Aortic Valve ; pathology ; Calcinosis ; Heart Defects, Congenital ; pathology ; Heart Valve Diseases ; pathology ; Humans

Aged, 80 and over ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Prosthesis Failure

Objective To evaluate the application value of bedside lung ultrasound in diagnosis of neonatal severe pneumonia.Methods Bedside lung ultrasound and chest X-ray were performed in 59 the newborn patients admitted to the newborn department for suspected severe pneumonia,from October 2015 to March 2016.According to the characteristics of the chest X-ray,patients were divided into consolidation group (widely spot shadow in double lung and airbronchograms) and the unconsolidation group (enlargement,fuzzy texture in double lung or small patch sample changes) Differences in ultrasonic characteristics were compared between the two groups.Results Ultrasonic image characteristics were pulmonary consolidation with air bronchograms,A-line disappearance,pleural line abnormalities.Among 23 patients with chest X-ray,21 patients were found pulmonary consolidation by lung ultrasound,and all 36 patients in unconsolidation group were not found pulmonary consolidation by lung ultrasound,and there was no significant difference in the detection rate by lung ultrasound between the two groups (P＞0.05) The pulmonary ultrasound results of 20 cases in the consolidation group showed A-line disappearance,37 cases in the unconsolidation group showed A-line disappearance.There was no statistical significant differences between the two groups (P＞0.05).The pulmonary ultrasound results showed 11 cases in the consolidation group and 15 cases in the unconsolidation group with pleural line abnormalities,there was no statistically significant differences between the two groups (P＞O.05).Conclusions Ultrasound image characteristics of neonatal severe pneumonia include pulmonary consolidation and air bronchograms,A-line disappearance,pleural line abnormalities.Compared lung ultrasound and chest X-ray result,there was no difference between consolidation group and unconsolidation group.Both of the two methods can be used for evaluating the diagnosis of pneumonia.

Objective To evaluate the influential factors of iron acquisition during Francisella tularensis LVS infection of mouse macrophages.Methods F.tularensis LVS expressing green fluorescent protein was used to infect murine macrophage J774A.1 cells.Transferrin receptor 1(Tfr1)was detected with mono-antibody and visualized with a goat-anti mouse IgG conjugated to Alexa 594.The expression profile of 5 iron metabolism related genes of J774A.1 murine macrophages uninfected or infected with F.tularensis LVS was determined with real-time PCR.Immunoblot analysis was used to compare the Tfr1 expression of live Francisella infected macrophage with dead bacteria.Tfr1 knock-off in J774A.1 cells was performed with siRNA.The transfected cells were infected with Francisella for immunoblotting and microscopy and infection assay.Results It was revealed that the live vaccine strain of F.tularensis induced the expression of Tfr1 in host macrophages.Gene expression analysis indicated that F.tularensis LVS drove an active iron acquisition program with induction of Tfr1 and iron regulatory proteins(Irp1 and Irp2).It was shown by Western-blotting that the siRNA-Tfrc-1 could knock off about 75% of Tfr1 in J774A.1 cells.It was determined by infection assay that,Tfr1 was knocked off,the bacteria number at 1h infection with Francisella was not different from that of control(F=1.06,P=0.326 5),while it was decreased significantly after 24h of infection(F=24.12,P=0.000 6).Conclusions It is demonstrated that upregulation of the Tfr1 may be mediated by post-transcriptional regulation during early infection,but sustained later through increased expression of Irp 1 and Irp 2.Increased expression of Tfr1 expands the intracellular iron pool through transferrin-mediated delivery and may thus be readily available for uptaking by Francisella.Knocking off the expression of Tfr1 does not affect bacterial invasion.Francisella,however,may fail to proliferate in macrophages in which the expression of transferrin receptor has been suppressed.

Objective To summarize the extra-bone joint characteristics of 18F-FDG PET/CT images in patients with adult-onset Still's disease. Methods Twelve patients with adult-onset Still's disease as confirmed by clinical and laboratory tests were enrolled in this study. The characteristics of 18F-FDG PET/CT images were retrospectively analyzed. Results Among the 12 patients, no patients were found with solid malignant tumors. Various degrees of high uptake were found in liver, spleen, bone marrow or lymph node. The hepatic SUV was 2.74 ± 0.89, the spleen SUV was 3.68 ± 1.24, and the SUV of thoracic spine was 4.36 ± 1.35. For the lumbar vertebral, the value of SUV was 4.26 ± 1.25. Lymph node high uptakes were found in 8 patients at different sites , including retroperitoneal , pelvic cavity and pelvic wall , inguinal bilateral neck , hepatic portal , axillary lymph nodes. The value of SUV was 3.76 ± 1.41. Conclusions 18F-FDG of AOSD has certain characteristics, such as diffusely uptake of liver, spleen, bone marrow, or lymph node, with or without pleural effusion.

OBJECTIVETo evaluate the safety and efficacy and summarize the initial experience of transcatheter mitral valve repair (TMVR) for treating Chinese patients with severe mitral regurgitation.

METHODSIn May 2012, TMVR using MitraClip system was applied in 3 patients with severe mitral regurgitation. One patient suffered from with mitral valve prolapse and two with functional mitral regurgitation. The efficacy and complications of the procedure were analyzed.

