Aged ; Cardiac Pacing, Artificial ; adverse effects ; Echocardiography ; methods ; Heart Failure ; diagnostic imaging ; etiology ; Humans ; Male

Aim To investigate the effects of ghrelin on alcohol-induced liver injury. Methods The alcoholic liver injury mouse model was induced by chronic etha-nol feeding ( 4-week ad libitum oral feeding with the ethanol liquid diet) plus a single binge ethanol (5 g· kg-1 ) feeding. The level of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in serum, malondiadehyde ( MDA ) content, superoxide dis-mutase (SOD) and glutathione peroxidase (GSH-Px) activities in liver homogenate were assayed by spectro-photometer. Hepatic pathological examination was ob-served by HE staining. The mRNA expression of proin-flammatory cytokines including TNF-α, IL-1β, IFN-γ, IL-6 and MCP-1 in the liver was measured by real-time PCR method. Results This chronic-plus-single-binge high dose ethanol feeding synergistically induced liver injury, inflammation and fatty liver change. Treatment with Ghrelin ( 5 , 10 , 20 μg · kg-1 ) significantly de-creased the enhanced level of transaminase ( ALT, AST) in serum, improved the pathologic change in liv-er, and reduced the infiltration of inflammatory cells induced by alcohol administration. Ghrelin also de-creased MDA content and increased the reduced SOD and GSH-Px level in liver homogenate. Furthermore, ghrelin decreased inflammatory cytokines mRNA ex-pression including TNF-α, IL-1β, IFN-γ, IL-6 and MCP-1 in the liver. Conclusion Ghrelin has protec-tive effects against alcoholic liver injury in mice via in-hibiting inflammation and suppressing oxidative stress.

Objective To assay the serum adiponectin levels in normal subjects and patients with insulin resistance syndrome, and to explore the correlation between adiponectin and insulin sensitivity, blood glucose, insulin, lipids etc. Methods Insulin sensitivity index (SI) was assessed by the reduced sample number of Bergman's minimal model method with intravenous glucose tolerance test in subjects of normal controls, obesity, impaired glucose tolerance (ICT) and type 2 diabetes mellitus (DM). Meanwhile the anthropometrical parameters such as body mass index (BMI) and waist hip ratio (WHR) were evaluated and the serum lipids, fasting and postprandial 2 h plasma glucose and insulin levels were also measured. Results Compared with normal control group, the SI in obesity, IGT and type 2 DM groups was significantly decreased (P

Objective To analyze clinical diagnosis and management of 5 patients with actinomycete keratitis.Design Retro- spective case series.Participants 5 patients (5 eyes) with actinomycete keratitis.Methods The clinical features and microbiologic da- ta of 5 culture-proven cases of actinomycete keratitis recorded between October 2004 to March 2006 were analyzed.Main Outcome Measures clinical characteristics,isolations identification,drug susceptibility test and treatments.Results All patients were males and farmers.Of the 5 cases presented in this study,4 cases were followed by minor trauma as a predominant risk factor,and were pre- sented by a chronic progressive corneal ulcer with a wreath pattern of infiltrate.The diagnosis of all cases was based on laboratory in- vestigations,by which 4 cases of nocardia and one case of streptomyce were identified.A variable drug sensitivities were presented in nocardia isolates,which including TMP-SMZ,amicasin,gentamicin and fluorine-quinolones.Conclusions Nocardia keratitis is mainly followed by a minor trauma.It is identified predominantly by laboratory investigations.Tropical and systemically sensitive biotic are the initial choice,while debridement and amnionic transplantation could be an effective alternative.

OBJECTIVETo evaluate the value of adenosine tissue Doppler stress echocardiography on ischemic myocardium.

METHODSRoutine dosage (140 microgxkg(-1)xmin(-1) IV for 6 min) adenosine stress echocardiography was performed on 40 patients with chest pain for diagnosis of coronary artery disease (CAD). The images of left ventricular myocardial motion were acquired by tissue Doppler imaging (TDI) based on traditional 2D stress echocardiography before and 3 min, 6 min after adenosine stress (GE Vivid 7, USA). The myocardial velocity, strain and strain rate in 16 segments were offline measured and analyzed on ECHOPAC software. The results were compared with that of coronary angiography (CAG).

