BACKGROUND AND OBJECTIVES : Anti-endothelial cell antibodies (AECA) are found in the sera of many patients with Kawasaki disease (KD). In this study, the pathogenic role of AECA in the development of coronary arterial lesions of KD was investigated. SUBJECTS AND METHODS : Serum IgM-AECA concentrations were measured in 22 KD patients. Cultured human coronary artery endothelial cells (HCAEC) were incubated with either acute or convalescent phase sera, and their expressions of intercellular adhesion molecule-1 (ICAM-1) assessed. IgM fractions of the sera were purified, and their ability to induce ICAM-1 mRNA and protein expressions evaluated. To address the signal transduction pathways involved in IgM-AECA-induced ICAM-1 expression, the blocking effect of four protein kinase inhibitors, PD98059, SB203580, dimethylaminopurine (DMAP) and parthenolide were measured. RESULTS : IgM-AECA was present in 14 out of 22 (64%) acute KD sera. ICAM-1 expression of HCAEC incubated with acute KD sera (117.1+/-46.7) and AECA-positive acute KD sera (143.3+/-37.5) were significantly higher than those of the convalescent KD sera (88.9+/-14.4, p<0.05) or AECA-negative acute KD sera (71.2+/-11.8, p<0.05), respectively. IgM-AECA from KD patients significantly induced ICAM-1 protein and mRNA expression. The upregulation of ICAM-1 expression was significantly inhibited by SB203580, DMAP and parthenolide, but not by PD98059. CONCLUSION : IgM-AECA was detected in the sera of about 2/3 of acute KD patients, which activated endothelial cells by upregulation of ICAM-1 expression, possibly via p38, JNK MAPK and NF-kappaB signal transduction pathways. Thus, IgM-AECA may play a pathogenic role in the development of coronary arterial lesions in KD patients.
Antibodies ; Coronary Vessel Anomalies ; Coronary Vessels ; Endothelial Cells ; Humans ; Immunoglobulin M ; Intercellular Adhesion Molecule-1 ; Mucocutaneous Lymph Node Syndrome* ; NF-kappa B ; Protein Kinase Inhibitors ; RNA, Messenger ; Signal Transduction ; Up-Regulation

Adult ; Aged ; Female ; Fluid Therapy ; methods ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pancreatitis ; mortality ; therapy ; Plasma ; Young Adult

A simple and quick method is described for the determination of ferulic acid, senkyunolide I, senkyunolide H, senkyunolide A and ligustilide in rhizomes of Ligusticum chuanxiong. The 5 active ingredients in the sample was extracted using 40% ethanol and analyzed by reversed-phase high performance liquid chromatography (HPLC). Chromatography separation was performed using Agilent 1100 series HPLC system with a Symmetry C18 column and gradient elution with a mixture of three solvents : solvent A, acetonitrile, solvent B, methanol and solvent C, 1% aqueous acetic acid, 0 min to 5 min A: B: C 20: 40: 40, 5 min to 30 min A: B: C 60 to 100 : 0 : 40 to 0. The effluent was monitored using a VWD detector set at 321 nm (0-4.3 min) and 275 nm (4.31-30 min). The flow rate was set at 1 mL x min(-1) and the injection volume was 10 microL. The column temperature was maintained at 35 degrees C. The calibration curve was linear (r > or = 0.99) over the tested ranges. The average recovery was 94.44%-103.1% (n = 6). The method has been successfully applied to the analysis in different harvest periods of L. chuanxiong samples. In this paper, single-factor randomized block design to study the 5 components content of L. chuanxiong on ten collecting stages. For the L. chuanxiong collected from April 15th to May 30rd, the content of 5 ingredients increased primarily, and then decreased. Determine the appropriate harvest time has important significance to the promotion of the quality of L. chuanxiong.
4-Butyrolactone ; analogs & derivatives ; analysis ; Acetic Acid ; chemistry ; Acetonitriles ; chemistry ; Benzofurans ; analysis ; Chromatography, High Pressure Liquid ; methods ; Coumaric Acids ; analysis ; Ligusticum ; chemistry ; Methanol ; chemistry ; Solvents ; chemistry ; Time Factors

Left atrial dissection is one of extremely rare complications associated with mitral valve surgery. We reported a case of left atrial dissection, which was developed after mechanical mitral valve replacement and was demonstrated by transesophargeal echocardiography. The cause of dissection was due to excessive traction of left atrial endocardial layer during surgery.
Echocardiography ; Echocardiography, Transesophageal* ; Heart Atria ; Mitral Valve* ; Traction

