Objective To evaluate the value of color Doppler flow imaging(CDFI) in the diagnosis of congenital coronary artery fistula (CAF).Methods Thirteen consecutive patients ranging in age from 8 to 68 years underwent conventional transthoracic echocardiography,which depicts their origin, course, and drainage site. Results Right CAFs were detected in 8 patients: four of them had drainages to the left ventricle, two to the main pulmonary artery, one to the right ventricle(RV) and the other to the right atrium(RA). CAFs arising from the left coronary artery were noted in five patients: three of them had drainages to the main pulmonary, and the other two to the RA and RV respectively. The origin and the course were precisely defined and the drainage site was clearly depicted in all thinteen patients. The diagnosis of the thirteen patients was confirmed by coronary angiography, and eight of them received surgical treatment. Conclusions CDFI offers a simple, useful and reliable technique in diagnosis of CAF.

Objective Currently, the effect of hydrogen peroxide solution( H2 O2 ) flush on the recovery of peripheral nerve injury are still undetermined. This study aims to explore the effects of different H2 O2 flushing time course on recovery of peripheral nerve injury during surgical debridement. Methods 18 New Zealand male white rabbits were randomly divided into isotonic saline group( isotonic saline flush) , H2 O21 min group ( hydrogen peroxide solution flush 1 min + isotonic saline flush) , H2 O23 min group ( H2 O2 flush 3 min + isotonic saline flush. Each group has 6 rabbits. We established rabbit sciatic nerve injury model. After 12 weeks, we executed the animals, drew materials at the suture nerve, detected motor nerve conduction velocity and observed pathological HE staining, as well as measuring the sciatic nerve function indexes( SFI) of rabbits at the 8th and 12th week, respectively. Results Nerve conduction velocity in H2O21min group and isotonic saline group[(25.89±1.42), (26.46±1.67) m/s] were higher than that in the H2O23min group[(23.80±2.91)m/s](P<0.05). Pathological section shows that the isotonic saline group has a better sheathstructure, nerve fibers structure damage is not obvious and myelin degeneration degree is mild in H2 O21 min group. blurred sheath structure and myelin axons obvious deformation in H2 O23 min group. 8 weeks and 12 weeks after operation, SFI in isotonic saline group [(-43.00±0.82), (-39.17±0.91) m/s] was significant higher than H2O21 min group [ (-49.79±1.47), (-46.60±0.79) m/s] and H2O23min group [(-51.66±1.27), (-46.39±0.94) m/s], thedifference was statistically significant (P<0.05). SFI in group of H2O21min [(-49.79±1.47)m/s] was higher than group og H2O23 min [(-51.66±1.27) m/s][P<0.05]. Conclusion H2O2 solution has side effect on the recovery of damaged peripheral nerve inju-ry and with prolonging the H2 O2 flushing time, the damage of peripheral nerve can be aggravated. So in the process of clinical surgical debridement, under the premise of guaranteed sterilization the time of H2 O2 flush should be shortened as far as possible.

Quorum sensing is defined as the cell density-dependent regulation of gene expression, and the involved system is the quorum sensing system, in which N-acyl homoserine lactone is known as the signal molecules of most gram-negative organisms. It can regulate diverse physiological functions. This paper reviewed the quorum sensing systems and the recent advances which play a major role in the formation of the symbiosis between the rhizobia and their host plants.

The government and general public has paid unprecedented attention to the public health after the outbreak of SARS in 2003. Based on the first and the second round of Three-year Action Plan for Public Health System Construction, the public health system in Shanghai has been gradually improved. The city's public health security has been increasingly consolidated and people's main health status and indicators have been constantly improved. Nowadays, the third round of Three-year Action Plan will be started. This paper will review the development of public health system in Shanghai in recent ten years, analyze the possible problems and challenges in the future and put forward the development direction and strategy of the system.

Bile Duct Neoplasms ; diagnosis ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver Transplantation ; Prognosis

Objective To investigate the expressions of PTEN and MDM2 in bladder transitional cell carcinoma (BTCC) and their clinical significance.Methods The expressions of PTEN and MDM2 were detected by tissue immunohistochemistry test (SP method) in BTCC (n =80) and normal bladder tissues (n =20).The relationship between PTEN and MDM2 as well as their correlations with clinical pathological features were analyzed.Results The positive rate of PTEN in different pathological grading (G1,G2,G3)and clinical staging [superficial (Tis ～ T1),infiltration (T2 ～ T4)] was (86.20％,74.07％,37.50％ ;80.00％,46.67％),respectively,with a significant difference (x2 =15.004,P ＜ 0.01 ; x2 =9.497,P ＜0.01).The positive rate of MDM2 in different pathological grading(G1,G2,G3) and clinical staging [superficial (Tis ～ T1),infiltration (T2 ～ T4)] was (82.75％,55.55％,37.50％ ; 70.00％,43.35％),respectively,with a significant differcnce(x2 =11.543,P ＜ 0.01 ; x2 =5.556,P ＜ 0.05).The expression of PTEN was negatively correlated with that of MDM2 in BTCC (r =-0.611,P ＜ 0.05).Conclusions Expressions of PTEN and MDM2 might be involved in the BTCC pathogenesis.The combined detection of PTEN and MDM2 might be of great value in the prediction of tumor behavior and prognosis.

