Objective To investigate the dangers of heart failure to the mother and fetal,and the diagnosis and treatment of pregnancy complicated with heart failure. Methods The clinical data of the causes,timing,management and outcomes of 87 cases of pregnant women complicated with heart failure from March 1993 to January 2006 were analyzed retrospectively. Results ①Thirty-one cases(35.6%) of heart failure in pregnancy were caused by rheumatic heart disease,26(29.9%) by pregnancy-induced hypertension(PIH),16(18.4%) by congenital heart disease,and 14(16.1%) by peripartum cardiomyopathy.②The heart failure appeared at the average of(32.69?5.57) weeks.③The average terminal time of pregnancy was(34.66?4.52) weeks.④There were 79 newborns with 6 cases of twins,and the perinatal mortality was 8.6%(8 cases).Hysterotomy was performed in 6 cases in mid-pregnancy.The average weight of babies was(2419.56?786.08) g.⑤The maternal mortality was 6.9%(6 cases).(Conclusion The main) causes of heart failure in pregnancy are rheumatic heart disease,PIH and congenital heart disease.Although the standard management of pregnancy complicated with heart failure is inotropic agents,diurectics and vasodilators,the treatment should be individualized according to the specific etiology and with the consideration of the safety of fetus as well.Pinpointing the causes of heart failure in pregnant patients and treating accordingly may be conducive to reduce the maternal and perinatal mortality.

Objective To investigate whether velocity vector imaging (VVI) combined with stress echocardiography could detect potential myocardial impairment of the left ventricle(LV) in diabetic rats.Methods DM rats ( n = 18,administered by STZ at 65 mg/kg) and control rats( n = 12) were performed with VVI and M-mode echocardiography both at rest and after dipyridamole stress 12 weeks later. Twodimensional echocardiographic cine loops and M-mode images of three consecutive beats were obtained from the short-axis views at the mid-LV level. The means of segmental peak systolic velocity(Vs), circumferential strain(εc) ,radial strain(εr), systolic circumferential and radial strain rate (SRc, SRr) and the percent wall thickening (WT% ,derived from M-mode) were obtained. After echocardiograms were performed,the hearts were excised and prepared for HE staining and ultrastructural observations under electron microscopy.Results At rest,only SRc in the DM group was significantly lower than that in the control group( P ＜0.05), the other parameters were statistically comparable between the two groups. After dipyridamole stress,all VVI values in the DM group were significantly lower than those in the control group ( P ＜0.05).However,there was no significant difference in WT% between the two groups either at rest or after dipyridamole stress ( P ＞0.05). Conclusions The VVI parameters combined with dipyridamole stress are more effective in evaluating potential myocardial impairment of the LV walls in diabetic rats. SRc might be more sensitive indices that can be used to detect myocardial impairment at rest.

Objective:This work aims to investigate diallyl disulfide (DADS) inhibition of cell migration and invasion in human colon cancer SW480 cells through the Rac1-ADF/cofilin1 pathway. Methods:The potential of cell migration and invasion was examined by scratch healing assay and transwell membrane assay. The expression of Rac1-ADF/cofilin1 pathway was detected by RT-PCR and Western blot. Results:After the SW480 cells were treated with 40 and 50 mg·L-1 of DADS for 24 h, the number of transmembrane cells through the Matrigel obviously decreased by 57.12%and 64.59%, respectively (P<0.05). After cell treatment for 48 h, the cell migration rates were 23.23%and 12.87%, which were significantly lower compared with the control group (75.86%;P<0.05). After the cells were treated with 45 mg·L-1 of DADS for 24 and 48 h, the expression of Rac1, Rock1, PAK1, LIMK1, and destrin mRNA respectively decreased compared with the control group (P<0.05). However, no significant difference was observed in the expression of cofilin1 mRNA (P>0.05). After the treatment with 45 mg·L-1 of DADS for 6, 12, 24, and 48 h, the expression of Rac1, Rock1, PAK1, LIMK1, and Destrin proteins respectively decreased in a time-dependent manner compared with the control group (P<0.05). However, no significant differences were observed in the expression of the cofilin1 protein (P>0.05). Moreover, the expression of p-LIMK1 and p-cofilin1 notably decreased in a time-dependent manner (P<0.05). Conclusion:DADS inhibits cell migration and invasion, which is related to the down-regulation of Rac1, Rock1, PAK1, LIMK1, p-LIMK1, p-cofilin1, and destrin through the Rac1-ADF/cofilin1 pathway.

