Objective: To analyze relative risk factors of hyperamylasemia after open-heart surgery, and provide basis for clinical prevention and treatment. Methods: A total of 521 adult patients, who received open-heart surgery under general anesthesia and low temperature in our hospital from Jan 1, 2013 to Jun 30, 2013, were selected. The 2ml peripheral venous blood was taken in each patient instant after ICU hospitalization, 24h, 48h and 72h after surgery, then serum was separated and measured for serum amylase level by Somogyi method. According to the measured results of serum amylase level, patients were divided into hyperamylasemia group (serum amylase≥500U/dl, n=76) and non- hyperamylasemia group (serum amylase<500 U/dl, n=445). Single factor and gradual Logistic regression analysis were used to analyze risk factors of hyperamylasemia in patients after open-heart surgery. Results: Gradual Logistic regression analysis indicated that cardiopulmonary bypass (CPB) time and hypotension during operation, renal dysfunction and infection after operation were independent risk factors for postoperative hyperamylasemia (OR=1.02~4.12, P<0.05 or <0.01). Conclusion: During perioperative treatment of open-heart surgery, shortening CPB time, avoiding hypotension during surgery, protecting renal function and preventing infection may reduce morbidity of postoperative hyperamylasemia and improve prognosis of patients.

Objective To investigate the clinical efficacy of acupuncture plus ashi point pricking bloodletting in treating acute gouty arthritis.Methods Seventy patients with acute gouty arthritis were randomly allocated to a treatment group of 38 cases and a control group of 32 cases. The treatment group received acupuncture plus ashi point pricking bloodletting and the control group, routine medication. Blood uric acid and C reaction protein contents were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant differences in blood uric acid and C reaction protein contents after one and two courses of treatment compared with before treatment in the two groups (P<0.01). After two courses of treatment, there was a statistically significant difference in comparing C reaction protein contents between the two groups (P<0.05). The total efficacy rate was 84.2% in the treatment group and 81.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Acupuncture plus ashi point pricking bloodletting is an effective way to treat acute gouty arthritis.

The angiotensinogen(AGT) expression and angiotensin Ⅱ (AngⅡ ) secretion levels in cultured SD rat mesangial cells were determined. High glucose up-regulated AGT mRNA(0. 29±0.07 vs 0. 20±0. 05,P< 0.05)and protein(0.66±0.23 vs 0.37±0. 15,P<0.05) expression and Ang Ⅱ secretion [(9.85±2.08 vs 7.50± 1. 51) pg/ml,P<0. 05]levels, which were down-regulated by pyrrolidine dithiocarbamate( PDTC) treatment via inhibiting NF-κB activity.

Objective To study the impact of QseBC on the motility of Salmonella enterica serovar Typhi ( S.Typhi ) . Methods The motility of wild-type ( WT) and null mutants (ΔqseB and ΔqseC) at mid-log phase was investigated by swimming assay.Quantitative RT-PCR was carried out to calculate the transcriptional variation of flhD and qseB among WT,ΔqseB andΔqseC.QseB overexpressing strain was constructed to compare its motility and flhD expression with the wild-type control.Results The result of motility assay showed that the motility of ΔqseB was similar to that of the WT strain , while the motility of ΔqseC was much lower than that of WT .qRT-PCR revealed that compared with WT , the expression of flhD was significantly decreased in ΔqseC while the expression of qseB was increased considerably .The motility of QseB overex-pressing strain was lower .Conclusion The expression of flhD may be regulated by QseBC which has an effect on the motil-ity of S.typhi, and the overexpression of QseB may inhibit the motility .

Objective To assess the binding capability of microbubbles targeted to VCAM-1 using the parallel plate flow chamber mimic the pulsatile high-shear flow conditions of artery. Methods Targeted microbubbles were designed by conjugating monoclonal antibodies against mouse VCAM-1 to the lipid shell of the microbubbles via an "avidin-biotin" bridge. The binding and retention of targeted microbubbles to VCAM-1 (MBv) immobilized on a culture dish were assessed in a flow chamber at variable shear stress (0.5～ 16.0 dynes/cm2 ). The pulsatile flow conditions were generated and compared to the continuous flow conditions. The retentive ability of MBv was evaluated by the detachment test. Results The marked binding of MBv were seen in pulsatile and continuous flow conditions at low-shear flow conditions of 0.5 ～ 2dyn/cm2 ,but the binding rate in the pulsatile flow group was higher ( P ＜0. 05) than that in the continuous flow conditions. Furthermore,the marked binding of MBv was still noted at the highest shear rates (4～8dyn/cm2) under pulsatile flow conditions, while it was not observed under continuous flow conditions. The half detachment rate of MBv was high up to (20.7 ± 3. 1)dyn/cm2. Conclusions The targeted microbubbles binding to VCAM-1 specific and effective at high-shear stress under pulsatile flow conditions. The molecular ultrasound imaging can be potentially used in the high-shear conditions artery system.

OBJECTIVETo compare the difference in the efficacy on low back pain of cold-damp pattern between electric-thermal Bian-stone therapy and moxibustion box therapy.

METHODSForty-one cases of low back pain of cold-damp pattern were randomized into an electric-thermal Bian-stone therapy group (group A, 26 cases) and a box moxibustion therapy group (group B, 15 cases). In the group A, the electric-thermal Bian-stone was placed over Shenshu (BL 23) and Weizhong (BL 40). The temperature of stone was adjusted in accordance with patient's comfort. In the group B, moxibustion box was used over Shenshu (BL 23) and Weizhong (BL 40). The treatment was given once every day or every two days. Ten treatments made one session. The symptom and physical signs score of low back pain and the score of cold-damp syndrome were observed before and after treatment in the patients.

RESULTSThe symptom and physical signs score of low back pain and the score of cold-damp syndrome were all improved in the two groups (all P < 0.01). The changing rate of symptom and physical signs and syndrome were (37.04 +/- 32.68)% and (22.85 +/- 29.95)% in the group A, and were (47.29 +/- 22.08)% and (23.89 +/- 22.53)% in the group B, respectively, without significant difference in comparison between the two groups (all P > 0.05).

CONCLUSIONThe efficacy on low back pain of cold-damp pattern treated with the electric-thermal Bian-stone therapy is similar to that of moxibustion box therapy. This therapy is characterized as more convenient, safer operation and less pollution.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Low Back Pain ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Moxibustion

Objective To investigate the relationship between the level of serum uric acid(SUA) and carotid atherosclerosis in male patients with type 2 diabetes mellitus(T2DM). Methods A collection of 579 male T2DM patients with or without carotid atherosclerosis were grouped based on quartiles of SUA. Age, SUA, smokers, duration, body mass index(BMI), blood pressure, total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), blood urea nitrogen(BUN), creatinine(Cr), and HbA1C were determined in all subjects. The plaques in carotid arteries and intima-media thickness(IMT) were measured with high-resolution ultrasound. Results BMI, systolic and diastolic blood pressures, TG, and Cr showed a gradual increase, while HDL-C and HbA1C showed a gradual decrease according to the higher SUA quartiles in male T2DM(P＜0.05). Nevertheless, the detectable rates of smokers, duration, age, TC, LDL-C, and BUN had no relationships with the SUA quartiles(P＞0.05). The detectable rate of carotid atherosclerosis and the thickness of carotid plaque were positively associated with the levels of SUA in male patients with T2DM(P＜0.05). However, intima-media thickness of carotid arteries did not illustrate the correlation with the levels of SUA in male T2DM patients(P＞0.05). Age, HbA1C, and SUA were independent factors of carotid atherosclerosis in these patients by logistic regression(P＜0.05). Conclusion The levels of SUA seems to be associated with the occurrence and development of carotid atherosclerosis in male patients with T2DM.

Objective To discuss the clinical management and significance of the prenatal diagnosis of Fetal Choroid Plexus Cysts(CPC).Methods From May 2004 to March 2007,55 cases of fetal CPC diagnosed by B-ultrasound during second trimester were prospectively studied.Each case was studied regarding fetal chromosome karyotype,disappearance weeks of the cyst,the clinical outcome and follow-up results respectively.Result The cases were diagnosed during 16-25 gestational weeks.The diameters of the cysts varied from 0.2 cm to 2.4 cm.There were 25 cases of bilateral cysts and 30 cases of unilateral or 50 cases of isolated CPC and 5 cases of complicated CPC.The cysts of all cases who continued pregnancy disappeared before 28 weeks.Fetal chromosome karyotypes were obtained in 50 cases.Among them,two cases were 18-trisomy,and one case was 21-trisomy.Five cases were terminated pregnancy because of abnormal chromosome karyotype or malformation during second trimester.One neonate was diagnosed as ventricular septal defect among 50 cases of follow up.Among these six cases,three were from advanced-age pregnant women,five cases were with abnormal fetal structure and five cases were with the diameter of bilateral or unilateral cysts more than 1.0 cm.Conclusion(1)Fetal CPC can be diagnosed during second trimester,and the majority disappear before 28 gestational weeks.(2)High risk factors for fetal abnormal chromosome karyotype may be:advanced-age pregnant women,abnormal structure of fetus,and the diameter of bilateral or unilateral cyst more than 1.0 cm.It is suggested that fetal CPC with the high risks should receive fetal chromosome karyotype test during pregnancy.

