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Objective To evaluate left ventricular(LV) systolic function by two-dimensional speckle tracking imaging(2D-STI) in severe aortic stenosis(AS) patients.Methods Standard echocardiography and 2D-STI examinations were performed in a total of 54 subjects including 26 consecutive patients with severe AS with LV ejection fraction(LVEF) ≥50％ and 28 controls.2D-STI including systolic longitudinal strain (LS) and strain rate(LSr) were assessed from the apical 4-chamber,3-chamber and 2-chamber views,the circumferential strain(CS) and strain rate(CSr),radial strain(RS) and strain rate(RSr) were measured from the standard short axis views (averaging 6 segments per view).The above parameters of AS groups were compared with those of normals.The repeatability of LVEF,LS and RS was evaluated in 6 AS patients and 6 normal volunteers selected at random from the investigation.Results ① There was no significant difference between AS group and control group in LVEF,LV end-diastolic dimension(LVEDD),LV endsystolic dimension (LVESD) and midwall fractional shortening (mwFS) (P ＞ 0.05).② Significant differences were detected between the two groups.LS,RS,CS,LSr,RSr,and CSr were obviously decreased in AS group(P ＜0.05).③The repeatability of LVEF,LS and RS was good by consecutive measurement of identical and independent observers.Conclusions Despite the presence of normal LVEF,the LV systolic function is impaired in severe AS patients.

Objective To explore the diagnostic value and optimal cut-off point of symptom index (SI) in gastroesophageal reflux-induced chronic cough (GERC).Methods The recordings of multichannel intraluminal esophageal impedance and pH monitoring were retrospectively analyzed in 118 patients with suspicious GERC.SI for all the refluxes,acid reflux and non-acid reflux was calculated respectively by analyzing the temporal association between detected reflux and cough recorded on diary card.Based on the favorable response to the anti-reflux therapy,the diagnostic value for GERC of SI was evaluated and compared with that of the symptom association probability (SAP).Results GERC was definitely determined in 100 patients (84.7％).When SI for all the refluxes was used for the diagnosis of GERC,the cut-off point of ≥45％ had the highest diagnostic efficacy,with the sensitivity of 56.0％,the specificity of 83.3％and Youden index of 0.393.SI for acid or non-acid reflux had the same optimal cut-off point of ≥30％ and presented with the similar efficacy in the diagnosis of acid or non-acid GERC.Compared with SAP of ≥75％,SIforall the refluxes of ≥45％ had a lower sensitivity (56.0％ vs 75.0％,x2 =7.988,P=0.005),a higher specificity (83.3％ vs 44.4％,x2 =5.900,P =0.015) and the comparable positive or negative predictive value in the diagnosis of GERC.The diagnostic accuracy for GERC was further improved when combining SI for all the refluxes with SAP.Conclusion SI for all the refluxes has a diagnostic value similar to SAP and its optimal cut-off point for GERC may be ≥45％.

Objective To evaluate the diagnostic value and limitation of multichannel intraluminal esophageal impedance and pH (MII-pH) monitoring on the diagnosis of gastroesophageal reflux-related chronic cough (GERC).Methods The patients with suspicious GERC consecutively referred to our respiratory clinic between May 2010 and July 2011 underwent a MII-pH monitoring,and received anti-reflux drug therapy,irrespective of the laboratory findings.Chronic cough due to gastroesophageal reflux was determined when there was a favorable response to anti-reflux therapy.Then,the sensitivity,specificity,false positive and negative rate,total consistence,positively and negatively predictive value,the area under the curve of ROC and the Kappa value of the laboratory investigation were calculated for the diagnosis of GERC.Results During the research period,56 patients completed MII-pH monitoring.Among them,the abnormal reflux was found in 35 patients,and GERC was finally confirmed in 30 patients (85.7％) including 25 patients (83.3％) due to acid reflux and 5 patients (16.7％) due to non-acid reflux.In the remaining 21 patients with normal reflux episodes,6 patients (28.6％) could be explained by non-acid reflux for their cough because of a relatively predominant weakly acid reflux and favorable response to empirical anti-reflux therapy.For the diagnosis of GERC,MII-pH monitoring had the sensitivity of 83.3％,the specificity of 75.0％,false positive rate of 25.0％,false negative rate of 16.7％,total consistence of 80.4％,positive predictive value of 85.7％,negative predictive value of 71.4％,the area under the curve of ROC of 0.792 and Kappa value of 0.577 respectively.Conclusion MII-pH is a sensitive and reliable tool for the diagnosis of GERC due to its ability to detect both acid and non-acid reflux.

