Superior Mesenteric Artery (SMA) syndrome is a well-known but rare complication following corrective surgery for scoliosis. It can be easily missed if not thought of in patients presenting with abdominal pain and vomiting post-scoliosis surgery. SMA syndrome is most commonly associated with conditions resulting in significant weight loss but can also occur as a result of biomechanical changes following scoliosis surgery. We present a case of a 13 year-old girl who developed SMA syndrome following scoliosis surgery. A high index of suspicion and early surgical referral are paramount for the successful management of SMA syndrome.

OBJECTIVETo compare therapeutic effects between arthroscopic medial retinaculum plication and plaster external fixation for the treatment of acute patellar dislocation.

METHODSFrom February 2006 to October 2012,29 patients with acute patellar dislocation were divided into two groups: operation group and non-operation group. The patellar dislocation duration was 2 weeks. In operation group, there were 7 males and 10 females, with an average age of (16.2 ± 6.2) years old, and the patients were treated with arthroscopic medial retinaculum plication. In non-operation group, there were 5 males and 7 females,with an average age of (16.3 ± 5.0) years old,and the patients were treated with plaster external fixation. The Kujala scores, patellar tilt angle measured on CT film, apprehension test and recurrence rate of patellar instability were observed before and 1 year after treatment.

RESULTSIn operation group, the pre-treatment and post-treatment patellar tilt angles had no statistical difference, but the post-treatment Kujala score was lower than that of pre-treatment; while in non-operation group, the post-treatment patellar tilt angle was larger than that of pre-treatment, and the post-treatment Kujala score was lower than that of pre-treatment. At 1 year after treatment, the patellar tilt angle (21.2 ± 5.3) of patients in non-operation group was larger than (13.5 ± 3.5) of operation group, and the Kujala score 73.3 ± 10.5 of patient in non-operation group was lower than 84.1 ± 5.6 of operation group.

CONCLUSIONDuring 1 year after operation, arthroscopic medical retinaculum plication is a more effective treatment for acute patellar dislocation compared with plaster external fixation.

Adolescent ; Adult ; Arthroscopy ; Case-Control Studies ; Casts, Surgical ; Child ; Female ; Fracture Fixation ; Humans ; Male ; Patellar Dislocation ; surgery ; therapy ; Patellar Ligament ; surgery ; Treatment Outcome ; Young Adult

AIM:To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs combined with other methods in the treatment of Coats disease.METHODS:Selected 13 patients 13 eyes with Coats disease in our hospital from May 2013 to May 2016.All eyes were treated with intravitreal injection of ranibizumab and combined with scleral drainage, laser photocoagulation and so on.We observed visual acuity and retinal reattachment.RESULTS:In 13 eyes, the treatment of 4 eyes with intravitreal injection of ranibizumab and combined with scleral drainage, 3 eyes combined laser photocoagulation, 6 eyes combined vitrectomy, membrane peeling, freezing, silicone oil filling or other treatments.Eyeball retention rate was 100%.Visual acuity at 6mo after treatment significantly improved compared with before treatment (P<0.05).The visual acuity was ≥0.05-0.1, 0.01-<0.05, counting finger, light perception and hand moving before treatment in 0, 0, 38%, 38% and 23%, after treatment were 23%, 23%, 38%, 15% and 0.Complete retinal reattachment was achieved in 5 eyes, accounting for 38%;basic reset in 3 eyes, accounting for 23%;5 eyes were not reset, accounting for 38%.CONCLUSION:Intravitreal injection of anti-VEGF drugs combined with other methods for the treatment of Coats disease have a certain effect, can improve or maintain the limited visual function, avoid enucleation of eyeball due to disease progression.

