Objective To assess the value of endorectal elastography in the diagnosis of malignant rectal adenoma. Methods Sixty patients referred to the department of basic surgery of Peking Union Medical College Hospital for the evaluation of rectal adenoma from January 2011 to May 2013 were included in this prospective cohort. All patients underwent elasticity score (ES) and strain ratio(SR) examine before operation. To evaluate the reproducibility of the strain-ratio measurements, the intraclass correlation coefficient (ICC) was calculated. Compared with final operational pathological results,the diagnostic values of elasticity score and strain ratio method were assessed. Results Histopathological result showed there were 20 adenomas and 40 adenocarcinomas. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ERUS was 68%(27/40), 40%(8/20), 58%(35/60), 69%(27/39), 38%(8/21), respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of elasticity score was 85%(34/40), 70%(14/20), 80%(48/60), 85%(34/40), 70%(14/20), respectively. The SR of adenocarcinomas was significantly higher than that of adenomas(2.82±1.81 vs 1.23±0.57, t=3.333, P < 0.05). The differences among the SR of benign adenoma, benign adenoma with severe atypical hyperplasia and completely malignant lesions were statistically significant (1.26±0.84 vs 2.94±1.95, 1.42±0.55 vs 2.94±1.95, t=2.619, 2.415, P=0.013, 0.021). When 1.240 was chosen as the best cut-off value of SR, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of strain ratio was 82%(33/40), 75%(15/20), 80%(48/60), 87%(33/38), 68%(15/22), respectively. Conclusion Endorectal elasotgraphy can accurately diagnose the malignant rectal adenoma, which can provide reliable preoperative imaging evidence for clinical operation mode.

Objective To investigate the effects of ischemic postconditioning on apoptosis, structural and functional changes of mitochondria induced by myocardial isehemia/reperfusion (I/R) injury of rabbits and potential mechanism. Methods Eighty healthy rabbits were divided randomly into five groups: sham operation group ( Group Sham) , ischemic reperfusion group (Group IR) , ischemic preconditioning group (Group IP) , ischemic postconditioning group (Group PC) and 5-HD plus ischemic postconditioning group (Group PC +5-HD). All rabbits in the five groups were killed 4 h after reperfusion. The hearts were quickly collected for microscopy by TUNEL. We observed ultrastructural changes of myocardium under electron microscope and examined mitochondrial membrane potential and Ca~(2+) concentration, MDA content and SOD activity of myocardial mitochondria. Results Compared with group IR, the damage of mitoehondrial ultrastrueture was milder, the apoptosis rate decreased and Ca concentration and MDA content were much lower in group IP and group PC ( P < 0. 05 ). Mitochondrial membrane potential and SOD activity of myocardial mitochondria in group IP and group PC was significantly higher than that in group IR(P<0.05). The protective effect of PC against I/R injury was partially counteracted by 5-HD .Conclusion Ischemic posteonditioning can protect the heart from I/R injury, this is supported by improvement mitochondrial ultrastructure and by decreasing apoptosis, increasing mitochondrial membrane potential and SOD activity, alleviating Ca~(2+) overload and decreasing MDA content in myocardial mitochondria. The cardio protective effects may be explained by mitochondrial ATP sensitive potassium channel.

Objective Our objective was to design a new type of bedpan (inflatable, bed urinal) and compare its effect with common bedpan. Methods We divided 144 patients with bone fracture and lying in bed into the test group and the control group with 72 cases in each group from May 2006 to February 2007. Inflatable bed urinals were used in the test group and common bedpans were used in the control group. The pain alleviation, comfort degree, staining of bed sheet and skin injury were observed and evaluated in each group. Results Application of inflatable bed urinal was superior to common bedpan in the following aspects: alleviation of pain, comfort degree, staining of bed sheets and skin injury. Conclusions Adoption of inflatable bed urinal could alleviate pain, prevent the incidence of complication and reduce the workload of nurses.

OBJECTIVETo assess the significance of platelet activation in unstable angina pectoris (UA) and acute myocardial infarction (AMI), and to explore the relationship of clinical effect of Xuefu Zhuyu concentrated pill (XCP) in vivo and the serum pharmacological anti-platelet activating effect of XCP in vitro.

