Objective To assess the alterations of the systolic peak radial strain (RS) and the time to systolic peak radial strain(TRS) in ischemic myocardial segments with different extent of coronary artery stenosis using three-dimensional ultrasound speckle tracking imaging(3D-STI).Methods RS and TRS of 16 left ventricular segments were analyzed by 3D-STI in 87 patients,every left ventricular segment of all patients were divided into 5 groups according to coronary stenosis based on the results of selected coronary angiography:normal,≤25 ％,＞25 ％ - ≤50 ％,＞50 ％ - ≤ 75 ％,＞ 75 ％.All times were corrected by heart rate.Results In the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞25％ - ≤50％ group,the variance of RS was non-significant( P ＞0.05).Compared with the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞ 25％ -≤ 50％ group,RS was decreased in groups of coronary stenosis ＞50％ - ≤75％ and ＞75％.Between the coronary normal group and coronary stenosis extent ≤25 ％ group,the variance of TRS was non-significant( P ＞0.05).Compared with coronary normal and coronary stenosis extent ≤25 ％ group,TRS was increased in groups of coronary stenosis ＞25％ - ≤50％,＞50％ - ≤75％,＞75％.Compared with group of coronary stenosis ＞ 50％ -≤ 75％,TRS was shorter in group of coronary stenosis ＞ 75％,some variance was significant( P ＜0.05).Conclusions The RS was decreased along with the coronary stenosis increase,but TRS was increased along with the coronary stenosis increase.There is a tendency that TRS was decreased when the coronary stenosis is more than 75 ％ compared with the coronary stenosis ＞50％ - ≤75 ％ group.3D-STI can access the regional radial systolic function of the ischemic myocardial segment.

Background and purpose: Magnetic resonance spectroscopy is currently the only non-invasive magnetic resonance imaging technique which can detect metabolite composition of live organ and tissue and also conduct semi-quantitative or quantitative analysis. We analyzed the characteristics of metabolic changes among normal liver, cirrhosis regenerative nodule and liver cancer on the background of cirrhosis by voxel proton MR spectroscopy at 1.5 Tesla. Methods: 20 healthy volunteers (control group), 25 cirrhosis (cirrhosis group) and 23 hepatocellular carcinoma after cirrhosis (HCC group) patients were our candidates. The characteristics of spectra of ~1H-MRS were observed. The height and ratio of choline complex (Cbo) and lipid methylene (Lip2) were recorded and the results were compared among the groups. Results: The success rate of ~1H-MRS was about 88.2% (60/68). There were statistically significant differences among the heights of Lip2 peak of the three groups, and also between that of the control group and the group of liver cancer. But there were no significant differences between that of control group and cirrhosis group, cirrhosis group and liver cancer group. The comparison of the height of Cho peak and the ratio of Cho/Lip2 showed statistically significances both among the three groups and between each other. Conclusion: The metabolic changes of the liver could be shown non-invasively by ~1H-MRS, which could be useful for differential diagnosis or diagnosis of cirrhosis regenerative nodule and HCC.

Objective To retrospectively analyze CT and MR appearances of hepatic adenoma,and to study the causes of misdiagnosis with review of relative literatures.Methods CT and MRI data of 8 patients with pathologically confirmed hepatic adenoma were retrospectively analyzed.Pre-and post-contrast tri-phase (arterial,portal venous and delayed) CT scans and routine MR .scan were performed in all 8 patients,and proton magnetic resonance spectroscopy (~1H-MRS) was performed in 2 patients.Results Typical demonstrations were found in 4 patients who were correctly diagnosed.Among the others with atypical findings,3 patients were misdiagnosed as liver cancer and 1 as focal nodular hyperplasia (FNH) .The ~1H-MRS curves of 2 adenoma tumor showed that the peak of choline of tumor tissue had no significant difference comparing with that of normal liver tissue around the tumor tissue.Conclusion CT and MRI findings of hepatic adenomas have some characteristics,but atypical manifestations lead to misdiagnose.~1H-MRS may be helpful for the differential diagnosis of hepatic adenoma.

