Aortic Valve Stenosis ; blood ; diagnosis ; etiology ; Child ; Coronary Artery Disease ; blood ; diagnosis ; etiology ; Coronary Vessels ; diagnostic imaging ; pathology ; Echocardiography ; Female ; Humans ; Hyperlipoproteinemia Type II ; blood ; complications ; diagnosis ; genetics ; Lipoproteins, LDL ; blood ; Triglycerides ; blood

Objective To evaluate clinical curative effect of levosimendan therapy on patients with refractory heart failure.Methods A total of 84 patients with refractory heart failure were randomly and equally divided into le-vosimendan group and routine treatment group.Both groups received routine antiheart failure medication,levosimendan group received levosimendan therapy while routine treatment received milrinone injection therapy additionally.Changes of left ventricular ejection fraction(LVEF)and plasma level of N terminal pro type B natriuretic peptide(NT -proB-NP)were compared between two groups before and after treatment.Results Compared with routine treatment group, there were significant increase in total effective rate of LVEF[(0.36 ±0.18)% vs.(0.42 ±0.36)%],and in NT -proBNP[(975.14 ±247.01)ng/mL vs.(832.14 ±224.78)ng/mL].The effect before and after treatment of levosi-mendan group were more obviously (NT -proBNP:t =2.3 -230.2,P <0.02;LVEF:t =2.29 -215.2,P <0.01). Conclusion Levosimendan can significantly improve heart function,decrease NT -proBNP level in patients with re-fractory heart failure.

Background Minocycline possesses neuroprotective effect in a variety of animal models and clinical trials of central nervous system,but whether it works on optic nerve injury remains unclear.Objective This study aimed to observe the protective effects of minocycline on retinal ganglion cells (RGCs) in the early stage of optic nerve crush and explore its mechanism.Methods One hundred and thirty-six clean C57BL/6J mice were randomly divided into normal control group,normal saline solution group and minocycline group.The optic nerve crush injury models were induced in the left eyes of the mice in the normal saline solution group and minocycline group by a cross-action forceps for 3 seconds.Minocycline was injected intraperitoneally in the minocycline group firstly 45 mg/kg(0.4 ml) and followed by 22.5 mg/kg per day after 24 hours until sacrifice of the animals,and the equivalent volume of normal saline solution was injected in the same way in the normal saline solution group.The mice were euthanized at 4,7,11,14 days postoperatively and the left eyeballs were collected.Retinal flat mounts and DAPI staining was used to observe and compare the change of RGCs density among different groups and various time points.Apoptosis of mice RGCs were assessed by TdT-mediated dUTP nick end labeling (TUNEL).Real-time polymerase chain reaction (real-time PCR) was used to detect the expression of CD11b mRNA in retinal microglials.Results DAPI staining in retinal flat mounts showed that the average RGCs density was (77.50±2.38)/0.01 mm2 and (70.00±2.94) /0.01 mm2 in the 4th and 7th day after modeling in the normal saline solution group,and those in the minocycline group were (88.75 ± 2.36) /0.01 mm2 and (81.00 ± 3.92)/0.01 mm2,with significant differences between the two groups (t4d =-6.708,P＜0.01 ;t7d =--4.491,P＜0.01).The apoptotic RGCs were (12±1)/mm and (4±1)/mm in the normal saline solution,which were significantly more than (4±1)/mm and (1±0)/mm in the minocycline group (t4 d =12.832,P＜0.01 ; t7d =3.455,P =0.026).However,no significant difference was found in apoptotic RGCs in postoperative 11 days and 14 days between the normal saline solution group and the minocycline group (P =0.708,0.777).The expressing levels of CD11 b mRNA in the retinal microglials were significantly higher in the 4th and 7th day in the normal saline solution group than those in the minocycline group (t4 d =8.312,P＜0.01 ;t7d=5.407,P＜0.01),but were not significantly different in the 11st and 14th day after modeling between the two groups (P=0.055,0.170).Conclusions Minocycline can play a neuroprotective effect on RGCs in the early stage of optic nerve crush in mice by inhibiting microglia activation and decreasing RGCs apoptosis.

