Objective To investigate the value of high-dose dobutamine stress echocardiography combined with two-dimensional strain imaging in early diagnosis of coronary artery disease. Methods Highdose dobutamine stress echocardiography was performed to 28 patients with suspected coronary artery disease. All wall movements were observed during resting condition and at all stress levels,respectively;the peak systolic longitudinal strain in each endomyocardial segment of left ventricular was measured; the sensitivity and specificity between visual method and two-dimensional strain imaging in diagnosing myocardial ischemia with high-dose dobutamine stress echocardiography were compared. The average peak systolic longitudinal strain was calculated against control group, coronary artery disease group during ischemia segments and non-ischemia segments, and a comparison was made inside each group as well as against the other groups. The area under receiver operating characteristic curve of the peak systolic longitudinal strain was used to predict the sensitivity and the specificity of myocardial ischemia. Results With dobutamine dose of 40 μg·kg-1 · min-1 ,wall motion abnormalities were diagnosed in 6 patients (20 segments) through visual method, myocardial ischemia was found in 15 patients (148 segments) through computing the peak systolic longitudinal strain. Inside the coronary artery disease group during ischemic　segments,the majority of peak systolic longitudinal strain was significantly reduced ( P＜0.05) compared to the non-ischemic segments and the control group. In diagnosing myocardial ischemia in high-dose dobutamine stress echocardiography, the sensitivity of visual method and two-dimensional strain imaging were 35.3％ and 88.2％(P＜0.01), specificity 100％ and 100％(P＞0.05), and accuracy 60.7％ and 92.8％ (P＜0.01). The cutoff value of the peak systolic longitudinal strain was less than or equal to 14.9％, its sensitivity and specificity in predicting myocardial ischemia were 83.3％ and 91.7％,respectively. Conclusions High-dose dobutamine stress echocardiography combined with two-dimensional strain imaging can increase the sensitivity of detecting myocardial ischemia and detect concealed myocardial ischemia. High-dose dobutamine stress echocardiography combined with two-dimensional strain imaging can be used in early diagnosis of coronary artery disease.

Objective To study the relationship between Couagen Ⅰ,MMP-2,TIMP-2 gene expression and atrial fibrosis during heart failure(HF)in dog.Methods Fourteen dogs were used and randomized into HF induced by ventricular tachypacing and control group.Burst atrial pacing was used to induce atrial fibrillation(AF).And the mRNA and protein level of collagen Ⅰ,MMP-2 and TIMP-2 were detected by RT-PCR and immunohistochemical technique.Tissue samples were stained with Mallory trichrome.Results Left ventricular ejection fraction (LVEF) decreased from (67.4? 6.0)% to (29.2?7.8)%,the inducible rate of AF(7/7 vs 2/7) and sustained AF(5/7 vs 0/7) increased and duration of AF stabeatrial fibrillation(SAF) [(462.12?181.43)s vs(0.57?0.57) s] prolonged significantly in HF group.Atrial fibrous tissue content and atrial size of HF group were significantly greater than the controls dogs(268.8% in lefe atria and 190.3% in right atria).The mRNA and protein level of collagen Ⅰ(56.2% and 132.2% in lefe atria,37.4% and 78.0% in right atria)and MMP-2 (100.0% and 115.7% in lefe atria,65.7% and 96.8% in right atria) increased evidently in both lefe atria and right atria,TIMP-2 mRNA decreased 46.3% in lefe atria and had no change in right atria and that its protein had no change in both atrium,whereas the ratio of MMP-2/ TIMP-2 of mRNA and protein increased markedly in both lefe atria (285.3% and 148.8%)and right atria (106.1% and 134.7%)of HF group.SAF had a positive correlation with fibrosis and the gene level of collagen Ⅰ in lefe atria,the ratio of MMP-2/TIMP-2 had a positive correlation with fibrosis and collagen Ⅰ gene level in lefe atria during HF.Conclusions The changes of collagen Ⅰ,MMP-2 and TIMP-2 gene expression appear to be a molecular mechanism of AF, and the molecular remodeling of collagen Ⅰ induced by regulation unbalance of MMP-2/TIMP-2 appears to be an important mechanism of atrial fibrosis during HF.