This study was aimed to observe the intervention effect of oxidation/antioxidation at different time point among mice induced by lipopolysaccharide (LPS) and bleomycin. It provided experimental basis for the establishment of chronic obstructive pulmonary disease (COPD) animal model with qi-deficiency and phlegm-obstructing pattern with inducers mentioned above. A total of 96 mice were randomly divided into the normal control group, bleomycin group, and LPS group, with 32 mice in each group. In the bleomycin group and LPS group, 40 μL of nasal drops were given with bleomycin at the concentration of 3.75 μg/μL or LPS at the concentration of 5 μg/μL, respectively to establish the COPD animal model with qi-deficiency and phlegm-obstructing pattern. On the 1st day, 7th day, 14th day and 28th day after the model establishment, the general status and activities of mice were recorded. And traditional Chinese medicine (TCM) signs such as skin color of the four limbs, skin color under the tongue and color of the tail were also collected when the animal model was sacrificed. At each time point, 8 mice were sacrificed. The lung tissues were removed. And the contents of GSH, MDA, SOD and T-AOC were detected in the homogenate of lung tissues. The results showed that compared with the normal control group, mice in the bleomycin group had slightly dull eyes, dry hair without burnish, upright and fluffy hair, dark purple skin color of the auricle and four claws, tiredness, inactivity, occasional cough, asthma or rapid breathing. The GSH content of lung tissues on the 7th day, 14th day and 28th day was obviously reduced (P< 0.05, or P< 0.01). The MDA, SOD and T-AOC contents on the 1st day, 7th day, 14th day and 28th day were obviously reduced (P< 0.05, or P< 0.01). Compared with the normal control group, mice in the LPS group had slightly dull eyes, soft hair with slight burnish, pale red skin color of the auricle and four claws, tiredness; some mice preferred to gather. Contents of GSH and SOD in lung tissues on the 1st day and 7th day were obviously reduced (P< 0.05, or P< 0.01). Contents of MDA and T-AOC on the 1st day, 7th day and 14th day were obviously reduced (P < 0.05, or P < 0.01). It was concluded that obvious oxidation/antioxidation imbalance started on the 7th day in lung tissues of mice in the bleomycin group. It reduced later on. And the oxidation/antioxidation imbalance continued until the end of the model establishment. Obvious oxidation/antioxidation imbalance started on the 1st day in lung tissues of mice in the LPS group. However, this oxidation/antioxidation imbalance was adjusted back to normal level through time.

The current situation of medical equipment management informatization was introduced in China,and its deficiencies were described in standard,top-level design,data island and etc.A development strategy divided into preliminary,intermediate and advanced levels was put forward,which used business support,data fusion and iterative analysis as the tools.The steps and methods for medical equipment management informatization were studied,and it's pointed out industrial informatization was of great significance to enhance the quality,efficacy and ability of medical equipment management.

Objective: In this study, we analyze the regulation mechanisms of the expression of ampD in AmpC β-lactamase and the regulation mechanism of β-N-acetylglucosaminidase (NagZ) in Yersinia enterocolitica. Methods: We construct the mutation strains of Yersinia enterocolitica AmpD (AmpD1-3) gene (ampD1-3), Low-Molecular-Mass Penicillin-Binding Proteins (LMM PBPs) gene (pbp4, pbp5a, pbp5b, pbp7), NagZ gene (nagZ), and ampR gene by deleting and complementing genes, and induce them by cefoxitin. We determined the activity of AmpC β-lactamase activity (U) of mutant strains (basal level and induce level) by using cephalothiophene hydrolysis method, the promoter activity of AmpC β-lactamase ((relative light unit (RLU)) was detected by the luxCDABEreporter system, and the activity of β-N-acetylglucosaminidase (nmol/L) was determined by by using 4-nitrophenyl N-acetyl-β-D-glucosaminide as the chromogenic substrate. Results: AmpD1 (Basal level: (3.29±1.58) U; Induced level: (4.08±1.75) U) was the most potent one. The YEΔ5b, YEΔ4Δ5b, YEΔ5aΔ5b and YEΔ5bΔ7 of ampC promoter activity increase significantly, whichYEΔ4Δ5b is the highest one (Basal level: (106 903.16±61 910.61) RLU; Induced level: (205 427.45±45 352.17) RLU). The YEΔ4Δ5bΔ7 of ampC promoter activity is the highest among triple mutant strain (Basal level: (304 108.04±99 274.53) RLU; Induced level: (531 440.21±68 891.02) RLU). Quadruple deletion strain YEΔ4Δ5aΔ5bΔ7 have the highest ampC promoter activity (Basal level: (1 013 810.99±260 955.96) RLU; Induced level: (1 230 214.59±205 526.79) RLU). After the deletion of nagZ gene, there is no significant change in β-lactamase activity of YEΔD1D2D3ΔZ, while β-lactamase activity of YEΔ4Δ5aΔ5bΔ7ΔZ shows a significant decrease (Basal level: (0.30±0.20) U; Induced level: (0.29±0.21) U), which basically drops to the wild strain level. Conclusion This is the first report of ampC multi-step upregulation mechanism driven by three AmpD homologues in Yersinia enterocolitica. The AmpC regulation mode with the function of single PBP4, PBP5a or PBP7 is relatively low, which work in coordination with PBP5b. Yersinia enterocolitica have both NagZ-depend and NagZ-independent mechanisms for β-lactamase expression.

