Evidence-Based Medicine ; Humans ; Occupational Diseases ; prevention & control ; Occupational Medicine ; methods

Adolescent ; Adult ; Anemia, Iron-Deficiency ; diagnosis ; etiology ; Child ; Female ; Hemoglobinuria, Paroxysmal ; complications ; diagnosis ; Humans ; Male ; Middle Aged ; Young Adult

Objective To explore the clinical significance of the disagreement between transmitral pulsed wave Doppler (PWD) and mitral annulus Doppler tissue imaging (DTI) in the estimation of left ventricular (LV) filling pressures. Methods One hundred and eighty-two sinus rhythm patients without arrhythmia, congenital heart disease and valvular disease underwent routine echocardiography and synchronous electrocardiogram for assessment of LV function. Early and late diastolic velocities of LV, which were composed of e and a waves, were recorded using DTI at the mitral annulus. Six sites at the mitral annuli were selected corresponding to the septal, lateral, anterior septal, posterior, inferior, and anterior walls of LV from apical 4-, 3-and 2-chamber views. Transmitral diastolic flow velocity, which was represented by E and A wave, was measured with PWD from apical 4-chamber view. Ratio of early and late diastolic transmitral valve (MV-E/A), ratio of DTI-e/a-ann and ratio of E/e-ann were calculated, respectively. The mean value of e-ann from the above 6 sites was selected to describe the early diastolic velocities of mitral annular. Results According to the results of MV-E/A ratio and DTI-e/a-ann ratios of the 6 sites, these 182 patients were divided into 4 groups: groupⅠ(n=68): MV-E/A＜1.0, DTI-e/a-ann＜1.0 at all the 6 sites at the same time, with mean MV-E/A ratio being 0.71±0.16 and mean E/e-ann ratio 15.91±6.78; groupⅡ(n=38): MV-E/A＜1.0, DTI-e/a-ann≥1.0 at 1-6 sites among the total sites, with mean MV-E/A ratio being 0.76±0.12 and mean E/e-ann ratio 10.37±2.63; group Ⅲ(n=23): MV-E/A≥1.0, DTI-e/a-ann≥1.0 at all the 6 sites at the same time, with mean MV-E/A ratio being 1.74±0.42 and mean E/e-ann ratio 9.57±2.39; group Ⅳ(n=53): MV-E/A≥1.0, DTI-e/a-ann＜1.0 at 1-6 sites among the total sites, with mean MV-E/A ratio being 1.31±0.31 and mean E/e-ann ratio 13.27±9.46. The mean ages of group Ⅰ, Ⅱand Ⅳ were older than that of group Ⅲ. Although there was no obvious difference between group Ⅰand groupⅡ in the mean age and mean MV-E/A (P＞0.05), the mean E/e-ann was much higher in group Ⅰthan that in groupⅡ (P＜0.05). The mean MV-E/A was similar in group Ⅲ and group Ⅳ (P＞0.05), but the mean age and mean E/e-ann in the latter were older and higher than those in the former (P＜0.05), respectively. The mean age in group Ⅳ was younger than that in group Ⅰand Ⅱ, while the mean E/e-ann in group Ⅳ was higher than that in group Ⅱ, but lower than group Ⅰ (P＜0.05). Conclusion ①Ratio of MV-E/A ＜1.0 and ratios of DTI-e/a-ann ＜1.0 at all the 6 sites indicates increasing LV filling pressures; ②MV-E/A≥1.0 and DTI-e/a-ann＜1.0 at 1-6 sites among the total sites predicts a tendency of high LV filling pressures; ③Wide variability may present in those with MV-E/A＜1.0, DTI-e/a-ann≥1.0 at 1-6 sites among the total 6 sites or MV-E/A≥1.0, DTI-e/a-ann≥1.0 at all the 6 sites at the same time; ④Age of the patient has great influence on the measurement of MV-E/A ratio and DTI-e/a-ann ratio.