AIMThe liposome/water partition coefficients of salmeterol and budesonide between aqueous phase and liposomes were determined and the factors that influence their partition coefficients were studied, the mechanism of interaction between the two drugs and phospholipid bilayer was elucidated.

METHODSThe liposome/water partition coefficients of the two drugs were determined by equilibrium dialysis technique. The change of the partition coefficients of the two drugs along with liposome composition and medium was also studied.

RESULTSThe partition coefficients of the two drugs decreased with the increase of cholesterol content and saturation of phospholipid used. The liposome/water partition coefficient of salmeterol increased with the increase of liposome surface negative charge, medium pH and ionic strength, while the liposome surface charge, medium pH and ionic strength had no distinct effect on the liposome/water partition coefficient of budesonide.

CONCLUSIONThe liposome/water partition coefficient of drug was affected by the type, saturation of phospholipid used in liposome preparation, the cholesterol content and surface charge of liposome, as well as the pH and ionic strength of medium also have effect on the liposome/water partition coefficient of drug. Accordingly, in order to reflect the actual partition of drug in biological membrane, the determination condition including liposome composition and medium should be similar to the biological membrane.

Albuterol ; analogs & derivatives ; chemistry ; Budesonide ; chemistry ; Cholesterol ; chemistry ; Drug Carriers ; Hydrogen-Ion Concentration ; Ions ; Liposomes ; Membranes, Artificial ; Phospholipids ; classification ; Salmeterol Xinafoate ; Water ; analysis

OBJECTIVETo investigate characteristics of treating dislocation and fracture of sacroiliac joint through anterior and posterior approaches.

METHODSBetween January 2006 and September 2012, 39 patients with dislocations and fractures of sacroiliac joint were treated with operation. There were 28 males and 11 females, aged 12 to 64 (mean, 41.3) years old. Seventeen cases were chosen through anterior approach, 13 cases through posterior and 9 cases were combined with anterior and posterior approaches. The anterior approach were made with supine position, performed open reduction, and two plates with 4 holes were used as internal fixation for arthrodesis of sacroiliac joint after reduction; while posterior approach prone position, close or open reduction was performed, and one or two partial thread lag screws, which with 7.3 mm in diameter and 60 to 75 mm in length, were penetrated via sacroiliac joint for fixation under X-ray. Postoperative complications were observed, Matta and Majeed scoring were used to evaluated currative effects.

RESULTSAll patients were followed up from 6 to 36 months. The patient could sit on the bed 2 to 4 weeks after surgery and walk with a crane 6 weeks' later. No breakage or loosening of screw occurred during follow-up. In all but one case with old sacral iliac fractures reducted poor, others obtained good opposition. According to Matta's criteria, 30 cases got excellent results, 8 good and 1 fair. According to Majeed's funtional standard, 14 patients got excellent results, 20 good 4 fair and 1 poor.

CONCLUSIONTreating dislocation and fracture of sacroiliac joint through anterior and posterior approaches can obtain good effects. However, anatomic location, fracture types, degree of displacement, the rate of preoperational reduction, vulnerability assessment of operation and fixation strength should be considered.

Adolescent ; Adult ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Internal Fixators ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Sacroiliac Joint ; injuries ; surgery ; Young Adult

BACKGROUNDSpinal muscular atrophy (SMA) is an autosomal recessive disease characterized by degeneration of anterior horn cells of the spinal cord. The survival motor neuron gene is SMA-determining gene deleted in approximately 95% of SMA patients. This study was undertaken to predict prenatal SMA efficiently and rapidly in families with previously affected child.

METHODSPrenatal diagnosis was made in 8 fetuses with a family history of SMA. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) were used for the detection of the survival motor neuron gene.

RESULTSThe survival motor neuron gene was not found in 6 fetuses, ruling out the diagnosis of SMA. Two fetuses were detected positive and the pregnancies were terminated.

CONCLUSIONOur method is effective and convenient in prenatal diagnosis of SMA.

