Objective To analyze diagnostic experience of children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) and assess its surgical results.Methods Six children with ALCAPA had been diagnosed in our hospital from Mar. 2006 to Oct.2007 aged from 6 months to 10 years old(median 43.5 months).The medical data included common clinical presentations,the findings of electrocardiogram(ECG),the echocardiogram,ECG-gated 64-slice computed tomography,the digital subtraction angiogram (DSA),surgical records and the outcome.Results Diaphoresis,fantod,breathlessness and difficult feeding were commonly presented in 5 cases ALCAPA and the 5 children presented with left ventricular failure in infancy.The predominant ECG findings were Q waves and ST segment changes in the anterolateral chest leads in 4 cases,ST changes in 1 case,and normal ECG in 1 case.Cross-sectional echocardiography showed dilated left ventricles with poor contractility in 4 cases,medium mitral regurgitation in 2 cases and severe mitral regurgitation in 2 cases,aneurysmal dilatation of the right coronary artery(RCA) in 2 cases.CT and DSA examinations showed characteristic changes in these children.The surgical reestablishment of a two-coronary system was performed in 5 cases,direct reimplantation in 2 cases and creation of an autologous extrapulmonary tunnel in 3 cases.Simultaneous mitral annuloplasty was performed in 2 cases.After operation,the symptoms of 5 cases were all improved and none died.Conclusions Understanding the clinical manifestations and lab findings of ALCAPA is helpful to making an early diagnosis of ALCAPA.Early surgical treatment can improve the patients′ outcome.

Flavonoid naringin is widely distributed in various types of plants and is an important component of herbal Drynaria. In previous studies, Drynaria has been demonstrated to have inhibitory effects on inflammatory responses and bone destruction and exert anabolic effects on bone, has been widely used in the clinical treatment. Naringin, was in the stage of experimental yet. The experimental results have confirmed that naringin suppressed inflammation including arthritis by lowering the expression of inflammatory cytokines, and the mechanism can be explained as reducing the expression of NF-κB. Naringin has been shown to increase osteoblast proliferation by increasing the expression of BMP-2, inhibit osteoclast activity by reducing the expression of RANKL. In animal experimental, naringin was useful for osteoporosis, and the mechanisms are in-depth studies. Research in the field of traditional Chinese medicine and orthopedics, naringin as a explicit material structure in the components of Drynaria, has been concerned about the experimental studies, it is not only prosperity the development of traditional Chinese medicine research,but also ready for clinical studies anti-inflammatory and bone effects of naringin in the future.
Animals ; Anti-Inflammatory Agents ; pharmacology ; Bone and Bones ; drug effects ; Flavanones ; pharmacology ; Humans ; Medicine, Chinese Traditional ; Osteoblasts ; drug effects ; Osteoclasts ; drug effects ; Osteoporosis ; drug therapy ; Polypodiaceae ; chemistry

Objective To explore the therapeutic effect of Lingzhu Infusion and Shenqi Capsule sequential therapy in combination with clomiphene citrate(CC)for polycystic ovarian syndrome(PCOS).Methods The 90 PCOS cases in accordance with the enrol- ment standard were randomized into three groups.The treatment groupⅠwas treated with Lingzhu Infusion and Shenqi Capsule se- quential therapy,the treatment groupⅡwas treated with Lingzhu Infusion and Shenqi Capsule sequential therapy and CC,and the control group was treated with CC only.The therapeutic effect was evaluated after two courses of treatment.Results After treat- ment,the changes of TCM syndromes and serum sex hormone indices,ovulation rate and conception rate of the treatment groupⅡwere all superior to those of the treatment groupⅠand the control group.Conclusion The effect of treatment groupⅠis similar to that of control group.The effect of treatment groupⅡis better than that of treatment groupⅠand control group,getting a higher ovulation rate and pregnancy rate.

