Objective To investigate the value of MR imaging methods for the quantification of fat content in a customized lipid phantom at 3.0 T.Methods Eleven homogeneous fat-water phantoms (50 ml)with fat volume percentages from 0 to 100％ were constructed with reference to Bernard's methods.Fat tractions of the lipid phantom were acquired using water selective saturation (WS),fat selective saturation (FS),in-and out-of-phase imaging (IOP),iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) gradient echo imaging and IDEAL Quant imaging methods on a 3.0 T MRI system.For statistical comparisons,paired-sample t test,Pearson correlation test,and Bland-Ahman maps were applied.Results Evaluated fat fractions acquired by WS,IDEAL Gradient echo imaging and IDEAL Quant were (49.6±28.8)％,(46.0±28.4)％,(51.0±32.0)％,the result has no significant difference with the true fat contents(t values were-0.186,-2.218,2.713;P values were 0.856,0.051,0.055).Evaluated fat fractions acquired by FS,corrected algorithm and IOP were (64.2±26.7)％,(58.9±31.9)％ and (45.3±32.3)％,these three kinds of methods have significant difference with the true fat contents (t values were 5.168,4.273,-6.441;P＜0.01).All the chemical shift imaging methods correlated with the true phantom model fat fractions,r values were 0.977(FS),0.978 (corrected algorithm),0.982 (WS),0.99 8(IOP),0.993 (IDEAL Gradient echo imaging),0.999 (IDEAL Quant) (all P＜0.01).Each method's 95％ confidence interval of the mean difference acquired by Bland-Altman map was WS (-14.7％ to 13.8％),FS (-3.6％ to 32.0％),corrected algorithm (-4.6％ to 22.5％),IOP(-9.4％ to 0.0％),IDEAL gradient echo imaging (-15.9％ to 7.8％),IDEAL Quant(-2.0％ to 4.0％).IDEAL Quant had the best correlation and confidence with the true fat fraction.Conclusions Chemical shift imaging methods (IOP,IDEAL Gradient echo imaging,IDEAL Quant) can acquire more accurate fat quantification results than chemical saturation imaging methods (FS,Corrected algorithm,WS) in a customized lipid phantom at 3.0 T.IDEAL Quant can acquire the best fat quantification result compared with the other imaging methods.

Glycyrrhiza uralensis Fisch. ex DC is widely used in traditional Chinese medicine (TCM). Among its various active components, glycyrrhizic acid is believed to be the marker component. Squalene synthase (SQS) and beta-amyrin synthase (beta-AS) are key enzymes in the biosynthetic pathway of glycyrrhizic acid in G uralensis. To reveal the effects of co-expression of SQS1 and beta-AS genes on this pathway, 7 yeast expression vectors harboring different SQS1 variants and beta-AS were constructed and expressed in Saccharomyces cerevisiae as fusion proteins. TLC and GC-MS results showed that co-expression of SQS1 and beta-AS enhanced the accumulation of beta-amyrin. The effects of SQS12 were more obvious than the other two SQS1 variants. This study is significant for further investigations concerned with exploring the biosynthesis of glycyrrhizic acid in vitro and strengthening the efficacy of G. uralensis by means of increasing the content of glycyrrhizic acid.
Farnesyl-Diphosphate Farnesyltransferase ; genetics ; metabolism ; Glycyrrhiza uralensis ; genetics ; Intramolecular Transferases ; metabolism ; Oleanolic Acid ; analogs & derivatives ; metabolism ; Plant Proteins ; genetics ; Recombinant Proteins ; metabolism ; Saccharomyces cerevisiae ; metabolism

Objective To analysis of preoperative preparation,operation,character,advantage and deficiency of two non-robotic TIMAH approach in MIDCAB,and to observe the short-term follow up result.Methods 7 male CAD patients with classic unstable angina pectoris,the age ranged from 52 to 75 years,average (63.8 ± 8.5) years,underwent TIMAH and MIDCAB,in which 6 single LAD disease patients and one patient for reoperation with saphenous vein graft (SVG) graft failure to LAD and progressive obtuse marginal(OM) coronary artery disease.These patients were intubated with a double-lumen endotracheal tube,and one-lung ventilation were used to facilitate the procedure.In the approach of two incisions TIMAH for 4 patients,the thoracoscope was placed at the third intercostals space(ICS) on the anterior axillary line,and LIMA was dissected with endo-instruments placed from the two angles of mini-thoracotomy at fifth ICS on the midclavicular line.In the approach of three incisions TIMAH for 3 patients,LIMA was dissected with endo-instruments placed from two ports at the fourth ICS on the anterior axillary line and at the fifth ICS on the midclavicular line,and the thoracoscope was placed at the second or third intercostals space (ICS) on the anterior axillary line.Anastomosis of LIMA and LAD followed through mini-thoracotomy at fifth ICS with the heart stabilizer after TIMAH.SVG graft was used from LIMA to OM in the reoperation patient.Results All patients underwent TIMAH and MIDCAB safely without transferece to stenotomy,only one LIMA was extended with 2 cm SVG for injure at the distal.In 6 single vessel disease patients the length of mini-thoracotomy incision was (6.0 ± 0.9) cm,TIMAH time was (112 ±18) min,operation time was (293 ± 75) min,bleeding volume was (233 ± 52) ml,endotracheal tube time was (14.2 ± 10.7) h,ICU time was (1.8 ±0.4) d and hospital stay time was (10.1 ±6.7) d.All patients were uneventful discharged and with no recurrence of cardiac symptoms in short-term follow up.Conclusion TIMAH can perform safely in both approaches for LIMA prepare to MIDCAB as described before.The minimally invasive procedure need not enlarge incision for LIMA harvesting with good short term results.

