Child ; Disease Management ; Humans ; Syncope ; diagnosis ; therapy

Objective To explore the difference of clinical features and laboratory indexs with different vasovagal responses in(head-up) tilt test(HUT) in children with vasovagal syncope(VVS).Methods Forty consecutive children diagnosed with VVS by HUT were analyzed.The vasovagal responses were divided into vasodepressor,cardioinhibitory and mixed patterns.The distribution and different clinical features and laboratory indexs of different response patterns in the VVS were studied.Results The most common vasovagal response was vasodepressor.There was no significant difference in their clinical features,including the motivation,presymptom,frequency and duration of syncope,baseline heart rate and blood pressure,and serum electrolytes among the children with different vasovagal respon-ses.Conclusion Vosodepressor response is the most common hemodynamic pattern in vasovagal syncope in children.

Objective The purpose of this study was to evaluate the efficacy of multipoint transfixion combined with filling of temporal fascia and the lateral orbicularis oculi muscle as an alternative rejuvenation technique on crow's feet wrinkles during face lift.Methods A retrospective review was conducted in 86 patients who underwent crow's feet wrinkles treatment during 2005 and 2009.During operation orbicularis' strength was broken down and blocked when we multi-pointly sutured and fixed the orbicularis oculi and deep tissue,temproal musculofascia was filled on the surface of multi-pointly sutured orbicularis oculi.By postoperative follow-up,complications,aesthetic outcome,and patient's satisfaction were recorded.Results In the group of 86 cases,50 cases were followed up from 3 to 28 months.The effect was lasting obviously and there was no any severe complications,such as hematoma or nerve injury.Patients were satisfied with their results.Among the total,2 patients appeared the temporary movement loss of the eyebrows in one side,but both recovered 3 months later.And 1 case appeared subcutaneous nodular inflammation and recovered after pulling out the suture.Conclusions The authors demonstrate that combination of filling with temporal fascia and the multipoint transfixion of lateral orbicularis oculi muscle is a safe technique,which may be a good alternative for periorbital rejuvenation and help in avoiding lower lid incisions or extensive dissections during face lifting in some cases.

ObjectiveTo explore a method for reconstruction of the middle and lower facial tension system for surgical rejuvenation.MethodsFrom 2003 to 2011,257 female patients were treated with this procedure,in which superficial musclo-aponeurotic system (SMAS) of the cheeks were tightened and fixed to the deep temporal fascia and the temporal muscle fascia in muhidirectional and oblique toward the eye and ear rather than just toward the ear through purse string suture method to achieve the goals of facial rejuvenation.ResultsThe follow-up data were obtained in 50 cases,with time range of 3-60 months.Each case was evaluated by both the patient and the surgical team.Excellent or good results were achieved for 255 cases.In all we succeeded in correcting the nasolabial sulcal deformity,and the cheek ptosis,and the contour of the face were more smoothly than that of preoperative appearance.The outlines of lower face became narrow,and thinner than the preoperative.All the patients were without loss of facial identity.Complications occurred occasionally,including the tensional blister on the dermal suture point and local numbness.No incision scar,alopecia and facial nerve injury occurred.Effects of rejuvenation were obvious and natural in 3-6 months after surgery.Especially 12 months after operation the results were the best.ConclusionsThis technique addresses the multiple factors involved in the senescent changes of the midface.Proper patient selection,good aesthetic judgment,and surgical competence are required to restore the midface and lower face tension system reconstruction.This novel approach is safe and effective,and the result is stable and lasting.

