Objective To investigate the value of wide-detector Revolution CTA with 70 kV tube voltage and prospective ECG-gated technique in diagnosis of congenital heart disease (CHD) in infants and children.Methods Forty-five infants and children with complicated CHD underwent echocardiography and wide-detector Revolution CTA.According to the sur gical findings,the diagnostic efficiency of Revolution CTA and echocardiography were calculated and compared.The radiation effective dose (ED) and iodine dose were calculated.The quality of CT images was also evaluated.Results There were 25 separate cardiovascular anomalies including 6 congenital cardiac structure anomalies and 19 congenital extracardiac vascular anomalies.For congenital extracardiac vascular anomalies,there was significant difference of diagnostic accuracy and the detectable rate between CTA (99.77％ [853/855],97.73％ [86/88]) and echocardiography (98.71％ [844/855],88.64％ [78/88];x2 =6.28,5.72,both P＜0.05).The average of ED was (0.20±0.05)mSv and the mean iodine dose was (2.06± 1.09)g.All CT images were qualified for diagnosis.Conclusion The wide-detector Revolution CTA,with the prospective ECG-gated technique and 70 kV tube voltage,can provide high accuracy for assessment of CHD in infants and children,which can keep good image quality,with the low radiation dose.

Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

Objective To observe adhesion and growth of Sehwann cells(SCs) on small intestinal submueosa(SIS) and study the bioeompatibility of SIS with SCs.Methods The SCs of SD neonate rat were isolated and cultured in vitro,then were seeded on prepared SIS.At different times,the adhesion,growth and proliferation of SCs on SIS were observed by phase contrast microscope,histological examination,scanning e- lectron microscope and transmission electron microscope.Results By phase contrast microscope,SCs grew well on the edge of SIS after 3 and 5 days.SCs adhered tightly on the surface of SIS after 5 days through histo- logical examination.By scanning electron microscope,on the surface of SIS,SCs grew and adhered actively, prominence of cells body were obvious.They connected end-to-end with each other or arranged in clusters. Protein granules were secreted on cells surface.By transmission electron microscope,SCs grew in good condi- tion and adhered tightly on the surface of SIS.At the interface of SCs and SIS,prominence was seen to contact with SIS in the bottom of cell body.Conclusion SCs are able to adhere and grow well on the surface of SIS.As a scaffold,SIS has good biocompatibility with SCs.

Objective To explore the etiology,clinical manifestations of infantal viral pneumonia in Luzhou area.Methods Five viral specific serum IgM antibodies were detected by enzyme-linked immunosorbent assay(ELISA) in acute period of viral pneumonia.Five kinds of virus were separated,as respiratory syncytial virue(RSV),influenza virus(IFV),adenovirus(ADV),cytonegalo virus(CMV),and parainfluenza virus(PIV).Serum specific IgM was positive,C-reactive protein(CRP) was less than 8 mg/L,and there was no(clini-)cal and laboratory proof of other pathogenic infection detected in 221 infants with pneumonia.Results 1.One hundred and four cases of viral infection were detected from 221 infants with pneumonia.The viral positive detected rate was 47.1%,and there were 75 cases of single viral infection(72.1%) and 29 cases of mixed viral infection(27.9%) among them.2.In the single viral infection,RSV was the first,IFV,ADV,PIV and CMV being the second,the third,the fourth,and the fifth respectively.3.The types of likely infection virus were different in different age-stage and seasons in infants.Conclusions The etiology of infantal pneumonia is complicated.The types of viral infection are various besides germ infection and the epidemic season peak;clinical manifestations are different.Earlier detection of(etiology) in infection will make clear the etiology and then take appropriate treatment measures to improve curative effect.