RESULTSCAG identified 18 CAD and 22 non-CAD patients with 159 ischemic segments and 465 non-ischemic segments. Adenosine significantly increased the systolic velocity (Sm), early diastolic velocity (Em), late diastolic velocity (Am), peak systolic strain (Smax), systolic strain rate (SRs), early diastolic strain rate (SRe) and late diastolic strain rate (SRa) both ischemic and non-ischemic segments (all P < 0.05). The baseline Sm and Em in ischemic segments were significant lower than non-ischemic segments [(3.16 +/- 1.20) cm/s vs (4.03 +/- 1.27) cm/s, P < 0.01; (3.75 +/- 1.67) cm/s vs (4.66 +/- 1.70) cm/s, P < 0.05]. At peak stress the differences in Sm and Em were more significant [(3.98 +/- 1.63) cm/s vs (5.07 +/- 1.52) cm/s; (4.51 +/- 2.32) cm/s vs (6.52 +/- 2.56) cm/s; P < 0.01]. The reductions on Smax and Se were more significant in ischemic segments compared those in non-ischemic segments (16.91% +/- 3.35% vs 19.56% +/- 5.47%, P < 0.01 and 9.53% +/- 2.89% vs 13.06% +/- 4.63%, P < 0.001). The biggest area under curve (AUC) in peak stress was seen in Se by ROC curve analysis (AUC = 0.740, with sensitivity 67% and specificity 83%).

CONCLUSIONParameters derived from TDI offer reliable and accurate information on ischemic myocardium during adenosine stress echocardiography.

Adenosine ; Diastole ; Echocardiography, Doppler ; Echocardiography, Stress ; Humans ; Myocardium

OBJECTIVETo explore the substantial resection limits of CO2 laser surgery for hypopharynx and the course of wound healing in animals, for the purpose of evaluating the clinic usefulness of transoral CO2 laser surgery in the treatment of selected hypopharyngeal carcinomas.

METHODSTwenty-three dogs were randomly assigned to two groups. Group one (11 dogs) received left piriform sinus resection, group two (12 dogs) received the resection of posterior wall of the hypopharynx. Six dogs in group one were killed immediately or 4, 8, 12, 16, 20 d post-operatively. Seven dogs in group two were killed immediately or 7, 14, 21, 28, 35, 42 d post-operatively. The whole larynx and hypopharynx were taken out and the specimens were examined by naked eyes and under microscope. The other 5 dogs in each group were fed until the wound healed, the duration were observed.

RESULTSAll the operations were successful and the results were satisfactory. In group one, the dogs could take food the day after operation; two dogs had slight cough during eating and recovered after five days. In group two, the dogs could take food the next day after operation, eight dogs had slight cough during eating and recovered after ten days. The excision dimension was satisfactory. In group one (resection of the lateral wall of piriform sinus), the size of raw surface was (7.5 +/- 0.8) cm2 (x +/- s) and the healing time was (18.4 +/- 1.5) d. In group two (resection of the posterior wall of the hypopharynx), the wound surface was (7.0 +/- 0.5) cm2 and the healing time was (39.8 +/- 1.9) d. The healing time in group two was significantly longer than that in group one (t = 19.535, P <0. 01). The post-operative healing process were observed, including cellulose membrane coverage, granulation filling and epithelization.

CONCLUSIONSTransoral CO2 laser was suitable for partial hypopharynx resection. Animals can recuperate well with little complications. Although the course of wound healing was delayed, wound surface can recover with good laryngeal and deglutition functions.

Animals ; Dogs ; Endoscopy ; Hypopharynx ; surgery ; Laser Therapy ; Lasers, Gas ; Pharyngectomy ; methods

OBJECTIVEThe aim of the study is to evaluate the left ventricular (LV) dyssynchrony in chronic heart failure (HF) patients with normal and wide QRS duration.

METHODSTime to peak velocity at peak systolic and early diastolic phase (Ts and Te) were determined in 12 segments of LV by echocardiography (GE Vivid 7) in 54 HF patients (28 with wide and 26 with normal QRS duration) and 15 normal controls to evaluate LV systolic and diastolic dyssynchrony. The risk factors related to LV dyssynchrony were also evaluated.

