Objective To investigate immunological effects of PAMHG injection in rabbits. Methods PAMHG was injected subcutaneously into bodies of the rabbits. In different periods after the injection, subgroups of T cell, activities of NK cells and expressive levels of IL 2 and SIL 2R were determined and compared with those measured before the injection. Results The levels of CD3 + and CD4 + T cells before injection were (17.8?5.9)% and (9.6?3.5 )%, and began to increase and till the third month after the injection, and the levels significantly increased to( 24.3?5.6) % and (15.8? 4.7) % ( P

In four patients with chronic pancreatitis from two hereditary pancreatitis (HP) families and 63 normal controls, five exons of cationic trypsinogen gene (PRSS1) were amplified by PCR and it's products were analyzed by sequencing, related clinical data were also collected. All the four patients were found mutations in the PRSS1 gene but their clinical feature is absolutely different. Six patients with diabetes mellitus were found in pedigree No. 1, it's members show pancreatitis symptom later, at about 29, the tumor markers (CA19-9, CA72-4) is obviously higher than the patients in pedigree No. 2, two patients with chronic pancreatitis in pedigree No. 2, show symptom earlier without diabetes mellitus, their clinical characterization are different too. The number of CD4+T cell/CD8+T is very low in Ⅲ 8, but Ⅲ 7 is normal, and the level of anti-HBs of Ⅲ 8 is variable in the course of pancreatitis, but the phenomenon was not found in Ⅲ 7. In their PRSS1 gene two guanosine (G) to adenosine (A) mutations were found in PRSS1 exon 3 of pedigree No. 1, one was detected at 336 basyl, the other mutation occurs at 361 basyl. The results of the mutations were Lys →Lys and Ala →Thr. While thymine (T) to adenosine (A) and (guanosine) G→(adenosine) A mutation in PRSS1 exon 3 was detected in the other patient of pedigree No. 2 (Ⅲ 8). One was 361 basyl, the other at 415 basyl. While c.415 T→A was not found in the proband of pedigree No. 2 PRSS1 gene (Ⅲ 7). All of the mutations were heterozygous mutation, that is to say all of the trypsinogen were wild type and mutant type concomitance, the normal and abnormal pathway of active trypsinogen exist partially. At the same time, the mutations of SPINK1 were not observed. Compared with the documents and registration of NCBI, it can be concluded that PRSS1 gene had many kinds of mutations in hereditary pancreatitis, the heterozygous mutations (c.336 G→A, c.415 T→A) were the novel mutations and related with clinical phenotype. What's more, it's the first time that the multisite heterozygous mutations of PRSS1 gene were reported. The presence of the mutations in four patients with chronic pancreatitis, it's absence in their relatives and the strong evolutionary conservation of the mutation, all indicate that the trypsinogen mutation is associated with hereditary pancreatitis and for the first time raises the question whether a gain or a loss of trypsin function participates in the onset of Chinese pancreatitis.

Objective To develop a real time amplification refractory system(RT-ARMS-qPCR) quantitative PCR method with SYBR Green I to assess the mtDNA A1555G mutation. Methods A specific fragment flanking mtDNA 1555 site was amplified with PCR and ligated into a pGEM Easy T vector. Serial dilutions of the plasmid DNA were quantified the actual copy numbers were assessed using RF-ARMS-qPCR with SYBR Green I. RF-ARMS-qPCR was established with mismatched base pairs at 3' in the primer todetect the copy number of mtDNA containing wild or mutant mtDNA. The specificity of amplified products was checked by melting curve analysis. Results The intra- and interassay variation was 1.34% and 1.96%, respectively when the assay was used to detect 1 copy/ul recombinant template of plasmid. Thequantitative standard curve showed that the assay had good linear correlation from 102 copies/ul to108 copies/ul. This assay could be served for the quantification of other samples. There was significantcorrelation between frequency of mutant mtDNA and phenotype (r=0.771, P = 0.003) in hearing lossgroup. Conclusions The established assay can be used to detect quantitatively mtDNA A1555G mutation byRF-ARMS-qPCR. This assay is specific, stable and accurate. There is significant correlation betweenquantification of mtDNA AI555G and the severity of hearing loss.

