Objective To investigate the prognostic value of heart rate turbulence (HRT) in patients with chronic heart failure (CHF). Methods From October 2006 to May 2009, a total of 96 elderly CHF inpatients were selected, and the clinic data were recorded. Based on the echocardiogram and dynamic electrocardiogram, the differences of sinus HRT index of patients with different cardiac function classification were analyzed. During 9-28 months medical follow-up, the treatment endpoint was death from heart disease. Based on Logisitc regression, the prognostic values of HRT, age, hypertension, diabetes, myocardial infarction (MI), left ventricular ejection fraction, ACEI and β- adrenergic blocker for death of CHF patients were analyzed.Results There was no significant difference in HRT between grade Ⅱ and grade Ⅲ cardiac function (χ~2 = 1.60, P>0. 05), and between grade Ⅲ and grade Ⅳ cardiac function (χ~2 = 1.43, P>0. 05). But there was significant difference in HRT between grade Ⅱ and grade Ⅳ cardiac function patients χ~2 =9.84, P<0. 05), and HRT was weaken in grade Ⅳ group. The average follow-up time was (18. 0±9.6) months. Of all 96 patients, there were 34 dead of heart disease. There were correlations of death of CHF with HRT, low LVEF (≤ 45%), age (≥65 years), diabetes, MI and classification of heart function. Conclusions The sinus HRT in CHF patients has a favorable prognostic value.

Adolescent ; Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Drug Interactions ; Drug Therapy, Combination ; Female ; Humans ; Male ; Methotrexate ; adverse effects ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Sex Factors ; Tetrahydrofolates ; administration & dosage ; therapeutic use ; Treatment Outcome

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Imaging, Three-Dimensional ; Male ; Maxillofacial Injuries ; diagnostic imaging ; surgery ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Skull Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the immunological effect of PM2.5 on cytokine production in female Wistar rats.

METHODSFemale Wistar rats were given 0.3 mg, 0.75 mg, 2 mg, 5 mg of PM2.5 per 0.5 mL saline, respectively. Saline was used as the negative control. TNF-alpha and IL-6 levels in the branchoalveolar lavage were measured by ELISA, and mRNA expression levels in lung tissue were detected by RT-PCR. Alveolar macrophages were collected for testing phogacytic function.

RESULTSExposure to PM2.5 stimulated TNF-alpha production in a dose-dependent manner (P < 0.05), However, no statistically significant difference was found. No time-dependent change in TNF-a and IL-6 production was found. TNF-alpha and IL-6 mRNA expressions were induced by PM2.5-exposure. The phagocytic rate (PR) was significantly decreased by PM2.5 treatment.

CONCLUSIONPM2.5 exposure increases inflammation response of the lung in a dose-dependent manner. Moreover, tissue injury induced by PM2.5 may be related to altered production of cytokines. PMz2.5 may impair the phagocytic activity of alveolar macrophages.

Animals ; Bronchoalveolar Lavage Fluid ; Cytokines ; biosynthesis ; genetics ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Macrophages, Alveolar ; metabolism ; Particle Size ; Phagocytosis ; RNA, Messenger ; genetics ; Rats ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction

Adrenal Cortex Hormones ; therapeutic use ; Anemia, Hemolytic, Autoimmune ; diagnosis ; drug therapy ; Female ; Humans ; Infant ; Treatment Outcome

Objective To investigate feasibility and safety of anterior pedicle screw fixation tunnel in the axis so as to provide theoretic evidence for further clinical application.Methods Thirty-two dry axis specimens were used for anterior pedicle screw placement,and the length of pedicle crews tunnel was measured by a digital caliper.The extraversion angle and the downslope angle were determined by CT cross-sectional scanning and reconstruction.Results All the anterior pedicle screws were positioned well,with no perforation of the pedicle.The anchoring point was at the vertex between the vertebral body and the superior articular process,with axis pedicle length of(28.4 ± 2.5)mm,the extraversion angle of (28.5 ±2.3)°and the downslope angle of(15.5 ±2.0)°.Conclusions Anterior pedicle screw fixation tunnel is feasible in the axis and can keep away from some important anatomy structures including transverse foramen,vertebral artery groove and vertebral canal to provide large safety space.

Objective To investigate the diagnostic value of double balloon endoscopy (DBE) in the elderly. Methods Clinical manifestations and endoscopic findings of 42 elderly patients (aged 60-80 years) and 73 young and middle-aged patients (aged 12-59 years) with small bowel lesions were obtained and compared. Factors influencing the diagnostic outcome of DBE in patients with small bowel bleeding were identified,and the optimal check time after the latest bleeding was determined.Results The procedures of 85.7％ (36/42) in the elderly and 79.5％(58/73) in young and middle aged were completed (P＞0.05).There was no significant difference in the procedure time between the two age groups.No severe complications were observed in the elderly group.The overall positive rate by double balloon enteroscopy examination were 71.4 ％ (30/42) and 63.0 ％ (46/73),respectively in the two groups (P＞ 0.05). Ulcer and tumor lesions were the most common findings,and diverticula and angiodysplasia were the second common findings. Longer duration of bleeding and higher number of bleeding episodes were found in the elderly with positive DBE findings than those with negative findings. Positive diagnostic rate was significantly higher when DBE was performed within 7 days than that after 7 days (90％ vs. 40％). Conclusions DBE is a safe,reliable diagnostic modality,especially in the elderly patients with small bowel bleeding in which ulcer and tumor lesions are the most common identifications.DBE is of greater benefit in patients with more bleeding episodes over a long period,and should be performed within 7 days after the last bleeding.

