Objectives To explore the characteristics and value of magnetic resonance imaging (MRI) in predicting prognosis of hypoxic ischemic encephalopathy (HIE) in neonatal period, at 4 months and 4 years old. Methods Twenty-four patients with HIE were examined by MRI. Their MRI results in the neonatal period, at month 4 and year 4 and neurological functions at year 4 were compared. Results Periventricular signal alterations and deep gray matter involvement were common in HIE neonates. The neonates with deep gray matter involvement usually had neurological malfunction and poor prognosis. The patients with encephalomalacia and periventricular leukomalacia at 4 months and 4 years old also had poor prognosis. The abnormal MRI ifndings in HIE children at 4 month and 4 year old predicted the occurrence of neurological malfunction. Con-clusions The MRI of infant at 4 months old is important in prediction of neurological malfunction and provides guidance of clinical intervention for children with HIE.

Objective To explore stimulative of posttraumatic growth(PTG) of head-injured patients associated with limb movement disorder,in order to provide reference for psychological nursing intervention.Methods Phenomenological methodology was used in the study.A semi-structured interview was conducted on seven head-injured patients with limb movement disorder recruited by purposive sampling method.Data were analyzed by Colaizzi's analysis procedure.Results Through interview,the following four themes were summarized:positive state of mind and coping style of patients; patients' high level of self-efficacy; social support; high quality of medical services.Conclusions In order to promote PTG of head-injured associated with limb movement disorder patients,nurses should strive to adjust the patient mentality and coping strategies,improve their self-efficacy levels,help patients get support from the community,at the same time should also focus on quality of medical services.

Objective To observe the clinical effect of gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy in treatment of advanced nasopharyngeal carcinoma.Methods Seventy-six advanced nasopharyngeal carcinoma patients were divided into observation group(38 cases)and control group(38 cases)by radom digits table.The patients in observation group were treated with gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy.The patients in control group were treated with fluorouracil combined with cisplatin concurrent chemotherapy and radiotherapy.The clinical effect and adverse reaction were compared between two groups.Results The total effective rate in observation group was 84.2％(32/38),which significantly higher than that in control group[60.5％(23/38)](P＜0.05).There was no significant difference in 1 year overall survival rate between two groups[89.5％ (34/38)vs.76.3％(29/38)](P ＞ 0.05).The rate of gastrointestinal reactions and oral ulcers in observation group were 42.1％(16/38)and 7.9％(3/38),which significantly lower than those in control group[73.7％ (28/38),31.6％(12/38)](P ＜ 0.05).The rate of bone marrow suppression between two groups had no significant difference[31.6％(12/38)vs.23.7％(9/38)](P ＞ 0.05).Conclusion Gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy in treatment of advanced nasopharyngeal carcinoma can enhance the clinical effect,and decrease the adverse reaction,which can be applied in clinic.

Objective:To study the clinical effect of local application of Gengigel gel (0.8%hyaluronic acid gel) in the treatment of plaque-induced gingivitis.Methods:30 volunteers with plaque-induced gingivitis were included. At least two molars and/or premolars in each quadrant of oral cavity in each subject were treated by local application of Gengigel gel adjunctive to sacling (group SG), scaling alone (group S), local application of Gengigel gel (group G) or without any treatment (group C ) respectively. Plaque index(PLI), gingival index(GI) and sulcus-fluid-flow-rate(SFFR) were monitored before treatment, 4 and 7 days after treatment.Results:GI and SFFR in group SG decreased significantly faster than those in the group S (P

Objective To evaluate four tumor markers of insulin-like growth factor 1((IGF-1), CEA, cytokeratin fragment antigen 21-1 (CYFRA21-1), neuron-specific enolase (NSE) for the diagnosis and prediction of treatment response in human lung cancer. Methods Serum samples were taken from three groups: 91 patients with lung cancer, 30 healthy adults and 15 patients with benign pulmonary diseases. Serum IGF-1 was assayed by radioimmunoassay and CEA, CYFRA21-1, and NSE by electrochemiluminescence immunoassay. The differences among the three groups were determined by Kruskal-Wallis one-way analysis of variance (ANOVA) and with Mann-Whitney rank-sum test. Diagnostic efficacy was evaluated by ROC curves. Results The four serum tumor marker levels were significantly higher in lung cancer group, as compared with the benign and the healthy (IGF-1:χ2=26.95,P<0.001, CEA:χ2=49.11,P<0.001; CYFRA21-1:χ2=40.63,P<0.001; NSE:χ2=14.76;P<0.001). The diagnostic sensitivities of IGF-1, CEA, CYFRA21-1 and NSE was 75.6% (34/45), 53.3% (24/45), 66.7% (30/45) and 42.2% (19/45) respectively for lung cancer. The diagnostic sensitivity of IGF-1 combined with CYFRA21-1 was 95.5 %( 43/45) and that of IGF-1 combined with CEA and CYFRA21-1was 97.8%(44/45). Only IGF-1 and CYFRA21-1 showed significant changes before and after treatment (IGF-1: χ2=5.99,P=0.014; CYFRA21-1:χ2=4.99, P=0.025) in cancer group. Conclusions Serum IGF-1, CEA, CYFRA21-1 and NSE are all valuable for lung cancer diagnosis and the combination of those parameters can enhance the diagnostic efficiency. Serum IGF-1 and CYFRA21-1 may also be useful for evaluating the treatment response in lung cancer.

