Objective To evaluate the left ventricular (LV) systolic dyssynchrony after the acute myocardial infarction (AMI) with two-dimensional speckle tracking echocardiography (STE). Methods STE were performed in 65 patients within 72 h of AMI and compared with 60 age- and sex-matched healthy volunteers. The peak longitudinal strain (LS_(peak)) was measured at LV myocardium. LV dyssynchrony was defined as an interval ≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall (TAS-POST). Size of myocardial infarction (MIS)was confirmed by wall-motion score index (WMSI). Results The LS_(peak) and LV ejection fraction (LVEF) were lower, and WMSI and TAS-POST were larger in AMI patients compared with controls. Forty-two patients had developed LV dyssynchrony (64.62%), and there were strong correlation between LV dyssynchrony (TAS-POST) and LS_(peak), LVEF, and WMSI (MIS). MIS was the most independent predictor for systolic dyssynchrony. Conclusion AMI with normal QRS can induce LV dyssynchrony, which is mainly determined by MIS. STE is a reliable technique for accurate evaluation of LV synchrony.

Objective To investigate the clinical characteristics and surgical management of adult presacral tumors.Methods The clinical data of 24 patients with adult presacral tumors from 2007 to 2012 were retrospectively analysed.All patients were diagnosed by digital rectal examination and imaging examination before operation.Seventeen patients with via sacrococcygeal approach,4 patients with via abdominal approach,and 3 patients with via combined abdominal and sacrococcygeal approach.Results The incision of 22 patients primary healing.There were 2 patients with postoperative incision infections,after dressing change cure.No patients died during perioperative period.Twenty patients were followed up for 3-17 months,1 patient with via abdominal approach recurrenced,and was healed after a second surgical resection.Conclusions Digital rectal examination and imaging examination are the main methods for diagnosis of adult presacral tumors.Most adult presacral tumors can be resected through sacrococcygeal route.

Objective To investigate the effect of procyanidin from Vaccinium vitisidaea on the proli-feration of cardiac fibroblast(CFb) induced by angiotensin Ⅱ(AngⅡ),and to explore its mechanism.Methods The CFb proliferation of cultured neonatal rat was induced by AngⅡ and detected by MTT assay.The levels of collagen Ⅰ,collagen Ⅲ,and TGF-?1 were measured by ELISA.The change of NO content and iNOS activity were measured by nitric acid reductase method and spectrophotometry.Cell cycle was assessed via flow cytometry(FCM). The expression of cell cycle regulatory protein p27 was determined by the combination of immunocytochemical staining and image analysis software.Results CFb Proliferation,collagen content,and TGF-?1 levels in culture medium were markedly inhibited when CFb were treated with procyanidin at concentration of 25,50,and 100 mg/L(P

OBJECTIVE:To establish the quality standard for Qindan granules. METHODS: The constituents including Radix Scutellariae, Radix Astragali, Cortex Moutan and Fructus Gardeniae in Qindan granules were identified respectively by TLC. RESULTS: The test samples and their respective reference substances were alike in that the same color chromatographic spots were noted at the corresponding places. The color spectra of the samples were clear yet without interference of surrounding impurity. CONCLUSION: The established method has high specificity and can be used for the quality control of Qindan granule.

Objective To investigate early diagnosis and treatment of tumor of duodenal papilla.Methods Their clinical data of 64 cases of tumor of duodenal papilla confirmed by operation and pathology were analyzed retrospectively.They included 60 cases of carcinoma of duodenal papilla and 4 cases of adenoma.Results The main clinical symptoms were jaundice(42 cases),digestive tract symptoms(35 cases),recurrent cholangitis(7 cases) and hemorrhage of upper digestive tract(1 case).The diagnosis rate accuracy of ERCP,Fiberoptic duodenoendoscopy,MRCP,BUS and CT were 100%,97.3%,82.4%,82.8% and 76.1% respectively.Fifly-five cases underwent pancreatoduodenectomy,5 cases received local resection,and the remaining 4 cases were treated by palliative surgery.The surgical complication rate was 16.1% and the surgical mortality rate was 3.6%.The 1-year,3-year and 5-year survival rate of pancreatoduodenectomy were 67.4%,40.6% and 36.3%.Conclusions Jaundice and abdommal pain are the main symptoms of tumor of duodenal papilla.Fiberoptic duodenoendoscopy and ERCP are most effective methods for diagnosis of tumor of duodenal papilla.It is essential to early select radical resection operation so as to improve the results of surgical treatment.

