Objective Color doppler ultrasonography of chronic Keshan disease (CKD) was evaluated to provide evidences for clinic diagnosis of the disease. Methods From September to Novermber 2009, according to "Diagnostic criteria of Keshan disease" (GB 17021-1997), 64 cases of CKD were randomly sampled from five Keshan diseased districts in Shandong province, Zoucheng, Sishui, Yishui, Wulian, Jvxian, and Pingyi as patient group. Thirty four healthy volunteers being checked up by Shandong Institute for Endemic Diseases Control and Research were put in control group. All the subjects were examined with Color doppler ultrasonography. The indexes of cardiac structure, left ventricular (LV) systolic function and LV diastolic function were measured.Results Left atrial internal diameter, LV end-diastolic internal diameter, LV end-systolic internal diameter, right ventricular diameter, aorta diameter, right atrial transverse diameter, right atrial long diameter and left ventricle mass of the patient group[(35.38 ± 6.89), (61.57 ± 8.61), (45.39 ± 10.29), (17.22 ± 3.79), (28.69 ± 2.81),(38.00 ± 6.05), (42.68 ± 8.65)mm, (283.22 ± 103.12)g] were higher than that of control group[(26.70 ± 3.27),(45.41 ± 4.93), (26.91 ± 4.35), (13.76 ± 2.27), (24.09 ± 2.89), (31.50 ± 3.32), (35.82 ± 3.14) mm, (156.03 ±39.86)g, t = 6.93, 10.09, 9.98, 4.87, 7.64, 5.81, 4.46, 6.90, all P＜ 0.05]. The LV ejection fraction and fractional shortening of the left ventricular of the patient group[(49.25 ± 14.33)%, (26.11 ± 9.17)%] were lower than that of control group[(73.88 ± 4.04)%, (42.88 ± 3.62)%, t = - 9.79, - 10.22, all P＜ 0.05]. Diffuse hypokinetic motion of the left ventricle reduced in 95% (61/64) of CKD patients, and 5% (3/64) of CKD patients had segmental LV dyskinesia. Seventy five per sent(48/64) of the patients accompanied with mitral regurgitation, and 39% (26/64) of these cases accompanied with tricuspid regurgitation. Meaningful Mitral or tricuspid regurgitation was not found out in control group. Conclusions The CKD patients' bore of atrio-ventricular cavity and LV mass are enlarged, and their motion of ventricle is reduced or partly reduced. They have poor heart function. Mitral regurgitation are more than tricuspid regurgitation. Color doppler Ultrasonography is important in diagnosis of chronic Keshan discase.

This study aimed to examine the preparation of cationic lipid microbubble (CLM), and evaluate its physical and chemical properties and toxicity, measure the gene transfection efficiency by ultrasound triggered microbobble destruction (UTMD) in combination with CLM. The CLM was prepared by the method of the thin film hydration, and its morphology was observed under the electron microscopy at 1st, 3rd, 7th, 10th, and 14th day after preparation, respectively. The size, Zeta potential and stability of CLM were tested. The acute toxicity of CLM was assessed. The green fluorescent protein gene (EGFP) transfection efficiency was evaluated. The experiment grouping was as follows: naked plasmid group (P group), ultrasonic irradiation plus naked plasmid group (P-US group), naked plasmid plus CLM group (P-CLM group), naked plasmid plus ultrasound and CLM group (UTMD group). The expression of EGFP was detected by fluorescent microscopy and flow cytometry. The results showed that CLMs were spherical in shape, with the similar size and good distribution degree under the light and electron microscopies. The size of CLMs was varied from 250.4±88.3 to 399.0±99.8 nm and the Zeta potential of CLMs from 18.80±4.97 to 20.1±3.1 mV. The EGFP expression was the strongest in the UTMD group, followed by the P-CLM group, P-US group and P group. Flow cytometry results were consistent with those of fluorescent microscopy. The transfection efficiency was substantially increased in the P-US group, P-CLM group and UTMD group as compared with that in the P group, almost 7 times, 10 times and 30 times higher than that in the P group respectively. It is suggested that CLMs prepared by the method of thin film hydration are uniform in diameter, and proved non-toxic. UTMD combined with CLM can significantly increase the transfection efficiency of EGFP to targeted cells.

