Objective To assess the echocardiographic characteristics of embolism and in-hospital mortality in patients with infective endocarditis using three-dimensional transesophageal echocardiography (3D TEE).Methods Retrospective review of 124 patients with native valve infective endocarditis was performed to examine its characteristics by two-dimensional transthoracic echocardiography (2D TTE),multi-plane and 3D TEE.The primary endpoint was embolism and mortality that occurred within one month before or after operation.The combined simple score was calculated by assigning 1 point each for the presence of large vegetation,abscess or fistula,rupture of valvular chord,moderated or severe valvular regurgitation and perforation or serious valvular destruction.Hosmer and area under the curve was calculated to predict embolism and adverse events with the combined simple score,length of vegetation,serious valvular destruction with abnormal morphology.Results In 124 patients,embolic events occured in 27 cases (27/124,21.77％).Multi-plane and 3D TEE can identify the exact location and length of vegetation compared with 2D TTE,which miss-diagnosed vegetation in left atrium and papillary muscle.The clinical presentation of embolism patients was remarkable for lower hemoglobin level (P＜0.05).The ratio of multi-located vegetation,mortality and serious valvular destruction with abnormal morphology were higher in embolism and adverse events patients than those in non-embolism and adverse events patients (all P＜0.05).The area under the curve of combined simple score,lengh of vegetation for embolisms and adverse events and serious valve destruction with abnormal morphology for embolism and adverse events were 0.65 (P=0.06),0.60 (P=0.19)) and 0.70 (P=0.03).Conclusion Multi-plan and 3D TEE plays a key role in the diagnosis of patients with infecitive endocarditis,especially vegetations in occasional location.Serious valve destruction with abnormal morphology is associated with embolism and adverse events.

Objective To discuss the allocation of oral medical resource in west area of Chongqing,and investigate the caries prevalence in these population.Methods Study samples was raised with the multistage stratified random cluster sampling method,then data was analyzed to compare the allocation of oral medical.Resource,awareness degree on oral health and caries prevalence in each age grade between urban and rural area.Results In west area of Chongqing,the allocation of oral medical resource and awareness degree on oral health were better in urban area than those in rural area.In each age grade,the caries prevalence is higher in rural area,when compared with that in urban area.In addition,the caries prevalence of 5 years old group and 12 years old group is the same between male and female in both urban area and rural area (P＞0.05).Nevertheless,in 35-44 years old and 65-74 years old group,the caries prevalence was higher in female compared with male in both urban area and rural area (P＜0.05).Conclusion In west area of chongqing,the rural allocation of oral medical resource is bad and needs improvement,the awareness of oral hygiene is weak among population of rural area.In west area of Chongqing,women in 35-44 years and 65-74 years old should pay more attention to caries prevention and treatment.

OBJECTIVETo compare the effects of Montessori education and traditional education on the intellectual development in children aged 2 to 4 years.

METHODSChildren aged between 2 to 3 years who were enrolled in a kindergarten in September 2006 were randomly assigned to the Montessori education and the traditional education groups. In addition to receiving the traditional education, the Montessori education group participated in the two-hour Montessori pedagogical activities every day. The intellectual development was evaluated by the Neuropsychological Development Examination Format for Children Aged 0~6 years published by Capital Pediatrics Research Institute at enrollment and one year after the trial.

RESULTSThere were no significant differences in the intelligence growth level between the Montessori education and the traditional education groups at enrollment. After one year, the levels of fine movements, adaptation ability, language, and social behavior developments in the Montessori education group were significantly higher than those in the traditional education group (p<0.05 or 0.01). The intelligence increasing scores of the large motor ability, fine movements, language, social behavior and development quotient in the Montessori education group were also higher than those in the traditional education group (p<0.05 or 0.01).

CONCLUSIONSMontessori education can promote the development of large motor ability, fine movements, language, and social behavior in children.

