Objective To summarize the echocardiographic characteristics and clinical signiifcance of prenatal diagnosis of coronary artery ifstula (CAF). Methods Images and follow-up results of ifve fetuses with CAF diagnosed by fetal echocardiography between January, 2011 and December, 2012 in our department were reviewed. Results Echocardiographic characteristics of CAF were a dilated coronary artery in the four chamber view and the left ventricular outlfow tract view. Track the course of the dilated coronary artery can conifrm the oriifce of the ifstula. Among the ifve cases, the oriifce of the ifstula included the aortic root of left ventricular outlfow tract, right atrium side of interatrial septum, the entrance of superior vena cava to right atrium, right ventricular apex and right ventricle cone. The colour Doppler lfow imaging showed turbulence in the dilated coronary artery. The spectral Doppler with the sampling gate in coronary artery showed the characteristic bidirectional lfow pattern. One case was associated with other complex intracardiac abnormalities and one case with persistent left superior vena cava. Among the ifve cases of CAF diagnosed by fetal echocardiography, one case was missed and four cases were conifrmed by postnatal echocardiography. Conclusion Coronary artery ifstula has special fetal echocardiographic characteristics. The fetal echocardiography plays an important role in early detection, diagnosis and treatment of CAF.

Objective To investigate the role of hypoxia inducible factor-1α (HIF-1α) and von Hippel-Lindau (VHL) in murine endochondral ossification. Methods The knockout of HIF-1α or VHL gene in murine osteoblasts was accomplished by conditional knockout technique at 4th, 8th and 12th week, and the differences between wild-type group and knock-out group in endochondral ossification were detected by HE staining, micro-CT scanning, trabecular bone area measurement, calcium content measurement, tetracycline fluorescence labeling, Real-time PCR and Western blotting. Results After knockout of HIF-1α gene in osteoblasts, the expression of vascular endothelial growth factor ( VEGF) reduced, the rate of new bone formation stepped down, the content of calcium became less, and the trabecular bone volume decreased (P <0.05) . After knockout of VHL gene in osteoblasts, the expression of VEGF increased, the rate of new bone formation stepped up, the content of calcium became more, and the trabecular bone volume was promoted (P < 0.001). Conclusion During murine endochondral ossification, VHL/HIF-1α signal pathway promotes angiogenesis through the stimulation of VEGF expression, which subsequently accelerates osteogenesis.

Iridoid glycosides were the main active ingredient of Rehmannia glutinosa, of which catalpol has the highest content. This work will provide theoretical basis for metabolic study and cultivation of iridoids on the basis of the dynamic accumulation of catalpol and total iridoids in the growth of R. glutinosa. The samples of rehmannia 85-5 were gathered in the same filed from July to October. The contents of catalpol and total iridoid glycosides were measured by HPLC and specteophotometric, respectively. The results showed that youngest leaves had the higher content of catalpol and total iridoid glyosides than that of the other two leaf ages in the same growth stage from July to September, while their content of catalpol and total iridoid glycosides were all decreased as the growth of leaves of R. glutinosa. The content of catalpol didn't differ significantly from July to September, whereas it has significantly increased in October in the three leaf stage. In the same stage, the wider the root diameter is, the higher content of the effective components are. In August and September, the total iridoid glycosides have the fastest accumulation. The content of catalpol was increased as the accumulation of total iridoid glycosides.
Iridoid Glucosides ; metabolism ; Iridoids ; metabolism ; Plant Roots ; metabolism ; Rehmannia ; growth & development ; metabolism ; Seasons ; Water ; metabolism

Objective To explore the expression and regulatory mechanism of hypoxia inducible factor-1?(HIF-1?)during fracture healing. Methods Mouse models of tibia fracture healing were established,and callus samples were collected 1,3,7,14,21 and 28 days after fracture.The development of callus and new bone formation were evaluated with roentgenology,Micro-CT and tetracycline double labeling method,and the expression of HIF-1?,vascular endothelial growth factor(VEGF),Runx2 and ALP in callus were detected with RT-PCR,Western blotting and immunohistochemistry.The relationship between HIF-1? and fracture healing was analysed. Results The expression of HIF-1? was detected in cells in the fracture sites as well as in evolved osteoblasts,chondrocytes and osteocytes in early callus under hypoxia.The highest expression rate of HIF-1? achieved on the 7th day after fracture,lasted for about 7 days,then decreased gradually,and returned to intact level on the 28th day after fracture.The expression tendency of VEGF resembled that of HIF-1?.Bone formation activity was more active in early callus,and the callus volume peaked on the 14th day after fracture and decreased gradually.The mineralization of callus mainly took place in the late healing period(14th to 28th day after fracture).Conclusion Cells involved in fracture healing are hypoxia-responsive cells,which express HIF-1?.HIF-1? can regulate cell state and function,and can promote angiogenesis so as to play a crucial role in fracture healing.

Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.

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Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of total anomalous pulmonary venous connection (TAPVC). Methods Fetal echocardiographic images of 13 fetuses with TAPVC conifrmed by pathology or postnatal echocardiography were reviewed. Echocardiographic features and clinical signiifcance of prenatal diagnosis of TAPVC were summarized. Results Twelve fetuses with TAPVC were diagnosed prenatally by fetal echocardiography, including seven cases of supracardiac type, three cases of infracardiac type and two cases of intracardiac type. The common echocardiographic characteristics of 12 fetuses with TAPVC included slightly size discrepancy of left heart and right heart, large foramen ovale with increased shunting at the atrial level, increased distance between left atrium (LA) and descending aorta, absent insertions of pulmonary veins in the LA, presence of pulmonary venous conlfuence on the top of LA and dilatation of vessels where pulmonary venous conlfuence drained. One case was missed prenatally and intracardiac type TAPVC was diagnosed by postnatal echocardiography. Among the 13 cases, three were isolated and the other ten were all in association with other abnormalities. Conclusions There are fetal echocardiographic characteristics of TAPVC. Fetal echocardiography plays an important role in prenatal diagnosis of TAPVC.

Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of fetal double aortic arch (DAA). Methods Totally 21 596 fetuses underwent fetal echocardiography in Nanjing Medical University Afifliated Suzhou Hospital and ifve cases were diagnosed as DAA by echocardiography. Echocardiographic characteristics, types and outcomes of these ifve cases were summarized retrospectively. Results Five fetal cases were diagnosed as DAA by fetal echocardiography. 1. Prenatal echocardiographic features:In three-vessel and trachea view, the normal“V”-shaped conlfuence formed by the aortic arch and ductal arch was absent. However, the ascending aorta bifurcated into the left and right aortic arch and these two arches encircled the trachea. Annular lfow signal around trachea was seen on color Doppler imaging. 2. Types:Among these ifve fetuses, three cases were called right arch predominant type, whose diameters of right arches were larger than those of left arches. The other two were balanced type, whose diameters of right arches were almost equal to those of left arches. 3. Accompanied malformations:Case 2 was accompanied with membranous ventricular septal defect and permanent left superior vena cava. Case 4 was associated by hemivertebrae. The other three cases had no other abnormalities. 4. Follow-up:These five cases were all arranged for MRI subsequently and all were confirmed by follow-up till to the induction of labor or three months after birth. Conclusions Double aortic arch is a kind of severe congenital heart disease. Echocardiography is the ifrst choice to diagnose DAA prenatally and three-vessel and trachea view are the effective cross sections in the diagnosis of double aortic arch.

Taking the First Hospital Affiliated to Traditional Chinese Medicine University of Guangzhou as an example,the paper puts forward to establish the hospital's intelligent Short Message Service (SMS) follow-up visit system based on the analysis of research conditions and existing problems of domestic and overseas follow-up visit system,introduces the follow-up visit registration process and functional modules,and summarizes the application efficiency.This system can greatly improve the follow-up visit efficiency,reduce the rate of loss to follow-up visit,and immediately update information of patients.

Objective To systematically evaluate the study of animal surgery course among medical students with different majors and languages so as to provide evidences for further improve-ment education quality. Methods Ten majors and two kinds of international medical students (in total of 1 105 students;2009 grade)of Southern Medical University were subdivided into five groups ac-cording to the relationship with clinical operative manipulation. Quality of experimental animal surgery education was tested respectively. Then SPSS 13.0 was used to statistically evaluate and analyze the data. Measurement data between two groups were compared by t-test,multi-group analysis of variance between groups was conducted using one-way ANOVA. Ranked data between groups were compared using non-parametric Mann-Whitney U rank sum test. Merits and demerits of the curriculum were dis-cussed by combing statistical results with in-class condition to provide evidences for further improve-ment. Results There was no significant difference between clinical group and clinical professional group in aseptic technique and operation skills (P=0.739),but scores of the two groups were signifi-cant higher than that of associate group (P=0.004). Moreover,scores of international students who passed Chinese TOEFL were significant higher than the others (P=0.001). Differences between groups existed predominantly in the animal surgical practice rather than in basic theory or knot and sterilized methods. Conclusions For students with different majors and languages,different teaching key points should be paid attention to. Basic surgery techniques might be emphasized on for students with associ-ate clinical major and foreign students with poor Chinese language.