OBJECTIVETo determine the correlation of the CYP1A1 (rs4646422) gene polymorphisms with male infertility in the Chinese Han population.

METHODSUsing the Mass ARRAY iPLEX GOLD technique, we conducted a case-control study on theCYPlA1 (rs4646422) gene polymorphisms in 636 infertile males aged 21-49 years (case group) and 442 normal healthy men aged 23-47 years (control group) of the Chinese Han population. We analyzed the genotypes and allele frequencies in the two groups ofsubjects with the SPSS 20.0 software.

RESULTSCompared with the wild homozygous genotype GG, the heterozygous genotype AG (OR = 1.06, 95% CI 0.81-1.38) and homozygous genotype AA (OR = 1.11, 95% CI 0.56-2.21) showed no correlation with male infertility, nor did the mutant allele A (OR = 1.06, 95% CI 0.85-1.32) in comparison with the wild allele G.

CONCLUSIONThe CYP1A1 (rs4646422) gene polymorphisms might not be correlated with male infertility in the Chinese Han population.

Adult ; Alleles ; Case-Control Studies ; China ; Cytochrome P-450 CYP1A1 ; genetics ; Gene Frequency ; Genotype ; Homozygote ; Humans ; Infertility, Male ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; Young Adult

OBJECTIVETo investigate therapeutic strategy of fulminant acute pancreatitis (FAP) in acute response stage.

METHODSSixty-four patients were divided into Death group (27 patients) and Survival group (37 patients). The time course of shock and recovery of enteral function, parameters of fluid resuscitation, PaO(2)/FiO(2) and AaDO(2) at 24 hours prior to mechanical ventilation, rate of continuous venovenous hemofiltration (CVVH) and abdominal compartment syndrome (ACS), severity of the disease in the acute response stage were investigated. And the effect of surgical manner and time on the prognosis was also analyzed.

RESULTSCompared with Survival group, the time course of shock and recovery of enteral function in Death group were prolonged significantly (P < 0.05). Between the groups, there was no difference in the amount of crystal fluid infused from admission to 72 hours after, but the amount of colloid fluid infused and ratio of amount of colloid and crystal fluid in Survival group were higher (P < 0.05). The amount of fluid retention in third space from admission to 72 hours after in Death group was higher than that of Survival group significantly (P < 0.05). The fluid infusing rate in Survival group in the first day of admission was faster than Death group (P < 0.05). PaO(2)/FiO(2) and AaDO(2) in 24 hours prior to mechanical ventilation in Death group were negatively changed significantly. Within 72 hours after the onset of the disease, the rate of CVVH in Survival group was higher than Death group. Incidence rate of ACS and the APACHEII scores within 72 hours after admission in Death group were higher than in Survival group. The cure rate of the patients operated in the day 7 to day 14 after admission was higher than that of patients operated prior and post this period. Time for the first operation in operated patients was earlier than patients received minimally invasive drainage (MID) and its cure rate was lower than that of MID Group.

CONCLUSIONSIt is the key point to shorten the time course of ischemia, to control persistent systemic inflammatory response syndrome (SIRS) and to adopt reasonable surgical intervention in acute response stage for FAP.

Acute Disease ; Adult ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis ; complications ; mortality ; therapy ; Resuscitation ; methods ; Retrospective Studies

OBJECTIVETo investigate strategy of treatment of hemofiltration on severe acute pancreatitis (SAP) and fulminant acute pancreatitis (FAP).

METHODSOne hundred and thirty patients with SAP and eighty-one patients with FAP treated with hemofiltration (HF) were prospectively observed from March 1997 to December 2008. Indications for HF, variables (time interval for hemofiltration), mode, therapeutic dosage, blood rate, heparin dosage and components of hemofiltration, therapeutic efficacy (time of disapearance of abdominal pain, intra-abdominal pressure and survival rate) and complications (incidence of bleeding and blood infection).

