Objective To investigate the right ventricular morphology and function of patients with atrial septal defects by single beat real-time three-dimensional echocardiography.Methods Thirty-four healthy volunteers and twenty-seven ASD patients were enrolled consecutively as normal controls and the ASD group respectively.Single cardiac cycle real-time three dimensional echocardiography was performed in all to evaluate parameters concerning modality and systolic function of participants' right ventricle.The relationship of indexed right ventricular end diastolic volume (IEDVRV) and end systolic volume(IESVRV)with mean pulmonary arterial pressure measured through cardiac catheter and systolic pulmonary artery pressure calculated though the three tricuspid regurgitation were observed.Results Indexed right ventricular end diastolic volume (IEDVRv),end systolic volume(IESVRV),right ventricular stroke volume (ISVRV) and right ventrieular ejection fraction (RVEF) were greater in the ASD group than in controls (P ＜ 0.05).IEDVRv and IESVRV had positive relation with pulmonary pressure measured by cardiac catheter and systolic pulmonary artery pressure calculated though the three tricuspid regurgitation.Conclusions Single cardiac cycle real-time three dimensional echocardiography has an obvious advantage than normal test in evaluating the change of the right ventricular function and shapes,furthermore,single cardiac cycle real-time three dimensional echocardiography can indirectly determined the pressure of the pulmonary without wound.

Objective To analyse CT and DSA appearances of intrahepatic cholangiocarcinoma,and to improve understanding of intrahepatic cholangiocarcinoma.Methods Plain and enhanced CT scanning were performed in 17 patients with intrahepatic cholangiocarcinoma pathollogically proved,6 patients(6/17) performed dynamic CT scanning,5 performed DSA examinations.Results Pre-contrast CT scanning was a single low density lesions in all patients,post-contrast CT scanning showed slightly inhomogeneous enhancement in 17 patients,3 patients(3/17) showed low density unenhancement area with margin enhancement,2 patients delayed enhancement;Intrahepatic billary delatation was found in 15 patients and was within the lesion in 10 patients(10/15);On DSA,5 patients showed enlaragement increasment and rigidity of supplying arteries and tumour stain.Conclusion CT scanning and DSA were important,investigative methods for intrahepatic cholangiocarcinoma,the billary dilatations with slightly inhomogeneous enhancement lesions is important sign in diagnosising intrahepatic cholangiocarcinoma.

BACKGROUND:Compared with smooth titanium, titania nanotubes cannot only induce mesenchymal stem cels osteogenic differentiation and promote bone integration, but also be used as drug nanocarriers. OBJECTIVE:To prepare dexamethasone-loaded titania nanotube system and to test its drug release characteristics. METHODS:Titania nanotubes were prepared by electrochemical anodic oxidation, and dexamethasone was dripped onto the prepared titania nanotubes. Subsequently layer by layer self-assembly technology was employed to fabricate gelatin/chitosan multilayered structure on the prepared samples. Scanning electron microscope and contact angle test were carried out during the process of building the gelatin/chitosan multilayered structure. The drug release was measured by a ultraviolet spectrophotometer. RESULTS AND CONCLUSION:Under the scanning electron microscopy, the fabricated titania nanotubes had integral structure with even tube size of about 70 nm and arranged regularly, and the nanotubes were completely covered and sealed by the gelatin/chitosan multilayered membrane. Contact angle test results showed that ever since the fifth layer, contact angles changed alternately and displayed a zigzag profile. Ultraviolet spectrophotometer test results showed that when cultured for 3 hours, the cumulative drug release was about 32.7% and demonstrated an initial burst folowed by sustained release. When cultured for 24 hours, the cumulative drug release about 52.3%. However, after cultured for 7 days, little drug release was detected. And there was about 8.0%-10.0% dexamethasone of initial loading preserved in nanotubes.