Objective To study the pharmacokinetics profiles of ibupro-fen and pseudo ephedrine with chlorpheniramine suspension after single and multiple dosing in healthy volunteers.Methods Three single and one multiple oral doses of ibuprofen and pseudo ephedrine with chlorphe-niramine suspension were given to healthy volunteers respectively.Ibu-profen concentrations in plasma were determined by HPLC-UV method.Pseudo ephedrine and chlorpheniramine concentrations in plasma were determined by HPLC-MS-MS method.The pharmacokinetic parameters were obtained with statistical analysis by DAS Ver 2.0.Results The main pharmacokinetic parameters of 3 single doses(ibuprofen:200,400,600 mg pseudo ephedrine:30,60,90 mg;chlorpheniramine:2,4,6 mg)and multiple dose(ibuprofe,pseudo ephedrine and chlorphe-niramine 200,30,2 mg,respectively)shown that the concentration-time curves of ibuprofen,pseudo ephedrine and chlorpheniramine were described by one-compartment open model and physiological disposi-tions were assumed by linear kinetics characteristics.Conclusion In multiple dosing study,physiological dispositions of ibuprofen,pseudo e-phedrine and chlorpheniramine all existed no induction and inhibition of drug enzyme phenomenon.

OBJECTIVETo study the effect of methotrexate (MTX), a folic acid antagonist which can lead to folic acid deficient, on the cardiac development and on the expressions of BMP2b and HAS2 in zebrafish.

METHODSThe zebrafish embryos at 6-48 hrs post fertilization (hpf) were treated with various concentrations of MTX (0.5 x 10(-3), 1.0 x 10(-3) and 2.0 x 10(-3) M). At 48 hpf, the percentage of cardiac malformation and heart rate were recorded. The zebrafish embryos at 6-10 hpf treated with 1.5 x 10(-3) M MTX were used as the MTX treatment group. At 24 and 48 hpf the cardiac morphology was observed under a microscope. The expressions of BMP2b and HAS2 in zebrafish were detected by in situ antisense RNA hybridization and real-time PCR.

RESULTS6-12 hpf, the early embryonic developmental stage, was a sensitive period that MTX affected cardiac formation of zebrafish. The retardant cardiac development and the evidently abnormal cardiac morphology was found in the MTX treatment group. The results of in situ antisense RNA hybridization showed that the expressions of BMP2b and HAS2 in the zebrafish heart were reduced in the MTX treatment group at 36 and 48 hpf. The real-time PCR results demonstrated that the BMP2b expression decreased at 12, 24, 36 and 48 hpf, and that the HAS2 expression decreased at 24, 36 and 48 hpf in the treatment group compared with the control group without MTX treatment.

CONCLUSIONSThe inhibition of folic acid function may affect cardiac development of early embryos, resulting in a retardant development and a morphological abnormality of the heart in zebrafish, possibly by down-regulating the expressions of BMP2b and HAS2.

Abnormalities, Drug-Induced ; etiology ; Animals ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; genetics ; Down-Regulation ; Folic Acid Antagonists ; toxicity ; Gene Expression Regulation ; drug effects ; Glucuronosyltransferase ; genetics ; Heart Defects, Congenital ; chemically induced ; Hyaluronan Synthases ; Methotrexate ; toxicity ; Polymerase Chain Reaction ; Zebrafish ; Zebrafish Proteins ; genetics

OBJECTIVETo study age and educational level and their relationship with fall-related injuries in Shanghai and to analyze the relevant costs.

METHODSMultistage cluster sampling was used for the selection of participants and standardized questionnaires were used for the information collection in 2006. Information on cases and deaths caused by fall-related injuries were obtained from 494 hospitals as well as from the mortality registry systems from 2001 till 2010.

RESULTSOf 45 857 participates, 674 suffered from fall-related injuries with the largest proportion among all injuries. The fall-related mortality increased from 10.63 per 100 000 in 2001 to 14.11 per 100 000 in 2010. The under-five mortality rate was the highest among children aged 0-14 years. Mortality increased dramatically among those aged 55 or above for the female and aged 60 or older for the male. Individuals with an educational level under the primary school were more likely to suffer fall-related injuries, accounting for 72.66% of all deaths and 49.24% of nonfatal cases respectively. The annual burden of fall-related injuries equated to 25.90% of the share of GDP for the healthcare, social security and welfare industries in 2006.

CONCLUSIONFall-related injuries were inversely related to victims' educational level. Children under the age of 5, women over 55 years old and men over 60 years old with an educational level lower than the primary school are the most risky groups of populations for intervention measures.

Accidental Falls ; mortality ; statistics & numerical data ; Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Educational Status ; Female ; Humans ; Male ; Middle Aged ; Sex Distribution ; Young Adult

BACKGROUNDTbx1 is the major candidate gene for DiGeorge syndrome (DGS). Similar to defects observed in DGS patients, the structures disrupted in Tbx1(-/-) animal models are derived from the neural crest cells during development. Although the morphological phenotypes of some Tbx1 knock-down animal models have been well described, analysis of the cardiac performance is limited. Therefore, myocardial performance was explored in Tbx1 morpholino injected zebrafish embryos.

