Objective To investigate the characteristics of pathogenesis and therapeutics of myelodysplastic syndrome(MDS)and aplastic anemia(AA)combined with autoimmune disease(AID).Methods Retrospective analysis and follow-up visit of 111 patients with MDS and 56 patients with AA in our hospital were studied.Results There were 9(8.1%)of 111 patients with MDS and 2 (3.6%)of 55 patients with AA coexistent with AID.Autoimmune hemolytic anemia(36.4%)and Behcet Disease(18.2%)were common among those combined with AID.5 patients had AID proceeding to the occurrence of MDS/AA.4 patients had simultaneous occurrence of AID and MDS/AA.2 patients developed AID three years later after the diagnosis of MDS.Conclusion There was a certain intrinsic relationship between MDS/AA and AID.

Objective To investigate standard diagnosis and treatment of cerebrospinal fluid (CSF) leakage to improve the prognosis of the patients. Methods A retrospective study was done on 75 patients with CSF leakage from January 2004 to March 2007 in our hospital. There were 51 patients with rhinorrhea, nine with otorrhea and 15 with wound/incision leakage. Of all, 39 patients had traumatic leakage, 32 postoperative leakage and four spontaneous leakage. In the study, 23 patients were cured by position testing and drug therapy and 16 by cerebrospinal fluid drainage and/or wound debridement but 36 were treated with surgeries including craniotomy repair in 17, extracranial repair in 17 and CSF shunt in five (three received CSF shunt after repair). Results Of all, 64 patients were cured, 10 gained im-provement but one died. Conclusion Standard diagnosis and treatment of CSF leakage helps improve cure rate and reduce complications.

Objective To evaluate the utility of MMP9,MPO and sCD40L in detection of the character of coronary artery plaque.Methods From April 2008 to January 2010,118 patients from outpatient of Fu Wai Hospital with chest pain were enrolled.All of them underwent 64 Multiple-detector row spiral computer tomography (64-MDCT),the CT value ＜ 130 Hu patients were enrolled in non-calcified plaque group (71 cases),CT value ≥ 130 Hu patients were enrolled in the calcified plaque group (47 cases).Ninty healthy volunteers were selected as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum markers,including MMP9,MPO and sCD40L.Levels of MMP9,MPO and sCD40L of each group were compared.ROC curve was used to evaluate the sensitivity and specificity of the markers in diagnosis of non-calcified plaque.Results MMP9,MPO and sCD40L levels of non-calcified were ( 762.25 ± 368.71 ),[ 844.10 (582.00 - 1220.70) ],(9.37 ± 3.15) μg/L,higher than the healthy control group (342.70 ± 178.53),[426.35 ( 283.20 - 592.00) ],(6.55 ± 2.96) μg/L and calcified plaque group ( 483.12 ± 219.09 ),[ 469.00 ( 302.45 - 723.55) ],( 7.24 ± 2.86) μg/L The difference was statistically significant ( F =42.47,H =50.28,F =17.94,all P ＜ 0.01 ). Areas of MMP9,MPO and sCD40L under the ROC curve to predict non-calcified plaque were 0.854,0.792,0.751 respectively,when the identification threshold for non-calcified plaque were 510.13,537.82,7.05 μg/L respectively,the diagnostic sensitivity was 80％,80％,80％ respectively,and specificity was 80％,67％ and 55％ respectively.Conclusion The serum MMP9,MPO and sCD40L levels can help to determine the　character of coronary plaque.