METHODSBy flow cytometry and special labelled antibodys to detect the whole blood platelet membranous glycoprotein CD62P and CD41/45 expressions in UA patients before and after XCP treatment, as well as those in peripheral blood of AMI rats before and after co-cultured with XCP containing serum from patients at 37 degrees C for 30 min.

RESULTSCD62P and CD41/45 expressions increased significantly in UA patients to 24.36 +/- 7.91% and 29.51 +/- 12.21% respectively. After effective treatment, they decreased to 19.57 +/- 7.22% and 20.87 +/- 8.73% respectively accompanied with increase of platelet adhesion and aggregation rate. The difference of CD62P before and after treatment was significant (P < 0.05). CD62P in blood of AMI rats was 39.73 +/- 12.36%, after being co-cultured with XCP containing serum from patients treated effectively, it reduced to 30.41 +/- 10.36% (P < 0.05), but after co-cultured with the serum from patients treated ineffectively, it showed less intervention effect (P > 0.05).

CONCLUSIONPlatelet was highly activated in UA patients and AMI rats. The consistency between clinical holistic effect of XCP and serum pharmacological effect of XCP in platelet activation inhibition reflects a good correlation between serum pharmacological effect of Chinese herbal medicine and its clinical holistic effect.

Aged ; Angina, Unstable ; blood ; drug therapy ; Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; blood ; P-Selectin ; blood ; Phytotherapy ; Platelet Activation ; drug effects ; Platelet Aggregation Inhibitors ; pharmacology ; therapeutic use ; Platelet Membrane Glycoprotein IIb ; blood ; Rats ; Rats, Wistar

BACKGROUND:Cell transplantation can repair damaged myocardial tissue.However,whether transplaned cells and host cells formed an effective electricity and mechanical couple or whether reconstruction of connexin (Cx) and arrhythmia formed,are still unclear.OBJECTIVE:It is hypothesized that arrhythmia can be treated by changing Cx levels and intervening abnormal GJ channel.Moreover,to explore the effects of bone marrow mesenchyma stem cells (MSCs) on the expression of Cx43 and Cx45 in rata with myocardial infarction.DESIGN,TIME AND SETTING:The randomized controlled animal study was performed at the Experimental Center,Guangxi Medical University from January 2008 to May 2009.MATERIALS:A total of 180 Wistar rats were randomly divided into four groups:normal control,sham operation,myocardial infarction,and MSCs,with 45 animals in each group.Each group was then divided into 3 subgroups (n=15) according to 4 weeks,8 weeks and 12 weeks post-transplantation.Additional 20 healthy,Wistar rats,aged 1 month,were selected to harvest MSCs.METHODS:The third passage of MSCs was induced by 5-aza like cardiomyocytes for 4 weeks,labeled with DAPI at 2 hours before transplantation.Models of acute myocardial infarction were established in all groups except sham operation group.At day 7 after model preparation,2×10~(10) /L MSCs were infused into the edge and center of myocardial infarcted region by multipoint injection.Rats in the myocardial infarction group were subjected to an equal volume of saline as wall as those in the normal control and sham operation groups.MAIN OUTCOME MEASURES:The mRNA expressions of Cx43,Cx45 were assayed by fluorescence quantitative PCR.RESULTS:The mRNA expression of Cx43 among each groups had no difference at weeks 4,8 and 12 after intervention in the normal areas.Compared to the normal areas,Cx43 mRNA reduced significantly at ischamic zone in the myocardial infarction group and MSCs group (P＜0.01),with notably increased of Cx45 mRNA expression (P＜0.01).Compared to myocardial infarction group,Cx43 mRNA expression was statistically higher in the MSCs group at the same points (P ＜ 0.01),and the Cx45 mRNA dramatically declined (P ＜ 0.01).CONCLUSION:Acute myocardial infarction reduces the mRNA expression of Cx43 and increases the Cx45 mRNA expression.The exogenous cells transplantation can upturn the mRNA expression of Cx43 in the border-zone of the infarcted area,and down-regulate the Cx45 mRNA expression in the border-zone of the infarcted area.