Objective To determine the usefulness of real time three-dimensional transesophageal echocardiography(RT-3D TEE) in the preoperative assessment of mitral valve (MV) pathology by comparing images with surgical findings and to evaluate the function of MV postoperatively. Methods Nineteen consecutive adult patients with established diagnosis of mitral regurgitation(MR) scheduled for surgical correction were enrolled. Intraoperative 2D and 3D transesophageal echocardiography(TEE) were performed. All the 3D images were compared with findings obtained from direct surgical inspection. Postoperative RT-3D TEE was performed immediately to evaluate outcomes of mitral annuloplasty. Results Superb 3D-TEE en face views of the MV were obtained in all patients. Correct diagnoses of MV pathology in agreement with the surgical findings were made in 16 of 19 patients (84. 2%), however in the remaining 3 patients, the diagnoses were incorrect despite good image quality. In one, RT-3D TEE diagnosed prolapse of A2 segment and P2 scallop,which was not confirmed at surgery, but MV degeneration and annular dilatation were observed. In another one, RT-3D TEE revealed prolapse of P3 scallop, while at surgery prolapse involved P2 and P3 with ruptured chordae. In the rest one,surgically detected prolapse of P2 was missed by RT-3D TEE. On the other hand with 2D TEE,the diagnoses correlated poorly with surgical findings,only 10 patients were accurately diagnosed (52.6%). In some patients,2D TEE was able to identify the MVP, but it had difficulty in defining the exact location of the prolapsed segment or scallop. The severity of MR decreased significantly after surgery. MV repair was successful in all patients except one(5.1%), in whom moderate to severe MR was still present and MV replacement was conducted subsequently as an alternative.Conclusions RT-3D TEE provides excellent imaging of MV components, including the anterior and posterior leaflets, as well as annulus and subvalvular structures, which can be especially helpful in planning the most appropriate surgery strategy. RT-3D TEE offers exact anatomic characteristics of mitral annuloplasty rings and bands, providing additional information for the evaluation of surgical outcomes.

OBJECTIVETo investigate the triaging pathways of patients after coronary computed tomography angiography (CCTA).

METHODSThe patients undergoing CCTA were enrolled consecutively during the period from March 3, 2008 to June 23, 2009. The rate of coronary angiography (CAG) examinations after CCTA was calculated. The rates of normal CAG, medication, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) were compared between CCTA and direct CAG cohorts.

RESULTSA total of 8030 cases receiving CCTA and 3260 receiving direct CAG were included in the study. The CCTA patients had significantly fewer risk factors than those having direct CAG. Of the 8030 patients undergoing CCTA, 953 (12.03%) received further CAG and 6977 (87.97%) did not. Of the patients who received CAG after CCTA, 35 (3.7%) had normal CAG findings, 604 (63.4%) underwent PCI, 108 (11.3%) received conservative treatment with medications, and 206 (21.6%) underwent CABG. In the 3260 patients directly undergoing CAG, 706 (52.3%) underwent subsequent PCI, 142(4.4%) underwent CABG, 815(25.1%) received medications, and 579 (17.9%) had normal CAG findings. Comparison between the cases receiving direct CAG and CAG after CCTA showed that CCTA resulted in a significant increase in the revascularization rate (P<0.0001).

CONCLUSIONCCTA can help prevent unnecessary CAG and allows more accurate patient triage.

Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed

Objective To compare the effects of 4 different shaping angle tubes on the success rate of tracheal intubation and postoperative pharyngeal complications among anesthetic beginners.Methods 160 patients who underwent laparoscopic cholecystectomy under general anesthesia,with ASA classification Ⅰ to Ⅱ,no history of difficult airway,were randomly divided into 4 groups according to the catheter shape and tip shaping angle:35°banana-shaped elbow group(A Group),50°banana-shaped bent pipe group(Group B),35°straight pipe group(Group C),50°straight pipe group(Group D),with 40 cases in each group.After induction of general anesthesia,tracheal intubation is performed using a video laryngoscope.The Cormack-Lehane grade of laryngoscope exposure,external laryngeal compression,one-time success rate of intubation and intubation time were recorded.SPO2,HR and MAP were recorded before anesthesia induction(T0),at the end of anesthesia induction drug injection(T1),immediately after intubation(T2)and 1min after intubation(T3).The incidence of pharyngeal pain and hoarseness immediately after extubation and 24 hours after operation were followed up.Results There were no statistically significant differences in Cormack-Lehane classification,HR,and MAP among the four groups of patients at each time point(P>0.05).The number of cases requiring external laryngeal compression,intubation time,first-time intubation success rate,immediate postoperative sore throat,and immediate postoperative hoarseness rates in Groups B and D were all lower than those in Groups A and C,and the differences were statistically significant(P<0.05).Conclusion When using video laryngoscope for tracheal intubation,50°banana-shaped curved tube and 50°straight tube can shorten the intubation time,reduce postoperative complications,and have no obvious hemodynamic fluctuations.

