OBJECTIVEExercise induced oscillatory ventilation (EIOB) during cardiopulmonary exercise testing (CPET) is associated with severity and prognosis of disease, but clinical approach for the character of EIOB due to circulatory dysfunction are seldom reported.

METHODSThis retrospective analysis of symptom-limited maximum CPET data with an increment of 10-20 W/min in 38 patients with CHF. We calculated the duration, frequency, amplitude and other parameters of EIOB.

RESULTSThere were 31 presenting with EIOB (82%) in all patients with CHF. In EIOB group, VE amplitude were (12.4 ± 4.4)L/min (accounting for 81% ± 30% of mean) and duration were (77.0 ± 20.0)s. The number of patients whose EIOB presenting at rest, exercise, recovery stage and the whole eriod were 24, 31, 4 and 4, respectively. Except VE, there were VO2, VCO2, RER and PETO2 presenting EIOB in all 31 patients; VE/VCO2, VO2/VE and breath frequency in 29 patients; PETCO2 in 26 patients; VT and VO2/HR in 25 patients; and HR in 2 patients.

CONCLUSIONEIOB may occur in any period of CPET, mostly in severe patient with CHF, and presenting in many variables. Due to it is resulted from the circulatory dysfunction, we should call it circulatory (cardiac) oscillatory breathing abnormality.

Exercise Test ; Heart Failure ; physiopathology ; Humans ; Oxygen Consumption ; Respiratory Physiological Phenomena ; Retrospective Studies

OBJECTIVETo explore the influence of exogenous putrescine and cadaverine on pro-inflammatory factors in the peripheral blood of rabbits.

METHODSForty ordinary adult New Zealand rabbits were divided into saline, necrotic tissue homogenate (NTH), putrescine, and cadaverine groups according to the random number table, with 10 rabbits in each group. Saline, NTH, 10 g/L putrescine, and 10 g/L cadaverine were respectively peritoneally injected into rabbits of corresponding group in the amount of 1 mL/kg. The blood sample in the volume of 2 mL was collected from the central artery of rabbit ears before injection and at 2, 6, 12, 24, 30, 36, 48, 60 hours post injection (PIH). Contents of TNF-α, IL-1, and IL-6 in the serum were determined with enzyme-linked immunosorbent assay. Data were processed with repeated measurement data analysis of variance and Spearman correlation analysis, and cubic model curve was applied in curve fitting for the contents of inflammatory factors.

RESULTS(1) The serum contents of TNF-α, IL-1, and IL-6 were increased in NTH, putrescine, and cadaverine groups in different degrees at most post injection time points. There was no significant change in the concentrations of the three pro-inflammatory factors in saline group, and they were significantly lower than those of the other three groups at most post injection time points (with F values from 3.49 to 13.58, P values all below 0.05). The serum contents of TNF-α, IL-1, and IL-6 in putrescine group began to increase at PIH 2, 6, and 6, which was similar to the trend of NTH group, but the changes were delayed compared with those of cadaverine group(all at PIH 2). The peak values of TNF-α, IL-1, and IL-6 in putrescine group were respectively (339 ± 36), (518 ± 44), and (265.9 ± 33.5) pg/mL, which were significantly lower than those of cadaverine group [ (476 ± 86), (539 ± 22), and (309.4 ± 27.1) pg/mL], with F values respectively 5.11, 1.90, and 5.56, P values all below 0.05. (2) The period of time in which contents of TNF-α, IL-1, and IL-6 began to increase (PIH 3-4) and the peaking time of the three pro-inflammatory cytokines (PIH 18-30) in putrescine group appeared later than those of cadaverine group (PIH 2 and 12-30). The duration of peaking time of the three pro-inflammatory cytokines in putrescine group was shorter than that of cadaverine group (PIH 18-30 vs. PIH 12-30). The increasing period and the duration of peaking time of TNF-α, IL-1, and IL-6 in putrescine group were close to those of NTH group (PIH 3-5 and 18-30). The correlation coefficient test analysis showed that the trends of changes in contents of three pro-inflammatory cytokines in putrescine group were significantly correlated with those of NTH group (r(TNF-α) = 0.933, P < 0.01; r(IL-1) = 0.967, P < 0.01; r(IL-6) = 0.950, P < 0.01). The obvious correlation between cadaverine group and NTH group was only found in the contents of IL-1 and IL-6 (r(IL-1) = 0.913, P < 0.01; r(IL-6) = 0.883, P < 0.05).