Objective To explore the risk factors in elderly type 2 diabetes mellitus with cerebral infarction. Methods Retrospective investigarion was performed on 148 elderly hospitalized patients with type 2 diabetes.The patients were classified based on the presence or absence of cerebral infarction and compared with 60 controls.Logis- tic regression analysis was used to reveal the risk factors for cerebral infarction.Results The levels of systolic blood pressure(SBP),body mass index (BMI),fasting blood glucose (FBG),total cholesterol (TC),triglyceride (TG) and plasma fibrinogen(Fg) were higher in the patients with cerebral infarction[141.15?17.46)mmHg,(23.81?3.53)kg/m~2,(8.82?2.81)mmol/L,(5.69?1.15)mmol/L,(2.08?0.75)mmol/L and (4.08?0.65)g/L] than those without cerebral infarction[(129.78?14.65) mmHg,(22.18?3.22)kg/m~2,(7.06?1.72 )mmol/L,(5.09?1.12)mmol/L,(1.62?0.43)mmol/L and (3.48?0.58)g/L].The logistic analysis showed COUR,SBP,FBG, TC,TG and Fg were the independent risk factors for cerebral infarction.Conclusion Early intervention of the inde- pendent risk factors including SBP,FBG,TC,TG and Fg in elderly patients with type 2 diabetes was important for reduction and postponement of cerebral infarction.

A rapid detection method of active pharmaceutical ingredients( API) in weak API signal drugs by surface enhanced Raman scattering ( SERS) technology combined with paper substrate was established in this work. By soaking the filter paper in silver nanoparticles solution ( Ag NPs) to synthesize Ag NPs-paper as the substrate, and then the sample solution was dropping on the substrate with SERS detection. On the basis of strengthen ability of Ag NPs-paper, result of SERS detection and optimal preparation conditions, the fast identification method of weak API signal drugs was established. In this case, the SERS spectra of weak API signal drugs and their standards SERS spectra were obtained, where the correlation coefficient of weak API signal drug SERS spectra and its standard was more than 0. 9. The result showed that by this method, the low content API in weak API signal drugs could be well investigated, and the deficiencies of the normal Raman spectroscopy efficiently was also overcome. In conclusion, the synthesize method of Ag NPs-paper was simple, and the strengthen effect of this Ag NPs-paper on the intensity was obviously observed. Paper substrate-SERS method was simple, rapid and sensitive, and could be used to detect weak API signal drugs, presenting broad application prospects in the rapid detection of weak API signal drugs.

AIM:To investigate the effects of 1.8mm coaxial micro incision phacoemulsification on corneal endothelial injury and postoperative visual acuity.METHODS: Totally 145 eyes in 120 patients underwent phacoemulsification from July 2013 to July 2015 were randomly divided into observation group 60 cases (73 eyes) and control group 60 cases (72 eyes).The observation group 60 cases were given 1.8mm coaxial micro incision cataract phacoemulsification operation,while the control group were given traditional 3.2mm coaxial micro incision cataract surgery.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),corneal thickness of incision area,incision width,incision length,macular retinal thickness,surgically induced astigmatism,corneal endothelial cell counts and complications of the two groups were compared.RESULTS: The UCVA and BCVA on 1wk after surgery of the observation group were significantly higher than the control group (t=3.604,7.109;P<0.05);the width of incision on 1wk and 1mo after surgery of the observation group were significantly less than the control group (t=205.3,225.2;P<0.05).The length of incision in observation group was significantly greater than the control group (t=3.926,5.009;P<0.05).Macular retinal thickness 1wk after surgery of the observation group was significantly less than the control group (t=2.817,P<0.05).The surgically induced astigmatism was significantly less than the control group (t=19.43,22.16;P<0.01);the difference of corneal edema between the two groups was not significant (8.22% vs 11.11%) (x2=0.348,P>0.05).CONCLUSION: The 1.8mm micro incision phacoemulsification is helpful to improve the visual acuity of patients with cataract phacoemulsification,which may be related to the reduction of corneal cell injury,enhancement of corneal closure and decrease post-operation corneal original astigmatism.