Adult ; Amniotic Fluid ; cytology ; Cyclic AMP Response Element-Binding Protein ; genetics ; Exons ; Female ; Fetal Blood ; cytology ; Humans ; Nerve Tissue Proteins ; genetics ; Polymerase Chain Reaction ; Pregnancy ; Prenatal Diagnosis ; methods ; RNA-Binding Proteins ; genetics ; SMN Complex Proteins ; Sequence Analysis, DNA ; Spinal Muscular Atrophies of Childhood ; diagnosis ; genetics

In order to minimize the residual tert-butyl alcohol (TBA) level in cyclodextrin complex prepared by freeze drying TBA/water cosolvent system, the formulation and lyophilization procedure that may influence the residual TBA was studied. Residual TBA in freeze dried cyclodextrin complex was determined by gas chromatography. The significant formulation and processing factors that influence residual TBA were identified by adjusting the initial TBA concentration in cosolvent, selecting cyclodextrin type (beta-cyclodextrin or hydroxypropyl beta-cyclodextrin), changing sample volume in flasket, altering freezing mode (fast freezing or slow freezing) and modifying the duration of secondary drying. The results show that the amorphous cyclodextrin material (hydroxypropyl beta-cyclodextrin), initial low TBA concentration in cosolvent and fast freezing would lead to high TBA residue in cyclodextrin complex, annealing was effective in reducing the residual TBA. The duration of secondary drying had no distinct effect on residual TBA. It is concluded that in order to reduce residual TBA in cyclodextrin complex prepared by lyophilization monophase solution, the initial TBA concentration in cosolvent should be higher than the crystal formation concentration, the appropriate cyclodextrin type and freeze drying processing should be choosen.
2-Hydroxypropyl-beta-cyclodextrin ; Anti-Inflammatory Agents ; chemistry ; Budesonide ; chemistry ; Chromatography, Gas ; Drug Residues ; analysis ; chemistry ; Freeze Drying ; methods ; Solvents ; chemistry ; Water ; chemistry ; beta-Cyclodextrins ; chemistry ; tert-Butyl Alcohol ; analysis ; chemistry

OBJECTIVETo study the effect of Shugan Shuru Granule (SSG) on the p53 gene expression in patients with hyperplastic disease of breast (HDB) to indirectly explore the mechanism of SSG's effect on HDB on the molecular pathological level.

METHODSSixty-six patients with HDB were allocated in the treated group and the control group, with the former treated with SSG and the latter not. All patients underwent breast operation and their diseased mammary tissues were cut out, sectioned, and observed under microscopy with HE staining and immunohistochemical staining, with ABC method adopted to estimate the degree of hyperplasia and p53 gene expression. The severity of HDB was classified into normal, mild, moderate and severe grades (marked as 0 to III), according to the degree of hyperplasia in the mammary gland.

RESULTSHyperplasia in the control group mostly belonged to grade I-III before treatment, showing overgrowth of gland and proliferation of glandular epithelial cells, which were high columnar shaped, more stratified, with papillary or substantive dysplasia. While in the treated group, most belonged to grade 0-I after SSG treatment, with proliferated gland and dysplasia recovered to normal or disappeared. The positive rate of p53 gene expression in the treated group was 9.09%, and in the control group 39.39%, comparison between the two groups showing significant difference (P < 0.01), the intensity in the former was significantly weaker than that in the latter.

CONCLUSIONSSG could not only inhibit the proliferation of mammary duct epithelia and lobuli, but also inhibit the over-expression of P53. Therefore, it could be regarded as an effective remedy for treatment of HDB and prevention of mammary cancer genesis.

