Objective To study the value of echocardiogram in preoperative examination for the diagnosis of silent myocardial is-chemia in patients before surgery .Methods 172 patients with surgical preoperative suspected diagnosis of coronary heart disease , were divided into heart valve surgery group (72 cases) and non heart valve surgery group (100 cases) .All of the patients had echo-cardiography and coronary angiography before 2 weeks of operation .We drew a series of analysis to assess the sensitivity、specialty and accuracy of diagnosis of silent myocardial ischemia with regional wall motion abnormality (RWMA) and wall motion score in-dex (WMSI) .Results Coronary angiography as the gold standard of coronary heart disease diagnosis .The sensitivity of RWMA for the diagnosis of silent myocardial ischemia in patients undergoing heart valve surgery group and non heart valve surgery group was 85 .7% and 100 .0% ,while the specificity of RWMA was 100 .0% and 80 .0% ,respectively ,the differences between the two groups had no statistical significance (P>0 .05) .We also drew the ROC curve of WMSI for the diagnosis of silent myocardial ische-mia ,maximum area under the ROC curve of WMSI were 2 .20 and 2 .05 .In patients undergoing cardiac surgery and non-cardiac sur-gery ,the curves indicated that the sensitivity were 79 .7% and 75 .9% ,the specificity were 83 .0% and 67 .7% ,respectively .Area under the ROC curve was 0 .832 and 0 .702 ,but the difference was not statistically significant (P>0 .05) .Conclusion Using RW-MA and WMSI as reference indicators ,surgical preoperative echocardiography in the diagnosis of patients with silent myocardial is-chemia has good sensitivity ,specific ,and accurate ,there is no statistically significant difference between heart valve surgery and non heart valve surgery .

BACKGROUND: Sonography is believed by many scholars to be sensitive for the detection of hepatic arterial thrombosis and stenosis, but it is difficult to show the anastomotic vascular stenosis. MR angiography is better than sonography in the display of vascular anatomy and the diagnosis of various vascular complications after liver transplantation.OBJECTIVE: To evaluate the role of MR angiography (MRA) in the display of vascular anatomy and the diagnosis of various vascular complications after liver transplantation.DESIGN: Contrast trial observation.SETTING: Medical Imaging Center of Nanfang Hospital, Southern Medical University.PARTICIPANTS: Eleven adult male patients had undergone liver transplantations at Nanfang Hospital of Southern Medical University between January 2004 and December 2006. They ranged in age from 40 to 58 years, average 49 yeas. Original causes of liver failure in the study group included cirrhosis (n =9) and primal hepatic carcinoma (n =2) diagnosed by pathohistological methods. And 9 cases had undergone orthotopic liver transplantations while 2 cases with piggy-back liver transplantation.METHODS: Eleven consecutive adult patients underwent MR imaging examinations after orthotopic liver transplantation using a breath-hold 2D True Fast Imaging with Stead-state Precession and Fast Low Angle Shot. MR triphasic contrast-enhanced 3D imaging was also performed. Enhancement scan: A final gadolinium-enhanced axial and coronal T1WI spin-echo sequence with spectral fat saturation was performed after completion of the MRA. The vascular diameter stenosis was calculated according to S (S=[(D-d)/D]×100%) by ECST method, d as the inner diameter of the most obvious stenosis while D as normal diameter. Degree of stenosis: normal as S 0-30%, mild stenosis as S 31%-50%, moderate stenosis as S 51%-85%, and severe stenosis as S 86%-100%. Then the imaging findings after liver transplantation were analyzed. Meanwhile the sonography was performed.MAIN OUTCOME MEASURES: ① MR Image analysis of vascular anatomy and vascular complications after liver transplantation.②Normal findings after liver transplantation by using sonography.RESULTS: All 11 patients were involved in the result analysis.①MRA: The anastomosis of hepatic artery, portal vein and inferior vena cava were smooth in 3 cases. The high signal intensity was seen around portal vein at T2WI in 1 case with a shorter interval after transplantation and persisted 3 weeks. In 1 case, the caliber of the donor portion was smaller than the recipient portion. Among other 8 cases, hepatic artery complication included hepatic artery winding in 2 cases and aneurysm formation of donor's hepatic artery in 2 cases, but the twig of the hepatic artery was normal. Mild Portal vein stenosis at the anastomosis was found in 2 cases, caused by the different calibers of the donor portion from the recipient portion, but the inter-hepatic branches of the portal vein were normal. Clubbed dilatation of hepatic veins end-brush was depicted in 2 cases whose inferior vena cava at the anastomosis was not stenosis. Inferior vena cava thrombosis was found in 1 case. The thrombus displayed the low signal intensity in the high signal intensity of inferior vena cava. By follow-up examination, the degree of clubbed dilatation of hepatic veins end-brush reduced after half a year and inferior vena cava thrombosis disappeared by treatment. ②Sonography: By ultrasound examination, 1 case who had hepatic artery winding combining to aneurysm formation of donor's hepatic artery was discovered just hepatic artery winding. In 2cases that had mild portal vein stenosis at the anastomosis, 1 case was diagnosed normal while the other was not affirmed. The clubbed dilatation of hepatic veins end-brush was not depicted. The others were same as MRI diagnosis.CONCLUSION: Dynamic enhanced 3D MRA imaging can provide a comprehensive assessment of vascular anatomy in most recipients of liver transplants, and is an accurate and quick method to diagnose the vascular complication after liver transplantation.