RESULTSLV end systolic and diastolic volumes were significantly larger and 12 segmental mean Ts and maximal Te difference (Te-diff) were significantly higher in HF patients with wide QRS duration than HF patients with normal QRS duration. Using mean Ts >or= 182 ms as the cut-off value, systolic dyssynchrony was present in 46% HF patients with normal QRS and 71% HF patients with wide QRS. Using Te-diff >or= 79 ms as the cut-off value, diastolic dyssynchrony was seen in 58% HF patients with normal QRS and 89% HF patients with wide QRS. Combined systolic and diastolic dyssynchrony was seen in 31% HF patients with normal QRS and in 64% HF patients with wide QRS. Systolic dyssynchrony was significantly correlated to LV end systolic volume and diastolic dyssynchrony was correlated to end diastolic volume.

CONCLUSIONPercentage of LV dyssynchrony was significantly higher in HF patients with wide QRS, especially in HF patients with increased LV end systolic and diastolic volume.

Adult ; Aged ; Case-Control Studies ; Echocardiography, Doppler, Pulsed ; Female ; Heart Failure ; diagnostic imaging ; physiopathology ; Heart Ventricles ; diagnostic imaging ; physiopathology ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology

Objective To analyze the clinical and genetic characteristics of 10 Chinese patients with 17? hydroxylase/17,20 lyase deficiency (17OHD). Methods Clinical features and laboratory data were collected from 7 kindreds with 17OHD. PCR products and subclone sequencing were performed to screen the mutation of CYP17A1 gene. Results All patients had typical clinical presentation of sexual infantilism, hypertension and hypokalemia. The laboratory examinations indicated decreased plasma cortisol, 17-hydroxy progesterone, estradiol and testosterone, and elevated blood adrenocorticotrophic hormone(ACTH), follcie-stimulating hormone(FSH) and luteinizing hormone(LH). CT scan showed bilateral adrenal hyperplasia. 5 CYP17A1 mutations were identified, 4 of which are novel types D487_F489del, the most frequent mutation, was identified in 4 families and 45% alleles. Conclusion Our study indicates that 17OHD should be considered in the diagnosis of patients with sexual infantilism. D487_F489del is the most frequent mutation in Chinese 17OHD patients.

A systemic treatment of granulocyte-colony stimulating factor (G-CSF) is known to improve healings of damaged tissues. However, recent studies suggested local actions of G-CSF on the healing processes of damaged tissues. We investigated the treatment effect of locally injected G-CSF and compared to that of systemically injected G-CSF in a rat model. A wound was created on the rat dorsum and treated either by local injection or by systemic injection of G-CSF. Wound healing rate, deposition of collagen, and gene expression were evaluated. G-CSF receptor (G-CSFR) protein was detected by Western blotting. The wound healing rate in the local injection group was significantly higher than that in the systemic injection group at days 9 and 15; it was also significantly higher than that in the control group at days 3, 9, and 15. The expression of G-CSFR protein in wound tissues was higher than in normal skin tissues. The local injection of G-CSF is more effective than systemic injection of G-CSF in promoting wound healing, which may implicate the local action of G-CSF treatment in wound healing processes.
Animals ; Blotting, Western ; Collagen ; Gene Expression ; Granulocyte Colony-Stimulating Factor ; Models, Animal ; Rats* ; Receptors, Granulocyte Colony-Stimulating Factor ; Skin ; Wound Healing* ; Wounds and Injuries*

[Summary] To explore the therapeutic effect of fecal microbiota transplantation (FMT) for severe psoriasis. A patient, male, 36 years old, diagnosed as severe plaque psoriasis for 10 years and irritable bowel syndrome (IBS) for 15 years, was administrated twice FMT via both upper endoscopy and colonoscopy with a 5‐week interval. The following items were used to evaluate responses: body surface area (BSA), psoriasis area and severity index (PASI), dermatology life quality index (DLQI), histological examination, intestinal symptoms, adverse reactions and serum level of tumor necrosis factor (TNF)‐α. After second FMT treatment for 5 weeks, aforementioned items were improved greatly compared with those before treatment. Moreover, IBS was completely relieved and no adverse reactions were observed during the treatment and follow‐up. In conclusion, FMT could be a novel therapy for psoriasis. Further clinical trials are needed to provide solid evidences.