Objective To evaluate the value of MSCT, MRI and SPECT in detecting acute myocardial ischemia in Chinese mini-swine model. Methods A total of six male mini-pigs were recruited with a mean body weight of (21.6 ± 1.2) kg. All pigs were scanned on MSCT before the ligation of distal segment of Left anterior descending artery. Then, MSCT was rescanned every 2 h from ligation till 8 h latter.MRI, SPECT and the last MSCT scan were performed within 24 h one by one. Finally pathological examination was carried out right after the pig killed. Results One pig died during operation, the other 5 finished all the examinations. The pathological staining showed the same areas of myocardial infarction in the left ventricular anterior wall with the all the imaging findings, including low perfusion region of MSCT arterial phase at 2-24 h, low perfusion region of SPECT at 24 h and low perfusion region of MRI first pass phase at 24 h. Three of 5 pigs showed enhanced edge of low perfusion region on MSCT delayed scan at 4-8 h. The mean CT values in the region with reduced first-pass perfusion were 75.9,36.4, 35. 2,37. 8,37.4,33.3 HU on MDCT image at baseline, 2-8 h after operation and within 24 h after operation, respectively,and there were statistically significant difference of CT values ( F = 12. 341, P ＜0. 01 ) between preoperative and all postoperative MSCT scan. There were no statistically significant difference (F = 2. 278, P = 0. 792)among all postoperative MSCT scan. At baseline, 2-8 h after operation and within 24 h, the average volumes of stroke volume(SV)were 21.7,11.9,10.3,11.4,12. 3,12.6 ml, respectively, while the average volume of end-systolic volume( ESV)were 15.2,23.4,25.0,24. 4,25.3,22. 8 ml,respectively. The average volume of end-diastolic volume ( EDV ) at these time point were 37. 0,35.4,35.0,35.7,37. 6,37.5 ml,respectively and the average percentage of ejection fraction (EF) were 58.9% ,33.8% ,29. 0%, 31.9%,32.6% ,33.5% ,respectively. SV(F =22. 349, P＜0.01) ,ESV (F=8. 810, P＜0.01) ,EF(F =27. 240,P ＜ 0. 01 ) were all significantly different among all postoperative MSCT scan except EDV ( F = 2. 339, P =0. 079). Infarct size, which was defined as the proportion of the area of infarction to that of the entire heart,were (39.4 ±12.6)% for MSCT,(37.2 ± 10.0)% for MRI, (35.9 ±9.6)% for TTC, respectively.There were no significant differences of infarct size between TTC and MSCT (t =0. 612, P =0. 574), TTC and MRI (t=0.820, P=0.458), MSCTand MR (t=0. 425 ,P =0. 692 ). Conclusions MSCT,MRI and SPECT were all able to be used to detect the myocardial infarction in acute myocardial ischemia model The infarct size defined on MSCT, MRI and pathology were consistent. The density of ischemic myocardium and cardiac function did not change over the time within 24 h right after infarction.

Objective To study the correlation between morphological characteristics of coronary artery calcified plaques and luminal stenosis of local coronary artery segments with 64-slice computed tomography.Methods One hundred and eleven patients who had undergone 64-slice computed tomographic coronary angiography(CTCA)and conventional coronary angiography(CAG)were retrospectively analyzed.The calcified plaques were classified as punctate,nodular,strip-like and nubbly in long-axis view of coronary artery lumen,and were classified as crescent,semilunar,round moon and circinate in short-axis view.The morphologic characteristics of these calcified plaques on CTCA were retrospectively analyzed and compared with luminal stenosis of CAG results.Results Among 528 calcified coronary segments which were analyzed in 111 patients,there were 383(72.5%)punctate calcified plaque segments and 145(27.5%)of non-punctate plaques.There were 34(23.4%,34/145)non-punctate calcified plaques which caused severe stenosis(≥75%),including 4(11.8%)nodular,8(23.5%)stripe-like and 22(64.7%)nubbly calcified plaques on the long-axis view,and 0(0.0%)cresent,8(23.5%)semilunar,18(52.9%)round moon and 8(23.5%)circinate calcified plaques on the short-axis view.The ratios of different morphological coronary artery calcifications which caused severe stenoses were significantly different with each other(all P＜0.01).Conclusion Different figures of coronary artery calcified plaques demonstrate different degrees of stenoses of local coronary artery lumen.Severe stenoses were mostly caused by nubbly calcified plaque on long-axis view,round moon and circinate calcified plaque on short-axis view.