BACKGROUND: Coronary flow reserve (CFR) was defined as the ability to increase coronary blood flow maximally in response to demand. The presence of viable myocardium in an infarcted zone indicates the presence of an intact microvasculature. We hypothesized that coronary flow reserve, which assesses the microcirculation, might be associated with the presence of viable myocardium. METHODS: Thirty seven patients with acute anterior myocardial infarction (mean age 55+/-10, 25 males) were enrolled and abnormal 127 segments were analyzed. Dobutamine stress echocard-iography (5 to 20 g/kg/min) was performed before coronary angiography (6+/-3 days after acute myocardial infarction (AMI)). Coronary flow reserve in infarct-related artery was measured at distal site to lesion immediately after successful angioplasty (7+/-2 days after AMI, with residual stenosis less than 20%) by using intracoronary Doppler flow wire. And follow-up 2-dimentional transthoracic echocardiography was performed in 26 patients during 333+/-161 (range of 109-780) days after acute myocardial infarction. Improvement of wall motion at least one segment by one more grade in dobutamine stress echocardiography was defined as contractile reserve. Viable myocardium was defined as the improvement of wall motion in transthoracic echocardiography during follow-up periods. RESULTS: In 26 patients, viable myocardium was detected in 19 patients (73%) and their mean CFR was 1.74+/-0.42, which was significantly increased than 1.16+/-0.14 of CFR of patients without viable myocardium (p<0.001). The agreement of CFR score and presence of viable myocardium in AMI was excellent when CFR was above 1.3 (Area under the curve was 0.906 in receiver operating characteristic (ROC) curve). Sensitivity and specificity to detect viable myocardium in CFR more than 1.3 were 84% & 85% respectively. CONCLUSION: CFR was increased in patients with viable myocardium, and the cut-off value of CFR more than 1.3 was agreed excellently to detect viable myocardium.
Angioplasty ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Dobutamine ; Echocardiography ; Echocardiography, Stress ; Follow-Up Studies ; Humans ; Microcirculation ; Microvessels ; Myocardial Infarction* ; Myocardium* ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Stress echocardiography have been emerged as an important non-invasive diagnostic tool to detect coronary artery disease. Previous studies indicated that adenosine triphosphate(ATP) is a potent coronary vasodilator as adenosine, the time of action onset and half-life is shorter than dipyridamole, the duration of adverse effect is transient and the use of aminophylline is not needed when side effects develop. The purpose of this study was to evaluate the feasibility and diagnostic accuracy of ATP stress echocardiography in patient with suspected coronary artery disease. METHOD: We investigated 20 patients(mean age 56+/-11, male 11, female 9) who underwent stress echocardiography with ATP infusion(0.15 mg/kg/min for 4 min) and quantitative coronary angiography(QCA). The digitized echocardiographic images were analyzed using wall motion score(1: normal, 2: hypokinesia, 3: akinesia, 4: dyskinesia) in 16 segments. Positivity of ATP stress echocardiography was based on the detection of transient regional wall motion abnormality. The hemodynamic changes and occurrence of adverse effects was carefully monitored. RESULTS: Forteen out of 20 patients had coronary artery disease(>50% diameter stenosis by QCA). Nine out of 14 patients had transient regional wall motion abnormality at coronary artery disease territory(sensitivity 64%). The mean wall motion score index in patients mth positive test was 1.01+0.01 at base and 1.20+0.08 during ATP infusion(p<0.05). Six out of 20 patients who had no regional wall motion abnormality had no coronary artery disease (specificity 100%) with overall diagnostic accuracy of 75%. ATP stress echocardiography showed good agreernent with QCA(kappa value 0.52). Side effect profile revealed chest pain in 6 patients(30%), facial flushing in 3 patients(15%), Wenchebach type AV block in 2 patients(10%) and significant ST-segrnent depression in 1 patients(5%). The mean heart rate, mean systolic and diastolic blood pressure, and mean rate-pressure product were not changed significantly. CONCLUSION: ATP stress echocardiography is feasible and has a diagnostic value similar to that of adenosine and dipyridamole for detecting coronary artery disease with low cost. In addition, it may have minimal side effects and insignificant clinical consequences.
Adenosine Triphosphate* ; Adenosine* ; Aminophylline ; Atrioventricular Block ; Blood Pressure ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Depression ; Dipyridamole ; Echocardiography ; Echocardiography, Stress* ; Female ; Flushing ; Half-Life ; Heart Rate ; Hemodynamics ; Humans ; Hypokinesia ; Male

