Objective Mechanisms for the dissection of aorta, a devastating disease, remain unknown. Studies showed that cytokine transforming growth factor (TGF)-131, a multifunctional regulator, was highly expressed in the aneurysms or dis-section of aorta and was responsible for the onset of the diseases. We try to explore the mechanisms of thoracic aortic dissection (TAD) by comparing the expression and distribution of TGF-β1 in the aortic wall and analyzing the association of TGF-β1 with extracellular matrix (ECM) in patients with TAD and control subjects. Methods Aortic specimens taken from surgical pa-tients with TAD( n = 20 ) at Zhongshao Hospital and organ donors ( n = 20, controls) were prepared with paraffin embedded tis-sue slide. ECM was investigated with hematoxylin-eosin, Verhoeff van-Giesen (EVG) and Maason's triehrome (MT) staining.Distribution and expression of TGF-β1 within aortic wall was examined with double immunofluoreseent staining and semi-quan-tiffed by fluoreseent intensity analysis. The expression of TGF-β1 in the two groups and among various layers of the arterial wall was compared. Results TAD was morphologically characterized by decreased and disrupted elastic fibers in the tunica media of the aorta wall with hyperplasia of the collagen fibers. TGF-β1 was expressed unevenly within aortic wall, with highest in the media, followed by intima and adventitia, in both TAD patients and eantrols. Specimen from TAD patients exhibited overall in-creased TGF-β1 expression by 9.56% as compared with that from the controls ( P <0.05 ). TGF-131 expression was increased by 16.09% (P<0.05) in the media and 16.75% (P<0.05) in the adventitia in TAD group as compared with those in the control group, but no difference was detected in intima between the two groups. TGF-β1 distribution histogram analysis dis-closed that TGF-β1 expression in the tunica media was evident in the elastic fibers, and was increased by 34.83% in TAD pa-tients as compared with that in the controls (P <0. 01 ). No significant associations between TGF-β1 expression and age, gen-der, maximal aortic diameter and type of dissection in TAD patients were detected. Conclusion TGF-β1 expression is up-reg-ulated and unevenly distributed in the dissected aortic wall of TAD patients. The finding that TGF-β1 was significantly up-regulated and condensed in the elastic fibers of the tuniea media suggested the crucial role of TGF-β1 in the development of TAD.

Objective To explore the incidence and etiology of infection after heart transplantation and discuss the prophylaxis and management. Methods Retrospective study was conducted on the 140 survival heart transplant recipients (HTs) with detail follow-up information. All patients received preventive therapy against bacterial infections postoperatively, of which 87. 8% patients used antiviral drugs to prevent cytomegalovirus (CMV) infection. The immuosuppressive regiment was as follows: tacrolimus (Tac) or cyclosporine A (CsA), mycophenolate mofetil (MMF),glucocorticoid. Postoperatively all patients had throat swabs, sputum smear Gram stain, sputum culture, blood culture, urine culture and fecal culture for microbiological monitoring. Schedule tables were made to record and analyze the demography of the patients and the timetable of infections. Results The incidence of infections was 42.9 episodes per 100 HTs. Sixty-four cases (76. 2% ) of the infections occurred in the first month after transplantation and all recovered, 20 cases (23.8%) took place after 1 months, and 4 patients died. Conclusion Perioperative infections are mostly caused by bacteria and the prognosis is good. Infections 2 months after operation are commonly caused by virus or fungi with poor prognosis.

Objective To evaluate the cardiopulmonary allograft function and to analyze key factors for long-term survival of heart-lung transplantation in a patient survived more than 5 years. Methods On December 17th, 2003 at Zhongshan Hospital of Fudan University, a homologous heart-lung transplantation was performed on a female who diagnosed with cardiopulmonary failure secondary to congenital atrial septal defect with severe pulmonary hypertension. Heart-lung allograft was preserved with 1 000 mL UW solution and 4 000 mL HTK solution.Postoperative immunosuppressive therapies were managed with Zenapax, cyclosporine A (or tacrolimus), mycophenolate mofetil and corticosteroids. Cyclosporine A maintained with serum trough levels of 100-200 μg/L and tacrolimus with serum trough levels of 8-20 μg/L. Cardiopulmonary allograft functions were evaluated by echocardiogram, pulmonary function test and thoracic CT periodically. Results The patient survived operation and experienced normal daily life with NYHA cardiac function of class Ⅰ-Ⅱ during the follow-up of 5 years and 6 months. Echocardiogram showed left ventricular ejection fraction of 65% to 86%. Pulmonary function test exhibited with nearly normal oxygen exchange, meanwhile, small airway obstruction was detected from one year after operation and keeping stable from then on. Two episodes of severe pneumonia were complicated and treated with antibiotics and fhconazob, no severe acute allograft rejection episode was experienced. Conclusions Heart-lung transplantation proves to be a reliable therapy modality for terminal cardiopulmonary failure. Excellent donor organ preservation, accurate balance of the risk between acute allograft rejection and infection, and strict preventive measures against infection are key factors for long-term survival of heart-lung transplantation.

