Objective To evaluate the clinical value of three-dimensional contrast-enhanced MR angiography (3D CE-MRA) in the diagnosis and treatment of aortic coarctation. Methods Twenty-one patients with aortic coarctation underwent 3D CE-MRA with a 3D FLASH sequence after injection of 0.2 mmol Gd-DTPA per kg b. w. The source images were subtracted and transferred to computer workstation subsequently post-procession. In six patients, cardioangiography was performed simultaneously. The diagnoses of all patients of them were proven by surgery. Results There were 6 cases (28.6%) of simple type of aortic coarctation and 15 (71.4%) accompanied other cardiovascular abnormalities. 3D CE-MRA could directly demonstrate the stenotic location, degree, extent and extracardiac vascular abnormalities, which accorded with surgical findings. The depiction of the entirety and collateral vessel formation was very helpful for surgery. It can be easier for pre- and post- operative evaluation. Conclusion 3D CE-MRA is a noninvasive and accurate technique in the diagnosis of aortic coarctation. It could replace the cardioangiography for extracardiac vascular abnormalities, and may be one of the first choice examinations.

[Objective]A prospective comparative evaluation of fulcrum bending radiographs(fulcrum)to determine curve flexibility and predict surgical correction in adolescent idiopathic scoliosis(AIS).[Method]A total of 64 consecutive patients with AlS according to inclusion and exclusion criterias who underwent surgical treatment were studied.All curve types were single-curve and the PUMC classification were Ia/Ib/Ic.All patients were divided into 4 groups according to the magnitude of Cobbs angle in preoperative standing anteroposterior radiograph:moderate thoracic curve(20 cases,40?60?),moderate lumbar curve(21cases,35?60?).The Cobbs angles were measured and the flexibility ratio was determined on fulcrum radiograph.The amount of correction obtained by fulcrum radiograph was compared with the amount of surgical correction by evaluating the differences from surgery as absolute values.The correlation of Cobbs angles between postoperative standing anteroposterior radiograph and fulcrum radiograph were analyzed.[Result]For the moderate thoracic curves,curve flexibility provided by fulcrum radiograph has no significant difference(P=0.141)from surgical curve correction,there was no significant difference(P=0.094)between the mean Cobbs angle on fulcrum bending and that on postoperative standing anteroposterior radiograph.The postoperative Cobbs angle was positively correlated with the preoperative Cobbs angle on fulcrum radiograph and the correlation degree in the moderate lumbar curve was relatively weak.[Conclusion]Fulcrum radiograph can only be used to assess the flexibility and correction of moderate thoracic curves in AIS.Pedicle screw instrumentation provides even more correction.

Adult ; Atrioventricular Block ; complications ; Cardiomyopathies ; complications ; diagnosis ; Humans ; Male ; Sarcoidosis ; complications ; diagnosis