Objective To explore the role of stem cell factor(SCF)-mediating fibroblasts and mast cells interaction in pathophysiology process of asthma.Methods We transfected NIH3T3 cells with SCF antisense oligonucleotide(SCF ASON) and detected SCF expression by immunochemistry and RT-PCR.Then,we isolated mast cells from mouse bone marrow and established NIH3T3 and mast cells cocultures.After SCF ASON intervention,histamine and eotaxin levels in culture supernatants were determined by ELISA and fluorometry.Growth curves of fibroblasts and mast cells were drawn.We also observed mast cells apoptosis by AO stain and flow cytometric analysis.Results SCF ASON strikingly down-regulated SCF protein and mRNA level of NIH3T3 cells.SCF ASON intervention inhibited the growth of NIH3T3,and induced mast cell apoptosis in cocultures(14.0%?0.81% at 96 hour).Both histamine[(3.08?0.38)?g/L vs(3.83?0.41)?g/L,P

AIM: To investigate the effects of selective phosphodiesterase 3 inhibitor olprinone on cough response in guinea pigs sensitized and challenged with ovalbumin. METHODS: Forty sensitized guinea pigs were randomly divided into control ( n = 10), challenged ( n = 10), olprinone ( n = 10) and aminophylline group ( n = 10 ). Two hours after challenged with the aerosol of 1% ovalbumin or saline, animals were intraperitoneally injected either with saline,25 mg/kg of olprinone or 25 mg/kg aminophylline. At 24 h, the injection was repeated with 2. 5 mg/kg and 25 mg/kg olprinone or 2. 5 mg/kg and 25 mg/kg aminophylline respectively in olprinone and aminophylline group, cough response to inhaled capsaicin and airway responsiveness to methacholine (PC150) were measured. Then, total cell number and differential counts were analyzed in bronchoalveolar lavage fluid. RESULTS: The cough frequency was (5 ± 2) times/3 min in control group and (24 ± 3 ) times/3 min in challenged group ( P ＜ 0. 05 ), while PC150 was (659 + 57 ) mg/L in control group and (238 + 67 ) mg/L inchallenged group ( P ＜ 0. 05 ). 25 mg/kg olprinone significantly inhibited the augmented cough response and airway hyperresponsiveness, the cough frequency and PC150 were (15 ±2) times/3 min and (580 ±45) mg/L (P ＜ 0. 05 ), which differed significantly from (18 ± 2) times/3 min and (438± 52) mg/L in aminophilline group (P ＜ 0. 05). However, olprinone failed to reverse the elevated total cell number and percentage of eosinophils in bronchoalveolar lavage fluid from guinea pigs challenged with ovalbumin (P ＞ 0. 05 ). CONCLUSION: Phosphodiesterase 3 inhibitor attenuates cough response associated with eosinophilic airway inflammation by bronchodilatory effect.

Objective To validate the repeatability of the simplified cough score and its responsiveness to effective treatment and investigate the relationship between the simplified cough score and cough symptom score.MethodsA total of 119 patients with chronic cough referred to our respiratory clinic were recruited into the study between June 2010 and February 2011. Cough severity was evaluated by the simplified cough score,cough symptom score,Leicester cough questionnaire,and cough reflex sensitivity detection,and the correlations among them were analyzed.The change ratio,effect size,and standardized response mean of the simplified cough score were calculated after a 2-week course of effective treatment.The repeatability of the simplified cough score was assessed in 99 untreated patients with stable chronic cough.ResultsThe intraclass correlation coefficient in a 3-day test-retest interval of simplified cough score was 0.90 ( 95 ％ CI =0.84 - 0.92,P =0.00 ) for daytime and 0.89 ( 95 ％ CI =0.91 - 0.96,P =0.00 ) for nighttime. There was an obvious positive linear correlation between the simplified cough score and cough symptom score ( daytime:r =0.82,P =0.00 ; nighttime:r =0.92,P =0.00 ),a significant negative linear correlation between the cough score and Leicester cough questionnaire,and a weak but significant negative correlation between the simplified cough score and cough threshold C2 or C5 to capsaicin. After a 2-week course of effective treatment,the change ratio,effect size,and standardized response mean were 46.71％,1.16,and 1.05 for daytime and 71.87％,1.09,and 1.10 for nighttime,respectively.ConclusionThe simplified cough score is a reliable and valid tool for evaluation of cough severity in clinical practice.

