Mid-ventricular hypertrophic obstructive cardiomyopathy (MVHOCM) is a rare type of cardiomyopathy thatcan be accompanied by apical aneurysm.We presented here a case report of MVHOCM with cornary artery disease.The sixty-fouryears old man was sent to hospital because of ventricular tachycardia.Large inversion T wave was showed on electrocardiography in the presence of abnormal coronary arteries and normal cardiac enzyme.Echoeardiogmphy showed an hourglass appearance of the leftventricle with an aneurysm in the apex and a pressure gradient between the outflow tract of left ventricle and the middle of the leftventricle was revealed by left-heart catheterization.

Objective To investigate current situation of disaster medicine courses among medical schools in China and perception of disaster management among medical students.Methods The survey was conducted among medical students from 14 medical schools in China.A questionnaire which included self-evaluation of ability to practice disaster management, status of disaster medicine courses and self-interest in learning disaster management was used.Results The survey showed that only a few of medical schools offered disaster medicine courses and the quality of current courses was not satisfying.Medical students were generally lack of systematic perception of disaster management, but they were interested in studying related knowledge.Conclusions It is necessary to design disaster medicine courses of high quality and promote them among medical schools in China.It can not only meet the requirements of medical students, but also effectively improve the response capacity of medical students and doctors when facing catastrophes.

Objective To approach the effects of full Marathon on striated muscle and renal function of Marathon amateurs without complaints. Methods A prospective self-paired design study was conducted. The amateurs without body discomfort, hematuria, brown urine, or persistent muscle pain within 1 week after the 2012 Xiamen International Marathon Race were enrolled voluntarily. The peripheral blood and random urine specimens of all subjects under static status 1 week before the race and after the race instantly (within 10 minutes after finishing the race) were collected to detect markers of renal function and striated muscle injury. Results Sixty-one subjects were included in the final analysis of the study with full Marathon of 42.195 km and mean race time of (297.05± 55.60) minutes. Compared with those under static status before the race, the markers of renal function including the levels of urinary N-acetyl-beta-D-glucusamidase [NAG (U/L): 64.00 (54.50, 85.50) vs. 9.50 (8.10, 11.50)], urinary β2-microspheres protein [β2-MG (μg/L): 261.00 (128.50, 1 608.00) vs. 66.60 (33.75, 123.00)], random urinary creatinine [UCr (μmol/L): 19 066.56±10 938.31 vs. 5 872.52±4 363.20] and serum creatinine [SCr (μmol/L): 129.97±25.84 vs. 97.39±14.51] immediately after the race were significantly increased (all P < 0.01); the markers of muscle injury including the levels of serum creatine kinase [CK (U/L): 864.00 (504.00, 1 644.00) vs. 164.00 (128.00, 256.00)], lactic dehydrogenase [LDH (U/L): 383.26±141.69 vs. 182.23±41.12], myoglobin [Mb (mg/L): 1 880.00 (1 080.00, 3 300.00) vs. 42.00 (36.00, 54.50)], alanine aminotransferase [ALT (U/L): 27.0 (19.5, 38.0) vs. 24.0 (15.0, 29.5)] and aspartate transaminase [AST (U/L): 52.07±25.13 vs. 28.28±11.86] were also significantly increased (all P < 0.01), and the increase in CK, Mb, and LDH were more significant. It was shown by correlation analysis that CK after race was negatively correlated with age (r = -0.352, P = 0.005) and body mass index (r = -0.271, P = 0.035), and it was positively correlated with racing time (r = 0.387, P = 0.002) and urinary β2-MG after the race instantly (r = 0.364, P = 0.004). Mb after race was negatively correlated with body mass index (r = -0.331, P = 0.009), and it was positively correlated with urinary β2-MG after the race instantly (r = 0.315, P = 0.013). LDH after race was negatively correlated with age (r = -0.275, P = 0.032) and body mass index (r = -0.377, P = 0.003), and it was positively correlated with urinary β2-MG after the race instantly (r = 0.424, P = 0.001). Conclusion Full Marathon could significantly impact striated muscle and renal function of Marathon amateurs without complaints.

