Objective To evaluate the therapeutic effect of tulobuterol tape on mild or moderate bronchial asthma in children less than three years old . Methods Sixty-two children with mild or moderate asthma were randomized to receive either tulobuterol tape(treatment group) or procaterol hydrochloride tablet(control group) on the basis of inhaled fluticasone propionate for 2 weeks. Symptom scores of asthma, frequencies of episode of wheeze, doses of inhaled ventolin as rescue drug and the incidence of adverse reactions were recorded. Results In the treatment group,the symptom scores during daytime in the treatment group were (2. 2 ±0. 9)/week and (0. 9 ±0. 5)/week after 1 and 2 weeks of treatment, respectively, which were significantly lower than that in the control group(3.4 ± 1. 1)/week and (1. 3 ± 0. 6)/week after 1 and 2 weeks of treatment, respectively) (P < 0. 05). The symptom scores during night in the treatment group was significantly lower than that in the control group after one week of treatment (1. 8 ± 0. 7) /week v. s. (3. 3 ± 0. 9) /week, P < 0. 05). The frequencies of episode of wheeze was significantly different between the two groups (2. 3 ±1.2 and 3. 6 ± 1.3 in the treatment and control groups, respectively (P < 0.05) .The doses of inhaled ventolin in the treatment group (2. 6 ±0.9 spray/week) was significantly lower than that in the control group (3.7 ± 0. 8) spray/week) (P < 0. 05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (3. 12% v. s. 23. 33% ,x2 = 3. 89,P<0.05). Conclusions Tulobuterol tape is a safe and effective medication for the treatment of mild or moderate bronchial asthma in children less than three years old.

Objective To compare the reliability and effectiveness of anterolateral thigh flap with double vein anastomosis or one vein anastomosis for reconstruction of head and neck defects.Methods Two hundred and sixty four cases of anterolateral thigh flap transfers for head and neck reconstruction from January,2013 to September,2013 in the Second Xiangya Hospital of Central South University were reviewed.260 patients were randomly divided into 2 groups.In the experimental group,there were 138 patients 140 cases of anterolateral thigh flap with one vein one artery anastomosis.In the control group,there were 122 patients 124 cases of anterolateral thigh flap with double vein one artery anastomosis.Results Among 264 anterolateral thigh flaps,the overall success rate of free flap was 98.1％ (259/264),5 free flaps were lost.In the experimental group,there were 6 free flaps occurred venous thrombosis,two of them were lost.In the control group,there were 5 cases occurred venous thrombosis,three of them were lost.No arterial thrombosis occurred in both groups.The time of micromanipulation was 18 to 101 min,with the average of 47 min in the experimental group.In the control group,the time was 45 to 133 min,with the average of 71 min.(P =0.0003).Conclusion Anterolateral thigh flap with one vein one artery anastomosis for head and neck reconstruction did not affect the survival rate but it can absolutely reduce the operation time.

Objective To investigate the role of intra-operative and percutaneous three-dimensional contrast-enhanced ultrasonic cholangiography (3D-CEUSC) in the diagnosis of biliary anomalies. Methods Diluted SonoVue, an ultrasonic contrast agent, was injected into the cystic duct of 13 living liver donors via a cannula for intra-operative 3D-CEUSC, while injection via a T tube or a PTCD tube were done in 14 patients for percutaneous 3D-CEUSC. The maximum branching order of the intra-hepatic bile ducts, the percentages of display of the first-, second-, and third-order intra-hepatic bile ducts, and the rates of detection of biliary anatomical anomalies were evaluated. Results The median of the maximum branching order of the intra-hepatic bile ducts shown was fourth-order on intraoperative 3D-CEUSC and third-order on percutaneous 3D-CEUSC, respectively. The difference was significant (P=0.01). From the first- to the third-order of intra-hepatic bile ducts, the percentages of display for intra-operative 3D-CEUSC were 100% (23/23), 96.2% (50/52) and 82.7% (86/104),respectively, while they were 100% (24/24), 94.6% (54/56) and 60. 7% (68/112) for percutaneous 3D-CEUSC. The differences were not significant when comparing the first- and the second-order branches of intra-hepatic bile ducts as shown either on intra-operative or percutaneous 3D-CEUSC (P=1).The percentages of display of the third-order branches using intra-operative 3D-CEUSC was higher than that of percutaneous 3D-CEUSC (P＜0. 0001). Three biliary anatomical anomalies were detected by intra-operative 3D-CEUSC and 4 anomalies were detected by percutaneous 3D-CEUSC. All of these anomalies were confirmed by X-ray cholangiography. Conclusion Both intra-operative and percutaneous 3D-CEUSC could diagnose biliary anatomical anomalies accurately. These procedures may become important techniques to evaluate the biliary anatomy in hepatobiliary surgery pre-operatively or intraoperatively.

