Alcohol Drinking ; adverse effects ; Cardiovascular Diseases ; etiology ; prevention & control ; Health Promotion ; Humans ; Risk Assessment

OBJECTIVETo study the feasibility to repair the peripheral nerve gap with tissue engineering scaffold complex that is composed of medical biodegradable material agarose hydrogel and nerve growth factor (NGF).

METHODSChitosan tube containing agarose hydrogel and NGF was transplanted to bridge a 10 mm gap of injured sciatic nerve in rat. Chitosan duct without agarose hydrogel and NGF was used as negative control, while autograft nerve as positive control. Sixteen weeks after operation, the regeneration of nerve fiber was observed with morphological and immunohistochemistrical methods.

RESULTThe number and diameter of regenerating nerve fibers bridged by the scaffold complex of agarose hydrogel and NGF were better than negative control group (P < 0.01) and reached the level of autograft nerve group.

CONCLUSIONSThe new type of tissue engineering scaffold complex of agarose hydrogel and NGF may provide a microenvironment, as well as autograft nerve, to promote nerve regeneration. This technique may benefit patients with nerve injury in the future.

Absorbable Implants ; Animals ; Biocompatible Materials ; Chitosan ; Disease Models, Animal ; Feasibility Studies ; Hydrogel, Polyethylene Glycol Dimethacrylate ; Male ; Nerve Growth Factors ; pharmacology ; Nerve Regeneration ; drug effects ; Peripheral Nerve Injuries ; Peripheral Nerves ; physiopathology ; surgery ; Prosthesis Implantation ; Rats ; Rats, Sprague-Dawley ; Sepharose ; Stents ; Tissue Engineering ; methods

Aged ; Anaphylaxis ; etiology ; Animals ; Female ; Humans ; Insect Bites and Stings ; complications ; Myocardial Infarction ; etiology ; Wasps

OBJECTIVETo explore the pathogenesis of idiopathic thrombocytopenic purpura (ITP) and improve the differential diagnosis from myelodysplastic syndromes (MDS).

METHODSPolymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was performed to detect the point mutation of codon 12,13 in N-ras gene and codon 301, 969 in fms gene in adult and aged ITP and MDS patients.

RESULTSIn 25 ITP patients, N-ras mutation and fms mutation were detected in one each (4%). Mutations were found in 3 of 8 MDS patients: two (25%) with N-ras mutation and one (12.5%) with fms mutation.

CONCLUSIONSPatients with N-ras or fms gene mutation diagnosed as MDS rather than ITP.

Adult ; Aged ; Female ; Genes, fms ; genetics ; Genes, ras ; genetics ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Purpura, Thrombocytopenic, Idiopathic ; genetics

OBJECTIVE: To assess the labial and lingual alveolar bone thickness in adults with maxillary central incisors of different inclination by cone-beam computed tomography (CBCT). METHODS: Ninety maxillary central incisors from 45 patients were divided into three groups based on the maxillary central incisors to palatal plane angle; lingual-inclined, normal, and labial-inclined. Reformatted CBCT images were used to measure the labial and lingual alveolar bone thickness (ABT) at intervals corresponding to every 1/10 of the root length. The sum of labial ABT and lingual ABT at the level of the root apex was used to calculate the total ABT (TABT). The number of teeth exhibiting alveolar fenestration and dehiscence in each group was also tallied. One-way analysis of variance and Tukey's honestly significant difference test were applied for statistical analysis. RESULTS: The labial ABT and TABT values at the root apex in the lingual-inclined group were significantly lower than in the other groups (p < 0.05). Lingual and labial ABT values were very low at the cervical level in the lingual-inclined and normal groups. There was a higher prevalence of alveolar fenestration in the lingual-inclined group. CONCLUSIONS: Lingual-inclined maxillary central incisors have less bone support at the level of the root apex and a greater frequency of alveolar bone defects than normal maxillary central incisors. The bone plate at the marginal level is also very thin.
Adult ; Bone Plates ; Cone-Beam Computed Tomography* ; Humans ; Incisor* ; Prevalence ; Tooth

