Objectives To analyze and compare the clinical features of autonomic nervous mediated syncope (NMS) and pseudo psychogenic syncope (PPS) in children.Methods Clinical features were retrospectively analyzed in children with syncope complaint not caused by cardiac syncope, situation of syncope, drug-induced syncope, and neurogenic and metabolic diseases that caused brief loss of consciousness, and the clinical features of similarities and differences between NMS and PPS were compared. Results In 106 children with syncope were included, there were 85 cases (80.2%) of NMS, 13 cases (12.3%) of PPS, and 8 cases (7.5%) of unexplained syncope. PPS was induced by recent mental stimulation; the syncope was more frequent; the score of orthostatic intolerance was higher; the omen was rare; the duration of attack was longer. NMS was induced by long time standing, movement and body position change; the omen was mainly dizziness, blurred vision and gastrointestinal symptoms; the duration of attack was short (<5 min).Conclusions NMS is the most common cause of syncope in children, while PPS is an important cause of transient consciousness of non-syncope. There are similarities in clinical features between NMA and PPA and differential diagnosis is needed.

ACEI,ACEII and Xyr1 are transcriptional factors that regulate cellulase gene expression in Trichoderma koningii.In vitro experiments have shown that ACEI and Xyr1 bind to the cbh1 promoter fragment(-304 to-18) and regulate the gene transcription.However,whether ACEII binds to this 287bp fragment is still unclear.To further elucidate the regulatory mechanism of ACEII for cellulase,DNA-binding domains of ACEII from T.Koningii were expressed in E.coli.It could not show binding to the cbh1 promoter fragment(-304 to-18) by electrophoresis mobility shift assays,suggesting that it is Xyr1 but not ACEII binds playing an essential role during induction of cbh1 gene transcription.

Objective To improve the therapeutic effects and to prevent the recurrence of the blepharoptosis. Methods The frontalis muscle was cut to form the ladder shaped frontalis muscle flaps, which was than were transferred under the orbicularis to touch the tarsus with its broad lower part perfectly. The flap was sutured with the tarsus directly. Results All blepharoptosis of twenty four eyes in sixteen patients were treated with excellent results in function and cosmetic appearance. The upper eyelids could be closed effectively. There were no any recurrence and complications in this group. Conclusions The transfer of the ladder shaped frontalis muscle flaps applied in this group benefits the moving of upper eyelid because of its effectiveness in contraction and stable suture with the tarsus. It is more suitable for the treatment of severe blepharoptosis.

Objective To investigate the usefulness of urapidil in the management of high risk cardiac patients undergoing emergency noncardiac operation Methods 20 cardiac patients (male 11, female 9) scheduled for emergency noncardiac surgery were included in this study The age averaged (54 1?16 5) years The heart diseases included pregnancy induced hypertension(PIH) complicated with congestive heart failure(CHF) in 5 patients, coronary artery heart disease in 7, hypertensive heart disease in 4 and rheumatic heart disease in 4 Functionally they were classed as Ⅱ or Ⅲ according to New York Heart Association(NYHA) classification 40 healthy blood donors served as normal control In operating room before anesthesia the patients were given an intravenous bolus of urapidil 0 4 mg kg -1 Venous blood samples were taken before and 15 min after intravenous administration of urapidil for determination of plasma concentration of endothelin (ET) neuropeptide Y (NPY) and calcitonin gene related pepitide (CGRP) by radioimmunoassay Results Plasma concentrations of ET and NPY were significantly higher and CGRP was significantly lower in high risk cardiac patients than normal control values 15 min after urapidial ET and NPY decreased significantly (P

Objective To compare the clinical effectiveness of incision-thread-drawing procedure and incision and drainage procedure in the treatment of perianal abscess.Methods Clinical data collected from 110 patients with perianal abscess were retrospectively analyzed.Forty-six cases were treated with incision-thread-drawing procedure(therapy group) and 64 with incision and drainage procedure(control group).Results Recurrence rate and incidence of anal fistula were 4%(2/46) and 4%(2/46) in therapy group,respectively,significantly lower than those in control group(19% and 23%,P

Objective To investigate the effects of propofol on death-associated protein kinase (DAPK) mRNA expression in a rat model of traumatic brain injury (TBI). MethodsSixty male Wistar rats with a mean age of 3-4 months and mean body weight of 250-300 g were randomly divided into 6 groups ( n = 10 each) : Ⅰ normal control;Ⅱ sham operation; Ⅲ TBI; Ⅳ normal saline (NS) +TBI;Ⅴ fat emulsinn+ TBI and Ⅵ propefol + TBI. TBI was produced according to Feeney et al. In group Ⅲ-Ⅵ the animals were killed and their brains were removed at 24 h after brain contusion. NS 2 ml·kg-1 · h-1 , 10% fat emulsion 2 ml · kg-1 · h-1 and propofol 2 ml·kg-1·h-1 were infused iv for 4 h after lead trauma in group Ⅳ, Ⅴ and Ⅵ respectively. DAPK mRNA expression in the brain tissue was determined by RT-PCR and neuronal apeptosis was assessed by TUNEL. Results The expression of DAPK mRNA and neuronal apoptosis were significantly increased in the TBI group as compared with normal control and sham operation groups. Propefol infusion significantly attenuated neuronal apoptosis and reduced DAPK mRNA expression as compared with TBI, NS and FE groups. ConclusionPropofol can protect the brain from traumatic injury by suppression of the expression of DAPK mRNA.

