Objective To explore the clinical value of prospective electrocardiography-triggering high-pitch spiral acquisition by dual-source CT (HP mode ) in children with congenital heart diseases (CHD).MethodsThirty-six patients ( mean age:0.67 years,range:1 month to 2 years and 6 months; 25 males;mean weight:7.7 kg)underwent prospective ECG-triggering high-pitch spiral acquisition.The dose length product (DLP) was recorded to calculate effective dose ( ED ).Two experienced radiologists made diagnosis and assessed the overall image quality by a five-point scale independently.The consistency of their judgment was determined by Kappa statistics.Surgeries were performed in 29 patients,and conventional cardiac angiography(CCA) was performed in 7 patients.The accuracy,sensitivity and specificity of HP mode were calculated based on the surgical or CCA findings.ResultsThe DLP was (5.12 ± 1.64) mGy.cm with a range of 2.4 mGy · cm to 9.2 mGy · cm and ED was (0.125 ± 0.027 ) mSv ranging from 0.078 mSv to 0.179 mSv.The average subjective image quality score was 4.2 ± 0.7.All images were diagnosable.Two radiologists made good agreement ( K =0.774,P ＜ 0.05 ).The accuracy,sensitivity and specificity of HP mode were 98.9％,94.2％ and 99.8％,respectively.ConclusionLow radiation dose with the accurate diagnosis of anomalies makes HP mode a new choice for children with CHD.

AIM To establish the quality standard for Tibeten medicine Ershiwuwei Feibing Pills [Inula racemosa Hook.f.,Swertia bimaculata (Sieb.et Zucc.) Hook.Thors.ex Clarke,Phyllanthus emblica Linn.,Terminalia billerica (Gaertn.) Roxb.,etc.].METHODS TLC was applied to the qualitative identification of L racemosa,S.bimaculata,P.emblica and T.billerica,and HPLC was adopted in the quantitative determination of alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A.RESULTS The TLC spots were clear without negative interference.Alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A showed good linear relationships within the ranges of 4.324-216.2 μg/mL (r =0.999 9),32.222-1 611.1 μg/mL (r =0.999 9),4.072-203.6 μg/mL (r =0.999 9) and 4.266-213.3 μg/mL (r =0.999 9),whose average recoveries (RSDs) were 100.6％ (0.93％),100.3％ (2.1％),101.5％ (3.0％) and 100.1％ (1.8％),respectively.CONCLUSION This simple method can be used for the rapid quality control of Ershiwuwei Feibing Pills.

Objective To investigate the waveform of the first-order kernel and second-order kernel of muhifocal electroretinogram stimulated with light emitting diode(LED).Design Prospective,noncomparative,interventional case series.Participant 18 subjects(18 eyes)who had been accepted the mfERG test.Method The patients were devided into two groups,they accepted the muhifocal elec- troretinogram(mfERG)stimulated with cathode ray tube(CRT)and LED using the Roland RETI Scan3.15 system.The first-order kernel or the second-order kernel was analyzed.The stimulation time of LED were changed from 1.7ms to 16.7ms.Five different stimulation time of LED in this study were 1/10(1.7ms),3/10(5ms),5/10(8.3ms),7/10(ll.7ms)and 10/10(16.7ms).Main Outcome Measure The summed responses were observed.The waveform,amplitude and implicit times of mfERG summed response were analyzed.Result The waveforms of the first-order kernel stimulated by LED were similar to those of CRT.In the second-order kernels of mfERG,the wave- forms were obviously different from those stimulated by LED and CRT.The P1 wave stimulated by CRT was sharp,but the P1 wave of LED was broad.The N2 wave of LED was deeper.The amplitude of N1 wave and P1 wave were increased,and their implicit times pro- longed with the stimulation times prolonging.Conclusion In the first-order kernel of mfERG,the waveform of the summed response stimulated by LED was similar to that of LED.In the second-order kernel of mfERG,the waveform stimulated by LED was more com- plicated,may be there were more inner retina information.(Ophthalmol CHN,2006,15:351-355)

OBJECTIVETo investigate the value of Qingyi Decoction (QYD) and Glauber's salt (GS) for treatment of severe acute pancreatitis (SAP).

METHODSSixty-five patients with SAP were randomly assigned to two groups, the treated group (33 patients) and the control group (32 patients). They received the same therapy except that to the patients in the treated group, QYD was given through naso-gastric tube and GS was applied externally.

RESULTSCompared with those in the control group, the alleviating time of clinical symptoms, such as abdominal pain and distention, time of hospitalization and time of blood amylase recovery in the treated group were shorter, with lesser complications and lower rate of transferring to operation (all with P < 0.05), showing a better efficacy in all aspects, but the mortality in the two groups was not different (P > 0.05).

CONCLUSIONCombined use of QYD and GS has significant therapeutic effect for treatment of SAP.

