Objective To evaluate the fetal cardiovascular function in selective intrauterine growth restriction (sIUGR)in monochorionic diamniotic(MCDA)twins by using 2D and color Doppler ultrasonography. Methods Twenty - four sIUGR pregnancies and 20 normal MCDA twins pregnancies were enrolled at the First Affiliated Hospital of Sun Yat - Sen University from December 2013 to September 2014,and cardiac structure of fetus and Doppler patterns of the umbilical artery(UA),umbilical vein(UV),pulsatility index of ductus venosus(DV - PI),atrioventricular valve, semilunar valve,tricuspid annulus systolic displacement(TAPSE),fractional shortening of left ventricle short axis(FS) and myocardial performance index(Tei index)of both ventricles were assessed. Results Cardiothoracic ratio,heart rate,DV - PI,FS,TAPSE,Tei index of the left ventricle(0. 34 ± 0. 03,0. 34 ± 0. 04),Tei index of the right ventricle (0. 35 ± 0. 03,0. 35 ± 0. 03)were not significantly different compared with those of the normal MCDA twins(all P ﹥0. 05). Cardiothoracic ratio,ventricular wall thickness,isovolumetric relaxation time( IRT),isovolumetric contraction time(ICT),TAPSE and tricuspid regurgitation(TR)in the larger twins of sIUGR were significantly bigger than those in the smaller twins of sIUGR(all P ﹤ 0. 05),Tei index of both ventricles in the larger twin of sIUGR was significantly higher than that in the smaller twins of sIUGR(Tei index of left ventricle:0. 43 ± 0. 06 vs 0. 35 ± 0. 04,Tei index of right ventricle:0. 43 ± 0. 06 vs 0. 34 ± 0. 04,P ﹤ 0. 05),the peak E in early diastolic / the peak A in atrial contraction (E/ A),the percentage of inflow during of cardiac cycle length(inflow/ CCL)in larger twin of sIUGR were significantly lower than those in smaller twin of sIUGR(all P ﹤ 0. 05). Conclusions There was no difference of cardiac function in normal MCDA twins,at the beginning of the diagnosis of sIUGR,cardiac dysfunction were found in larger twin,follow -up examination are helpful to clinical decision.

Environmental Monitoring ; methods ; Female ; Hexanes ; analysis ; Humans ; Male ; Occupational Exposure ; adverse effects ; analysis ; prevention & control ; Workplace ; standards

Animals ; Hyperbaric Oxygenation ; Inflammation ; Interferon-gamma ; metabolism ; Interleukin-6 ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; metabolism ; therapy ; Tumor Necrosis Factor-alpha ; metabolism

Objective To explore the effects of Atorvastatin and Simvastatin on serum levels of lipid,high sensitive C-reactive protein (hs CRP)and ventricular remodeling in patients with acute coronary syndromes(ACS).Methods In this prospective study,96 patients with acute coronary syndrome were admitted in our hospital from December 2014 to September 2016.In the prospectively study,they were randomized into Atorvastatin group(Atorvastatin 20 mg daily,n =48) and Simvastatin group(Simvastatin 40 mg daily,n=48),and serum levels of hs CRP,lipids and changes in myocardial function were detected and compared between two groups before and after treatment.Results The serum levels of hs-CRP and lipids were significantly lower in Atorvastatin group than in Simvastatin group at 8 weeks after treatment(P＜0.05).At the end of the treatment,the levels of left ventricular reject fraction and left ventricular end-diastolic volume index were improved (all P ＜ 0.05) in two groups,but significantly higher in Atorvastatin group [(44.8 ± 6.3) ％ and (62.7 ± 10.4)] than in Simvastatin group [(48.9 ± 6.9) ％ and (67.9 ± 10.5) respectively,all P ＜ 0.05).Conclusions Simvastatin and Atorvastatin can effectively promote the decrease in levels of blood lipids and inflammatory reaction,and help to improve the myocardial function in patients with acute coronary syndrome,but Atorvastatin effects are more significant.

OBJECTIVETo investigate the effect of different pressure oxygen pre-breathing in preventing decompression sickness of rats.

