Objective To evaluate the value of 64-slice spiral CT angiography based on pre- contrasted raw data in diagnosing pulmonary arteriovenous fistula.Methods 64-slice spiral CT plain scan and enhanced scan was performed in 16 patients with pulmonary arteriovenous fistula,pulmonary angiography based on pre-contrast and post-contrast raw data was performed respectively,including maximum intensity projection(MIP),shaded-surface display(SSD),and volume rendering(VR).According to the results of angiocardiography and surgical findings,comparson of the three methods was made in the display of PAVF in pre-contrast and post-contrast phase images.Results 8 of the 16 PAVF cases were single lesion,8 cases were multi-lesions.30 PAVF lesions were found in all the patients.MIP,SSD and VR based on pre-contrast raw data displayed PAVF lesions in 20,14,and 22,respectively.The combination of the 3 methods based on pre-contrast raw data could show 26 PAVF lesions.MIP,SSD,and VR based on post-contrast raw data displayed PAVF lesions in 24,18,and 30,respectively.The combination of the 3 methods based on post- contrast raw data could show 30 PAVF lesions.Conclusion 64-slice spiral CT angiography based on pre- contrasted raw data can clearly show the position,number,and shape of PAVF lesions,which is of great value in diagnosing PAVF.

Ten flavonoids were isolated from the 95% ethanol extract of the seeds of Alpinia galanga Willd. with a combination of various chromatographic techniques, including silica gel, Sephadex LH-20 and preparative HPLC. On the basis of spectroscopic data analysis, they were elucidated as (2R, 3S)-pinobaksin-3-cinnamate (1), (2R, 3R)-pinobaksin-3-cinnamate (2), pinocembrin (3), pinobaksin (4), 3-O-acetylpinobaksin (5), galangin (6), galangin-3-methylether (7), kumatakenin (8), 3-methylkaempferol (9) and (2R, 3R)-3, 5-dihydroxy-7-methoxyflavanone (10). Among them, compound 1 is a new compound, compounds 2, 5 and 10 were isolated from the genus Alpinia for the first time, and others were isolated from this plant for the first time.
Alpinia ; chemistry ; Benzopyrans ; chemistry ; isolation & purification ; Cinnamates ; chemistry ; isolation & purification ; Flavanones ; chemistry ; isolation & purification ; Flavonoids ; chemistry ; isolation & purification ; Kaempferols ; chemistry ; isolation & purification ; Molecular Structure ; Plants, Medicinal ; chemistry ; Seeds ; chemistry

Objective To investigate the effects of Sacubitril/Valsartan on amino terminal probrain natriuretic peptide (NT-proBNP),high sensitivity C-reactive protein (hs-CRP),soluble suppression of tumorigenicity 2(sST2)levels and on left ventricular(LV)structure in NYHA Ⅳ heart failure with reduced ejection fraction(HFrEF) patients.Methods A total of 67 HFrEF patients with NYHA Ⅳ were randomly divided into the control group (n =30)receiving conventional medical treatment,and the observation group(n=32)receiving Sacubitril/Valsartan instead of ACEI(or ARB if ACEI induced cough) in conventional medical treatment.NT-proBNP levels were determined by fluorescer-enhanced chemiluminescence.hs CRP levels were detected by latecx enhanced immunoturbidimetric assay.sST2 levels were determined by enzyme-linked immunosorbent assay (ELISA).The modified Simpson method was used to detect left ventricular end-diastolic diameter (LVEDD),LV posterior wall(LVPW)and LV ejection fraction(LVEF).Two groups of patients were treated and followed-up for 6 months.Results Clinical efficacy was better in the observation group than in the control group(effective rate,20 cases or 61.3％ vs.8 cases or 26.7％,P＜0.05).As compared with the control group,the observation group of patients had an increased LVEF[(46.7±9.2) ％ vs.(41.8±8.0)％,P＜0.05]and a decreased LVEDD[(52.6±6.7)mm vs.(58.8±7.5)mm,P＜0.05].After vs.before treatment,NT-proBNP,hs-CRP and sST2 levels were decreased in both control and observation groups [(1 427 ± 219) μg/L vs.(2 615 ± 273)μg/L,(1.14 ± 1.02) mg/L vs.(1.55±1.38)mg/L,(0.30±0.12)μg/L vs.(0.41±0.10)μg/L,all P＜0.05],and the decrements were much more in the observation group than in the control group (P＜0.05).The annual accumulated frequence and duration of hospitalization were less in the observation group than in the control group[(0.8±0.6)times vs.(1.8±1.0) times,(10.2±5.8)d vs.(16.5±7.2)d,P＜0.05].The maintenance dose of tolasemide was lower in the observation group than in the control group [(15.2±8.4)mg vs.(20.6±10.8)mg,P＜0.05].Conclusions Sacubitril/valsartan therapy is safe and effective and it can reduce hs-CRP and sST2 levels and improve the ventricular remodeling in HFrEF patients of HYHA Ⅳ.

