Objective To investigate the value of ultrasound in tethered cord syndrome (TCS) in infants. Methods From December 2005 to July 2013, 25 cases TCS were confirmed by surgery in Shenzhen children's hospital. The ultrasonogram and MRI of 25 infants were analysed retrospectively. The diagnostic accuracy of ultra-sound and its clinical significance were evaluated. Results In 25 cases of TCS confirmed by surgery, the coincidence rate of conus level detected by ultrasound [96%(23/24)] was lower than that by MRI (100%(25/25)). Ultrasound showed reduced spinal cord vibration in 4 cases, disappeared spinal cord vibration in 21 cases. Two cases of reduced spinal cord vibration detected by ultrasound were confirmed as disappeared spinal cord vibration by surgery. The coincidence rate of disappeared spinal cord vibration detected by ultrasound was 91%(21/23). The sacral spinal seg-ments form showed by ultrasound were entirely consistent with those of MRI, including 4 cases of enlarged spinal cord, 13 cases of spinal cord without enlargement and 8 cases of spinal cord ended with rat caudate. Twenty-five cases of TCS had malformations:7 cases meningocele (3 cases combined lipoma), 14 cases myelomeningocele (5 cases combined lipoma, 1 case combined hydromyelia), 3 cases spinal canal-epidermis fistula (all combined lipoma) and 1 case solitary lipoma. Compared with the operation findings, ultrasound misdiagnosed 2 cases of myelomeningo-cele as meningocele, missed 1 of case lipoma which combined with meningocele. MRI missed two cases of spinal canal-epidermis fistula. Conclusions Infantile spinal ultrasound examination can accurately locate the position of conus, accurately display the spinal cord. Compared with MRI, ultrasound examination can real-time visually display spinal cord vibration and help to diagnose tethered cord. Ultrasound examination are convenient, repeatable opera-tion with low cost, therefore it can be used as the preferred screening method to diagnose of tethered spinal cord.

OBJECTIVETo assess left ventricular (LV) regional diastolic function in patients with hypertrophic cardiomyopathy (HCM) using single-beat real-time three-dimensional echocardiography (RT-3DE).

METHODSSixty-nine patients with HCM (LV ejection fraction≥45%) and 50 normal control subjects underwent examinations by two-dimensional echocardiography (2DE) and RT-3DE. The parameters analyzed by RT-3DE included the end diastolic sphericity index (EDSI), diastolic dyssynchrony index (DDI), dispersion end diastole [DISPED, including late (DDI-late) and early (DDI-early) diastole, dispersion end diastole (DISPED-late), and dispersion early diastole (DISPED-early)]. The patients were divided into 3 groups with impaired relaxation (n=23), pseudonormal filling (n=37), and restrictive filling (n=9).

RESULTSDDI and DISPED increased with the severity of diastolic dysfunction. In end diastole, DDI-late and DISPED-late were abnormal in cases with severe diastolic dysfunction (7.95∓2.75 and 26.76∓17.19, respectively, P<0.0001) but normal in cases with mild diastolic dysfunction. In early diastole, DDI-early and DISPED-early both increased in cases of mild (8.57∓2.24 and 25.44∓6.31, respectively, P<0.0001) and moderate (9.56∓4.66 and 35.42∓14.19, respectively, P<0.0001) diastolic dysfunction.

CONCLUSIONIn patients with HCM, dyssynchrony in early diastole is more obvious than that in late diastole and shows also a stronger correlation with diastolic dysfunction. This preclinical lesion can be detected by single-beat RT-3DE.

Adult ; Cardiomyopathy, Hypertrophic ; diagnostic imaging ; physiopathology ; Case-Control Studies ; Diastole ; Echocardiography, Three-Dimensional ; Female ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology

OBJECTIVETo investigate the effects of mTOR siRNA on mTOR-p70S6K signaling pathway in esophageal squamous cell carcinoma (ESCC) cells in vitro,and growth and apoptosis in transplanted tumor in nude mice.

METHODSmTOR siRNA was transfected into ESCC cell line EC9706 cells. The expressions of factors of the mTOR/p70S6K signaling pathway were detected by RT-PCR and Western blot. DNA contents and cell apoptosis were determined by flow cytometry, and cell proliferation was measured by CCK-8 assay. The effects of mTOR siRNA on the transplanted tumor growth were assessed in nude mice.

RESULTSThe levels of mTOR and p-p70S6K were significantly decreased (P < 0.05) while the level of p70S6K was increased (P < 0.05) in the cells transfected with mTOR siRNA, compared with that in untransfected cells and cells transfected with control siRNA. After being interfered by mTOR siRNA, the number of apoptotic cells was increased, cell proliferation became slower and cell cycle was arrested in G(1) phase compared with that in control cells. Also, mTOR siRNA inhibited the growth of transplanted tumor in vivo.