Objective To explore the high risk factors of brain injury in preterm infants,and to reduce its morbidity and improve the developmental outcome.Methods One hundred and thirty preterm infants,who were admitted to our neonatal intensive care unit(NICU)between Aug.2005 and Aug.2007,were scanned by echo in 1,3,4,7,15 days,and 1,3 and 6 months after birth,respectively.Those who had intraventricular hemorrhage(IVH)of grade Ⅰor Ⅱ were regarded as mild brain injury,whereas those who had IVH of grade Ⅲ or Ⅳ or periventricular leukomalacia(PVL)were regarded as severe brain injury.Logistic regression was adopted to analyze 17 factors:gestational age,birth weight,hypertension syndrome during pregnancy,premature rupture of membranes,modalities of delivery,fetal distress,asphy-xiate,resuscitation,surfactant,apnea,seizures,hypoxia,hypercarbia,hypocarbia,acidosis,use of oxygen,nasal constant positive airway pressure or mechanical ventilation.Results Among 130 preterm infants,88 cases(66.7%)were detected with brain injury,which included 29 cases(33%)with mild brain injury(5 cases with IVH of grade Ⅰ,24 cases with IVH of grade Ⅱ)and 59 cases(67%)with severe brain injury(53 cases with IVH of grade Ⅲ,1 case with IVH of grade Ⅳ and 5 cases with PVL).Gestational age and birth weight were the fundamental factors of brain injury in premature infants.The smaller the gestational age and the lower the birth weight,the highter the brain injury rate.Resuscitation,hypoxia,the use of auxiliary ventilation were also important high risk factors of brain injury in preterm infants.All these high risk factors could influence the autoregulation of cerebral blood and trigger or aggravate brain injury of preterm infants.Conclusions Smaller gestational age,lower birth weight,resuscitation,hypoxia,the use of auxiliary ventilation were all the high risk factors of brain injury in premature infants,which could influence the parameters of cerebral blood dynamics by influencing cerebral blood autoregulation of preterm infants and lead to the occurrence of brain injury in premature.

Objective To report the clinical outcome and prognostic factors for locally recurrent nasopharyngeal carcinoma(NPC)treated with intensity modulated radiotherapy(IMRT).Methods From January 2001 to August 2004,the data of 132 such NPC patients were analyzed retrospectively;104 male and 28 female with a median of 44.5 years(range 21-73 years).Ninety-eight patients(74.2%)were confirmed by biopsy as having NPC:9 with WHO TypeⅡand 89 WHO TypeⅢ.The other 34 patients were only diagnosed by MRI scan because of the extension/invasion was in the base of skull and/or cavernous sinus.Median interval time were 24 months(range 6-184 months).According to the 1992 Chinese Fuzhou Staging System:stageⅠ3.8 %,Ⅱ10.6 %,Ⅲ22.0% andⅣa 63.6%;T1 5.3%,T2 10.6%,T3 22.7% and T4 55.3%.Twenty-two patients had recurrence in the neck lymph nodes.IMRT was given with the sequential tomotherapy system(NOMOS Peacock systems)of 6 MV X-rays.Prescription dose was 60-70 Gy in GTV,with the fractional dose of 1.94-2.8 Gy.Sixty patients were also supplemented with two to six courses of cisplatin-based chemotherapy.Results The median volume of GTV was 39.5 cm~3(range 0.8-158.9 cm~3).The D95,V95,mean dose and fractionation dose of GTV was 66.9 Gy,98.3%,69.8 Gy and 2.32 Gy,respectively.The median follow-up time was 12 months(range,2-47 months).The 1-,2-and 3-year local progression-free rate was 96.4%,88.4% and 85.3%,respectively.The overall 1-,2-and 3-year survival rate was 6.5.9%,49.6% and 41.6%,respectively.Eleven patients developed distant metastases.Forty-seven patients were observed to devdop mucosa necrosis and/or massive hemorrhage in the nasopharynx.On univariate and multivariate analysis,fractional dose and vohane of GTV were significant prognostic factors for overall survival(P=0.016,0.009).Conclusions The local control and survival rate can be improved for patients with locally recurrent nasopharygeal carcinoma after treatment of intensity modulated radiotherapy.The fractional dose and volume of GTV are independent prognostic factors for the overall survival. The main death reasons are mucosa necrosis and/or massive hemorrhage in the nasopharynx.