ObjectiveTo analysis the clinical characteristics and the high risk factors of children with cerebral palsy.MethodsClinical data of 100 children with cerebral palsy were retrospectively analyzed.Results51% of children were born with asphyxia, 42% were born prematurely, 39% were low birth body weight. 85.7% of children involved had mental retardation, 12% had hearing loss and 7% had visual impairment. 88% of children involved had abnormal cranial CT results and 46.1% had abnormal EEG. 50.0% of the children had abnormal brain stem auditory evoked potentials.ConclusionAsphyxia, prematurely birth and low birth body weight are high risk factors of cerebral palsy. Most of the children with cerebral palsy in this group are mental retarded.

Adolescent ; Adult ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Recovery of Function ; Tibial Fractures ; diagnostic imaging ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo study the numbers and locations of spermatic veins, testicular arteries, and lymphatic vessels in the spermatic cord of the varicocele patient under the laparoscope.

METHODSFifty-seven varicocele patients received laparoscopic ligation of spermatic veins, during which we recorded the numbers and observed the locations of spermatic veins, testicular arteries, and spermatic lymphatic vessels.

RESULTSDuring the surgery, we identified 3.3 ± 1.2 spermatic veins, 1.4 ± 0.9 testicular arteries, and 4.3 ± 1.1 spermatic lymphatic vessels. No statistically significant differences were observed between the two side in the numbers of the spermatic veins, testicular arteries and spermatic lymphatic vessels (P > 0.05). The testicular arteries were seen on the exterior of the spermatic veins and winding around them, while the spermatic lymphatic vessels mostly between the veins.

CONCLUSIONThe spermatic veins, testicular arteries, and lymphatic vessels in the spermatic cord of the varicocele patient have their specific anatomic characteristics. Laparoscopic identification of these vessels may contribute to the surgical treatment of varicocele.

Arteries ; anatomy & histology ; Humans ; Laparoscopy ; Ligation ; Male ; Spermatic Cord ; anatomy & histology ; Testis ; Varicocele ; pathology ; Veins ; anatomy & histology

Objective To explore the role of p16 gene methylation in fibroblasts in the occurrence and development of keloid.Methods Skin tissue specimens were resected from the lesions of patients with keloid and normal skin of healthy human controls.Fibroblasts were isolated from these tissue specimens and subjected a primary culture.An immunohistochemical analysis was performed to measure the expression of p16 protein in tissue specimens,real-time fluorescence-based quantitative PCR to determine the mRNA expression level (expressed as 2-△△Ct) of p 16 and DNA methyltransferases (DNMTs) in fibmblasts,and bisulfite sequencing PCR (BSP) to estimate the methylation status of p16 gene in the tissue specimens and primary fibroblasts.Results The keloid fibroblasts (KFbs) showed significandy lower mRNA expression of p16 gene (0.64 ± 0.18 vs.1.92 ± 0.23,t =10.54,P＜ 0.05),but significantly higher mRNA expressions of 3 DNMTs (DNMT1:2.58 ± 0.23 vs.1.13 ± 0.21,t =11.22,P ＜ 0.05; DNMT3A:4.87 ± 0.46 vs.2.38 ± 0.32,t =10.81,P＜ 0.05; DNMT3B:1.57 ± 0.12 vs.0.57 ± 0.16,t =12.45,P＜ 0.05) compared with the normal fibmblasts (NFbs).The DNA methylation rate in the p16 gene promoter region was significantly increased in keloid tissue (1.81％ ± 0.46％) and KFbs (3.15％ ± 0.94％) compared with normal skin tissue (0.90％ ± 0.35％,F =14.23,P＜ 0.01) and NFbs (0.17％ ± 0.29％,F=37.62,P＜ 0.01).Conclusions The methylation and low expression of p16 gene in KFbs may be associated with the uncontrolled growth of keloid,and DNMTs may play a role in the pathogenesis of keloid.