Objective To observe the effects of electro-acupuncture on the expression and inhibition of DNA binding protein 2 (Id2) and myelin basic protein (MBP),and to explore the mechanism of remyelinization after compressive spinal cord injury (CSCI) in rats.Methods Fifty-four SD rats were randomly divided into a control group and a treatment group,and each was further subdivided into 3 time point subgroups:3,7 and 14 days.There were 9 rats in each subgroup.The CSCI models were made with a self-designed method.The acupuncture points Jiaji (EX-B2),bilateral Zusanli (ST36) and Taixi (KI3) were selected for treatment.Electro-acupuncture (continuous wave,2 Hz,1.5 V)was applied to the bilateral Zusanli (ST36) and Taixi (KI3) points.The control group received the injury but no treatment.The changes in the ultrastucture of the nerve fibers＇ white matter were de-termined by transmission electron microscopy (TEM).The alterations in the expression of MBP and Id2 were observed by double labeled immunofluorescence and Western blotting on the 3rd,7th and 14th day after the injury.Results TEM showed that the myelin sheaths in the control group had degenerated,swollen,and even broken down after CSCI.Changes to the myelin sheaths in the treatment group were milder than those in the control group.The immunofluorescence results showed the amount of Id2-immunoreactive oligodendrocytes in the control group to be (20 ±2) on the 3rd day after CSCI,becoming (16 ± 1) on the 14th day.The differences among the 3 control subgroups were not statistically significant.The amount of Id2-immunoreactive oligodendrocytes in the treatment group was (13 ± 1) on the 3rd day,reaching a minimum the 14th day.The differences among the 3 treatment groups were statistically significant.The differences compared with the control group at the same time points were also statistically significant.Western blotting showed that the expression of Id2 in the contrast and treatment groups was (1.12 ±0.12) and (0.67 ±0.01) respectively on the 3rd day after CSCI,and both decreased with time.The expression of Id2 in both groups reached their minima ((0.86 ±0.02) and (0.25 ±0.01) respectively) on the 14th day.The difference between the treatment groups and the contrast group was statistically significant at each time point.The expression of MBP in the contrast and treatment groups at day 3 was (0.44 ± 0.02) and (0.67 ± 0.04) respectively,and these increased with time.The expression of MBP in both groups peaked at the 14th day (at (0.95 ± 0.04) and (1.74 ± 0.09) respectively).These differences were again statistically significant.Conclusion Electro-acupuncture can regulate the expression of Id2 and MBP after CSCI.The down-regulation of Id2 which controls MBP negatively and the up-regulation of MBP may contribute to remyelination in the injured spinal cord.

0.05).(2) Compared with NC group,there was a significant decrease in GG fatigue resistance in CIH group(P

AIM: To compare the effectiveness on 10g/L cyclopentolate and 10g/L atropine on cycloplegia in children before optometry.
METHODS:Eighty eyes of 40 children among 4-12 years old with refractive error were recruited in this study. 10g/L cyclopentolate eye drops were topically administered once per 5min for 3 times and optometry was performed after 45min. Three days after that, 10g/L atropine sulfate eye gel then was used 3 times per day for consecutive 3d and again the refractive diopter was obtained at the 4th d. The differences of the results in retinoscopy refraction were compared between 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel.
RESULTS: Therefraction results of those given 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel were no statistical different in both 4-8 years group and 9-12 years group with myopia (≤-3. 00D) (P=0. 411, 0. 924). The differences of refraction results of both the drugs were significant in 4 - 8 years group with low hypermetropia, medium hypermetropia and high hypermetropia (P=0. 007, 0. 007, 0. 009). No significant difference was found in 9 - 12 years group with low hypermetropia (P= 0. 592), given 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel, but the differences of refraction results of both the ophthalmic preparations above were significant in 9-12 years group with medium and high hypermetropia (P=0. 039, 0. 012).
CONCLUSION:Both 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel have the cycloplegic effects, but their cycloplegic effects are significant different among hypermetropia children. Thus, the reasonable cycloplegic should be chosen according to the specific situation.

Objective To describe an improved percutaneous tracheostomy combined with conventional tracheostomy technique with result of less trauma and fewer complications, and to explore its application in the patients for whom conventional tracheostomy is difficult to perform.Methods A prospective study was conducted.Fifty-seven hospitalized patients, in whom ordinal tracheostomy was difficult to perform, and admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Bengbu Medical College from January 2013 to December 2014 were enrolled.According to the random digital table method, the patients were divided into small incision combined with percutaneous tracheostomy group (small puncture incision group, n =25) and conventional tracheostomy group (n =32).Amount of blood loss, postoperative bleeding, incision size, operation time and wound healing time were compared between the groups.Results Compared with traditional surgical tracheostomy group, the blood loss and postoperative bleeding were decreased [blood loss (mL): 11.36 ± 4.25 vs.23.72 ± 7.29, t =-7.201, P =0.000;postoperative bleeding (mL):11.60 ± 6.57 vs.26.77 ± 10.77, t =-5.834, P =0.000], incision size was smaller (cm: 2.20 ±0.63 vs.4.06 ± 1.19,t =-6.806, P =0.000), and operation time and wound healing time were shortened [operative time (minutes): 18.16 ±3.61 vs.29.09±6.77, t =-7.001, P =0.000;incision healing time (days): 4.96± 1.59 vs.7.19±2.35, t =-3.975,P =0.000] in small puncture incision group.Conclusion Compared with the traditional method, small incision puncture tracheostomy is less time consuming, with fewer traumas, and fewer intraoperative and postoperative complications.

