Objective To explore the causes of congenital hypothyroidism by single photon emission computed tomography(SPECT) thyroid imaging.Methods Nineteen cases with congenital hypothyroidism were collected,and SPECT thyroid imaging was performed 15 minutes late after injected 99m TcO_ 4- 18.5-37.0 MBq.Results Five cases were found with normal glands,1 case with enlarged thyroid, 2 cases with enlarged thyroid and increased radiation,4 cases with ectopic thyroid,4 with a hypogenetic thyroid,and the last 3 cases showed no thyroid imaging.Conclusions The causes of congenital hypothyroidism can be found by SPECT thyroid imaging,which is important to the diagnosis of congenital hypothyroidism combined with detection of T_3,T_4,TSH.

Objective To evaluate the diagnostic value of 99mTc-dimercaptosuccinate acid(DMSA) renal cortical scintigraphy for the identification of distinguishing between upper urinary infection(UUTI) and lower upper urinary infection(LUTI).Methods Two hundred and seventy-five children (111 males,164 females)ranging from 44 days to 15 years old,presented with urinary tract infection underwent 99mTc-DMSA renal cortical scintigraphy.The images were scored as normal (indicating LUTI) and abnormal (indicating acute pyelonephritis or renal scarring).Results Of 275 children with UTI,95 cases had normal images diagnosed as LUTI,41 males,54 females;and 180 cases had abnormal images,70 males,110 females.One hundred and seventy-four cases were diagnosed as acute pyelonephritis,6 cases were diagnosed as renal cortical scars,56 cases were single renal involved and 118 cases were both renal involved,and 22 cases repeatedly underwent renal cortical scanning after therapy.Sixteen of 18 cases with acute pyelonephritis completely recovered normal or obviously ameliorated after 0.5 to 2.0 years,2 cases did not show any improvement after 0.5 to 1.5 years,4 cases with renal scarring,and showed little change on repeated images after 1.0 to 1.5 years.Conclusions The 99mTc-DMSA renal scintigraphy is very useful in differentiating the children with urinary tract infection.It also can be used to determine the extension,degree and nature of UUTI,and might play an important role in the treatment and follow-up observation in children with UUTI.

Objective To examine the hemodynamic changes and oxygen metabolism during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty patients (18 male, 2 female) aged (60?8)yr, weighing (71?9)kg undergoing OPCABG were studied. The patients were premedicated with diazepam 10 mg PO 2h before operation and morphine 10 mg and scopolamine 0.3 mg im 30 min before operation. Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1, fentanyl 5-10 ug?kg-1 and vecuronium 0.12-0.15 mg?kg-1 and maintained with 0.5%-2% isoflurane inhalation, fentanyl 10-20 ug?kg-1 and intermittent iv boluses of vecuronium and in some patients propofol infusion. Radial artery was cannulated. Swan-Ganz catheter was placed via internal jugular vein into pulmonary artery. Hemodynamic parameters including MAP, HR, cardiac index (CI), stroke volume (SV), MPAP, PCWP, SVR, left ventricle stroke work index (LVSWI) and RVSWI; oxygen metabolism including oxygen delivery (DO2) , oxygen consumption (VO2) and oxygen extraction ratio (ERO2); regional cerebral oxygen saturation (rSCO2) and arterial blood lactate level (ABL) were measured and recorded before skin incision (A), when pericardium was incised before operation on the heart (B), during operation on the heart (C), 10 min after operation on the heart (D) and at the end of surgery (E) . Results During surgical manipulation on the heart (C) MAP, SV and CI decreased while CVP and HR increased, but the decrease in CI and SV was not significant. During manipulation on the heart(C) DO2 decreased whereas ERO2 increased, but there was no significant change in VO2. After manipulation on the heart (D) DO2 and ERO2 returned to the pre-manipulation level. Arterial blood lactate concentration increased at E. Conclusion OPCABG can be performed uneventfully under our general anesthetic regimen. During operation while the beating heart is being manipulated MAP tends to decrease while CVP and HR increase. The changes are of short duration and do not result in any serious consequeaces.

Objective To explore the incidence and distribution features of neonatal phenylketonuria(PKU) and congenital hypothyroidism(CH) in Lianyungang area.Methods The heel blood samples dried on filter paper was collected from newborns after 72 hours.As the screening indicators,PKU was detected through serum phenylalanine concentration(Phe) detection by Guthrie′s bacterial inhibition assay and CH was detected through serum thyroid stimulating hormone(TSH) levels detection by time-resolved fluorometry(TRFIA) or enzyme linked immunosorbent assay(ELISA).Results Sixty-four children with CH were diagnosed and the rate of CH was 1∶2423,41 patients were examined by thyroid gland nuclein kinescope picture,among which there were 23 patients whose thyroid glands were unusal.These patients lived in 45 towns(streets),which had no difference between men and women,city and country side.A couple of twins were screened for CH;15 cases of PKU was detected with an incidence of 1∶10 339.These patients′ parents were neither consanguineous marriage nor dominance hereditary family history.Their physical and mental development were similar to the same age children after interventive treatment.Conclusions The distribution of CH and PKU is diffuse in Lianyungang.Neonatal screening is the only valid means to find patients with CH and PKU.