Objective To observe the clinical features and to identify γ-secretase gene mutations in a Chinese family with follicular occlusion triad (FOT).Methods Clinical evaluation was carried out in a family with FOT through field investigation.Peripheral blood samples were obtained from the family members and 100 unrelated healthy controls.DNA was extracted from the blood samples,and PCR was performed to amplify all the coding regions of PSEN1,PSENEN and NCSTN genes followed by DNA sequencing and comparative analysis.Results There were 14 members over 3 generations in this family,of whom,6 (4 males and 2 females) were affected by FOT.FOT was inherited in an autosomal dominant manner in this family.Clinical manifestations varied greatly among the 4 surviving affected members.DNA sequencing revealed a novel missense mutation,c.647A ＞ C (p.Q216P),in the exon 6 of NCSTN gene in the proband,which was cosegregated perfectly with affected,but not with unaffected,members in the family.The mutation was not found in any of the unrelated controls and had not been registered in the single nucleotide polymorphism (SNP) database in NCBI.Conclusions There is a novel heterozygous missense mutation,c.647A＞C in the exon 6 of NCSTN gene,which may be the molecular basis of pathogenesis of FOT in this family.

Objective To investigate the role of contrast-enhanced ultrasound(CEUS) for detection of hepatic artery stenosis(HAS) in recipients following orthotopic liver transplantation(OLT). Methods CEUS was performed in 50 OLT recipients (42 men and 8 women) with abnormal liver function test and/or abnormal findings on color Doppler ultrasound(CDUS). Digital subtraction angiography (DSA), computed tomographic angiography(CTA) or follow-up CDUS was used as the reference standard. The degree (mild,narrowing rate＜50 %; moderate, narrowing rate 50 % ～ 75 %; severe, narrowing rate＞ 75 % ), location and type (single or multiple) of HAS were evaluated. Moderate and severe stenosis were defined as substantial stenosis. Results CTA or DSA depicted substantial HAS in 39 patients, 8 patients with mild HAS or normal HA were depicted on CTA,and the remaining 3 patients were diagnosed as non-substantial HAS on clinical and CDUS follow-up. CEUS depicted substantial HAS in 38 cases. Moreover,CEUS corrected falsepositive findings on CDUS in 9 of 50 cases(18.0% ). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of CEUS in diagnosing HAS were 90.0% ,92.3% ,81.8% ,94. 7% and 75.0%,respectively. Conclusions CEUS is able to provide comprehensive information including presence,degree,location and type of HAS, which may facilitate the further interventional procedure or surgical treatment.

The tumor multidrug resistance reversal effect of NPB304, a novel taxane, was studied. MTT assay was used to determine the IC50 of chemotherapy drugs. Western blotting assay was applied to analyze the expression of P-glycoprotein (P-gp). The effect of compounds on the P-gp function and P-gp ATPase activity was determined by rhodamine 123 (Rh123) accumulation assay and analysis kit, respectively. Molecular docking was employed to predict the binding force between compounds and P-gp. Transmembrane transport of NPB304 was analyzed using MDCK II and MDR1-MDCK II cell model. NPB304 displayed multidrug resistance reversal effect on KBV cells and MCF-7/paclitaxel cells, NPB304 collaborative with P-glycoprotein (P-gp) inhibitors verapamil enhanced the reversal activity, specifically, 10 μmol x L(-1) verapamil in combination with paclitaxel reversed resistance by 56.5-fold, while combined with NPB304 increased the reversal fold; NPB304 synergistically increased Rh123 accumulation in the resistant cells when combined with verapamil, and NPB304 at 0-1 μmol x L(-1) enhanced the ATPase activity activated by verapamil was observed. NPB304 existed the hydrophobic interactions with the TM regions of P-gp, and the binding force between NPB304 and the A chain of the TM region was stronger. P-gp ATPase activity assay demonstrated NPB304 at lower concentrations (0-1.5 μmol x L(-1)) could activate the P-gp ATPase, playing a role on inhibition of P-gp function. However, NPB304 did not have an obvious feature of P-gp substrate. NPB304 exerted itself and synergy with verapamil activity on reversing tumor resistance via inhibiting the P-gp function.

Adolescent ; Adult ; Aged ; Cadherins ; genetics ; metabolism ; physiology ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; Ki-67 Antigen ; genetics ; metabolism ; Male ; Microtubule-Associated Proteins ; genetics ; metabolism ; physiology ; Middle Aged ; Neoplasm Invasiveness ; physiopathology ; Pituitary Neoplasms ; pathology ; physiopathology ; Young Adult

OBJECTIVETo investigate the relationship between degree of abnormal deeper lateral femoral notch between anterior cruciate ligament tear.

METHODSThe radiograph and MRI image material of 16 patients with anterior cruciate ligament injury from January 2013 to November 2013 were reviewed including 14 males and 2 females with an average age of 28.3 years old ranging from 18 to 52 years. Eleven cases was on right side and 5 on left. Survey tool of PASC imaging system was used to measure the depth of lateral femoral notch in patients with abnormal indicated by lateral X-ray view or sagittal view of MRI in knee joint,while clinical data,physical examination,image material in arthroscopy of these patients were retrospective researched.