Objective To construct an expression system to produce the virus-like particles containing a part of the sequence of PSA mRNA, which are ribonuclease-resistant due to the encapsulation of the mRNA by bacteriophage MS2 coat proteins. Methods The PCR products of PSA cDNA fragments were cloned to TA vector pBS-T, then the targeted segments could be obtained when the pBS-T-PSA were digested by restriction endonuclease Hind Ⅲ and cloned to prokaryocytic expression vector pNCCL1. The recombinant plasmids named PNCCL1-PSA were transfected into E. Coli BL21-DE3 and induced to express with IPTG. Results The recombinant plasmids were successfully constructed. The bacteriophage MS2 coat protein which expressed in BL21 can self- assemble to form ribonuclease resistant virus-like particles and the PSA mRNA was encapsulated into virus-like particles. Conclusions The virus-like particle containing PSA mRNA can be expressed in prokaryocyte and it can be used as standard and control in detecting PSA mRNA. It provides a new, stable and ribonuclease-resistant RNA standard in RNA detection.

Objective To establish a molecular inversion probe ( MIP) method for detection of single base drug-resistance mutation in Hepatitis B virus ( HBV) gene.Methods The HBV wild type and YVDD mutant strain were isolated by Daping Hospital of the Third Military Medical University.The MIP was designed and applied to detect the HBV drug-resistance YVDD mutation in one case of wild type and one case of YVDD mutant HBV strain isolated previously.The results of MIP method were compared with that of sequencing to evaluate the detection accuracy.Results Thermal cycling single-base extension and connection reaction performed by Taq DNA Ligase and Ampligase DNA Ligase could ensure the specificity of the detection.The optimum probe concentration of MIP was 1 nmol/L.Through detection of the target gene with different DNA concentrations , the detection sensitivity of MIP was determined as 1 nmol/L.The results of MIP were consistent with that of sequencing method in detection of the clinical samples.Conclusion MIP is successfully used to detect single-base drug-resistance mutation in HBV gene.

Objective To investigate the variation of morbidity and clinical features of Henoch-Seh(o)nlein purpura (HSP) in childhood in recent years.Methods The clinical data of 901 cases with HSP admitted to our hospital from January 1,1995 to December 31,2005 were retrospectively analyzed.The constitute rate of admission,the initial clinical presentations,specific manifestations such as multi-system 23/2165(1.06%),29/2098(1.38%),24/1973(1.22%),39/2008(1.94%),54/2433(2.22%),86/2611(3.29%),94/2724(3.45%),99/3014(3;28%),138/2900(4.76%),143/3177(4.50%)and 172/3500(4.91%),resp-sixty-five of 901 HSP children (1 8.3%) had no palpable purpura at onset, 90 cases initially manifested as abdominal pain and (or) gastrointestinal bleeding,14 of them was diagnosed by gastroendoscopy which demonstrated mucous membrane vasculitis.Sixty-three cases manifested as arthritis/arthralgias,6 cases presented as renal involvement,1 case with neurological symptoms and 5 cases with other symptoms at their pancreatic involvement was present in 3 cases,cardiac involvement in 47 Cases and one case had lung hemorrhage.Conclusion The morbidity of HSP has increased in recent years.The diagnosis in patients who do not have palpable purpura at onset and patients who present with the cerebral,pulmonary,cardiac and pancreatic involvement as the initial manifestations is difficult.Special attention should be paid to this group of patients.Gastrointestinal endoscope is valuable in diagnosing HSP in patients whose initial symptoms are abdominal pain and (or) gastrointestinal bleeding.

