Objective To observe the changes of systolic time interval after neonatal asphyxia and explore its relationship with clinical manifestation and prognosis. Methods Tow-dimensional and Doppler echocardiography were employed to detect tow - dimension parameters and left and right ventricular STI in 27 mild and 18 severe asphyxiated neonates as well as 14 normal controls and its relationship with clinical manifestation and prognosis was analyzed. Results There was no difference in cavity and thickness of heart and great arteries between normal and asphyxiated neonates. In acute stage mild and severe asphyxiated neonates had a shorter right ventricular ejection time (RVET) than normal neonates and a longer right ventricular prejection period (RPEP) was found in severe neonates than that in normal and mild asphyxiated neonates. Left ventricular preejection time (LPEP) was prolonged in comparison with normal neonates in acute stage and convalescence. There were more cases with increased RPEP/RVET in severe asphyxiaed group than those in mild and normal group in acute stage. The incidence of heart failure in acute stage and disability in late period was higher in cases with increased RPEP/RVET than that with normal RPEP/RVET. Conclusion Asphyxia has more severe damage to right ventricle than that to left ventricle. Cases with increased RPEP/RVET are prone to suffering from heart failure in acute stage and more likely to undergo disability in late period.

Objective To study the value of heart-type fatty acid-binding protein(H-FABP)for the early diagnosis of blunt cardiac injury(BCI).Method A prospective stuay was carried out in 42 patients,who suffered from blunt thoracic injury and were admitted from January 2007 to June 2008,and another42 heathy individuals in the health center of the Shanghai Fifth Hospital were recruited as control.Serum H-FABP,cTn Ⅰ and Myo levels of both healthy individuals and petients at 3,6 and 12 hours after trauma were measured by using ELLSA.Serum cTn Ⅰ levels was taken as a golden standard for the diagnosis of BCI.Accroding to serum cTn Ⅰ levels.42 patients with blunt thoracic injury were divided into group of patient with myocardial damage(13 patients)and group of patients without(29 patients).The receiver operating characteristic curves(ROC)of H-FABP and cTn Ⅰ in the diagnosis of BCI drawed at 3,6 and 12 hours after trauma,respectively,and the areas under curve(AUC)of ROC were compared.The values of H-FABP and cTn Ⅰ for diagnosing at 3,6 and 12 hours after trauma were analyzed Differences in serum H-FABP,cTn Ⅰ and Myo concentrations between groups were compared by Kruskal Wallis tegt.The delong.clarkepearson test was used to compare the areas under the ROC curves.Results AUCH-FABP and AUCcTn Ⅰfor diagnosing BCI at 3 hours after trauma were 0.9257 and0.6844,respectively,and AUCH-FABF was significantly more than AUCcTn Ⅰ(P=0.0125).AUCH-FABP,was significantly less than AUCcTnⅠ(0.9841 vs0.8276,P=0.0278)for diagnosing BCI at 12 hours after trauma.There was no significant difference in diagnosing BCI between AUCH-FABp and AUCcTn Ⅰat 12 hours after trauma(0.9655 vs.0.9125,P=0.2609).Conclusions H-FABP is valuabe in the early diagnosis of BCI,and its sensitivity is higherthanthat of cTnⅠ in diagnosing BCI at 3 hours after trauma.

Objective To explore the characteristics and the long-term trend of suicidal deaths among the rural population in Hubei province. Methods Data on suicide deaths from 1984 through 2008 were released from Macheng Death Registration System and analyzed by year, gender and age. Results The suicidal death rates were decreasing during the last 25 years in Macheng city, with the standardized suicide mortality rapidly decreasing from 113.29/100 000 in 1984 to 20.11/100 000 in 2008. The proportion of suicide deaths in the total deaths caused by injuries were declining but not obviously. Suicide was still the leading cause of deaths among all the deaths due to injuries.Number of suicidal deaths among females was outnumbered the males during the last 25 years,representing 50%-60% in total suicide deaths annually. The proportion of suicide deaths among the elderly aged 65 and over had significantly increased in the recent years, which accounting for 46.81% of all the suicidal deaths in 2008. Conclusion Suicide remained the leading cause of injury deaths among the population in this area, especially in females. Attention should be paid to the females and the elderly aged 65 and over,in the rural areas.