METHODSTo elucidate these issues, Tbx1 specific morpholino was used to reduce the function of Tbx1 in zebrafish. The differentiation of the myocardial cells was observed using whole mount in situ hybridization. Heart rates were observed and recorded under the microscope from 24 to 72 hours post fertilization (hpf). The cardiac performance was analyzed by measuring ventricular shortening fraction and atrial shortening fraction.

RESULTSTbx1 morpholino injected embryos were characterized by defects in the pharyngeal arches, otic vesicle, aortic arches and thymus. In addition, Tbx1 knock down reduced the amount of pharyngeal neural crest cells in zebrafish. Abnormal cardiac morphology was visible in nearly 20% of the Tbx1 morpholino injected embryos. The hearts in these embryos did not loop or loop incompletely. Importantly, cardiac performance and heart rate were reduced in Tbx1 morpholino injected embryos.

CONCLUSIONSTbx1 might play an essential role in the development of pharyngeal neural crest cells in zebrafish. Cardiac performance is impaired by Tbx1 knock down in zebrafish.

Animals ; Branchial Region ; cytology ; drug effects ; Heart ; drug effects ; physiology ; Heart Rate ; drug effects ; In Situ Hybridization ; Myocardium ; cytology ; Neural Crest ; cytology ; drug effects ; Oligonucleotides, Antisense ; pharmacology ; T-Box Domain Proteins ; antagonists & inhibitors ; metabolism ; Thymus Gland ; cytology ; drug effects ; Zebrafish ; embryology ; metabolism ; Zebrafish Proteins ; antagonists & inhibitors ; metabolism

OBJECTIVETo develop the techniques of total hip arthroplasty(THA) for Crowe type IV developmental dysplasia of the hip (DDH) with S-ROM prosthesis,and to assess its clinical results.

METHODSFrom October 2000 to October 2011,30 patients (36 hips) with Crowe type IV DDH underwent THA,including 6 patients with bilateral hip involved and 24 patients with unilateral. S-ROM prosthesis was adopted together with subtrochanteric transverse osteotomy. All the cementless acetabular cups were placed at the original anatomic location. The threaded cups were put in or near the level of the true acetabulum in all patients. Full coating stems were used in femoral side. All the patients were evaluated by using the Modified Harris Hip Score. Radiographic evaluations were made preoperatively and during follow-up.

RESULTSTwo patients lost of follow-up. Twenty-seven patients with 32 hips were followed up,and the average duration was 48 months (ranging from 7 to 84 months). There was 1 patient with bilateral THA died from hemorrhagic shock. Two patients could walk freely with the visible fracture lines at 12th and 18th months postoperatively. There were no complications such as infection or nerve injuries. Modified Harris Hip Score improved from preoperative 41.7+/-3.7 to postoperative 89.1+/-2.9. There was no acetabular or femoral component revision because of mal-position or loosening of the prostheses in all patients. Postoperative X-ray showed that all the prostheses in place,good integration between acetabular cups,femoral prosthesis and host bone without loosening. All bone grafts were integrated. All the hips acquired union of osteotomy and bone in-growth. None of the patients had radiographic evidence of aseptic loosening of prosthesis.

CONCLUSIONFor the complex DDH, follow methods should be used to improve therapeutic effects:good exposure of the true acetabulum,deepen acetabulum, femoral shortening, oblique osteotomy, using the S-ROM prosthesis.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Hip Dislocation, Congenital ; surgery ; Hip Prosthesis ; Humans ; Male ; Middle Aged

OBJECTIVETo observe the influence of acupoint catgut-embedding therapy on the quality of life (QOL), the reproductive endocrine and bone metabolism of postmenopausal women.

METHODSA total A total of 65 women with climacteric syndrome were enrolled and randomly assigned to two groups, thirty-three in the treatment group on whom acupoint catgut-embedding was performed with Shenshu (BL23), Sanyinjiao (SP6) and Guanyuan (CV4) as main acupoints, and thirty-two in the control group who were only medicated with Fufuchun Capsule (妇复春胶囊). The treatment course for both groups was 3 months. Before and after Before and after treatment, the clinical symptoms, the QOL score, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E(2)), testosterone (T), osteocalcin (BGP), parathyroid hormone (PTH), calcitonin (CT) and alkaline phosphatase (AKP) were measured. In addition, another 28 women with childbearing potential and normal regular menstrual cycle were selected and the reproductive endocrine hormone were tested in the ovulatory period as controls.

