Objective To investigate the changes of right ventricular(RV) volume and function in patients with atrial septal de-fect(ASD) .Methods 31 patients with ASD-type secundum(ASD group) and 30 age-matched controls(control group) were includ-ed .Single beat real-time three dimensional echocardiography (sbRT3DE) were performed in all to evaluate right ventricular volume and function ,then right venrtricular cardiac output(RVCO) were calculated with heart rate .Further correlative analysis was calcu-lated between right ventricular volume and function parameters of the ASD group and ASD size and the patient′s age .Results Right ventricular end-systolic volume(RVESV) ,right ventricular end-diastolic volume(RVEDV) ,right ventricular stroke volume (RVSV) ,right ventricular ejection fraction(RVEF) ,RVCO of the ASD group were significantly higher than that of control group (P<0 .001) .The maximum diameter of ASD had positive relation with RVESV ,RVEDV ,RVSV ,RVCO(r=0 .55 ,P<0 .01 ;r=0 .61 ,P<0 .01 ;r=0 .63 ,P<0 .01;r=0 .61 ,P<0 .01 ,respectively ) ,and was best correlation with RVSV .But ,there was no signifi-cant correlation between the maximum diameter of ASD and RVEF (r=0 .00 ,P>0 .05) .The patients′age had positive relation with RVESV ,RVEDV ,RVSV(r=0 .53 ,P<0 .01 ;r=0 .48 ,P<0 .01 ;r=0 .41 ,P<0 .01 ,respectively) ,had negtive relation with RVEF (r= -0 .44 ,P<0 .05) ,while there was no significant correlation between the patient′s age and RVCO(r=0 .26 ,P>0 .05) .Conclu-sion sbRT3DE is a fast and accurate new technology in evaluating RV volume and function .Atrial level left-to-right shunt leading to an increase in RV volume ,RV enlargement produces myocardial contractility .RV volume increases with ASD size ,then RV func-tion was enhanced .RV volume increases with patient′s age ,RV function is relatively lower .

p38 mitogen-activated protein kinase (p38) is a member of MAP kinase family. Its widespectrum roles in the control of energy metabolism have been indicated in numerous studies. P3 8 participates in the energy metabolism in all major tissues/organs involved in the control of energy metabolism, including adipose tissue, skeletal muscles, islet cells, and liver. In white adipose tissue, p38 plays an important role in adipose differentiation and glucose uptake although it is still inconclusive whether this role of p38 is stimulatory or inhibitory. The stimulatory role of p38 in transcription of the uncoupling protein 1 ( UCP1 ) gene in brown adipose tissue is relatively clear. A fundamental role for p38 in the differentiation of skeletal muscles and mitochondrial biogenesis in skeletal muscles is rather definitive although the role of p3 8 in glucose uptake of skeletal muscles remains controversial. In islet cells, p38 appears to be involved in β-cell apoptosis. P38 has been indicated in the control of preproinsulin gene transcription, but remains controversial. However, it seems clear that p38 does not play a significant role in insulin secretion. In the liver, p38 plays a central role in hepatic glucose and lipid metabolism. Activation of p38 participates in the processes to increase blood glucose levels through reducing glycogen synthesis and increasing hepatic gluconeogenesis. P38 appears to prevent fat storage by inhibiting hepatic lipogenesis and promoting fatty acid oxidation in the liver. Additionally, p38 may play a critical role in cholesterol metabolism by regulating expression of the LDLR gene and bile metabolism. P38 does not only participate in various physiological and pathophysiological processes in cardiomyocytes, but also is heavily involved in the development of atherosclerotic lessions through its influences on monocytes/macrophages, vascular endothelial cells, and vascular smooth muscle cells.