Objective To explore the diagnostic value of DWI after secretin stimulation for the diagnosis of mild chronic pancreatitis (CP). Methods This was a prospective study. Ninety-nine consecutive individuals including 23 healthy volunteers, 11 risk volunteers, 15 mild CP patients, 14 moderate CP patients and 36 severe CP patients underwent secretin DWI and faecal elastase 1(FE-1) testing. The subjects were grouped by Cambridge classification about endoscopic retrograde cholangiography (ERCP), CT and ultrasonography. Secretin stimulated diffusion weighted imaging(S-DWI), the ADCs, time to peak ADCs and FE-1 were performed on all subjects. The changes of pancreatic ADC values were observed before and after the injection of secretin. All ADCs and FE-1 were compared between groups with single factor analysis of variance, and the correlation between ADCs and FE-1 was determined with Pearson analysis. ROC curves were performed to identify the diagnostic efficacy of DWI related measures. Results Eight patients with severe CP were excluded because the significant atrophy of the pancreatic parenchyma prohibited the evaluation of ADC measurement. Ninety-one individuals were divided into five groups including 23 healthy volunteers, 11 risk volunteers, 15 mild CP patients, 14 moderate CP patients and 28 severe CP patients. The mean baseline and peak ADCs were higher in the healthy volunteers than in other groups, with significant differences (P<0.05). There was no ADC peak in severe CP patients. There were significant differences between the mean baseline ADCs and the peak ADCs in the other groups (P<0.05). The mild and moderate CP groups showed a delayed peak. The area under curve (AUC) of the mean baseline and peak ADCs, time to peak ADCs for differentiating mild CP was 0.818, 0.912 and 0.965, respectively. Using 4.67 min as the cutoff value, time to peak ADCs were most accurate for differentiating healthy from risk patients and those with evident pancreatitis, yielding a sensitivity of 80.0%and a specificity of 100.0%. Good correlations between baseline and peak ADCs, time to peak ADCs, and FE-1 were shown(r=0.57, 0.72 and-0.84, P<0.01). Conclusions Using the peak and time to peak ADCs may improve the detection of risk and mild CP. Secretin-enhanced DWI is a noninvasive, convenient and accurate method.

Objective To investigate the effect of controlled hypotension with nitroglycerin on intraocular pressure(IOP)during gynecological laparoscopic surgery.Methods Forty ASA Ⅰ or Ⅱ patients,aged 25-55 yr,weighing 55-70 kg,undergoing gynecological laparoscopic surgery,were randomly divided into 2 groups(n =20 each):control group(group C)and controlled hypotension with nitroglycerin group(group N).Anesthesia was induced with iv injection of midaaolam 0.1 mg/kg,fentanyl 3 μg/kg,vecuronium 0.1 mg/kg and etomidate 0.3 mg/kg and maintained with iv infusion of propofol at 8 mg· kg-1 · h-1 and vecuronium at 0.1 mg· kg 1 · h-1.Additional fentanyl 2 μg/kg was injected intravenously at 3 min before the starting of surgery.The patients was tracheal intuhated and mechanically ventilation.PETCO2 was maintained at 35-40 mm Hg.BIS value was maintained at 50-60.Controlled hypotension was induced by infusion of nitroglycerin at 2-4 μg· kg-1 · min-1 after the starting of surgery.CVP was maintained at 12-14 cm H2 O.Controlled hypotension was stopped at the end of operation.IOP and CVP were recorded before induction(To),at 3 min after tracheal intubation(T1),at 10,30,60,90 and 120 m in of pneumoperitoneum(T2-6)and at 10 min after pneumoperitoneum(T7).Intraocular hypertension(IOP ＞ 21mm Hg)was also recorded.Results Compared with group C,IOP at T3-6 and CVP at T2-6 were significantly decreased,and the incidence of intraocular hypertension was also decreased in group N(P ＜ 0.01).Conclusion Controlled hypotesion with nitroglycerin can prevent the intraocular hypertension effectively during gynecological laparoscopic surgery.