Objective To investigate the feasibility of ultrasound speckle tracking imaging(STI)in assessing left ventricular(LV)systolic and twist function in patients with heart transplantation.Methods Nine patients with heart transplantation and 10 subjects with normal LV function were examined by GE Vivid 7 with a M3S probe.Eighteen regional peak systolic strain and displacement in longitudinal,radial,circumferential,and 18 regional degree of rotation were measured respectively.Results The segmental regional peak systolic strain and displacement were less than those in subjects with normal LV function(P ＜0.05),but segmental regional degree of rotation was more than that in subjeets with normal LV function (P＜0.05).Conclusions STI may provide a noninvasive,simple and quick tool for evaluation of left ventricular systolic and twist function in patients with heart transplantation.

Objective To investigate the reliability and validity of a novel hand-held dynamometer, OE-210, for muscles strength of low-er extremities. Methods From March 1st to August 30th, 2016, 38 young adults were tested the muscle strength of quadriceps and ham-strings with OE-210 dynamometer by 2 rators, and were retested by one of the raters three days later. The isokinetic test was also conducted on all the subjects one day afterwards. The intraclass correlation coefficient (ICC) of OE-210 test results and the Pearson's correlation coeffi-cient between results of OE-210 and isokinetic test were calculated. Results The ICC of test-retest were 0.718 to 0.924, and the ICC of in-ter-rater were 0.784 to 0.870. The correlation between muscle performance measured with 2 tools were significant (P<0.001), that was light to medium on quadriceps (r=0.270-0.413), and strong on hamstrings (r=0.582-0.668). Conclusion OE-210 dynamometer was reliable for muscle strength measurement on quadriceps and hamstrings, and the conditions for valid application need further research.

OBJECTIVE:To establish a method for simultaneous determination of residual methylparaben,ethylparaben,nipa-sol and benzalkonium chloride in marketed eye drops. METHODS:HPLC method was adopted. The determination was performed on Hypersil GOLD C18 column with mobile phase consisted of 0.005 mol/L ammonium acetate(10 mL triehtylamine in 1 L solu-tion,pH adjusted to 5.0±0.5 with glacial acetic acid)-acetonitrile(45:55,V/V)at the flow rate of 1.0 mL/min. The detection wave-length was 262 nm(methylparaben,ethylparaben,nipasol)and 214 nm(benzalkonium chloride),respectively. The column tem-perature was 30 ℃ and sample size was 20 μL. RESULTS:The linear range were 1.2350-15.4380 μg/mL for methylparaben(r=0.9999),1.3170-16.3836 μ g/mL for ethylparaben (r=0.9997),1.2072-15.0894 μ g/mL for nipasol (r=0.9996) and 17.776-222.0 μg/mL for benzalkonium chloride(r=0.9999),respectively. Limits of quantitation were 2.0,2.0,2.0,1.11 μg,re-spectively;limits of determination were 0.375,0.375,0.375,0.333 μg,respectively. RSDs of precision,stability and reproducibili-ty tests were all lower than 2.0%. The average recoveries were 98.14%-102.48%(RSD=1.6%,n=9),98.79%-102.42%(RSD=1.3%,n=9),98.19%-102.49%(RSD=1.5%,n=9)and 98.76%-100.53%(RSD=0.6%,n=9),respectively. CONCLUSIONS:The method is accurate,reproducible,simple and suitable for the determination of residual methylparaben,ethylparaben,nipasol and benzalkonium chloride in marketed eye drops.