Purpose The diagnosis, treatment and prognosis of benign and malignant biliary stricture are significantly different. This study aims to evaluate the quantitative analysis of biliary structures using magnetic resonance cholangiopancreatography (MRCP) combined with dynamic contrast enhanced CT (DCE-CT).Materials and Methods The quantitative parameters of MRCP and DCE-CT imaging data from 27 patients with benign biliary stricture (benign group) and 30 patients with malignant biliary stricture (malignant group) were retrospectively analyzed. The wall thickness, stricture length and diameter, proximal ductal dilatation and degree of enhancement in two groups were compared, and its correlation was analyzed to evaluate the accuracy of MRCP and DCE-CT.Results There were significant differences in wall thickness [(3.2±2.0) mmvs (2.1±0.6) mm], stricture length [(15.8±8.1) mmvs (9.5±6.5) mm] and diameter [0 mmvs (2.0±0.9) mm], proximal ductal dilatation and the degree of enhancement [(12.7±3.6) mmvs (9.3±2.7) mm] between the two groups (t=2.825, 3.270, 4.025,P<0.001;Z=-3.909,P<0.001). Multivariable stepwise regression analysis showed that the wall thickness and diameter, and the CT HU in portal venous and equilibrium phases combined with CT plain scanning were significant predictors of malignant biliary strictures (t=-6.424-2.309,P<0.05). The sensitivity, specificity, inter-modality agreement and Youden index of MRCP and DCE-CT in diagnosing 57 patients with biliary stricture were 96.67%, 100.00%, 98.25% and 0.97, respectively; with statistical significance in predicting benign and malignant biliary stricture (AUC=0.994,P<0.001).Conclusion Using MRCP and DCE-CT, the wall thickness and diameter of the stricture, and the difference in CT HU in portal venous and equilibrium phases combined with CT plain scanning are valuable in differential diagnosis of benign and malignant biliary stricture.

BACKGROUND:In view of the unavoidable problems of autogenous and al ogenous bone grafts, it is an urgent need to develop biodegradable bone substitute materials, among which is calcium phosphate material that has become a hot spot in the domestic and foreign research. OBJECTIVE:To develop a biodegradable calcium phosphate material for bone repair based on tetracalcium phosphate (TTCP). METHODS:The biodegradable calcium phosphate cement made from TTCP, dicalcium phosphate anhydrous and different constituents of curing liquids was prepared under room temperature (about 25 ℃). The effects of solid components, liquid components as well as calcinations and drying temperature on the physical and biological performances were detected through X-ray diffraction test, hardness test, decay in a simulated body fluid, hemolysis and cytotoxicity tests, respectively, to select the bone repair material with excel ent performances. RESULTS AND CONCLUSION:When the calcination temperature was lower than 1300 ℃, TTCP was rarely available;only close to 1400 ℃, the relatively pure TTCP was gained. A large number of pure TTCP were gained by rapid cooling because of avoidance of the moisture impact, but slow cooling made the main products to be hydroxyapatite, suggesting that rapid cooling is essential to obtain pure TTCP. With the increase of the proportion of citric acid solution in the liquid phase, the pH values and the hemolysis rate in the bone cement soak solution were increased gradually, illustrating that citric acid solution is easy to induce hemolysis. In vitro cel experiments showed that the hemolysis rate of bone cement with a solution of 2:1 NH4/Na ratio was the lowest, and the biocompatibility was the best, which was the most favorable to cel growth. Cements was made of calcined powders sieved at 1400 ℃ and showed the shortest initial setting time, least effect on pH values, lowest disintegration rate and hemolysis rate, and slightest inhibition effect on the cel proliferation, indicating that the bone cements made of sieved powder after 1400 ℃ calcination is more suitable for clinical application.