Objective To compare the effects of different surgical techniques for treatment of concealed penis. Methods A retrospective review of 219 patients underwent surgical correction of concealed penis between 1986 and 2007 was performed. The mean age was (10.3±2.4) years(3-15 years). The penile length was (1.9±0. 5)cm(0. 5-3. 0 cm)before operation. Ninty-three patients were the severe degree of concealed penis. The others were the moderate degree. All patients under-went operation with different techniques, including Johnston's technique in 34, Devine's technique in 42, modified Devinds technique in 125 and Brisson's technique in 18. The increased length of penile af-ter operation was compared among the 4 groups with different surgical techniques by statistical meth-od. Results The postoperative increased length of penile in Johnston's technique, Devine's tech-nique, modified Devine's technique and Brisson's technique was (1.8 ± 0. 4) cm, (2. 0 ± 0. 5) cm, (2.1±0.4)cm and (2.3±0.4)cm respectively. The difference was significant by ANOVA test (F=13.1,P<0. 001). Devines technique, modified DevineSs technique and Brisson's technique were better than Johnston's technique considering the increased length of penile. The complication of severe penile lymphedema of 4 groups developed in 8, 5, 6 and 2 patients respectively. Conclusion Modified De-vine's technique has the satisfactory increasing of penile length for treatment of concealed penis and less complication rate after operation.

ObjectiveTo investigate the serum prostate-specific antigen (tPSA),serum free PSA to total PSA ratio (f/tPSA),prostate volume (PV) and prostate-specific antigen density (PSAD) in early prostate cancer (PCa) diagnosis.MethodsRetrospective analysis was performed on serum PSA values and related test results from 252 cases of BPH patients and 49 patients with PCa.Prostate volume (PV) was measured by transrectal ultrasound (TRUS),and the f/tPSAand PSAD values were calculated.The differences of serum tPSA,f/tPSA,PV,and PSAD between BPH and PCa group were compared,the area under the ROC curve was used to evaluate these four indicators for its diagnostic sensitivity and diagnostic specificity.ResultsThe values of tPSA,PSAD in PCa group were significantly higher than BPH group ( P ＜0.05),while the values of f/tPSA,PV in PCa group were significantly lower than BPH group ( P ＜0.01orP ＜0.05).The ROC area showed that serum tPSA(0.8013),f/tPSA(0.7390),PV(0.5613) had lower diagnosis value than PSAD(0.9214) in early prostate cancer ( PSAD ＞ tPSA ＞ f/tPSA ＞ PV).When the upper limit of normal PSA was set to take 4ng/ml,the sensitivity was 91.49％,diagnostic specificity was 51.05％.When the f/tPSA threshold set to 0.16,the diagnostic sensitivity was 57.78％,diagnostic specificity was 78.72％.When PSAD threshold was set to 0.15,diagnostic sensitivity was 88.24％,diagnostic specificity was 81.52％.ConclusionsPSA,f/tPSA and PSAD are indicators for biopsy or followup in early diagnosis of prostate cancer.In particular,the diagnostic value of PSAD has higher sensitivity and specificity than PSA and f/tPSA in the diagnosis of prostate cancer.

OBJECTIVETo retrospectively analyze the causes of death in elderly patients with hypertension in a hospital-based population from 1993 to 2012.

METHODSDuring the study period of over 19 years, a total of 2866 cases of death in 25238 hospitalized hypertensive patients with the age of 60 years or older were documented. Age, gender, complications, cause of death and other relevant variables were collected. All patients were divided into different subgroups according to gender, age or hypertension stage and risk stratification. The mortality of elderly hypertensive patients was analyzed using chi-square test.

RESULTS(1) Target organ damage (TOD) associated with hypertension was present in a substantial proportion of elderly patients. The complications related to death were heart disease (45.15%), stroke (34.37%), renal failure (11.88%), infective disease (4.58%), and cancer (4.06%). (2) Mortality in male elderly hypertension was higher than in women (53.31% vs 46.69%). The percentage of deaths from heart disease and stroke were higher in men than those in women (heart disease: 46.73% vs 43.35%; stroke: 37.04% vs 31.32%). (3) Age-specific constituent ratio of cause of death showed that deaths from stroke were significantly lower in very old patients (> or = 90 years) than in patients with 60-79 years of age (P < 0.01). In addition, deaths from heart disease, renal failure and infection disease were significantly lower in patients with more than 90 years than other patients. Deaths from cancer were highest in patients with 70-79 years of age (P < 0.01). (4) When compared with patients at stage 1 and 2 hypertension, subjects at stage 3 were more likely to die from stroke (P < 0.01) and renal failure (P < 0.05), while less likely to die from heart disease and cancer (P < 0.01). Patients in high and very high risk stratification of hypertension, compared with subjects in low and medium risk were likely to die from renal failure (P < 0.01) whereas less likely to die from heart disease (P < 0.05) and stroke (P < 0.01).