OBJECTIVETo observe the analgesic effect of triptolide (TP) of high, middle and low doses on rats with adjuvant arthritis (AA), and the expressions of inducible nitric oxide synthase (iNOS) and substance P (SP) in spinal dorsal horn and dorsal root ganglion (DRG) of corresponding sections, in order to discuss the possible mechanism for the analgesic effect of TP on rats with adjuvant arthritis.

METHODFifty SD rats were selected and randomly divided into the normal group (group A), the model group (group B), and TP low (group C), middle (group D), high (group E) dose groups. Except for the group A, all of the remaining groups were injected with 0.1 mL of Freund's complete adjuvant through their right rear toes to establish the model. At 14 d after the model establishment, rats in C, D and E groups were intraperitoneally injected with different doses of TP (0.1 mg x kg(-1) for the group C, 0.2 mg x kg(-1) for the group D, 0.4 mg x kg(-1) for the group E) once a day for 9 days. Then the 50% mechanical withdraw threshold (MWT) was determined. And the expressions of iNOS and SP in lumbar5 (L5) spinal dorsal horn and DRG were detected with the immunohistochemical method.

RESULTThe 50% MWT of rats in the group B was significantly lower than that of the group A (P < 0.01). After being treated with TP, the Thermal withdrawal latencies of groups C, D and E were significantly higher than that of the group B (P < 0.01). TP could notably increase the MWT of AA rats, with a certain dose-effect relationship. The immunohistochemical results indicated that the iNOS and SP expressions significantly increased in the group B (P < 0.01), while the positive expression levels of iNOS and SP in groups C, D and E were significantly lower than that of the group B (P < 0.01), with a certain dose-effect relationship.

CONCLUSIONTP shows a good analgesic effect on AA, and could inhibit the iNOS and SP expressions in spinal dorsal horn and DRG in rats with adjuvant arthritis, which may be one of action mechanisms for the analgesic effect of TP.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Arthritis, Experimental ; drug therapy ; metabolism ; physiopathology ; Diterpenes ; pharmacology ; Dose-Response Relationship, Drug ; Epoxy Compounds ; pharmacology ; Female ; Ganglia, Spinal ; drug effects ; metabolism ; Immunohistochemistry ; Male ; Nitric Oxide Synthase Type II ; biosynthesis ; Pain Measurement ; methods ; Phenanthrenes ; pharmacology ; Phytotherapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; drug effects ; metabolism ; Substance P ; biosynthesis ; Time Factors ; Treatment Outcome ; Tripterygium ; chemistry

Objective To study the distributive characteristics of HLA-A,B,DRBI alleles and haplotypes patients with ALL in southern Chinese Han.Methods The frequencies of HLA-A,B,DRB1alleles and haplotypes were estimated by Expectation-Maximization method based on the genotypes of 572patients with ALL and 5645 unrelated health donors,and then compared by chi-square test.Results The frequencies of HLA-A33(7.15%vs 9.3%,OR=0.73,P＜0.05),B58(5.93%vs 8.75%,OR=0.64,P＜0.05),DRB1*17(5.15%vs 6.30%,OR=0.82,P＜0.05)alleles and HLA-A33-B58-DRB1*17(2.46%vs 4.14%,OB=0.35,P＜0.05)haplotype were significantly lower in ALL patient groups than that in controls.The frequencies of HLA-A3(2.1%vs 1.26%,OR=1.7,P＜0.05),B51(7.25%vs 5.78%,OR=1.3,P＜0.05)and DRB*12 (16.13%vs 12.99%,OR=1.35,P＜0.05)alleles and A2-B51-DRB1*12(1.24%vs.0.89%,OR=1.66,P＜0.05)haplotype were significantly higher in ALL patient groups than that in controls.Conclusion These results indieated that HLA-A33-B58-DRB1*17 haplotype was a associated with a diminished incidence of ALL.and HLA-A3 auele or A2-B51-DRB1*12 haplotype was weakly associated with ALL.