Objective To evaluate the immediate and short term therapeutic efficacy of percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to investigate the prevention of the related complications. Methods PTSMA was conducted in 3 patients with HOCM refractory to medication. The immediate effect was evaluated by pressure monitor, but the follow up effect by observation of the clinical symptoms and ultrasonic cardiogram. Results The left ventricular outflow tract gradients triggered by ventricular premature beats decreased from 143 mmHg (ranging from 70 to 180 mmHg) to 53 mmHg (ranging from 30 to 80 mmHg). Complete atrioventricular block (Ⅲ?AVB) with atrioventricular node rhythm was found in 1 case, and complete right branch bundle block (CRBBB) in another one. Follow up of the 3 cases at 6 months after operation revealed remarkable improvement of the patients' cardiac function (NYHA), disappearance of angina pectoris, and obvious attenuation of ventricular septal hypertrophy and SAM (systolic anterior motion of mitral) phenomenon. Conclusion PTSMA is an effective method with satisfactory short term effect for the patients with HOCM refractory to medication.

Objective To explore the correlation between-173G/C gene polymorphism of macrophage migration inhibitory factor(MIF) and Henoch-Schonlein purpura(HSP),Henoch-Schonlein purpura nephritis(HSPN) in children in Jiangxi Province.Methods One hundred and thirty-one ethnic Han children with HSP were enrolled,including 80 children with concurrent nephritis(HSPN group) and 51 children without nephritis(HSP without nephritis group).One hundred and five healthy children were used as the healthy control group.Germline DNA was extracted from peripheral blood by Promega blood genomic DNA kit.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) was used for genotyping the-173G/C polymorphism of MIF.Genotype distribution and allele frequencies were obtained by direct counting.Statistical analysis was performed by using SPSS 11.5 software.Allele and genotype distribution were compared by using the chi-square test.The relative risk of allele was described by odds ratios(OR) and 95% confidence intervals(95%CI).Results Three genotypes(GG,GC,CC) were detected in MIF-173 G/C.GG,GC genotypes were detected in HSP without nephritis and healthy control group.GG,GC and CC genotypes were detected in HSPN group.Mutant genotype(37.5%) and C allele frequency(20.0%) in HSPN group were significantly higher than those in healthy control group(20.0% and 10.0%,respectively)(?2=6.964,7.400,Pa

AIM: To evaluate the effects of 23G vs 20G pars plana vitrectomy ( PPV ) combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation for macular epiretinal membrane with cataract. ·METHODS: Totally 45 eyes of 45 patients with macular epiretinal membrane and cataract were enrolled in this retrospective non-randomized controlled clinical study. All eyes were treated with PPV combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation. There were 20 eyes in 23G PPV group, and 25 eyes in 20G PPV group. The best corrected visual acuity ( BCVA ) , intraocular pressure (IOP), counting of corneal endothelial cells ( CEC) and central retinal thickness ( CRT ) were examined before surgery. BCVA results were converted to the logarithm of the minimum angle of resolution ( LogMAR ) visual acuity. All operations were performed by the same doctor. Operation time for vitrectomy and membrane peeling, average ultrasound energy ( AVE) and effective phacoemulsification time ( EPT ) were recorded. BCVA and CRT were observed postoperatively at 30d and 90d, counting of CEC was observed postoperatively at 90d. IOP was observed postoperatively at 1d and 7d. ·RESULTS:The mean operation time for vitrectomy were 12. 57± 1. 35min in 23G group and 17. 30 ± 1. 19min in 20G group. The difference was statistically significant ( t =-12. 488, P<0. 01). There were no statistical significances in operation time for membrane peeling, AVE and EPT between 23G and 20G groups ( t=-0. 68,-1. 186,-0. 737, P=0. 500, 0. 242,0. 465). On 1d after surgery, IOP in 23G group was lower than that in 20G group, the difference was statistically significant (t= -2. 345, P=0. 024). The BCVA and CRT of the two groups both improved after operations. There were no statistically significant differences between two groups in terms of IOP, BCVA, and CRT ( F = 0. 465, 1. 895, 0. 689; P = 0. 499, 0. 176, 0. 411). IOP, BCVA and CRT were significant statistical different in different time-point within each group ( F=291. 245, 103. 06, 665. 402, P<0. 01 ). Different surgical methods of 23G and 20G had interactive effects on IOP with different time points ( F = 13. 245, P<0. 01 ), but different surgeries had no interactive effects on BCVA and CRT with different time points (F=1. 212, 2. 293;P=0. 283, 0. 129). The counting CEC in 23G group was more than that in 20G group postoperatively at 90d, the difference was statistically significant (t=2. 049, P=0. 048). ·CONCLUSION: The 23G PPV combined with internal limiting membrane peeling, phacoemulsification, intraocular lens implantation for macular epiretinal membrane with cataract is effective. Compared with 20G PPV, 23G PPV has advantages in operation time for vitrectomy and counting CEC. But lower IOP is likely in 23G PPV on 1d after surgery

