Objective To investigate the independent echocardiographic pathogenesis associated with left atrial spontaneous echo contrast(SEC) formation in patients with atrial fibrillation(AF).Methods Twenty-one patients with valvular AF and twenty-three patients with nonvalvular AF undergoing transthoracic and transesophageal echocardiography(TTE/TEE) were studied.Morphological and functional parameters of the heart in patients with AF were detected by TTE,while the sizes of the left atrial appendage(LAA),its Doppler flow patterns,Doppler flow patterns of the left upper pulmonary vein and integrated backscatter(IBS) values of left atrial SEC relative to those of the left ventricle were measured by TEE.Results There were the following 10 variables significantly associated with the left atrial SEC,some of which associated positively with SEC were left atrial diameter(r=(0.40252),P=(0.0061)),diameter of the open mouth of LAA to the left atrium(r=(0.37816),P=(0.0161)),while the others of which associated negatively with SEC were antegrade/retrograde blood flow velocity peak,integrate(RVi) and retrograde blood flow velocity mean(RVm) values,and S/D wave peak,S wave integrate(Is) and D wave mean(Md) values,their r values ranged from(-0.40379) to(-0.32832),their P values between(0.0018) and(0.0386).Collinearity analyses suggested that RVi,RVm,Is,Md represented completely all the blood flow velocity parameters of LAA and the left upper pulmonary vein,respectively.Multivariate analyses demonstrated that RVm and Md were the independent predictors of the left atrial SEC in patients with AF(both P

Pi-Wei theory is an important component of the basic theory of Chinese medicine. The pathogenesis of Pi-Wei damp-heat syndrome is an important content of Pi-Wei theory. The tongue coating is one of the most important signs reflecting Pi-Wei damp-heat syndrome. From the perspective of microecology and pathogenesis, the microbial disequilibrium caused by quantity changes of Helicobacter pylori (Hp) and Lactobacillus acidophilus (LA) and their interaction in the gastric mucosa and the tongue coating might have certain correlation with "mutual struggle between the evil and the vital qi, the disequilibrium between yin and yang". The pathogenesis features of chronic gastritis patients of Pi-Wei damp-heat syndrome was initially proposed in this article.
Diagnosis, Differential ; Gastric Mucosa ; microbiology ; Helicobacter Infections ; diagnosis ; Helicobacter pylori ; isolation & purification ; Humans ; Lactobacillus acidophilus ; isolation & purification ; Medicine, Chinese Traditional ; methods ; Stomach Diseases ; diagnosis ; microbiology

OBJECTIVETo observe the effect of natural type ginsenoside Rg2 (Rg2) and its stereoisomers [20 (R)-Rg2 and 20 (S)-Rg2] at different concentrations on oxygen-glucose deprivation/ reperfusion (OGD/R) induced cortical neuronal injury model in vitro, and to explore the mechanism, and compare their differences of action.

METHODSCortical neurons after 7-day culture were randomly divided into 5 groups, i.e., the control group, the model group, the Rg2 group, 20 (R) -Rg2 group, and 20 (S) - Rg2 group. Cortical neurons in the Rg2 group, 20 (R)-Rg2 group, and 20(S)-Rg2 group were pretreated with 20, 40, and 80 μmol/L Rg2, 20 (R) -Rg2, and 20 (S) -Rg2 for 24 h to prepare OGD/R model. The cell survival rate, the activity of Caspase-3, the intracellular Ca2+ concentration, contents of superoxide dismutase (SOD) and malondialdehyde (MDA) were detected 24 h later.

RESULTSCompared with the control group, cell survival rates and activities of SOD obviously decreased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly increased with statistical difference (P < 0.05). Compared with the model group, cell survival rates and activities of SOD obviously increased, the activity of Caspase-3, Ca2+ fluorescent optical gray value, and contents of MDA significantly decreased in 20 μmol/L Rg2 group, 40 μmol/L 20 (R) -Rg2 group, and 80 μmol/L 20 (S) -Rg2 group (P < 0.05). Compared with 20(S)-Rg2 group, cell survival rates increased and contents of MDA significantly decreased in 20, 40, and 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). The activity of Caspase-3 decreased and contents of SOD increased in 80 μmol/L 20 (R)-Rg2 group, and 40, 80 μmol/L Rg2 groups (P < 0.05). Ca2+ fluorescent optical gray value decreased in 40, 80 μmol/L Rg2 and 20 (R)-Rg2 groups (P < 0.05). Compared with 20 (R)-Rg2 group, Ca2+ fluorescent optical gray value decreased in 80 μmol/L Rg2 group (P < 0.05); contents of SOD increased in 40 and 80 μmol/L Rg2 groups (P < 0.05); contents of MDA decreased in 20, 40, and 80 μmol/L Rg2 groups (P < 0.05).