OBJECTIVE To investigate whether α-lipoic acid(α-LA)can promote the anti-prolifera-tion effect of pyrrolidine dithiocarbamic acid(PDTC)in Hep-2 cells. METHODS The laryngeal carcino-ma Hep-2 cells were cultured with α-LA,PDTC or α-LA+PDTC respectively for 12,24 and 48 h. The proliferation of Hep-2 cells was detected by WST-1 assay and soft agar colony formation while apoptosis and cell cycle were analyzed by Hoechst33258 staining and flow cytometry. RESULTS α-LA 5 -500 μmol·L-1 could not inhibit Hep-2 cell proliferation,but PDTC 5 -50 μmol·L-1 could( P ﹤0.05,P ﹤0.01). The cell proliferation inhibitory rate of PDTC 5 μmol·L-1 combined with α-LA 5,10 and 20 μmol·L-1 groups was much higher than in control group(P﹤0.01)and PDTC alone group(P﹤0.05). When α-LA 5 μmol·L-1 was used in combination with PDTC 5 μmol·L-1 for 12-48 h,the cell proliferation was inhibited in a time-dependent manner(r=0.987,P﹤0.05). When the cells were treated for 24 h,the number of soft agar colony formations in combined group was significantly smaller than that of both α-LA alone group(P﹤0.01)and PDTC alone group(P﹤0.05). The result of Hoechst33258 staining and flow cytometry indicated that after combined treatment with PDTC 5 μmol·L-1 and α-LA 5 μmol·L-1 for 24 h,the level of apoptosis and the percentage of cells in G2 / M stage were significantly increased compared with PDTC alone or α-LA alone treatment. CONCLUSION α-LA can enhance the anti-proliferation and pro-apoptosis effect of PDTC in Hep-2 cells.

Objective To evaluate the effects of ischemic postconditioning on nuclear factor kappa B (NF-κB) and intercellular adhesion molecule-1 (ICAM-1) expression during lung ischemia-reperfusion (I/R) injury in a dog model of cardiopulmonary bypass (CPB), and further investigate the pulmonary protection induced by ischemic postconditioning and the underlying mechanism.Methods Twelve adult mongrel dogs of both sexes, weighing 12-15 kg, were randomly divided into either CPB group or ischemic postconditioning group (IPO group) using a random number table, with 6 dogs in each group.CPB was established after the chest was opened in dogs anesthetized with pentobarbital sodium.Ischemic postconditioning was induced by 2 cycles of 5 min reperfusion followed by 5 min ischemia immediately after occlusion of the left pulmonary artery was released in group IPO.Before CPB (T1), before occlusion of the artery was released (T2) , and at 2 h after termination of CPB, lung specimens were obtained for examination of pathological changes which were scored (with light microscope) and for determination of the expression of NFκB and ICAM-1 (using Western blot) and wet/dry lung weight ratio (W/D ratio) in left lung tissues.Blood samples were collected from femoral arteries at T1 and T3 for blood gas analysis, and oxygenation index (OI), respiration index (RI) and dynamic lung compliance (Cdyn) were calculated.Results OI and Cdyn were significantly decreased, and RI was increased at T3 , and W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were increased at T2,3 than at T1 in the two groups.W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were significantly higher at T3 than at T2 in the two groups.Compared with group CPB, OI and Cdyn were significantly increased, and R1, W/D ratio, pathological scores, and expression of NF-κB and ICAM-1 were decreased at T3 in group IPO.Conclusion Ischemic postconditioning up-regulates the expression of ICAM-1 through inhibiting NF-κB activity, thus reducing lung I/R injury induced by CPB and improving the lung function in dogs.

Ovbective To study the perioperative changes in neurohormonal factors and hemodynamics in rheumatic valve disease. Methods Method: The neurohormaonal factors, including catecholamine (CA), angiotesin II (AGII), aldosterone (ALD), atrial natriuretic factor (ANP) and hemodynamics were studies in twenty-four patients with rheumatic valve disease (RVD). 7 congenital heart disease (CHD) as the control group. Results Plasma CA, AGII, ALD and ANP were higher preoperatively in RVD groups than that in CHD group, and significantly rose during cardiopulmonary bypass in RVD groups. Conclusion There is a hyperaldosteronism in patients with mitral valve disease during perioperative period. The high systemic resistance is closely related to significantly high levels of plasma NA and AGII during operation and in the early stage after operation. In patients with mitral valve disease and pulmonary hypertension, most of pulmonary pressure and resistance decrease in the early stage after operation.

