Objective To assess the clinical value of HRCT in diagnosis of cholesteatomatous tympanitis.Methods HRCT findings of 26 patients with cholesteatomatous tympanitis proved by surgery and pathology were analyzed.Results HRCT findings of cholesteatomatous tympanitis included:soft tissue mass in the superior tympanium,tympanal sinus and mastoid(100%,26/26),destruction of the bone includeing ossicles chain (92%,24/26),secutum(46%,12/26),facial nerve canal (54%,14/26);enlargement of the tympaniosinus with sclerosing borders;intracranial complications including temple abscess(1 case),meningitis(1 case).Conclusion HRCT is of great value in diagnosis of cholesteatomatous tympanitis.

BACKGROUNDMutations in the lamin A/C gene (LMNA) may cause familial dilated cardiomyopathy (dilated cardiomyopathy) characterized by early onset atrio-ventricular block (A-V block) before the manifestation of dilated cardiomyopathy and high risk of sudden death due to ventricular arrhythmia, which is very similar to the phenotype of gap junction related heart disease. This study aimed to determine the expression and localization of connexins in neonatal myocytes transfected with wild-type (WT) or mutant LMNA to elucidate how these mutations cause heart diseases.

METHODSWe studied the connexin 43 (Cx43) and connexin 40 (Cx40) expression in cultured neonatal myocytes transfected with wild-type (WT) or mutant LMNA (Glu82Lys (E82K) and Arg644Cys (R644C)) using confocal imaging and Western blotting analysis.

RESULTSCx43 protein expression was reduced by 40% in cells transfected with LMNA E82K than that in cells transfected with WT LMNA cDNA. Confocal imaging showed that the Cx43 located inside the cells by LMNA E82K. By contrast, LMNA E82K mutation had no effect on expression and localization of Cx40. LMNA R644C transfection did not show any significant effects on gap junctions at all.

CONCLUSIONSOur findings suggest that LMNA E82K significantly reduced the Cx43 expression and altered its localization which may be one of the pathological mechanisms underlying LMNA-related heart disease.

Animals ; Atrioventricular Node ; pathology ; Blotting, Western ; Cardiomyopathy, Dilated ; metabolism ; pathology ; Cells, Cultured ; Connexin 43 ; metabolism ; Connexins ; metabolism ; Fluorescent Antibody Technique ; Gap Junctions ; metabolism ; Humans ; Lamin Type A ; genetics ; physiology ; Mutation ; Rats ; Transfection

Objective To understand the prevalence of urinary incontinence(UI) and its related factors so as to develop a three-tier program for prevention of the disease.Methods A cross-sectional study was carried out in two townships of Jixian county,Tianjin,during July to November 2007.A total of 743 people aged 60 years and over were selected under cluster sampling,and all information were collected with a standardized structured questionnaire by face-to-face interview.All the data were analyzed with multivariate logistic regression method to explore the related factors for UI in the elderly.Results The overall prevalence of UI was 33.38 percent among people aged 60 years and over in two townships.Risk factors flor UI in men would include older age (OR=1.39).occupation(OR=5.00),awareness of UI(OR=1.91),having in chronic respiratory diseases(OR=2.23),prostate(OR=11.47),neurological(OR=11.76),or motor systems (OR=2.48).while protective factors would include high educational level(taking primary school or below as control group),OR for the junior middle school group appeared to be 0.35,for senior middle school group it was 0.77.and ofundergraduate group it was 0.53.Risk factors for UI in women would include older age(OR=1.31),constipation(OR=1.46),awareness of UI(OR=1.94),increased bodv nlass index(when normal weight group served as control group,OR in the overweight group was 1.03 and in the obesity group OR was 1.54),suffering from chronic respiratory diseases(OR=4.84).diabetes mellitus(OR=2.36),or motor system diseases(OR=1.37),more gravidity(OR=1.03),more parity(OR=1.02),suffering from perinea laceration(OR=1.72) and wound infection during delivery(OR=1.65),while protective factors would include physical exercises(OR=0.64).Conclusion Prevalence of UI was higher among the elderly people in rural areas of Jixian county,Tianjin.UI in the elderly might have been influenced by various factors which suggesting the intervention strategy should be targeted at those related factors as well as focusing on primary prevention.