Objective To investigate the effect of acupuncture at Sanyinjiao with functional magnetic reso- nance imaging(fMRI),analyse the regulating effect of the acupoint Sanyinjiao on various brain areas,explore the mechanisms of Sanyinjiao(SP.6) acupuncture in treating diseases.Methods Eight right-handed healthy volun- teers were scanned at 1.5 Tesla magnetic resonance imaging scanner while they were aeupunctured at the right Sany- injiao acupoint.Image data were co-registered to correct head motion,spatial normalization and deconverlution analy- sis were conducted.Functional activation maps were generated.Results There observed certain activation in both sides of medial frontal gyrus,right middle frontal gyrus,left inferior frontal gyrus,both sides of paracentral lobule, precentral gyrus and postcentral gyrus,left inferior parietal lobule,both sides of preeuneus,right middle temporal gy- rus,right cingulated gyrus,posterior cingulated gyrus,both sides of superior temporal gyrus,transverse temporal gy- rus,insula and thalamus.Conclusion Acupuncturing the Sanyinjiao can lead to the functional changes in parietal lobe,frontal lobe,temporal lobe and insula,precuneus,cingulated gyrus,thalamus,which are closely related to the therapeutical effects of Sanyinjiao.The phenomenon that needling Sanyinjiao can activate certain brain areas proved the correlation between acupoint and corresponding brain cortices.

Objective To investigate the proliferation and identification of dendritic cells(DC)de- rived from peripheral blood of patients with bladder cancer in vitro.Methods The mononuclear cells were prepared from peripheral blood of patients with bladder cancer by Ficoll-Hypaque centrifugation method,and were induced by the recombinant cytokines hGM-CSF(50 ng/ml),hlL-4(10 ng/ml)and hTNF-?(50 ng/ ml)for 2 weeks.The growth and morphology of DC were observed through the phase contrast or electron mi- croscope,and their pheuotypes were determined by flow cytometry.The capacity of DC to activate T cell-de- pendent anti-tumor immune responses was tested by MTT method.Results The DC cultured in vitro turned into suspensive growth from adhesive situation on the 6th day,then the number of DC increased con- tinuously and the cells showed the irregular morphologic appearance of DC with veiled edges on the 8th day. Flow cytometry showed that the mature DC expressed high levels of specific markers such as CD_(1a),CD_(83), CD_(86)and HLA-DR.T cells activated by DC showed strong cytotoxicity to bladder cancer cell line BIU87 with a killing rate of(48.8?3.7)%,while the killing rate of T cells which were not activated by DC was(25.7?1.5)%;the difference of the rate between them was significant(P＜0.01). Conclusions The DC can be cultured from peripheral blood of patients with bladder cancer by induction of rhGM-CSF,rhIL-4 and hT- NF-?in vitro.This may lay an experimental foundation for further research on DC vaccine.

OBJECTIVETo compare the difference in the clinical efficacy on premature ovarian failure (POF) between the acupoint catgut implantation combined with artifical periodic therapy and the simple artificial periodic therapy and explore its effect mechanism.

METHODSSixty-five patients of POF were randomized into the two groups. In a western medication group, 32 cases were treated with the artificial periodic therapy with the oral administration of medroxyprogesterone acetate tablets. In a catgut implantation + western medication group, 33 cases were treated with the acupoint catgut implantation combined with artificial periodic therapy. The acupoints of Neiguan (PC 6), Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6) were selected. The treatment was lasted for half a year and the follow-up visit was for another half a year in the two groups. Kupperman index was used to assess the improvements in the clinical symptoms. The levels of serum sexual hormones such as follicle stimulating hormone (FSH) and estradiol (E2) were evaluated of the patients in the two groups before and after treatment. The efficacy was compared between the two groups.

RESULTSThe scores of the clinical symptoms were all significantly improved after treatment and in the follow-up in the two groups (P < 0.01, P < 0.05). In the 6-month follow-up visit after treatment, the result in the catgut implantation + western medication group was better than that in the western medication group (8.17 +/- 1.19 vs 13.68 +/- 1.08, P < 0.01). FSH was reduced after treatment in the two groups (all P < 0.01) and E2 was increased (all P < 0.05). The curative and remarkably effective rates were 75.8% (25/33) and 81.8% (27/22) after treatment and in the follow-up visit in the catgut implantation + western medication group, which were better than 67.9% (19/28) and 53.6% (15/28) in the western medication group separately (P < 0.05, P < 0.01).

CONCLUSIONThe acupoint catgut implantation combined with artificial periodic therapy achieve the remarkable improvements in the clinical symptoms of POF in the patients and the better results as compared with the simple western medication therapy. The combined therapys efficacy is stable and the long-term efficacy is apparently superior. The effect mechanism is related to the improvements in the serum sexual hormone levels.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Catgut ; utilization ; Female ; Follicle Stimulating Hormone ; metabolism ; Humans ; Primary Ovarian Insufficiency ; metabolism ; therapy ; Prostheses and Implants ; Treatment Outcome ; Young Adult