As there are not many research reports on segmentation and quantitative analysis of soft tissues in lumbar medical images, this paper presents an algorithm for segmenting and quantitatively analyzing discs in lumbar Magnetic Resonance Imaging (MRI). Vertebrae are first segmented using improved Independent component analysis based active appearance model (ICA-AAM), and lumbar curve is obtained with Minimum Description Length (MDL); based on these results, fast and unsupervised Markov Random Field (MRF) disc segmentation combining disc imaging features and intensity profile is further achieved; finally, disc herniation is quantitatively evaluated. The experiment proves that the proposed algorithm is fast and effective, thus providing doctors with aid in diagnosing and curing lumbar disc herniation.
Algorithms ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Intervertebral Disc ; pathology ; Intervertebral Disc Displacement ; diagnosis ; pathology ; Lumbar Vertebrae ; pathology ; Magnetic Resonance Imaging ; Markov Chains

This study sought to measure accurately the thickness of the frontal, parietal and occipital bones of the alive human skull based on CT images. The images were treated with a series of processes by coding into a program: image segmentation and binary coding; eliminating edge interference; rectifying image deviation and clarifying boundary edge; redrawing the boundary and reference point fixing; and finally thickness measurement. The new method can measure not only the different points in one CT image but also the same point in massive CT images. The measurement results are of great practical value in the fields of anatomy, clinical medicine, biomechanics study, head injury analysis, etc.
Cephalometry ; methods ; Humans ; Radiographic Image Enhancement ; methods ; Skull ; anatomy & histology ; diagnostic imaging ; Tomography, X-Ray Computed

Two kinds of algorithm have been set forth to estimate the symmetry characteristic of live human skull on CT image. These CT images were treated with a series of processes such as coding into programs, formatting originals, binary coding, rectifying image deviation, detecting boundary edge, and quantitatively measuring the skull symmetry. The statistical analyses of measuring 3000 live human skull images have worked out the ratio and the distribution of the skull symmetry, so that dependable data are provided for establishing the human head injury biomechanics model. The results are of great practical value in the fields of anatomy, clinical medicine, biomechanies study, head injury analysis, etc.
Biomechanical Phenomena ; Cephalometry ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Male ; Reference Values ; Skull ; anatomy & histology ; diagnostic imaging ; Tomography, X-Ray Computed

Objective:To investigate the clinical characteristics and gene mutation of seven cases of CDKL5 gene related early-onset epileptic encephalopathy diagnosed by next-generation sequencing.Methods:The clinical data of children with early-onset epileptic encephalopathy from February 2018 to December 2019 in the Department of Neurology, Children′s Hospital Affiliated to Zhengzhou University were retrospectively analyzed. The whole exome sequencing method was used to analyze the entire exome of the proband, and seven cases of CDKL5 gene mutation positive were screened out, and Sanger sequencing verification on family members was performed to identify the source and the characteristics of gene mutations were analyzed.Results:Among the seven children diagnosed with CDKL5 gene related early-onset epileptic encephalopathy, the ratio of male to female was 2∶5, and the age of onset was 15 days to five months of birth. The clinical phenotypes all included different degrees of developmental delay and repeated seizures, which were manifested as general seizures, myoclonic seizures, convulsive seizures or focal seizures; the outcome of use of antiepileptic drugs to control seizures was poor, and some applications of ketogenic diet had better effects. CDKL5 gene mutation sites were all denovo mutations, including NM_003159: c.772_776del (p.K258Efs *10) frameshift mutation, NM_003159.2 (exon: 9-15) heterozygous deletion, CDKL5 hemizygous deletion, NM_003159: c.268 (exon5) G>T (p.E90 *, 941) and NM_003159: c.2578C>T (p.Q860 *, 171) nonsense mutation, NM_003159: c.211A>G (p.Asn71Asp) and NM_001323289: c.545T>C (p.L182P) missense mutation. Among them, c.772_776del (p.K258Efs *10), c.268 (exon5)G>T and c.2578C>T (p.Q860 *, 171) have not been reported. Conclusions:CDKL5 gene related early-onset epileptic encephalopathy is an early onset epilepsy, which is more common in women, and has different forms of seizures. The early electroencephalogram is characterized as severe abnormal brain discharge, and the disease progresses in various forms. There are no specific changes in head magnetic resonance imaging. Different gene mutation sites may lead to different phenotypes and prognostic differences. Many anti-epileptic treatments are ineffective, and ketogenic diets are effective for some patients.