OBJECTIVETo investigate the effect of parathyroid hormone related protein (PTHrP) on proliferation of human osteoblasts (MG-63) under the circumstance of tension force in vitro.

METHODSAn apparatus was designed and fabricated by which force was loaded onto the cultured cells in vitro. Reverse transcription-polymerase chain reaction (RT-PCR) was used for measuring the expression of PTHrP mRNA and c-fos mRNA. The effect of tension force and different PTHrP dose(0, 0.01, 0.1, 1 nmol/L) on the proliferation of human osteoblasts were examined using flow cytometry.

RESULTSVarious forces of the mechanical stretching exerted different influences on the intensities of the mRNA' expression. The strain of 12% induced the most remarkable mRNA' expression. The mitogenesis happened in the group with tension force (12%) combined with PTHrP was more active than that in the group with PTHrP or tension' force only. Tension force combined with PTHrP induced significantly more c-fos mRNA than that of tension force only.

CONCLUSIONThe mechanical stretching can inevitably influence the expression of PTHrP mRNA. The most active mitogenesis happened in the group with tension force combined with PTHrP. The effect may be related with the signaling pathways of c-fos.

Cell Line ; Cell Proliferation ; Cells, Cultured ; Humans ; Osteoblasts ; Parathyroid Hormone-Related Protein ; RNA, Messenger

AIMTo study the characteristics of neural information encoding of the epileptic networks involved caudate-putamen(CPu) and the hippocampi induced by tetanization of the right CPu in rats.

METHODSExperiments were performed on 59 SD rats. Acute or chronic tetanization of the right CPu (ATRC or CTRC) (60Hz,0.4-0.6 mA, 2 s) was used to induce rat epilepsy.

RESULTS(1) The bursting or primary unit afterdischarges of single neurons were asymmetric in dual hippocampi induced by the ATRC. (2) Continuous sharp waves were observed in ipsilateral or contralateral CPu induced by the CTRC. The oscillatory network seizures with phase shift appeared between two sharp waves in ipsilateral CPu. The frequency of oscillatory waves was negatively correlated with the time and fluctuated from 70 Hz to 110 Hz, then to 35 Hz, and finally to 30 Hz. (3) In the contralateral side primary network after discharges in the CPu were induced by the CTRC. Therefore, the characteristic primary network afterdischarges could be shifted from the CPu or to the HPC, but amplified. On the other hand, HPC sharp waves could be depressed when the CPu network seizures occurred.

CONCLUSIONThe reestablishment of CPu-hippocampal epileptic networks could be transhemispherically promoted by over-activation of the right CPu network, in which bilateral hippocampal neuronal network and CPu neural network were involved in some particular pathophysiological information encoding.

Animals ; Caudate Nucleus ; metabolism ; Epilepsy ; physiopathology ; Hippocampus ; metabolism ; Male ; Neurons ; metabolism ; Putamen ; metabolism ; Rats ; Rats, Sprague-Dawley

BACKGROUND AND OBJECTIVECombined hypoxic cytotoxic drugs and chemoradiotherapy is an important mean of oncotherapy, and Tirapazamine (TPZ) is one of the most remarkable drugs. It has been shown that TPZ has a synergistic effect with radiotherapy on tumor cells, but whether TPZ would down-regulate the expression of the hypoxia-induced genes has not been reported. This study was to investigate the hypoxia-induced mRNA expressions of hypoxia inducible factor-1alpha (HIF-1alpha) and osteopontin (OPN) in human nasopharyngeal carcinoma HNE-1 and CNE-1 cells and the radiosensitization of TPZ, a hypoxia-specific drug, on HNE-1 and CNE-1 cells in vitro.

METHODSThe IC50 values of TPZ for HNE-1 and CNE-1 cells were measured using MTT assay, and the mRNA expressions of HIF-1alpha and OPN in HNE-1 and CNE-1 cells was determined using RT-PCR under aerobic and hypoxic conditions, respectively. The survival rates of HNE-1 and CNE-1 cells treated with or without TPZ at IC10 in the presence or absence of oxygen for 6 h were determined using colony formation assay following exposure to 1-6 Gy of 60Co radiation. The dose-survival curves were plotted and the values of D0, Dq and SER were calculated as a single-hit multitarget model.

