Objective To investigate the early diagnostic value of plasma D-dimer level in acute aortic dissection (AAD) . Method A total of 80 patients with chest pain were enrolled from January 2006 to March 2009, and 40 patients of them were confirmed to be AAD with computerized tomographic angiography (CTA), and these patients were matched with 40 controls presenting suspected dissection, which were ruled out later. The D-dimer test was performed in all patients within 12 hours after onset of chest pain,and plasma D-dimer concentrations were compared between two groups. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of D-dimer used for diagnosing AAD were analyzed. The receiver operating characteristic (ROC) curve was also established. The statistical analysis of data was carried out by using Mann-Whitney test with SPSS 11.5 software. Results The plasma D-dimer oncentrations in AAD were significantly higher than those in controls [(5.48±7.95) vs. (0.64±0.75), P <0.0l]. Receiver operating characteristic curve analysis showed that D-dimer ( > 0.5 μg/mL) was predictive in the diagnosis of AAD, and the area under ROC curve was 0.848 ± 0.042, (95% CI: 0.766-0.930) with 87.5% sensitivity, 62.5% specificity,70% PPV and 83.3% NPV. Conclu-sions D-dimer may be a valuable biomarker in early diagnosis of AAD.

Aim To study the effects of Free Anthra-quinone from Rhubarb (FAR)on myocardial CTGF and collagen expression and interstitial fibrosis in dia-betic rats.Methods The male SD rats were randomly divided into normal group (CON),diabetic cardiomy-opathy group (DCM) and FAR treatment group (FAR).Streptozocin was intraperitoneally injected in-to the animals in the latter 2 groups to induce diabetic rat model.The model was expected to be stable for 2 weeks before the treatment.At the end of the 8th week in treatment,fasting plasma glucose and heart mass in-dex were measured.Masson staining was used to ob-serve the myocardial fibrosis.RT-PCR was used to de-tect the mRNA levels of CTGF,procollagen type Ⅰand collagen type Ⅲ.Immunohistochemical method was used to detect the content of CTGF.ELISA was used to detect the depositions of collagen type I and collagen type Ⅲ. Results Compared with CON group,fasting plasma glucose,heart mass index,the degree of myocardial fibrosis,and the expressions of CTGF,collagen type I and collagen type Ⅲ in left ven-tricular myocardial tissue of DCM group were signifi-cantly increased. However, compared with DCM group,fasting plasma glucose,heart mass index,the degree of myocardial fibrosis,and the expressions of CTGF,collagen type I and collagen type Ⅲ in left ven-tricular myocardial tissue of FAR-treated rats were sig-nificantly decreased.Conclusion FAR retards the process of myocardial fibrosis in diabetic rats by down-regulating the expression of CTGF,reducing the syn-thesis and depositions of collagen type I and collagen type Ⅲ.

ObjectiveTo evaluate the effect and safety of different thrombolytic therapies for acute cerebral infarction due to occlusion of middle cerebral artery(MCA).MethodsOne hundred and thirty-two cases of acute cerebral infarction in territory of MCA were randomly divided into 3 groups,all of which were treated with alteplase.Group A (48 cases) was treated by intra-venous therapy with alteplase,group B (43 cases) was treated by infusing alteplase at the site of the internal carotid artery,and group C(41 cases) was treated by infusing alteplase into the thrombus.The improvement of neurological function,complications and mortality rate were recorded and statistically compared,with analysis of variance for counting data of normal distribution,x2 test for quantitative data,and the mean difference was significant at the 0.05level.ResultsThe effective rates of group A,B and C at 2 h,24 h,2 w were 18.8％ (9/48),39.6％ ( 19/48),45.8％ (22/48) ;39.5％ (17/43),53.5％ (23/43),58.1％ (25/43) ;78.0％ (32/41),85.4％ (35/41 ),87.8％ (36/41)respectively.The effective rate of group C was obviously better than group A( x2 =12.809,9.979,9.289,P ＜ 0.01 ) and B (x2 =31.295,19.425,17.161,P ＜ 0.01 ) with statistical significance.The effective rate of group B was better than group A at 2 h after thrombolytic therapy with statistical significance (x2 =4.801,P ＜ 0.05 ).The effective rate of group A and B did not have significant difference at 24 h,2 w after therapy ( x2 =1.765,1.375,P ＞ 0.05 ).The hemorrhage rates of group A,B and C were 14.6％ (7/48),14.0％ (6/43),7.3％ (3/41 ),the mortality rates of group A,B and C were 6.2％ (3/48),4.6％ (2/43),2.4％ (1/41),and there was no significant difference among the 3 groups ( x2 =1.328,0.786,P ＞ 0.05 ).ConclusionIt is suggested that the thrombus-imbeded thrombolytic therapy is a better way in treating acute cerebral infraction due to occlusion of MCA for its rapid and better therapeutic effect.

