Objective To assess the value of two-dimensional speckle tracking echocardiography (2D-STE) of predicting the acute response to cardiac resynchronization therapy (CRT) in patients with congestive heart failure. Methods Twenty-four patients with congestive heart failure scheduled for CRT were included. 2D-STE was performed within 7 days of implantation with device ON and OFF. Left ventricular (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 (T_(AS-POST)) with 2D-STE. Acute hemodynamic response was measured as LVdp/dt, and percentage change in LVdp/dt was used to classify responders (Δdp/dt%＞25%) and nonresponders (Δdp/dt%≤25%). Results Fifteen patients (62.50%) were classified as acute responders. Compared with nonresponders, the responders demonstrated significant increase of LV ejection fraction and reduction of TAS-POST after CRT-ON. T_(AS-POST)was the only determinants of Δdp/dt%＞25%. T_(AS-POST)≥130 ms prognosticated acute response to CRT with sensitivity of 86.24% and specificity of 70.38%. Conclusion CRT can immediately increase the LV systolic function and synchrony. 2D-STE is highly predictive for acute response to CRT.

OBJECTIVETo prospectively compare the rates of gastroesophageal variceal rebleeding in patients underwent TIPS alone and TIPS combined with embolization of gastric coronary veins.

METHODSAccording to the bleeding state within one week before the shunt placement, 122 patients with hepatic cirrhosis indicated for the secondary prevention of gastroesophageal variceal rebleeding were allocated to the shunt group (n = 44, treated with TIPS alone) and the shunt plus embolization group (n = 78, treated with TIPS combined with embolization of gastric coronary veins). All the patients were followed up for 1 year, and the 1-year cumulative rates of rebleeding, shunt patency and mortality were compared.

RESULTSThe basic characteristics of patients in the two groups were comparable (P is more than 0.05). The 1-year cumulative re-bleeding rates were 41.5% in the shunt group and 19.5% in the shunt combined with embolization group (x2 = 6.320, P = 0.012). The differences of 1-year cumulative rates of shunt patency and mortality between the two groups were not significant (P is more than 0.05).

CONCLUSIONSTIPS combined with embolization of gastric coronary veins could reduce significantly the rate of rebleeding in 1 year after the shunt placement as compared with TIPS alone.

Adult ; Aged ; Embolization, Therapeutic ; Esophageal and Gastric Varices ; surgery ; Female ; Gastrointestinal Hemorrhage ; surgery ; Humans ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic ; Stomach ; blood supply

OBJECTIVE: To explore the forensic pathological features of death caused by anaphylactic shock. METHODS: One hundred and forty-two death cases of anaphylactic shock were retrospectively analyzed. The IgE level in the serum of anaphylactic shock cases were statistically compared with that of 62 non-anaphylactic shock cases. RESULTS: Most cases (77.46%) of anaphylactic shock death occurred in the medical institutes, with intravenous drug administration accounting for 53.53% of anaphylactic shock death. β-Lactam antibiotics, glucocorticoid and herbal medications were responsible for a significant proportion of such cases. Although characteristic histopathological changes were absent in vast majority of these anaphylactic shock cases, the differences of IgE levels in the serum between anaphylactic shock group and non-anaphylactic shock group were statistically significant (P<0.05). CONCLUSION Combined information including clinical data, autopsy results, IgE level, and other specific test results should be evaluated together in the forensic pathological diagnosis of anaphylactic shock.
Anaphylaxis ; Autopsy ; Cause of Death ; Forensic Pathology ; Humans ; Infusions, Intravenous ; Retrospective Studies ; Serum

OBJECTIVETo develop a tight tetracycline-controlled HCV-C double transgenic mouse model.

METHODSBy crossbreeding of ApoE-rtTA-tTS transgenic mice with TRE-HCV-C transgenic mice, the double transgenic mice were produced in the F1 generation. The presence of HCV-C and tTS gene in the F1 generation was confirmed by PCR, followed by further identification and quantification of the transgene using Southern blot hybridization. The expression of HCV-C in the liver of the mouse model was detected immunohistochemically.