Child Development ; Child, Preschool ; Education ; methods ; Female ; Humans ; Intelligence ; Language ; Male ; Motor Activity ; Social Behavior

Objective To investigate the effects of transcranial direct current stimulation (tDCS) on motor function of upper limbs of stroke patients. Methods 80 stroke patients were randomly divided into experimental group and control group. Both groups accepted routine rehabilitation, while the experimental group accepted anodal stimulation, and the control group received sham stimulation. They were assessed with Brunnstrom stages of arms and hands, Fugl-Meyer Assessment (FMA) of upper extremities, Action Research Arm Test (ARAT), Motor Assessment Scale (MAS) and modified Barthel Index (MBI) before and 1 month after treatment. Results All the scores improved in both groups after treatment (P<0.05), and improved more in the Brunnstrom stages of arms and hands, FMA, ARAT in the experimental group than in the control group (P<0.05). Conclusion tDCS may promote the recovery of arms and hands function of stroke patients.

OBJECTIVETo compare the clinical features in children with different control levels of asthma and to explore the factors influencing asthma control.

METHODSA cross-sectional study was performed on 115 children diagnosed with asthma between October 2013 and February 2014. All the patients were classified into two groups: fully controlled group (n=65) and non-fully controlled group (n=55), according to the Children Bronchial Asthma Prevention and Treatment Guideline (2008 version) and the asthma control test results. The differences of clinical features between the two groups were compared. The quality of life was evaluated by an asthma-related quality of life questionnaire. The main factors influencing asthma control were analyzed by the logistic regression method.

RESULTSThere were significant differences in the frequencies of respiratory tract infection and acute asthma attacks within the 3 months, and unplanned hospital visits due to acute asthma attacks between the fully controlled and non-fully controlled groups (P<0.05). The scores of asthma-related quality of life in the fully controlled group were significantly lower than in the non-fully controlled group in children under 7 years old. In contrast, the scores of asthma-related quality of life in the fully controlled group were significantly higher than in the non-fully controlled group in children at the age of 7-16 years (P<0.05). The logistic regression analysis showed that the patients without experiencing regular hospital visits (OR=7.715) and with allergic rhinitis (OR=5.531) had increased risks for poor asthma control and that the patients with other allergic diseases (eg. eczema, food allergy) had decreased risks for poor asthma control (OR=0.299).

CONCLUSIONSThe appearance of some clinical features suggests that the asthmatic children may be in the status of poor asthma control and need an active intervention. A poor asthma control status can result in a decreased quality of life. To improve the asthma control level, the incidence of allergic rhinitis should be reduced and a regular hospital visit should be performed in the children.

Adolescent ; Asthma ; drug therapy ; psychology ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Male ; Quality of Life

It is generally accepted that the inhibition of apoptosis is one of the mechanism of drug resistance to tumor. Members of the bcl-2 gene family are the most important regulators in apoptosis. The purpose of this study is to evaluate the value of expression of bcl-2 and bax gene in predicting the prognosis of acute leukemia patients, and to explore the relationship between bcl-2 and bax expression and drug resistance. Seventy patients with acute leukemia entered this study. Expressions of bcl-2, bax and mdr-1 gene were measured by RT-PCR method and FCM. The result showed that: bcl-2 had been widely detected in specimens of blood or bone marrow from acute leukemia patients, the expression levels were much higher than those in normal control (1.46 vs 0.71, P < 0.05), bax expression levels and bax/bcl-2 ratio in patients had no significant difference with the control. No relationships were found between the expression levels of bcl-2 and bax and AL patients' age, sex, platelet counts, hemoglobin levels, percentage of marrow blasts, FAB classification, and S + G(2)M%. Both Bcl-2 protein expression (34.6% vs 69.2%, P < 0.03) and bax/bcl-2 mRNA ratio (37.1% vs 82.9%, P < 0.01) were associated with response to therapy and CR rate, bax/bcl-2 ratio also influences the overall survival time. There was no relationship between bcl-2 and bax expression levels and mdr-1 expression levels.

OBJECTIVETo summarize our experiences in the treatment of type C3 (AO/OTA) distal radius fractures fixed with AO 2.4 mm locking plates combined with percutaneous pinning after manipulative reduction.