BACKGROUNDTraditionally, displaced greater tuberosity fractures are treated with open reduction and internal fixation. Arthroscopic treatment and outcome of greater tuberosity fractures is far from comprehensive. The objective of the current study was to assess the surgical procedure and outcome of an arthroscopic method in the treatment of isolated greater tuberosity fractures.

METHODSFrom January 2006 to December 2009, 23 patients with isolated greater tuberosity fractures were treated with an arthroscopic procedure using three cannulated screws combined with washers. During follow-up, radiographs and the constant shoulder score (CSS) were used to evaluate the outcome.

RESULTSThree cannulated screws with washers were used to fix the fractured fragment of the greater tuberosity under an arthroscope. All incisions healed at primary intention without infection. The mean duration of follow-up was 20 months (range 18 - 36 months). Fracture fixation was excellent, and fractures healed 2 - 6 months (mean 3.8 months) after surgery. At final follow-up, the CSS was 92 (range 86 - 100).

CONCLUSIONSThe described arthroscopic procedure provides anatomical reduction and firm fixation for isolated greater tuberosity fractures. It is a successful and minimally invasive procedure with satisfying therapeutic effects as well as excellent functional recovery.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome

Background Traditionally,displaced greater tuberosify fractures are treated with open reduction and internal fixation.Arthroscopic treatment and outcome of greater tuberosity fractures is far from comprehensive.The objective of the current study was to assess the surgical procedure and outcome of an arthroscopic method in the treatment of isolated greater tuberosity fractures.@@Methods From January 2006 to December 2009,23 patients with isolated greater tuberosity fractures were treated with an arthroscopic procedure using three cannulated screws combined with washers.During follow-up,radiographs and the constant shoulder score (CSS) were used to evaluate the outcome.@@Results Three cannulated screws with washers were used to fix the fractured fragment of the greater tuberosity under an arthroscope.All incisions healed at primary intention without infection.The mean duration of follow-up was 20 months (range 18-36 months).Fracture fixation was excellent,and fractures healed 2-6 months (mean 3.8 months) after surgery.At final follow-up,the CSS was 92 (range 86-100).@@Conclusions The described arthroscopic procedure provides anatomical reduction and firm fixation for isolated greater tuberosity fractures.It is a successful and minimally invasive procedure with satisfying therapeutic effects as well as excellent functional recovery.

Chemokine signal pathways are important for the regulation of tumour metastasis. Chemokine receptors CXCR4 (C-X-C chemokine receptor type 4) and XCR1 (chemokine XC receptor 1) are involved in the metastasis of breast cancer, while the interaction between them remains unclear. Here we first identified the interaction between CXCR4 and XCR1 based on membrane protein yeast two-hybrid assays. Bioluminescence resonance energy transfer (BRET) showed that XCR1 could competitively bind to CXCR4 to form a heterodimer (P < 0.01). Results of wound healing assays via transient transfection of XCR1 and CXCR4 into HEK293 cells showed that 41.55% of the migration area rate in the co-transformation group was lower than 58.75% in the CXCR4-alone group after adding 30 nmol/L S D F-β. The co-expression of XCR1 inhibited the cellular motility, possibly mediated by the SDF-1β (stromal cell-derived factor 1)/CXCR4 signal pathway (P < 0.05). Furthermore, CXCR4 on the cell surface after co-expression of XCR1 in CXCR4-EGFP transgenic HEK293 cells was detected by flow cytometry. And the result suggested that XCR1 could accelerate the internalization of CXCR4 into the heterodimer induced by 30 nmol/L SDF-1β (P<0.05), which increased the internalization rate from 14.38% to 64.10%. Finally, the phosphorylation of Akt and ERK, which were involved in cell proliferation and migration, respectively, were examined. After 10 minutes of SDF-1β stimulation, ERK phosphorylation in the CXCR4-alone group showed a 3.59-fold increase, whereas the increase of ERK phosphorylation in the co-transfected group was only 2.08-fold. Interestingly, heterodimer formation reduced the phosphorylation level of ERK and shortened the activation time, whereas the phosphorylation level of Akt remained unchanged. Collectively, our findings revealed the hetero-dimerization of CXCR4 and XCR1 and its effects on CXCR4-mediated cellular motility, receptor internalization, and ERK pathway phosphorylation. Therefore, XCR1-targeting drugs could be candidates for cross-desensitization of CXCR4 and might represent a possible option for inhibiting breast cancer metastasis.

BACKGROUNDBronchial carcinoids are rare malignant neuroendocrine neoplasms. Some issues regarding surgical treatment of bronchial carcinoids remain controversial, including the role of bronchoplastic surgery and necessity of systematic lymphadenectomy.

METHODSThis retrospective study involved 131 consecutive patients surgically treated for carcinoid tumors at Shanghai Chest Hospital between March 1990 and August 2010.

