Objective To observe the changes of left ventricular diastole function in the old patients with paroxysmal atrial fibrillation(PAF)and probe the value of multiindexes to evaluate the left ventricular diastole function.Methods Us the ultrasonic color doppler to determinate the different indexes of left ventricular diastole function in the thirty-four older patients with PAF after converting who came to my hospital from September 2004 to February 2006,and the healthy elder were the controls.Results The index of isovolumic relaxation time(IVRT),flowing velocity E wave(EV),flowing velocity A wave(AV)and the ratio of EV and AV(EV/AV)of the group with PAF after converting were higher significantly in PAF group after converting(99?11 ms,75?13 ms),(0.65?0.14 m/s,0.84?0.15 m/s),(0.77?0.12 m/s,0.55?0.13 m/s)and(0.84?0.13〈1,1.52?0.16〉1)than those in control group.(P〈0.01).Conclusion A significant failure of left ventricular diastole function exists in the old patients with PAF and the multiindexes to evaluate the left ventricular diastole function are more objective.

Objective To investigate the accuracy and reproducibility of multi echo data imagine combination (MEDIC) sequence with water excitation at 3. 0 T in swine knee cartilage. Methods Sagittal MEDIC sequences (0.6 mm slice thickness, isotropic) were acquired twice at 3. 0 T MRI in 30 swine knees. The knee cartilage was then removed and the volume was directly measured with water substitution method. The cartilage volume was also determined with a validated open source image software OsiriX by two observers ( A and B). The cartilage volumes obtained by two methods were compared. The reproducibility of MEDIC for quantitative measurement was accessed by the root-mean-square (RMS) of variation coefficient. Interobserver and intraobserver precision errors were compared using a paired students t-test. The accuracy of MEDIC for quantitative measurement was determined by the random pairwise differences, systematic pairwise differences and the Pearson correlation coefficients. Time of semiautomatic and manual segmentation were recorded. Results Time was saved about 75% by using semiautomatic segmentation methods [(4.0 ±1.5) min] versus manual segmentation [(16.0 ±0.9) min]. Interobserver precision errors (RMS CV%for paired analysis) between A and B for cartilage volume measurement were (2. 66 ±0. 82) ml and(2. 61 ±0.81) ml, t=0.24, P=0. 81 (patella); (2.40 ±0.69) ml and(2.49 ±0. 85) ml, t= -0.45,P =0. 65 (medial femoral condyle) ;(2. 28 ±0.74) ml and(2.41 ±0. 78) ml, t = -0. 66, P = 0. 51 (lateral femoral condyle);(3.43±1.28) ml and(3. 51 ±1. 08) ml, t= -0.26, P=0.79 (femora trochlea) with sagittal MEDIC. Intraobserver precision errors ( RMS CV% for paired analysis) of observer A for the first and second cartilage volume measurement were(2. 64 ±0. 62) ml and(2. 67 ±0. 60) ml, t = -0.19, P =0. 85(patella); (2.43 ±0.60) ml and(2. 39 ±0.59) ml, t =0.26, P = 0. 80 (medial femoral condyle);(2. 26 ±0. 56) ml and (2. 30 ±0. 57) ml, t = - 0.27, P = 0. 78 (lateral femoral condyle); (3.40 ±1.20) ml and(3.47 ±1. 11) ml, t = -0.23, P = 0. 82 (femora trochlea) with sagittal MEDIC. The cartilage volume of direct measurement were (2.73 ±0.97 ) ml ( patella ) , (2. 28 ±0. 66 ) ml ( medial femoral condyle) ,(2. 18 ±0. 55) ml (lateral femoral condyle) and (3. 39 ±1.31) ml (femora trochlea).Correlation coefficients between MEDIC and direct measurement for cartilage volume measurement were high [r = 0.95, t = 16. 10, P<0.05 ( patella); r=0.92, t = 12.42, P<0.05 (medial femoral condyle); r =0.94, t = 14.58, P < 0.05 (lateral femoral condyle) and r = 0.98, t = 26.06, P < 0. 05 (femora trochlea) ]. Conclusion Using image software OsiriX, sagittal MEDIC sequence permits accurate and precise measurement of cartilage volume at reasonable acquisition and segmentation time at 3.0 T MRI in swine knee.

To introduce the application of CBL teaching method on neuroanatomy teaching in undergraduate of con -tinue education school .Cases selection and reconstruction , designing problems , organization , implementation and standardized teaching were analyzed .Finally, we discussed the advantages and disadvantages of CBL teaching method.