CONCLUSIONPrevalence of complication and TOD is high in elderly hypertensive inpatients, especially in deaths. The male patients and 60- 79-year-old patients have a higher percentage of causes of death. The stage and risk stratification of hypertension are associated with constituent ratios of the causes of death.

Aged ; Cause of Death ; Female ; Humans ; Hypertension ; mortality ; Incidence ; Inpatients ; Male ; Middle Aged ; Renal Insufficiency ; mortality ; Retrospective Studies ; Risk Factors ; Stroke ; mortality

OBJECTIVETo investigate the effect of mitogen-activated protein kinase (MEK) kinase cascade, extracellular signal-regulated kinase (ERK1/2) signal pathway on Schwann cells proliferation promoted by Pyrroloquinoline Quinine (PQQ) and its molecular mechanisms.

METHODSSchwann cells were cultured and purified in vitro. The purity was identified by S-100. Different time and concentration of PQQ was added into culture medium. The expression of ERK1/2 and phosphorylated-ERK1/2 was detected by western blot. The expression of p-ERK1/2 after blocking of MEK signal pathway by specific inhibitor PD98059 was detected by western blot.

RESULTSMorphological change was observed in PQQ treated Schwann cells. 1-500 nmol/L PQQ could up-regulate the expression of p-ERK1/2, and 1000 nmol/L had no effects, while 10 000 nmol/L exhibited inhibitory effect (P < 0.05). p-ERK1/2 increased to peak 1 h after PQQ added, and this up-regulation of p-ERK1/2 was inhibited by PD98059 (P < 0.05).

CONCLUSIONSPQQ could affect morphology of Schwann cells and activation of ERK1/2. MEK inhibitor PD98059 could, block this activation. It suggests that MEK/ERK signal pathway should be involved in Schwann cells proliferation promoted by PQQ.

Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; physiology ; Mitogen-Activated Protein Kinases ; metabolism ; physiology ; Pyrroles ; pharmacology ; Quinolines ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Schwann Cells ; cytology ; drug effects ; Signal Transduction

This article was aimed to assess the effectiveness and safety of Y in-Dan Xin-Nao-Tong (YDXNT) Cap-sule combined with routine modern therapies for treatment of type-2 diabetes mellitus (T2MD) complicated with coronary heart disease (CHD). Databases including CBMDisc, CMAC, CNKI, VIP, Wanfang Data, PubMed, EMbase, and Web of Science were electronically searched from inception to December 2013. Randomized controlled trials (RCTs) on YDXNT capsule combined with routine modern therapies for treatment of T2MD complicated with CHD were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, ex-tracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.1.0 software. The results showed that a total of 9 RCTs with 667 T2MD with CHD cases were included. The results of meta-analysis indicated that the total effective rate of YDXNT capsule combined with routine modern therapies was significant higher than the routine treatment for T2MD complicated with CHD treatment with statistical significance (OR = 4.01, 95%CI [2.37-6.79], P< 0.000 01). It showed that YDXNT capsule combined with routine modern therapies can control angina pectoris. Due to limitation of included data, controlling of the duration of angina pectoris, the attack frequency of angina pectoris, and fasting blood glucose, may be better than the routine treatment group with significant differences. YDXNT capsule can improve hemorheology indices and reduce high condensation state among CHD with T2DM patients in order to relieve angina pectoris. It was concluded that on the basis of current clinical evidences, YDXNT capsule had better treatment effect than the routine treatment group in the treatment of CHD with T2DM. However, the results have certain limitations. It still required double-blind multi-center RCTs with high quality, large samples for further verification.

Objective To detect plasma amino-terminal pro-brain natriuretic peptide (NT-ProBNP) ,D-Dimer levels in the pa-tients with acute pulmonary embolism (APE) in order to investigate their change characteristics and significance .Methods Among 60 patients with suspected APE ,40 cases diagnosed by CT and meeting the thrombolytic condition were set as the experimental group and other 20 cases of excluded APE by CT as the control group .Plasma NT-ProBNP and D-dimer before treatment in the two groups and after 2-week thrombolytic therapy in the experimental thrombolysis were detected and compared .Results The diagnos-tic sensitivity of NT-ProBNP for early APE was 92 .3% and the specificity was 65% ,while the diagnostic sensitivity of D-dimer for early APE was 100% and the specificity was 70% ;the plasma NT-ProBNP and D-dimer levels before thrombolysis in the experi-mental group were significantly higher than those in the control group with statistical differences (P<0 .01) .Conclusion Plasma NT-ProBNP and D-dimer has important clinical significance for APE and can provide the basis for the early diagnosis and the cura-tive effect observation of the patients with APE .