Objective To explore the efficacy of hormone replacement therapy (HRT) for rheumatoid arthritis (RA).Methods The literature about HRT in the treatment of rheumatoid arthritis were searched.Eleven papers were subjected to a Meta-analysis and a heterogeneity test was conducted to evaluate the efficacy of HRT.Results HRT reduced the level of erythrocyte sedimentation rate (ESR) in RA patients (P=0.016),the SMD was-0.22(-0.40,-0.04); improved bone mineral density (BMD) in RA patients (P=0.022),the WMD was 2.83(0.41,5.26); decreased clinical parameters for disease activity evaluations of RA patients (P=0.048),the SMD was-0.19 (-0.38,0.00); decreased the level of C-reactive protein (CRP) in RA patients,the SMD was-0.08 (-0.37,0.21),but the difference was not statistically significant (P=0.591).Conclusion The findings from this Meta-analysis indicate that HRT can reduce the ESR level,improve clinical indexes and improve BMD level of RA patients.HRT may suppress disease activity and osteoporosis of RA patients,so it may be used as an auxiliary therapy in the treatment of RA.

Objective To investigate the effect of vitamin E on progression of breast cancer tumor and to explore its underlying mechanism.Methods Human Breast cancer cells MCF-7 were inoculated into mice to establish mouse model of breast cancer and MCF-7 cell was cultured in vitro.Reactive oxygen species (ROS)level and p53 expression were determined by fluorescence probe CM-H2DCFDA and Western blot respectively.In addition,proliferation of human breast cancer cells MCF-7 was observed after transfected by siRNA targeting p53.Results Supplementing the diet with vitamin E markedly increased tumor progression and decreased ROS level and p53 expression in tumor tissue.Supplementing the culture medium with trolox significantly accelerated the growth of MCF-7 and decreased ROS level and p53 expression in tumor cells.p53-siRNA could eliminate p53 expression in MCF-7 and increase the proliferation of MCF-7 cells.Conclusion Vitamin E can accelerate breast cancer tumor progression by reducing ROS level and decreasing the expression of p53 in tumor cells.

A poly( GMA-EGDMA) coated SPME fiber was prepared using an in-situ polymerization by direct bonding to the surface of a polydopamine-modified stainless steel wire. Then the fiber was modified by sulfuric acid. A novel solid phase microextraction coating coupled to high performance liquid chromatography ( HPLC) method based on the as-prepared fiber was developed for the determination of four pharmaceuticals and personal care products ( PPCPs) in water samples. The influences of extraction parameters, including pH, extraction time, extraction temperature and salt addition were investigated. 3 mL water sample was extracted by the as-prepared fiber for 60 min at 30 ℃, and then desorbed with mobile phase for 30 min, respectively. Desorption solution was analyzed by HPLC-DAD ( diode array detection ) . The results indicated that the extraction yield of the fiber was good for four PPCPs. The linear correlation coefficients were>0. 997 with the linear range of 2-200 μg/L. The limits of detection (S/N=3) were 0. 5-5 μg/L with RSD (n=5) of 4. 1%-11. 9%. The recoveries of four PPCPs at spiked level of 20, 50, 100 μg/L were within the range of 70. 6%-105. 5%. The results showed that this method was easy, green, accurate and precise, and could be used to assay the four PPCPs in real water samples.

Objective To assecess the role of CT in the diagnosis and the reasons of misdiagnosis of biliary duct carcinoma.Methods 23 cases with biliary duct carcinoma pathologically comfirmed were reviewed.Results 2 cases were peripheral type,10 cases were major intrahepatic biliary duct type,7 cases were extrahepatic type and 4 cases ampullar type.The masses within biliary duct were showed by CT in 16 cases.The obstruction of biliary duct was cut off abruptly in 18 cases and narrowing sharply in 5 cases.The intrahepatic biliary duct indicated mild or marked expansion,of them,17 cases were showed as vine and 6 as segmental.The extrahepatic biliary duct were dilated in 11 and gallbladder dilatation in 7.4 cases were misdiagnosed and leaked diagnosis was in one cases by CT preoperation.Conclusion CT is valuable in diagnosis of biliary duct carcinoma,but it still has some limitations.