CONCLUSIONSRg2 and its stereoisomers could improve cell vitality of cortical neurons against OGD/R induced injury. This might be related to improving anti-apoptotic capacities and antioxidant abilities, and reducing Ca2+ inflow. Besides, the neuroprotective effect of 20 (R) -Rg2 was better than that of 20 (S) -Rg2, but inferior to that of Rg2.

Antioxidants ; metabolism ; Apoptosis ; Calcium ; metabolism ; Caspase 3 ; metabolism ; Cell Survival ; Cells, Cultured ; Ginsenosides ; pharmacology ; Glucose ; Humans ; Malondialdehyde ; metabolism ; Neurons ; drug effects ; Neuroprotective Agents ; pharmacology ; Oxygen ; Random Allocation ; Reperfusion Injury ; Stereoisomerism ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the effect of retinoic acid on differentiation of periodontal ligament cells (PDLCs) and gingival fibroblasts (GFs).

METHODSThe periodontal ligament cells and gingival fibroblasts were cultured, challenged with different concentrations of retinoic acid in medium and detected for the alkaline phosphatase (ALP) activity and its mRNA by biochemical technique, in situ hybridization and RT-PCR.

RESULTSALP activity in normal PDLCs was higher than that in GFs. The mRNA signals were positive in PDLCs, and negative in GFs. After treated with different concentrations of retinoic acid, ALP activity of PDLCs was increased than that of the control, and its mRNA signals were enhanced, especially in 5 x 10(-6) mol/L. The treated GFs showed a slight increase of ALP activity and a weak band of mRNA signals only in 5 x 10(-6) molUL concentration.

CONCLUSIONThere were differences between PDLCs and GFs in differentiating into osteoblast-like cells.

Cell Differentiation ; Fibroblasts ; Gingiva ; Osteoblasts ; Periodontal Ligament ; RNA, Messenger ; Tretinoin

OBJECTIVETo explore the health status of workers exposed to Cd at low concentration.

METHODSOne hundred eighteen workers of zinc powder finishing and 34 staffs were served as the exposure group and control group, respectively. The physical examination, blood cadmium, urinary cadmium, blood lead, urinary 32-microglobin, urine creatine, chest film, pulmonary function , pure tone teat and were detected for all subjects.

RESULTSTwelve air samples from 6 monitoring points in workshop were detected, the air Cd concentrations were 0.002-0.015 mg/m³, which were under the national limit of occupational exposure. In exposure group, the rates of exceeding standards of blood Cd and urinary Cd were 65.25% and 38.16%, respectively, the rate of exceeding standards of urinary Cd for two times was 27.12%, the rate of exceeding standard of urine Cd for two times plus the positive urinary 32-microglobin was 2.54 %. In control group, the rates of exceeding national standard of blood Cd was 26.47 %, but the values of urinary Cd were normal. In exposure group, the rate of exceeding standards of urinary Cd increased with the service length. Smoking could enhance the rates of exceeding standards of blood Cd and urinary Cd.

CONCLUSIONIn zinc powder finishing, the low-concentration cadmium exposure could cause the occupational cadmium poisoning, the comprehensive protection measures can reduce the occupational cadmium poisoning. It is suggested that the limits of occupational exposure to cadmium should be declined.

Adult ; Cadmium ; blood ; urine ; Cadmium Poisoning ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Smoking ; epidemiology ; Workplace ; Young Adult ; Zinc ; analysis

OBJECTIVETo assess the effect and adverse reaction of total glucosides of paeony capsule (TGPC) in combining with citirizine for the treatment of chronic urticaria.

METHODSA total of 120 patients were assigned to two groups by lottery, 65 in the treated group and 55 in the control group. They all were orally treated with citirizine tablet 10 mg per day, but to the treated group, additional 0.2 g TGPC was given three times per day, the therapeutic course for both groups was 4 weeks. The effectiveness of treatment was observed, and the changes of total symptom score, serum levels of interleukin-4 (IL-4), and immunoglobulin E (IgE) were measured before and after treatment. Moreover, a follow-up was carried out one month after ending the treatment.

RESULTSThe dropped cases were two in the treated group and seven in the control group; so, the study was accomplished on 63 patients in the treated group and 48 patients in the control group. The total effective rate was assessed at 73.02% (46/63) in the treated group, which was significantly higher than 47.92% (23/48) in the control group (P<0.01). After treatment, the total symptom score decreased in both groups, but the decrement in the treated group was more significant (P<0.05). Serum levels of IL-4 and IgE in the treated group lowered significantly, while the changes in the control group were insignificant, so statistical significant differences were shown between groups (P<0.01). A follow-up study showed that the relapse rate in the treated group was 30.00% (6/20), while that in the control group was 90.00% (9/10), and the former was lower than the latter (P<0.01). Adverse reactions, revealed as drowsiness, dizziness, and weakness, were seen in eight cases and seven cases in the two groups, respectively. Besides, mild diarrhea occurred in two cases of the treated group.