Objective:To evaluate the effects of maxillary protraction with or without rapid maxillary expansion in the treatment of Class Ⅲ malocclusion by Meta-Analysis.Methods:The randomized controlled trail,quasi-randomized controlled trail and the clinical controlled trail about the treatment of Class Ⅲ malocclusion by protraction with or without expansion were searched in the database of Cochrane Library,Embase,PubMed,Medline,CBM,Wan Fang,CNKI,VIP.2 authors qualified and extracted the data independently.Then the Meta-analysis was performed by using the RevMan 5.3 software.Results:7 studies with 228 cases were included,114 cases were treated by maxillary protraction with expansion and the other 114 cases by maxillary protraction without expansion.The Meta-analysis showed that:there was no significant difference in SNA,SNB,ANB and SN-PP except ANS-Me,U1-NA,SN-MP.A favorable improvement of the sagittal relationship between maxillary and mandibular was observed by using protraction whether with expansion or not.The expansion did not shorten the course of treatment,but it lowered the inclination of upper incisors,resulting in more clockwise rotation of mandibular plane and increase of the facial vertical dimension.Conclusion:Maxillary protraction with rapid maxillary expansion can be used in the treatment of class Ⅲ malocclusion with incisor labioclination.

Objective To investigate the applicability of zebra fish thrombosis model in antithrombotic activity screening of Chinese materia medica.Methods The living zebra fish thrombosis model was induced by adrenaline hydrochloride. Zebra fish were randomly divided into blank control group, model group, positive medicine group and medication group. Each group was given the corresponding medicine or embryo culture water. O-anisidine staining solution was used to stain and calculate the staining intensity of erythrocytes in zebra fish heart, and quantitative analysis was carried out. The platelet aggregation of transgenic zebra fish was observed and under qualitative analysis. Results Compared with the model group, 100μg/mL salvianolic acid B, 300, 900μg/mL aqueous extract of Salvia miltiorrhiza, 45μg/mL 95% ethanol extract and 400, 1200μg/mL hypothalamus could significantly inhibited the formation of zebra fish thrombosis (P<0.01).ConclusionZebra fish thrombosis model has good applicability in antithrombotic activity screening of Chinese materia medica.

Objective To evaluate the clinical effectiveness of double balloon dilation in percutaneous kyphonplasty on curing vertebral?compression fractures. Methods From January 2009 to September 2013, 84 patients (94 vertebral bodies) with vertebral compression were treated by percutaneous kyphonplasty. All were fresh fractures and were injured or obvious low back pain 1 month, accompanied by local tenderness, kowtow attack painful, lumbar mobility, but no lower extremity injury numbness, activities and defecation disorders. After randomization, the double balloon dilation in percutaneous kyphonplasty method was used to treat 44 patients (49 vertebrae). In the process of performing percutaneous unilateral pedicle puncture and balloon dilata?tion of the vertebral body, the balloon has been moved some distance in the vertebral body. Then completed the perfusion of bone cement, vertebral body forming. 40 cases (45 vertebrae) were used conventional unilateral percutaneous kyphonplasty to vertebtal compression fractures. Recorded the operation time, amount of bleeding, bone?cement injection volume. Used visual analogue scale (VAS), the height of the vertebral body and Cobb angle to evaluated the curative effect. Results All 84 patients completed the operation, follow?up time was 22 months (18-24 months). In two mobile open expansion group, the operation time was about 48 min. The amount of bleeding was 8-15 ml. The average bone?cement injection volume was 5.1 ml. No patients quit the study and no bone cement?leakage cases or other side effects were observed , and no clinical accidents occurred. In a single stretching group, 40 cases (45 vertebrae) completed conventional vertebroplasty, the time of 44 min, bone cement average injection rate 3.2 ml, bleeding 10-15 ml. In two mobile open expansion group, the VAS score was 8.5 points, the height of the vertebral body height was 2.1cm, and the Cobb angle was 34°. After operation, the VAS score 2.9 points, the height of the vertebral body 2.8 cm, and Cobb 20° . In the other group, the pain was significantly relieved and the relief was satisfactor after operation.Vertebral height of 2 cm turned to the last follow?up of 2.4 cm. The Cobb angle was 32°, and the last follow?up was 27°. The VAS score, operation time and bleeding volume of the two groups were not statistically significant, and a statistically significant difference of the average bone ce?ment injection volume, postoperative vertebral height and cobb angle improved with statistical significance. A single open group were 2 cases of bone cement leakage and leakage, 1 cases of bone cement tail, the complication rate was 5.6%. Conclusion The application of double balloon dilation in percutaneous kyphonplasty to vertebral?compression fractures improve relocation of verte?bral compression fractures, increase recovery of vertebral height, and more effectively strengthen and stiffen pathological vertebral bodies, while improving kyphosis. Moreover, it can reduce pressure during bone?cement injections, minimizing the chance of over?flow and leakage, as well as the related side effects, but it will also result in an increase of bone cement?injection volume.