CONCLUSIONSBoth exogenous putrescine and cadaverine can cause inflammatory reaction in rabbits. The trend of the inflammatory reaction induced by putrescine was similar with that by NTH, suggesting that putrescine may play a leading role in the inflammatory reaction induced by necrotic tissue decomposition.

Animals ; Cadaverine ; adverse effects ; Inflammation ; blood ; Interleukin-1 ; blood ; Interleukin-6 ; blood ; Necrosis ; blood ; Putrescine ; adverse effects ; Rabbits ; Tumor Necrosis Factor-alpha ; blood

Objective To evaluate the availability and security of exercises quantizing prescription for type 2 diabetes mellitus. Methods 1 to 5 grades of prescriptions were designed according to different exercises. 80 patients of type 2 diabetes mellitus were treated by 1 to 5 grades of exercise prescriptions. One hour after dinner, each patient started from a minimum amount of Exercise Prescription 1 for three days. Then the patient increased the grade of exercise prescription every three days, until to the greatest amount of Exercise Prescription 5. Exercise time of each exercise prescription was 60 minutes. Heart rate, blood pressure, and PaO2 were determined before exercise, instantly after exercise, 4 hours after exercise, and 12 hours after exercise in all patients, and the incidence of hypoglycemia was counted, so that the security of exercises quantizing prescription could be evaluated. Changes of blood glucose, glycosylated hemoglobin, blood fat, waistline, hip circumference, and weight 3 months after discharge were compared to evaluate the availability of exercises quantizing prescription. Results The values of heart rate, systolic blood pressure, diastolic blood pressure and PaO2 were in the normal range instantly after exercise, 4 hours after exercise, and 12 hours after exercise. There was no occurrence of hypoglycemia among the patients instantly after exercise. The incidences of hypoglycemia were 1.25% and 2.5% 4 hours and 12 hours after exercise. After 3 months, fasting blood sugar, 2hFBG and glycosylated hemoglobin in each group significantly decreased. Total cholesterol decreased obviously except in B2 group. Waistline, hip circumference and weight of those patients whose BMI were 25 decreased obviously. Conclusions Exercises quantizing prescription of diabetes mellitus is a safe and effective exercise therapy for type 2 diabetes mellitus. 1 to 5 grades of exercise prescriptions provide more choices of individual exercise therapy for type 2 diabetes mellitus patients.

OBJECTIVETo evaluate the value of transbronchial needle aspiration (TBNA) combined with transesophageal endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of mediastinal and pulmonary hilar lesions as well as in the lymph node staging (N staging) of lung cancer.

METHODS129 patients with mediastinal and pulmonary hilar lesions underwent either TBNA or EUS-FNA with cytological needle aspiration. The samples obtained from TBNA or EUS-FNA were examined by both cytologiy and histopathology.

RESULTSOf the 129 patients, 59 underwent TBNA and 70 EUS-FNA. The diagnostic rate were 84.7% (50/59) by TBNA and 94.3% (66/70) by EUS-FNA, resepectively. The diagnosis of 116 (89.9%) patients were confirmed by either TBNA or EUS-FNA. The pathological and cytological diagnostic rates were 92.2% (107/116) and 88.0% (102/116), resepectively. The diagnostic rate was elevated by 8.4% (9/107) through pathological examination. The histological classification rates by cytological and pathological examination were 73.8% (76/116) and 89.3% (92/103), respectively. The diagnostic rate of histological classification was elevated by 35.5% (27/76) through pathological examination.

CONCLUSIONThe combination of TBNA and EUS-FNA can improve the diagnostic rate for wider mediastinal and pulmlonary hilar lesions. Pathological examination of the samples obtained from the TBNA and EUS-FNA can elevate not only the rate of diagnosis but also the rate of histological classification.

Adenocarcinoma ; diagnostic imaging ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; methods ; Biopsy, Needle ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; Endosonography ; methods ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; Male ; Mediastinal Neoplasms ; diagnostic imaging ; pathology ; secondary ; Mediastinum ; Middle Aged ; Neoplasm Staging ; Small Cell Lung Carcinoma ; diagnostic imaging ; pathology ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of endoscopic mucous resection with transparent cap (EMR-Cap) and endoscopic multi-band mucosectomy (MBM) in the treatment of early esophageal cancer and precancerous lesion.

METHODSA retrospective study was performed to review 30 EMR-Cap cases from December 2008 to December 2009 and 32 MBM cases from January 2010 to January 2011 of early esophageal cancer and precancerous lesions. The differences between these two techniques in efficacy, safety, and cost were compared.