Adult ; Breast Diseases ; drug therapy ; pathology ; surgery ; Breast Neoplasms ; prevention & control ; Drugs, Chinese Herbal ; administration & dosage ; Epithelium ; pathology ; physiology ; Female ; Gene Expression ; drug effects ; Humans ; Hyperplasia ; Mammary Glands, Human ; pathology ; physiology ; Middle Aged ; Tumor Suppressor Protein p53 ; genetics

ObjectiveTo analyze the outcome of psychiatric prevention and therapy program in the community in Huicheng District,Huizhou city.MethodsThe variables of supervision rate,improvement rate,society participation rate,disturbance creating rate of violence,the mean recurrence frequency in one year and hospitalization rate,etc.were observed in psychiatric patients pre-and post initiation of the program as the model of socialization,complexity,accessibility.Results3 years after carrying out the program in Huicheng District of Huizhou city,the supervision rate,improvement rate,society participation rate of psychiatric patients have significantly increased,and the disturbance creating rate of violence,the mean recurrence frequency in one year and hospitalization rate have substantially decreased.ConclusionThe psychiatric prevention and therapy program in the community in Huicheng District,Huizhou city has been shown to be an effective way for psychiatric intervention.

OBJECTIVETo explore the effects of di(2-ethylhexyl)phthalate (DEHP) on neonatal mice's testes and Leydig cells in vivo.

METHODSPregnant mice were exposed to DEHP at the dose of 100 mg/kg, 200 mg/kg or 500 mg/kg (body weight) per day by gavage from gestation day 12 (GD 12) through postnatal day 3 (PND 3), respectively. The testis and body weights, testicular histopathology and the activity of 3beta-hydroxysteroid dehydrogenase (3beta-HSD) of the neonatal mice were investigated.

RESULTSThe body and testis weights of the male mice's offspring were significantly reduced following DEHP exposure. Leydig cell morphology was affected significantly by DEHP as compared with the controls. Leydig cells obviously increased in the neonatal mice's testes on PND 15 and PND 30 when exposed to DEHP (500 mg/[kg x d]). Activities and positive area of the steroidogenic enzymes 3beta-HSD immunoexpression decreased markedly when exposed to DEHP (100 mg/[kg x d] or 200 mg/[kg x d]). Image analysis showed a decrease in the activities of 3beta-HSD in the animals exposed to DEHP (500 mg/[kg x d]), but an increase in the positive area of 3beta-HSD immunoexpression as compared with the control animals on PND 15 (P < 0.01).

CONCLUSIONDEHP affects the Leydig cell morphology, the activity of 3beta-HSD, the testis and body weights and the testicular histopathology of neonatal mice, and it may function as an antiandrogenic agent.

3-Hydroxysteroid Dehydrogenases ; metabolism ; Animals ; Animals, Newborn ; Diethylhexyl Phthalate ; pharmacology ; Dose-Response Relationship, Drug ; Female ; Leydig Cells ; cytology ; drug effects ; Male ; Mice ; Mice, Inbred Strains ; Pregnancy ; Prenatal Exposure Delayed Effects ; Testis ; drug effects

OBJECTIVETo investigate the prevalence of rheumatic heart disease (RHD) among schoolchildren in Guangdong Province and Xinjiang Uygur Autonomous Region.

METHODSUsing a cluster sampling method, an epidemiological survey of RHD was conducted in 16 682 primary and high school students by auscultation in Guangdong Province and Xinjiang Uygur Autonomous Region from 2005 to 2006. Review of the clinical records, RHD survey in adults, and examination of the positivity rate of group A beta-hemolytic Streptococcus (GAS) by throat swab cultures in the students aged between 9 and 12 years in the sampled schools were also carried out.

RESULTSNo RHD patient was found in the sampled population. In Xinjiang, the prevalence of RHD was 12.9/1000 among adults, higher than that (2.2/1000) in Guangdong Province. The GAS-positive rate in the schoolchildren in Xinjiang ranged from 9.8% to 12.6%, higher than that in Guangdong (2.3%-3.9%).

CONCLUSIONThe GAS-positive rate among children and incidence of RHD in adults are higher in Xinjiang than in Guangdong. The prevalence of RHD among the schoolchildren shows a reduction compared with that in 1994.

Adolescent ; Adult ; Child ; China ; epidemiology ; Cluster Analysis ; Female ; Heart Valve Diseases ; epidemiology ; Humans ; Male ; Mass Screening ; Prevalence ; Rheumatic Heart Disease ; epidemiology ; microbiology ; prevention & control ; Streptococcal Infections ; epidemiology ; Streptococcus agalactiae