Objective To evaluate the effect of dexmedetomidine on spinal purinergic receptor 2X-4 (P2X4)/nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) pathway in a rat model of diabetic neuropathic pain (DNP).Methods Twenty-four pathogenfree adult male Sprague-Dawley rats,weighing 200-220 g,aged 8 weeks,were allocated into 3 groups (n =8 each) using a random number table:control group (C group),DNP group and DNP plus dexmedetomidine group (DNP+D group).Diabetes mellitus was induced by intraperitoneal 1％ streptozotocin 60 mg/kg and confirmed by blood glucose ≥ 16.7 mmol/L 3 days later.In group DNP+D,dexmedetomidine 50 μg/kg was intraperitoneally injected once a day for 6 consecutive weeks starting from 3 days after the model was successfully established.The mechanical paw withdrawal threshold (MWT) and sciatic nerve conduction velocity (SNCV) were measured at 2,4 and 6 weeks after injection of dexmedetomidine.The rats were sacrificed at 6 weeks after injection of dexmedetomidine,and the L4-6 segments of the spinal cord were removed for examination of the pathological changes (with a light microscope) and for determination of P2X4,NLRP3 and interleukin-lbeta (IL-1β3) expression (by Western blot).The sural nerve was obtained for examination of the ultrastructure by electron microscopy.Results Compared with group C,the MWT was significantly decreased at 2,4 and 6 weeks after injection of dexmedetomidine,the SNCV was decreased at 6 weeks after injection of dexmedetomidine,the expression of P2X4,NLRP3 and IL-1β in the spinal cord was up-regulated (P＜0.05),and the pathological changes of the spinal cord and sural nerve were marked in DNP and DNP+D groups.Compared with group DNP,the MWT was significantly increased at 2,4 and 6 weeks after injection of dexmedetomidine,the SNCV was increased at 6 weeks after injection of dexmedetomidine,the expression of P2X4,NLRP3 and IL-1β in the spinal cord was down-regulated (P＜0.05),and the pathological changes of the spinal cord and sural nerve were significantly attenuated in group DNP+D.Conclusion The mechanism by which dexmedetomidine mitigates DNP is probably related to inhibition of P2X4/NLRP3 pathway in rats.

Objective To discuss the ability of 64 slices CT to display the image of peripancreatic vessels. Methods 105 patients underwent abdomen enhancement scans. The scan data of aterial phase and venous phase were reconstructed respectively, the peripancreatic vessels were displayed by means of volume rendering (VR) and multiplanar volume reconstructions (MPVR). The percentage of successful display of the peripancreatic vessels were calculated. Results ①The display frequency of the peripancreatic big arteries and veins, including celiac trunk artery(CTA), common hepatic artery (CHA), 1eft gastric artery(LGA), splenic artery (SA), gastroduodenal artery (GDA), right gastloepiploic artery(RGEA), superior mesenteric artery (SMA), portal vein(PV), superiormesenteric vein(SMV), spleenic vein (SV)was 100%. ②The display frequency of small arteries including superior pancreaticoduodenal artery (PSPDA), inferior pancreaticoduodenal artery (PIPDA), dorsal pancreatic artery (PDA), transverse pancreatic artery (PTA), pancreaticomegana artery (PMA) and caudal pancreatic artery (PCA) ranged from 43.3% to 97.20%,while of the posteriorsuperior pancreaticoduodenal vein (PSPDV) and posterior-inferior pancreaticoduodenal vein (PIPDV) was 71.4% and 30.5% respectively. ③The display frequency of the peripancreatic small vessels by the multiplanar volume reconstruction (MPVR) was higher than that of the volume rendering (VR)(P＜0.05). Conclusions Multislice CT can display the peripancreatic peripancreatic vessels. Furthermore, there is a significant difference in the display frequency of the peripancreatic small vessels between the MPVR and VR reconstruction methods.