Objective The purpose of this study was to evaluate the effect of patient’s body mass index on applications of auto-matic tube voltage selection (ATVS)for contrast-enhanced abdominal CT.Methods 1 60 patients underwent contrast-enhanced ab-dominal CT scan were assigned into the study group (ATVS technique)and the control group (120 kVp)with equal size (both n =80)according to the scanning mode.The two groups were both divided into four subgroups according to BMI (A:BMI <18.5 kg/m2 ;B:BMI 18.5~23.9 kg/m2 ;C:BMI 24~28.9 kg/m2 ;D:BMI ≥29 kg/m2 ).Image quality were assessed and compared with Rank-sum test.Analysis of variance was used to compare differences in mean contrast-to-noise ratio (CNR)and image noise a-mong the two groups.Two sample t tests were used to compare the radiation dose.Results In the study group,tube voltage of 100 kVp were selected highest(78.75%)and distributed from subgroups A to D,accounting for 60%,80%,90% and 60% respectively, with average BMI of (23.71±3.1 9)kg/m2 .Compared to control group,the effective dose of study group from subgroups A to C re-duced by 35.09%,27.61% and 1 9.08% respectively(t=3.829,4.389,2.238,P =0.005,<0.001,0.025).Despite the higher image noise in study group,the overall image quality was acceptable.Conclusion The contrast-enhanced abdominal CT with AVTS technique can reduce radiation dose in patients with BMI smaller than 28.9 kg/m2 .

Functional magnetic resonance imaging (fMRI), a newly developing technique, contains function, anatomy and image, which makes the real-time, dynamic and non-invasive measurement of the functional brain imaging availability. This paper summarized the characteristics of fMRI in health and stroke populations, introduced the advances of fMRI in neuroplasticity, rehabilitation assessment and prognosis in hand movement dysfunction in patients with stroke, and discussed the difficulty fMRI faced in rehabilitation assessment and the further researches.

Objective To investigate the impact of automatic tube voltage selection ( ATVS) and sinogram-affirmed iterative reconstruction ( SAFIRE) on image quality and radiation dose in the arterial phase (AP) and portal venous phase (PVP) abdominal dual-source CT imaging.Methods Abdomen contrast-enhanced computed tomography ( CECTs ) in 70 patients were scanned with dual-source CT.Patients were divided into study group and control group based on the scanning date.In the first 35 patients ( study group) , ATVS mode was applied; in the second 35 patients ( control group ) , the conventional fixed at 120 kVp mode was used.The imaging of the study group was reconstructed with FBP ( protocol A ) or SAFIRE ( protocol B ) respectively; the imaging of the control group was reconstructed with FBP ( protocol C).Image quality scores of the 3 protocols were assessed and compared with Rank-sum test.Analysis of variance was used to compare mean signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and image noise among the 3 protocols.Two sample t tests were used to compare the radiation dose difference.Results The effective radiation dose in the study group ( 3.9 ±0.4 ) mSv was much lower than that in the control group (4.9 ±0.4) mSv, dropped by 20.41% (t =2.315, P=0.021).The subjective rating scores in protocol A, B, C in arterial were (3.65 ±0.08), (4.41 ±0.10) and (3.79 ±0.10) point, while the subjective rating scores in venous phase were (3.57 ±0.08), (4.41 ±0.10) and (3.95 ±0.11) point.The differences were statistically significant (Z value were 27.587 and 27.436, P<0.01).The image noise of protocol A , B, C in dual-phase were ( 11.96 ±0.33 ) , ( 8.45 ±0.26 ) , ( 10.38 ±0.26 ) HU and (12.79 ±0.39),(9.14 ±0.36), (11.13 ±0.18) HU.The differences were statistically significant (F value were 39.235 and 29.846, P<0.01).Compared to protocol A and C, SNR and CNR in protocol B were much higher (P<0.01).No statistically significant differences were shown between protocol A and C in SNR and CNR ( P>0.05).Conclusion Use of ATVS and SAFIRE could reduce the radiation dose and provide better quality images compared with conventional abdominal CECT and FBP .