OBJECTIVETo study the relationship between TMPRSS2: ERG gene fusion and the pathological grade of prostate cancer (PCa).

METHODSWe collected fresh prostatic tissue samples from 62 patients with PCa and another 10 with benign prostatic hyperplasia ( BPH) and included 9 cancer cell strains as the control. We examined the TMPRSS2:ERG fusion gene in the PCa samples by nest RT-PCR, compared the Gleason scores between the TMPRSS2:ERG-positive and -negative cases, and analyzed the association of TMPRSS2: ERG fusion with the pathological features of PCa.

RESULTSThe TMPRSS2: ERG fusion gene was detected in 28 (45.16%) of the PCa cases, but in none of the 10 BPH cases or the 9 cancer cell strains. No statistically significant differences were found in the Gleason scores between the TMPRSS2:ERG-positive and -negative cases (Z = -0.609, P = 0.542), but the primary Gleason score was markedly higher in the former than in the latter (Z = -2.600, P = 0.009). Univariate logistic regression analysis showed that TMPRSS2:ERG was associated with the cribriform growth pattern (OR = 6.250, P = 0.002), foamy gland morphology (OR = 6.666, P = 0.023), and signet-ring cells (OR = 3.240, P = 0.035), but multivariate logistic regression analysis manifested that it was associated with the cribriform growth pattern only (OR = 3.750, P = 0.033).

CONCLUSIONTMPRSS2:ERG gene fusion was associated with higher pathological grades of prostate cancer.

Gene Fusion ; Humans ; Male ; Oncogene Proteins, Fusion ; genetics ; Prostatic Hyperplasia ; genetics ; Prostatic Neoplasms ; genetics ; pathology

The teaching reform on functional experiment is an attractive problem of the medical teaching development at present. Our school has opened the course of functional experiment according to integrating and recombining with physiology, pathologic physiology and pharmacology, which brought into playing a positive role in enhancing the medical students' capability of practice, the comprehensive application of knowledge and the consciousness of innovation. However, some problems still exist and further practice is needed for more improvement.

OBJECTIVETo explore and sum up the characteristics of infection after cardiac transplantation and to discuss the prophylaxis and management.

METHODFrom May 2000 to April 2003, 36 patients received orthotopic heart transplantation, the clinical data were observed and analyzed.

RESULTSInfection occurred in 2 (6%) cases, both belonged to lung infection caused by human cytomegalovirus. The 2 cases were cured by ganciclovir intravenously.

CONCLUSIONGood prophylactic method may decrease post cardiac transplantation infection significantly. It is very important to early diagnose and treat infection.

Adolescent ; Adult ; Aged ; Antibiotic Prophylaxis ; Antiviral Agents ; therapeutic use ; Cytomegalovirus Infections ; drug therapy ; Female ; Follow-Up Studies ; Heart Transplantation ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Postoperative Period

OBJECTIVETo compare the effect and safety of the no-flip method versus the external method in Shang Ring circumcision.

METHODSWe searched relevant randomized controlled trials published in China and abroad comparing the no-flip method and external method of Shang Ring circumcision. Based on the Cochrane Handbook for systematic review, two reviewers independently eval- uated the quality of the included studies and abstracted relevant data, followed by a meta-analysis using the statistical software Review Manager 5.1.0.

RESULTSTotally 7 studies with 1 200 cases were included. Compared with the external method, the no-flip method was associated with a lower total rate of complications (RR = 0.40, 95% CI: 0.18, 0.87, P = 0.02), a lower incidence of postop- erative edema (RR = 0.28, 95% CI: 0.09, 0.81, P = 0.02), and a lower 24 h postoperative pain score (MD = -0.35, 95% CI: -0.55, -0.14, P < 0.001).

CONCLUSIONThe no-flip method of Shang Ring circumcision was superior to the external method for its advantages of fewer complications, lower incidence of postoperative edema, and mild postoperative pain. However, our findings need further support by more high-quality randomized controlled trials.