Objective To assess the diagnostic accuracy of 64-slice computed tomography coronary angiography (64-SCTCA) in individuals with suspected coronary artery disease (CAD). Methods The study enrolled 285 individuals undergoing 64-SCTCA with calcium scoring and thereafter invasive coronary angiography (CAG) within 4 weeks for suspected CAD. Pretest probability of having obstructive CAD was determined using the Duke clinical score, which was estimated by type of chest discomfort, age, gender,and traditional risk factors and stratified into 3 levels of probability: low ( ≤ 30%, n = 80), intermediate (31% to 70%, n =92), and high ( ≥71%, n = 113). CAD was defined as the presence of at least one vessel of ≥50% coronary stenosis on CAG. Results The patient-based diagnostic accuracy of 64-SCTCA for detecting CAD according to CAG revealed a sensitivity of 81.2%, a specificity of 93.3%, a positive predictive value of 68.0% and negative predictive value of 96.6%. The CAD prevalence in the low,intermediate and high risk groups according to Duke probability was 46.3%, 72.8% and 82.3%,respectively. The sensitivity and positive predictive value were lower in the low probability group than those in the intermediate and high probability groups. For those with coronary artery Agatston calcium score ＞400, the diagnostic accuracy was linked with a higher sensitivity but lower specificity. The diagnostic value of 64-SCTCA for proximal and mid-segment of coronary artery was superior to that for distal segment. Conclusions 64-SCTCA is mainly indicated in individuals with an intermediate probability of having CAD. The diagnostic value of 64-SCTCA could be affected by coronary artery calcium, lesion location and vessel diameter.

Objective To assess the dose-response relationship between alcohol consumption and relative risk of coronary heart disease (CHD) morbidity, mortality and all-cause mortality among Eastern Asian men. Methods Potential prospective cohort studies were retrieved by searching Pubmed (1966-2000), Biosis Previews (1980-2009), Embase (1980-2009) and ISI Web of Knowledge (1986-2009)using Medical Subject Headings alcohol drinking, ethanol, coronary heart (or artery) disease, myocardial infarction, mortality, etc; and Koreans,or Japanese or Chinese.From the 28 relevant retrieved reports,15 prospective cohort studies met the criteria were included.Information on study design,participant characteristics, level of alcohol consumption, CHD outcome, control for potential confounding factors, and risk estimates were abstracted using a standardized protocol.For each study, relative risks (RR) and 95% confidence intervals (CI) were extracted and pooled with either a fixed effect model or random effect model according to the result of the test of heterogeneity. Results Due to the limited available data for women,this study only comprised of 2406 cases of CHD among 177 723 male subjects.Findings were also pooled from 216 233 male subjects and 15 462 deaths from any cause. Compared with nondrinkers, the RRs on CHD morbidity for those who drank alcohol≤20, 21-40, 41-60,＞60g/d were 0.65 (0.34-1.23,P=0.18), 0.48 (0.26-0.87,P=0.02), 0.46 (0.32-0.67,P＜0.01),and 0.48(0.29-0.78,P＜0.01 ) respectively; the RRs on CHD mortality were 0. 98 (0.73-1.31 ,P=0.87), 0.68 (0.58-0.79,P＜0.01), 0.64 (0.43-0.96,P=0.03), 0.75 (0.54-1.03,P=0.08); and on all-cause mortality were 0.83 (0.79-0.91, P＜0.01), 0.93 (0.87-0.99, P=0.03), 1.01 (0.95-1.07, P=0.86),1.32 (1.29-1.36, P＜ 0.01 ). Conclusion Light-to-moderate alcohol intake was associated with decreased risk of CHD morbidity and mortality, while heavy alcohol intake was associated with increased allcause mortality among Eastern Asian men.