OBJECTIVETo explore activity laws of mitochondrial complex II in patients of deficiency-cold syndrome (DCS) and deficiency-heat syndrome (DHS) under various ambient temperatures.

METHODSSubjects were recruited by questionnaire and expert diagnosis from grade 1 - 3 undergraduates at Henan College of Traditional Chinese Medicine in November 2012, and assigned to a normal control group, the DCS group, and the DHS group, 20 in each group. Their venous blood samples were collected at two different temperature conditions. Activities of mitochondrial complex II were measured by spectrophotometry.

RESULTS(1) Comparison of mitochondrial complex It under various ambient temperatures: Compared with room temperature in the same group, activity values were all increased in the normal control group at cold temperature with significant difference (P <0.05), but there was no significant difference in the DCS group and the DHS group (P >0. 05). Compared with the normal control group, activity values of complex H were reduced in the DCS group at cold and room temperatures with significant difference (P <0.05). Compared with the DCS group, activity values of complex It were increased in the DHS group with significant difference (P <0. 05). (2) Changes of adjustment rates: Compared with room temperature, the adjustment rate all rose at cold temperature in the normal control group and the DHS group with significant difference (P <0.05), but with no significant difference found in the DCS group (P >0. 05). Compared with the normal control group at the same temperature, the adjustment rate in the DHS group and the DCS group was all reduced at cold and room temperatures with significant difference (P <0. 05). There were no significant difference in the adjustment rate between the DHS group and the DCS group (P > 0. 05).

CONCLUSIONSEnvironment temperature can affect the activity of mitochondrial complex II with different influence degrees on different syndrome types of people, but its change trend are basically identical.

Cold Temperature ; Electron Transport Complex II ; metabolism ; Hot Temperature ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Temperature

Objective · To identify broad-spectrum bacteriophages against extensively drug-resistant Klebsiella pneumonia and analyze their characteristics by biological and genomic methods. Methods · Multi-drug resistant Klebsiella pneumonia strains collected from a hospital were used as host bacteria to isolate and purify broad-spectrum phages in the wastewater at the same hospital area. The size and shape of phages were observed by transmission electron microscope. Titer, host range, pH stability and thermal stability were measured. Moreover, the DNA extracted from the phage SH-Kp152234 was sequenced and analyzed. Results · One strain of bacteriophage against Klebsiella pneumonia was isolated and named as SH-Kp152234. The electron microscope revealed it belongs to Podoviridae family. Moreover, genome of SH-Kp152234 showed to be a linear double-stranded DNA of 40578 bp with the GC content of 52.85%. It was predicted to have 49 open reading frames with related known functions.Conclusion · SH-Kp152234, with a broad host range and a short latent period, which could exert its activity in a wide range of temperature and pH, is a promising candidate to be exploited in the treatment of multiple drug-resistant Klebsiella pneumonia.

OBJECTIVETo explore the preoperative diagnostic value of ¹⁸F-fluorodexyglucose positron emission tomography combined with contrast enhanced computed tomography (¹⁸F-FDG PET-ceCT) in patients with colorectal cancer liver metastasis.

METHODSClinical and imaging data of 58 patients with suspicious colorectal cancer liver metastasis between April 2010 and March 2013 were retrospectively evaluated. All the patients underwent ¹⁸F-FDG PET-ceCT. On the basis of definitive diagnosis, the sensitivity, specificity, accuracy and consistency of routine PET-CT, ceCT and ¹⁸F-FDG PET-ceCT were calculated.