METHODSForty male SD rats were randomly divided into 4 groups: decompression sickness (DCS) group and three oxygen pre-breathing groups with 1 ATA, 2 ATA and 3 ATA pressure respectively. The rats of DCS group were placed in the hyperbaric chamber and the chamber was compressed evenly within 3 minutes to depths of 7 absolute atmosphere(ATA) and held at the designated depth for 60 min, then decompressed (3 min) at constant speed to the surface pressure. After that, the rats were taken out for further detection. While the rats of oxygen pretreatment groups pre-breathed different pressure oxygen for 20 min before entering into chamber. The mortality and behavioral of rats were observed with 30 min post decompression. The dry/wet ratio of the lung, protein levels in the bronchoalveolar lavage fluid (BALF), and the inflammatory cytokine tumor necrosis factor (TNF-alpha) expression were also tested.

RESULTSCompared with that of the DCS group, the mortality and morbidity of oxygen pre-breathe groups didn't change obviously. But the total BALF protein level and the inflammatory cytokine TNF-alpha expression of 1 ATA oxygen pre-breathe group were obviously decreased, while the dry/wet ratio of lung as obviously increased instead (P < 0.05).

CONCLUSIONAlthough preoxygenation can' t obviously change the mortality and mobidity of rats, normal pressure oxygen pre-breathing can mitigate the protein infiltration in BALF and the expression of inflammatory cytokine in lung tissue.

Animals ; Bronchoalveolar Lavage Fluid ; chemistry ; Decompression Sickness ; Diving ; Lung ; pathology ; Oxygen ; physiology ; Pressure ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism

Objective:To systematically evaluate the therapeutic efficacy of tuina therapy for primary insomnia.Methods:Nine Chinese and English databases were searched from the inception to May 2017 to identify randomized controlled trials (RCTs) studying tuina therapy for insomnia.The enrolled articles were all RCTs with tuina as the monotherapy or major therapy in the experiment group,with clear diagnostic criteria for primary insomnia well recognized worldwide or in China,and Pittsburgh sleep quality index (PSQ I) as one of the outcome measures.Two researchers evaluated the risk of bias and quality of the enrolled studies by following Cochrane Handbook version 5.1.0.The meta-analysis was performed by RevMan version 5.3.Results:Eleven studies were included with a total of 1 076 participants.The Western medication adopted in the control groups were benzodiazepine receptor agonists.The studies were all assessed as high risk of bias for blinding since blinding method was unable to be performed due to the specificity of tuina therapy;no study reported the support of fund or potential interest conflict,so they were all rated unclear for selective reporting.The meta-analysis showed that compared with other traditional Chinese medicine therapies,tuina worked more effectively in reducing the PSQI score (MD=-4.11＜0,95％ confidence interval (CI)-6.01 to-2.22,P＜0.0001);compared with oral administration of Western medication,tuina showed more significant efficacy in reducing the PSQI score (MD=-3.42＜0,95％CI-5.19 to-1.66,P＜0.0001).Subgroup analysis showed that head tuina alone showed no significant difference compared with oral administration of Western medication regarding the change of PSQI score (MD=-4.19＜0,95％CI-8.87 to 0.50,P＞0.05);a combination of head and back tuina could more effectively reduce the PSQI score compared with oral administration of Western medication (MD=-2.08＜0,95％CI-3.09 to-1.06,P＜0.0001).Conclusion:Tuina can produce more significant efficacy in treating primary insomnia compared with other traditional Chinese medicine therapies and oral administration of Western medication,especially the combination of head and back tuina.

Objective:To study the effect of OSAHS on adult nasal-cycle.Method:The nasal cycle of 20 healthy adults,18 patients of snoring and 22 patients of OSAHS were examined with acoustic rhinometry,which was performed every 30 minutes in 7 hours.Result:The ratio of nasal cycle in healthy adults was(19/20,95.0%), in snoring patients was(15/18,83.0%),in patients of OSAHS was(15/22,68.2%). The mean alteration amplitude of nasal cycle in healthy adults was significantly larger than that in patients with OSAHS (P<0.05).The distribution of the healthy adults and patients with OSAHS between the typical cycle categories was significantly different(P<0.05).Conclusion:The characteristics of nasal-cycle in of OSAHS patients were different with healthy adults,which maybe owing to change of physical function of nasal cavity.