Objectives:To analyze the prevalence and risk factors of chronic nephropathy among hospitalized gout patients.Methods:537 hospitalized gout patients in Tianjin Medical University Chu Hsien-I Memorial Hospital were enrolled. According to the levels of glomerular filtration rate (eGFR>90 ml/min, 60-90 ml/min and <60 ml/min), patients were divided into normal group, mild chronic nephropathy group and moderate-severe chronic nephropathy group. The height, weight, waist, hip and blood pressure of the patients were measured. Blood samples from elbow vein were collected to measure biochemical indexes. The 24-hour urine was collected to measure creatinine and uric acid. Multivariate regression analysis was used to analyze the related factors that may affect eGFR.Results:The prevalence of chronic nephropathy among gout patients was 46.76%(251/537), which the prevalence of mild chronic nephropathy was 34.82%(187/537), and moderate severe chronic nephropathy was 11.92%(64/537). With the decline of eGFR, the older the patients, the longer the course of gout and hypertension, the more the number of joints involved, the higher the blood uric acid, urinary microalbumin, urinary protein, white blood cell count, uric acid excretion fraction (FeUA), and the lower the red blood cell count, hemoglobin and serum albumin. Pearson correlation analysis of eGFR showed that age, duration of gout and hypertension, number of involved joints, hemoglobin, serum albumin, serum uric acid, urinary microalbumin, and FeUA were correlated with eGFR ( r=-0.43, -0.238, -0.25, -0.128, 0.155, 0.138, -0.169, -0.29, -0.372, respectively, P<0.01). Multivariate regression analysis showed that age, the course of gout, serum uric acid, microalbuminuria and FeUA were independent risk factors for eGFR decline ( P<0.01). Conclusions:Eldly, long course of gout, poor control of serum uric acid and increased excretion of uric acid and microalbumin are risk factors of gout.

Objective To study the role of epidermal growth factor (EGF),epidermal growth factor receptor(EGFR),extracellular signal-regulated kinase 1/2 (p-ERK1/2) in the pathogenesis of endometriosis under estrogen deprivation conditions.Methods The estrogen was quickly-stripped in medium and the female nude mice were castrated by bilateral oophorectomy to build estrogen deprivation in vitro and in vivo experimental models,respectively.(1) In vitro experiments:according to different treatments the estrogen deprived ectopic endometrial cells were classified into 4 groups:①EGF group:the ectopic endometrial cells were cultured for 72 hours with different concentrations of EGF (0.01,0.1,1,10,50,100 ng/ml),the results of EGF group were represented by the result of cells treated by 10 ng/ml EGF cultured for 72 hours ; ②EGF + PD98059 group:the ectopic endometrial cells were cultured for 72 hours with 5 × 10-2 mol/L PD98059 (inhibitor of ERK),followed by a cultivation for 72 hours treated by 10 ng/ml EGF + 5 × 10-2 mol/L PD98059 ; ③EGF + ICI182780 group:the ectopic endometrial cells were cultured for 72 hours with 10-6 mol/L ICI182780 [inhibitor of estrogen receptor(ER)],followed by a cultivation for 72 hours treated by 10 ng/ml EGF + 10-6 mol/L ICI182780; ④Blank control group:the ectopic endometrial cells were cultured with no treatment.The proliferation activity of ectopic endometrial cells in all groups after treatment were examined by methyl thiazolyl tetrazolium (MTT) method represented by absorbance value (A).The expression of p-ERK1/2 protein were detected by western blot.(2) In vivo experiments:64 female nude mice were randomly divided into control and castration groups (both n =32) using random number chart.The mice in castration group were castrated by bilateral oophorectomy on 3 weeks after the endometriosis model was established.The levels of EGF,EGFR,p-ERK1/2 protein in ectopic lesions of both groups were measured on 4,6,8 and 10 weeks after the endometriosis model was established by western blot.Results (1) The proliferation activity of ectopic endometrial cells:the proliferation activity of ectopic endometrial cells treated by different concentrations of EGF (0.01,0.1,1,10,50,100 ng/ml) for 72 hours were 0.310 ± 0.010,0.340 ± 0.020,0.670 ± 0.010,0.980 ± 0.030,1.360 ± 0.020,1.670 ± 0.020,respectively,the proliferation activity was increased along with of EGF concentrations.The proliferation activity was 0.680 ± 0.030 at EGF + PD98059 group,the differences exhibited significant difference when compared with that at EGF group with 100 ng/ml for 72 hours(P ＜0.01).The proliferation activity of EGF + ICI182780 and blank control groups were 0.330 ±0.030 and 0.310 ±0.030,respectively,which did not reached statistical differences(P ＞ 0.05).(2) The expression of EGF,EGFR,pERK1/2 protein:① In vitro experiments:the levels of p-ERK1/2 protein in EGF and blank control groups were 0.670 ± 0.020 and 0.600 + 0.010,respectively,which reached statistical differences (P ＜ 0.05).The level of p-ERK1/2 protein in EGF + PD98059 group was 0.610 ± 0.020,which exhibited significant differences with that at blank control group(P ＞ 0.05).② In vivo experiments:at 4,6 and 8 weeks after the endometriosis models were established,the expression of EGF protein in the ectopic lesions of castration group and control group were (0.530±0.015 versus 0.610 ±0.015),(0.400 ±0.029 versus 0.620 ±0.018),(0.560 ±0.026versus 0.630 ± 0.021),respectively,the levels of EGFR protein were (0.500 ± 0.030 versus 0.640 ±0.030),(0.470 ± 0.020 versus 0.630 ± 0.020),(0.510 ± 0.030 versus 0.610 ± 0.020) respectively,and the level of p-ERK1/2 protein were (0.500 ± 0.020 versus 0.580 ± 0.020),(0.490 ± 0.020 versus 0.580 ±0.020),(0.570 ±0.020 versus 0.590 0.020),respectively.The difference of EGF,EGFR,pERK1/2 protein expression levels between two groups did not exhibited significant difference(P ＜ 0.01,P ＜0.01,P ＜0.05).At 10 weeks after the endometriosis models were established,the levels of EGF protein in castration group and control group were both 0.620 ± 0.020,the levels of EGFR protein were both 0.610 ±0.020,and the level of p-ERK1/2 protein were 0.590 ±0.010 and 0.600 ± 0.020.No statistical difference (P ＞0.05) was found between those two groups (P ＞ O.05).Conclusions EGF could stimulate the proliferation of ectopic endometrial cells by activating the ERK pathway under estrogen deprivation conditions.The inhibition of EGF signaling system in ectopic lesions was alleviated along with the prolongation of the period of estrogen deprivation.