Age-related macular degeneration (AMD) has become a leading cause of irreversible visual loss in senior population with serious influence to their ability of living independently.Epidemiological researches have revealed various risk factors of AMD,some of which are not controllable such as age,heredity and race ;while others are modifiable such as lifestyle,eye conditions and other systemic diseases.However,the awareness of AMD risk factors is alarmingly low in public.Meanwhile,the understanding of AMD risk factors among ophthalmologists is also unsatisfactory.Therefore,the risk factors of AMD are reviewed here in order to improve the understanding of the ophthalmologists and better guide the clinical management of AMD.

Objective To explore the relationship between calcium-sensing receptor's expression and papillary thyroid carcinoma.Methods Seventy cases of postoperative papillary thyroid carcinoma were selected.Immunohistochemical technique was used to detect expression of calcium-sensing receptor in papillary thyroid carcinoma,thyroid benign lesions,and normal thyroid tissue,respectively.SPSS 17.0 statistical analysis was used with non parametric test,P＜0.05 indicated significant difference.Results The expression of calcium-sensing receptor in papillary thyroid carcinoma,benign thyroid,and normal thyroid were significantly different (90％,40％,0％,respectively; P ＜ 0.05).The expression of the calcium-sensing receptor in the group of papillary thyroid carcinoma with calcification was significantly higher than that in thyroid cancer without calcification (P ＜ 0.05).Conclusions This study suggests that the calcium-sensing receptor may be associated with papillary thyroid carcinoma and may play a key role in the calcification of the carcinoma.

ObjectiveTo investigate the effect of defibrase on hemorheology on the patients with acute ischemic stroke. Methods40 patients with acute ischemic stroke were treated by defibrase and the change of hemorheology was recorded before and after the treatment respectively. ResultsThe whole blood viscosity, the blood plasma viscosity, RBC aggregate index and RBC hematocrit got reduced on different degrees.Conclusions Defibrase can reduce the blood viscosity,inhibit RBC aggregate,and improve the micro-circulation. It is helpful to recover the nerve function earlier.

Aim To investigate the inhibition of cell proliferation and the expression of PCNA gene of human glioma U251 by elemene.Methods Normal control and treatment group with elemene in human glioma U251 were studied, then the inhibition effect was examined by MTT methods and the density of half death was worked out (IC50). The expression of PCNA protein and gene was examined by immunohistochemical method and RT-PCR in different action time or at different concentrations.Results Elemene had a marked antineoplastic effect on glioma U251 with the dependence of dose and time,IC50 was 0.062 g?L-1. Elemene exhibited the expression of PCNA protein and gene,which could be examined by immunohistochemical method and RT-PCR. The expression of PCNA mRNA was lowered with the increase of drug concentration and action time.Conclusion Elemene inhibited the expression of PCAN gene,induced the inhibition of cell proliferation,and had a marked antiproliferative effect on glioma cells.

Objective To study the relationships between hepatocellular carcinoma (HCC) and the polymorphisms,promoter methylation,and expression of glutathione S-transferases P1 gene (GST) P1 gene.Methods Using methylation-special PCR (MSP),the methylated status of CpG islands of GSTP1 gene in tumor tissues of 53 HCC and its adjacent nontumor tissues were studied.The enzyme activities of GSTP1 were evaluated by ultraviolet colormetry.And using PCR-RFLP,the genetic polymorphisms of the GSTP1 genes of 74 healthy controls and 53 HCC patients were studied.Results The diffe-rences of the frequency of GSTP1 Ile/Ile,Ile/Val and Val/Val genotypes between HCC patients and the normal controls did not reach statistical significance (X~2=0.84,v=2,P=0.656).The frequency of methyla- tion of CpG islands of GSTP1 gene was significantly higher among the HCC tumor tissues when com- pared to the corresponding nontumor tissues (X~2=19.08,P＜0.001),and significantly higher in stageⅢ-Ⅳcases when compared to the stageⅠ-Ⅱcases (X~2=4.84,P=0.028).GSTP1 enzyme activities of cytoplasm in tumor cells were lower significantly than that in the adjacent nontumor tissues (t=2.49, P=0.014),and significantly higher in stageⅠ-Ⅱcases when compared to the stageⅢ-Ⅳcases (t= 2.31,P=0.025).On the other hand,the GSTP1 enzyme activities of cytoplasm in tumor cells with methylated status of GSTP1 gene were significantly lower than that in tumor cells with unmethylation (t=3.50,P=0.001).Conclusion GSTP1 inactivation via CpG island hypermethylation may contrib- ute to the pathogenesis of HCC.