Objective To investigate the characteristics of epidemic and genotype/subtype distribution of hepatitis C virus (HCV) among entry travelers at Tengchong port,to provide references for HCV prophylaxis and treatment.Methods A total of 54 serum samples were collected from anti-HCV positive travelers at Tengchong port from June 2009 to June 2016.HCV NS5B gene was amplified using reverse transcription polyonerase chain reation (RT-PCR) and subsequently sequenced.Based on the obtained sequences and retrieved reference sequences,phylogenetic analysis was conducted to determine HCV genotype/subtype.Results HCV infection rate among entry travelers at Tengchong ports was 0.45 ％ (54/12 059).Forty five samples were successfully genotyped.Phylogenetically,HCV genotype 3b was revealed to be the predominant subtype (28.89 ％,13/45) in this population,followed by genotype 6n (20.0％,9/45),genotype 1b (17.78％,8/45),genotype 3a (13.33％,6/45),genotype 2a (11.11％,5/45),genotype 1a (2.22％,1/45) and genotype 6a (2.22％,1/45).The major genotype in Myanmar travelers was genotype 6,while in Chinese population,genotype 1 predominated.Genotype 6 in the population showed close phylogenetic relationship with strains prevalent in China and Southeast Asia.Genotype 3 was closely clustered with strains prevalent in China.Conclusions The distribution of HCV genotypes among entry travelers at Tengchong port is impacted by HCV epidemic strains both in Yunnan province and neighboring regions.This population serves as a transmitting media which may influence the epidemiological characteristics of HCV in Tengchong and neighboring areas.

Objective To study the effects of different types of fluid resuscitation on mesenteric microcirculation and inflammatory factors in rabbits with hemorrhagic shock.Methods The model of hemorrhagic shock rabbits was established by reducing the basic mean arterial pressure by 40%through draining the blood from the common carotid artery.Animals were randomly divided into control group,saline group,lactate Ringer group,acetic acid Ringer group,hydroxyethyl starch group and succinyl gelatin group with 8 animals in each group.Mesenteric microcirculation was monitored with microcirculation monitor.Mean arterial pressure(MAP),heart rate(HR),microvascular perfusion ratio(PPV)and microvascular blood flow index(MFI)were recorded before bleeding(T0),at hemorrhagic shock(T1),at the beginning of fluid resuscitation(T2),at the completion of fluid resuscitation(T3),and at the end of the experiment(T4).The contents of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)and lactic acid(Lac)were measured at T0,T2 and T4.Results Compared with hydroxyethyl starch group,there were statistically significant differences in T3 MAP(P<0.05),except for succinyl gelatin group,hydroxyethyl starch group had higher MAP at T4 than other groups,the difference was statistically significant(P<0.05).The differences in MAP between experimental control group and other groups were statistically significant at T4(P<0.05).PPV and MFI of hydroxyethyl starch group and succinyl gelatin group were higher than those of normal saline group,lactic acid Ringer group and acetic acid Ringer group at T4(P<0.05),and the lactic acid value of hydroxyethyl starch group at T4 was the lowest,compared with lactic acid Ringer group and normal saline group,the difference was statistically significant(P<0.05).There were statistical significances between all groups and experimental control group at T4(P<0.05).There were no significant differences in TNF-αand IL-1 in T0,T2 and T4 among all groups(P<0.05).Conclusion Hydroxyethyl starch solution and succinyl gelatin solution can improve the microcirculation of rabbits with hemorrhagic shock,but can not improve the level of inflammatory factors.

Lao-Xiang-Huang (LXH) of Chaozhou is the processed product of Fructus Citri sarcodactylis.LXH from different producing areas were used as research objects in the study for the establishment of HPLC fingerprints of LXH.Contents of hesperidin and 5,7-dimethoxycoumarin were also determined to provide scientific basis for the establishment of quality standard of LXH.Samples were separated by an Agilent Eclipse XDB C18 column (4.6 mm × 250 mm,5 μm) using acetonitrile-0.1％ phosphoric acid with water gradient system as a mobile phase.The flow rate was 1.0 mL· min-1.The injection volume was 20 μL.The detection wavelength was at 283 nm.The results showed that HPLC fingerprint of LXH was established with good separation and repeatability.The similarity evaluation on 27 batches samples of LXH showed that there was a certain similarity on the HPLC fingerprints of LXH.However,there was a certain difference as a whole.Contents of hesperidin and 5,7-dimethoxycoumarin in LXH were simultaneously determined.It was concluded that the established HPLC fingerprint of LXH and content determination of hesperidin and 5,7-dimethoxycoumarin method were accurate,sensitive and repeatable.It provided scientific evidence for the quality control standard of LXH of Chaozhou.