Objective To discuss the key technique of ultrasound-guided biopsy in superficial lymph nodes,and to explore the value of ultrasound in qualitative diagnosis for the lymph nodes.Methods Three hundred and twenty-five patients who underwent ultrasound-guided lymph node biopsy from Jan 2006 to Jan 2009 were retrospectively reviewed.Results The sizes of the lymph nodes were 0.8 cm×1.0 cm-5.0 cm×7.0 cm.Each patient was punctured 3 to 6 times.Pathological results showed lymph nodes in 230 patients (70.77%) were malignant,including metastatic carcinoma in 134 patients,malignant lymphoma in 96 patients,while lymph nodes in 87 patients (26.77%) were benign,including specific infection in 82 patients,non-specific infection in 5 patients,whereas uncertain in 8 patients (2.46%) .The tissue amount got from biopsies could be used for qualitative pathological diagnosis in 317 patients (97.54%) .Taking lymph node with the ratio of long diameter to short diameter less than 2,unclear medulla structure,multi-vessel and arterial resistance index≥0.65 as the standard,the diagnostic accuracy rate of malignant lesions was 76.41%.Conclusion Ultrasound-guided biopsy of superficial lymph nodes is convenient and effective for pathological diagnosis.

OBJECTIVETo explore the mechanisms of Qianjing Decoction in the treatment of oligoasthenospermia (OAS).

METHODSWe randomly divided 100 SPF male rats into five groups of equal number: normal, model, Huangjingzanyu, levocarnitine, and Qiangjing. OAS models were established in the animals followed by intragastrical administration of normal saline, ornidazole, Huangjingzanyu Capsules (200 mg per kg body weight per day), levocarnitine (100 mg per kg body weight per day), and Qianjing Decoction (10 g per kg body weight per day), respectively, qd, for 4 successive weeks. Then, we detected the concentration and motility of the epididymal sperm, obtained the contents of superoxide dismutase (SOD), malonaldehyde (MDA), glutathione peroxidase (GSH-Px), lactate dehydrogenase (LDH), α-glucosidase, and fructose in the epididymis, and determined the mRNA expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and succinate dehydrogenase (SDH) in the epididymal tissue of the rats by real-time PCR.

RESULTSThe concentration and motility of the epididymal sperm in the model, Huangjingzanyu, levocarnitine, and Qianging groups were (35.34 ± 4.22) x 10(6)/ml and (40.04 ± 7.05)%, (48.12 ± 5.56) x 10(6)/ml and (62.46 ± 7.12)%, (47.14 ± 4.87) x 10(6)/ml and (63.23 ± 6.34)%, and (50.25 ± 5.08) x 10(6)/ml and (66.34 ± 7.58)%, respectively, all significantly lower than in the normal group ([53.05 ± 4.55] x 10(6)/ml and [70.20 ± 8.54]%) (P < 0.05), but remarkably higher in the Huangjingzanyu, levocarnitine, and Qiangjing groups than in the model rats (P < 0.05). Compared with the thinned epididymal lumen walls, decreased sperm count, and disorderly and loose arrangement of the lumens in the OAS models, the rats in the Huangjingzanyu, levocarnitine, and Qiangjing groups showed evidently thicker epididymal lumen walls, with the lumens full of sperm cells and arranged regularly and compactly, similar to those of the normal rats. The levels of SOD and GSH-Px were significantly lower but that of MDA markedly higher in the model rats ([84.12 ± 23.25], [10.56 ± 3.02], and [14.04 ± 2.06] nmol/mg) than in the normal group ([110.04 ± 19.56], [17.25 ± 3.56], and [8.87 ± 1.35] nmol/mg) (P < 0.05), while the former two indexes remarkably higher and the latter one significantly lower in the animals treated with Qiangjing Decoction ([120.56 ± 23.68], [16.34 ± 3.12], and [8.45 ± 1.56] nmol/mg), Huangjingzanyu Capsules ([115.34 ± 21.35], [15.23 ± 3.67], and [8.33 ± 1.54] nmol/mg), and levocarnitine ([116.67 ± 22.67], [15.35 ± 3.45], and [8.05 ± 1.78] nmol/mg) than in the models (P < 0.05). The levels of fructose, LDH and α-glucosidase were decreased markedly in the OAS models ([100.22 ± 12.12] mg/[ ml x g], [322 ± 46.13] U/[ ml x g], and [10.48 ± 2.33] U/[ml x g]) as compared with the normal rats ([128.12 ± 13.45] mg/[ml x g], [428 ± 35.12] U/[ml x g], and [15.34 ± 3.12] U/[ ml x g]) (P < 0.05), remarkably higher in the rats treated with Qiangjing ([130.23 ± 13.67] mg/[ml x g] [455 ± 51.50] U/[ml x g], and [18.56 ± 4.67] U/[ml x g]), Huangjingzanyu ([124.16 ± 14.02] mg/[ml x g], [ 419 ± 43.14] U/[ml x g], and [17.64 ± 4.08] U/[ml x g]), and levocarnitine ([123.34 ± 14.02] mg/[ml x g], [430 ± 31.80] U/ [ml x g], and [16.85 ± 5.55] U/[ml x g]) than in the models (P < 0.05). The Nrf2 mRNA expression was significantly reduced in the models as compared with the normal rats (P < 0.05) but remarkably increased in the Huangingzanyu, Qiangjing and levocarnitine groups as compared with the model and normal animals (P < 0.05). The SDH mRNA expression was significantly lower in the model than in the normal rats (P < 0.05) but markedly elevated in the Huangjingzanyu, Qiangjing and levocarnitine groups as compared with the model and normal animals (P < 0.05), remarkably higher in the Qiangjing than in the Huangjingzanyu group (P < 0.05).