China ; Circumcision, Male ; adverse effects ; instrumentation ; methods ; Edema ; epidemiology ; Humans ; Male ; Pain Measurement ; Pain, Postoperative ; epidemiology ; Randomized Controlled Trials as Topic

Objective To study the clinical application anatomy of interventricular foramen and offer a base for operation.Methods Interventricular foramens were observed in 15 adult cadaveric brainThirty- two patients of obstructive hydrocephalus were operated to observe the structure of interventricular foramen un- der neuroendoscope.Results Interventricular foramen was a poriform structure which consists of fornixan- terior pole of thalamencephalon and choroid plexus and was a oval shape in most of themThe plane of the fo- ramen was a included angle with the median sagittal planeThe septal veinthalamostriate veinthalamen- cephal and even the floor of third ventricle could be observed clearly in endoscope.At the same timewe found the foramen had a significant change in obstructive hydrocephalus.Conclusion The interventricular foramen has a simple relatively structure but a variation on size and shape especially in obstructive hydroceph- alusA clearly comprehension of it's structure and adjacent is a base to microsurgery and endoscopic surgery on the foramen.

OBJECTIVETo investigate the role of mitochondrial calcium uniporter in cardioprotection elicited by ischemic postconditioning (Postcond).

METHODSMale Sprague-Dawley rats were used for Langendorff isolated heart perfusion. The hearts subjected to global ischemia for 30 min followed by 120 min of reperfusion. Left ventricular developed pressure (LVDP), maximal rise/fall rate of left ventricular pressure (± dP/dtmax) were measured. The level of lactate dehydrogenase (LDH) in the coronary effluent was measured spectrophotometrically, the content of formazan of myocardium was also measured at the end of reperfusion.

RESULTCompared to I/R group, Postcond had an significant increase in the mechanical function of the left ventricle, with LDH release reduced and the content of formazan increased. Spermine, the opener of mitochondrial calcium uniporter, deteriorated the mechanical function of left ventricle and decreased the formazan content, and increased LDH release. Ruthenium red, the inhibitor of mitochondrial calcium uniporter, increased the mechanical function of the left ventricle, decreased the LDH release, but the content of formazan was not increased.

CONCLUSIONThe inhibition of mitochondrial calcium uniporter is involved in the mechanisms of ischemic postconditioning.

Animals ; Calcium Channels ; metabolism ; physiology ; Disease Models, Animal ; Formazans ; analysis ; Heart ; physiopathology ; Ischemic Postconditioning ; L-Lactate Dehydrogenase ; analysis ; Male ; Myocardial Reperfusion Injury ; metabolism ; physiopathology ; prevention & control ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo determine whether preoperative contrast delay-enhanced cardiovascular magnetic resonance imaging (DE-CMR) could help predict long-term survival of patients with severe chronic aortic regurgitation and extremely dilated left ventricular chamber after aortic valve replacement.

METHODSTotally 37 patients enrolled between February 2008 and November 2010 with severe chronic aortic regurgitation and extremely dilated left ventricular chamber, who met the echo criteria, that was left ventricular end diastolic dimension > 70 mm or left ventricular end systolic dimension > 55 mm, and were scheduled to the surgery. The 2-dimensional echocardiographic examinations and CMR with late gadolinium-enhancement (LGE) were performed routinely preoperatively. According to the results of CMR, the patients were divided into 2 groups: the LGE positive(+) group and LGE negative(-) group. The association of LGE with event free survival, postoperative cardiac function and postoperative hospital stay time was investigated. Fifteen patients had significant LGE signals in CMR films, while the other twenty-two were silent. All of them received the operative procedures, including aortic valve replacement in 28 cases, Bentall procedure in 3 cases, aortic valve replacement and ascending aorta replacement in 6 cases, and concomitant mitral valve repair in 11 cases.

RESULTSOver a follow-up of 33.6 months, 1-year, 2-year and 3-year event free survival rates in LGE(-) group were 94.7%, 88.4%, and 72.6%, respectively, compared to 80.0%, 48.9%, and 32.6%, respectively in LGE(+) group (χ(2) = 7.244, P = 0.007). The postoperative hospital stay time of LGE(-) group was (9 ± 2) days, which of LGE(+) group was (10 ± 3) days (t = 1.175, P = 0.248).

CONCLUSIONSLGE positive signal in CMR films is a potential predictor of persistent cardiac failure after aortic valve replacement for patients with severe chronic aortic regurgitation and extremely dilated left ventricular chamber. It has intimate relationship with malignant arrhythmia and sudden death, which makes it a valuable technique in preoperative evaluation and risk stratification.

Aortic Valve Insufficiency ; complications ; diagnosis ; surgery ; Follow-Up Studies ; Humans ; Hypertrophy, Left Ventricular ; complications ; diagnosis ; surgery ; Magnetic Resonance Imaging ; methods ; Postoperative Period ; Prognosis