Objective To investigate how functional connectivity changes within default-mode network related to posterior cingulated cortex employing resting-state functional MRI (tMRI). Methods fMRI was compared between 16 mild Alzheimer' s disease (AD) patients and 16 normal elder subjects. Regions of functional connectivity to posterior cingulated cortex were gathered by calculating temporal correlations in low frequency fMRI signal fluctuations. SPM2 was applied to calculate significant differences of connectivity between group and within group. Significance threshold was set up at the corrected P <0. 01, pixel extent > 5. A random effect two-example t test was performed by SPM2 to achieve significant difference of functional connection between groups ( P < 0. 01, corrected, t = 2. 47, pixel extent > 5 ). Results Regions showing disrupted connectivity to posterior cingulated cortex were: ventral medial prefrontal cortex (MPFC), bilateral visual cortex, infero-temporal cortex (ITC), and left hippocampus, right thalamus, right dorsal-lateral prefrontal cortex ( DLPFC), and precuneus. There were also regions showing increased connectivity with leftward asymmetry, these regions included: MPFC, left ITC, bilateral DLPFC, left pre- central motor cortex and left basal ganglia. Conclusions Impairments of memory and high visual-related functions in AD can be explained by functional disconnection in resting-state. Remoldability is reserved in mild AD to compensate for brain function which is taxed by left hemisphere preferentially. Our findings suggest that resting-state fMRI might be an appropriate approach for evaluating AD brain mechanism.

Objective To explore the value of combined detection with MMP-9 and uPA in the progno-sis of pancreatic carcinoma. Methods By immunohistochemistry PV methods,the expression of MMP-9 and uPA was respectively studied in 63 surgical specimens of primary pancreatic carcinoma and the survival time of patients with pancreatic carcinoma was analysed. Results The expressions of MMP-9 and uPA were positively related(r=0. 573,P=0. 000). The expression of MMP-9 and uPA significantly correlated with differentiation (r= -0. 271,P=0. 032;r= -0. 333,P=0. 008),TNM stages(r= -0. 449,P=0. 000;r= -0. 430,P=0. 000)and lymph node metastasis(r=0. 329,P=0. 009;r=0. 400,P=0. 001),separately. The expression of MMP-9 had also a significant correlation with tumer size(r= -0. 297,P=0. 018)and distant metastasis(r=0. 320,P=0. 011). Univariate analysis identified that tumor size(χ2 =8. 766,P=0. 012),differentiation(χ2 =29. 050,P=0. 000),clinical stage(χ2 =24. 940,P=0. 000),distant metastasis(χ2 =12. 846,P=0. 000), lymph node metastasis(χ2 =15. 457,P=0. 000),MMP-9(χ2 =32. 700,P=0. 000)and uPA(χ2 =41. 495,P=0. 000)were significantly associated with prognosis. Kaplan-Meier survival analysis showed that 1-year survival rate of patients with MMP-9 ( -),uPA ( -)were significantly longer than that of the patients with MMP-9( ﹢),uPA( ﹢),respectively(χ2 =32. 700,P=0. 000;χ2 =41. 495,P=0. 000);1-year survival rate of patients with MMP-9( -)/uPA( -)was significantly longer than the others( Log-rank test,χ2 = 54. 892, P=0. 000). COX regression revealed that differentiation(RR=2. 315,P=0. 004),clinical stage(RR=1. 694, P=0. 002),MMP-9(RR=0. 165,P=0. 000)and uPA(RR=0. 244,P=0. 007)was independent prognostic factors in pancreatic carcinoma. Conclusion They may have a synergistic function in the the process of growth and invasion in pancreatic cancer between MMP-9 and uPA,and the posssible mechanism is that uPA activate degradation of MMP-9,which is not favorable to prognosis. Combined analysis of MMP-9 and uPA may lead to a more reliable prognostic estimation,as the beneficial supplement of the differentiation,and clinical stage to judge the prognosis of pancreatic cancer.