RESULTSAll patients underwent high volume hemofiltration (HVHF) or hemodialysis-filtration (HDF) within 72 hours after onset of the disease. Dose of SAP and FAP was (53 +/- 6) mlxkg(-1)xh(-1) and (59 +/- 10) mlxkg(-1)xh(-1) (P < 0.05), respectively. Rate of short veno-venous hemofiltration in SAP (76.9%) was higher than that of FAP (38.3%) (P < 0.05); however, rate of continuous veno-venous hemofiltration (23.1%) was lower than that of FAP (37.0%) (P < 0.05). Rate of HDF was much higher in FAP than that of SAP. Low molecular weight heparin and heparin were both available to anticoagualte;but dosage required in patients with FAP was much higher than that of SAP (P < 0.05). Time intervals for amelioration of abdominal pain in SAP and FAP were (9 +/- 6) h and (15 +/- 10) h, respectively. Itra-abdominal pressure was decreased significantly at the end of hemofiltration compared to prior to hemofiltration in SAP and FAP (P < 0.05). Level of serum triglyceride decreased abruptly after adsorption (P < 0.05). Rate of operation within 28 days in SAP (73.8%) was lower than FAP (87.7%). The in-hospital survival rates in SAP and FAP were 88.5% and 67.9%, respectively. Amount of platelet decreased in patients with blood flow rate less than 240 ml/min was higher than that of more than 240 ml/min (P < 0.05). And incidence of blood stream infection and bleeding increased significantly (P < 0.05).

CONCLUSIONSHVHF and HDF used in SAP and FAP patients underwent conservative treatment within 72 hours, respectively, can increase survival rate significantly.

Acute Disease ; Hemofiltration ; Humans ; Pancreatitis ; therapy ; Survival Rate

BACKGROUNDFluid therapy for severe acute pancreatitis (SAP) should not only resolve deficiency of blood volume, but also prevent fluid sequestration in acute response stage. Up to date, there has not a strategy for fluid therapy dedicated to SAP. So, this study was aimed to investigate the effects of fluid therapy treatment on prognosis of SAP.

METHODSSeventy-six patients were admitted prospectively according to the criteria within 72 hours of SAP onset. They were randomly assigned to a rapid fluid expansion group (Group I, n = 36) and a controlled fluid expansion group (Group II, n = 40). Hemodynamic disorders were either quickly (fluid infusion rate was 10 - 15 ml x kg(-1) x h(-1), Group I) or gradually improved (fluid infusion rate was 5 - 10 ml x kg(-1) x h(-1), Group II) through controlling the rate of fluid infusion. Parameters of fluid expansion, blood lactate concentration were obtained when meeting the criteria for fluid expansion. And APACHE II scores were obtained serially for 72 hours. Rate of mechanical ventilation, incidence of abdominal compartment syndrome (ACS), sepsis, and survival rate were obtained.

RESULTSThe two groups had statistically different (P < 0.05) time intervals to meet fluid expansion criteria (Group I, 13.5 +/- 6.6 hours; Group II, (24.0 +/- 5.4) hours). Blood lactate concentrations were both remarkably lower as compared to the level upon admission (P < 0.05) and reached the normal level in both groups upon treatment. It was only at day 1 that hematocrit was significantly lower in Group I (35.6% +/- 6.8%) than in Group II (38.5% +/- 5.4%) (P < 0.01). Amount of crystalloid and colloid in group I ((4028 +/- 1980) ml and (1336 +/- 816) ml) on admission day was more than those of group II ((2472 +/- 1871) ml and (970 +/- 633) ml). No significant difference was found in the total amount of fluids within four days of admission between the two groups (P > 0.05). Total amount of fluid sequestration within 4 days was higher in Group I ((5378 +/- 2751) ml) than in Group II ((4215 +/- 1998) ml, P < 0.05). APACHE II scores were higher in Group I on days 1, 2, and 3 (P < 0.05). Rate of mechanical ventilation was higher in group I (94.4%) than in group II (65%, P < 0.05). The incidences of abdominal compartment syndrome (ACS) and sepsis were significantly lower in Group II (P < 0.05). Survival rate was remarkably lower in Group I (69.4%) than in Group II (90%, P < 0.05).

CONCLUSIONSControlled fluid resuscitation offers better prognosis in patients with severe volume deficit within 72 hours of SAP onset.

Acute Disease ; Adult ; Female ; Fluid Therapy ; methods ; Humans ; Male ; Middle Aged ; Pancreatitis ; pathology ; therapy