Objective To investigate the distribution pattern of the ADAS-Cog scores among the elderly in Beijing and to evaluate the application of ADAS-Cog in distinguishing patients with mild Alzheimer's disease (AD) and healthy elderly. Methods In total, 1616 healthy elderly (NC), 125 elderly patients with non-AD disorders (ND), and 310 patients with probable AD including 201 patients with mild AD and 109 patients with moderate AD (by NINCDS-ADRDA criteria) were recruited in the study and their cognitive performance was measured by the ADAS-Cog.Results In NC group, those older than 80 years and those with less than 5 years schooling scored highest. There was statistically significant correlation between the total scores of the ADAS-Cog and age and duration of schooling in NC group (F=14.34, 113.27,both P<0.01). No correlation was suggested in the mild AD group. The total score of ADAS-Cog was significantly associated with duration of schooling in both moderate AD and ND groups (F=4.18, 8.72, both P<0.05). The total score of ADAS-Cog differentiated the patients with mild AD from NC healthy elderly with AUC ranging from 0.69 to 0.82 in each subgroup by age, and from 0.75 to 0.88 in subgroups by durations of schooling with the highest AUC of 0.88 in the subgroup having more than 15 years of schooling education. Conclusions The ADAS-Cog score in the healthy elderly is significantly associated with age and duration of schooling education. The ADAS-Cog can be applied in the cognitive assessment of Chinese AD patients. The total score of ADAS-Cog could efficiently differentiate patients with mild AD from healthy elderly, especially in subjects with higher education level.

Objective To analyze the characteristics of erectile dysfunction(ED)in aged men.Methods Erectile dysfunction(ED)was diagnosed according to the International Index of Erectile Function(IIEF).78 aged men(average 65.9 yrs)as the study group,and 82 young patients(average 36.0 yrs)as the control group,all with ED,Were compared in complicating diseases,self-rating SDS scores,penile-brachial indexes(PBI),the time of achieving erection,and ejaculatory latency time.Results The main complicating diseases in study group were cardiovascular diseases(42 cases,53.9%),lower urinary tract symptoms(LUTS)(31 cases,39.7%)and diabetes(26 cases,33.3%).In the control group,the main complicating diseases were chronic prostatitis(52 cages,63.4%),premature ejaculation(PE)(32 cases,39.0%)and depression(12 csses,14.6%).SDS scores of study group and control group were(29.13±5.63)and(39.59±13.31),PBI were(0.78±0.12)and(0.91±0.06),the time of achieving erection were(13.85±5.75)min and(3.61±4.29)min,ejaculatory latency time were(7.03±5.35)min and(3.81±5.53)min.All with significant difference(P＜0.01).Conclusion Most of the ED old men were complicated with organic diseases,such as the time of achieving erection,PBI low scores and longer ejaculatory latency time.

Objective To investigate the effect of angiotenisn ⅡI (Ang Ⅱ) on RIN-m β-cell,and to explore the mechanism of β-cell function impairment caused by Ang Ⅱ.Methods RIN-m cells were cultured with various concentrations of AngⅡ (0.1,1,10,100 nmol/L).After incubation for 24 hours,the basal(3.3 mmol/L) and glucose-stimulated(16.7 mmol/L) insulin secretion(GSIS)were detected by radioimmunoassay,mRNA and protein expressions of uncoupling protein 2(UCP2)were determined by RT-PCR and Western blot,respectively.The intracellular ATP content was measured by luciferase bioluminescence.The mitochondrial membrane potential and cellular Ca~(2+) concentration were detected by flow cytometry.Results (1) Various concentrations of Ang Ⅱ had no significant influence on the basal insulin secrection of RIN-m cell(F=0.644,P = 0.634).Except for 0.1 nmol/L AngⅡ,the other concentrations of Ang Ⅱ markedly reduced GSIS of RIN-m cells(F= 118.528,P = 0.000).(2) Compared with the control group,Ang Ⅱ significantly increased mRNA and protein expression of UCP2(F= 1 370,P = 0.000;F=675.175,P = 0.000).(3)Except for 0.1 nmol/L Ang Ⅱ,the other concentrations of Ang Ⅱ significantly decreased the mitochondrial membrane potential,cellular ATP content,and cellular Ca2+ concentration of RIN-m cell(F=4.035,P=0.008;F=3.353,P = 0.013;F=5.867,P = 0.001).Conclusion Ang Ⅱ impairs GSIS of p-cell,the mechanism of impairment may be interpreted that Ang Ⅱ can increase the expression of UCP2,furthermore,it can reduce mitochondrial membrane potential,decrease the content of cellular ATP and the concentration of cellular Ca~(2+),can finally impair the function of β-cell.

AlM:To evaluate the efficacy of retrobulbar injection of triamcinolone acetonide ( TA ) combined with 577nm laser macular grid photocoagulation for the treatment of cystoid macular edema.
METHODS: Fifty-eight cases ( 66 eyes ) with cystoid macular edema caused by different diseases were recruited in this study. The included patients were treated with both retrobulbar injection of triamcinolone acetonide and 577nm laser macular grid photocoagulation. The best corrected visual acuity, macular thickness, fundus and intraocular pressure were observed in the 1wk, 1 and 3mo after the treatment in all of the included cases.
RESULTS: After treatment, all of the 66 eyes showed cystoid macular edema partially or completely subsided according to optical coherence tomography and fluorescence fundus angiography; 54 eyes ( 82%) visual acuity improved, 12 vision remained the same.
CONCLUSlON: Retrobulbar injection of triamcinolone acetonide combined with 577nm laser macular grid photocoagulation has good curative effect, simple operation procedure and rare complications in the management of cystoid macular edema.