Asian Continental Ancestry Group ; China ; Diabetes Mellitus, Type 2 ; ethnology ; genetics ; Genetic Variation ; Genotype ; Humans ; Insulin Receptor Substrate Proteins ; Intracellular Signaling Peptides and Proteins ; Phosphoproteins ; genetics

AIM:To investigate the mechanism of quercetin improving rat coronary artery myogenic response under high glucose ( HG) by measuring muscle tension of coronary arterial ring and recording voltage -gated K +channel ( Kv) current of coronary artery smooth muscle cells by whole cell patch clamp .METHODS:The coronary rings from the normal SD rats were acutely isolated , and then divided into 6 groups:(1) control group;(2) HG group;(3) HG+low dose (3 μmol/L) of quercetin group;(4) HG+moderate dose (10 μmol/L) of quercetin group; (5) HG+high dose (30 μmol/L) of quercetin group;(6) HG+C6303 (PKC inhibitor) +high dose of quercetin group.Determinations of coronary artery response to vasoconstrictor (60 mmol/L KCl or 0.1 mmol/L U46619) or vasodilator (Ach at 10 -9 ~10 -5 mol/L) were performed, and the percentage of coronary ring tension was calculated using the contraction as 100%caused by 60 mmol/L KCl.The rat coronary artery smooth muscle cells were acutely isolated for recording the Kv current using whole cell patch clamp .RESULTS:Compared with control group , the contraction amplitudes to 60 mmol/L KCl or 0.1 mmol/L U46619 were significantly increased under HG incubation .Quercetin intervention concentration-dependently re-duced the coronary artery contraction amplitude .Incubation of PKC specific inhibitor C 6303 attenuated the effect of querce-tin.Compared with control group , the diastolic amplitude to Ach decreased significantly in HG group , and quercetin inter-vention concentration-dependently increased the coronary artery diastolic amplitude .Incubation of PKC specific inhibitor C6303 attenuated the effect of quercetin .Compared with control group , HG incubation inhibited Kv current of coronary ar-tery vascular smooth muscle cells significantly , and quercetin intervention attenuated the inhibitory effect of HG on Kv cur-rent intensity .Incubation of PKC specific inhibitor C 6303 attenuated the effect of quercetin .CONCLUSION: Quercetin has a protective effect on myogenic response of coronary artery under HG and the effects is related to the increase in Kv cur -rent and the activation of PKC in vascular smooth muscle cells .

OBJECTIVETo investigate the efficacy and safety of percutaneous radiofrequency perforation and valvuloplasty in infants with pulmonary atresia with intact ventricular septum (PA/IVS).

METHODSFour infants (body weight 4 - 10 kg) aged 11 months, 9 months, 12 days and 9 months old, respectively, were hospitalized for dyspnea and cyanosis. All patients had a continuous murmur in the left second intercostal space. Doppler echocardiogram showed membranous pulmonary atresia with intact ventricular septum. Right ventriculogram showed a tripartite right ventricle, vasiform infundibulum, and membranous pulmonary valve atresia without ventriculocoronary connections. Descending thoracic aortogram showed good-sized confluent pulmonary arteries being filled from a ductus arteriosus. All the patients were taken up for radiofrequency perforation followed by a balloon dilatation. A 6F Judkins right coronary guiding catheter was positioned in the right ventricular outflow tract and under the atretic pulmonary valve membrane. The radiofrequency perforation catheter along with coaxial injectable catheter was then passed through the right coronary guiding catheter, using it as the guide to the imperforate membrane. The proximal end of the radiofrequency perforation catheter was then connected to radiofrequency generator. After the cusps of pulmonary valve were perforated, the coaxial injectable catheter was moved into the main pulmonary artery. A tiny floppy-tipped coronary guidewire was then passed through the coaxial injectable catheter into the main pulmonary artery and directed through the patent ductus arteriosus into the descending thoracic aorta or directed into pulmonary arteriola. Thereafter, serial balloon dilation catheters were introduced across the pulmonary valve, and dilations were sequentially performed with increasing balloon diameters. The balloon was dilated until the concave of the balloons disappeared. The radiofrequency energy (5 to 8 W) was delivered for 2 to 5 seconds once, but commonly twice, to perforate the valves. After a predilation with a 3 mm x 20 mm to 5 mm x 20 mm balloon at 6 - 14 atm pressure, the valve was subsequently dilated with 10 mm x 30 mm to 14 mm x 30 mm balloon once or twice. The duration of procedures was 120 to 150 min and exposure time was 25.4 to 43.9 min.