RESULTSIn EMR-Cap group, the median resection time was 26(10-56) min and median procedure time was 43(22-81) min, significantly longer than those in MBM group [10(7-18) min and 32(28-45) min, P=0.036 and 0.038, respectively]. There were no significant differences between the two groups in total thickness and depth of resected lesions (P>0.05). In EMR-Cap group, the median cost was significantly higher than that of MBM group [(5466±354) vs. (4014±368) RMB, P=0.008)].

CONCLUSIONSEMR-Cap and MBM are minimally invasive, safe and effective methods in the treatment of early esophageal cancer and precancerous lesions. Compared to the EMR-Cap, MBM is simple with shorter treatment time and lower cost.

Aged ; Endoscopy ; methods ; Esophageal Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Precancerous Conditions ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate a facial rhytidectomy technique to reduce the complications of temporal alopecia and incisional scar hyperplasia.

METHODSThe 82 aged patients were divided into 2 groups in random way: group A in 46 with the use of the three-point relief-tension suspension technique and group B in 36 as control. In group A, the two point of every relief-tension suture was located respectively in the subcutis of the hairline and fascia under the incision. The parallel three sutures formed a mechanical plane to make the relief suture more strong and permanent. The temporal alopecia and incisional scar was observed with the follow-ups after the operation.

RESULTSWith the 82 cases of facial rhytidoplasty, the complications of the temporal alopecia and incisional scars in group A were much less than in group B.

CONCLUSIONSThis technique could decrease the complications such as temporal alopecia and incisional scars, and get a good and long term effect of temporal lifting simultaneously.

Adult ; Fasciotomy ; Female ; Humans ; Male ; Middle Aged ; Petrous Bone ; surgery ; Rhytidoplasty ; methods

OBJECTIVETo investigate the value of intensity modulated radiation therapy (IMRT) for patient with gynecological malignancies after treatment of hysterectomy and chemotherapy/radiotherapy.

METHODSAll 32 patients with cervical or endometrial cancer after hysterectomy received full course IMRT after 1 to 3 cycles of chemotherapy (Karnofsky performance status(KPS) > or =70). Seventeen of these patients underwent postoperative preventive irradiation and the other 15 patients were pelvic wall recurrence and/or retroperitoneal lymph node metastasis, though postoperative radiotherapy and/or chemotherapy had been given after operation.

RESULTSThe median dose delivered to the PTV was 56.8 Gy for preventive irradiation, and 60.6 Gy for pelvic wall recurrence or retroperioneal lymph node metastasis irradiation. It was required that 90% of iso-dose curve could covere more than 99% of GTV. However, The mean dose irradiated to small intestine, bladder, rectum, kidney and spinal cord was 21.3 Gy, 37.8 Gy, 35.3 Gy, 8.5 Gy, 22.1 Gy, respectively. Fourteen patients presented grade I (11 patients) or II (3 patients) digestive tract side-effects, Five patients developed grade I or II bone marrow depression. Twelve patients had grade I skin reaction. The overall 1-year survival rate was 100%. The 2- and 3- year survival rate for preventive irradiation were both 100%, but which was 5/7 and 3/6 for the patients with pelvic wall recurrence or retroperioneal lymph node metastasis.

CONCLUSIONIntensity modulated radiation therapy can provide a better dose distribution than traditional radiotherapy for both prevention and pelvic wall recurrence or retroperioneal lymph node metastasis. The toxicity is tolerable. The adjacent organs at risk can well be protected.

Adult ; Aged ; Combined Modality Therapy ; Diarrhea ; etiology ; Endometrial Neoplasms ; drug therapy ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; adverse effects ; methods ; Survival Analysis ; Uterine Cervical Neoplasms ; drug therapy ; radiotherapy ; surgery

OBJECTIVETo identify independent risk factors for myocardial infarction (MI) in Chinese men and to develop a model to predict risk profile of an individual suffering MI.

METHODSStudy sample included 5 137 men aged 45.2 +/- 7.8 years who came from a cohort in Beijing Capital Steel and Iron Company, based on the three surveys on coronary heart disease conducted in 1974, 1979 and 1980, respectively. Demographic data and other risk factors, such as life style, medical history, blood pressure, total serum cholesterol level (TC), etc. were collected according to the same protocol in 1980. All the participants were followed up for MI in an average period of 20.84 years until 2001.