Objective To explore the risk factors on chronic diseases related to falls in the urban-community elderly and to provide evidence for developing a three-tier program for prevention. Methods A cross-sectional study was conducted in one community of Beijing. People aged 60 years and over were selected, using a stratified cluster sampling method, and data on falls within the past 12 months and falls-related chronic diseases were collected through face-to-face interview. Results The incidence of falls was 18.0% within one year among the 1512 interviewees. Seven factors showed statistical significances through univariate analysis including diabetes mellitus (OR =1.62), postural hypotension (OR=1.84), hypertension (OR=1.48), cerebral infarction (OR=1.98), cataract (OR=1.56), osteoarthritis (OR=1.50), dementia (OR=5.34) and depression (OR=4.61). Data from multivariate logistic regression analysis showed that the risk factors for falls would include dementia (OR=4.82), depression (OR=4.27), postural hypotension (OR=1.92) and suffering from several kinds of chronic diseases etc. Conclusion The incidence of falls in an urban elderly community of Beijing was considered to be high. The risk of falls was higher among persons suffering from dementia and depression and having more than two kinds of chronic disease. The chances of falls would parallel the increase of several kinds of chronic diseases among the elderly, suggesting that measures should be actively taken to prevent from falls.

Objective To understand the prevalence of urinary incontinence(UI)and its severity in rural elderly people,as well as to investigate the awareness on UI in the elderly and health-care service seeking behavior.Methods A cross-sectional study was carried out in two townships of Jixian county,Tianjin.A total of 743 people aged 60 years and over were selected under cluster sampling method.All the information was collected with a standardized structured questionnaire by face-to-face interview.Prevalence,severity,the awareness on UI in the elderly and their utilization of health-care service for its diagnosis and treatment were analyzed.Results Prevalence of UI was 33.38% among people aged 60 years and over in two townships of Jixian,higher in females than in males(43.15% vs.22.75%,χ~2=34.70,P＜0.0001).The prevalence rates of UI in 60-age group,65-age group,70-age group,75-age group,80-age group,85-95 age group were 28.64%,32.12%,34.08%,35.45%,47.76%,30.00%,respectively,and increased with age (for trend χ~2=219,P=0.029).Stress urinary incontinence(SUI)and urge urinary incontinence(UUI)were mild,while mixed urinary incontinence(MUI)were mainly moderate.The differences of severity of SUI,UUI,MUI between men and women did not show statistical significance(all P＞0.05).In 743 elderly people,more than half of the respondents had never heard of UI(50.20%,373/743)and only 170(22.88%)elderly people considered UI as a disease.630(84.79%)and 665(89.50%)elderly people in our research group did not know that such condition was curable and preventable.In 248 elderly people with UI,only 12(4.84%)of them ever seeking community health-care services in the health-care centers or hospitals.For the ones who did visit the centers,the purpose was only to seek for drug treatment.Conclusion Prevalence of UI appeared to be high among the elderly people in rural areas of Jixian county.Most of the elderly people were lack of knowledge about UI that hindered them from seeking for diagnosis and treatment in the clinics,plus the treatment program for UI was not standardized.Knowledge on UI and health care seeking behavior should be popularized and strengthened among elderly people living in the rural areas.

OBJECTIVETo analyze the genetic polymorphism of 15 single nucleotide polymorphism (SNP) loci on the nonrecombining portion of the Y chromosome in 6 populations in China.

METHODSAllelic specific polymerase chain reaction and 2% agarose gel electrophoresis and 6% PAGE were used to analyze the genetic polymorphism of 343 unrelated males, representing 6 populations in China, including Fujian Hans, Sichuan Hans, Mongolian, Hezhen, Sibo and Hui from the South, Northeast and Northwest.