RESULTSA total of 147 suspicious lesions of colorectal cancer liver metastasis were found in 58 patients. Finally, 125 lesions were confinmed as malignant, of which 58 (46.4%) lesions were less than 1.0 cm. The other 22 lesions were confinmed as benign, of which 17 (77.3%) lesions were less than 1.0 cm. The diagnostic accuracy of routine PET-CT, ceCT and ¹⁸F-FDG PET-ceCT in colorectal cancer liver metastasis for the lesions more than 1.0 cm was 100%, 93.1%, 100% respectively, and the consistency with final diagnosis was perfect, moderate, and perfect respectively (Kappa value 01.00, 0.408, 1.00). For the lesions less than 1.0 cm, the accuracy was 42.7%, 78.7%, 94.7% respectively, and the consistency with definitive diagnosis was insignificance, fair, and almost perfect respectively (Kappa value -0.005, 0.305, 0.848). The area under curve(AUC) was 0.525 (95% CI: 0.407-0.462) for routine PET-CT, 0.651(95% CI:0.532-0.757) for ceCT, and 0.924 (95% CI:0.839-0.972) for ¹⁸F-FDG PET-ceCT respectively. The AUC of ¹⁸F-FDG PET-ceCT was significantly larger than that of routine PET-CT (Z=5.559, P<0.05) or ceCT (Z=4.183, P<0.05).

CONCLUSION(18)F-FDG PET-ceCT can improve the diagnostic accuracy for smaller lesions of colorectal cancer liver metastasis.

Colorectal Neoplasms ; Contrast Media ; Fluorodeoxyglucose F18 ; Humans ; Liver Neoplasms ; Multimodal Imaging ; Positron-Emission Tomography ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVEThe complementarity determining region 3 (CDR3) of T cell receptor (TCR) is the place through which T cells connect to the antigen. The lengths and DNA sequences of CDR3s are different according to different T cell clones. This leads to a diverse TCR CDR3 repertoires which can reflects the functional status of T cells precisely. This study aimed at elucidating the abnormality of TCR beta chain variable region (BV) CDR3 repertoires of children with acute B lymphoblastic leukemia, the pathogenesis of leukemia associated with T cell dysfunction and the immuno-reconstruction of T cells after the chemotherapy.

METHODSTwelve children aged from 3 to 13 years (average 4.50 +/- 3.78 years) with acute B lymphoblastic leukemia before chemotherapy and 8 healthy control donors aged from 6 to 16 years (average 10.30 +/- 3.00 years) were enrolled. Four of 12 patients were studied for the second time 3 months after complete remission (CR). Reverse transcription-polymerase chain reaction (RT-PCR) and polyacrylamide sequencing gel electrophoresis were used to detect the diversity of TCR BV CDR3 repertoires of these children.

RESULTS(1) The expression of BV2 and BV3 in 12 children increased and BV17 and BV18 decreased before the chemotherapy as compared with controls (P < 0.05). There were 4 children with a lower level expression of BV21 before the chemotherapy, and much lower level expression was found after the remission. (2) Normally each lane contained eight to ten bands, which represented unique CDR3 sizes for a given TCR BV family. Bands differed in size by 3 nucleotides and generally form a Gaussian distribution. There were 14% TCR BV families with abnormal CDR3 length distribution in 12 patients before therapy, which was significantly higher than that of controls (5.5%, P < 0.05). Restricted CDR3 length distribution was observed in BV14, BV1, BV16, BV20, BV13.1, BV13.2 and BV6. Every abnormal BV family recovered to normal Gaussian distribution 3 months after CR.

CONCLUSIONT lymphocytes in children with acute B lymphoblastic leukemia revealed markedly skewed repertoires, which suggests the abnormality of T cell functions. Most abnormal T cell repertoires recovered to normal Gaussian distribution 3 months after the first CR, which suggests the immunological reconstitution of T cell repertoires.

Adolescent ; Burkitt Lymphoma ; genetics ; immunology ; Child ; Child, Preschool ; Complementarity Determining Regions ; genetics ; DNA, Complementary ; chemistry ; genetics ; Electrophoresis, Polyacrylamide Gel ; Female ; Humans ; Male ; Receptors, Antigen, T-Cell, alpha-beta ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA