Objective To summarize the clinical manifestations and surgical treatment of unroofed coronary sinus syndrome(UCSS). Methods Nine patients underwent surgical repair for UCSS from Jan. 1999 to Jun. 2009 in our hospital, and the patients included 3 with type I a, 1 with type I b, 1 with type II a, 3 with type III a, and 1 with type III b UCSS. The diagnosis of UCSS was made by echocardiography in 6 patients and by the surgical exploration in 3 patients. Persistent left superior vena cava (PLSVC) was found in 7 cases; 3 cases with PLSVC directly draining into the left atrium ( I a) were reconstructed by the intra-atrial routes to guide PLSVC to the right atrium, and 4 cases with PLSVC draining into the coronary sinus and coronary sinus orifice opening to the left atrium and right atrium (1 case, II a) and left atrium (3 cases, III a) were dealt with the abnormal coronary sinus orifice. Other associated cardiac lesions were corrected concomitantly. Results Two cases had early complications and the other 7 cases had smooth recovery after operation; all the patients were cured and discharged. Eight cases were followed up for 2 months to 5 years and there was no death or late complications. Conclusion UCSS is a rare congenital cardiac anomaly and is difficult to diagnose preoperatively; so careful exploration should be done during operation. Different surgical approaches should be chosen according to the types of communication between PLSVC and cardiac atrium, the positions of abnormal sinus ostium, and other cardiac lesions. Satisfactory prognosis can be obtained if physiological correction is achieved.

Objective: To investigate whether pituitary adenylate cyclase-activating polypeptide (PACAP) can modulate the immune function of mouse LPS-stimulated dendritic cells. Methods: DCs were derived from bone marrow of C57BL/6 using rmGM-CSF and rmIL-4, then the DCs were exposed to different stimuli for indicated time periods. The stimulated DCs and their culture supernatant were subjected to ELISA and FACS analysis. The total RNA was extracted from the stimulated DC for RT-PCR and RNase Protection Assay. Results: PACAP significantly inhibited the production of IL-2, IL-12,TNF-α and MIP-2 in LPS-stimulated DCs (P<0. 05,P<0. 01,P<0. 01 ,P<0. 01.respectirely), but the inhibition of LPS-induced IL-6, MIP-1α and MIP-1β production was not apparent. Conclusion: PACAP can negatively modulate the immunity of LPS-stimulated DCs.

Objective To investigate the effects of Par-4 gene silence on hydrogen peroxide-induced apoptosis in alveolar epithelial cells. Method The alveolar epithelial cells A549 were cultured and exposed to hydrogen peroxide. The siRNA sequences targeted Par-4 gene was chemically synthesized and transfected to A549 cells with or without the exposure of hydrogen peroxide. The cells were divided into normal control groups, hydrogen peroxide-treated group(The cells were treated with 0. 1 mmol/L hydrogen peroxide), hydrogen peroxide and Par-4-siRNA-treated group(The cells were treated with 0. 1 mmol/L hydrogen peroxide after transfection of Par-4-siRNA), Non-specific DNA sequence transfection control group. The apoptosis of A549 cells was quantified by flow cytometry. The expression of Smac protein was detected by Western blot.Electrophoretic mobility shift assay was applied for evaluating the change of E2F1 DNA binding activity. Relative activity of Caspase-3 was detected by clolorimetric assay. Results The percent of apoptotic cells in hydrogen peroxide and Par-4-siRNA-treated group was (29.7 ± 2.3) %, which was significantly lower than that of hydrogen peroxide-treated group [(54.2 ± 4.1)%, q= 8.91, P ＜ 0.01)]. Par-4 siRNA could significantly suppress the increase of Smac protein, E2F1 DNA binding activity and caspase-3 activity induced by hydrogen peroxide in A549 cells. Conclusions Par-4 gene silence induced by siRNA might inhibit the apoptosis of alveolar epithelial cells, which might be resulted from suppression of the up-regulation of Smac gene expression, E2F1 DNA binding activity and caspase-3 activity.

Coronary Artery Bypass ; adverse effects ; Humans ; Male ; Middle Aged ; Radiodermatitis ; etiology

Objectives To clarify the differential diagnostic value for iron deficiency anemia (IDA)and anemia of chronic disease(ACD)with analysis method of multiple parameters.Methods The serum concentrations of iron parameters (SI,TIBC,TF,SF and sTfR),inflammatory index(IL-1,IL-6,TNF-β),CRP and hepcidin were detected in patients with IDA and ACD by biochemical method and ELISA respectively.Results In the differential diagnosis of IDA versus ACD,the SF (98.6 versus 6.0,P=0)and sTfR/logSF[(13.1-±-4.4) versus (27.6 ± 16.5),P=0.002] had clinical value for the differential diagnosis.Inflammatory factors level was increased in two groups,only the difference in CRP between IDA and ACD showed a statistical significance.The hepcidin had the clinical value in differential diagnosis for single disease diagnosis of IDA and ACD and for differential diagnosis between IDA and ACD [(144.6 ±-1.9) versus (86.5-±-3.1),P＜ 0.05].Correlation analysis showed that the sTfR/logSF had a significantly negative correlation with SI(P=0.002),a significantly positive correlation with TIBC and TRF,and no significant correlation with inflammatory factors.The hepcidin had significantly positive correlation with IL-6 and TNF-β,and a significantly negative correlation with SI.The positive correlation was observed between sTfR/logSF and Hepcidin(r=0.376,P=0.005).Conclusions Analysis method of multiple parameters could make a differential diagnosis of ACD in the elderly.