Objective:To observe therapeutic effects of blood glucose control by using acarbose in combination with different insulin.Method:58 patients were randomly divided into two groups treated with either insulin glargine (Lan- tus;Aventis) or human NPH insulin (Novolin;NovoNordisk).Subcutaneous injection of insulin before sleep and oral acar- bose were carried out for the treatment,which lasted three weeks.The degree of blood control,the amount of insulin used, and the cases of hypoglycemia for both groups were observed at the end of the experiments.Result:The fasting blood glu- cose showed its normal and stable result,and the average blood glucose values at different time slots per day in the group treated with insulin glarglne were lower than those in the group treated with human NPH insulin.The maximum difference of blood glucose values occurred after dinner while no significant variance appeared after breakfast and after lunch.Conclu- sion:The therapeutic effects are quite efficient and stable in controlling 24-hour blood glucose in type 2 diabetes by using acarbose in combination with either insulin glargine or human NPH insulin (Novolin;NovoNordisk).In addition,the oc- currence rates of hypoglycemia with both methods are low whereas the therapeutic effects for the first group are superior to those for the latter group.

BackgroundProliferative vitreo-retinal disease (PVD)is one group of ocular complications marked by the enhanced proliferation of various cells included retinal pigment epithelial (RPE) cells.Insulin-like growth factor-1 (IGF-1)and vascular endothelial growth factor(VEGF) are implicated in the aberrant cell proliferation and pathological neovascularization that characterizes PVD,but the signaling mechanism is unclear now. Objective This study was to explore the effect of IGF-1 on VEGF in cultured human RPE cells under the small hairpin loop RNA (shRNA) keeping hypoxia-inducible factor-1 α ( HIF-1 α) silencing. Methods Human retinas were isolated from 4 healthy male donors,and the RPE cells were harvested and cultured.The ceils were identified using anti-human keratin antibody.The third to fifth generation of human RPE cells were used in the experiment.One target site of HIF-1α mRNA was chosen by certain design principle,and shRNA was designed and synthesized by the target site and transferred into the cells in vitro,and then the cells were cultivated with 50 μg/L IGF-1 for 24 hours.The mRNA and protein expressions of HIF-1α and VEGF were detected by RT-PCR and Western blot respectively. Results Cultured human RPE cells showed the flat irregularly multangular shape,and 97％cells appeared the positive response for keratin.HIF-1α mRNA expression in human RPE cells was significantly lower in 50 μg/L IGF-1 group than the 0 pg/L IGF-1 group ( 1.49±0.18 vs 1.46±0.17 ) ( t =0.335,P =0.743 ),however,the expressing levels of HIF-1α protein( 1049.86±172.54 vs 0.00±0.00) and VEGF mRNA(0.95±0.15 vs 0.35±0.07) and VEGF protein (391.98±56.77 vs 214.36±37.15)were raised in the 50 μg/L IGF-I group compared with 0 μg/L IGF-1 group (t=16.098,9.935,6.928,P＜0.05).After the HIF-1α-specific shRNA was transferred into cultured RPE cells,the expressions of both HIF-1α mRNA and its protein significantly decreased in RPE cells under 50 μg/L IGF-1 concentration condition( F=68.679,89.904,P=0.000),moreover,the expression of VEGF mRNA and its protein were significantly lowed(F=21.770,6.205,P＜0.05). ConclusionsIGF-1 promotes the accumulation of HIF-1α protein and induce the expression of VEGF in human RPE cells,which probably play a pivotal role in the development of PVD.

Objective To observe the therapeutic effect of pericarpium zanthoxylum oil on experimental hyperlipemia in mice. Methods Hyperlipemia model was reproduced in mice, and then pericarpium zanthoxylum oil was garaged for 4 weeks. Blood samples were obtained from retro-ocular vessel. The levels of blood lipids were determined, the hemorrheology parameters were determined by hemorrheometer, and the pathological changes in the liver of mice were observed microscopically. Results Zanthoxylum oil could obviously reduce contents of TC, TG, LDL-C (P

Objective To investigate the correlation between ABCD2 scores and vertebrobasilar artery stenosis in patients with posterior circulation transient ischemic attack (TIA).Methods The patients with posterior circulation TIA who performed cerebral angiography were enrolled in the study,and their ABCD2 scores and imaging data were analyzed.Results A total of 108 patients with posterior circulation TIA were enrolled.There were significant differences in the main trunk stenosis degree of vertebrobasilar artery with different ABCD2 scores in patients with posterior circulation TIA (P =0.005).The overall degree of stenosis increased with the increase of ABCD2 score (P =0.000).After adjustment for other vascular risk factors,ABCD2 score had significant predictive ability for whether had posterior circulation stenosis (odds ratio [OR]1.771,95％ confidence interval [CI] 1.234-2.542; P =0.002) and moderate to severe stenosis (OR 2.083,95％ CI 1.336-3.176; P =0.001).Its receiver operating characteristic area under the curve was 0.693(95％ CI 0.586-0.800) and 0.755 (95％ CI 0.661-0.849) respectively.When the ABCD2 score was ≥3,the sensitivity and specificity of predicting posterior circulation stenosis were 62.6％ (95％ CI 53.4％-71.7％) and 70.6％ (95％ CI62.0％-79.1％) respectively,and the sensitivity and specificity of predicting posterior circulation stenosis ＞ 50％ were 78.7％ (95％ CI 70.9％-86.4％) and 67.5％ (95％ CI58.7％-76.3％) respectively.Conclusions In patients with posterior circulation TIA,the stenosis degree of vertebrobasilar arterial trunk increases with the increase of ABCD2 score.In a certain extent,ABCD2 score may predict whether the main trunk of the posterior circulation has stenosis and whether has moderate to severe stenosis.