Objective:To investigate the status of hypoglycemia fear, diabetes distress, self-regulatory fatigue and self-management in type 2 diabetes patients. The chain mediating effects of self-regulated fatigue and psychological distress on hypoglycemic fear and self-management were investigated.Methods:The Hypoglycemia Fear Survey-Worry Subscale (CHFSII-WS), Diabetes Distress Scale (DDS), Self-Regulatory Fatigue Scale (SRF-S) and Summary of Diabetes Self-Care Activities (SDSCA) were used to investigate the type 2 diabetes patients from the department of Endocrinology of the First Affiliated Hospital in Jinzhou Medical University. And constructed the structural equation model.Results:The scores of fear of hypoglycemia in type 2 diabetes patients were positively correlated with psychological pain and self-regulating fatigue ( r=0.739, 0.625, P<0.05), but negatively correlated with self-management level ( r=-0.602, P<0.05). The psychological pain score was positively correlated with the self-regulating fatigue score ( r=0.669, P<0.05) and negatively correlated with the self-management level score ( r=-0.609, P<0.05). The score of self-regulation fatigue was negatively correlated with the score of self-management ( r=-0.596, P<0.05). Pathway analysis showed that hypoglycemia fear could directly affect self-management behavior, indirectly predict self-management level through self-regulation fatigue and psychological pain respectively, and negatively affect self-management behavior through chain mediation of self-regulation fatigue and psychological pain ( χ2/ df=3.079, GFI=0.920, CFI=0.961, NFI=0.943, IFI=0.961, RMSEA=0.078). Conclusions:The Self-regulated fatigue and psychological distress acts as the chain mediators of hypoglycemic fear and self-management in patients with type 2 diabetes.

BACKGROUND/AIMS: This study investigated the protection provided by gabexate mesylate thermo-sensitive in-situ gel (GMTI) against grade III pancreatic trauma in rats. METHODS: A grade III pancreatic trauma model with main pancreatic duct dividing was established, and the pancreas anatomical diagram, ascites, and serum biochemical indices, including amylase, lipase, C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α), were examined. The pancreas was sliced and stained with hematoxylin eosin and subjected to terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. RESULTS: Ascites, serum amylase, lipase, CRP, IL-6, and TNF-α levels were significantly increased in the pancreas trauma (PT) groups with prolonged trauma time and were significantly decreased after GMTI treatment. The morphological structure of the pancreas was loose, the acinus was significantly damaged, the nuclei were irregular and hyperchromatic, and there was inflammatory cell invasion in the PT group compared to the control. After GMTI treatment, the morphological structure of the pancreas was restored, and the damaged acinus and inflammatory cell invasion were decreased compared to the PT group. Moreover, the cell apoptosis index was significantly increased in the PT group and restored to the same levels as the control group after GMTI treatment. CONCLUSIONS: GMTI, a novel formulation and drug delivery method, exhibited specific effective protection against PT with acute pancreatitis therapy and has potential value as a minimally invasive adjuvant therapy for PT with acute pancreatitis.
Amylases ; Animals ; Apoptosis ; Ascites ; C-Reactive Protein ; DNA Nucleotidylexotransferase ; Eosine Yellowish-(YS) ; Gabexate* ; Hematoxylin ; Interleukin-6 ; Lipase ; Methods ; Necrosis ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Rats*

OBJECTIVE To summarize surgical treatment effects and to discuss surgical strategy for Small acoustic neuroma.METHODS The clinical data of 26 patients with small acoustic neuroma treated with surgery in our department were analyzed retrospectively.25 patients with preoperative hearing grading of C and D received the labyrinthine approach acoustic neuroma resection,and 1 patient with preoperative hearing grading of B received middle fossa approach acoustic neuroma resection.The preoperative and postoperative hearing level,incidence of tinnitus,balance disturbance and weakness of facial muscles were analyzed retrospectively.The control and recurrence of the tumor,the incidence of complications were recorded.RESULTS Total resection was achieved in 25 cases (96％),and in 1 cases achieved sub total resection due to the fact that the tumor was too adhesive to the facial nerve The follow-up time ranged from 6 months to 7 years with 7 cases lost contact.No deaths nor intracranial infection were encountered.Cerebrospinal fluid rhinorrhea was found in 1 cases after the operation and eustachian tube blockage was performed.All patients(100％) had their facial nerve reserved and 16 patients (88％) had their cochlea nerve reserved.17patients(89.5％) had intact facial nerve function and 2 patients suffered from level Ⅲ facial nerve paralysis (House-Brackmann grade) post operatively.6 patients suffered from vertigo pre-operatively and 5 of them reported disappearance of vertigo after the surgery.Of the 13 patients who did not have vertigo before the surgery,1 patient complained sense of dizziness and unsteady walking post-operatively.5 patients (33.3％) reported disappeared or alleviated tinnitus,8 patients (53％) had the same degree of tinnitus and 2 patients reported worsened tinnitus post-operatively.For patients who did not have tinnitus before the surgery,no tinnitus was reported post-operatively.CONCLUSION treatment strategy for small acoustic neuroma requires personalized setting based on the age of the patient,the combined systemic disease,the severity of the symptoms and the growth rate of the tumor.For patients without practical hearing,the tumor could be removed with labyrinthine approach,and the integrity of the cochlear nerve should be preserved as far as possible,for further reconstruction of hearing ability and cochlear implantation.