RESULTSThe primary procedure was successful in all the infants except one who died early of cardiac perforation with tamponade. After a follow-up period ranging from 2 to 8 months (mean 4.3 m), the remaining 3 survivors achieved complete biventricular circulation. Two of them were awaiting occlusion of the patent ductus arteriosus and 1 needed right ventricular outflow tract reconstruction because of infundibular obstruction.

CONCLUSIONPA/IVS consists of 0.7% to 3.1% of congenital heart defects. 85% of the untreated patients die within half a year. Surgical repair for the infants with PA/IVS is associated with a high mortality. In carefully selected patients with PA/IVS, radiofrequency perforation and balloon dilatation of the pulmonary valve is feasible and may represent a new alternative to surgery due to its low mortality and avoidance of cardiopulmonary bypass.

Balloon Occlusion ; Catheter Ablation ; methods ; Catheterization ; methods ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pulmonary Atresia ; physiopathology ; therapy ; Pulmonary Valve ; surgery ; Ventricular Septum

Objective To evaluate the clinical feature of patients with atrial septal defects (ASD)and the safety and efficacy of transcatheter closure of ASD in elderly patients.Methods Between May 2000and June 2010,82 patients aged (64.5 + 3.8)years underwent attempted transcatheter ASD closure.Right heart catheterization was performed before intervention.Echocardiography was made at 1 day,1,3,6 months after the procedure.The pre- and post-closure clinical feature,pulmonary artery pressure (PAP) and cardiac function were evaluated.Results In 82 patients,37 (45.1％) patients were associated with pulmonary arterial hypertension ( PAH ).The systolic PAP and mean PAP [ (44.1 ± 12.4) mm Hg ( 1mm Hg = 0.133 kPa) and (25.2 + 6.8) mm Hg,respectively ] were measured by right heart catheterization before the procedure.One patient was unsuitable for closure because of severe PAH.The remaining 81patients underwent successful ASD closure without major complications.After closuring,systolic PAP decreased from (52.7 ± 10.3 )mm Hg to (31.8 ± 6.3) mm Hg ( P ＜ 0.05 ),and mean PAP descended from (30.9 ± 4.7 ) mm Hg to (21.8 ± 3.4) mm Hg( P ＜ 0.05 ) in the 36 patients with PAH.The cardiac function improved post procedure.There were 6 new-onset atrial fibrillations during follow up.Conclusions ASD in elderly patients are commonly associated with PAH.Transcatheter ASD closure is safe and effective in the majority of elderly patients.

OBJECTIVETo study the associations between paraoxonase, 55 Met/Leu (PON1 55 Met/ Leu), paraoxonase2 148 Ala/Gly (PON2 148 Ala/Gly) and manganese superoxide dismutase 9 Ala/Val (MnSOD 9 Ala/Val) genetic polymorphisms and coronary heart disease (CHD), plasma activities of paraoxonase (PON), total superoxide dismutase (T-SOD), MnSOD, as well as plasma concentration of maleic dialdehyde (MDA).

METHODSUsing PCR-RFLP method to identify genotype of PON1 55 Met/Leu, PON2 148 Ala/Gly and MnSOD 9 Ala/Val genetic polymorphisms, and using colorimetry to detect plasma activities of PON, T-SOD, MnSOD and plasma concentration of MDA in 262 CHD patients and 100 controls.