Objective To research the correlation of the expressions of lipocalin-2 (LCN-2) and its receptor (NGALR) in serum and placenta with preeclampsia.Methods From Dec.2010 to Apr.2011,64 women with preeclampsia who delivered in Affiliated Hospital of Qingdao University Medical College were recruited in the study,including 26 women with moderate preeclampsia ( MPE group) and 38 women with severe preeclampsia (SPE group).Twenty-five healthy pregnant women were taken as control group.LCN-2 and NGALR mRNA and protein expression in placenta were measured by reverse transcription-PCR ( RTPCR) and western blot,respectively.Results ( 1 ) The serum levels of LCN-2 in MPE group and SPE group [ (58 ±20),(90 ± 18) μg/L] were significantly higher than that in control group [ ( 19 ±6) μg/L,P＜0.01] ; the serum LCN-2 level in SPE group was significantly higher than that in MPE group (P ＜0.01).(2) LCN-2 mRNA expression in placenta in MPE group and SPE group (0.55 ±0.14,0.61 ±0.14) were both significantly higher than that in control group (0.28 ±0.16,P ＜0.01 ) ; LCN-2 protein expression in placenta of MPE group and SPE group ( 2.2 ± 0.4,2.4 ± 0.5 ) were also significantly higher than that in control group (1.4 ±0.4,P ＜0,01 ),no significant difference was found between MPE group and SPE group ( P ＞ 0.05 ),(3) No significant difference was found in the expressions of NGALR mRNA in placenta among MPE group,SPE group and control group (0.46 ±0.1l,0.46 ±0.14,0.45 ±0.15,P ＞0.05 ).(4) NGALR protein expressions in MPE group,SPE group and control group were 2.7 ±0.8,3.0 ±0.9,and 2.7 ± 0.9,and there were no significant difference among these three groups ( P ＞ 0.05 ).(5) In preeclampsia,serum LCN-2 level significant associated with 24 hours total urinary protein and uric acid ( r =0.565,0.476,P＜0.01).LCN-2 serum level were not associated with systolic pressure and diastolic pressure (P ＞ 0.05 ) ; there were no association with the expressions LCN-2 mRNA aud protein in placenta ( P ＞ 0.05).Conclusions Serum LCN-2 level is closely related to the progress of preeclampsia.Increasing expression of LCN-2 in placenta may be a compensatory response to preeclampsia.

Objective To evaluate the clinical application and the therapeutic effect of the Fresnel press-on prism for children ocular torticollis.Design Retrospective case series.Participants 64 patients with ocular torticollis.Methods All the patients with ocular torticollis wore Fresnel press-on prism on glasses for 6-12 months to correct small angle vertical paralytic heterotropia.Main Outcome Measures Changes of abnormal head position and stereoscopic vision when naked and glasses-wearing.Results Fresnel press-on prism could provide an improvement in the correction of symptoms in children ocular torticollis.58 patients(90.6%) had improvement of abnormal head position and three-grade binocular vision.All 55 cases(100.0%)matching examination after wearing prism showed simultaneous perception,52 eases(94.5%)had fusion,and 50 cases(90.9%)had stereoscopic vision.Chi square test showed significant difference from pre-wearing prism(P