Objective: To determine the mechanism of protective effects of lidocaine on brain during ischemia. Method: Wistar rats within 24h after birth were enrolled. The brain cortex cells were separated and then cutured under normal or anoxic condition. The OD value of these cells were detected with rapid colorimetric assay after they were cultured 24h and 48h. According to the above values, other cells were cultured in different condition and divided intc three groups: control group(N) cultured under normal condition (37℃, 5%CO_2+95%air); anoxic group(A) and anoxic+ lidoeaine group(L) cultured under anoxic condition(37℃, 5%CO_2+95%N_2). 6.9?10~(-5)mol/L lidocaine was added to the medium in group L. Cells of these three groups were cultured under different condition for 48h, then malondiadehyde and lactate levels of each group were measured. Result: The survival cells of anoxic group were significantly lower than that of control group after cultured for 48h, the malondiadehyde levels were as follows (nmol/ml): group N(4.93 ?0.43, n=12), group A(5.56?0.34, n=12), group L(4. 80?0.25, n=11); the lactate levels (mmol/L): group N(8.05?1.64, n=21), group A (11.86?2.58, n=22), group L(9.96?1.88, n=21), Conclusion: Lidocaine may protect brain from ischemia through inhibiting malondiadehyde and lactate production induced by anoxia.

Objective To explore the clinical effect of surgery on treating multi-extensively drug resistant (MDR) and extensively drug resistant pulmonary (XDR) tuberculosis (M/XDR-PTB) in order to provide the new approach for patients with M/XDR-PTB.Methods The information of 75 cases with M/XDRPTB were recorded and they were underwent thoracic surgery at the National Tuberculosis Center in Tbilisi,Georgia from October 2008 to February 2011.Results Of 75 patients,52 cases were MDR and 23 were XDR with PTB underwent adjunctive thoracic surgery.The following surgical procedures were performed including pneumonectomy(10％),lobectomy (51％),segmentectomy (33％).Median age was 30 years and average duration of preoperative M/XDR-PTB medical therapy was 350 days.Mean postoperative follow up period was 372 days.Of 72 patients with complete outcomes information,59 (82％) had favorable outcomes including 90％ of MDR and 68％ of XDR-TB patients.No postoperative death occurred,7 patients (9％) had postoperative complications.Univariate analysis showed that,compared with good treatment outcomes,risk factors of poor treatment outcomes included cavitary disease (62％ vs.27％,P =＞ 0.02),probability of suffering from XDR (62％ vs.27％,P =0.02),positive preoperative sputum culture (77％ vs.14％,P＜ 0.001),acceptance of sensitive drugs(1.9％ vs.2.8％,P =0.03) and major postoperative surgical complication (23％ vs.5％,P =0.03).Conclusion Patients with M/XDR-PTB undergoing adjunctive thoracic surgery show with high rates of favorable outcomes,and no surgical related death as well as the low complications rates.Adjunctive surgery appears to play an important role in the treatment of select patients with M/XDR-PTB.

Objective To study the characteristics of pointing movement time for targets with different position in front of human body,to detect the effects of targets location on pointing movement time.Methods A pointing movement experiment of human arm was designed and carried out.By the statistic analysis of the experimental data,the relationship between pointing movement time and target position was discussed.Results It was shown that the starting point position and target position extremely affected the pointing movement time.Conclusion When a right-handed person touches the different targets,both the direction to target and the starting point position(target-circle location) would affect the pointing movement time extremely.When the position of the starting point changed by horizontal or vertical,the pointing movement time is more changeful by horizontal than that by vertical.To compare the pointing movement time for each target on a target-circle,the pointing movement time for right-upper target is the shortest.When the starting point is located on the right side of human body,all pointing movement time of that target-circle is the shortest.

Objective To study pointing movement characteristics and ergonomics when human upper limb touches different targets on the front board. Methods An experiment was designed, in which the data of motion duration, peak velocity, trajectory length and peak power at shoulder and elbow joint were collected. Results By analysis of the experimental results, the pointing movement characteristics among the different regions on the front board were disclosed preliminarily. Conclusion When a right-handed person touches a target on the front board, the pointing movement ergonomics on left-upper region is the best, while that on right-lower region is the worst.