CONCLUSIONSmTOR siRNA can effectively interfere in mTOR-p70S6K signaling pathway, induce cell apoptosis and inhibit cell proliferation and tumor growth, suggesting that mTOR-p70S6K signaling pathway plays an important role in the carcinogenesis and development of esophageal squamous cell carcinoma.

Animals ; Apoptosis ; Carcinoma, Squamous Cell ; enzymology ; pathology ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Esophageal Neoplasms ; enzymology ; pathology ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; pharmacology ; Ribosomal Protein S6 Kinases, 70-kDa ; metabolism ; Signal Transduction ; TOR Serine-Threonine Kinases ; genetics ; metabolism ; Transfection ; Tumor Burden

Objective To investigate the diagnostic value of ultrasonography in radial head subluxation (RHS).Methods The clinical data and ultrasonographic findings of 34 children with RHS were retrospectively analyzed.All patients were routinely treated by bilateral compared and multi-sectional elbow joints ultrasonography.And the X ray results were negative.Results Ultrasonographic manifestations of RHS included increased radiocapitellar distance in 29 cases (29/34,85.29％);widened joint space and enhanced echo in 25 cases (25/34,73.53％);hook sign,supinator muscle above the radial head in 32 cases (32/34,94.12 ％);annular ligament entrapment in 33 cases (33/34,97.06％).Conclusion Ultra sonographic manifestations of RHS have certain characteristics.Comparation of bilateral elbow joints and the application of continuous scanning ultrasound are helpful to make a quick and accurate diagnosis of X-ray negative RHS.

Objective To compare the efficacy of Wang Juyi meridian regulating method for determining abnormal meridians versus syndrome differentiation-based acupoint selection in the textbook in treating stroke patients and analyze whether this method has an advantage in discriminating and treating stroke disorders. Method One hundred and thirty-eight stroke patients were allocated, in order of visits, to treatment and control groups. The therapeutic effects were evaluated after 20 treatments and compared at three months after treatment. The Stroke Specific Quality of Life (SS-QOL) scale score, meridian distribution state and correlation between syndrome type and meridian distribution were used as indicators. Result In the treatment group, the SS-QOL score had a statistically significant difference after treatment and at three months after that compared with before (both P<0.05), indicating that the quality of life improved in the treatment group of stroke patients. There was no statistically significant difference in the SS-QOL score after treatment (P>0.05) but there was at three months after treatment (P<0.05) between the two groups, indicating that after stroke the quality of life improved more in the treatment group than in the control group. In the stroke patients,meridian abnormality mainly occurred in hand and foot Taiyin, hand and foot Yangming, foot Jueyin and hand and foot Shaoyang meridians and seldom in hand and foot Taiyang, foot Shaoyin, Ren and Du meridians. There was a correlation between every syndrome type and a certain meridian. Conclusion Meridians have a specific distribution in stroke patients. There is a correlation between different syndrome type and the corresponding meridian. In stroke patients, Wang Juyi meridian regulating method can improve the quality of life in discriminating and treating stroke disorders.

Objective To establish a subjective indicator system for the evaluation of sub-health status and study on its reliability and validity. Methods Based on the basic features of general malice and losing ability of workforce, the indicator system for sub-health status evaluation was developed according to the chronic stress on human body' s main systems. The items were adjusted according to the experience from experts and the results of the pilot study. Indices as Chronbach' s a, IIC and ICC were used to evaluate the reliability of the questionnaire. Factor analysis and ANOVA were used to evaluate the construct validity and discriminative ability of the questionnaire. Results The formal sub-health survey questionnaire would include five domains and 25 questions in total. The whole questionnaire' s Chronbach's α coefficient was 0.92. Cronbach's α of the four domains, including cardiovascular, digestive tract, immunity and mental health were no less than 0.7 while IIC ranging from 0.51 to 0.72 and ICC ranging from 0.89 to 0.98. The five extracted common factors which contributed 62.35% to the total variation were basically consistent with the five dimensions. ANOVA showed significant differences among different groups (P<0.05). Conclusion The questionnaire appeared reliable and valid for measurement of sub-health status.

Background: Diabetes can complicate hypertension management by increasing the risk of cardiovascular disease (CVD) and all-cause mortality. Studies targeting diabetes detection in hypertensive individuals demonstrating an increased risk of diabetes are lacking.We aimed to assess the performance of hemoglobin A1c (HbA1c) and its cut-off point in detecting diabetes in the abovementioned population. Methods: Data from 4,096 community-dwellers with hypertension but without known diabetes were obtained from the Study on Evaluation of iNnovated Screening tools and determInation of optimal diagnostic cut-off points for type 2 diaBetes in Chinese muLti-Ethnic (SENSIBLE) study; these data were randomly split into exploration (70% of the sample) and internal validation (the remaining 30%) datasets. The optimal HbA1c cut-off point was derived from the exploration dataset and externally validated using another dataset from 2,431 hypertensive individuals. The oral glucose tolerance test was considered the goldstandard for confirming diabetes. Results: The areas under the ROC curves for HbA1c to detect diabetes were 0.842, 0.832, and 0.829 for the exploration, internal validation, and external validation datasets, respectively. An optimal HbA1c cut-off point of 5.8% (40 mmol/mol) yielded a sensitivity of 76.2% and a specificity of 74.5%. Individuals who were not diagnosed as having diabetes by HbA1c at 5.8% (40 mmol/mol) had a lower 10-year CVD risk score than those diagnosed as having diabetes (P = 0.01). HbA1c ≤ 5.1% (32 mmol/mol) and ≥ 6.4% (46 mmol/mol) could indicate the absence and presence of diabetes, respectively. Conclusions HbA1c could detect diabetes effectively in community-dwellers with hypertension.