Objective To evaluate the repeatability and accuracy of semi-automated software OsiriX in the assessment of cartilage volume in normal knees on 3.0T MR. Methods Thirty right knees of healthy subjects were scanned twice with 3.0T MR using 3D-FLASH sequence with selective water excitation. Cartilage volume of the patellar compartment was determined with a validated open-source software OsiriX and manual segmentation separately by 3 observers using MRI data sets. After calculating the cartilage volumes, the segmentation processing times, the repeatability and volume results were compared between two segmentations. Results ①Compared with the manual segmentation, a time saving of at least 50% for cartilage volume measurement was achieved with OsiriX software segmentation. ②The interobserver repeatability error was 4.88% and 9.82% with OsiriX software segmentation and manual segmentation, respectively;the intraobserver repeatability error of high experienced observer was 0.77% and 1.29%, the interindividual repeatability range were 0.14%-1.11% and 0.52%-1.61%, respectively. The repeatability error of OsiriX software segmentaion was proved to be significantly smaller than manual segmentation (P＜0.05). ③System difference between results obtained with OsiriX software measurement and manual measurement was (-3.80±3.93)% and absolute pairwise difference was (4.68±2.70)%. There was no statistical difference between the volume results measured using two techniques (t=0.92, P=0.36). Conclusion Compared to manual segmentation, cartilage volume measurement with OsiriX semi-automated segmentation is faster and has higher inter- and intraobserver repeatability with relatively fixed standard. This technique may therefore be used for clinical and multi-center trials of large sample.

Objective:The clinical features, risk factors, and outcomes of coma were analyzed in patients treated with bevacizum-ab combined with chemotherapy This study also aims to increase the awareness on the toxicity of this regimen. Methods:Two cases of coma induced by bevacizumab combined with chemotherapy were reported. Diagnosis, treatment, and relevant literature were reviewed and discussed. Results:Inadequate blood pressure (BP) control was one of the risk factors leading to coma in patients treated with this therapy. The clinical feature of these patients was reversible posterior leukoencephalopathy syndrome (RLPS). Imaging results showed no typical finding. Reinforced supportive treatment including intensive BP control showed satisfactory outcomes. Conclusion:Coma is common in patients treated with bevacizumab combined with chemotherapy. This regimen should be used cautiously in patients with a history of hypertension. BP should be monitored closely and managed promptly during the combination therapy to prevent coma. RLPS-related coma is reversible after appropriate treatment.