RESULTSFour patients had an abnormal lateral femoral notch with the depth of 2 mm on lateral X-ray and sagittal MRI, while positive anterior drawer sign and Lachman test as well as anterior cruciate ligament tears on MRI, and completed tears were comfirmed on the operation of arthroscopy. Two patients without abnomal lateral femoral notch on lateral view of X-ray while with the depth of 1 mm on sagittal view of MRI were also coupled with positive anterior drawer sign and Lachman test as well as anterior cruciate ligament tears on MRI, and one of them were comfirmed completed anterior cruciate ligament tears on the arthroscopy operation and completed tear could not comfirmed on another one because of disagreed with arthroscopy operation.

CONCLUSIONThere appears to be an association between abnormal lateral femoral notch on lateral view of knee with anterior cruciate ligament tears. An abnormal deeper lateral femoral notch is an indirect evidence for anterior cruciate ligament tears.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Femur ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged

ObjectiveTo study the role of alpha smooth muscle actin (α-SMA) positive cells (pericytes)in early myocardial ischemia.MethodsThirty healthy female Wistar rats were randomly divided by body weight into normal control group and subcutaneous multi-point injection of isoprenaline(Isp) group.Five rats were anesthetized after 0,2,4,6,12,24 and 48 h in each group.Blood was taken in eyeballs and,serum was separated,heart was taken and fixed in 4％ paraformaldehyde solution.The myocardial enzymes [serum apartate aminotransferase ( AST ),lactate dehydrogenase (LDH),creatine kinase (CK),creatine kinase isoenzymes (CK-MB)] were determined by biochemical automatic analyzer,the expression of α-SMA and vimentin in myocardial tissue was detected by immunohistochemical staining and changes of pericytes in early myocardial ischemia was observed by morphometric analysis.ResultsThe level of myocardial enzymes AST[(160.25 ± 3.86),(172.60 ± 8.82),(192.20 ± 25.35)U/L],and LDH[(1466.25 ± 643.38),(1645.20 ± 326.83),(1701.60 ± 640.06)U/L],12,24 and 48 h after subcutaneous injection of Isp,were higher than that[(129.18 ± 19.65),(849.45 ± 248.54)U/L,all P ＜ 0.05] of the control group.The level of CK[(1097.60 ± 301.57),(1247.20 ± 243.84),(1263.75 ± 271.22),(1448.00 ± 647.00),(1268.40 ± 479.81)U/L],and CK-MB[(217.12 ± 35.89),(229.08 ± 97.11),(251.70 ± 46.82),(318.80 ±77.76),(249.04 ±:98.54)U/L],4,6,12,24 and 48 h after subcutaneous injection of Isp,were higher than that [(713.45 ± 146.30),(147.05 ± 25.75)U/L,all P ＜ 0.05] of the control group.The number of α-SMA positive cells(61.00 ± 17.25),4 h after Isp injection,was significantly increased compared with that(28.20 ± 5.81,18.20 ± 2.17) of 24 and 48 h after Isp injection.The number of α-SMA positive cells in 48 h group was less than that(50.00 ± 3.61,P ＜ 0.05) of 6 h group.The number of vimentin positive cells in 6,12,24,48 h groups (4.17 ± 2.49,5.24 ± 2.84,8.37 ± 2.18,7.73 ± 2.49) were higher than that(1.88 ± 1.85,2.21 ± 1.54) of the control group and 4 h group(all P ＜ 0.05).Compared with 24 and 48 h groups,the level of vimentin protein was increased in 6 and 12 h groups(P ＜ 0.05).ConclusionThe number of pericytes in early myocardial ischemia is higher than that of other mesenthymal cells,and pericytes may be the main effector cells in the generation and development of myocardial fibrosis.

Objective To investigate the relationship between pure -tone audiometry (PTA ) ,speech dis‐crimination abilities in quiet or in noise and the international outcome inventory for hearing aids (IOI-HA) in pres‐bycusis patients .Methods Twenty presbycusis subjects were tested in this study .Pure-tone audiometry (PTA) and speech discrimination threshold were obtained before being fitted with hearing aids .They weared hearig aids more than six months ,and pure-tone audiometry ,speech discrimination scores in quite(the level = 65 dB SPL) and in noise(signal to noise ratio = 10 dB) were carried out in sound field .A stepwise forward multiple-regression analysis was performed to investigate the impact of PTA and speech discrimination scores to IOI-HA .Results The PTAs before or after hearing aid fittings showed a negative association with IOI-HA ,while speech discrimination scores in quiet or in noise before or after hearing aid fittings showed a positive association with IOI-HA .Speech discrimination threshold in noise was identified as a single predictor of IOI-HA(P<0 .001) .Conclusion The relation between speech discrimination scores in noise and IOI-HA suggests that a poor score might limit the hearing aids outcome .The speech discrimination scores in noise help the clinicians predict the outcomes of hearing aid in real‐ities .