Adult ; Aged ; Double-Blind Method ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis, Acute Necrotizing ; drug therapy ; Phytotherapy ; Prospective Studies ; Sulfates ; therapeutic use ; Treatment Outcome

The purpose of this study was to observe the ultrastructure of human umbilical cord mesenchymal stem cells (hUCMSC). hUCMSC from full-term newborn umbilical cord were isolated and cultured by collagenase digestion, and then subcultured, amplification, and cell morphology was observed by microscopy. The immunophenotype and trilineage differentiation potential of hUCMSCs at passage 3 were analyzed. Transmission electron microscopy and scanning electron microscopy were used to observe the ultrastructure of hUCMSC. The results indicated that appearance of hUCMSC was spindle-shaped and polygonal, and nuclei were observed. hUCMSC expressed immunophenotype CD44, CD73, CD105, did not express CD34, CD45, CD31 and human leukocyte antigen HLA-DR. hUCMSC were capable of adipogenic, osteogenic, and cartilage differentiation; the short and thick microvilli processes were seen at the surface of hUCMSC by scanning electron microscope. Two different cell morphologies of hUCMSC were seen under transmission electron microscope, the one was a quiescent period in which a large and round or oval nucleus only one nucleolus were seen, cytoplasmic organelles were less; the other was in a relatively active period in which one or two nuclei in the same one cell were observed, the organelles were rich, structure was clear, expansion of the mitochondria was visible. It is concluded that the cells successfully isolated and cultured from umbilical cord, which possess biological characteristics of MSC and display two different states of ultrastructure.
Cells, Cultured ; Humans ; Mesenchymal Stromal Cells ; cytology ; ultrastructure ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Umbilical Cord ; cytology

Objective To investigate the different memory outcomes in temporal lobe epilepsy patients underwent different surgical approaches.Methods Two hundred forty-eight patients with temporal lobe epilepsy and hippocampal scle-rosis underwent standard anterior temporal lobectomy ( ATL, n=83 ) or selective amygdalohippocampectomy ( SAH, n=165) from 2009 to 2013.All the patients underwent clinical memory function assessment before surgery, 3 months and 2 years after surgery respectively.Results The memory quotient ( MQ) of patients who underwent brain surgery in the domi-nant hemisphere significantly decreased 3 months after surgery (74.5 ±16.2, 75.6 ±19.5) compared to presurgery MQ (82.9 ±15.8, 83.2 ±21.2) in both ATL and SAH groups (P<0.05).Although MQ was slightly recovered at 2 years af-ter surgery, MQ (75.1 ±14.1, 76.1 ±17.6) was still significantly lower compared with presurgery MQ (P<0.05).A-mong this, both the decrease extent of the MQ 3 months after surgery and 2 years after surgery were smaller in the SAH group than in the ATL group (7.6 vs.8.4;7.1 vs.7.8).The MQ of patients who underwent brain surgery in the non-dominant hemisphere (either ATL or SAH ) increased slightly 3 months after surgery (87.2 ±15.1, 88.1 ±16.9) com-pared to presurgery MQ (85.5 ±13.5, 85.3 ±19.7) although the difference was not statistically significant.The MQ of these two groups improved significantly 2 years after surgery (92.8 ±12.7, 93.7 ±17.1)(P<0.05).The improvement extent of the MQ was larger in the SAH group than in the ATL group (8.4 vs.7.3).Conclusions SAH may be better than ATL in the maintenance of memory function in patients with temporal lobe epilepsy and hippocampal sclerosis.

Objective: To make long-term comparison of drug-eluting stent (DES) implantation betweenleft internal mammary artery (LIMA) graft and native vessel in patients with previous coronary artery bypass grafting (CABG).
Methods: A total of 151 patients with anterior wall ischemia because of previous CABG induced LIMA graft lesion who received percutaneous coronary intervention (PCI) in our hospital from 2004-07 to 2012-12 were retrospectively studied. The clinical, coronaryangiography (CAG) and follow-up conditions for DES implantation were analyzed;according to the target vessel, the patients were divided into 2 groups:LIMA group, n=40 and Native vessel (NV) group, which meant all segments of left main to left anterior descending arteries, n=111. Primary end points included target lesion revascularization (TLR), target lesion failure (TLF) as cardiac death, target vessel related non-fatal MI with the composition of TLR and major adverse cardiovascular events (MACE).
Results:The median follow-up time was 30 (10-100) months. The rates of TLR and TLF were similar between 2 groups:(15.0%vs 11.7%, log-rank P=0.65) and (17.5%vs 13.5%, log-rank P=0.63). MACE occurrence in LIMA group was higher than NV group (35.0%vs 18.0%, log-rank P=0.043) which was mainly presented by new non-target vessel revascularization as right coronary artery, left circumlfex and saphenous vein graft(17.5%vs 4.5%, log-rank P=0.014). Cox multivariate analysis indicated that target lesion stent length was the only independent predictor for both TLR (HR=1.03, 95%CI1.00-1.06, P=0.01) and TLF (HR=1.03, 95%CI1.00-1.05, P=0.02);whereas, LIMA-PCI was the only independent predictor for MACE occurrence (HR=3.09, 95%CI1.28-7.60, P=0.012).
Conclusion: The chances of TLR and TLF were similar inpatients with previous CABG by either LIMA or NV, while MACE occurrence was higher in LIMA patients which should be further investigated.