Adult ; Aged ; Female ; Humans ; Male ; Mediastinoscopy ; methods ; Middle Aged ; Stents ; Superior Vena Cava Syndrome ; diagnosis ; therapy

The aim of this study was to investigate the circulating levels of IL-11 in the patients with chronic idiopathic thrombocytopenic purpura (CITP), and its significance, and to evaluate the curative effect of rhIL-11 on CITP. The level of IL-11 in patients with CITP was determined by ELISA before and after treatment, respectively. 1.5 mg of rhIL-11 were injected subcutaneously, once a day, continuously for 14 days as one course, treatment time 1 - 2 courses as total. The results showed that the higher blood IL-11 level was found in CITP patients than that in controls (P < 0.01) and during the course of treatment the number of platelets in peripheral blood of patients with CITP parallelled to the level of IL-11. The platelet counts were obviously increased in all CITP patients after rhIL-11 treatment. It is concluded that the serum level of IL-11 in patients is correlated to the number of platelets in patients. rhIL-11 can be used as an effective treatment for CITP.
Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Humans ; Interleukin-11 ; blood ; therapeutic use ; Male ; Middle Aged ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Recombinant Proteins ; therapeutic use ; Treatment Outcome

OBJECTIVETo study the chemical constituents from the bark of Morus macroura.

METHODThe compounds were isolated with silica gel column chromatography and their structures were elucidated on the basis of chemical evidences and spectral analysis (IR, EI-MS, 1H-NMR, 13C-NMR).

RESULTFive compounds were identified as alpha-amyrin acetate (1), gult-5-en-3 beta-yl acetate (2), 3 beta-hydroxylup-20 (29)-en-28-oic acid (3), 3 beta-hydroxylup-12-en-28-oic acid (4), butyrospermol acetate (5).

Morus ; chemistry ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Organic Chemicals ; Plant Bark ; chemistry ; Plant Extracts ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry

OBJECTIVELandmark trials have demonstrated that statins can reduce the risk of coronary events. Despite the widespread use of statins in the settings of primary and secondary prevention of CHD, withdrawal of statins is a frequent problem in clinical practice. Several recent clinical studies have suggested that withdrawal of statin therapy might be associated with an increase in thrombotic vascular events and the onset of acute coronary syndromes. However, the effects of discontinuing of statins treatment on endothelial function and underlying mechanism are unknown. Objectives We investigated the effects after withdrawal of simvastatin on brachial artery endothelial function in patients unreached cholesterol target with coronary heart disease (CHD) or CHD risk factors.

METHODSWe included 33 patients with established CHD or CHD risk factors, whose serum cholesterol did not achieve NCEP target level. They were administered simvastatin (20 mg) for 4 weeks. Endothelial dependent flow-mediated vasodilation (FMD) was assessed in the brachial artery using high-resolution ultrasound at baseline, after 4 weeks of simvastatin and after termination of therapy 1 week. We evaluated fasting serum lipid profiles and vasoactive substances simultaneously, included nitric oxide (NO), endothelin (ET), 6-keto-PGF1(alpha) and thromboxane B(2) (TXB(2)), which were measured as plasma prostacyclin and TXA(2) respectively.

RESULTSSimvastatin treatment reduced low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels and improved endothelial-dependent vasodilation in patients after 4 weeks. Withdrawal of simvastatin, however, FMD showed a significant reduction [(4.82 +/- 0.71)% vs (11.51 +/- 0.87)%, P < 0.01], that remained in low level after 1 week, and the FMD were even lower than the baseline values [(4.82 +/- 0.71)% vs (5.89 +/- 0.65)%, P < 0.01]. After terminating simvastatin treatment, serum NO and plasma 6-keto-PGF1(alpha) levels decreased, as well as plasma ET and serum LDL-C levels increased. But there was no significant difference between plasma TXB(2) levels before and after withdrawal of simvastatin (P > 0.05). Overall, there were significant positive correlations between withdrawal-induced changes in FMD and serum NO level (r = 0.674, P = 0.004), whereas no correlations were shown between the changes in FMD and serum LDL-C level (r = -0.414, P = 0.083).

CONCLUSIONSAbrupt withdrawal of simvastatin therapy resulted in the significant adverse impact on brachial artery endothelial function in patients unreached cholesterol target with CHD or CHD risk factors. Termination of therapy may suppress endothelial NO production and impair endothelial function that is independent of lipid-lowering effect.

Aged ; Brachial Artery ; drug effects ; Cholesterol, LDL ; blood ; Coronary Disease ; drug therapy ; physiopathology ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Hypolipidemic Agents ; administration & dosage ; Male ; Middle Aged ; Nitric Oxide ; blood ; Risk Factors ; Simvastatin ; administration & dosage ; Vasodilation

OBJECTIVETo analyze the changes in the cardiac function after St. Jude Regent mechanical valve replacement and assess the prosthesis-patient matching.

