Animals ; Cardiac Electrophysiology ; Heart Atria ; innervation ; physiopathology ; Humans ; Vagus Nerve ; physiology

To evaluate the significance of plasma ACTH (pACTH), serum cortisol (SC) and urinary free cortisol UFC as well as low or high dose dexamethasone suppression test in Cushing syndrome, the levels of hormones were evaluated in 136 cases of Cushing syndrome. It was found that the levels of SC and UFC were elevated in almost all the 121 patients with Cushing syndrome. The mean levels of pACTH were higher in 86 patients with Cushing disease and lower in 36 cases with adrenocortical tumor or ACTH independent nodular adrenocortical hyperplasia (AINAH) than those in normal subjects. The ACTH levels might be in normal range in many patients with Cushing syndrome, but they were higher in patients with Cushing disease and lower in the patients with adrenocortical tumor or AINAH than those of the high limit at ACTH0am in normal subjects. It was a common feature that the diurnal rhythm of hormone secretion disappeared and the hormone levels were not suppressed by low dose dexamethasone suppression test in the patients with Cushing syndrome. In more than 90% of the patients with adrenocortical tumor or AINAH the levels of SC and UFC were not suppressed by high dose dexamethasone. In 12 of clinically cured patients with Cushing disease the levels of pACTH8am, SC8am and UFC were normal or even low. The pACTH levels were low in two patients with iatrogenic Cushing syndrome. The results suggested that examinations of SC, UFC and low dose dexamethasone suppression test were very important in the diagnosis of Cushing syndrome. The pACTH level was a key parameter to distinguish Cushing disease from adrenocortical tumor or AINAH.

? AlM: To examine choroidal thickness and its relationship with axial length and spherical equivalent by spectral domain optical coherence tomography ( SD -OCT ) in patients with myopic choroidal neovascularization ( mCNV) .
?METHODS: We prospectively recruited 30 cases of mCNV in Beijing Anzhen Hospital from October 2010 to December 2014. SD-OCT was used to measure choroidal thickness subfoveally and at 1. 5mm superiorly, inferiorly, nasally and temporally ( SFCT, SCT1. 5mm , lCT1. 5mm , NCT1. 5mm , TCT1. 5mm ) . Paired t- test was conducted to assess the difference of spherical equivalent, axial length and choroidal thickness between mCNV group and controls. Logistic regression analysis was performed to evaluate the correlation between spherical equivalent, axial length, choroidal thickness and mCNV.
?RESULTS: The difference of spherical equivalent and axial length between mCNV group and controls was not significant (P>0. 05). lnferior was decreased in mCNV group compared with controls (140. 85±33. 46μm vs 168. 95±45. 36μm). The difference was significant (P=0. 008). Logistic regression demonstrated that decreased choroidal thickness ( lCT1. 5mm ) at inferior location was associated with mCNV (OR=2. 12;95%CI 1. 35~3. 28;P=0. 02).
?CONCLUSlON: The decrease of lCT1. 5MM may be one of the risk factors of mCNV.

Acute Disease ; Child ; Cytokines ; blood ; Humans ; Purpura, Thrombocytopenic, Idiopathic ; blood ; immunology

ObjectiveTo investigate the effect of volume embolization ratio(VER) in evaluating the embolization efficacy of aneurysms.MethodsFifty-three patients who received intracranial aneurysm embolization surgery were all treated with detachable coils endovascular embolization,While fifty-seven intracranial aneurysms were treated.The VER was calculated and the relationships between the VER values and the size,the neck,embolization degree of intracranial aneurysm were analyzed.ResultsThe VER of small,medium,large,and giant aneurysms were (40.8 ± 26.5 )％,( 18.6 ± 16.1 )％,(2.3 ± 2.1 )％,(0.4 ±0.1 )％,respectively,which had statistical significance (F =7.091,P ＜ 0.01 ).The VER of wide-necked and narrow-necked aneurysms were (27.5 ± 23.1 )％,(29.4 ± 26.6)％,which had no statistical significance(P ＞0.05 ).The VER of complete embolization,neck residual and partial embolization were (41.8 ± 29.3 )％,(31.4 ± 21.2)％,( 12.3 ± 15.1 )％,respectively,which had statistical differences (F =7.970,P ＜ 0.01 ).ConclusionsThe VER is an objective index to evaluate the embolization degree of aneurysms.It has certain prediction significance for the efficacy judgement of embolization of aneurysms.

ObjectiveTo explore the clinical effects of forearm cutaneous neurovascular flaps to be used on repairing remote wound.Methods17 cases of soft tissue defect of head and facial region and upper extremity were repaired with forearm cutaneous neurovascular flaps.Results The flaps of 16 cases were entirely survived, partial necrosis appeared in 1 case and healed after changing dressing.Following up for 3 to 6 months, the quality and shape of all the flaps and function recovery of all patients were satisfied.ConclusionsWith adequate blood supply, the survival rate of forearm cutaneous neurovascular flaps is high and the procedure to repair remote wound is easy, and it is one of best ways to repair the soft tissue defect in head and facial region and upper extremity with forearm cutaneous neurovascular flaps.