BACKGROUNDNon-invasive nasopharyngeal carcinoma (NPC) screening usually involves serological testing for the presence of IgA antibodies to Epstein-Barr virus (EBV) capsid antigen (VCA). The present meta-analysis determined the accuracy of VCA-IgA in the diagnosis of NPC.

METHODSA systematic review of studies was conducted and data on the accuracy of VCA-IgA concentrations in the diagnosis of NPC were pooled using random effects models. Receiver operating characteristic curves were used to summarize the overall test performance.

RESULTSTwenty studies met the inclusion criteria for the meta-analysis. The summary estimates for VCA-IgA in the diagnosis of NPC were: sensitivity 0.91 (95% confidence interval (CI): 0.90 - 0.92), specificity 0.92 (95%CI: 0.92 - 0.93), positive likelihood ratio 31.65 (95%CI: 10.99 - 91.15), negative likelihood ratio 0.10 (95%CI: 0.07 - 0.13) and diagnostic odds ratio 414.59 (95%CI: 174.96 - 982.42). The area under the summary receiver operating characteristic curves was 0.98.

CONCLUSIONThe sensitivity and the specificity of serum VCA-IgA are very high, suggesting that the presence of VCA-IgA in peripheral blood is a valuable predictor for NPC.

Antigens, Viral ; immunology ; Capsid Proteins ; immunology ; Carcinoma ; diagnosis ; immunology ; Humans ; Immunoglobulin A ; immunology ; Nasopharyngeal Neoplasms ; diagnosis ; immunology

This study was aimed to investigate the curative effect and safety of human umbilical cord mesenchymal stem cells (hUCMSC) to treat acute graft-versus-host disease (aGVHD) of children after hematopoietic stem cell transplantation (HSCT). HUCMSC were isolated and cultured by collagenase digestion and passage culture. The 3rd to the 5th passage of hUCMSC were used for clinical treatment. Five cases of children acute leukemia achieved complete remission after chemotherapy. Two cases received HLA 3/6 loci matched haploidentical bone marrow HSCT. One case received HLA-matched sibling bone marrow and peripheral blood HSCT. One case received unrelated HLA 4/6 loci matched umbilical cord blood HSCT. One case received unrelated HLA 5/6 loci matched umbilical cord blood HSCT. The children received immunosuppressive therapy after III-IV aGVHD occurring. They received 0.5×10(6)/kg hUCMSC infusion when conventional therapy was ineffective. The results showed that 5 cases of children acute leukemia achieved hematopoietic reconstitution and developed the III-IV grade aGVHD. The five cases of children were infused with hUCMSC. The rash subsided, the liver function was normalized and the gastrointestinal symptoms were improved. The infusion-related adverse reaction did not happen. At present, the 5 children are in remission. It is concluded that allogeneic HSCT is an effective therapeutic method for children with acute leukemia. HUCMSC infusion can be safely and effectively used for the treatment of refractory aGVHD.
Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation ; Female ; Graft vs Host Disease ; therapy ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Treatment Outcome

The roots of Glycyrrhiza uralensis are widely used in Chinese medicine for their action of clearing heat, detoxicating, relieving cough, dispelling sputum and tonifying spleen and stomach. The reason why Glycyrrhiza uralensis has potent and significant actions is that it contains various active secondary metabolites, especially glycyrrhizic acid. In the present study, we cloned the cDNA coding 3-hydroxy-3-methylglutary CoA reductase (HMGR) involved in glycyrrhizic acid biosynthesis in Glycyrrhiza uralensis. The corresponding cDNA was expressed in Escherichia coli as fusion proteins. Recombinant HMGR exhibited catalysis activity in reduction of HMG-CoA to mevalonic acid (MVA) just as HMGR isolated from other species. Because HMGR gene is very important in the biosynthesis of glycyrrhizic acid in Glycyrrhiza uralensis, this work is significant for further studies concerned with strengthening the efficacy of Glycyrrhiza uralensis by means of increasing glycyrrhizic acid content and exploring the biosynthesis of glycyrrhizic acid in vitro.
Amino Acid Sequence ; Cloning, Molecular ; DNA, Complementary ; genetics ; Escherichia coli ; genetics ; metabolism ; Glycyrrhiza uralensis ; enzymology ; genetics ; Glycyrrhizic Acid ; metabolism ; Hydroxymethylglutaryl CoA Reductases ; genetics ; metabolism ; Mevalonic Acid ; metabolism ; Phylogeny ; Plant Roots ; enzymology ; Plants, Medicinal ; enzymology ; genetics ; Recombinant Proteins ; genetics ; metabolism