OBJECTIVE To observe the controlled hypotensive effect of remifentanil in patients of different age groups undergoing FESS. METHODS Forty-seven ASAI-II patients were divided into two groups: young-middle aged group(18～55yr,n=24)and elderly group(60～72yr,n=23). Both groups received remifentanil by continuous infusion. Their systolic blood pressures (SBP) were reduced to 30～35 % of the base values and sustained throughout surgery. SBP,diastolic blood pressure (DBP) and heart rate (HR) were monitored throughout surgery. The surgical field quality score, total dose of remifentanil and postoperative complications of each patient were recorded after the operation. RESULTS The SBP and DBP of two group were reduced to the target pressure at the beginning of the operation(P0.05). CONCLUSION Remifentanil enabled controlled hypertensions and offer superior surgical field conditions for FESS in patients of different age groups. Moreover,it was a more suitable alternative for elderly patients because HR did not increase during controlled hypotension.

Adolescent ; Adult ; Debridement ; methods ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Neuroleptanalgesia ; methods ; Nose ; surgery ; Postoperative Period ; Young Adult

OBJECTIVETo investigate the clinical application, feasibility and value of 3 T whole-heart contrast enhanced free-breathing navigator-gated three-dimensional coronary magnetic resonance angiography (CE-CMRA).

METHODS3 T CE-CMRA was used to examine patients with suspected coronary heart disease (CAD). Gd-BOPTA (0.2 mmol/kg) was injected intravenously with slow infusion rate (0.3 ml/s) to perform enhancement. Data were post-processed to obtain principal branches of coronary artery and picture quality was evaluated. According to results of selective coronary arteriography (SCAG), the diagnostic accuracy of CE-CMRA for diagnosing CAD was judged by means of detecting significant stenosis (> 50%) of the principal branches based on the 9 segments of coronary artery.

RESULTSTwenty-three out of 26 patients successfully completed the examination. The mean scanning time was (10.4 ± 2.1) minutes, 178 out of 202 (88.1%) SCAG demonstrated segments could be evaluated by CE-CMRA. The imaging quality was superior in proximal and middle segments of coronary artery principal branches than in distal segments. Based on patient-level, there were 9 positive cases and 14 negative cases examined by CE-CMRA compared with 11 positive cases and 12 negative cases examined by SCAG, respectively. The whole diagnose accordance rate of CE-CMRA was 91.3% (21/23) compared with SCAG. The sensitivity, specificity and negative predictive values were 81.8% (9/11), 88.5% (169/191) and 98.8% (9/31) respectively.

CONCLUSIONS3 T CE-CMRA is a feasible non-invasive imaging modality for diagnosing CAD, especially to detect significant stenosis in proximal and middle segments of coronary artery principal branches. However, the detecting efficacy is limited in assessing stenosis of distal segment and small branches of coronary artery.

Aged ; Coronary Angiography ; methods ; Coronary Vessels ; pathology ; Female ; Heart ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Angiography ; methods ; Male ; Middle Aged

OBJECTIVETo survey the prevalence and risk factors of HSV-2 among Chinese and Vietnamese female sex workers (FSW) in the border county of Hekou, Yunnan Province, China.

METHODSA cross-sectional survey was conducted on demographics, sexual behavior, medical history, and drug use among FSWs. Laboratory samples were obtained to test for HSV-2 and other STIs such as HIV, Syphilis, Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Bacterial vaginosis, and Yeast infections. Cervicitis and genital warts were also diagnosed.

RESULTSOf the 345 FSWs who participated in this study, 112 (32.5%) were ethnic Chinese and 233 (67.5) were Vietnamese. Among FSWs in Hekou, the prevalence rates were 58.3% for HSV-2, 5.5% for HIV, and 4.1% for bacterial vaginosis (BV). Age<21 (OR: 0.5; 95% CI: 0.3, 0.8), duration of commercial sex work≤3 months (OR: 0.5; 95% CI: 0.3, 0.8), oral and vaginal sex with the last client (as opposed to only vaginal sex) (OR: 1.6; 95% CI: 1.0, 2.7), HIV (OR: 11.4; 95% CI: 1.5, 87.2), and bacterial vaginosis (BV) (OR: 5.6; 95% CI: 1.2, 26.9) were significantly correlated with HSV-2 infection.