BACKGROUND: Stem cell transplantation in repairing infarct myocardium and in improving cardiac function has been widely accepted. However, whether transplanted cells and host cells formed an effective electricity and mechanical couple, whether a relevant independent electrical system with contractile function formed or whether severe malignant ventricular arrhythmia formed, are still unclear.OBJECTIVE: To investigate electrophysiological abnormaltiy and left ventricular remodeling in rats with myocardial infarction following allogenic bone marrow mesenchymal stem cell (BMSC) transplantation.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Experimental Center, Guangxi Medical University from December 2005 to October 2008.MATERIALS: A total of 120 healthy Wistar rats were equally randomized into normal control, sham operation, saline control and cell transplantation groups. Healthy Wister rats aged 1 month were selected to harvest bone marrow.METHODS: At the third passage, rat BMSCs were collected and treated with 5-aza, and differentiated into cerdiomyocytes.BMSCs were labeled with DAPI at 2 hours before transplantation. In the saline control and cell transplantation groups, rat models of myocardial infarction were established by ligating the left anterior descending coronary artery. In the sham operation group, the coronary artery was not ligated, but only braid. At 7 days following ligation, BMSCs in the cell transplantation group at 2×10-1/L were infused into the edge and center of myocardial infarct region by multipoint injection. Rats in the other three groups were subjected to an equal volume of saline.MAIN OUTCOME MEASURES: Electrocardiogram and cardiac electrophysiology were performed. Ultrasonic cardiography was used to detect left ventricular function. Infarct size was determined. DAPl-labeled donor cell migration and distribution was observed with a fluorescence microscope.RESULTS: BMSCs could differentiate into cardiacmuscle cell-like cells which were capable of pulsing spontaneously, expressing cardiactoponin T and forming myofilament in vitro. Compared with the saline control group, PR interval, QRS duration and ventdcular effective refractory period shortened, ventricular fibrillation threshold increased at 4, 8 and 12 weeks (P < 0.05); left ventricular internal diameter at end-systole reduced, and left ventricular ejection fraction and shortening traction was significantly increased (P< 0.05). At 8 and 12 weeks, infarct size was significantly smaller (P < 0.05). At 4 weeks, DAPl-labeled BMSCs could be seen under the fluorescence microscope, and still could he detected at 12 weeks. However, the fluorescence became weak with prolonged time.CONCLUSION: BMSCs have the plasticity of differentiating into cardiac muscle cell-like cells, which can modulate theelectrophysiological abnormality and left ventricular remodeling following myocardial infarction.

Objective To evaluate the mid-term follow-up of the pereutaneous angioplasty of the occlusive acrtoiliac artery diseases.Methods The data of 30 patients who had distal abdominal aorta and bi-lateral iliac artery stenosis or occlusion and treated by percutaneous angioplasty were retrospectively reviewed.They are 24 males and 6 females,aged from 35 to 75 years (average 55 ± 10 years). The interventional procedures include wire-guided canalization,thrembolysis,balloon angioplasty and stents implantation.They were followed up by telephone,letter or visiting after discharged.Results Twenty-six patients with aarto-iliac are revascularized successfully.Three cases failed.Of them,one failed because only one side of iliac artery and aorta were successfully canalized while the eontralateral not,one failed to revascularize both the aorta and the iliac artery,the other one failed due to the ihac rupture and replaced by WallGraft implantation.Two cases had distal thrombosis during the procedure.One case was amputated due to the aggravated isebemia of the right lower extremity after the revascularization failed.Twenty-seven cases were followed uo after 1 to 112 months,averaged (41±9) months.One case showed that the iliac artery was uncanalized after 6 months.One case showed bilateral iliac artery occlusion during 25 months follow-up and re-occluded 3 months after balloon angioplasty and finally had stent implanation in bilateral iliac artery.The other patients had no aggravated symptom of recurrence.Conclusion The percutaneous angioplasty is a good choice for occlusive aorto-iliac artery disease,showing good recovery during mid-term follow-up.