Objective To evaluate surgical therapies in patients with popliteal aneurysms (PA).Method The clinical data of 25 PA patients admitted from January 1988 to January 2012 were retrospectively analyzed.There were 21 men and 4 women,the mean age was (56 ± 16)years.There were 27 PA in these 25 patients,with bilateral PA in 2 cases.The main symptoms were pulsatile mass in the popliteal fossa,limb pain,acute or chronic distal limb ischemia and limb edema.Result In this series 23out of 25 PA cases recieved operations,17 of them were treated with aneurysmectomy and saphenous vein interposition or bypass grafting,4 of them were treated with aneurysmectomy and prosthetic grafts interposition,1 was treated with aneurism ligation and 1 underwent end-to-end anastomosis after aneurysm resection.There was no perioperative mortality.One patient recieved amputation for distal anastomotic thrombosis and severe limb ischemia.The mean follow-up time is (6.5 ± 0.5) years.After 4 years,a right subclavian artery aneurysm was found in a bilateral PA case and treated surgically.Conclusions Early elective surgical treatment is recommended for patients with PA because PA may go rupture or induce dital limb ischemia and these patients may have good outcome after surgical treatment.Long-term follow-up is warranted to detect the new aneurysm formation.

Objective To prepare the 99Tcm-labeled human epidermal growth factor receptor type 2 (HER2) affibody molecule ZHER2:342 and evaluate its receptor binding specificity in vitro.Methods The molecular ZHERa:342 was labeled with 99Tcm using the ligand exchange method.The labeling efficiency and radiochemical purity were measured by HPLC.The major factors,such as the mass of SnC12 and NaOH and reaction time were analyzed,and the optimal method was summarized.Cell binding kinetics and cellular retention of the probe were investigated in HER2-expressing SKOV-3 cells and MDA-MB-231 cells with low HER2 expression respectively.HER2 binding specificity of 99Tcm-ZHER2:342 was analyzed by a pre-injection of excess unlabeled ZHER2:342 to saturate HER2 receptors.One-way analysis of variance and two-sample t test were used.Results The optimal labeling procedure was as follows:5 μg (1 g/L) of ZHER2:342 was mixed with 5 μg of NaOH (1 g/L),then 8.8 μg SnC12(1 g/L,solution) was added,followed by 150 μl (37 MBq) 99TcmO4-solution,and finally the mixture was slightly vortexed and incubated for 1 h at room temperature.99TcmZHER2:342 was stable in vitro with a high labeling efficiency of (98.10± 1.73)％.The radiochemical purity was ＞ 98％,and was more than 85％ after the incubation for 24 h in saline and fresh human serum.The cell binding of 99Tcm-ZHER2:342 with HER2-expressing SKOV-3 cells gradually increased over time with a peak of (9.95± 1.02)％ at 6 h.The binding of 99Tcm-ZHER2:342 in SKOV-3 cells was significantly higher than that in MDA-MB-231 cells at every time point (5.68-9.88 vs 0.56-2.11 ; t:from-34.50 to-13.14,all P＜0.01).The labeled molecular probe retained the capacity to bind specifically to HER2-expressing SKOV-3 cells since the cell binding decreased from (9.95 ± 1.02) ％ to (2.11 ±0.27) ％ after receptor saturation (t =-13.14,P＜0.01).Conclusions 99Tcm-ZHER2:342 has a high labeling efficiency,good stability and optimal binding specificity.These characteristics enable it to be a promising molecular probe for HER2-targeting imaging.

Yang deficiency syndrome.There were 126 cases with one diseased artery branch(31.1%),135 cases with two diseased artery branches(33.3%),144 cases with three diseased artery branches(35.6%).The blood stasis syndrome and phlegm-turbid syndrome were mainly in those cases with three diseased artery branches,and Qi stagnation syndrome was common in those with one diseased artery branch(P