OBJECTIVETo investigate the value of dual-source computed tomography (DSCT) angiography in the examination of congenital coronary artery anomalies.

METHODSWe retrospectively examined 2530 patients by DSCT angiography between January 2008 and September 2010. Congenital coronary artery anomalies were shown by maximum intensity projection, curved planar reconstruction, and volume rendering.

RESULTSA total of 284 segments with congenital coronary artery anomalies in 225 patients were displayed. The anomalies included those originated from the main branch of coronary artery (n=121, including 35 segments of right coronary artery with high take-off origin and 24 segments of left coronary artery, 17 segments of right coronary artery dated from left aortic sinus, 4 segments of left coronary artery dated from right aortic sinus, 2 segments of left coronary artery dated from posterior aortic sinus, 2 segments of single coronary artery, and 37 segments of para-coronary artery) , coronary artery dysplasia (n=18) , coronary artery fistula (n=9, including 4 segments of right coronary artery-right ventricle fistula, 2 segments of right coronary artery-pulmonary artery fistula, 2 segments of left coronary artery-left ventricle fistula, and 1 segments of left coronary artery-pulmonary artery fistula) , and myocardial bridge (n=136) . In addition, 818 segments of left sinuatrial nodal artery original anomalies in 1720 patients whose sinuatrial nodal artery were well shown.

CONCLUSIONDSCT can be helpful in detecting the anomalies of coronary artery.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Coronary Angiography ; methods ; Coronary Vessel Anomalies ; diagnostic imaging ; Female ; Humans ; Infant ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods ; Young Adult

Objective:To explore the effects of pedicled rectus abdominis myocutaneous (PRAM)flap combined with free deep inferior epigastric artery perforator (DIEAP) flap carrying inguinal lymphatic flap in breast reconstruction and upper limb lymphedema treatment post radical mastectomy.Methods:From October 2014 to September 2016, 9 patients with upper limb lymphedema after mastectomy were treated with PRAM flap combined with free DIEAP flap carrying inguinal lymphatic flap for breast reconstruction and upper limb lymphedema treatment in Hunan Province Cancer Hospital. The patients were all females, aged 34-66 (44±7) years. The location of deep inferior epigastric artery perforator was detected by audible Doppler ultrasound blood stream detector and computed tomography angiography for designing combined tissue flap, with length of (25.32±0.27) cm, width of (13.14±0.76) cm, and thickness of (3.55±0.34) cm. The donor site of combined tissue flap was closed by suturing, and two or more tubes for negative pressure drainage were placed according to the situation of donor site and recipient site. Operation time and average placing time of negative pressure drainage tube, postoperative condition of combined tissue flap and the donor site, reconstructed breast condition, recovery of upper limb lymphedema were documented and followed up.Results:The operation time was 290-420 (396±55) min. The average retaining time of negative pressure drainage tube in breast was 5.9 d, while the average retaining time of negative pressure drainage tube in abdomen was 4.3 d. Ecchymoma occurred in DIEAP flap of one patient and in the flap donor site of another patient. Delayed healing was also seen in the rectus abdominis myocutaneous flap of a patient, which healed eventually after dressing change, and the other flaps survived well. The appearance of reconstructed breast was good with good elasticity, and no contracture or deformation occurred in the tissue flap. The upper limb lymphedema in 7 patients was alleviated in varying degrees, with 2.0-4.0 cm reduction in circumference. During follow-up of 12-24 months of 9 patients, averaged 17.5 months, with 6 patients received long term bandage pressure therapy and physical therapy to the affected limbs after operation and all patients were satisfied with appearances of the affected limbs. Neuropathic pain in affected limbs was significantly relieved in 2 patients and stopped aggravating in the other 2 patients. Only linear scar was seen in the donor site of abdomen without affecting obviously the function of abdomen.Conclusions:The PRAM flap combined with free DIEAP flap carrying inguinal lymphatic flap is an effective way for breast reconstruction and upper limb lymphedema treatment post mastectomy.