Objective To observe the regulatory effect and significance of hydrogen sulfide (H2 S)on low -density lipoprotein receptor (LDLR).Methods Mouse primary hepatocytes were divided into control group,low -den-sity lipoprotein (LDL)group and LDL +sodium hydrosulfide (NaHS,the donor of H2 S)group.The cells in LDL group were treated with LDL (50 mg/L)and the cells in LDL +NaHS group were pretreated with NaHS (100 μmol/L)for 0.5 hours and then treated with LDL (50 mg/L).Real -time PCR and Western blot were used to detect the expres-sions of LDLR mRNA and protein,respectively.Mouse primary hepatocytes were divided into control group,1,1′-dioctadecyl -3,3,3′,3′-tetramethyl -indocarbocyanine perchlorate low -density lipoprotein (DiI -LDL)group and DiI -LDL +NaHS group.The cells in DiI -LDL group were incubated with DiI -LDL (10 mg/L)for 3 hours.The cells in DiI -LDL +NaHS group were pretreated with NaHS (100 μmol/L)for 1 hour before DiI -LDL (10 mg/L) was added.Confocal method was used to measure the uptake of DiI -LDL by mouse primary hepatocytes,and fluores-cent quantitative method was performed to detect the content of DiI -LDL in the supernatant of mouse primary hepato-cytes.Results The levels of LDLR mRNA and protein in the mouse primary hepatocytes were significantly downregu-lated compared with those in the control group (t =5.733,P <0.01;t =2.527,P <0.05);after NaHS was adminis-tered,LDLR mRNA and protein level in the mouse primary hepatocytes were significantly upregulated (t =-7.639, P <0.01;t =2.388,P <0.05).In the mouse primary hepatocytes,compared with that in the control group,the uptake of DiI -LDL by cells in DiI -LDL group was increased;the uptake of DiI -LDL by mouse primary hepatocytes in DiI -LDL +NaHS group was significantly increased in comparison with that in the DiI -LDL group.Compared with that in the control group,the DiI -LDL content of culture supernatant in the DiI -LDL group was significantly increased (t =-39.156,P <0.01);after treatment with H2 S donor,the content of DiI -LDL in the culture supernatant was sig-nificantly decreased in comparison with that in the mouse primary hepatocytes without H2 S donor treatment (t =17.202,P <0.01).Conclusion H2 S upregulated the expression of LDLR protein in the mouse primary hepatocytes.

Purpose To study the expression of livin and caspase-3 protein in pancreatic carcinoma and their correlation with clinicopathologic features and survivial time.Methods High-throughput tissue microarray technique and immunohistochemistry were used to detect the expression of livin and caspase-3 protein in 88 pancreatic carcinoma specimens without a history of chemo-radiation therapy and 11 non tumorous pancreatic tissues,and the relationship of these subjects was analyzed with Spearman rank correlation. Among these 88 cases, 54 cases were followed-up for 2 months to 6 years, whom were used for the prognosis analysis.Results In the 88 cases, the positive rate of livin was 76.1% (67/88); however, the positive expression of caspase-3 was 90.9%(10/11) in non-tumorous pancreatic tissue, which was much higher than that in the cancer (40.9%,36/88), with statistically significant differences(P＜0.01). There were significant relationships of livin protein expression with sex, TNM stage and lymph node metastasis (P＜0.05); the expression of caspase-3 protein expression was significantly related to sex, histological grade, TNM stage and lymph node metastasis (P＜0.01). Spearman rank correlation showed a significant correlation between livin and caspase-3 protein (P＜0.01). In 54 cases with followed-up data, univariant analysis revealed that both of livin protein expression and lymph node metastasis were related to the survival rate (P＜0.05), but caspase-3 protein expression, sex, age, tumor location, size, histological grade and TNM stage were unrelated to prognosis (P＞0.05). Furthermore,COX stepwise proportional hazards analysis showed that only livin status retained independent significance in prospecting prognosis of pancreatic carcinoma.Conclusions The expression of livin is associated with clinicopathologic features and prognosis in pancreatic carcinoma. High expression of livin protein indicates poor prognosis, which could become an independent index for the evaluation of prognosis.caspase-3 protein may be involved in the regulation of apoptosis and the progression of pancreatic carcinoma.