CONCLUSIONSThe treatment of TGPC combining citirizine shows definite curative effect in treating chronic urticaria, with low relapse rate and without evident adverse reaction. Its therapeutic effect might be realized by means of regulating patients' immune function. Besides, the medication should be continued for a rather long period to achieve the full effect.

Adolescent ; Adult ; Anti-Allergic Agents ; adverse effects ; therapeutic use ; Capsules ; Cetirizine ; adverse effects ; therapeutic use ; Chronic Disease ; Drug Therapy, Combination ; Female ; Glucosides ; adverse effects ; therapeutic use ; Humans ; Immunoglobulin E ; blood ; Interleukin-4 ; blood ; Male ; Middle Aged ; Paeonia ; chemistry ; Phytotherapy ; Recurrence ; Treatment Outcome ; Urticaria ; blood ; drug therapy ; Young Adult

BACKGROUND:There is a general consensus that patients undergoing joint arthroplasty surgery wil be in hypercoagulable state and easily to induce deep vein thrombosis. Thromboelastography is a new kind of method to monitor blood coagulation state, but not widely used in orthopaedics. No final conclusion has yet been reached on whether we can guide the clinical prevention of deep vein thrombosis and medication through using thromboelastography to monitor perioperative coagulation state of patients treated with joint arthroplasty. OBJECTIVE:To investigate the correlation between thromboelastography and routine coagulation functional tests, and evaluate the clinical application value of thromboelastography in monitoring the perioperative coagulation state of patients treated with joint arthroplasty.
METHODS:A total of 204 patients who treated with joint arthroplasty at First Affiliated Hospital of Soochow University from November 2014 to August 2015 were retrospectively analyzed. The thromboelastography, routine coagulation, platelet and other data before and after the replacement were respectively col ected. The correlative analysis was conducted between the thromboelastography result and the results of conventional coagulation test, that is, routine coagulation and platelet count. RESULTS AND CONCLUSION:In total knee arthroplasty group, activated partial thromboplastin time and reaction time showed good consistency (φ=0.713, Kappa value=0.647);Prothrombin time had moderate correlation and general consistency with reaction time (φ=0.392, Kappa value=0.362);Coagulation time and fibrinogen had moderate correlation and consistency (φ=0.392, Kappa value=0.488);Aggregates formation rate (αangle) and fibrinogen had moderate correlation and consistency;the remaining parameters had poor correlation and consistency. In total hip arthroplasty group, there was a weak correlation and consistency between the reaction time, activated partial thromboplastin time and prothrombin time;the other correlations were poor. However, there was a higher proportion of consistent clotting trend between some parameters of thrombelastography and routine coagulation. In total hip arthroplasty group, the consistent proportion of coagulation time and fibrinogen accounted for 67.6%;the consistent proportion of aggregates formation rate (αangle) and fibrinogen accounted for 78.3%. These results suggest that thromboelastography and routine coagulation tests have some correlations and consistency. Thromboelastography parameters have more consistent tendency on the data. Thrombelastography can serve as an auxiliary mean to monitor coagulation state of perioperative joint arthroplasty.

OBJECTIVETo summarize and analyze the application of neuroendoscopic techniques in neurosurgery, and to discuss the role and significance of neuroendoscopic techniques in the diagnosis and treatment of neurosurgical diseases.

METHODSWe treated 1300 patients with different neurosurgical diseases by performing endoscopic neurosurgery (EN) and endoscopy-assisted microneurosurgery (EAM). Among 1300 paitents, 522 were treated with pure endoscopic neurosurgery, 260 with endoscopy-assisted microneurosurgery, 79 with endoscope-controlled bur hole trephination neurosurgery, 434 with endoscope transsphenoidial surgery, and 5 with other techniques through which an endoscope was used in conjunction with stereotactic guidance.