This study was aimed to investigate the effects of flavonoids of puerarin (PR) on apoptosis of acute promyelocytic leukemia (APL) cell line NB4 cells and its mechanism. The NB4 were treated with PR in vitro, the MTT assay was used to detect the inhibitory effect of PR on cell proliferation. The apoptosis of NB4 cells were detected by flow cytometry labelled with Annexin V/PI. The expressions of pml/rar alpha, bcl-2 and survivin were detected by real time reverse transcription-polymerase chain reaction (real time RT-PCR), the expressions of JNK, p38 MAPK, FasL, caspase 3, caspase 8 were detected by Western blot. The results showed that with the increasing of PR concentrations, the apoptosis rates of NB4 cells were gradually elevated. Simultaneously, the mRNA expression of pml/rar alpha, bcl-2 and survivin decreased, while the protein expression of JNK, FasL, caspase 3 and caspase 8 increased, which presented the positive correlation to PR concentrations. When PR combined with arsenic trioxide (ATO), the expression levels of above mentioned mRNA and protein decreased or increased more significantly. It is concluded that PR can effectively induce the apoptosis of NB4 cells. PR combined with ATO displays synergistic effect. It may be triggered by the activation of JNK signal pathway.
Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Humans ; Isoflavones ; pharmacology ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Leukemia, Promyelocytic, Acute ; pathology

OBJECTIVETo review the outcome of repeated percutaneous sperm aspiration (PESA) and testicular sperm extraction (TESE) for intracytoplasmic sperm injection (ICSI).

METHODSForty-three cycles of 31 cases of azoospermic patients which underwent at least two PESA or TESE for ICSI from January 2001 to December 2002 were collected. The sperm retrieval, fertilization, implantation and clinical pregnancy were analyzed.

RESULTSTwenty-four cases underwent PESA and 7 cases underwent TESE. There were not any complications in these patients. Compared with the first cycle of 154 cases, the fertilization rate, implantation rate and clinical pregnancy rate were 78.39% vs 73.64%, 19.68% vs 18.38% and 34.88% vs 37.91%, respectively(P > 0.05).

CONCLUSIONSRepeated PESA or TESE is safe and well tolerated in azoospermic patients. Compared with the first cycle, the differences of repeated PESA or TESE cycles in fertilization rate, implantation rate and clinical pregnancy rate were not statistically significant.

Adult ; Azoospermia ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic ; methods ; Tissue and Organ Harvesting ; methods

OBJECTIVESTo review the retrospective treatment results of the azoospermia patients during January 2001 to January 2002 in the fertility center.

METHODSOne hundred males attempted intracytoplasmic sperm injection (ICSI) cycle for treatment of azoospermia. All patients were undergone sperm retrieval by percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE) while their wives received conventional ovarian hyperstimulation. The hormone levels, testicular histology, the rates of sperm retrieval, fertilization, implantation and pregnancy were analysed and evaluated.

RESULTSSperm were retrieved by PESA in 76 of 100 (76%) and by TESE in 23 of 100 (23%) men of azoospermia. The fertilization rate, implantation rate and clinical pregnancy rate were 71.3%, 20.35% and 42.11% respectively in PESA group, and 75.18%, 22.05% and 41.60% respectively in TESA group. Thirty-two clinical pregnancies were achieved with 15 ongoing pregnancies and subsequent live delivery for 15 cases in PESA group, and 2 cases of miscarriage, while 10 clinical pregnancies were achieved with 6 ongoing pregnancies, 2 cases of live delivery and 2 cases of miscarriage in TESA group. One case failed to retrieve sperm by TESE and canceled.

CONCLUSIONSHormonal levels and testicular histology are unable to predict which men with azoospermia will have sperm retrieved by PESA and TESE. PESA and TESE with ICSI are effective methods to treat azoospermia. There were no significant differences in fertilization, implantation and clinical pregnancy rate between two groups.

Adult ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Male ; Middle Aged ; Oligospermia ; blood ; therapy ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; methods