Objective:To establish a glioma cell line U251 stably expressing programmed cell death 4(PDCD4)gene,and to observe the influence of exogenous PDCD4 gene on the proliferation and cell cycle of U251 cells.Methods:Recombinant eukaryotic expression vector pEGFP-PDCD4 was transfected into human glioma cell line U251 by Lipofectamine 2000,and the U251 cells stably expressing PDCD4 were established by G418 selection.Reverse transcription polymerase chain reaction(RT-PCR)and Western blotting were employed to detect the expression of PDCD4 mRNA and protein.Furthermore,cell proliferation and colony forming ability were determined by cell counting and colony formation assay;the cell cycle was detected by FACS.Results:High expression of PDCD4 mRNA and protein was observed in U251 cells transfected with pEGFP-PDCD4,whereas no PDCD4 mRNA and protein expression was detected in the non-transfected and vector-transfected cells.Further,cells transfected with pEGFP-PDCD4 grew more slowly and had lower colony formation rate than cells of the other two control groups(P

Objective To detect K-ras mutations in plasma by a nano capture probe system , and to explore the diagnostic and prognostic value of this method for patients with pancreatic cancer .Methods The clinical data of 62 patients with pancreatic cancer , 38 patients with benign pancreatic diseases and 31 healthy controls admitted in the Second Affiliated Hospital of Jiaxing Medical College from June 2013 to June 2015 were collected.The diagnosis of all the patients were confirmed by pathology .The DNA were extracted from all plasma samples and were detected for the codon 12 and 13 mutation of K-ras gene by nano capture probe and conventional PCR plus direct sequencing .The correlation of K-ras gene mutation with certain clinical data and the diagnostic and prognostic value in pancreatic cancer were analyzed .Results The K-ras mutation were detected by nano capture probe in 27 pancreatic cancer patients , and the mutation rate was 43.5%(27/62), including 25 cases with codon 12 mutation and 2 cases with codon 13 mutation .The K-ras mutation rate in patients with benign pancreatic diseases was 7.9%(3/38), which were all in codon 12.K-ras mutation was detected in only 17 pancreatic cancer patients by conventional PCR plus direct sequencing , and the mutation rate was 27.4%(17/62), The K-ras mutation rate of benign pancreatic diseases was 5.3%(2/38).The mutation rate detected by nano capture probe was higher than that by conventional PCR , and the difference was statistically significant (P=0.006).K-ras mutation in the plasma of patients with pancreatic cancer was related to TMN stage and liver metastasis , but there was no correlation of the factors such as sex , age, clinical symptoms, tumor size, serum CA19-9 and CEA levels with K-ras mutation.The sensitivity of K-ras gene mutation for diagnosing pancreatic cancer was 43.5%, the specificity was 92.1%, the positive predictive value was 90%, the negative predictive value was 50%, Youden index was 0.356.The 1-year survival rate of patients with K-ras mutation was 44.4%, which was lower than that (71.4%) of patients with wild-type K-ras, and the difference was statistically significant (P<0.05).Conclusions The nano capture probe system could certainly detect K-ras mutation in a small quantity of plasma DNA , and its diagnosis sensitivity for pancreatic cancer is low , but the specificity is relatively high .K-ras mutation in plasma is closely related to the TMN stage and prognosis of pancreatic cancer .

Objective To develop the scale of volume-management for peritoneal dialysis(PD) patients.Methods The item pool was formulated based on literature review and in-depth interviews.An initial scale was constructed through two rounds of Delphi expert consultation and preliminary test.Totally 125 PD patients from Jiangsu-Zhejiang-Shanghai area were investigated to test the reliability and validity of the scale.Results 2 factors were extracted by exploratory factor analysis,which contained 8 items and could explain 66.07％ of the total variance.The content validity index was 1.0,the Cronbach α was 0.870,and test-retest reliability was 0.930.Conclusions The scale is proved to be a reliable and valid tool for the volume-management assessment of PD patients.