Based on the characteristic of nucleotide distribution in nucleosome positioning and inhibiting sequences, the method of Increment of Diversity with Quadratic Discriminant (IDQD) was applied to the classification of these two types of sequences. The mean area under ROC curve archives 0.958. By using this model, the nucleosome formation potential was analyzed in the regions around the splice sites (GT/AG). The results show that coding regions have a high potential to form the nucleosome and the primary RNA transcripts are rigid, while DNA sequences corresponding to the splice sites and their adjacent intron regions tend to be nucleosome free and the primary transcripts from these regions are relative flexible. Moreover, the negative correlation between nucleosome positioning/inhibiting of DNA sequences and RNA flexibility/rigidity is demonstrated around the splice sites, providing a mechanism for understanding the correlation between the nucleosome positioning of DNA and the splicing of transcribed RNA sequences.

Objective To explore the clinical application value of blood routine examination in judgment of the activity of inflammatory bowel diseases.Methods 102 patients with inflammatory bowel disease were selected as the main research objects,60 healthy persons in the same period were selected as the control group,all of the subjects were received routine testing of blood,C-reactive protein and erythrocyte sedimentation rate,and the relationships between disease and blood routine indexes were compared.Results In UC group,the PLT,WBC RDW index levels of remission were higher than those of the control group,the differences were statistically significant(t =6.75,8.21,5.73,all P ＜0.05).In patients with UC,the HGB,HCTand MPV index levels were lower than those in the remission patients and the control group,the differences were statistically significant(t =8.12,11.03,6.72,9.35,10.23,8.71,all P ＜0.05).But the PLT index was higher than that of patients in remission,the RDW and WBC indexes were higher than those in the control group and the remission period,there were statistically significant differences (t =7.59,8.51,6.03,all P ＜ 0.05).The routine blood indexes of the relief patients of CD group had significant differences compared with the control group(t =6.17,7.29,9.01,10.35,8.27,7.69,8.01,9.91,allP ＜ 0.05),the HCT,MCV,HGB and MPV indexes were lower than those of the control group,the differences were statistically significant (t =9.01,10.35,8.27,9.9i,all P ＜ 0.05),the WBC,PLT,N and RDW indexes were higher than those of the control group,the differences were statistically significant (t =6.17,7.29,7.69,8.01,all P ＜ 0.05).In UC group,the HGB,HCT,MCV and MPV indexes were lower than those in the remission patients and the control group,there were statistically significant differences(t =8.19,6.97,7.53,9.02,all P ＜ 0.05).But the PLT,RDW,WBC and N indexes were higher than those in the remission patients and the control group,the differences were statistically significant (t =9.81,7.94,8.36,7.61,P ＜ 0.05).In the active patients of CD group,the WBC and N indexes were significantly higher than those of UC group,the differences were statistically significant (t =8.15,9.07,all P ＜ 0.05).In the remission patients of CD group,the PLT index was significandy higher than that in the remission patients of UC group,the difference was statistically significant (t =10.35,P ＜ 0.05).Conclusion Indexes of blood routine has obvious significance in activity of inflammatory bowel disease,and it is significant correlation with inflammation index,which can be used as one of the routine clinical method to determine the activity of inflammatory bowel diseases.

Objective To investigate the influence of different educational methods on the metabolic indices in patients with diabetes .Methods A total of 218 patients with diabetes in the First Affiliated Hospital of Guangxi Medical University were ran-domized divided into two groups .Different intervention ways were used :patients in the control group received conventional educa-tional methods ,while patients in experiment group received the educational methods combined with empowerment and multi-stage theory of change .The C-DES-SF scale scores and the HbA1c ,FPG ,2 h PG ,TC ,TG ,LDL ,HDL indices was compared between the two groups .Results Indices and empowered ability of HbA1c ,FPG ,2 h PG ,TC ,LDL were changed in accordance with time .As compared with control group ,the educational method in intervention group had better change of FPG ,2 h PG ,TC ,LDL(P< 0 .05) . Indices and empowered ability of HbA1c ,FPG ,2 h PG ,TC ,LDL had inter-action with time ,and indexes in intervention group were better than those in the control group(P< 0 .05) .At the 3rd and 6th month after invention in the intervention group ,patients in movement stage and movement maintaining stage were higher than those in control group(P< 0 .05) .Conclusion Well correction of bad diet behaviors by application of educational methods of combined with empowerment and multi-stage theory of change for the type 2 diabetes patients would help the patients to improve the ability of self-care and control the level of metabolic indices .