RESULTSThirty haplogroups were observed, and 3 of them (H15, H16, H18) were seen in all of the six populations. Although the heterozygosity levels of the Hezhen, Mongolian, Sibo populations are similar and those of the other 3 populations (Fujian Hans, Sichuan Hans, Hui) are similar, the pairwise differences among haplogroups are significant. Analysis of molecular variance (AMOVA) and principal component (PC) analysis of the haplogroup distributions suggested highly different allele diversity between group I including Hezhen, Mongolian, Sibo and group II including Hui, Fujian Hans, Sichuan Hans.

CONCLUSIONThe above analyses show more significant variance components in Northeast/South populations and clearly reveal the geographic genetic relationship among the six populations in the Northeast/Northwest/South. These results confirm the complexity of the genetic structure of Chinese populations and make a significant contribution for constructing the contemporary human gene pool and tracing genetic dispersal trail from Chinese populations.

Alleles ; China ; ethnology ; Chromosomes, Human, Y ; Genetic Variation ; Genetics, Population ; Humans ; Polymorphism, Single Nucleotide

BACKGROUNDVerapamil-sensitive, idiopathic left ventricular tachycardia (ILVT) with right bundle branch block configuration and left-axis deviation is known to be due to re-entry mechanism but the exact nature of reentrant circuit in ILVT is not fully elucidated. Radiofrequency (RF) ablation was applied during ventricular tachycardia (VT) and termination of the VT or abolishing the inducibility of the tachycardia was used as an endpoint for successful RF. In this study, the left posterior fascicular block in surface electrocardiogram (ECG) was used as a new endpoint of ablation to cure ILVT.

METHODSElectrophysiological studies and radiofrequency ablation were performed in 39 consecutive patients [30 men, 9 women; age ranging from 10 to 64 years, mean (29 +/- 16) years] with verapamil-sensitive ILVT and structurally normal hearts. VT could be terminated by the intravenous administration of verapamil in all patients. The target site was the midseptum of LV where the earliest Purkinje potentials were recorded during VT. RF current was applied to the target site with or without late diastolic potential (LDP) during sinus rhythm in 37 patients and during VT in 2 patients to meet the ablation endpoint: the left posterior fascicular block in the surface ECG.

RESULTSThirty-seven patients with ILVT had been treated by RF ablation during sinus rhythm and two had been treated during VT. All of them met the endpoint of the left posterior fascicular block. Thirty-eight cases were symptom-free without medications during the follow-up period (range from 3 to 95 months, median 17 months). One patient developed a clinical recurrence and the left posterior fascicular block in surface ECG disappeared. The patient received another treatment. The endpoint was met and the procedure was successful.

CONCLUSIONSThe left posterior fascicular block in surface ECG used as an endpoint of RF ablation to treat ILVT is effective. It is important especially in those patients whose VT can not be induced or the inducible condition is unstable. The effective endpoint implied that the left posterior fascicle might be a critical part of the re-entrant circuit.

Adolescent ; Adult ; Catheter Ablation ; methods ; Child ; Diastole ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular ; physiopathology ; surgery ; Verapamil ; therapeutic use

OBJECTIVETo summarize the clinical characteristics and outcome of patients with long-QT syndrome (LQTs) accompanied with torsade de pointes.

METHODSThirty-two eligible patients were included in this study. Clinical and electrocardiographic data were analyzed and telephone or out-patient follow-up were made in all patients.

RESULTSThere were 15 patients with inherited LQTs (h-LQTs) and 17 patients with acquired LQTs (a-LQTs). There are more women (n = 24) than men (n = 8). β blockers, potassium and magnesium supplement were the basic therapy for h-LQTs patients, bivent pacemaker was implanted in 2 patients and implantable cardioverter defibrillator was implanted in 5 patients. Ventricular tachyarrhythmias and syncope occurred in 4 patients during (39.4 ± 25.1) months follow-up. In 17 a-LQTs patients, one patient with dilated cardiomyopathy died suddenly and another patient with implanted cardioverter defibrillator experienced one ventricular tachycardia during (30.9 ± 13.3) months follow-up.