BACKGROUND: Human keratinocyte growth factor-2 (hKGF-2) has extensive physiological functions, which plays an important role in embryonic development, tissue-repairing, nervous regeneration, vascularization and development of tumor.OBJECTIVE: To clone hKGF-2 gene, obtain the expression of hKGF-2 in Escherichia coli(E.coli) and determine its bioactivity, so as to provide experimental basis for further investigation.DESIGN: Open experiment.SETTING: Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention.MATERIALS: The experiment was conducted in State Key Laboratory of Viral Genetic Engineering, Institute for Viral Disease Control and Prevention of Chinese Center for Disease Control and Prevention. The temperature control expression vector pBV220 was constructed by State Key Laboratory of Viral Genetic Engineering; EcoR Ⅰ , BamH Ⅰ , T4 DNA ligase (Promega Co., Ltd.); The specific polymerase chain reaction (PCR) of hKGF-2 (Manufactured by Shanghai Boya Biotechnology Co., Ltd.); Heparin-Sepharose CL-6B (Pharmacia Company); PCR rapid purification kit,Trizol kits for total RNA extract, Kits for RT-PCR (GIBCO Co., Ltd.); Kits for rapid extraction of plasmid DNA (Boda Company); BL-21-codon plus compent cells (Stratagene Co., Ltd.).METHODS: High-expression strain BL-21 codon plus competent cells was used to express and purify initially recombinant hKGF-2 protein, and its activity was detected. RT-PCR was adopted to obtain hKGF-2 cDNA from lung tissues of naturally aborted fetus and clone it into pBV220 carri er plasmid. The hKGF-2 protein expressed in BL-21 codon plus competent cells of E.coli. Affinity chromatography and ion exchange chromatography were applied in isolation and purification, and the bioactivity of expression protein was determined in cell proliferation test.MAIN OUTCOME MEASURES: The length and sequence of cDNA segment in hKGF-2, the expression of hKGF-2 gene inE.coli and the purification of hKGF-2 activity.RESULTS: The segment of hKGF-2 cNDA was about 500 bp, and hKGF-2 protein highly expressed in BL-21, which had soluble expression in the supernatant. SDS-PAGE showed that the relative molecular mass was about 20000, and hKGF-2 protein could significantly promote the mitotic activity of NIH3T3 cells. The A value (490 nm) of hKGF-2 in the 1 μg/L, 5 μg/L and 10 μg/L groupswere higher than that in the blank control group, and the differences were significant (which were 0.174±0.022,0.220±0.029,0.306±0.050,0.066±0.004 respectively,P ＜ 0.001).CONCLUSION: hKGF-2 gene is successfully cloned, which highly expresses in BL-21 of the E.coli. Purified hKGF-2 protein can stimulate the proliferation of NIH3T3 cells and significantly promote its mitotic activity.

Objective To detect the value of serum galactomannan (GM) for diagnosis of invasive aspergillosis (IA) in hematological patients. Methods We prospectively evaluated the diagnostic value of twice-weekly screening for circulating Aspergillus fumigatus with sanditch enzyme linked immunosorbent assay. Results On the basis of the analysis of 472 serum samples from 113 episodes of 92 patients, the sensitivity, specificity, positive and negative predictive values of the sandwich ELISA for proven and probable IA cases were 83.3 %, 91.1 %, 78.9 % and 93.1 %, respectively, when samples with 2 consecutive positive results≥0.7 were used. Furthermore, GM antigenemia was detected before the onset of radiologic signs with a median of 7 days (range, 1-14 days), before isolation of Aspergillus with a median of 4 days (range, 1-7 days),and before anti-fungal therapy with a median of 6 days (range, 1-15 days). Conclusion The sandwich ELISA for GM detection is a reliable method for early diagnosis of IA in patients with haematological diseases.