Objective To investigate the effects of lactoferrin on activity of PKG in spinal dorsal horn in a rat model of neuropathic pain(NP).Methods Thirty-two male SD rats weighing 200-250 g were randomly divided into4 groups(n = 8 each): sham operation group(group S),NP group,lactoferrin group and KT5823(an inhibitor of PKG)group.Neuropathic pain was produced by placing loosely constrictive ligatures around the common sciatic nerve in group NP,lactoferrin and KT5823,while the sciatic nerve was only exposed but not ligated in groupS.In group S and NP,normal saline 10 μl + 50% dimethyl sulfoxide(DMSO)10 μl were injected intrathecally.Lactoferrin 100 μg + 50% DMSO 10 μl were given intrathecally in group lactoferrin.Lactoferrin 100 μg + KT5823 10 μl were given intrathecally in group KT5823.The paw withdrawal latency(PWL)to a thermal nociceptive stimulus was measured every 30 min within 180 min after administration.The rats were then sacrificed and the spinal cord was removed.The activity of PKG in the spinal dorsal horn was determined by immunofluorescence.Results Compared with group NP and KT5823,the PWL was significantly prolonged after administration in group lactoferrin and the PKG activity was significantly increased in group lactoferrin(P ＜ 0.05).There was no significant difference in the parameters mentioned above between group NP and group KT5823(P ＞ 0.05).Conclusion Lactoferrin reduces NP by inhibiting the activity of PKG in spinal dorsal horn in rats.

Objective Clinical strains of Shigella dysenteriae isolated from eastern parts of India in 1988, 1995 and 2002 were examined for the presence of class 1, 2 and 3 integrons which closely related with drug resistance and the distribution of resistance gene cassette in order to clarify the influence of integron system on drug resistance of Shigella dysenteriae. Methods Susceptibility to antimicrobial agents was tested by the disk agar diffusion method. Class 1, 2 and 3 integron genes (intI) were screened by polymerase chain reaction (PCR) in 16 clinical strains with drug resistance.The variable regions of gene cassette of positive strains were sequenced. Results All 16 isolates were resistant to at least 4 agents including β-lactams, aminoglycosides, tetracyclines, sulfonamides,chloramphenicols and quinolones. Class 1 integron gene was detected in 13 strains and all isolates carried class 2 integron which indicated that strains with two integron structures were detected simultaneously and class 3 integron was not detected. Class 1 integron inserted gene cassette was mainly blaara30 -aadA 1 family, conferring resistance to β-lactamase, spectinomycin and streptomycins isolates carried class 2 integron were mainly dfrAl-satl genes cassettes conferring resistance to methoxybenzyl aminopyrimidine and streptothricin, while dfrA\-sat\-aadA\ genes were present only in 4 isolates. Conclusions These data indicate that class 2 integrons are widespread in Shigella dysenteriae strains, and closely associated with multidrug resistance of Shigella.

Objective To increase the quality of blood transfusion medical record and strengthen the management of clinical blood transfusion by establishing a management system for clinical blood transfusion.Methods The management system of clinical blood transfusion was developed by using Sybase PowerBuilder 10.5 program and Oracle 8/8i database,through the function module's development of blood application and evaluation by using C/S structure.Results The management system of clinical blood transfusion realized the exchange of the internal data information with the blood information management system and LIS database,and implemented online audit of transfusion application and evaluation,which improved the work efficiency and reduced the human error.Conclusion The management system of clinical blood transfusion can improve the quality of blood transfusion medical record and realize real-time regulation of clinical blood transfusion to ensure the safety of transfusion.

Objective:To investigate the relationship between college freshman adaptation and adverse childhood events,and to explore the mediating role of personality characteristics.Methods:A sample of 523 college freshmen from a key university in Sichuan Province was assessed with the China College Student Adjustment Scale (CCSAS),Adverse Childhood Events Questionnaire (ACEQ) and Eysenck Personality Questionnaire-Revised,Short Scale for Chinese(EPQ-RSC).Results:The rate of adverse childhood events of college freshmen was 87％ in current study.The total scores of adaptation were negatively correlated with the scores of adverse childhood events influence and neuroticism (r ＝-0.13,-0.51,Ps ＜ 0.01),while positively correlated with introversion-extroversion and lie (r ＝ 0.47,0.25,Ps ＜ 0.01).The scores of adverse childhood events influence were negatively correlated with scores of introversion-extroversion (r ＝-0.08,P ＜0.05) and lie (r ＝-0.12,P ＜0.01),while positively correlated with scores of neuroticism (r ＝ 0.17,P ＜ 0.01).Introversion-extroversion and neuroticism mediated the relationship between adverse childhood events influence and college freshman adaptation,the mediating effects were 51.65％ and 58.10％.Conclusion:College freshman adaptation may be closely associated with adverse childhood events influence and personality characteristics.Personality characteristics may play a mediating role between adverse childhood events influence and adaptation in college freshman.