Animals ; Betaine-Homocysteine S-Methyltransferase ; therapeutic use ; Homocysteine ; blood ; Hyperhomocysteinemia ; blood ; therapy ; Male ; Rats ; Rats, Wistar ; Recombinant Proteins ; therapeutic use

Objective To investigate the effectsof quercetin on human umbilical vein endothelial cell (HUVEC)-12 undergoing endothelial-to-mesenchymal transition (EndMT) induced by TGF-β1; To discuss its mechanism of action. Methods Cell activity of intervening by quercetin with different concentrations and TGF-β1 for 72 h was detected by CCK-8 method;RT-PCR and immunofluorescence staining were used to detect the transition of endothelial and stromal markers; Western blot was used to detect the signal transduction pathway; RT-PCR was performed to detect the transcription factors that play crucial roles in the process of transformation. Results The results of RT-PCR and immunofluorescence double staining showed that TGF-β1 (10 ng/mL) stimulated HUVEC-12 cells for 72 h to induce fibroblast phenotype, showing more interstitial markers and less endothelial markers;Western blot and RT-PCR results showed that quercetin inhibited the phosphorylation of smad2/3 in a concentration-dependent manner;After TGF-β1 stimulation, the downstream transcription factors EndMT of snail1, twist1, twist2, ZEB1, and ZEB2 significantly increased, while 100 μmol/L quercetin could down-regulate the five downstream transcription factors. Conclusion Quercetin has anti-fibrosis effects through inhibiting HUVEC-12 cells undergoing EndMT.

Objective To summarize the clinical experience of repairing facial scar with tubed pattern skin flap from the cervical cutaneous branch of transverse cervical artery.Methods Firstly,a skin flap in the cervical cutaneous branch of transverse cervical artery was designed at chest according to the size of facial scar.The chest skin would be expanded if it was not large enough.Secondly,a skin flap was cut,and the proximal end was rolled and sutured as a tube,whereas the remote end was formed an interface.Thirdly,the scar was removed from the facial scar area and the wound was covered with the tubed pattern skin flap interface.After a blood circulation was established between the face skin and the flap,the flap was trained so that it had plentiful blood supply.Lastly,the tubed pattern skin flap was cut off and open,the remaining facial scar was removed,and the wound was covered and sewed up with the sectioned tubed pattern skin flap.Results The facial scar 35 patients were repaired with tubed pattern skin flap from the cervical cutaneous branch of transverse cervical artery.The survival rate of flap was 100％.Twenty patients received thinning and shaping on flaps in 0.5 to 1 year after surgery.All patients were satisfied with this repair within 1 ～ 5 year follow-up.Conclusions The tubed pattern skin flap in the cervical cutaneous branch of transverse cervical artery is of highly similar to the facial skin.In addition,the supply of the skin is enough.Therefore,it is an ideal flap to repair large facial skin defects.

Objective To investigate the epidemiology of drug-resistant tuberculosis (TB) in five rural counties of eastern China and analyze the biological,demographic and social risk factors.Methods Subjects of this study were all the diagnosed TB patients registered in the five study sites in Shandong Province,Jiangsu Province and Zhejiang Province during one year of 2008- 2009.Questionnaire interview was conducted in all the subjects to acquire the socio-demographic and clinical information.Sputum samples were collected for culturing and isolating of Mycobacterium tuberculosis (M.TB) strains.All the M.TB isolates were further tested for the susceptibility to first-line drugs including rifampin,isoniazid,ethambutol and strepomycin by proportion method.Mantel-Haenszel chi-square test,Fisher's exact test,ANOVA and nonconditional Logistic regression modeling were applied for data analysis.Results Among the total 380 M.TB isolates,105 were resistant to at least one of the first-line drugs.The total drug resistant TB prevalence was 27.6％.Multidrug-resistant tuberculosis (MDR-TB) was observed in 8.4％ of newly treated TB patients,whereas it was 23.3％in previously treated TB patients.After adjusted by county,gender and age of the subjects,multivariate analysis showed that previous treatment history (OR=3.900,95％CI: 1.737-8.704),tuberculosis cavity (OR - 1.987,95 ％ CI: 1.001 - 3.942) were independent factors influencing the occurrence of MDR-TB.Conclusions The prevalence of drug resistant TB in rural area of eastern China is relatively low compared with the average level in China,while it is still higher than the global average level.The present study highlights that TB patients with previous treatment history,cavitaryTB are correlated with MDR-TB,and elderly patients are at high risk of MDR-TB.