RESULTSCompared with controls, the plasma activities of PON [(349.27 +/- 138.36 vs. 454.75 +/- 166.00) nmol x min(-1) x ml(-1), P < 0.001], T-SOD [(23.61 +/- 16.51 vs. 44.01 +/- 22.68) U/ml, P < 0.001] and MnSOD [(21.56 +/- 13.11 vs. 28.79 +/- 8.65) U/ml, P < 0.001] reduced obviously,while plasma MDA concentration increased markedly [(2.47 +/- 0.73 vs. 2.15 +/- 0.55)nmol/ml, P < 0.01] in CHD patients. There were more LM genotype and Met allele of PON, 55 Met/Leu (24.8% vs. 1.4%, P < 0.001 and 12.4% vs. 0.5%, P = 0.001, respectively), GG and AG genotype and G allele of PON2 148 Ala/Gly (11.8% vs. 5.0%, P < 0.001, 48.1% vs. 24.0%, P < 0.001 and 36.0% vs. 17.0%, P < 0.001, respectively) and AA genotype, A allele of MnSOD 9 Ala/Val genetic polymorphisms (64.2% vs. 43.0%, P = 0.001 and 80.0% vs. 67.0%, P = 0.014, respectively) in CHD patients than in controls. The activities of plasma PON and T-SOD were lower in individuals with PON1 55 LM genotype than those with LL genotype. The activity of plasma PON was also lower in individuals with PON2 148 GG/AG genotype than those with AA genotype. The activities of plasma PON and MnSOD depressed in individuals with MnSOD AA genotype compared with those with VV genotype. Logistic regression analysis demonstrated that PON1 55 LM genotype, PON2 148 GG/AG genotype and G allele were independent risk factors for CHD.

CONCLUSIONThe antioxidative ability decreased, while lipid superoxide increased in CHD patients. Gene polymorphisms of PON1 55 Met/Leu, PON2 148 Ala/Gly and MnSOD 9 Ala/Val seemed to involve in the morbidity of CHD by influencing the plasma activities of PON and MnSOD.

Aryldialkylphosphatase ; genetics ; metabolism ; Case-Control Studies ; China ; Coronary Disease ; enzymology ; genetics ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Superoxide Dismutase ; genetics ; metabolism

A series of noscapine analogues have been synthesized via 13-step reaction starting from 2-hydroxy-3-methoxybenzaldehyde. Anti-tumor activities of these compounds were evaluated against HL-60 cell lines in vitro by the standard MTT assay. It was found that most of these derivatives showed appreciable inhibitory activity against HL-60 and tubulin polymerization. The results also indicated that the potency of compound 31 is about three times more than that ofnoscapine against HL-60 cell line and tubulin polymerization. Moreover, it induced a massive accumulation of cells in G2/M phase. These results showed noscapine and its derivatives were worth to be intensively studied further.
Antineoplastic Agents ; chemical synthesis ; pharmacology ; Cell Cycle ; drug effects ; HL-60 Cells ; Humans ; Noscapine ; analogs & derivatives ; chemical synthesis ; pharmacology ; Polymerization ; drug effects ; Tubulin ; metabolism ; Tubulin Modulators ; chemical synthesis ; pharmacology

OBJECTIVETo detect human bocavirus (HBoV) and investigate its genetic and evolutionary characteristics in children with acute respiratory infection in Tianjin, China.

METHODSA total of 1,259 samples of nasopharyngeal aspirates were collected from children with a confirmed diagnosis of acute respiratory infection between January and December, 2012. Viral nucleic acid was extracted, HBoV was detected by real-time quantitative PCR, and the gene segments of nucleocapsid protein of HBoV in positive samples were amplified by PCR. Several products were randomly selected and sequenced.The sequence obtained was compared with the known sequence of HBoV, and a phylogenetic analysis was performed. All the samples were examined to detect for other common respiratory tract viruses.

RESULTSAmong the 1,259 samples, the positive rate of HBoV was 4.53% (57/1,259), and among the 57 samples with positive HBoV, 75% (43/57) were positive in children with an age of 6-36 months. The positive rate of HBoV in children peaked in summer (from June to August), and there was a mixed infection with other viruses. Sequence analysis was performed for the PCR products from 36 positive samples, and the presence of HBoV was confirmed, with a higher homology to the known sequence of HBoV.

CONCLUSIONSIn Tianjin, acute respiratory infection in some children may be associated with HBoV infection, which is commonly seen in infants with an age of 6-36 months. The peak of HBoV infection occurs in summer. The phylogenetic analysis shows a high homology to the known sequence of HBoV, with few gene sequence variations.

Bocavirus ; classification ; isolation & purification ; Child, Hospitalized ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Phylogeny ; Polymerase Chain Reaction ; Respiratory Tract Infections ; virology ; Seasons