Objective To explore the clinical efficacy and indications of kyphoplasty with movement and secondary en?largement of balloon for the compression fracture of vertebral body with ruptured posterior wall. Methods A retrospective analy?sis was carried out on the data of 29 patients (10 males, 19 females;age range:55-86 years old;mean age:71 years old;29 verte?bral bodies in total) who suffered from compression fracture of the thoracolumbar spine and below, and underwent kyphoplasty through the movement and secondary enlargement of balloon within the vertebral body and were followed up from January 2011 to November 2014. These patients had backache, accompanied by lowered support, limitation of movement, no symptom of nervous lesion on both lower extremities and no past history of balloon kyphoplasty. All fractured vertebral bodies were at T 11 or below, in?cluding 1 case at T11, 4 cases T12, 11 cases L1, 9 cases L2 and 4 cases L3. The causes of injury included fall (19 cases), car accident (8 cases) and unknown reasons (2 cases). All patients underwent kyphoplasty with the movement and secondary enlargement of bal?loon within the vertebral body. Photos were taken immediately after the surgery, at 1 month, 3 months, 6 months and 12 months, and these patients were assessed and analyzed in terms of vertebral height, Cobb angle, visual analogue score (VAS) and Oswestry disability index (ODI). Results The operation time (including the formation and solidification of bone cement) of 29 patients was 40 to 65 min and the mean time was 55 ± 7 min;the blood loss during operation was 2 to 15 ml and the mean blood loss was 5 ± 2 ml;the injected volume of bone cement was 2.5-7.5 ml and the mean volume was 5.5±0.5 ml. Post?operative pain was relieved and ambulation was performed under the protection of lumbar orthosis brace. Statstical analysis was conducted on VAS, ODI, vertebral height and Cobb angle before operation and at 1 month, 3 months, 6 months and 12 months after operation, showing statistically significant differences. X ray examination found that there was no alternation or displacement of bone cement location, and no change in vertebral morphology, the vertebral height and cobb angle remained the post?operative status, and posterior wall rupture of the vertebral body was recovered well. CT revealed that the morphology of bone cement was irregular and closely integrated with bone substance, and no cavity or fissure was seen. Conclusion Kyphoplasty with movement and secondary enlargement of bal?loon within the vertebral body has a good, definite clinical efficacy in treating compression vertebral fracture with incomplete pos?terior wall of the vertebral body without obvious displacement of fractured bone and symptom of nervous lesion on both lower ex?tremities. This surgery is easy to operate, and has an immediate analgesic effect, which could recover vertebral height as well as re?duce kyphosis deformity and improve patient’s prognosis.