RESULTSThe IC50 values of TPZ were 34.81 μmol/L and 35.02 μmol/L in HNE-1 and CNE-1 cells under aerobic condition, and 30.20 μmol/L and 28.48 μmol/L under hypoxic condition, respectively. The expressions of HIF-1alpha and OPN mRNA were reduced by TPZ in HNE-1 cells, but not in CNE-1 cells under hypoxic condition. For the HNE-1 cells, the respective values of D0 and Dq were 0.89 Gy and 0.28 Gy following normoxic irradiation versus 1.47 Gy and 0.44 Gy following hypoxic irradiation. For the CNE-1 cells, the respective values of D0 and Dq were 0.72 Gy and 0.68 Gy following normoxic irradiation versus 0.95 Gy and 0.56 Gy following hypoxic irradiation. The values of D0 and Dq for HNE-1 and CNE-1 cells treated with TPZ under hypoxic condition following irradiation were 0.66 Gy, 0.21 Gy and 0.85 Gy, 0.79 Gy, respectively.

CONCLUSIONTPZ can down-regulate hypoxia-induced expression of HIF-1alpha and OPN mRNA of HNE-1 cells and radiosensitize the HNE-1 cells but not CNE-1 cells, and act as a hypoxia modifier.

Antineoplastic Agents ; pharmacology ; Cell Hypoxia ; Cell Line, Tumor ; Cell Survival ; drug effects ; radiation effects ; Cobalt Radioisotopes ; Down-Regulation ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Inhibitory Concentration 50 ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Osteopontin ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Radiation Tolerance ; drug effects ; Radiation-Sensitizing Agents ; pharmacology ; Triazines ; pharmacology

OBJECTIVETo investigate the allocation and management of large medical equipment (LME) in Xuzhou, Jiangsu Province, China, in order to make the best use of LME to meet the medical needs of local people.

METHODSThe research collected data from all hospitals that have LME in Xuzhou using questionnaire; 38 (97.4%) hospitals returned the questionnaire.

RESULTSIn Xuzhou, there are a total of 71 pieces of LME, each serving 126 600 people in an area of 163 km(2). Sixty-two percent of them are allocated in urban areas, with Gini coefficient at 0.52, indicating imbalance and biased allocation of LME.

CONCLUSIONThe allocation of LME in Xuzhou is out of control and unfairly allocated.

China ; Equipment and Supplies ; Hospitals ; Medical Laboratory Science ; Surveys and Questionnaires

OBJECTIVETo evaluate the impact of lymphadenectomy on the relapse and survival of malignant ovarian germ cell tumor (OGCT).

METHODSThe clinical data of 102 OGCT cases treated in Peking Union Medical College Hospital from June 1980 to June 2003 were analyzed retrospectively. All the data about lymphadenectomy during primary and secondary surgery were collected, and other factors related to prognosis were also collected at the same time. Chi-squared test was applied in the univariate analysis related to relapse of disease. Cox model was applied in multivariate analysis related to relapse and survival of disease.

RESULTSPelvic and paraaortic lymph node metastasis was not significantly related to prognosis in primary and secondary treated patients. Lymphadenectomy showed no significant impact on disease relapse and survival. In the primary treatment, International Federation of Gynecology and Obstetrics (FIGO) staging, chemotherapy regimen, residual tumor and lymphadenectomy were the significant factors related to the relapse. After being stratified for the chemotherapy regimen, lymphadenectomy was not significantly related to the relapse in bleomycin +etoposide +cisplatin or cisplatin +vincristine +bleomycin regimen group, and lymphadenectomy could prevent relapse in no chemotherapy or other chemotherapy regimen group. In relapsed patients, only residual tumor was significantly related to survival time after relapse.

CONCLUSIONSPelvic lymph node metastasis is not the significant risk factor related to prognosis. Lymphadenectomy may have a beneficial effect on survival, although such effect is not significant. Although lymphadenectomy provides important information for prognosis, they provide little benefit to those patients already requiring chemotherapy based on the original operative findings. Lymphadenectomy should be performed to primary or relapsed patients by an expert surgical team.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Combined Modality Therapy ; Female ; Germinoma ; mortality ; pathology ; surgery ; therapy ; Humans ; Lymph Node Excision ; methods ; Lymphatic Metastasis ; Neoplasm Recurrence, Local ; mortality ; pathology ; surgery ; therapy ; Neoplasm Staging ; Ovarian Neoplasms ; mortality ; pathology ; surgery ; therapy ; Prognosis ; Retroperitoneal Space ; Retrospective Studies

OBJECTIVETo evaluate clinical effectiveness of total pelvic floor reconstruction surgery for repair of severe pelvic organ prolapse.