RESULTSEighty-nine (67.9%) of the patients were male, and the mean age was 46 years, ranging from 17 to 81 years. Preoperative fiberoptic bronchoscopy was performed in all patients. Endoscopic biopsy was performed in 100 patients with central tumors, and 70 (70%) patients were diagnosed as bronchial carcinoid. The resections performed consisted of 31 pneumonectomie, 32 lobectomies, 26 bilobectomies, 34 sleeve lobectomies, six bronchoplastic procedures without lung resection, and two segmentectomies. During a median of 87 months follow-up, there were nine recurrences including three local recurrences and 6 distant recurrences. No bronchial recurrences were observed. The 3-, 5- and 10-year overall survival rates of pneumonectom and bronchoplastic surgery (including sleeve lobectomy and bronchoplastic procedure without lung resection) were 93.2%, 81.0% and 69.4%, 97.5%, 91.9% and 70.0%, respectively. Multivariate Cox regression indicated that histology and nodal status were significant independent prognostic factors.

CONCLUSIONSBronchoplastic surgery should be considered whenever possible for central carcinoids. Systematic lymphadenectomy is recommended for bronchial carcinoid patients. Histology and nodal status were significant independent prognostic factors of overall survival of patients with bronchial carcinoid.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoid Tumor ; mortality ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome

In this paper, we present a virtual endoscopy (VE) for diagnosis of heart diseases, which is proved efficient and affordable, easy to popularize for viewing the interior of the heart. The dual source CT (DSCT) data were used as primary data in our system. The 3D structure of virtual heart was reconstructed with 3D texture mapping technology based on graphics processing unit (GPU), and could be displayed dynamically in real time. When we displayed it in real time, we could not only observe the inside of the chambers of heart but also examine from the new angle of view by the 3D data which were already clipped according to doctor's desire. In the pattern of observation, we used both mutual interactive mode and auto mode. In the auto mode, we used Dijkstra Algorithm which treated the 3D Euler distance as weighting factor to find out the view path quickly, and, used view path to calculate the four chamber plane.
Algorithms ; Endoscopy ; methods ; Heart ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Tomography, Spiral Computed ; methods ; User-Computer Interface

AIM:To investigate the RELMα/FIZZ1 signaling pathway on the regulation of the Ca 2+/CaM sig-naling pathway in the mouse aortic smooth muscle cells MOVAS and on the formation of blood vessels in the mouse aortic endothelial cells(MAEC).METHODS:The MAEC cultured in vitro were divided into pGSadeno-HK group,pGSadeno-RELMα/FIZZ1 group,pGSadeno-shRNA control group and pGSadeno-shRNA RELMα/FIZZ1 group.MTT assay was used to detect the viability of the MAEC.The formation of stroma tubes was observed for determining angiogenesis.The MOVAS cells cultured in vitro were also divided into pGSadeno-HK group,pGSadeno-RELMα/FIZZ1 group,pGSadeno-shRNA con-trol group and pGSadeno-shRNA RELMα/FIZZ1 group.The viability of MOVAS cells was measured by MTT assay.Fluo-3 AM fluorescence probe was used to detect intracellular Ca 2+concentration.The expression of calmodulin(CaM)and my-osin light chain kinase(MLCK)at mRNA and protein levels was determined by real-time PCR and Western blot.RE-SULTS:Over-expression of RELMα/FIZZ1 significantly promoted the viability of the MAEC.The number of lumen forma-tion was increased significantly(P<0.05).Knockdown of the RELM α/FIZZ1 expression inhibited the viability and lumen formation of MAEC(P <0.05).Over-expression of RELMα/FIZZ1 significantly promoted the viability of the MOVAS cells,enhanced the mean fluorescence intensity of intracellular Ca 2+,and the expression of CaM and MLCK at mRNA and protein levels was significantly increased.Knockdown of the RELMα/FIZZ1 expression significantly inhibited the viability of the MOVAS cells,the mean fluorescence intensity of Ca 2+was decreased, the expression of CaM and MLCK at mRNA and protein levels was decreased significantly(P<0.05).CONCLUSION:RELMα/FIZZ1 signaling pathway is involved in the angiogenesis,and the mechanism may be related to the changes of intracellular Ca 2+concentration and then to regu-late the intracellular CaM and MLCK expression.

Abstract As dietary issues of children and adolescents become increasingly complex, the assessment of food literacy (FL) is increasingly importance. FL involves a comprehensive cognition and practical ability concerning food among children, playing a key role in fostering healthy eating habits and improving health levels. The article explores the definition and connotations of FL, and introduces eight FL assessment tools in terms of theoretical foundations, dimensions, assessment methods, and their reliability and validity. Moreover, it provides a comparative analysis of these tools by examining their dimensional design, evaluation indicators, strengths, and weaknesses, as well as their applicable subjects and scenarios, aiming to offer references for implementing relevant policies and developing more comprehensive and effective FL assessment tools.