Objective To explore the siRNA as a new antiviral therapy,evaluate the inhibition effect of siRNA based on vector on the HBV of HepG2.2.15 cell,and observe the side effect and toxicity of siRNA vector on cells and the off-target effect of siRNA.Methods Three pairs of siRNA duplexes targeting HBV C gene were designed as double strands,and the duplex were annealed and ligated into the p-Silencer-Cmv 4.1-hygro vector.The ligation products were used to transform JM109 cells.The clones with shRNA were obtained,and the vectors were purified.After the initial identification of the vector with agarose gel and the size of the inserted sequence got examined by native polyacrylamide gel electrophoresis,furthermore the sequencing was further carried out.The recombinant plasmids were purified with ultrapure Midipreps DNA Purification System.Then HepG2.2.15 cells were transfected with the plasmid mixed with siPort XP-1.The expression of HBsAg and HBeAg were detected by immunofluorescence and Western blot,and the HBV RNA was investigated by RT-PCR.Furthermore the real-time quantitive PCR was carried out to detect the changes of HBV DNA.In order to evaluate the toxicity of the shRNA,MTT was used to examine the growth rate and curve of cells.The ELISA was performed to detect the changes of interferon-? (IFN-?).Results The Western blot showed that the HBsAg and HBeAg protein were suppressed with (81.15?0.69)%,(88.12?0.92)% respectively by vector p-C2 on the third day of post-transfection.It had the similar result indicated by immunofluorescence.And the RT-PCR showed that the specific siRNA targeting HBV C gene could markedly suppress the expression of HBV mRNA and the HBV C gene mRNA was inhibited with 96.9%.The real-time quantitive PCR showed that the specific functional siRNA could markedly suppress HBV DNA copy with two orders of magnitude,while the siRNA vector had no effect on the growth of cell showed by MTT detection.Compared with the non-transfected group and p-NC group,the IFN-? level was almost the same with siRNA p-C1,p-C2,p-C3 groups.Conclusions The siRNA based on the expression vector can suppress the expression and replication of HBV in HepG2.2.15 cell.The inhibition effect was specific and had a certain dependency on siRNA concentration.No toxicity effect was found in the study.And the drug resistance wouldn′t happen because the silence was based on the split of gene.

Objective To prepare F7 thermosensitive liposome and evaluate its physicochemical properties, then investigate its cytotoxicity against tumor cells in vitro. Methods The F7 thermosensitive liposome was prepared by the pH gradient active drug loading method using dipalmitoyl phosphatidylcholine myristoyl lyso-phosphocholine and 1, 2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy (polyethylene glycol)-2000 as membrane materials. The encapsulation efficiency and drug loading were determined for the F7 thermosensitive liposome by HPLC. The phase transition temperature of F7 thermosensitive liposome was investigated by differential scanning calorimetry;the liposome morphology was observed by atomic force microscopy;the drug release of liposome was examined by dialysis;and the particle size and zeta potential were measured through Malvern particle size analyzer. The cytotoxicity of F7 and F7 thermosensitive liposome was determined by the MTT method, and the freeze-drying process was optimized using the designexpert software. Results The encapsulation efficiency of F7 thermosensitive liposomes was (97.56±0.22) ％, and the drug loading ratio was (1.51±0.01) ％. The phase transition temperature of F7 thermosensitive liposome was 39.9℃, the zeta potential was (-15.10±0.85) mV, the particle size was (86.94±1.21) nm, and the poly disperse coefficient was 0.17±0.01. Compared with the F7 injection, the F7 thermosensitive liposomes showed a stronger, dose-dependent inhibitory effect on the growth of lung cancer H1299 and breast cancer MCF-7 cells. The freeze-dried powder of liposomes dissolved well with the encapsulation efficiency of 95％ and the particle size of approximately 130 nm. Conclusion The F7 thermosensitive liposome prepared by the pH gradient active drug loading method has high encapsulation efficiency and good stability. The preparation method is simple and feasible for further development of the F7 preparation.

The objective of this study was to explore the differences between refractory anemia with ringed sideroblast (RARS) and RARS associated with marked thrombocytosis (RARS-T) in the clinical, biological features and prognosis. The morphological changes of cells were observed by bone marrow smear and biopsy. Immunologic phenotype was analyzed by flow cytometry, and chromosome was examined by conventional chromosomal analysis. JAK2 V617F and MPL W515L mutations were screened by allele-specific polymerase chain reaction (AS-PCR) and sequence analysis. The results showed that this case was clinically diagnosed as RARS with thrombophilia, the level of serum potassium was positively related with platelet counts. When platelets increased, the clusters of atypical giant platelets and megakaryocytes were observed in peripheral blood and bone marrow examined by bone marrow smear and bone marrow biopsy respectively, JAK2 V617F and MPL W515L mutations were negative. It is concluded that RARS may transform into RARS-T accompanied with megakaryocyte proliferation, large atypical platelets and negative JAK2 V617F. Preventing thrombophilia and monitoring relative gene mutations are necessary when atypical giant platelets and fluctuant platelet counts occurred in process of RARS with tendency to RARS-T.
Aged ; Anemia, Refractory ; diagnosis ; metabolism ; pathology ; Anemia, Sideroblastic ; diagnosis ; pathology ; Blood Platelets ; pathology ; Female ; Humans ; Platelet Count ; Thrombocytosis ; pathology