METHODSFrom May 2009 to March 2012, 19 patients (2 cases of both sides) with type C3 (AO/OTA) distal radius fractures were treated with volar locking plates combined with percutaneous pinning for distal radius after manipulative reduction. Among the patients, the average age was (45.3 ± 17.4) years old (ranged, 31 to 66 years old). The fracture were complicated with ulnar styloid fracture in 14 wrists and 6 wrists had distal radioulnar joint instability. All the patients had closed fracture and the mean duration was (6.7 ± 3.5) days (4.5 to 9 days). The Henry approach was applied to expose the fracture site. Joint capsule and ligaments were retained for indirect reduction. After indirect reduction, the poking reduction technique was used to correct the residual compression, and congruence of distal ulnar radial joint was verified under fluorscopic guidance. Styloid process was first pinned percutaneously and then AO 2.4 mm volar locking plate was used to support rigid fixation. The fractures complicated with distal radioulnar joint instability and ulnar styloid fracture were treated with forearm plaster support in supination for 6 weeks.

RESULTSNineteen patients (21 wrists) were followed up for an average duration of 10.5 months (ranged, 7 to 17 months). Radiographic bone union of distal radius was achieved in all cases, nonunion of the ulnar styloid occurred in 3 cases, and no distal radioulnar joint instability occurred. Tendon irritation was found in 2 cases and disappeared after the internal fixation was removed. The volar tilt, radial angle, radial length, incongruence of articular surface and distal radioulnar joint were observed at the follow-up. According to Batra and Gupta scoring system, 13 wrists were assessed to have a score of more than 80, 5 wrists 70 to 90, 3 wrists less than 70. Meanwhile, the subjective and objective evaluation was executed,range of motion of wrist, residual deformity and complications were observed. According to Sarmiento's modification of the system of Gartland and Werley, 17 wrists got an excellent result, 3 good and 1 fair.

CONCLUSIONType C3 (AO/OTA) distal radius fractures could be managed with manipulative reduction. Locking plate internal fixation combined with percutaneous pinning can offer enough support for early mobilization and rehabilitation, resulting in a better clinical outcome and satisfactory prognosis.

Adult ; Aged ; Bone Plates ; Fracture Fixation, Internal ; methods ; Humans ; Manipulation, Orthopedic ; methods ; Middle Aged ; Radius Fractures ; complications ; surgery

AIMTo determine whether 7-oxo-dehydroepiandrosterone (7-oxo-DHEA) can reverse the hypoimmunity in BALB/c mice exposed to chronic mild stress.

METHODSA chronic mild stress animal model was established by subjecting BALB/c mice to a stressful regimen arranged in an unpredicted manner for 4 consecutive weeks. Immunological function alternations under chronic mild stress were assessed by lymphocytes proliferative response to mitogens and NK cell lysis activity test.

RESULTSThe studies showed the correlation between the state of depression and abnormalities in the immune response, such as a decrease of T lymphocytes proliferative response to Con A and suppression of cytotoxic of NK cell. Meanwhile, significant decrease of T3 and T4 levels was also observed. When stressed mice were daily given 7-oxo-DHEA 15 mg.kg-1, lymphocyte proliferative response and the NK cell activity were significantly enhanced and the decreased levels of T3 and T4 were restored in the stressed mice.

CONCLUSION7-oxo-DHEA can improve the depressive symptoms and hypoimmunity of BALB/c mice induced by chronic mild stress as its parent DHEA.

Adjuvants, Immunologic ; pharmacology ; Animals ; Antidepressive Agents ; pharmacology ; Cell Division ; drug effects ; Chronic Disease ; Dehydroepiandrosterone ; analogs & derivatives ; pharmacology ; Killer Cells, Natural ; immunology ; Male ; Mice ; Mice, Inbred BALB C ; Stress, Physiological ; blood ; immunology ; T-Lymphocytes ; immunology ; pathology ; Thyroxine ; blood ; Triiodothyronine ; blood

BACKGROUNDThis study investigated the inhibitory effect of berberine (BBR) on lipopolysaccharide (LPS) induced cyclooxygenase-2 (COX-2) expression via the mitogen activated protein kinase (MAPK) signalling cascade pathways in human peripheral blood monocytes (PBMC).

