplastic syndrome and secondary acute myeloid leukemia.Methods 125 patients with MDS/AML were selected as the research subjects,and selected 20 healthy subjects as a healthy control group.The mRNA and protein ex-pression levels of CDKN1C in CD34 +cells of MDS/AML patients were analyzed.The expression levels of CDKN1C were compared with those of MDS patients.The survival rate of patients with MDS and AML was analyzed by Cox regression analysis.The survival rate of MDS patients with different expression levels of CDKN1C was also analyzed.Results The expression of CDKN1C at levels of mR-NA and protein in bone marrow CD34 +cells of MDS/AML patients were significantly higher than those in healthy controls(P <0.05).There has a positive correction with BM(P<0.05).The survival rate of CDKN1C high expression group was significantly low-er than that in the low and mediate CDKN1C expression groups(P<0.05).The results of Cox regression analysis showed that age, high BM count,cytogenetic difference and the positive expression of CDKN1C significantly affected the survival rate of patients with MDS/AML(P< 0.05);The survival rate of MDS/AML chemotherapy in the CDKN1C positive group was significantly lower than that of CDKN1C negative expression group(P<0.05).The survival rate of MDS/AML after chemotherapy AlloSCT CDKN1C positive ex-pression group was significantly lower than that of CDKN1C negative expression group(P<0.05).Conclusion The expression of CDKN1C in bone marrow of MDS/AML patients was significantly increased,and the positive expression of CDKN1C significantly in-creased,and the positive expression of CDKN1C significantly affected the survival rate of MDS/AML patients.

A boy, aged 2 years and 4 months, had a sudden onset of blepharoptosis of the right eyelid, accompanied by the mouth deviated to the right side, drinking cough, nystagmus, and developmental regression. Cranial MRI showed softening lesions formed after infarction of the right dorsolateral medulla oblongata, while head CT angiography showed no imaging of the proximal part of the V4 segment of the right vertebral artery. The child was diagnosed with dorsolateral medulla oblongata syndrome and was treated with gamma globulin to regulate immune function, with mannitol to reduce neuronal edema, with low-molecular-weight heparin sodium to improve local hypercoagulation of occluded blood vessels, with hyperbaric oxygen to improve local ischemia and hypoxia and promote the recovery of brain function, and with neuromuscular electrical stimulation to promote the recovery of neuromuscular function. Before discharge, only mild right ataxia and Horner syndrome remained. This article reports the first case of infantile dorsolateral medulla oblongata syndrome and provides experience for the diagnosis and treatment of the disease.
Blepharoptosis/etiology* ; Child, Preschool ; Dysarthria/etiology* ; Humans ; Lateral Medullary Syndrome/diagnosis* ; Magnetic Resonance Imaging ; Male ; Medulla Oblongata/diagnostic imaging*

OBJECTIVETo study the inhibitory effect and reasons of liposomes survivin antisense oligonucleotides (ASODN) on growth of human gastric carcinoma transplanted subcutaneously in nude mice.

METHODSHuman gastric carcinoma transplanted subcutaneously in nude mice model was established, and subsequently was divided randomly into six groups: control group, liposome group, sense oligonucleotide (SODN) group, 100, 200 and 400 nmol/L ASODN group. Different treatments were given respectively. The weight and volume of subcutaneous tumors were measured, and tumor growth inhibitory rate and decreased rate was calculated. The morphological changes of transplanted tumor cells were observed under light microscope. The expression of survivin was detected by immunohistology (SP). Changes of survivin gene transcription and protein expression were determined by western blot and RT-PCR.

RESULTSGrowth of the tumors was significantly inhibited in all ASODN groups as compared with that in the control, liposome and SODN group. The highest growth inhibitory rate in the 400 nmol/L group is 93%. The number of apoptotic cells of ASODN group increased and expression of survivin became weaken under the microscope. Liquified necrosis regions could be seen in 6 cases (6/12) of tumor tissues. The content of survivin mRNA and protein decreased in all survivin ASODN groups. The survivin protein expression of 400 nmol/L group was about 36.8% of the control group.

CONCLUSIONSSurvivin gene ASODN can inhibit the growth of human gastric carcinoma in nude mice by inducing cells apoptosis and decreasing the expression of survivin mRNA and protein.

Animals ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Humans ; Inhibitor of Apoptosis Proteins ; Liposomes ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Microtubule-Associated Proteins ; biosynthesis ; genetics ; Neoplasm Proteins ; biosynthesis ; genetics ; Neoplasm Transplantation ; Oligonucleotides, Antisense ; genetics ; pharmacology ; RNA, Messenger ; genetics ; Stomach Neoplasms ; metabolism ; pathology ; therapy