CONCLUSIONOrnidazole induces OAS in rats, which is closely associated with excessive oxidation and energy metabolism dysfunction. Qiangjing Decoction can improve and even reverse ornidazole-induced OAS in rats as well as improve the ultrastructure of their testicular and epididymal tissues. Antioxidation and improvement of energy metabolism are probably the action mechanisms of Qiangjing Decoction in the treatment of OAS.

Animals ; Antioxidants ; Asthenozoospermia ; chemically induced ; drug therapy ; metabolism ; Carnitine ; pharmacology ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Energy Metabolism ; drug effects ; Epididymis ; metabolism ; Glutathione Peroxidase ; metabolism ; L-Lactate Dehydrogenase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Oligospermia ; chemically induced ; drug therapy ; metabolism ; Ornidazole ; Random Allocation ; Rats ; Sperm Count ; Sperm Motility ; Spermatozoa ; drug effects ; physiology ; Succinate Dehydrogenase ; metabolism ; Superoxide Dismutase ; metabolism ; alpha-Glucosidases ; metabolism

Two new polyesters, talapolyesters G-H (1-2) were isolated from the wetland soil-derived fungus Talaromyces flavus BYD07-13, and their structures were determined by NMR and MS spectroscopic data. The absolute configurations of the residues were determined by alkaline hydrolysis. The cytotoxicity against five tumor cell lines (HL-60, SMMC-7721, A-549, MCF-7 and SW480) of 1-2 was examined.
Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; Molecular Structure ; Polyesters ; chemistry ; isolation & purification ; pharmacology ; Talaromyces ; chemistry ; growth & development ; Wetlands

OBJECTIVETo explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension (PAH) in patients of chronic obstructive pulmonary disease (COPD) associated with chronic cor pulmonale (CCP) during exacerbation.

METHODSSeventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group. The control group received standard treatment with antibiotics, antiasthmatic and expectorant medications, and oxygenation; and the ligustrazine treatment group received ligustrazine treatment (80 mg/d; i.v.; for 2 weeks) in addition to the standard treatment. Before and at the end of 2 week treatment, the clinic responses of the two regimens were evaluated, plasma levels of endothelin-1 (ET-1) and nitric oxide (NO) were determined; arterial oxygen partial pressure (PaO2, mean pulmonary arterial pressure (mPAP), outflow tract of right ventricle (RVOT), and internal diameter of right ventricle (RV) were measured.

RESULTSGood clinic benefits were achieved in both the standard and ligustrazine regimens, plasma level of ET-1, values of mPAP, RV and RVOT decreased significantly, plasma level of NO and PaO2 values decreased (all P < 0.01 vs pre-treatment to all parameters). Compared with the control group, ligustrazine greatly enhanced the clinic efficacy from 77.1% to 97.1% (P < 0.05), and also resulted in more significant changes of all these parameters (P < 0.01 vs control group for all parameters). For both groups, the levels of plasma ET-1 were positively correlated with values of mPAP, RVOT, and RV (r = 0.710, 0.853, and 0.766, respectively, all P = 0.000), and negatively correlated with plasma NO and PaO2 (r = - 0.823, and - 0.752, respectively, all P = 0.000).

CONCLUSIONLigustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area. The observed changes in the plasma levels of NO and ET-1 in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-1 from lung vascular endothelial cells, thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension.