BACKGROUND: Coronary angiography is called "the golden standard" for the diagnosis of coronary heart disease (CAD). Foreshortening of vessel segments in angiographic projection images usually caused by the inappropriate projection angles or positions may lead to misdiagnosis or missed diagnosis.OBJECTIVE: To investigate the optimal angiographic views of main coronary artery and its branches in different somatotype or heart type patients and to investigate the specific relationships between the optimal angiographic views and the different somatotypes and heart types with computer-assisted techniques.DESIGN: A controlled observation.SETTING: Department of Cardiology, the Second Affiliated Hospital of Nanchang University.PARTICIPANTS: Altogether 1 369 patients were admitted to the Second Affiliated Hospital of Nanchang University to undergo coronary angiography from January 2001 to December 2006 and recruited for this study. Written informed consents of coronary angiography were obtained from all the patients. The protocol was approved by the Medical Ethics Committee of Medical College of Nanchang University.METHODS: All 1 369 inpatients were assigned into 3 groups by body mass index (BMI): fat somatotype group (n =489, BMI: 26-31 kg/m2, transverse heart type), general somatotype group (n =502, BMI: 23-25 kg/m2, general heart type), and thin somatotype group (n =378, BMI: 17-22 kg/m2 vertical heart type). In each group, all arteries including left main coronary artery (LM), proximal segment of the anterior descending coronary artery (LAD), distal-mid segment of LAD, proximal segment of circumflex branch (LCX), distal-mid segment of LCX, proximal-mid and distal segments of right coronary artery (RCA) were properly and carefully analyzed using Compart software, and then we got its optimal angiographic viewing angle. Finally, we arranged these data and induced whether different somatotype group patients have different optimal angiographic viewing angles specifically for some coronary artery or not.MAIN OUTCOME MEASURES: Optimal angiographic viewing angles.RESULTS: All 1369 patients participated in the final analysis. Optimal angiographic viewing angle for LM: left anterior oblique (LAO)(40±5)°/ caudal (CAU)(25±5)° or right left anterior oblique (RAO) 25°/CAU35°. In the fat somatotype group, the angle should be added 10° to its optimal angle, and in the thin somatotype group, the angle should be decreased by 10°, and the differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significant (all P < 0.05). Optimal angiographic viewing angle for proximal segment of LAD: RAO (50±8)°/ cranial (CRA)(23±8)°. In the fat somatotype group, the optimal angle should be added 10°, but in the thin somatotype group, it should be decreased by 10°. The differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significant (all P < 0.05). Optimal angiographic viewing angle for distal-mid segment of LAD: RAO (40±5)°/CRA (45±5)° or LAO (11±5)°/CRA (45±5)°. Optimal angiographic viewing angle for proximal segment of LCX: LAO (45±5)°/CAU (35±5)° or anteroposterior (AP)/CAU36°. Optimal angiographic viewing angle for distal-mid segmental of LCX: LAO (45±5)°/CAU (35±5)° or RAO (6±4)°/CAU (30±5)°. Optimal angiographic viewing angle for proximal-mid segment of RCA: LAO (35±5)°/CAU (14±5)° or LAO (48±5)°/CRA (15±5)°. For the thin or fat somatotype group, the optimal LAO angle should be increased by 15°, the optimal RAO angle should be decreased by10° for fat somatotype group and should be increased by 10° for thin somatotype group, and the differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significantly (P < 0.05). Optimal angiographic viewing angle for distal segment of RCA: LAO (53±5)°/CAU (17±5)°.CONCLUSION: The message can be got clearly about the whole coronary artery and the accuracy percentage of stenosis by changing angiographic viewing angle regularly to its own optimal angle in different somatotype or heart type patients. It's very important for making the choice of diagnosis and therapy