RESULTS(1) There were 122 cases with MI identified during the period of follow-up, with an incidence of MI 117.4 per 100 000 person-years. Age of more than 50, smoking, higher systolic and diastolic blood pressure (SBP and DBP) levels, higher TC all were identified as important risk factors of MI. (2) Incidence of MI increased with TC. An increment of 0.52 mmol/L of TC significantly increased relative risk of MI by approximately 40% after adjusted for age, blood pressure and smoking. (3) An increment of 20 mm Hg in SBP or 10 mm Hg in DBP associated with a 40% increase in incidence of MI, adjusting for age, TC and smoking. (4) Smoking was the most risky factors for MI. Smokers had 2.3 times risk of MI, after as compared to non-smokers (or its incidence increased by 137%), after adjusting for blood pressure, TC and age, etc. (5) Incidence of MI increased by 20% with increment of five-year of age in those aged over 50 (P < 0.05), after adjusting for blood pressure, TC and smoking. And, (6) finally, based on multivariate logistic and Cox regression analyses, a model containing several risk factors, such as age, blood pressure, TC and smoking, was developed to predict individual's risk for afflicting MI.

CONCLUSIONSResults of this prospective study showed several established risk factors for MI, including age, blood pressure, TC and smoking all as independent predictors of MI in Chinese men. It is clear and rational that intervention and modification of those traditional risk factors can lead to a decrease in coronary events in Chinese population.

Adult ; Age Factors ; Blood Pressure ; physiology ; China ; epidemiology ; Cohort Studies ; Follow-Up Studies ; Humans ; Incidence ; Iron ; Male ; Metallurgy ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; epidemiology ; etiology ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Smoking ; adverse effects ; Steel ; Triglycerides ; blood

OBJECTIVETo evaluate the safety and immunogenicity of Canada split influenza virus vaccine.

METHODSCluster samples were by randomly chosen and divided into split vaccination group and homoimported influenza vaccination group.

RESULTSAfter injection, fever-reaction and local reaction rates of 'trial' group were found as 3.69% and 1.75% respectively, but no statistical significance was found when compared with 'control' group. However the antibody positive rates of 'trail' and 'control' groupsappeared statistically significant (H1N1: 96.8% vs. 92.3%, H3N2: 95.8% vs. 90.2%, B: 52.3% vs. 62.3%). For geometric mean titer (GMT) of type H1N1, H3H2 and B antibody, 'trial' group and 'control' group increased 22.4, 16.8, 8.2 and 21.2, 12.5 and 7.4 times respectively. The antibody protective rates of type H1N1, H3N2 and B were 99%, 99% and 53.9% for 'trial' group, and 96.2%, 98.4% and 62.3% for 'control' but with no statistically significant difference.

CONCLUSIONInfluenza split vaccine made in Shire company in Canada was safe and with good immunogenicity.

Adolescent ; Adult ; Age Factors ; Antibody Formation ; immunology ; Canada ; Child ; Child, Preschool ; Drug-Related Side Effects and Adverse Reactions ; immunology ; Female ; Humans ; Infant ; Injections ; Male ; Middle Aged ; Orthomyxoviridae ; immunology ; Time Factors ; Viral Vaccines ; administration & dosage ; adverse effects ; immunology ; Young Adult

HA and M2 genes derived from human highly pathogenic avian influenza H5N1 virus (A/Anhui/ 1/2005) isolated from China, were amplified and cloned into the DNA vaccine expression vector pVRC. In order to improve the expression of hemagglutinin, the human codon usage preference was made and the whole length of HA gene of H5NI (A/Anhui/1/2005) influenza virus was synthesized,named HA/YH/K, and inserted to pVRC vector, the expression of HA/YH/K protein in eukaryotic cells was significantly improved according to internal control of actin protein. Furthermore, the M2 and HA/YH/K genes were cloned into bicistronic eukaryotic expressing vector pIRES to yield the recombinant plasmid pIRES-HA/ YH/K-M2/YS/K, which could expressed HA and M2 protein simultaneously by transfection of one plasmid. Western blot and IFA showed that the recombinant pIRES-HA/YH/K-M2/YS/K plasmid was successfully expressed in several mammalian cells (Hela, MDCK and 293FT). The above results may help to identify the function and pathogenic mechanism of HA, M2 genes derived from HPAI H5N1 (Anhui strain) and pave a way for the development of novel bivalent vaccines against human highly pathogenic avian influenza virus and for preparedness for influenza pandemic.
Animals ; Cell Line ; Gene Expression ; Genetic Engineering ; Genetic Vectors ; genetics ; metabolism ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; metabolism ; Humans ; Influenza A Virus, H5N1 Subtype ; genetics ; isolation & purification ; metabolism ; Influenza, Human ; virology ; Recombinant Fusion Proteins ; genetics ; metabolism ; Viral Matrix Proteins ; genetics ; metabolism