RESULTS AND CONCLUSIONTwo transgenic mice were obtained, which contained ApoE-rtTA-tTS and TRE-HCV-C genes in the genome. Five founders contained HCV-C gene as confirmed by PCR and Southern blot hybridization. The tight tetracycline-controlled system may facilitate further study of HCV-C gene expression and gene therapy of hepatic cellular carcinoma.

Animals ; Apolipoproteins E ; genetics ; Blotting, Southern ; Breeding ; Crosses, Genetic ; Female ; Gene Expression Regulation, Viral ; drug effects ; Hepacivirus ; genetics ; immunology ; Hepatitis C Antigens ; genetics ; immunology ; Male ; Mice ; Mice, Transgenic ; Polymerase Chain Reaction ; Tetracycline ; pharmacology ; Trans-Activators ; genetics ; Viral Core Proteins ; genetics

OBJECTIVE: To establish more sensitive methods for detection of DYS385 in routine forensic casework. METHODS: The primers recommended by Genome Database (GDB) and Schneider were used to amplify DYS385 respectively. Then, a semi-nested PCR of DYS385 was designed by using the two different primers as outer and inner primer. A series of experiments were carried out to achieve good result by adjusting the ratio of outer/inner primer and optimizing the PCR condition. RESULTS: It showed that an overall 112 bp shorter DYS385 fragments and better electrophoretic separation were obtained by using primer2B. By using the semi-nested PCR approach, the shorter specific DYS385 fragments could be amplified and detectable DNA amounted to 50 pg. CONCLUSION This method is 20 fold more sensitive than the ordinary method.
Chromosomes, Human, Y/genetics* ; Forensic Medicine ; Gene Frequency ; Humans ; Male ; Polymerase Chain Reaction/methods* ; Sequence Analysis, DNA/methods* ; Tandem Repeat Sequences

OBJECTIVETo study the expression of COX-2 and pregnancy associate plasma protein A (PAPP-A) in coronary arteries and their relationship with acute coronary syndrome.

METHODSTwenty-one autopsy cases with acute coronary syndrome encountered during the period from 2002 to 2007 were enrolled into the study. Another 21 autopsy cases without evidence of acute coronary syndrome were used as the controls. The right and left coronary arteries of each group were dissected, embedded and processed as paraffin sections. Immunohistochemical study for CD68 and alpha-actin was performed to highlight the presence of macrophages and smooth muscle cells, respectively. The expression of COX-2 and PAPP-A was evaluated.

RESULTSIn the acute coronary syndrome group, COX-2 was localized mainly in the cytoplasm of endothelial cells, macrophages and smooth muscle cells. COX-2 expression in the cytoplasm of smooth muscle cells (28.60%) was significantly higher than that in the control group (4.76%, chi(2) = 14.13, P< 0.05). There was a positive correlation on COX-2 and PAPP-A expression in smooth muscle cells of the media layer of coronary arteries in acute coronary syndrome group (r = 0.88, P < 0.05). The expression of PAPP-A in smooth muscle cells of the media layer in coronary arteries not associated with plaque formation, was higher than that when there were atherosclerotic plaques (chi(2) = 10.36, P < 0.05).

CONCLUSIONIn coronary arteries, COX-2 and PAPP-A play certain roles in the pathogenesis of acute coronary syndrome.

Acute Coronary Syndrome ; metabolism ; pathology ; Adult ; Aged ; Autopsy ; Coronary Vessels ; metabolism ; pathology ; Cyclooxygenase 2 ; metabolism ; Female ; Humans ; Middle Aged ; Myocytes, Smooth Muscle ; metabolism ; Plaque, Atherosclerotic ; metabolism ; Pregnancy ; Pregnancy-Associated Plasma Protein-A ; metabolism ; Young Adult

Animals ; Borrelia burgdorferi ; genetics ; China ; DNA, Bacterial ; genetics ; isolation & purification ; Rodentia ; microbiology ; Sequence Analysis, DNA