Objectives To investigate gestational multiple metabolic abnormalities aggregation and diagnostic criteria for gestational metabolic syndrome(GMS),and to analyze the risk factors of GMS.Methods A cohort study recruiting 309 pregnant women with preeclampsia,627 pregnant women with gestational diabetes mellitus(GDM)and 1245 normal pregnant women was performed from January 2008 to December 2011 in Guangdong Women and Children's Hospital.Information regarding age,gestational weeks,basic blood pressure,admission blood pressure,height and body mass index(BMI)before pregnancy was recorded.Biochemical indicators including fasting plasma glucose(FPG),fasting insulin (FINS),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),free fatty acids(FFA)were tested.GMS was diagnosed with three or all of the following conditions:(1)overweight and/or obesity before pregnancy(BMI ≥ 25 kg/m2);(2)hypertension with blood pressure ≥ 140/90 mm Hg(1 mm Hg =0.133 kPa);(3)hyperglycemia:diagnosed as GDM;(4)dyslipidemia with TG≥3.23 mmol/L The incidence of GMS of the three groups were calculated and the risk factors were analyzed.Results(1)The age,gestational weeks,basic blood pressure,admission blood pressure,BMI before pregnancy of women with preeclampsia and women with GDM were significantly different compared to normal women,respectively(P ＜ 0.01).(2)Biochemical indicators of women with preeclampsia were as following:FPG(4.6 ± 1.0)mmol/L,FINS(10.1 ± 5.6)mU/L,TC(6.3 ±1.6)mmol/L,TG(3.9 ± 1.8)mmol/L,HDL-C(1.4 ±0.4)mmol/L,LDL-C(3.0 ± 1.0)mmol/L,FFA (0.8 ±0.4)mmol/L.And those in women with GDM were:FPG(4.7 ± 0.9)mmoL/L,FINS(10.2 ± 5.8)mU/L,TC(5.7 ± 1.3)mmol/L,TG(3.2 ± 1.1)mmol/L,HDL-C(1.4 ± 0.4)mmol/L,LDL-C (2.7 ± 0.9)mmol/L,FFA(0.6 ± 0.3)mmol/L In normal pregnant women they were:FPG(4.3 ±0.5)mmol/L,FINS(9.0±4.4)mU/L,TC(5.7 ±1.1)mmol/L,TG(2.8 ±1.1)mmol/L,HDL-C (1.5 ± 0.4)mmol/L,LDL-C(2.9 ± 0.8)mmol/L,FFA(0.6 ± 0.2)mmol/L Statistic differences were found in preeclampsia and GDM women compared to normal women respectively(P ＜ 0.01).(3)The prevalence of GMS in preeclampsia group and in GDM group was 26.2％(81/309)and 13.6％(85/627),statistically different from that of the control group(0)(P ＜0.01).(4)Compared to normal women,women with preeclampsia had higher risk of developing GMS(OR =1.62,95 ％ CI 1.31-2.00,P ＜ 0.01).The risk factors were BMI(OR =1.29,95％ CI 1.13-1.47)and TG(OR =2.49,95％ CI 1.87-3.31).Also,women with GDM had higher risk of developing GMS than normal women(OR =1.27,95％ CI 1.09-1.49,P ＜ 0.01),and the risk factors were BMI(OR =1.13,95 ％ CI 1.04-1.23)and TG(OR =1.16,95 ％ CI 1.02-1.33).TG was the independent risk factor in both preeclampsia women and GDM women(P ＜ 0.01,P ＜ 0.05).HDL-C seemed to have less importance in identifying GMS(P ＞ 0.05).Conclusions According to the GMS diagnostic criteria used in this study,some preeclampsia patients and some GDM women had aggregation of multiple metabolic abnormalities including pre-pregnancy overweight/obesity,hyperglycemia,high blood pressure and dyslipidemia.TG was the independent risk factor for GMS.HDL-C seemed to have less importance in identifying GMS.