RESULTSThe levels of serum FSH and LH of postmenopausal women were higher, and serum E(2) and T were lower than those of normal women (P<0.01). After treatment, the levels of serum E(2) In both groups and T in the treatment group were increased, while in the control group the serum E(2) increase was more significant than that in the treatment group (P<0.05), and serum T showed no statistical difference. The levels of serum FSH, LH, BGP, CT, PTH and AKP were reduced significantly in both groups after treatment (P<0.05). The QOL scores were Increased remarkably in both groups on physiological functioning, bodily pain, general health, vitality, and mental health after treatment (P<0.05),but the improvement of bodily pain and mental health in the treatment group were better than those in the control group (P<0.01). There was no significant difference in the therapeutic effect between the two groups after treatment (P>0.05).

CONCLUSIONSAcupoint catgut-embedding showed an obvious effect on climacteric syndrome, and enhanced the QOL in postmenopausal women. The therapy could regulate the hypothalamic-pituitary-ovarian axis to raise the serum E(2) level which may be significant in preventing and curing the osteoporosis in postmenopausal women.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Bone and Bones ; metabolism ; Catgut ; Endocrine System ; metabolism ; Female ; Hormones ; blood ; Humans ; Middle Aged ; Postmenopause ; blood ; metabolism ; Quality of Life ; Reproduction ; physiology

OBJECTIVETo retrospectively study medium-term follow-up outcomes of total hip arthroplasty (THA) for patients with ankylosing spondylitis (AS).

METHODSFrom January 2000 to December 2008, 67 patients (88 hip joints) with AS were treated with all ceramic interface THA. And 55 patients (74 hips) were finally followed up. Among them, there were 30 males and 25 females, with an average age of 32.6 (ranged 19 to 58) years old. Sixty-one hips were treated with biological prosthesis and 13 hips were treated with hybrid prosthesis. Fifty-five patients were followed up at least 5 years, with an average of (75.2 +/- 8.6) months. Clinical symptoms and radiography information were evaluated after follow-up.

RESULTSHarris hip score were significantly improved from 30.8 +/- 7.0 preoperatively to 85.2 +/- 5.5 at the last follow-up (P<0.01). The hip movement range increased from (21.2 +/- 8.5) degrees preoperatively to (142.0 +/- 10.2) degrees postoperatively (P<0.01). The 5-year survival of prosthesis was 95.9%. One patient were renovated because of internal wall broken caused by injury, 1 was renovated for infection, 1 was renovated for fracture arround femoral stem prostheses, and 1 was treated with conservative treatment by dislocation. Three cases with abnormal sound were cured with non-operation. 7 cases with heterotopic ossification were not treated, 2 cases with thigh pain received conservative treatment. Bone dissolve around prosthesis, loose and sink of femur and acetabulum prosthesis were occurred in other cases.

CONCLUSIONTHA for the treatment of AS is a reliable method, which has a satisfied medium-term follow-up outcomes.

Adult ; Arthroplasty, Replacement, Hip ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spondylitis, Ankylosing ; surgery ; Treatment Outcome ; Young Adult

BACKGROUNDFolic acid is very important for embryonic development and dihydrofolate reductase is one of the key enzymes in the process of folic acid performing its biological function. Therefore, the dysfunction of dihydrofolate reductase can inhibit the function of folic acid and finally cause the developmental malformations. In this study, we observed the abnormal cardiac phenotypes in dihydrofolate reductase (DHFR) gene knock-down zebrafish embryos, investigated the effect of DHFR on the expression of heart and neural crest derivatives expressed transcript 2 (HAND2) and explored the possible mechanism of DHFR knock-down inducing zebrafish cardiac malformations.

METHODSMorpholino oligonucleotides were microinjected into fertilized eggs to knock down the functions of DHFR or HAND2. Full length of HAND2 mRNA which was transcribed in vitro was microinjected into fertilized eggs to overexpress HAND2. The cardiac morphologies, the heart rates and the ventricular shortening fraction were observed and recorded under the microscope at 48 hours post fertilization. Whole-mount in situ hybridization and real-time PCR were performed to detect HAND2 expression.

RESULTSDHFR or HAND2 knock-down caused the cardiac malformation in zebrafish. The expression of HAND2 was obviously reduced in DHFR knock-down embryos (P < 0.05). Microinjecting HAND2 mRNA into fertilized eggs can induce HAND2 overexpression. HAND2 overexpression rescued the cardiac malformation phenotypes of DHFR knock-down embryos.

CONCLUSIONSDHFR plays a crucial role in cardiac development. The down-regulation of HAND2 caused by DHFR knock-down is the possible mechanism of DHFR knock-down inducing the cardiac malformation.

Animals ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; physiology ; Female ; Heart ; embryology ; Heart Defects, Congenital ; etiology ; Tetrahydrofolate Dehydrogenase ; genetics ; physiology ; Zebrafish ; Zebrafish Proteins ; genetics ; physiology