Objective:To investigate the value of baseline 18F-fluorodeoxyglucose (FDG) PET/CT radiomics features in predicting the prognosis of non-small cell lung cancer (NSCLC) before treatment. Methods:From January 2016 to August 2018, a total of 300 patients with solitary NSCLC (189 males, 111 females, age (62.3±9.0) years) who underwent 18F-FDG PET/CT imaging before treatment in Fourth Hospital of Hebei Medical University were retrospectively analyzed. According to the ratio of 7∶3 (R language), 300 patients were randomly divided into training group ( n=210) and validation group ( n=90). LIFEx software package was used to extract the PET and CT radiomics features of primary focus in 300 NSCLC patients. The least absolute shrinkage and selection operator (LASSO) algorithm combined with Cox proportional hazard regression model were used to select radiomics features and clinical features for predicting overall survival (OS) and progression-free survival (PFS) in training group. Then radiomics model, clinical model and complex model which integrated the two were established and the radiomics score (Rad-score), clinical score and complex score of each patient were calculated. Data of validation group was used to validate each training model. Efficiencies of each model in predicting the prognosis of patients with NSCLC were further evaluated by the concordance index (C-index), and a nomogram was developed based on the best prediction model. Results:In training group, the C-indices of predicting OS and PFS in NSCLC patients of radiomics model were 0.762 and 0.724 respectively, which were 0.834 and 0.780 respectively in clinical model, and were 0.842 and 0.787 respectively in complex model. Cox multivariate analysis showed that both Rad-score and complex score were independent prognostic factors for OS (hazard ratio ( HR): 1.804, 9.996, 95% CI: 1.023-3.184, 4.582-21.808, both P<0.05) and PFS ( HR: 1.771, 5.627, 95% CI: 1.138-2.756, 3.429-9.234, both P<0.05). Conclusions:Pre-treatment 18F-FDG PET/CT radiomics can predict OS and PFS of NSCLC patients. The complex model based on the combination of radiomics and clinical model is effective in predicting the prognosis of NSCLC patients, and the nomogram of complex model is simple and convenient to assist clinical decision-making.

Objective: To evaluate the change of tooth root volume and length after rapid maxillary expansion by CBCT three dimensional reconstruction method. Methods: 33 patients underwent rapid maxillary expansion were examined by CBCT before and after treatment. The CBCT images of the first,second premolars and the first molars were segmented and reconstructed by Mimics image processing software for the analysis of the changes of root volume and length. All data were analyzed by SPSS software statistically. Results: After maxillary expansion,all root volumes were reduced(P ＜ 0. 05),more reduction was observed in anchorage teeth than in non-anchorage teeth(P ＜ 0. 05). The length of most teeth roots was not decreased(P＞ 0. 05) except the buccal and distal roots of the first molars(P ＜ 0. 05). Conclusion: Rapid maxillary expansion may result in root resorption and this resorption is mainly based on the volume decrease.

This study aimed to elucidate the effect of tryptophan (Trp) on gut hormone secretion as well as the roles of the calcium-sensing receptor (CaSR) and its downstream signaling pathway in gut hormone secretion by assessing swine duodenal perfusion in vitro. Swine duodenum was perfused with Krebs-Henseleit buffer as a basal solution. Various concentrations (0, 10, and 20 mM) of Trp were applied to investigate its effect on gut hormone secretion. A CaSR antagonist was used to detect the involvement of CaSR and its signal molecules. The 20 mM Trp concentration promoted the secretion of cholecystokinin (CCK) and glucose-dependent insulinotropic peptide (GIP), elevated the mRNA level of CaSR, and upregulated the protein levels of CaSR, protein kinase C (PKC), and inositol trisphosphate receptor (IP3R). However, NPS 2143, an inhibitor of CaSR, attenuated the CCK and GIP release, reduced the mRNA level of CaSR, and decreased the protein levels of CaSR, PKC, and IP3R with 20 mM Trp perfusion. The results indicate that CCK and GIP secretion can be induced by Trp in swine duodenum in vitro, and the effect is mediated by CaSR and its downstream signal molecules PKC and IP3R.
Cholecystokinin ; Duodenum ; Gastric Inhibitory Polypeptide ; In Vitro Techniques ; Inositol ; Perfusion ; Protein Kinase C ; Receptors, Calcium-Sensing ; RNA, Messenger ; Swine ; Tryptophan