Objective To evaluate the impact of mean fasting glucose over the first 72 hours after admission on in-hospital outcomes in patients with ST-segment elevation myocardial infarction ( STEMI ).Methods The data of 357 non-diabetic patients hospitalized with STEMI were collected from the database of Sun Yat-sen Memorial Hospital, affiliated to Sun Yat-sen University between January 2006 and April 2009.The patients were categorized into 3 groups according to mean fasting glucose over the first 72 hours after admission: ＜ 5.6 ( n = 165 ), 5.6 - 7.0 ( n = 122 ) and ＞ 7.0 mmol/L ( n = 70). Clinical characteristics,therapeutic approaches and the incidence of heart failure, malignant arrhythmias, and death during hospitalization were compared among groups. Multivariate logistic regression analysis was performed to determine the association between risk factors and in-hospital outcomes. Receiver-operator characteristic (ROC) curve was generated to assess the power of mean fasting glucose on predicting in-hospital death. Results Age, past history of infarction and early revascularization therapy were similar among groups. Heart rate on admission, white blood cell count, peak CK-MB level, and proportion of extensive anterior infarction were increased in proportion to higher mean fasting glucose levels. Higher mean fasting glucose levels were associated with increased risk of reduced left ventricular ejection fraction, heart failure characterized by higher Killip class, and malignant arrhythmias. After multivariate adjustment, mean fasting glucose remained to be an independent risk factor for increased in-hospital death of patients with STEMI (OR = 1.31, 95% CI: 1.10 - 1. 57;P =0. 003). Mean fasting glucose had the higher area under the ROC curve than admission glucose or fasting glucose after admission based on single measurement (0. 758, 0. 674and 0. 717;P ＜ 0. 001 ). Conclusion Mean fasting glucose during first 72 hours after admission is an independent predictor for in-hospital death and complications in patients with STEMI, which is superior to admission glucose or fasting glucose after admission based on single measurement in predicting in-hospital outcomes.

Objective To investigate the efficacy and safety of staged bilateral thalamus and globus pallidus stereotactic lesioning in patients with idiopathic Parkinson's disease (PD). Methods Nineteen PD patients,admitted to our hospital from February 1998 to May 2008 and received staged bilateral thalamus and globus pallidus stereotactic lesioning under the stereotactic microelectrode-guidance,were chosen in our study; 16 of them had a primary operation with ventral intermediate (Vim) stereotactic lesioning,and other 3 had globus pallidus-intemal segment (Gpi)stereotactic lesioning; second-staged operation with contralateral Gpi and small focal of Vim nucleus stereotactic lesioning was performed on all patients.The unified Parkinson disease rating scale (UPDRS)was used to estimate the "switch-on" and "switch-off" states of each patient before operation and 1 week after operation.The improvement of symptoms and the happening of complications after the operation were analyzed. Results Improvements were observed in all the 19 patients postoperatively in terms of stiffness and tremor.Stiffness was significantly alleviated after lesioning of Gpi,and tremor was markedly relieved after the Vim nucleus small focal lesioning.Two patients had dysarthria postoperatively,and 1 of them had dysphagia; the symptoms were alleviated 3 months after the operation. Conclusion Staged bilateral thalamus and globus pallidus stereotactic lesioning is a safe and effective surgical treatment for PD patients with bilateral severe symptoms.Controlling the indications and the size of lesioning strictly,and selecting the targets appropriately are of vital importance to the operation.

Objective To evaluate the effect of surgical excision of the anterior temporal lobe and hippocampus on the cognitive function of patients with refractory temporal lobe epilepsy. Methods Nineteen patients with refractory temporal epilepsy received surgical excision of the anterior temporal lobe and hippocampus, and cognitive neuropsychologieal assessments were conducted, 3 and 6 months after the surgery, to evaluate the changes in the patinets' cognitive functions. Results Satisfactory effects were achieved in these patients after the operations. One patient showed temporary speech disorder, and two exhibited temporary euphoria. Patients with refractory temporal lobe epilepsy had severe cognitive dysfunctions involving especially in the intelligence, attention and memory, which were not aggravated after the operation, Conversely, the operation resulted in gradual improvement of some of the cognitive functions in these patients. Conclusion Patients with refractory temporal lobe epilepsy have cognitive dysfunction, and surgical excision of the anterior temporal lobe and hippocampus can cure or reduce seizure of temporal lobe epilepsy and improve the cognitive dysfunctions to some extent.