Objective To investigate the effect of acupuncture combined with antidepressant on behavioral changes and 5-hydroxytryptamine 1A and 2A receptor ( 5-HT1AR and 5-HT2AR) mRNA expression in nucleus raphes dorsalis (NRD) of sleep deprivation depression (SDD) rats. Methods Eight normal Sprague Dawley (SD) rats were caged together without any stimulus or treatment, serving as the normal group. Thirty-two SD rats were given solitary raise for 21 days, together with chronic unpredictable mild stress ( CUMS) and rapid eye movement ( REM) sleep deprivation to establish the model. Twenty-eight rats completed the modeling successfully, and were divided into model group, acupuncture group, medicine group, and combination group, 7 rats in each group. Rats in the model group were given modeling treatment but without any intervention. Rats in the acupuncture group were given acupuncture on acupoint Yintang, Shenting and bilateral Taichong, acupuncture stimulation lasting 15 s every 10 min and acupuncture retention for 20 min in each day. Rats in the medicine group were given gastric gavage of Zoloft solution (0.83 mg·kg-1·d-1) and Alprazolam solution (0.067 mg· kg-1·d-1) , and rats in the combination group were given both acupuncture and medicine intervention. The intervention for the three intervention groups lasted for 7 days. Results Compared with the normal group, body weight, Open-field scores and sucrose preference of the model rats were significantly decreased on modeling day 7, 14, 21 (P<0.05). On modeling day 28, body weight and Open-field scores of each intervention group were significantly increased compared with those of the model group (P<0.05), and Open-field scores of combination group differed from those of acupuncture group and medicine group ( P<0.05). Only sucrose preference of combination group was improved significantly compared with the model group (P<0.05). Compared with the model group, NRD 5-HT1AR mRNA expression level was increased in the combination group (P<0.05), and NRD 5-HT2AR mRNA expression level was down-regulated in all of the three intervention groups ( P<0.05). Conclusion Acupuncture and antidepressant treatment covering 7 days can evoke rapid effect on SDD rats, which can improve the slow effect of antidepressant.

Objective To investigate the infections caused by Staphylococcus aureus carrying Panton-Valentine leukocidin(PVL)genes.Methods 26 isolates of Staphylococcus aureus carrying Panton- Valentine leukocidin(PVL)genes were determined by multiplex PCR.Multilocus sequence typing(MLST) was used to determine the STs of the isolates.The genotypes of SCCmec were also determined by another multiplex PCR in the isolates of methicillin-resistant Staphylococcus aureus(MRSA).Results Among 26 isolates,there were 6 isolates of ST88 MRSA,7 isolates of ST88 methicillin-susceptible Staphylococcus aureus (MSSA),5 isolates of ST239 MRSA,5 isolates of ST398 MRSA,1 isolate of ST25 MRSA,1 isolate of ST30 MRSA and 1 isolate of ST59 MRSA.20 isolates were hospital-acquired(HA)which mainly caused pulmonary infection and post-operative pyogenic infection.6 isolates were community-acquired(CA)which mainly caused soft tissue necrosis.Among 19 isolates of MRSA,ST88-SCCmec Ⅲ A,ST239-SCCmec Ⅲ,ST398- SCCmec Ⅳ and ST398-SCCmec Ⅲ were main types.26 isolates were isolated from 14 wards.ST88-SCCmec Ⅲ A-MRSA caused clone spread in maternity department in our hospital.Conclusion ST88,ST239 and ST 398 are main STs in Staphylococcus aureus carrying PVL in our hospital.The isolates not only cause nosocomial infections but also cause community infection.

Objecttve To explore the value of electrocardiographic(ECG)Cornell criteria for detecting left ventricular hypertrophy(LVH)in elderly Chinese men.Methods Since 1990,244 autopsies were performed in our hospital in elderly men,LVH was determined in these autopsy hearts and correlated to EGG LVH signs recorded within 3 months before death according to Comer(Sv3+RIvL)and Sokolow-Lyon criteria(Svl+Rvs or RV6).The reference value of Comell criteria was obtained based on valUes from autopsied healthy hearts,the sensitivity and specificity of Cornell and Sokolow-Lyon criteria for detecting left ventricular hypertrophy in these eldedy men were talculated.Results There were significantly correlations between QRS amplitudes of Cornell and Sokolow-Lyon criteria and autopsy left ventricular wall thickness in tllese hearts.The reference value of Comer criteria(SV3+RaVL)was 2.9 mV.The sensitivity of Sokolow-Lyon and Cornell criteria for detecting LVH Wag 25.4%and 34.3%(P＜0.05 vs Sokolow-Lyon criteria),respectively.Condusion Voltage(SV3+R.RavL)≥2.9 mV might be a suitable diagnostic value for detecting left ventricular hypertrophy in Chinese elderly men.