OBJECTIVE: To compare the clinical efficacy of staged surgery on Sanders Ⅳ calcaneal fractures with soft tissue Ⅲ swelling. METHODS: The clinical data of 76 patients with Sanders type Ⅳ closed calcaneal fracture with soft tissue three-degree swelling treated from June 2017 to May 2020 was retrospectively analyzed, including 54 males and 22 females, aged from 25 to 50 (38.16±10.24) years. The patients were divided into observation group and control group according to different treatment methods. Twenty-four patients in the observation group were treated by staged surgery stageⅠclosed prying traction reduction and Kirschner wire fixation, stageⅡopen reduction and internal fixation with titanium plate, including 17 males and 7 females, aged from 25 to 50 (36.12±9.56) years. There were 52 patients in the control group, including 37 males and 15 females, aged from 25 to 50 (38.32±10.67) years, these patients were treated with open reduction and internal fixation with titanium plate after the dermatoglyphic signs appeared. The swelling subsidence time, the length of hospitalization days, and the incidence of postoperative incision complications were compared between two groups. The Bhler angle, Gissane angle, and calcaneal varus angle were measured by X-ray before and 6 months after operation. American Orthopedic Foot and Ankle Society (AOFAS) about the ankle hindfoot score was used to evaluate the clinical efficacy. RESULTS: All 76 patients were followed up for 8 to 12 (9.52±2.01) months. The swelling subsidence time and hospitalization days in observation group were (12.12± 3.24) d and (24.53±6.44) d, respectively, which in control group were (15.16±4.16) d and (29.46±9.61) d, with statistical difference between two groups ( CONCLUSION Compared with open reduction and internal fixation with titanium plate after the appearance of dermatoglyphic signs, staged surgery for Sanders type Ⅳ calcaneal fractures with soft tissue three-swelling does not increase the risk of soft tissue complications, and can significantly shorten the patient's swelling subsidence time and hospitalization days, improve the quality of fracture reduction and short term function, and relieve pain.
Ankle Injuries ; Calcaneus/surgery* ; Female ; Foot Injuries ; Fractures, Bone/surgery* ; Humans ; Male ; Retrospective Studies

Objective: To explore the clinical effects of free deep inferior epigastric perforator flap carrying lymphatic groin flap for treatment of upper limb lymphedema after radical mastectomy and breast reconstruction. Methods: From October 2014 to December 2016, 10 female patients, aged 37-60 (48±8) years, who had lymphedema in the upper limb after radical mastectomy, were admitted to Department of Oncology Plastic Surgery of Hunan Cancer Hospital. Three patients suffered recurrent erysipelas infections, and 4 patients suffered consistent neuropathic pain in the upper limb. Free deep inferior epigastric perforator flap carrying lymphatic groin flap was used for breast reconstruction and lymphedema treatment. Operation was performed by 2 surgeon groups including recipient site prepare group and flap harvest group. In the 10 patients, the length of the flaps was (26.2±0.3) cm, the width of the flaps was (13.4±0.4) cm, and the thickness of the flaps was (3.4±0.3) cm. All the donor sites in the abdomen were closed directly. The choices of vascular pedicles and vessels in the recipient sites, operation time, complications, operation effects, and follow-up were recorded. Results: (1) Bilateral vascular pedicle was adopted in flaps of 5 patients. Unilateral vascular pedicle was adopted in flaps of 5 patients. The recipient vessels were proximal and distal ends of internal thoracic vessels in 4 cases, the proximal end of thoracodorsal vessels in 3 cases, the proximal end of internal thoracic vessels in 2 cases, and the proximal end of internal thoracic vessels and thoracodorsal vessels in 1 case. (2) The operation time of the patients was 330-480 (406±55) min. (3) Subcutaneous edema was observed in flaps of 2 patients and donor site of 1 patient, which were all healed by dressing change therapy. The other flaps survived successfully. The reconstructed breasts were in good shape and elasticity. Nine patients had different degrees of relief in lymphedema in the upper limb. All 10 patients were followed up for 6 to 28 months, no one had recurrent erysipelas infections, and neuropathic pain in the upper limb was relieved in 2 patients. Only linear scar was left in the donor sites of 10 patients, and the function of abdomen was not affected without related complications. Conclusions Free deep inferior epigastric perforator flap carrying lymphatic groin flap can simultaneously accomplish breast reconstruction and upper limb lymphedema treatment, which is worthwhile to be popularized in clinic.