Objective To investigate whether myocardial contrast echocardiography(MCE)combined with stress echocardiography could detect myocardial microcirculation disturbance of left ventricular(LV)in diabetic rats.Methods MCE were performed at rest and after dipyridamole infusion from parasternal shortaxis views at the papillary muscle level in DM rats(n=18,12 weeks later after STZ administration)and control rats(n=12).Regions of interest(ROI)were positioned with the anterior, lateral, posterior and septum walls.Plateau intensity(PI), initial slope of the curve(β)and time to PI(TTP)were obtained from the curve and myocardial blood flow(MBF)and myocardial flow reserve(MFR)was estimated.After the performance of MCE, myocardium was prepared for γ Well counting with ~(99m)Tc-MIBI and CD31 immunohistochemistry staining.Results There was no significant difference in MBF between the ROI of anterior, lateral, septum walls beyond posterior wall in each group at rest and after stress.MCE values from anterior wall were selected as the indexes for comparisons between the two groups.The PI., MBF and MFR in the DM group were significantly lower than those in the control group at rest and after stress(all P< 0.05).The β in the DM group was significantly lower and TTP was significantly longer after dipyridamole stress(P<0.05).The nuclide intake of myocardial tissue in different walls was similar in the DM group, but theY were all lower than those in the control group(P<0.05).The capillary density decreased significantly in the DM group compared with the control group.Conclusions The PI,β,TTP,MBF and MFR derived from MCE were all sensitive parameters in detecting the microcirculation disturbances in the earlier period of DM.

Objective To investigation the pathological characteristics of esophageal squamous cell carcinoma to provide reference criteria for delineating the target area in radiotherapy.Methods Fifty-two patients from the Fourth Hospital of HeBei Medical University underwent resection whom all had been proved to have esophageal squamous cell carcinoma before operation.Chest CT was scanned and transmitted to the 3- dimensional conformal planning system for radiotherapy by VRX-16 scanner.The lesion of esophageal carcinoma was delineated in the 3-dimensional rebuild CT image and the lesion volume was computed by digital rebuild program.Every surgically resected specimen was made into pathologic giant section.The actual size of the specimen was obtained by calculating the size under the microscope with the shrinkage ratio.Multicentric carcinomatous lesion,severe dysplasia and direct intramural infiltration were observed in the giant section with a microscope and the order of such pathological characteristics were analysed statistically.Results 1.The tumor length by different method of preparation of operated specimens differed obviously.The longest was shown by CT. 2.Multicentric carcinomatous lesion was found in 15(29%)cases out of 52 patients.Proximal to the tumor,the mean distance between the multicentric carcinomatous lesion and the main lesion plus the length of the multicentric carcinomatous lesion was 3.02?1.45cm.Distal to the tumor,it was 2.60?2.44 cm.Severe dysplasia was found in 28 patients.Proximally,the mean distance between the severe dysplasia and the main lesion plus the length of the severe dysplasia was 2.45?1.30 cm.Distal to the tumor,it was 3.24?2.19 cm.Direct intramural infiltration was found in 41 patients,of which the mean length being 2.80?1.52 cm proximally and 2.02?1.51 cm distally. 3.Tumor thrombus was found in 6 patients and lymphoduct infiltration in 36 patients.Direct intramural infiltration was found at higher incidence in specimens complicated with lymphoduct infiltration(86%)and those complicated with tumor thrombus(91%).There were no apparent factors affecting severe dysplasia.The proximal distance to direct intra- mural infiltration was much longer than distally.Conclusions Multicentric carcinomatous lesion,severe dysplasia and direct intramural infiltration may be observed in esophageal squamous cell carcinoma.Multicentric carcinomatous lesion and direct intramural infiltration are obviously correlated with lymphoduct infiltration.To cover 95% of the microscopic extension,a margin of 5.0 cm is needed proximal to the base of gross tumor volume,and 7.5 cm distal to it.To cover 90% of the microscopic extension,a margin of 4.5 cm is needed proximally,and 5.0 cm distally.

Objective To investigate the therapeutic effects of electroacupuncture (EA) on post stroke depres- sion (PSD) after lacunar infarction (LI).Methods Seventy-five PSD patients with lacular infarction were recruited and randomly divided into a control group and an EA group.All patients were treated with Fluoxetine,in addition to EA treat- ment in the EA group.Then all patients were evaluated using the Hamilton Depression Scale (HAMD),the Chinese stroke scale (CSS) and the Barthel Index (BI).The evaluations were carried out at 0,14 and 28 days.Results Depression symptoms (DSs) in the EA group were improved by day 14 of the treatment,and their HAMD scores had decreased.DSs in both groups had improved significantly by day 28,and the HAMD scores in the EA group were then significantly lower than those in the control group.Improvements in neurological impairment and in the activities of daily living were observed earlier in the EA group.Conclusion The combination of EA and Fluoxetine is helpful for PSD with complex patho- genesis and clinical symptoms.Therapeutic effects are enhanced and side effects are reduced.