Objective To study the effect of early application of heparinate in fulminant epidemic cerebrospinal meningitis in children.Methods Twenty eight patients of fulminant epidemic cerebrospinal meningitis were reviewed and summarized.Results After application heparinate, there were 14 out of 28 platelet increase,12 patients died of diffuse intravascular coagulation.Conclusion Early application heparination is safe and effective in fulminant epidemic cerebrospinal meningitis,and side effect such as hemorrhage is not found.

OBJECTIVETo explore the alterations of after depolarization and triggered activity in myocardiac muscle during progression of mouse aortic stenosis.

METHODSAfter the establishment of mouse aortic stenosis model, the heart was collected and intracellular potential was recorded using standard glass microelectrode. After the recording, the action potential (AP), early after depolarization (EAD), delayed after depolarization (DAD) in papillary muscles were analysed.

RESULTS(1) Compared with that of time-matched control mice, there were no changes of the action potoutial duration at 90% repolarization(APD90) in model mice at 2 and 5 weeks, whereas the APD90 was progressively prolonged at 9 and 13 weeks. (2) During the 30 minites of the experiment, spontaneous EADs and DADs were frequently present in medel mice at 9 and 13 weeks, were not in control and model mice at 2 and 5 weeks. (3) Compared with those of control group, EADs and DADs triggered by hypokalaemia or isoproterenol were increased significantly. The incidence rate of triggering EADs and DADs was progressively increased over time.

CONCLUSIONEAD, DAD and trigger activities increase gradually during the process of aortic stenosis, and it suggests that the myocardium electrical-instability is markedly increased in the insult hearts.

Action Potentials ; physiology ; Animals ; Aortic Valve Stenosis ; physiopathology ; Disease Models, Animal ; Male ; Mice ; Myocytes, Cardiac ; physiology

OBJECTIVETo find the characteristic parameters from electrocardiogram (ECG) which is most related to pathological progress, surface ECG was performed in mice at 2, 5, 9 and 13 week post surgery.

METHODSElectrocardiogram recordings: The mice were anaesthetized with tribromoethanol (250 mg/kg, i.p.). Lead II surface ECG were acquired by using the Biopac System MP150 at a rate of 5 kHz.

RESULTS(1) No arrhythmia was observed in Sham and 2-week Band mice. Spontaneous arrhythmias were observed in ECG recordings, with an incidence of 15%, 28% and 63% in 5-, 9- and 13-week Band mice, respectively. Tachyarrhythmias, such as frequent premature ventricular extrasystole, bigeminy, trigeminy, and paroxysmal tachycardia were found. (2) Analysis of ECG recordings revealed a significant prolongation of QT and QTc intervals. Compared with age-matched Sham mice, the increment in QT and QTc intervals was 20.4%, 32.7%, 49.7%, 61.0% and 27.1%, 32.1%, 43.9%, 59.1% at 2, 5, 9 and 13 week, respectively (P < 0.01). (3) The characteristic change in electrocardiogram was on the J wave. The amplitude of J wave was upward in Sham mice, and it was significantly flattened or inverted in Band mice. (4) Except that RR interval at 2 week showed a slight decrease, there was no significant change in PR interval and RR interval in Band mice.

CONCLUSIONIn the present study, we found that the increase incidence of spontaneous arrhythmias, prologation of QT interval and changes in the amplitude of the J wave in the surface ECG during progression of mouse cardiac hypertrophy and failure, and the progressive pattern indicated that a gradual aggravation of the ventricular repolarization delay in this mouse model.

Animals ; Cardiomegaly ; physiopathology ; Disease Models, Animal ; Electrocardiography ; Male ; Mice

Objective To evaluate the effect of isoflurane or sevoflurane inhalation before and after gestation on the offspring brain development. Methods Thirty female adult Sprague Dawley rats were randomly assigned into 5 groups(n=6 each):control group(group C),group that ex?posed to isoflurane with the concentration of 1.6%for 6 hours before gestation(group BI),group that exposed to isoflurane with the concentration of 1.6%at the 6th,10th,14th and 18th day for 6 hours(group PI),group that exposed to sevoflurane with the concentration of 2.4%for 6 hours before gestation(group BS),and group exposed to sevoflurane with the concentration of 2.4%at the 6th,10th,14th and 18th day for 6 hours after gestation (group PS). Twelve offspring rats from pregnant rats in each group were chosen on the day of birth(T1),and 7th,14th and 28th days after birth(T2, T3 and T4)and sacrificed,and the hippocampi were then isolated. Hematoxylin and eosin stain were adopted to observe the tissue pathological change. Electron microscope was used to observe the neuron ultrastructure change of hippocampus. Immolunohistochemistry was used to detect cas?pase?3,the expression of growth associated protein?43(GAP?43)and neuronal nitric oxide synthase(nNOS). Results Compared with group C, no significant change was found in caspase?3,GAP?43 and nNOS expression in offspring rat hippocampus in groups BI and BS(P>0.05),and no damage change in hippocampal was seen by HE staining and electron microscopy. In group PI and PB,the expression of caspase?3 was significantly up?regulated,the expression of GAP?43 and nNOS was down?regulated at T1 to T3(P<0.01),and structural changes in cell were seen by electron microscopy. In group PI,significant pathological changes in hippocampal were seen by HE staining at T1 to T3. Compared with group PI,the expres?sion of GAP?43 and nNOS was significantly up?regulated(P<0.01),and the expression of caspase?3 was down?regulated at T1 to T3(P<0.01). Conclusion Isoflurane or sevoflurane inhalation before gestation does not affect the offspring brain development,while isoflurane or sevoflurane in?halation after gestation can induce transient abnormal change of offspring brain development,and isoflurane′s toxicity was greater than sevoflurane.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cyclin D1 ; metabolism ; Female ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Middle Aged ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Mouth Mucosa ; chemistry ; metabolism ; pathology ; Mouth Neoplasms ; metabolism ; pathology ; Prognosis