METHODSWe retrospectively analyzed the clinical data of 21 patients with severe pelvic organ prolapse. The anatomical outcomes were evaluated by Pelvic Organ Prolapse Quantitation, functional effectiveness by Prolapse Quality of Life method, and sexual function and operation-related complications were also analyzed.

RESULTSAll surgical operations were accomplished successfully by the same surgeon. No impairment of bladder, urethra, rectum, or great vessels was noted, and no patient required blood transfusion. The mean operation duration was (63±19) minutes, and the mean intra-operative blood loss was (143±72) ml. One patients experienced post-operative urinary retention for 7 days, and the remaining 20 patients were able to micturate spontaneously 1-2 day after surgery. The post-operative morbidity rate was 14.3%. Three patients (14.3%) experienced mesh erosion. Of 12 patients who were sexually active, two patients suffered from algopareunia from dyspareunia, one from de novo overactive bladder, and one from stress urinary incontinence Questionnaire scores showed that the overall post operative quality of life was improved significantly (P=0.000), while quality of sexual life significantly degraded (P=0.044) The anatomic cure rate was 95.2% (20/21), and the patient subjective satisfaction rate was 85.7% (18/21)

CONCLUSIONSThe total pelvic floor reconstruction is a safe and effective approach for the repair of severe pelvic organ prolapse, although its functional effectiveness is not as notable as anatomical outcomes However, the complications such as mesh erosion, low urinary tract symptoms, algopareunia, and dyspareunia should be carefully managed.

Aged ; Humans ; Middle Aged ; Pelvic Floor ; surgery ; Pelvic Organ Prolapse ; surgery ; Retrospective Studies ; Treatment Outcome

Background and Objective: Combined hypoxic cytotoxic drugs and chemoradiotherapy is an important mean of oncotherapy, and tirapazamine (TPZ) is one of the most remarkable drugs. It has been shown that TPZ has a synergistic effect with radiotherapy on tumor cells, but whether TPZ would down-regulate the expression of the hypoxia-induced genes has not been reported. This study was to investigate the hypoxiainduced expression of hypoxia inducible factor-1α (HIF-1α) and osteopontin (OPN) mRNA in human nasopharyngeal carcinoma HNE-1 and CNE-1 cells and the radiosensitization of TPZ, a hypoxia-specific drug, on HNE-1 and CNE-1 cells in vitro. Methods: The IC_(50) values of TPZ for HNE-1 and CNE-1 cells were measured using MTT assay, and the expression of HIF-1α and OPN mRNA in HNE-1 and CNE-1 cells was determined using RT-PCR under aerobic and hypoxic conditions, respectively. The survival rates of HNE-1 and CNE-1 cells treated with or without TPZ at IC_(10) in the presence or absence of oxygen for 6 h were determined using colony forming assay following exposure to 1-6 Gy of ~(60)Co radiation, and the dose-survival curves were plotted and the values of D_0, D_q and SER were calculated as a singlehit multitarget model. Results: The IC_(50) values of TPZ were 34.81 μmol/L and 35.02 μmol/L in HNE-1 and CNE-1 cells under aerobic condition, and 30.20 μmol/L and 28.48 μmol/L under hypoxic condition. The expressions of HIF-1α and OPN mRNA were reduced by TPZ in HNE-1 cells, but not in CNE-1 cells under hypoxic condition. The values of D_0 and D_q in HNE-1 and CNE-1 cells following irradiation under aerobic and hypoxic conditions were 0.89 Gy, 0.28 Gy and 0.72 Gy, 0.68 Gy, and 1.47 Gy, 0.44 Gy and 0.95 Gy,0.56 Gy, respectively. The values of D_0 and D_q for HNE-1 and CNE-1 cells treated with TPZ under hypoxic condition following irradiation were 0.66 Gy,0.21 Gy and 0.85 Gy, 0.79 Gy, respectively. Conclusion: TPZ would downregulate hypoxia-induced expression of HIF-1α and OPN mRNA of HNE-1 cells and radiosensitize the HNE-1 cells but not CNE-1 cells, and act as a hpoxia modifier.