Objective To evaluate the changes of right ventricular (RV) volume and function by using single beat real-time three dimensional (3-D) echocardiography in patients with atrial septal defect (ASD) before and after percutaneous closure. Methods During the period from July 2011 to Oct. 2013, a total of 45 patients with pure ostium secundum defect were admitted to authors’ hospital to receive percutaneous transcatheter closer. The patients were divided into ASD without pulmonary hypertension (PH) group (group A, n = 28) and ASD with PH group (group B, n = 17). By using 3-D echocardiography and right cardiac catheterization, the right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular stroke volume (RVSV), right ventricular ejection fraction (RVEF), right ventricular cardiac output (RVCO), pulmonary artery systolic pressure (PASP) and the mean pulmonary artery pressure (mPAP) were determined before and after the percutaneous transcatheter closer. The results were compared between the two groups. Results After the treatment a statistically significant reduction in RVEDV, RVESV, RVSV and RVCO were seen in all patients (P < 0.05). In group A, RVEF decreased significantly after ASD closure when compared with that determined before transcatheter closer (P < 0.05), while no significant reduction in RVEF was seen in group B (P > 0.05). Pulmonary artery pressure (PAP) decreased significantly in group B after ASD closure when compared with that obtained before Objective To evaluate the changes of right ventricular (RV) volume and function by using single beat real-time three dimensional (3-D) echocardiography in patients with atrial septal defect (ASD) before and after percutaneous closure. Methods During the period from July 2011 to Oct. 2013, a total of 45 patients with pure ostium secundum defect were admitted to authors’ hospital to receive percutaneous transcatheter closer. The patients were divided into ASD without pulmonary hypertension (PH) group (group A, n = 28) and ASD with PH group (group B, n = 17). By using 3-D echocardiography and right cardiac catheterization, the right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular stroke volume (RVSV), right ventricular ejection fraction (RVEF), right ventricular cardiac output (RVCO), pulmonary artery systolic pressure (PASP) and the mean pulmonary artery pressure (mPAP) were determined before and after the percutaneous transcatheter closer. The results were compared between the two groups. Results After the treatment a statistically significant reduction in RVEDV, RVESV, RVSV and RVCO were seen in all patients (P < 0.05). In group A, RVEF decreased significantly after ASD closure when compared with that determined before transcatheter closer (P < 0.05), while no significant reduction in RVEF was seen in group B (P > 0.05). Pulmonary artery pressure (PAP) decreased significantly in group B after ASD closure when compared with that obtained before transcatheter closer (P < 0.05). Conclusion Single beat real-time 3-D echocardiography is a newly-developed technique. This technique can quickly and accurately assess the right ventricular volume and function. Right ventricular volume will decrease after ASD closer. In ASD patients without PH the right ventricular function will decrease after ASD closer, while in ASD patients with PH the right ventricular function shows no changes after ASD closer although their PAP will decrease.

Objective　To investigate the preventive measurement of vagal reflex occurrence on patients with percutaneous transluminal coronary angioplasty (PTCA).Methods　On the reason of vagal reflex occurrence,to 75 patients with PTCA adopt the measurement to prevent hypovolemia,control the excessive rebound of cavity viscera,adjust the patients mental state,and so on.Then to observe the level of patients with vagal reflex occurrence,and compare with the control group of 75 patients under common care.Results　The prevent group level of patients with vagal reflex occurrence is 2.61%;the control group is 28%.Conclusion　To patients with PTCA adopt the measurement to prevent hypovolemia,control the excessive rebound of cavity viscera,adjust the patients mental state,and so on.The effect to decrease the level of vagal reflex occurrence is great.

Background Malignant osteopetrosis is an extremely rare dense bone disease,and sometimes features ocular disease and cranial nerve palsy.This disease received high attention because of its poor prognosis.And whether the eye manifestation improved after treatment is a problem for concern.Objective This study was to clarify the clinical manifestation,treatment and prognosis of malignant osteopetrosis associated with ocular disease.Methods A retrospective study was adopted.Two children with malignant osteopetrosis associated with eye symptoms were collected from Beijing Children Hospital.The systemic and ocular medical examinations were performed on the patients,including physical examination,hematology laboratory examination,abdominal B ultrasound and bone X ray radiography,external ocular examination,flash visual evoked potential (F-VEP) and CT of orbit.Bone marrow hematopoietic stem cell transplantation was employed and 5-year following-up was cinducted on the chidren.Results The children showed increased bone density,systemic bone sclerosis,basilar thickening,abnormalities of hematology indexes,anemia,hepatosplenomegaly,optical canal stenosis and abnormality of F-VEP P2 wave.In addition,optical disc pale,facial paralysis and paralytic esotropia were seen in a female child and alternating strabismus was found in another boy.After successful treatment,the systemic symptoms remitted in both children,but the eye findings remained unchanged in the female child during the follow-up duration.However,the strabismus diminished in the male child.The optical bone canal widening to 1.9 mm 1 year and 3.2 mm 5 years after treatment in the female child.Conclusions Strabismus and eye disease are the signs of malignant infantile osteopetrosis and reflections of the impairment of the central nervous system.The pathogenetic mechanism of malignant osteopetrosisrelated eye disease is below understanding now.Early bone marrow hematopoietic stem cell transplantation for malignant osteopetrosis can offer the best chance of long-term survival and improve the prognosis of eye diseases.