Objective To analyze the clinical and imaging features of a family(3 patients)with familial hemangioblastoma,and their diagnosis and prognosis.Methods The detailed data about clinical and imaging features of all patients diagnosed as familial hemangioblastoma,admitted to our hospital from October 2004 to May 2010,were analyzed,and the lesions of other regions,besides the tumor lesion,were observed.Results No lesions of other regions were noted in these 3 patients.Cranial MRI showed that 2 had cystic and solid tumor and 1 had solid tumor;,total removal was performed on these patients under microscope; regular follow-up was given and no recurrence was noted.Conclusion Familiar hemangioblastoma is serious hereditary disease; and MRI is the most important detective method; microsurgical operation is the most important therapy.Early diagnosis and treatment should be given to the patients with familiar hemangioblastoma due to its high recunence rate,having difficulty in operation and its trend to combining with other lesions of the other parts.

Based on the optimum clinical evidence, consulting the international guide, the outstanding guidelines of acupuncture clinical practices is formulated in order to promote the process of acupuncture modernization and internationalization. According to consensus of experts, using the questionnaire method, integrating the characteristics and requirements for acupuncture clinical practices, the guidelines reflect the characteristics of acupuncture, for instance, applicability, inheritance, holism, and the discipline characteristics. Thus, the guidelines will standardize the treatments in acupuncture clinical practices, strengthen medical service quality management, control medical costs, and promote the process of acupuncture modernization and internationalization.
Acupuncture Therapy ; standards ; Humans ; Practice Guidelines as Topic ; Practice Patterns, Physicians' ; standards

Objective To improve the load resistance ability of students in teenager aviation schools and carry out specialized training for the body situation and shape of students.Methods We selected students from 14 teenager aviation schools and measured their height,weight,and the circumferences of necks,chests,upper-arms,waists,hips,and thighs.We compared the data of these students from different areas and the parameters were analyzed statistically by correlation analysis.Results Totally 411 students from 6 southern schools and 403 students from northern schools were investigated.Their average body height,weight and body mass index (BMI) were (172.3 ± 4.39) cm,(62.7 ± 7.3) kg,and (21.1 ± 2.23)kg/m2 respectirely.Students from northern schools were taller and heavier than those from southern schools (P ＜ 0.05).There was no difference between students from northern and southern schools in BMI.Compared with the domestic average levels of height,weight and chest circumference of teenagers aged 14 to 17,students of teenager aviation schools were higher,but there was no difference in weight or chest circumference.The average circumferences of the chest,neck,left upper-arm,right upper-arm,waist,hip,left thigh and right thigh were (83.1 ± 5.06),(34.7 ±3.07),(25.2±2.33),(25.5 ±2.30),(73.4 ±6.73),(89.7 ±5.89),(50.1 ±5.22),and (50.2 ±5.27)cm,respectively.According to the data,students from northern schools had a bigger chest circumference and thigh circumference but a smaller neck circumference and upper-arms circumference than those from southern schools (P ＜ 0.05).The correlation coefficient between BMI and the circumferences of the chest,neck,left upper-arm,right upperarm,waist,hip,left thigh and right thigh was 0.2201,0.1066,0.2466,0.2499,0.2291,0.2149,0.2299,0.2264,respectively.All of them were statistically significant (P ＜ 0.0001).Conclusion Load resistance related parameters of students in teenager aviation schools are not different from the domestic levels,which points to the urgent need for load resistance ability training for these students.Some parameters vary between areas.BMI is positively related to those load resistance parameters.Based on regional variations and regularities found in this study,specialized load resistance ability training could be made more efficient.

AIM To explore analgesic mechanism of Yaobitong Capsules (Notoginseng Radix et Rhizoma,Chuanxiong Rhizoma,Corydalis Rhizoma,etc.) on lumbar intervertebral discs.METHODS An array of data mining,molecular docking and network analysis were employed to investigate the active compounds and key target protein.RESULTS Among the forty-six active hits identified by virtual screening,most compounds displayed good oral bioavailability and might confer an optimal CNS exposure.And eleven molecules (coptisine,diligustilide,corypalmine,chuanxiongterpene,etc.) were further confirmed to alleviate lumbar intervertebral discs through their targeting at nineteen proteins (such as p38,CGRP,MMPs,TNFα) to inhibit the inflammatory response and the infiltration of microvasculature,to reduce the nociceptors sensitivity,and to modulate the balance of Collagen and proteoglycans in catabolic and anabolic responses.CONCLUSION Yaobitong Capsules' clear molecular working mechanism and the key active compounds are revealed by this network-assisted investigation highlight the subsequent experiments on targets and active compounds.