METHODSFrom October 2007 to March 2009, 44 patients received implantation of 17 mm St. Jude aortic prostheses in our hospital. The patients were followed up for clinical symptoms, signs, electrocardiogram (ECG), echocardiogram and cardiac functions, and the results were compared with those of randomly selected 44 patients receiving 21 mm St. Jude aortic prostheses.

RESULTSIn 17 mm St Jude Medica Regent valve group, 8 patients presented with ECG ST segment changes, 3 complained of chest tightness, 3 had occasional chest pain and discomfort, and 8 had grade II and 4 grade III cardiac function. In 21 mm St Jude Medical Regent valve group, 6 patients had ECG ST segment changes, 2 complained of chest tightness, 2 reported occasional chest pain and discomfort, 11 had grade II and 2 grade III cardiac function. No significant differences were found in these indices between the two groups (P=0.32). Compared with those before operation, the two groups showed significant improvements in the left ventricular end-diastolic diameter, left ventricular posterior wall thickness, left ventricular mass index, and aortic pressure gradient (P<0.05). A significant increase in the left ventricular ejection fraction occurred 6-12 months after operation, but without statistical difference between the two groups (P>0.05).

CONCLUSIONFor underweight patients (<60 kg) and those with small body surface area (<1.6 cm(2)), 17 mm St. Jude Medical Regent valve prosthesis may produce good therapeutic effect, and some indices are even close to those after placement of 21 mm St. Jude Medical Regent valve prosthesis. No obvious prosthesis-patient mismatch occurs after the placement of the 17 mm valve prosthesis and aortic valve ring expansion is not necessary.

Adolescent ; Adult ; Aortic Valve ; diagnostic imaging ; surgery ; Aortic Valve Stenosis ; diagnostic imaging ; surgery ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; adverse effects ; methods ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Treatment Outcome ; Ultrasonography ; Young Adult

OBJECTIVETo summarize lessons learned from an outbreak of severe acute respiratory syndrome (SARS) in China during the spring of 2004.

METHODSData of SARS cases were officially reported by Beijing Municipal Center for Disease Control and Prevention (BCDC) and Anhui Provincial Center for Disease Control and Prevention (APCDC) and results of epidemiological investigations were collected and analyzed.

RESULTSThree generations of 11 cases of SARS were identified during the outbreak. Initial two cases were most likely to be infected in Diarrhea Virus Laboratory of National Institute of Virology, China Centers for Disease Control and Prevention and main mode of transmission was direct contact with SARS patients. Delay in detecting initial case resulted in spread of the illness at hospitals and communities with two generations of secondary cases.

CONCLUSIONSSARS outbreak in 2004 has yielded following lessons for public health globally. (1) Lab bio-safety programs should be made and should be strictly abided by. Studies in highly pathogenic viruses such as SARS coronavirus should be utmost cautious. (2) Management systems of occupational exposure to virus and disease surveillance need to be strengthened to take all risk factors into account so as to detect potential patients with infectious disease as early as possible.

China ; epidemiology ; Disease Outbreaks ; Female ; Humans ; Male ; Occupational Exposure ; prevention & control ; Occupational Health ; Retrospective Studies ; Severe Acute Respiratory Syndrome ; epidemiology ; prevention & control ; transmission

Objective · To investigate the micro/ nano structure of human vaginal wall acellular matrix, and provide parameters for bionic vagina.Methods · A total of 35 vaginal specimens were obtained from 35 postmenopausal patients who underwent cystocele repair and/or rectocele repair.Cells in specimens were entirely removed, and the extracellular matrix was maintained. Then the acellular matrix was observed by general observation,H-E staining, Masson staining, scanning electron microscope and Micro-CT. The external and internal structure properties were measured and analyzed.Results · All cells in 35 vaginal specimens were totally removed. The vaginal wall acellular matrix was a double-layer fibrous reticular structure composed of interlaced collagen fibers, which were further arranged into bundles. Pores were distributed among fiber bundles. Epithelial side structure of vaginal wall acellular matrix was dense and subepithelial tissue was loose. There was no significant difference in fiber diameter [(82.4±9.3) nm vs (87.5±10.2)nm, P=0.432] and fiber bundle thickness [(67.6±9.3) μm vs (65.3±5.2) μm, P=0.634] between the dense and loose layers. Fiber bundle separation [(180.1±24.5) μm vs (118.2±23.0) μm, P=0.003] and total porosity [(77.1±4.2)% vs (66.6±2.8)%, P=0.002] were higher in loose layer. There was no significant difference in the micro/nano structure parameters of the acellular matrix between the anterior vaginal wall and the posterior vaginal wall.Conclusion · There was no significant difference in the fiber diameter and the fiber bundle thickness between the dense layer and the loose layer of vaginal wall acellular matrix, but the porosity of the dense layer fiber bundle was smaller than that of the loose layer.