Objective To monitor the co-infection status of Borrelia burgdorferi sensu lato (R.b.s.1) and spotted fever group Rickettsia (SFGR) in tourist areas of Heilongjiang province.Methods Polymerase chain reaction (PCR) was used to detect the 5S-23S rRNA intergenic spacer of B.b.s.1 and ompA of SFGR in ticks,dynamically collected from tourist areas of Heilongjiang province in 2010.Amplification products from positive ticks were sequenced,and phylogenetic analysis was conducted by Mega 5.0 software package.Results 849 ticks were collected from two tourist points,with the dominant ticks in Tiger Mountain and Jingpo Lake were Ixodes persulcatus and Haemaphysalis concinna.Regarding the Ixodes persulcatus from Tiger Mountain,the infection rates of B.b.s.1 and SFGR were 26.15％ and 10.05％.The infection rate of SFGR was 13.33％ in Haemaphysalis concinna and the B.b.s.1 was tndiscovered in the same ticks from Jingpo Lake.However,the co-infection could only be detected in Ixodes persulcatus of both tourist areas.Surveillance data showed that the major ticks were more likely to be appeared in July at Tiger Mountain and in June at Jingpo Lake.Data from the sequence analysis on B.b.s.1 showed that the B.b.s.1 in tourist areas could be classified into three different genotypes,other than B.garinii and B.afzelii.We first detected B.valaisiana-like group genotype in northeast of China.Results from the sequence analysis of SFGR positive products showed that the two DNA sequences of newly detected agents were completely the same as Rickettsia sp.HL-93 which was detected in Hulin and Rickettsia sp.H820 found in northeast,China.Conclusion The co-infection of B.b.s.1 and SFGR was detected in ticks from the tourist areas of Heilongjiang province,and data from the sequencing of specific fragment showed that various kinds of genotypes existed in this area.However; the rates of co-infectionitis-different according to environment,time and population that contributed to the kinds of and the index of ticks existed in the surveys points,also the infection rate of the ticks was studied.

OBJECTIVE: To investigate KCNQ1, KCNH2, KCNE1 and KCNE2 gene variants in the cases of sudden manhood death syndrome (SMDS). METHODS: One hundred and sixteen sporadic cases of SMDS and one hundred and twenty-five healthy controlled samples were enrolled. Genomic DNA was extracted from blood samples. Gene variants of KCNQ1, KCNH2, KCNE1 and KCNE2 were screened by direct sequencing. RESULTS: A total of 14 mutations and 14 SNP were detected. Two non-synonymous mutations of them were newfound. There was no non-synonymous mutation found in the control group. CONCLUSION There are KCNQ1, KCNH2, KCNE1 and KCNE2 gene variants found in Chinese SMDS cases. KCNQ1, KCNH2, KCNE1 and KCNE2 gene mutation may correlate partly with the occurrence of some cases of the SMDS in China.
Base Sequence ; Case-Control Studies ; China ; DNA Mutational Analysis ; Death, Sudden/ethnology* ; ERG1 Potassium Channel ; Ether-A-Go-Go Potassium Channels/genetics* ; Humans ; KCNQ1 Potassium Channel/genetics* ; Long QT Syndrome ; Mutation ; Polymorphism, Single Nucleotide ; Potassium Channels ; Potassium Channels, Voltage-Gated/genetics*

Objective To investigate the value of B-type ultrasound during and after operations in patients sustaining craniocerebral injury in Wenchuan earthquake. Methods The patients with suspected multiple intracranial hematomas due to intraoperative acute encephalocele were referred for B-type ultrasonic examination. After the operation, B-type ultrasonic examination was performed at the cranial defects or the site of cranial drilling by horizontal coronal or sweep scanning. Results Open cranial surgery was performed in 58 cases of craniocerebral injury resulting from the earthquake. Intraoperative B-type ultrasound was used in 24 cases, and intracranial hematomas or hemorrhage in different brain regions were found in 18 cases. Hematomas in the injured hemisphere were found in 2 cases, and ultrasound-guided hematoma clearance was performed in 14 cases. In 28 cases, postoperative B ultrasonic examination was carried out along with CT scanning, and the results demonstrated basic agreement between the two medalities. Conclusions Intraoperative B-type ultrasound may help accurately localize multiple intracranial hematomas and can be crucial to identify the causes of intraoperative acute encephalocele. Postoperative sweep scanning with B-type ultrasound at the cranial defect can accurately identify delayed hematoma to allow timely management and improve the operative SUCCESS.