Objective To analyze the image quality of coronary arteries by dual-source computed tomography (DSCT) in children with congenital heart disease(CHD). Methods Image quality of coronary arteries were scored by two radiologists with an ordinal grading system. Score 3 or 4 was considered to be good image quality and diagnostic. Score differences among 3 groups of various baseline heart rate levels, 3 groups of various age levels and 4 coronary branches were analyzed by using ANOVA. Multiple linear regression analysis was used to test the effects of age, heart rate, tube voltage, tube current, pitch, contrast volume, contrast injection rate on the coronary image scores. Results A total of 72 consecutive patients were enrolled. 71.2% (205/288) of coronary artery branches was good enough for diagnosis. Image quality of left main coronary artery (LM, score 3.64±0.49), left anterior descending (LAD, score 2.97±0.40), right coronary artery (RCA, score of 2.82±0.70), left circumflex (LCX, score 2.76±0.73) were in a descending order (F=29.00, P<0.01). Image scores of age groups of 0--1 years old (2.80±0.65), >1--3 years old (2.81±0.74), >3--14 years old (3.58±0.52) were in an ascending order (F= 20.16,P<0.01). Image scores of heart rate groups of<100 bpm (3.54±0.56),100--150 bpm (2.86± 0.70) and >150 bpm (2.81±0.63) were in a descending order (F=16.72, P<0.01). Multiple linearregression analysis demonstrated that multiple impact factors affected image quality of LM, LAD, LCX and RCA. Age(r=0.013 ,P<0.01)and contrast volume(r=0.292, P<0.01)had positive correlation with LM score. Age(r=0.509, P<0.01) and voltage (r=0.292, P=0.011) had positive correlation with LAD score. Heart rate(r= -0.179, P<0.05) had negative correlation with LAD score. Age (r=0.063, P< 0.01) had negative correlation with LCX score. Age (r=0.486,P<0.01) and voltage (r=0.220, P<0.05) had positive correlation with RCA score. Conclusions Dual-source CT could clearly shows coronary arteries of children with CHD over the age of 3 or with heart rate less than 100 bpm. Limitations of Dual-source CT coronary angiography for CHD children included young age and fast heart rate.

OBJECTIVETo compare inhibitory effects of recombinant receptor activator of nuclear factor kappaB protein with bisphosphonate treatment (ALN) on osteoclasts activity and bone loss in ovariectomized mice.

METHODSTwenty-four female KM mice were ovariectomized bilaterally and treated with recombinant receptor activator of nuclear factor kappaB protein, alendronate, or PBS. Twelve weeks later, body weight, biochemical markers of bone metabolism, Micro CT scan and bone morphology were examined.

RESULTSAfter 12 weeks administration, the Micro CT scan and bone morphology values of each group were as follow. The control group: BMD (92.600 +/- 14.319) mg/cc, Tb.Th (0.094 +/- 0.011) mm, Tb.Sp (0.455 +/- 0.124) mm, BVF 0.192 +/- 0.023, SMI 1.388 +/- 0.328; the recombinant receptor activator of nuclear factor kappaB protein group: BMD (133.050 +/- 13.022) mg/cc, Tb.Th (0.098 +/- 0.009) mm, Tb.Sp (0.365 +/- 0.105) mm,BVF (0.291 +/- 0.025)%, SMI 0.661 +/- 0.384; the ALN group: BMD(128.013 +/- 16.040) mg/cc, Tb.Th (0.097 +/- 0.011) mm, Tb.Sp (0.376 +/- 0.104) mm, BVF 0.281 +/- 0.024, SMI 0.753 +/- 0.307. In the ovariectomized mice experiments, both recombinant receptor activator of nuclear factor kappaB protein and ALN significantly inhibited ovariectomy-induced bone loss. Compared to the control group (PBS), the recombinant receptor activator of nuclear factor kappaB protein group showed increased distal femur BMD and decreased trabecular spacing (Tb.Sp), whereas the control group had significantly decreased distal femur BMD, significantly decreased Tb.Th, and increased Tb.Sp. There was a significant difference in bone volume fraction among the groups. The TRAP-positive osteoclasts in distal femur bone slices were nearly complete inhibited for Recombinant receptor activator of nuclear factor kappaB protein group and alendronate group.

CONCLUSIONIn vivo, recombinant receptor activator of nuclear factor kappaB protein effectively inhibits the activity of osteoclasts and the resulting bone loss, which has a similar effect as alendronate.

Animals ; Bone Density ; drug effects ; Diphosphonates ; therapeutic use ; Female ; Mice ; Osteoporosis ; diagnostic imaging ; drug therapy ; Ovariectomy ; Radiography ; Receptor Activator of Nuclear Factor-kappa B ; therapeutic use