Objeetive To investigate the effects of nimodipine combined with edaravone on cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH).Methods The consecutive patients with aSAH who underwent microsurgical clipping were included retrospectively.All patients received intravenous prophylaxis with nimodipine,and some patients also used edaravone (30 mg,twice a day for 2 weeks).They were divided into either a CVS group or a non-CVS group according to the findings of transcranial Doppler.They were also divided into a DCI group and a non-DCI group according to the findings of CT reexamination and clinical examination.The demographics,baseline clinical data,Glasgow Coma Scale (GCS) score,Fisher grade,Humt-Hess grade,and aneurysm location of all patients were collected.The multivariate logistics regression analysis was used to identify the independent risk factors for CVS and DCI.Results A total of 220 patients with aSAH were enrolled in the study,132 (60.0％) had CVS and 106 (48.2％) had DCI.One hundred twenty-three patients (55.9％)were treated with nimodipine + edaravone,97 were treated with nimodipine alone,none of them died.The incidences of CVS (51.2％ vs.71.1％;x2 =8.962,P =0.003) and DCI (35.0％ vs.65.0％;x2 =19.535,P ＜0.001) in patients receiving nimodipine + edaravone therapy were significantly lower than those receiving nimodipine alone.The proportions of hypertension,hyperlipidemia,diabetes,smoking,high Fisher grade in the CVS group were significantly higher than those in the non-CVS group (all P ＜0.05),while the proportion of patients receiving nimodipine + edaravone therapy (47.7％ vs.68.2％;g2 =8.962,P =0.003) and the GCS score (11.2 ±3.1 vs.13.4 ±2.6;t =5.492,P＜0.001) were significantly lower than those in the non-CVS group.Multivariate logistic regression analysis showed that low GCS score (odds ratio [OR] 6.57,95％ confidence interval [CI] 1.04-12.96;P=0.001),high Fisher grade (OR 5.39,95％ CI 4.09-20.15;P =0.004),hyperlipidemia (OR 4.39,95％ CI 2.97-34.15;P =0.004),hypertension (OR 3.24,95％ CI 1.06-13.47;P=0.016) were the independent risk factors for CVS,while received nimodipine + edaravone was the independent protective factor for CVS (OR 0.39,95％ CI0.13-0.91;P =0.039).The proportions of patients with hypertension,hyperlipidemia,diabetes,smoking,and high Fisher grade in the DCI group were significantly higher than those in the non-DCI group (all P ＜0.05),while the proportion of patients received nimodipine + edaravone (40.6％ vs.70.2％;x2 =19.535,P ＜ 0.001) and the GCS score (10.2 ± 2.4 vs.13.8 ± 2.6;t =10.648,P ＜ 0.001) were significantly lower.Multivariate logistic regression analysis showed that low GCS score (OR 8.92,95％ CI 2.48-26.94;P =0.001),high Fisher grade (OR 7.49,95％ CI 1.96-20.47;P =0.001) were the independent risk factors for DCI,while.received nimodipine +edaravone was an independent protective factor for DCI (OR 0.27,95％ CI 0.08-0.97;P =0.020).Conclusions Compared with nimodipine alone,nimodipine combined with edaravone can significantly reduce the incidences of CVS and DCI.The GCS score,high Fisher grade,and hypertension are the independent risk factors for CVS and DCI in patients with aSAH,and nimodipine combined with edaravone is the independent protective factor for CVS and DCI.

Objective:To evaluate the correlation between the polysomnographic findings and the degree of obstruction caused by adenoid and tonsillar hypertrophy in children with clinical history of apnea. Method: Retrospectively studied the children who were diagnozed clinically of, obstructive sleep apnea hypopnea syndrome(OSAHS) and underwented polysomnograph and endoscopy. Patients were divided nto OSAHS and non-OSAHS group according to polysomnographic findings. Result: Ninty-four children were involved in the study population, and 63 children of them were male. The mean age of the children at the time of inclusion in the study was 6.7 years. 36 children(38.3%) diagnosed OSAHS clinically had normal polysomnographic findings. No differences were found between children with PSG-documented OSAHS and others. Tonsillar and/or adenoid hypertrophy were not correlated to more severe apnea among enrolled children. Conclusion-There was no significant correlation between polysomnographic and clinical findings in children with OSAHS.

Prognostic factors of differentiated thyroid carcinomas ( DTC ) were analyzed and the related literatures were systematically reviewed in order to justify the diagnostic and therapeutic modalities for improving the patient′s survival.150 patients ( female,n =113 ; male,n =37 ) with histopathologically diagnosed DTC,including papillary thyroid carcinoma ( n =131,87.3％ ) and follicular thyroid carcinoma ( n =19,12.7％ ),were postoperatively followed up and their clinical data were retrospectively reviewed.Patients were followed up for 4.15-31 years wherein 140 patients( 93.3％ ) survived but with relapse in 30 patients( 20.0％ ),and 10 patients( 6.7％ ) died.Surgical procedures consisted of near-total or subtotal thyroidectomy ( n =83,55.3％ ),partial thyroidectomy ( n =64,42.7％ ),and total thyroidectomy ( n =3,2.0％ ).Out of the patients receiving lymph node dissection ( n =63 ),45 patients( 71.4％ ) had detectable lymph node metastasis.Age of onset,tumor size at initial visit,and early metastasis showed the statistically significant difference between mortality group and survival group (P＜ 0.05 ),as well as between relapse group and relapse-free group( P＜0.05 ).Age of onset,tumor size at initial visit,and early metastasis are prognostic factors for DTC.