CONCLUSIONMultivariate analysis showed that several factors were significantly correlated with the high prevalence of HSV-2 in FSWs in the border area between China and Vietnam. Further studies and interventions are needed for HSV-2 epidemiology in the border area.

Adolescent ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Herpes Genitalis ; epidemiology ; Herpesvirus 2, Human ; isolation & purification ; Humans ; Risk Factors ; Sex Workers ; Vietnam ; epidemiology ; Young Adult

OBJECTIVETo investigate the limited digestion of recombinant staphylococcal enterotoxin C2 (SEC2-His)in different conditions.

METHODSThe purified recombinant SEC2-His was treated with different reagents and the cleavage of rSEC2 molecule was observed by SDS-PAGE.

RESULTThe cleavage occurred in positions Cys93-Cys110 of the disulfide loop. Complete auto-cleavage of recombinant SEC2 was observed in solution at 37degrees within 24 hrs, and that was accelerated under alkaline conditions. The auto-cleavage of the recombinant protein was inhibited in the presence of beta-ME (2%), PMSF (5-10 mmol/L), imidazole (1 mol/L) or crude E.coli lysate. Non-specific degradation of recombinant SEC2 was promoted with the increasing of the concentration of H(2)O(2).

CONCLUSIONThe recombinant SEC2-His is broken down in special site of protein, which may be associated with the protein structure.

Amino Acid Sequence ; Enterotoxins ; chemistry ; genetics ; Molecular Sequence Data ; Protein Conformation ; Protein Stability ; Recombinant Fusion Proteins ; chemistry ; genetics

OBJECTIVETo detect potential mutations of OTC gene in a male infant affected with ornithine transcarbamylase deficiency.

METHODSGenomic DNA were isolated from peripheral blood samples of family members and 100 healthy individuals. Potential mutations of the 10 exons of OTC gene were screened with PCR and Sanger sequencing.

RESULTSA homozygous missense mutation c.917G>C in exon 9, which results in p.R306T, was identified in the infant. Sequencing of the mother and two female members of the family indicated a heterozygous status for the same mutation. The same mutation was not found in other members of the family and 100 healthy controls.

CONCLUSIONA missense mutation c.917G>C in the OTC gene is responsible for the pathogenesis of the disease. Identification of the mutation can facilitate prenatal diagnosis and genetic counseling for the family.

Computational Biology ; Female ; Humans ; Male ; Mutation ; Ornithine Carbamoyltransferase ; genetics ; Ornithine Carbamoyltransferase Deficiency Disease ; diagnosis ; genetics ; Sequence Analysis, DNA

OBJECTIVETo screen of high cariogenicity Streptococcus mutans (S. mutans) strains isolated from clinical specimens preliminary.

METHODSAcidogenicity, aciduricity, extracellular polysaccharide production and adhesion of 41 strains of S. mutans isolated from clinical specimens were investigated to screen high cariogenicity S. mutans strains.

RESULTSThere were different cariogenicity among 41 strains of S. mutans, in which 3 strains of S. mutans had all high ability to produce extracellular polysaccharide, adhere to the saliva-coated hydroxyapatite, produce acid and tolerate acid, indicated there were 3 strains with high cariogenicity S. mutans strains isolated from clinical specimens. Another 3 strains of S. mutans with all low ability to produce extracellular polysaccharide, adhere to the saliva-coated hydroxyapatite, produce acid and tolerate acid indicated they were low cariogenicity S. mutans strains isolated from clinical specimens.

CONCLUSIONWe may have obtained high cariogenicity S. mutans strains isolated from clinical specimens.

Dental Caries ; Durapatite ; Humans ; Saliva ; Streptococcus mutans

OBJECTIVETo identify Streptococcus mutans (S. mutans) strains from clinical samples.

METHODSPlaque samples from caries-active and caries-free sites on enamel surfaces were obtained and cultivated for S. mutans isolation. Morphology, biochemistry, automatic microorganism analysis system and polymerase chain reaction using primers homologous to surface protein antigen I/II (spaP), glucosyltransferase B (gtfB) and dextranase (dexA) were used to identify S. mutans. Genotype of isolated S. mutans was determined by arbitrarily primed polymerase chain reaction.