Acupressure ; Acupuncture, Ear ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Phytotherapy ; Postmenopause ; Premenopause ; Syndrome

Objective To improve the diagnosis and treatment of pulmonary lymphangiomyomatosis (PLAM). Methods The clinical data of 1 PLAM case in our hospital was analysed, along with a review of the related literatures.Results PLAM was a rare diffuse interstitial plumonary disease of unknown cause, which was oiraracterized by recurrent spontaneous pneumothorax shortness of breath (dyspnea) with physical activity, haemopthsis and chylothorax. Radiological appearances were extensive bilateral linear pattern, and honeycomb pattern in the end. High resolution CT scan (HRCT) showed multiple thin walled cysts distributed evenly throughout the bilateral lung fields with normal intervening lung parenchyma. Pathological characters were abnormal, pervasice multiplication of smooth muscle of cell in and around the small airway, lymphatic and small blood vessels. Immunohistochemical test showed HMB45(+).Conclusion It should be considered the probability of PLAM when women of childbearing ages have some clinical manifestations as follows, the increasing dyspnoea that can not be relieved similar to emphysema, high- resolution CT scan (HRCT) shows multiple thin walled cysts distributed evenly throughout the bilateral lung fields with normal intervening lung parenchyma, and recurrent pneumothorax or chylothorax. The optimal confirm diagnostic method is lung tissue biopsy.

Objective: To investigate the chemical constituents of Swertia chirayita. Methods: Column chromatography, such as silica gel, MCI, Sephadex LH-20 were used to isolate and purify the compounds. Physicochemical properties and spectroscopic methods were used to elucidate their structures. Results: Twelve compounds, including 2 xanthones, 4 triterpenoids, 3 secoiridoids, and 3 other compounds, the chemical constituents were isolated from the ethyl acetate fraction from 85% ethanol extract of S. chirayita, and identified as bellidifolin (1), norbellidifolin (2), oleanolic acid (3), 4-epi-hederagenin (4), 2-epi-corosolic acid (5), ursolic acid (6), amarogentin (7), swerimilegenin I (8), erythrocentaurin (9), pyrocatechol (10), syringic acid (11), and 4-hydroxy-3-methoxybenzoic acid (12). Conclusion: Compounds 4, 5, and 11 are isolated from genus Swertia for the first time, compounds 8 and 9 are found from S. chirayita for the first time.

Objective To evaluate the advantages and disadvantages of transabdominal myomectomy (TAM), transvaginal myomectomy (TVM) and laparoscopic myomectomy (LM). Methods We retrospectively reviewed the clinical data of 89 cases of TAM (Group TAM), 34 cases of TVM (Group TVM) and 62 cases of LM (Group LM). Results About the operation time, the Group LM occupied the first place (123 7 min?56 7 min), the Group TAM came second (90 5 min?31 1 min), and the Group TVM last (60 7 min?20 5 min), with significant differences among the three groups ( P 0 05), but the blood loss in both of the groups was much more than that in the Group TVM ( P 0 05), but markedly lower than that in the Group TAM ( P

Objective To study the effects of BCG-PSN on the expression of the receptor of selectins——one of the important cell adhesion molecules, and the characteristics of cytoskeleton structure in lung cancer cells. Methods The effects of BCG-PSN on the expression of sialyl Lewis X (slex) and the cytoskeleton structure of highly metastatic human pulmonary giant cell carcinoma (PG) cells and lowly metastatic human pulmonary adenocarcinoma (PAa) cells were observed by flow cytometry and transmission electron microscopy. Results Flow cytometric results showed that the expression of slex on the surface of PAa cells (66.8%) was higher than that on PG cells (5.72%). After treatment with BCG-PSN, the expression of slex on PAa cells decreased in a dose-dependent manner. Transmission electron microscopy showed that the microtubules and microfilaments were sparse in the PAa cells and diminished in PG cells. After treatment with BCG-PSN, the microfilaments were more abundant than before in PG cells and showed a branch-like appearance, but still remained sparse in PAa cells. Conclusion Changes in the components of the cytoskeleton structure are associated with the ability of the migration and movement of the tumor cells. The inhibitory effect of BCG-PSN on the adhesiveness of lung cancer cells may not be the cytoskeleton-mediated enhancement of adhesion, but the start-up process resulted from the down-regulation of cell adhesion molecules on the surface of lung cancer cells.