Altitude ; Blood Gas Analysis ; Chronic Disease ; Endothelin-1 ; blood ; Humans ; Hypertension, Pulmonary ; drug therapy ; Nitric Oxide ; blood ; Pulmonary Artery ; physiopathology ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Pyrazines ; therapeutic use ; Respiration

Objective To investigate the occurrence of regular and rare types of beta thalassemia in Guangxi,and to reduce the misdiagnosis and missed diagnosis.Methods Between Jan 2010 and Dec 2013,42 770 patients (20 740 males and 22 030 females,one month to fifty-four years old) from Maternal and Child Healthy Hospital of Guangxi,who were suspected with thalassemia were involved in this study.All these patients were went through the following screening tests:routine blood cell count,hemoglobin electrophoresis test,and serum iron and ferritin tests.Positive patients in the screening test would be taken gene diagnosis with regular reverse dot blot (RDB) method; negative patients in gene diagnosis but positive in the screening test would be under the test of beta globin gene sequencing.Results Totally 28 101 patients were confirmed with thalassemia from 42 770 suspected patients,including 10 891 patients with beta thalassemia,49 patients were homozygous,10 718 patients were heterozygote,and 124 patients were compound heterozygous.After beta globin gene sequencing test,14 regular mutations in people of south China and 7 rare types mutations were detected,the detection rate of rare type of beta thalassemia was 17.949％ (7/39).Conclusions Mutation spectrum of beta thalassemia in Guangxi is complex.Gene diagnosis of rare type thalassemia needs to be done in patients with phenotypes of thalassemia and negative of regular gene diagnosis,in order to reduce misdiagnosis,and improve accuracy of clinical diagnosis.

Objective To evaluate the left ventricular twist in patients with coronary heart disease (CHD) with two-dimensional strain echocardiography (2DSE). Methods Thirty-eight patients with CHD and 31 control subjects proved with selected coronary angiography were enrolled. Two-dimensional images from LV short-axis views at the levels of mitral annulus and apex in 3 continuous cardiac cycles were recorded. LV ejection fraction (LVEF) was calculated with bi-plane Simpson's method, torsion and torsional rate were obtained in each plane, and the corresponding curve was accessed. Results No statistical difference of conventional echocardiographic parameters such as LV diameter, left atria diameter, LVEF, FS, E/A and E-wave deceleration time were detected, while significant difference of torsional direction (P＜0.01) and global torsion rate (P＜0.05) were found between the two groups. Conclusion The global torsional rate and torsional direction have higher sensitivity than conventional echocardiography in the diagnosis of CHD.

ObjectiveTo analyze the disc working zone of intervertebral foramens (ⅣF) for percutaneous posterolateral approach to the lumbar disc with dissection and measurement of adult cadaveric spine speciments.MethodsTwenty-five lumbar IVFs of cadaveric spines(age:45-65 years; body height:150-176 cm) were studied.The heights of the intervertebral space at the most posterior margin (h) and the angles between the nerve root and the plane of the disc (β) at the sagittal plane and the distance from the nerve root to posterolateral margin of disc(d) were measured.The distances from nerve root to the lateral edge of articular process at the plane of the inferior endplate of the upper vertebra (a1) and the plane of the superior endplate of the vertebra below(a2) were measured.We also measured the distance between the nerve root and the dura at two planes of the vertebra endplate(b1,b2) after removing the lamina and articular processes.ResultsThe disc in the ⅣF is contained in the trapezoid shaped zone at the sagittal plane or the coronal plane.The parameters of two trapezoids are displayed:h is (7.0±1.1) mm; β is 77.6°±8.4°; d is (3.4±2.3)mm; a1 is (9.4±2.2) mm; a2 is (10.8±4.6) mm; b1 is (9.9±2.7) mm; and b2 is (17.7±2.1) mm.All values increase as the level goes down except the value of β,which decreases.ConclusionThe disc working zone of ⅣF is a complicated three-dimensional structure changed from the Kambin's triangle,which could be simulated by construction of two trapezoid on sagittal and coronal planes.The anatomic study of the structure is able to help the clinical transforaminal managements of the lumbar disc.For example,the dimension of working cannula could be figured out by the height of the intervertebral space.The angle of the needle inserted is affected by the distance from nerve root to the disc in this structure.