METHODSPBMC from whole blood were isolated and cultured for up to 24 hours after division into 5 groups treated with LPS, LPS + BBR 25 micromol/L, LPS + BBR 50 micromol/L or LPS + BBR 100 micromol/L and untreated. Monocytes were extracted for RT-PCR and Western blot analyses to examine COX-2 mRNA and protein activated expression of p38 mitogen activated protein kinase (p38MAPK), Jun N-terminal kinase (JNK) and extracellular regulated kinases 1/2 (ERK1/2) signalling pathways.

RESULTSCOX-2 mRNA and protein expression decreased to a minimum at 12 hours after BBR treatment (P < 0.05). With the increasing concentration of BBR treatment, the COX-2 expression decreased progressively (P < 0.01). With BBR treatment for 6, 12 or 24 hours at three doses, ERK1/2 protein expression was significantly inhibited. For the JNK pathway, only with the treatment of BBR at the concentration of 100 micromol/L was JNK protein expression inhibited compared with the LPS stimulation group (P < 0.01). Irrespective of the BBR concentration, no difference was shown between the BBR group and the LPS group for p38MAPK protein expression. Human monocytes COX-2 mRNA, by RT-PCR, and protein expression, by Western blot analysis, were inhibited when incubated with PD98059, SP600125 and SB203580 (P < 0.05).

CONCLUSIONSBerberine inhibits COX-2 expression via the ERK1/2 signalling pathway and, possibly, at a high dosage via the JNK pathway. P38MAPK may have no relationship with the effect of BBR in PBMC. Berberine inhibited COX-2 mRNA and protein expression in a dose dependent manner and suppressed COX-2 expression to a minimal level after 12 hours of berberine treatment.

Atherosclerosis ; drug therapy ; Berberine ; pharmacology ; therapeutic use ; Cells, Cultured ; Cyclooxygenase 2 ; genetics ; Cyclooxygenase 2 Inhibitors ; pharmacology ; Dose-Response Relationship, Drug ; Extracellular Signal-Regulated MAP Kinases ; antagonists & inhibitors ; Humans ; JNK Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; Lipopolysaccharides ; pharmacology ; MAP Kinase Signaling System ; Time Factors

OBJECTIVETo investigate the protective effect of astragalus on testis tissues following unilateral testicular torsion/detorsion.

METHODSThirty healthy adult Wistar rats were equally randomized into Group A (sham-operation control), B (torsion/detorsion) and C (torsion/detorsion plus intraperitoneal injection of astragalus). The testicular torsion/detorsion model was established by the Turner method. All the rats were fed under the same condition for 7 days and sacrificed, and the torsional testes were harvested for the detection of germ cell apoptosis, glutathione activity and the level of malonic diethylaldehyde (MDA).

RESULTSThe apoptosis indexes (AI) of spermatogenic cells in the torsional testes were (5.82 +/- 1.21), (36.18 +/- 8.40) and (20.39 +/- 3.57) in Group A, B and C, significantly higher in Group B and C than in A (P < 0.05) and in Group B than in C (P < 0.05). Significant differences were observed in glutathione activity in the ipsilateral testes among Group A (48.03 +/- 2.01), B (30.93 +/- 1.25), C (38.44 +/- 1.06) U/mg (P< 0.05), as well as in the level of MDA, (1.43 +/- 0.17), (3.98 +/- 0.36), (2.57 +/- 0.53) nmol/ml, among the three groups (P < 0.05).

CONCLUSIONAstragalus could significantly reduce the apoptosis of spermatogenic cells, decrease the level of lipid peroxidation and protect glutathione activity in the torsional testis.

Animals ; Apoptosis ; Astragalus Plant ; Disease Models, Animal ; Lipid Peroxidation ; Male ; Phytotherapy ; Rats ; Rats, Wistar ; Spermatic Cord Torsion ; drug therapy