RESULTSTotally 362 hydrocephalus patients were treated using EN. Among them, 190 were treated by third ventriculostomy, 30 by V-P shunt, and 142 patients with complicated hydrocephalus and unsymmetry hydrocephalus by endoscopy-controlled pathologic septum fenestration, septum pellucidum fenestration, and treatment of inventricula inflammation. Clinical symptomatic improvement was achieved in 341 of 362 patients (94.2%). Also 160 intracranial cyst patients were treated using EN for resection and partial resection. Eighty-two patients were performed through cyst-ventricula fenestration. Clinical symptomatic improvement was achieved in 76 of 82 patients (92.7%). Seventy patients treated with endoscopy-controlled bur hole neurosurgery and 8 cases with endoscopy-assisted microneurosurgery got better recovery after operation. Among 260 patients with brain tumors, 252 patients were operated with EAM (190 patients with epidermoid cyst), 8 patients with EN (all brain tumors with diameters < 2.5 cm in inventricular). Clinical symptomatic improvement was achieved in 228 of 260 patients (87.7%). Among 49 patients with inventricular and cistern cyst, 40 patients who were treated by EN and 9 patients by endoscopy-controlled bur hole neurosurgery were resected and their clinical symptoms were improved after operation. Among 434 patients with sellar region lesions, 387 patients with pituitary adenomas, 19 patients with repair for CSF leaks, 9 patients with chordoma, and 19 patients with other neurosurgical diseases were performed with endoscopy-controlled transsphenoidial surgery. Clinical symptoms in 88.9% (386/434) of these patients were improved. Another 5 patients were treated with endoscopy combined with navigation and stereotatic guidance with good results. The complications related to operation were found in only 2% of all the patients including hemorrhage, infection, and damage of important structure.

CONCLUSIONSClinical application of neuroendoscopic techniques can decrease the damage caused by pure open surgery operation. It is possible to resect lesions at the utmost and protect normal tissue from lesions for using EN and EAM or endoscopy-controlled microneurosurgery (ECM). It is also helpful to enhance surgical quality and, reduce the complications.

Adolescent ; Adult ; Aged, 80 and over ; Brain Diseases ; surgery ; Child ; Child, Preschool ; Epidermal Cyst ; surgery ; Female ; Humans ; Hydrocephalus ; surgery ; Infant ; Male ; Microsurgery ; methods ; Middle Aged ; Minimally Invasive Surgical Procedures ; Neuroendoscopy ; Neurosurgical Procedures ; methods ; Pituitary Neoplasms ; surgery

OBJECTIVE: To investigate the rules of lymphatic metastasis of rectal carcinoma, and to help clinical diagnosis and treatment. METHODS: A retrospective analysis was performed in the 979 patients with rectal carcinoma who underwent surgical resection from 1995 to 2004. The associations between lymphatic metastasis and clinicopathologic variables were evaluated by Chi-squared test and logistic regression. RESULTS: The rate of lymph node metstasis was 71.4% for patients younger than 30 years old, 40.7% in the patients with tumor diameters over 6 centimeters, 82.5% in the patients with extraneous tumor invasion, 71.6% for patients of poor-differentiated adenocarcinoma, 70.4% for patients with mucoid adenocarcinoma, 100% for patients with signet-ring cell carcinoma and 46.4% for patients with more than half intestinal circumference invasion. Logistic regression analysis showed that the degree of lymphatic metastasis was related to the differentiating degrees, depths of tumor invasion and intestinal circumference invasion, and the differentiating degree was the major factor. CONCLUSION The lymphatic metastasis of rectal carcinoma is related to age, tumor size, intestinal circumference invasion, depth of tumor invasion and the differentiating degree of the tumor; the differentiating degree is the major factor.
Adenocarcinoma ; pathology ; Adult ; Age Factors ; Carcinoma, Signet Ring Cell ; pathology ; Female ; Humans ; Logistic Models ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Rectal Neoplasms ; pathology ; Retrospective Studies

Objective To investigate the operation method for congenital tracheal stenosis(CTS) with vascular ring(VR),in order to minimize surgical risk.Methods The data of 53 VR patients diagnosed by CT imaging,fiber bronchoscope and color doppler echocardiography were analyzed retrospectively.The age ranged from 5.0 days to 2.5 yeas old,median age was 12.5 months,including pulmonary artery sling,double aortic arch,right arch combined with abnormal left subclavian artery and innominate artery oppression,et al,in which 12 patients (8 male,4 female) associated with CTS symptoms.All patients were treated by operations,8 patients were dead,others were followed up for 3 to 5 years at 6-month interval.Results Fifty-three patients with VR were categorized into 2 treatment groups.There were 41 patients(25 male,16 female) without CTS symptoms treated by VR repair(3 cases died),mortality was 7.3％.Of the 12 patients(8 male,4 female) with VR + CTS symptoms,7 cases were treated by selective VR repair with 2 cases deaths,5 cases underwent combined V R and CTS repairs with 3 cases died,for an overall mortality of 41.7 ％.Of the 41 patients with VR but no CTS,7 cases had intracardiac anomalies with 2 cases died.In contrast,3 of 12 patients with VR + CTS and intracardiac anomalies with 2 cases died;5 patients received cardiac and CTS repairs(3 cases died) and 7 cases in selective VR repairs(2 cases died).Conclusions Not all cases of TN associated with VR require combined correction.CTS and the combined cardiac abnormalities increased the risk of VR surgery in children.The individualized treatment program should be developed for such children.