Objective To investigate the maximum-tolerated dose (MTD) of cisplatin in docetaxel,cisplatin,and fluorouracil (TPF) induction chemotherapy followed by intensity-modulated radiotherapy (IMRT) and concomitant chemotherapy as well as the safety and short-term efficacy of TPF induction chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC).Methods Thirtythree patients with locally advanced NPC were enrolled in this trial.The MTD of cisplatin was determined by dose escalation study,and the short-term efficacy and toxicities were evaluated.Results When the doses of docetaxel and fluorouracil were 60 mg/m2 d1 and 550 mg/m2 d1-5,respectively,the MTD of cisplatin was 65 mg/m2 d1.In this regimen (repeated every 3 weeks),grade 3-4 toxicities included neutropenia (67％),febrile neutropenia (9％),diarrhea (21％),and oral mucositis (6％).Except those who experienced dose-limited toxicity,other patients completed the whole treatment schedule.After TPF induction chemotherapy,the overall response rate was 97％,and the complete response rate was 21％.Conclusions In the endemic areas of NPC,induction chemotherapy with docetaxel (60 mg/m2 d1),cisplatin (65 mg/m2 d1),and fluorouracil (550 mg/m2 d1-5),which is repeated every 3 weeks,is proved safe and effective for Asian patients with locally advanced NPC.

Objective To study the clinical significance of the serum angiopoietin-2(Ang-2) in the diagnosis,recurrence,invasion and metastasis of gastric cancer.Methods The serum Ang-2 and carcino-embryonic antigen (CEA) levels in 158 patients with gastric cancer (gastric cancer group) and 30 normal controls(control group) were measured by enzyme linked immunosorbent assay(ELISA) technique respectively.The serum Ang-2 and CEA levels were also measured 2 weeks after operation in gastric cancer group and reexamined in the recurred gastric cancer patients in 2 years after operation (recurred and metastasis group).The correlation between the serum Ang-2 level and pathologic c haracterization of gastric cancer was evaluated.Results The serum Ang-2 and CEA levels in gastric cancer group [ (331.8 ±64.3),(42.6 ±37.3)μg/L] and recurred and metastasis group [(318.7 ±72.9),(40.5 ±36.7)μg/L] were significantly higher than those in control group [ (187.4 ± 32.7),(4.2 ± 3.1 )μ g/L] (P ＜ 0.01 ),and the serum Ang-2 level 2 weeks after operation [ (211.6 ± 75.1 ) μ g/L ] was significantly decreased to the control group (P ＞ 0.05 ),while the serum CEA level [ (33.4 ± 30.6) μ g/L ] was still significantly higher than the control group (P ＜ 0.01 ).The sensitivity of the serum Ang-2 for diagnosis of gastric cancer was markedly higher than that of the serum CEA (P ＜ 0.01 ).There was correlation between serum Ang-2 and degree of tumor differentiation,TNM pathological staging,lymphatic metastasis,invasion depth and tumor size (p ＜0.01 ),but there was no correlation between serum Ang-2 and tissue classification and location of gastric cancer (P＞ 0.05).Conclusion The serum Ang-2 level is suggested to be a valuable gastric cancer marker and conduce to the diagnosis of gastric cancer,the monitoring of recurrence after operation and evaluation of prognosis.

Objective To investigate the characteristic and clinical significance of airway inflammation in children with acute asth-ma. Methods Underwent sputum induction and sputum induction in children (n=34) with acute asthma was repented in recovered children ( n = 24).Induced sputum were also taken from 15 healthy children as controls.Total and differential cell counts were per-formed. Interleukin(IL)-8、IL-6 were measured,The relationship between inflammatory cells and IL-8、 IL-6、peak expiratory (PEF) were analyzed.Results The inflammatory cell infiltrate was mixed including eosmophilic granulocytes, neutrophils, and macrophages. They decreased significantly, but eosinophilic granulocyte remained a higher percentage compared with healthy subjects. There was low-er percentage of lymphocytes at acute exacerhation.Eosinophilic granulocytes were correlated with the degree of airflow obstruction. Levels of IL-8、IL-6 were elevated during the acute exacerbation and decreased at resolution.IL-8 was correlated significantly with neutrophils at acute exacerhation and resolution.IL-6 was correlated signifficantly with eosinophilic granulocytes at acute exacerbation. Conclusions Airway inflammation is chataeterized by infiltration of eosinophils, neutrophils and macrophages.IL-8、IL-6 possibly is the important cytokines of airway inflammation in children with acute asthma. Increased eosinophils in induced sputum correlates with asthma severity. Therapy to the cytokines may have potential values.J Appl Clin pediatr,2004,19(12): 1023-1025