RESULTSForty-six strains of S. mutans were obtained from the 32 subjects and were identified as S. mutans by biochemistry, automatic microorganism analysis system and polymerase chain reaction. Five identical genotypes were found by arbitrarily primed polymerase chain reaction.

CONCLUSIONForty-one strains of S. mutans with different genotype were obtained from clinical samples.

Dental Caries ; Dental Plaque ; Genotype ; Glucosyltransferases ; Humans ; Polymerase Chain Reaction ; Streptococcus mutans

OBJECTIVETo compare and analyze the MRI features of different renal cell carcinoma (RCC) subtypes.

METHODSThe MR images of 81 surgically and pathologically confirmed renal cell carcinomas from 79 patients were reviewed retrospectively. The MR imaging features of lesions in plain scan, the degree and patterns of lesion enhancement (homogeneous, heterogeneous, peripheral), and tumor spreading patterns were analyzed. In order to evaluate the diagnostic validity of differentiating RCC subtypes using signal enhancement, receiver operating characteristic curves (ROC) were generated. The cutoff value of post-contrast signal intensity to noise ratios (SNR) of the tumor parenchyma were also generated in order to differentiate clear cell RCC from other subtypes.

RESULTSOf the 81 lesions, 58 were clear cell carcinomas, 10 chromophobe cell carcinomas, 8 papillary cell carcinomas, and 5 unclassified RCC. All the chromophobe cell subtype tumors showed a homogeneous density (P < 0.05). The clear cell subtype tumors were likely heterogenous, and also showed heterogenous enhancement with mixed signal than other subtypes (P < 0.05). The cutoff value of SNR, which was used to differentiate clear cell subtype from the other subtypes, were 616 (corticomedullary phase), 579 (nephrographic phase) and 278 (excretory phase), retrospectively. The nephrographic phase is the most appropriate for differentiation, with a sensitivity of 62.1%, specificity of 91.3%, positive predictive value of 94.7%, negative predictive value of 48.8% and an accuracy value of 70.3%. No significant difference was found in tumor spreading patterns among all subtypes of RCC.

CONCLUSIONMR imaging features, particularly tumor heterogeneity and degree of enhancement are useful in differentiation of the renal cell carcinoma subtypes, and in choosing an individualized therapy.

Adult ; Aged ; Carcinoma, Renal Cell ; pathology ; Female ; Humans ; Image Enhancement ; methods ; Kidney Neoplasms ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Young Adult

OBJECTIVETo seek ideal strategies in saving a patient with very extensive deep burns, and measures for functional reconstruction after convalescence.

METHODSA patient with 99. 5% TBSA flame burn injury (III degrees 80%, deep second degree 14.5% and superficial II degrees 5%), complicated with hypernatremia and hyperchloraemia was admitted 76 hours after the injury. Early escharectomy and alloskin grafting were performed. Because of the lack of autoskin donor site, the skin grafting of autologous skin was only undertaken whenever there was an available source, and the remaining wounds were temporarily covered with allografts. Finally the patient survived. After healing of all the wounds, contractures were corrected with skin from scars, flaps of scarred skin or composite skin, and more than 30 cicatricial contracture deformities were corrected after convalescence.

RESULTSAfter initial treatments and extensive early escharectomy, the patient's condition became stable gradually, without adverse complications. After 7 operations, the wounds finally healed completely after 106 days. The function of all joints were restored well and external appearance improved after 15 plastic and reconstructive operations during convalescence period. The patient was fully rehabilitated and resumed his original work 26 months after the injury.

CONCLUSIONFor those patients with massive burns and short of donor site, alloskin grafting after early escharectomy, and persistent repeated microskin grafting whenever any small amounts of own skin is available, is essential to stabilize the patients' condition, and reduce complications. Covering the wounds as the result of shedding off of eschar with alloskin can protect the undamaged cells in skin appendages to promote re-epithelization and wound healing. It is feasible to harvest skin grafts from scars, and use scar skin flaps and composite skin to repair contractures after convalescence with good outcome in function and external appearance.

Adult ; Burns ; surgery ; therapy ; Cicatrix ; surgery ; Contracture ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Wound Healing