BACKGROUND: Estradiol, as an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization embryo transfer (IVF-ET) cycles. The aim of this retrospective study was to evaluate the association between elevated serum estradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and IVF-ET pregnancy and birth outcomes. METHODS: A total of 1771 infertile patients with their first fresh IVF-ET cycles were analyzed retrospectively between January 2011 and January 2016 in Peking University First Hospital. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 205), group 2 (serum E2 levels 1001-2000 pg/mL, n = 457), group 3 (serum E2 levels 2001-3000 pg/mL, n = 425), group 4 (serum E2 levels 3001-4000 pg/mL, n = 310), group 5 (serum E2 levels 4001-5000 pg/mL, n = 237), and group 6 (serum E2 levels > 5000 pg/mL, n = 137). The retrieved oocyte and MII oocyte numbers and implantation and clinical pregnancy rates of the groups were compared as the first objective of the study. For the 360 women with singleton births among all patients, the area under the corresponding receiver operating characteristic curve (ROC curve) was calculated to assess the predictive value of the E2 change for the probability of low birth weight (LBW) infants as the second objective. RESULTS: The retrieved oocyte and MII oocyte numbers and implantation and clinical pregnancy rates gradually increased from groups 1 to 5 but decreased in group 6. The parameters of group 1 were statistically worse than those of the other groups, from group 2 to group 6 (the number of retrieved oocytes, t = 13.096, t = 23.307, t = 23.086, t = 26.376, t = 19.636, P < 0.003; the number of retrieved MII oocytes, t = 10.856, t = 20.868, t = 21.874, t = 23.374, t = 19.092, P < 0.003; the implantation rate, χ = 12.179, χ = 22.239, χ = 23.993, χ = 23.344, χ = 16.758, P < 0.003; the clinical pregnancy rate, χ = 16.415, χ = 28.074, χ = 35.387, χ = 37.025, χ = 24.590, P < 0.003). ROC analysis revealed that when a serum peak E2 of 3148 pg/mL was used to predict LBW. CONCLUSIONS The results indicate that serum E2 levels have a concentration-dependent effect on clinical outcomes. The optimal range of the E2 level during a fresh IVF-ET cycle is 1000 to 3148 pg/mL.

OBJECTIVETo employ reverse first dorsal metatarsal artery island flap to recover the donor site of great toe after free lateral pulp flap transfer, and decrease the morbidity of microsurgical donor site.

METHODSFrom February 2000 to June 2004, 12 cases of soft tissue defect in thumb and finger were treated by free lateral pulp flap of great toe transplantation, and that the secondary defect of great toes were repaired by reverse first dorsal metatarsal artery flap according to the anatomical communicating between first dorsal metatarsal artery and plantar metatarsal artery. The donor exposure of dorsal pedis were straightly sutured.

RESULTSAll the lateral pulp flaps of great toe and the reversed first dorsal metatarsal flaps survived uneventfully with desirable appearance and sensation. In thumb and finger defect reconstructed with lateral pulp flaps of the great toe, there was in mean static two-point discrimination of 6 mm at 10 month follow-up, that was 10 mm in reverse flaps.

CONCLUSIONSIt is an instructive and practical creation to adopt the reverse first dorsal metatarsal artery flap to recover the raw surface in the lateral aspect of the great toe, which minimizes the morbidity at the donor site and gains the twin-win results.

Adolescent ; Adult ; Arteries ; transplantation ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Metatarsus ; blood supply ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; pathology ; Young Adult

To establish a platform for high throughput screening and in vitro evaluating novel metabolic enzyme-targeted inhibitors towards anti-malarial drugs, a lactate dehydrogenase gene of Plasmodium falciparum (PfLDH) was amplified from the Hainan isolate FCC1/HN. The fusion expression vectors, pGEX-2TK and pET-29a( + ), were utilized to introduce the PfLDH gene into strains of Escherichia coli, BL21 and BL21 (DE3), for over-expression. Consequently, the enzymatic activity of PfLDH was successfully detected in the suspension of lytic bacteria. The PfLDH gene cloned in pGEX-2TK was mainly expressed as inclusion bodies, while the same gene cloned in pET-29a( + ) was nearly expressed in a soluble form of PfLDH, demonstrating the latter vehicle might be more suitable for the large-scale preparation of recombinant PfLDH. Furthermore, according to the electrophoregram of SDS-PAGE and the sequencing data, a series of truncated PfLDH sequences generated randomly from gene amplification were screened and cloned, from which four pre-matured genes with a terminator mutation, PfLDH-delta271, -delta236, -delta167 and -delta53 coding for 45, 80, 149 and 263 amino acid residues, were individually recovered. Through the gene expression and enzymatic activity measurement, the effect of pre-matured terminator mutation on the activity of PfLDH was evaluated, which should pave the way for probing the relationship between structure and function of PfLDH.
Animals ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Inclusion Bodies ; genetics ; metabolism ; L-Lactate Dehydrogenase ; genetics ; metabolism ; Plasmodium falciparum ; enzymology ; genetics ; Protozoan Proteins ; genetics ; metabolism ; Recombinant Fusion Proteins ; genetics ; metabolism ; Solubility