Objective To study the effect of type 2 diabetes mellitus (T2DM) on the cerebral blood vessels in Alzheimer's disease (AD), and to explore its mechanism of influence on the pathogenesis of Alzheimer's disease. Methods To generate a mouse model with AD complicated with long-term T2DM, forty 6-month-old APP/PS1 transgenic mice were fed with high-sugar and high-fat diet for 6 months, that was, when mice at 12 months of age, they were intraperitoneally injected with 1% streptozotocin solution for 4 consecutive days. Then, mice were randomly divided into 4 groups: the normal control group, AD model group, T2DM model group and AD complicated with T2DM model group, 10 mice were used in each group. The learning and memory ability of the mice were tested by the mouse step-down assay, and the vascular morphology of the mice's hippocampal CAI area was observed by ink perfusion. Then oil red 0 staining and immunofluorescent staining were applied to test the pathological indices of the hippocampal area in the model. Results Compared with the control group, AD combined with T2DM mice showed decreasing significantly abilities in the learning and memory (P<0.05), and the blood vessels in the hippocampus became thinner and the vascular density decreased. Moreover, T2DM promoted lipid deposits and vascular leak in the hippocampus of the model. Additionally, the expression of β-site amyloid precursor protein cleaving enzyme-1 (BACE-1), nuclear factor (NF)-κB and matrix metalloproteinase (MMP) -9 were increased compared with the controls in the hippocampal CAI region. Conclusion T2DM plays a negative regulatory role on learning and memory functions of mice, accelerates the onset of AD and result in cerebrovascular lesions. In addition, the abnormal expression of MMP-9 may also be one of the causes of AD vascular lesions.

OBJECTIVETo investigate the relation of GSTM1 polymorphism in leukemia patients with therapeutic efficacy and the main biological characteristics.

METHODSThe GSTM1 genotypes were detected by nested PCR; the remission rate after 1 course of treatment and main biological characteristics at occurrence of leukemia were compared between AL patients with different GSTM1 genotypes, and their relation was analyzed.

RESULTSThe remission rate and partial remission rate after 1 course of treatment in patients with GSTM1-undeleted genotype were no significantly different from those in patients with GSTM1 null genotype (χ=0.290, P>0.05). The stratification analysis showed that GSTM1 null genotype was not related with age, sex, WBC count, Hb level, plt count at initial diagnosis and spleen enlargenent or no(P>0.05). The comparison of AML and ALL with GSTM1 null genotype by Log-rank showed that the survival rate was no statistically different between AML and ALL patients(χ=2.043, P>0.05), while the LDH level in serum of patients with GSTM1-undeleted genotype at initial diagnosis was statistically different from that in patients with GSTM1 null genotype (P=0.001).

CONCLUSIONThe GSTM1 genotype does not relate with remission and partial remission rates after 1 course treatment of AL patients, but relates with LDH level. GSTM1 null genotype deletion may play a role in risk of leukemia.

Objective : To investigate the effectiveness of fluoride varnish in preventing first permanent molars caries inschool-age children and provide necessary information for oral health instruction. Methods: 378 children aged 6-7 years old in the first grade of primary school in dahua country, hechi city, Guangxi province (1 053 first permanent molars) were randomly recruited into 2 groups. The test group (542 first permanent molars in 191 children) was treated with fluoride varnish one time in a half year and given oral hygiene instruction 3 times; The control group (511 first permanent molars in 187 children) was only given oral hygiene instruction 3 times. All first permanent molars were checked after 18 months later for caries. Results: After intervention, the caries prevalence rate in the test group raised from 21.99% to 27.75% compared with the control group from 24.60% to 37.43%. The caries incidence rate in test and control group was 5.76% and 12.83% respectively. There was a significant difference between 2 groups regardless of caries prevalence, caries incidence, the DMFT reduction, the DMFs reduction, the occlusal caries prevalence, the pit and fissure caries prevalence, the proximal caries prevalence. Conclusion Semi-annual application of fluoride varnish is effective in the prevention of dental caries in first permanent molars , which was worth of being popularized in clinic.