Objective To explore the diagnostic significance of differential cell count in induced sputum to chronic cough and assessment of airway inflammation.Methods The sputum of 335 chronic cough patients were induced.Differential cell counts were measured in these samples.The side effects were observed during the induced procedure.The final diagnosis was made based on clinical manifestation and examination findings including pulmonary function tests,provocation test,induced sputum cell differentials, etc.Results The cause of chronic cough was defined in 322 patients.The six most important causes of cough were typical asthma(TA,n=84),eosinophilic bronchitis (EB,n=62),atopic cough (AC,n= 42),cough variant asthma (CVA,n=40),gastroesophageal reflux cough(GERC,n=37),rhinitis and/ or paranasal sinusitis (PNDs,n=32),and others and indefinite cause (n=25,13).Percentage of eosinophils were significantly increased in the induced sputum of AC,EB,CVA,and GERC patients (0.005,0.052,0.059,0.234) compared with those in other causes and the healthy controls (0) (P

Polymerase chain reaction was employed to amplify the whole HBV CP region from the serum of patients with chronic hepatitis B virus(HBV) infection, and then the PCR products were subcloned into pGEM Teasy vectors. Clones were randomly selected to be sequenced and the selected clones were compared to look for the difference.The sequencing results suggested that each sequence of selected clones was different and there were HBV quasispecies groups in patients. There were hot deletion region and point mutation near the TATA like box of CP gene. To address whether the mutations were responsible for the transcriptional activity, the wild type(wt) and the mutants of HBV CP genes were subcloned into pcDNA3 1( ) vectors, respectively. The reverse oriented clones were digested with KpnI and XhoI, and cloned into the KpnI and XhoI sites of the chloramphenicol acetyltransferase (CAT) expressing vector (pCAT3 basic).The recombinant CAT plasmids were transfected into HepG2 cells using lipofectamine PLUS reagent, and the CAT expression which indirectly represented the transcriptional activity of HBV CP lying upstream of CAT gene was detected with a CAT ELISA kit. The restriction enzyme digesting results indicated that the recombinant CAT plasmids were successfully constructed, and the transfection tests indicated that the transcriptional activity of the mutants with deletion or substitute point mutation of TATA like box were reduced in comparison with that of CPwt. The HBV CP gene heterogeneity downregulated the transcriptional activity to some extent.

Objective To analyze plague epidemic tendency in the Three-River Region of Qinghai.Methods Using retrospective study,the Three-River Region during 1954-2006 year pestis epidemic focus were investigated and analyzed.Result Pestis prevailed mainly in Yushu,Chindu,Qumalai,Nangqian,Zhiduo and the Geermu.Tanghla Township.It was first found that the nature plague focus of miefitus existed in Chengduo County.There are 1 5 kinds of 12 branches in 8 trees infected plague animals were founded,336 Yersinia pestis were separated from the driven objects.Among them there were 291 Himalayas marmot body,account for 86.60%of the total,13 of Tibet sheep,accounts for 3.87%.10 of Qinghai field-mouse,accounts for 2.98%,Also there were 114 Yersinia pestis which were separated from each kind of vector insect in vivo.And,46 pestis strains came from the axe shape of flea in vivo account for 40.35%(46/114),38 pestis strains separated from Xie mountain flea,account for 33.33% (38/114).During 1960-2006 years there were 85 human plague cases were founded,238 occurred,134 died,the case fatality rate wero 56.30%(134/238),the popular seasons were started from May to November,the peak season happened in Aug and Sep.After Oct mainly due to Tibet sheep pestis which will cause as the origin of infection.The majority of sickness was pulmonary plague,account for 49.58%(117/238),whereas the first round case caused by the gland bubonic plague,account for 77.12%(91/118).Conclusions There are two pestis strains natural epidemic focus places in Three-River Source Region of Qinghai including the Himalayas marmot pestis strain and the Qinghai field-mouse pestis strain.The case of human pestis strain causes by the marmot strain,the fiehl-mouse mold mushroom spawn causes human pestis strain has not yet discovered,Three-River Source Region of Qinghai is a pestis strain key popular area in Qinghai Province.