OBJECTIVETo investigate the value of diffusion-weighted imaging (DWI) in the diagnosis of T staging for rectal cancer.

METHODSClinicopathologic data and MR images of 46 patients with rectal cancer in our hospital from July 2013 to September 2014 were retrospectively analyzed. The diagnostic sensitivity, specificity and accuracy of T2WI were compared with those of T2WI plus DWI in T staging for rectal cancer. The relationship of mean apparent diffusion coefficient (ADC) value with different T stages of rectal cancer was analyzed.

RESULTSThere were no significant differences in the diagnostic sensitivity, specificity and accuracy between T2WI and T2WI plus DWI (all P>0.05). The mean ADC value of DWI performed in pathologic T2, T3a, T3b, T3c and T4 stage was (1.110 ± 0.117) × 10⁻³ mm²/s, (1.035 ± 0.121) × 10⁻³ mm²/s, (0.948 ± 0.109) × 10⁻³ mm²/s, (0.932 ± 0.122) × 10⁻³ mm²/s and (0.843 ± 0.050) × 10⁻³ mm²/s, respectively (F=6.972, P=0.000).

CONCLUSIONDWI can serve as a complement for T2WI in the diagnosis of T stage patients with rectal cancer, and its ADC value presents a downward trend with the advance of T stage.

Objective To explore the safety and effectiveness of bridging therapy in elderly patients with acute stroke due to posterior circulation large vessel occlusion.Methods A total of 160 eld-erly patients with acute stroke caused by posterior circulation large vessel occlusion admitted to our department were prospectively recruited and randomly divided into bridging group(n=80)and control group(n=80).The bridging group received thrombolysis treatment and then mechan-ical thrombectomy.The control group received mechanical thrombectomy directly.Prognosis and adverse reactions were compared between the two groups.Results The NIHSS score and BATMAN score after treatment were significantly decreased in both groups(P＜0.01),and the two scores were obviously lower in the bridging group than the control group(6.54±1.23 vs 7.12± 0.98,2.12±0.34 vs 2.87±0.44,P＜0.01).There was no statistical difference in the conversion rate of bleeding after cerebral infarction between the two groups(5.00％vs 3.75％,P＞0.05).The number of intraoperative thrombus removal was significantly lower in the bridging group than the control group(2.43±0.33 vs 2.98±0.41,P＜0.01).Remarkable difference was observed in the mRS score between the two groups after treatment(P＜0.05),with the proportion of mRS score ranging from 0 to 1 larger in the bridging group than the control group(52.50％vs 27.50％,P＜0.05).Conclusion Bridging thrombolysis can significantly improve the neurological function in elderly patients with acute stroke due to posterior circulation occlusion.

Insulin increases microvascular perfusion and substrate exchange surface area in muscle, which is pivotal for hormone action and substrate exchange, by activating insulin signaling cascade in the endothelial cells to produce nitric oxide. This action of insulin is closely coupled with its metabolic action and type 2 diabetes is associated with both metabolic and microvascular insulin resistance. Muscle microvascular perfusion/volume can be assessed by 1-methylxanthine metabolism, contrast-enhanced ultrasound and positron emission tomography. In addition to insulin, several factors have been shown to recruit muscle microvasculature, including exercise or muscle contraction, mixed meals, glucagon-like peptide 1 and angiotensin II type 1 receptor (AT1R) blocker. On the other hand, factors that cause metabolic insulin resistance, such as inflammatory cytokines, free fatty acids, and selective activation of the AT1R, are capable of causing microvascular insulin resistance. Therapies targeting microvascular insulin resistance may help prevent or control diabetes and decrease the associated cardiovascular morbidity and mortality.
Cytokines ; Endothelial Cells ; Endothelium ; Fatty Acids, Nonesterified ; Glucagon-Like Peptide 1 ; Hand ; Insulin ; Insulin Resistance ; Meals ; Microcirculation ; Microvessels ; Muscle Contraction ; Muscles ; Nitric Oxide ; Perfusion ; Positron-Emission Tomography ; Receptor, Angiotensin, Type 1 ; Vasoconstriction ; Vasodilation ; Xanthines