CONCLUSIONSThe prognosis in h-LQTs and a-LQTs patients with structure heart disease is poor. ICD or CRT-D therapy is suggestive for a-LQTs patients with structure heart disease.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Long QT Syndrome ; complications ; therapy ; Male ; Middle Aged ; Pacemaker, Artificial ; Torsades de Pointes ; complications ; therapy ; Treatment Outcome ; Young Adult

Objective To retrospectively analyze the postoperative morbidity of patients with complex intracranial aneurysms treated by stent-assisted coiling and investigate the causes and treatment strategy of postoperative morbidity. Methods 62 SAH patients with intracranial aneurysm were treated by stent-assisted coiling, 53 cases of single aneurysms, 9 cases of multi-aneurysms (8 cases of 2 aneurysms, 1 cases of 3 aneurysms), amount to 72 aneurysms, 71 aneurysms were treated by stent-assisted coiling. Results Completed embolization 53 cases were completed with embolization partial embolization (74.64％), Nearly all embolization 17 cases were nearly all embolization (23.94％), partial embolization and 1case was s (1.42％) . According to GOS, 52 patients with a score of GOS 5, 6 patients with a score of GOS 4, 3 patients with a score of GOS 3, 2 patients with a score of GOS 1. 58 (93.5％) patients survived favorably. 9 patients with complications (14.5％), 3 patients with acute thrombosis; 2 patients with rupture of aneurysms during surgery; 3 patients with cerebral angiospasm; There was no obvious abnormality during the surgery in 1 patient, and there was a focal ischemic change followed by a mild neurological deficiency. Conclusions Stent assisted coil embolization of intracranial ruptured aneurysm is safe, effective and feasible, but we should improve clinical skills, summarize the analysis in the clinical operation experience of clinical treatment so as to reduce complications. Timely and correct treatment is also very important when complications occur.

BACKGROUNDBecause of the potential proarrhythmic effect of current antiarrhythmic drugs, it is still desirable to find safer antiarrhythmic drugs worldwide. Paeoniflorin is one of the Chinese herb monomers that have different effects on many ion channels. The present study aimed to determine the effects of paeoniflorin on cardiac ion channels.

METHODSWhole-cell patch-clamp technique was used to record ion channel currents. L-type calcium current (I(Ca-L)), inward rectifier potassium current (I(K1)), and transient outward potassium current (I(to1)) were studied in rat ventricular myocytes and sodium current (I(Na)), slow delayed rectifier current (I(Ks)), and HERG current (I(Kr)) were investigated in transfected human embryonic kidney 293 cells.

RESULTSOne hundred µmol/L paeoniflorin reduced the peak I(Ca-L) by 40.29% at the test potential of +10 mV (from (-9.78 ± 0.52) pA/pF to (-5.84 ± 0.89) pA/pF, n = 5, P = 0.028). The steady-state activation curve was shifted to more positive potential in the presence of the drug. The half activation potentials were (-11.22 ± 0.27) mV vs. (-5.95 ± 0.84) mV (n = 5, P = 0.007), respectively. However, the steady-state inactivation and the time course of recovery from inactivation were not changed. One hundred µmol/L paeoniflorin completely inhibited the peak I(Na) and the effect was reversible. Moreover, paeoniflorin inhibited the I(K1) by 30.13% at the test potential of -100 mV (from -25.26 ± 8.21) pA/pF to (-17.65 ± 6.52) pA/pF, n = 6, P = 0.015) without effects on the reversal potential and the rectification property. By contrast, 100 µmol/L paeoniflorin had no effects on I(to1), I(Ks) or I(Kr) channels.

CONCLUSIONSThe study demonstrated that paeoniflorin blocked I(Ca-L), I(Na), and I(K1) without affecting I(to1), I(Ks), or I(Kr). The multi-channel block effect may account for its antiarrhythmic effects with less proarrhythmic potential.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Benzoates ; pharmacology ; Bridged-Ring Compounds ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Glucosides ; pharmacology ; Heart ; drug effects ; Humans ; In Vitro Techniques ; Ion Channels ; drug effects ; Male ; Monoterpenes ; Patch-Clamp Techniques ; Rats ; Rats, Sprague-Dawley