Humans ; Immunoglobulin D ; Male ; Middle Aged ; Multiple Myeloma ; classification ; complications ; Testicular Diseases ; etiology

Objective To characterize the systolic torsion in dilated cardiomyopathy (DCM) by velocity vector imaging(VVI).Methods Eighty-seven subjects were studied using VVI:27 patients with DCM and 60 healthy control subjects.Left ventricular short-axis acoustic images were acquired at base and apex levels.The rotation angle and rotation velocity of endocardium and epicardium were measured.Results LVEF of DCM group was significantly lower than that of control group ( P＜0.01).The basal and apical rotation angle, rotation velocity were significantly lower in DCM group.The endocardial and epicardial rotation angle, rotation velocity were also significantly lower in DCM group than those in control group (P＜0.01).Conclusions VVI is a rapid and noninvasive tool to quantitatively assess cardiac torsional deformation in DCM patients,which providing another useful modality for evaluating cardiac function.

Objective To investigate strain and strain rate of right ventricular(RV)based on twodimensional image by velocity vector imaging in normal subjects.Methods Thirty-two healthy adults were rolled in this study.Echocardiographic images in 4 chamber view were analyzed by conventional manual tracing for volumes and ejection fractions,which were also measured by velocity vector imaging.Myocardial velocity,strain rate,and strain were determined at the basal,mid,and apical segments of the RV free wall and ventricular septum by velocity vector imaging.Results RV ejection fractions obtained with manual tracing correlated strongly with the same indexes obtained by velocity vector imaging method in all subjects(r=0.91,P＜0.01).The strain and strain rate value of middle segment and basal segment in RV free wall were higher than those of apical segment.There were same trend in ventricular septal.The strain and strain rate of middle segment and basal segment in RV free wall were higher than those of homologous segments in ventricular septal,but the indexes of apical segment in free wail and septal had no difference.The strain and strain rate in RV were not correlated with age.Conclusions Velocity vector imaging could accurately and quantitatively assess the strain and strain rate of RV.

Objective To evaluate the efficacy of nimodipine combined with cerebrospinal fluid exchange in treating subarachnoid hemorrhage (SAH) .Methods The electronic databases and manual retrieval ,and the meta-analytic method were used to conduct the systematic evaluation on the efficacies of nimodipine combined with cerebrospinal fluid exchange versus routine internal medicine therapy for treating SAH in all the included randomized controlled trials (RCTs) .Results 16 RCTs(n=1 076) were included .The methodological quality of all included trials was poor .Compared with the routine internal medicine therapy ,nimodipine combined with cerebrospinal fluid exchange could reduce the occurrence of cerebral vasospasm (RR 0 .33 ,95% CI 0 .25-0 .43 ,P<0 .01) ,hy-drocephalus(RR 0 .28 ,95% CI 0 .18-0 .44 ,P<0 .01) and mortality after SAH (RR 0 .41 ,95% CI 0 .24-0 .70 ,P=0 .001) ,while no difference was found in the occurrence of re-bleeding between two groups(RR 0 .89 ,95% CI 0 .53-1 .50 ,P=0 .67) .Conclusion The current clinical research evidences demonstrate that the combination of nimodipine and cerebrospinal fluid exchange can re-duce the occurrence of cerebral vasospasm and hydrocephalus ,decrease the mortality after SAH But further well-designed multi-center RCTs with larger sample should be carried out to confirm our findings due to the influence of the poor quality of included tri-als .

Cardiomyopathies ; diagnosis ; pathology ; Echocardiography ; Heart Ventricles ; pathology ; Humans ; Magnetic Resonance Imaging ; Young Adult

Adenomatous Polyposis Coli Protein ; genetics ; Chromatography, High Pressure Liquid ; methods ; Codon ; genetics ; DNA Mutational Analysis ; Fibromatosis, Aggressive ; genetics ; pathology ; Humans ; Mutation ; Polymerase Chain Reaction ; beta Catenin ; genetics

OBJECTIVETo study the effect of Bushen Tongdu Capsule (BTC) on RANK/RANKL/ OPG pathway of collagen induced arthritis (CIA) rats, thereby laying theoretic evidence for treating rheumatic arthritis (RA) by Chinese medicine.

METHODSRA model was induced by CIA. Totally 42 rats were randomly divided into six groups, i.e., the normal control group, the model group, the low dose BTC (BSL) group, the medium dose BTC (BSM) group, the high dose BTC (BSH) group, and the Tripterygium Glycosides (TG) group, 7 in each group. BTC at the daily dose of 120, 240, and 480 mg/kg was given by gastrogavage to rats in the BSL, BSM, and BSH group respectively from the 13th day of modeling. TG at the daily dose of 24 mg/kg was given by gastrogavage to rats in the TG group. All medication was given once daily, 2 mL each time. Two mL normal saline was administered to rats in the normal control group and the model group. All medication lasted for 18 days. Samples were taken at day 31. The TRAP section of the ankle joint was fixed in 10% formalin for TRAP stain. Serum levels of osteoprotegerin (OPG), receptor activator of nuclear factor-κB ligand (RANKL), and macrophage colony-stimulating factor (M-CSF) were detected using ELISA.