RESULTSTMVR procedure was successful in all 3 cases. NYHA classification improved by 1 grade in 2 patients and 2 grades in one patient. The mean operation time was (105 ± 38) minutes and X-ray exposure time was (10 ± 4) minutes. Mean aortic pressure was increased from (62 ± 18) mm Hg (1 mm Hg = 0.133 kPa) to (75 ± 14) mm Hg, and mean left atrial pressure was significantly reduced from (15 ± 10) mm Hg to (9 ± 5) mm Hg immediately after the deployment of MitraClip. Three days after the procedure, left ventricular diastolic dimension decreased from (63 ± 11) mm to (59 ± 10) mm, left atrial dimension declined from (59 ± 11) mm to (51 ± 8) mm, and NT-ProBNP was reduced from (4292 ± 1137) mmol/L to (1187 ± 489) mmol/L. No complications occurred in all three cases.

CONCLUSIONSOur initial experience showed that TMVR using MitraClip system is safe and effective for patients with severe mitral regurgitation. However, the long term benefit of the procedure should be validated through follow up.

Aged ; Cardiac Catheterization ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Mitral Valve Insufficiency ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the impact of infertility on men's self-esteem, self-confidence, sexual satisfaction and overall relationship with their spouses.

METHODSUsing Self-Esteem and Relationship questionnaire (SEAR), we conducted an investigation among 253 infertile men and 52 fertile male controls. We divided the infertile men into four subgroups according to their perceived causes of infertility: male (M) factors, female (F) factors, both M and F factors, and unknown factors, and compared the SEAR scores among different groups.

RESULTSIn the infertile men, the total SEAR score was significantly higher in those with < 3 years than in those with > or = 3 years of infertility duration (75.50 +/- 17.05 vs 68.66 +/- 17.19, P < 0.05) and so was it in those with above-high-school than in those with high-school or lower education background (81.42 +/- 13.99 vs 67.61 +/- 17. 8, P < 0.01), but showed no significant difference between the > or = 30- and < 30-year-olds (71.77 +/- 17.42 vs 72.74 +/- 18.38, P > 0.05). The total SEAR scores in the M factor, M & F factor, unknown factor and F factor groups were 65.69 +/- 18.68, 68.52 +/- 17.68, 74.85 +/- 15.19 and 83.21 +/- 12.61, respectively, with significant differences between the first two and the latter two groups (P < 0.05), as well as between the unknown factor and F factor groups (P < 0.05). In the fertile male controls, the total SEAR score and subdomain scores on sexual relationship, self-confidence, self-esteem and overall relationship were 90.04 +/- 9.85, 88.40 +/- 10.74, 92.23 +/- 9.41, 91.95 +/- 10.67 and 90.38 +/- 14.14, respectively, all remarkably higher than in the M factor, M&F factor and unknown factor groups of the infertile men after adjustment of their infertility duration and education levels (P < 0.05).

CONCLUSIONInfertility reduces men's self-esteem, self-confidence, sexual satisfaction and relationship with their spouses, and the degree of its impact is correlated with the patients' infertility duration and education level.

Adult ; Erectile Dysfunction ; psychology ; Humans ; Infertility, Male ; psychology ; Male ; Personal Satisfaction ; Self Concept ; Surveys and Questionnaires

OBJECTIVETo summarize the experience in the treatment of erectile dysfunction (ED) with no successful intercourse at the baseline with tadalafil.

METHODSWe retrospectively analyzed 21 cases of ED with no successful intercourse at the baseline treated with tadalafil on alternate days combined with sex guidance.

RESULTSAfter 4 weeks of tadalafil treatment, 19 of the patients achieved successful sexual intercourse, and the IIEF-5 score was remarkably improved as compared with pre-medication (3.24 +/- 1.55 vs 18.95 +/- 3.02, P<0.0001). Mild adverse reactions were observed in 6 cases, including 2 cases of mild headache and 4 cases of facial blush.

CONCLUSIONTadalafil on alternate days combined with sex guidance can significantly improve ED with no successful intercourse at the baseline.

Adult ; Carbolines ; administration & dosage ; therapeutic use ; Coitus ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Male ; Retrospective Studies ; Tadalafil ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the safety and efficacy and summarize the initial experience of transcatheter aortic valve implantation (TAVI) for treating patients with severe aortic stenosis.

METHODSFrom October 2010 to May 2011, TAVI using 18 F Corevalve system was applied in 3 patients with severe calcified aortic valve stenosis at high risk for surgery. The efficacy and complications of the procedure were analyzed and the procedure experiences were summarized.

RESULTSTAVI procedure was successful in all 3 cases. The mean operation time was (109.0 ± 22.6) minutes and X-ray exposure time was (24.0 ± 9.5) minutes. The peak pressure gradients after surgery were significantly reduced [from (84 ± 15) mm Hg (1 mm Hg = 0.133 kPa) to (6 ± 3) mm Hg]. A trivial to mild paravalvular leak was observed in all patients post procedure. Case 1 was free from perioperative complications. Case 2 experienced a transient complete left bundle branch block. Case 3 developed 3 degree atrioventricular block and implanted with a permanent cardiac pacemaker, cardiac tamponade which was relieved through conservative treatment, including pericardial puncture and drainage and acute kidney injury.

CONCLUSIONSOur initial experience showed that TAVI using the 18 F Corevalve system is safe and effective for patients with severe calcified aortic valve stenosis at high-risk for surgery, though the procedure may cause some complications. Strict patient selection and proficient surgical techniques may reduce the incidence of complications.

Aged ; Aged, 80 and over ; Aortic Valve ; surgery ; Aortic Valve Stenosis ; surgery ; Cardiac Catheterization ; Female ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Treatment Outcome