Adolescent ; Biopsy ; Female ; Hepatocytes ; diagnostic imaging ; pathology ; Humans ; Jaundice, Chronic Idiopathic ; pathology ; Sibling Relations ; Ultrasonography

Objective To assess the value of contrast enhanced ultrasound (CEUS) in diagnosing subtypes of postpartum placenta accreta.Methods 31 puerperal clinically diagnosed of postpartum placenta accreta were collected.They were inspected by using CEUS and 2-dimensional color Doppler ultrasound,respectively.The operation was used as a reference.Results Both 2-dimensional color Doppler and CEUS could identify the sizes of residual placenta for the patients,but CEUS showed more explicit boundary for placenta and uterus and the rich/poor blood flow areas in the placenta.Among the 31 patients,7,23 and 1 were classified of accreta,increta and percreta,respectively,by using 2-dimensional color Doppler ultrasound,while 11,16 and 4 were classified of accreta,increta and percreta,respectively,by using CEUS based on the myometrial thickness and contrast agent subsided time.With respect to operation,10 patients were confirmed of accrete,with the other diagnosed of increta and percreta.The misclassification rate of 2-dimensional color Doppler ultrasound was 19.6 ％,while CEUS had only 6.5 ％.CEUS had a good agreement with operation (Kappa =0.859,P ＜ 0.001).Conclusions CEUS has higher accuracy in diagnosing subtypes of postpartum placenta accrete compared with 2-dimensional color Doppler ultrasound.CEUS can increase the accuracy and reliability for diagnosing those who were clinically considered of postpartum placenta accrete,and can provide helpful guidelines for clinical treatment.

OBJECTIVE:To evaluate evidence foundation of phamracogenetics personalized medication,and to provide refer-ence for clinical application. METHODS:Using“phamracogenetics”“pharmacogenomics”and“gene polymorphism”as key words,related literatures and clinical guideline were retrieved from PubMed,CNKI,Wanfang database,and analyzed in respects of involved gene,site and drug types,etc. Evidences of package inserts of phamracogenetics biomarker were evaluated by using phamracogenetics practice and prevention evaluation guideline. RESULTS:8 276 papers,25 guidelines and 166 drug package in-serts are available for analysis. The phamracogenetics literatures mostly focus on the relationship between some one gene and differ-ent drugs. In guidelines,some one specific gene can guide clinical application of multiple drugs in different fields. In drug package inserts,general level of clinical evidence is not high;detectable biomarkers is inadequate in category,and detection rate is only 38.06% besides targeting preparation. CONCLUSIONS:Under the condition of low clinical evidence level the detection of pharma-cogenetics biomarker should be conducted carefully,and basic study should be further strengthened.

AlM:To observe the efficacy of using botulinum toxin A in the treatment of blepharospasm.
METHODS: Totally 113 patients with blepharospasm were managed with a local injection of botulinum toxin A, and the therapeutic effect was evaluated.
RESULTS:Fifty-nine cases ( 52. 2%) had a complete remission of symptoms, 49 patients ( 43. 4%) presented with obvious relieved spasm, 4 cases ( 3. 5%) were partially relieved and the 1 patient ( 0. 9%) remained unchanged. The total effective rate was 99. 1%. The time of beginning effect was 1-14d. The recover time was mostly in 14d. The average of therapeutic effect lasted 1-9mo. Adverse reactions such as mild palpebra dysraphism, palpebra ptosis and local subcutaneous blood stasis were found in 23 patients, and the symptoms disappeared in 2-4wk.
CONCLUSlON:Botulinum toxin A can effectively control medium and severe blepharospasm by injecting a little dose on local muscle.

Objective To discuss the combined value of gray-scale ultrasound ( GSUS) and contrast-enhanced ultrasound (CEUS) in the diagnosis of benign and malignant thyroid lesions and to explore the optimal diagnostic point of scoring method .Methods Ultrasound images of 178 thyroid lesions confirmed by pathology were synthetically reviewed by scoring 5 GSUS indicators including shape , orientation, interior echogenicity, halo sign, microcalcification and 6 CEUS indicators including relative arrival time of microbubbles in the periphery and interior, peak periphery and interior echogenicity, peripheral ring-enhancement, and homogeneity of enhancement .One positive indicator scored one point .The optimal diagnostic points and their clinical value were explored according to ROC curves .Results Scores of GSUS, CEUS and the combination of GSUS and CEUS were significantly different (Z =10.188,9.843,10.705,all P <0.001). Areas under ROC curves of GSUS, CEUS and the combination of GSUS and CEUS were 0.936, 0.919 and 0.964, respectively.Three or more positive GSUS indicators of five in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 79.6% and the specificity of 91.2%.Two or more positive CEUS indicators of six in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 91.8% and the specificity of 81.2%.Five or more positive GSUS and CEUS indicators of eleven in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 93.6%and the specificity of 92.3%.The areas under the ROC curve of GSUS and CEUS were 0.936 and 0.919.The area under the ROC curve of the combination of GSUS and CEUS was 0.964, larger than the areas under the GSUS ROC curve and the CEUS ROC curve.Conclusion Ultrasound is valuable in the differential diagnosis of benign and malignant thyroid lesions , and the combination of GSUS and CEUS is the most valuable with 5 points as the optimal diagnostic scoring method .