RESULTSCompared with the normal control group, positive reactions of pathological ankle joint section, inflammation, and osteoclasia degree were significantly improved in the model group, serum levels of RANKL and M-CSF were up-regulated, levels of OPG and OPG/RANKL were significantly lowered (all P < 0.01). Compared with the model group, positive reactions of pathological ankle joint section, inflammation, and osteoclasia degree also significantly decreased in the BSH group and the TG group (all P < 0.01). RANKL and M-CSF were significantly down-regulated in each medicated group, while levels of OPG and OPG/RANKL were significantly up-regulated (all P < 0.01). Compared with the TG group, M-CSF was lower, but levels of OPG and OPG/RANKL were significantly up-regulated in the normal control group (all P < 0.01). RANKL and M-CSF were significantly up-regulated, while levels of OPG and OPG/RANKL were significantly down-regulated in the model group and each BS group (all P < 0.01).

CONCLUSIONBTC could relieve bone damage of CIA rats possibly through regulating and controlling osteoclasts.

Animals ; Arthritis, Experimental ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Inflammation ; Macrophage Colony-Stimulating Factor ; metabolism ; Osteoclasts ; Osteoprotegerin ; metabolism ; RANK Ligand ; metabolism ; Rats ; Receptor Activator of Nuclear Factor-kappa B ; metabolism ; Tripterygium

Objective To retrospectively analyze the effect of interventional embolization for hepatocelluar carcinoma (HCC) associated with arteriovenous shunting (AVS), and to discuss the factors influencing the therapeutic results. Methods The clinical data of 62 cases with HCC associated with AVS , who were treated with interventional chemoembolization , were retrospectively analyzed. Based on the type and extent of AVS identified by angiographic manifestations, appropriate obstruction of the shunt and Lipiodol chemoembolization of HCC were conducted. The curative effect of the shunt embolization was assessed by DSA at one or two months after the treatment. The relevant factors influencing the prognosis of embolization were analyzed by using univariate and multivariate Cox regression analysis methods. Results Of the 62 patients, arterioportal shunting (APS) was detected in 44, hepatic arterio-venous shunting (HAVS) in 11, APS together with HAVS in 4, and hepatic artery-pulmonary artery shunting (HAPAS) in 3. Re-examination with DSA was carried out in 53 patients at 1 - 2 months after the treatment , which showed that the shunting disappeared in 18 cases, obvious reduction of the shunt flow was seen in 19 cases, the lesion remained stable in 9 cases and the disease became worse in 7 cases. Univariate analysis indicated that the kind of embolic material and the presence of tumor thrombus could affect the obstructive result of the shunt , while multivariate Cox regression analysis showed that portal tumoral thrombus was an independent risk factor. The embolization effect of polyvinyl alcohol (PVA) particles and Lipiodol-ethanol mixture, used as the embolic agents, was better than that of gelatin sponge particles. Conclusion To ensure a successful interventional chemoembolization for HCC combined with AVS the procedure should be individualized according to the type and extent of the arteriovenous shunting. The type of embolic materials used for embolization can affect the results to a certain degree.

Objective To compare the perioperative outcomes of laparoscopic liver resection (LLR) versus open liver resection (OLR) for hepatocellular carcinoma (HCC).Methods A total of 89 HCC patients undergoing liver resection between January 2012 and November 2016 were enrolled.Nonparametric tests were employed to compare the clinicalpathological characters and preoperative outcomes.Results No significant difference was observed in clinicalpathological features and postoperative morbidity.LLR group had shorter hospital stay (Z =4.642,P ＜0.01),lower serum ALT level in 1st,3rd and 5 day (Z =2.157,3.089,2.384,all P ＜0.05) and AST level in 1st-and 3rd-day postoperatively (Z =2.688,2.566,all P ＜0.05).The growth rate in serum total protein (TP) and albumin (ALB) postoperatively is higher for LLR group (y =2.348 4x + 51.696 vs.y =0.902 9 + 35.532),(y =1.539 9x + 29.68 vs.y =0.732 9x + 30.406).Conclusion LLR allows quicker liver function recovery and shortens patients' postoperative hospital stay.

Objective To investigate the results of defect reconstruction using anterolateral thigh free flap in medial and lateral approaches.Methods We reviewed the soft tissue defect reconstruction in 200 patients from February 2010 to June 2014 with anterolateral thigh flap in medial or lateral approach,to compare the operative time and donor site morbidity.Results The mean time of flap raising in medial group was (45 ± 4.5) minutes,while in lateral group was (65 ± 3.5) minutes.In medial group,fascial lata was closed directly in 39 cases (39％),while fascial lata was closed directly in all the cases (100％) in lateral group.All the 200 flaps survived uneventfully.All the donor sites healed smoothly.No infection occurred.An 8 to 32 months follow-up revealed a high satisfactory rate from the patients.No sensory deficit or functional impairment was noted in the donor sites.Conclusions Both in medial and lateral approach can achieve safely harvesting free anterolateral thigh flap.