Objective To analyze the impact of extent of mitral valve stenosis on the short and longterm outcome of percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral valve stenosis.Methods Two hundred and eighty-four patients with mitral valve stenosis were divided into two groups according to the Wilkins scoring system,and 191 cases whose score ≤8 were classified as group A,while the rest were classified as group B.All the patients were using the modified Inoue balloon method.Patients of successful PBMV were followed up at least 48 months and the efficiency was compared between two groups.Results The success rate of PBMV was 97.9％(187/191) and 92.5％(86/93) in group A and group B,there was significant difference between two groups (P ＜ 0.05).Echocardiography parameters improved significantly in both groups at 6 months after PBMV compared with those before PBMV (P＜ 0.05).Compared with those in group A,the changes of left atrial mean pressure [(14.31 ± 4.79) mm Hg (1 mm Hg =0.133 kPa) vs.(15.42 ± 5.14) mm Hg],across the valve pressure difference [(9.18 ± 4.66) mm Hg vs.(10.21 ± 4.38)mm Hg],pulmonary arterial systolic pressure [(26.21 ± 8.76) mm Hg vs.(32.04 ± 9.58) mm Hg],mitral valve orifice area [(1.01 ±0.16) cm2 vs.(1.21 ±0.18) cm2] after PBMV in group B were less (P＜0.05).Long-term follow-up (48-92 months) was completed in 273 successful cases and echocardiography parameters after PBMV improved significantly in both groups compared with those before PBMV during follow-up (P＜ 0.05).Compared with those in group A,the changes of left atrial mean pressure [(12.91 ±5.00) mm Hg vs.(15.1 7 ± 5.14) mm Hg],across the valve pressure difference [(7.26 ± 4.58) mm Hg vs.(9.63 ± 4.22) mm Hg],pulmonary arterial systolic pressure [(20.54 ± 7.68) mm Hg vs.(29.11 ± 8.53)mm Hg],mitral valve orifice area [(0.92 ±0.15) cm2 vs.(1.09 ±0.18) cm2] after PBMV in group B were less (P＜ 0.05).The incidence of mitral restenosis was also significantly higher in group B than that in group A [19.8％(17/86) vs.8.0％(15/187)],and there was significant difference (P ＜ 0.05).Conclusions The extent of mitral valve stenosis plays a key role on the outcome of PBMV in patients with mitral valve stenosis.Patients with lower echocardiography scores benefit more from PBMV than patients with higher echocardiography scores.

Aneurysm ; diagnosis ; Carotid Artery, Internal ; pathology ; Diagnostic Errors ; Female ; Humans ; Hypertrophy ; diagnosis ; Middle Aged ; Palatine Tonsil ; pathology

Objective To study the effect of candesartan (Can) on the LPS‐induced proinflammatory cytokines release in VSMCs ,and to explore the role of TLR4‐mediated signaling pathway in this process .Methods Rat VSMCs were primarily cul‐tured ,and the effect of different concentrations of Can on VSMCs activity was observed by M TT assay .The cells were divided into 5 groups :A(control) ,B(LPS intervention) ,C(LPS + 10 - 7 mol/L Can) ,D(LPS + 10 - 7 mol/L Can ) and E (LPS + Can 10 - 5 mol/L Can) .mRNA and protein levels of Toll‐like receptor‐4(TLR4) ,myeloid differentiation primary response gene 88(Myd88)and nu‐clear factor‐κB(NF‐κB) nuclear translocation were determined by real‐time PCR and Western blot ,respectively ;IL‐1β and TNF‐αconcentration were detected by ELISA .The production of intercellular reactive oxygen species(iROS) was measured by the DCFH‐DA assay .Pretreating VSMCs with the inhibitors against TLR4 ,NADPH oxidase ,and NF‐κB ,or a combination with candesartan and these inhibitors ,and then the expression of IL‐1β and TNF‐α was measured by ELISA .Results Can in the concentration range of 10 - 8 - 10 - 3 mol/L had no significant effect onVSMCs activity .Compared with th control group ,Can could effectively inhibit LPS‐induced VSMCs ,IL‐1β and TNF‐α release ,decreased the mRNA and protein expression of TLR4 ,Myd88 ,reduced the produc‐tion of iROS ,inhibited the NF‐κB(p65) nuclear translocation with a concentration‐dependent manner(P< 0 .05) .Anti‐TLR4 anti‐body ,DPI ,and PDTC all inhibited LPS‐induced inflammatory cytokines release in VSMCs ,and the combination of Can and these blockers showed stronger anti‐inflammatory effect .Conclusion Can can decrease the releaseof inflammatory cytokines IL‐1β and TNF‐α in VSMCs stimulated by LPS ,which is realized by inhibiting the signaling pathway of TLR4/Myd88‐iROS‐NF‐κB .

OBJECTIVE: To study the preventive effect of Breviscapus Injection on the chronic hypoxic myocardium injury in rats and its mechanism. METHODS: Transmission electron microscope and biochemical analysis were used to assay the therapeutic effect of Breviscapus Injection in rat model induced by 4 week's hypoxia. RESULTS: The contents of malondialdehyde (MDA) and Ca(2+) in the homogenate of myocardial tissue of the hypoxic rats were significantly higher than those of the control rats. The activities of superoxide dismutase (SOD), nitric oxide synthase (NOS) in the homogenate of myocardial tissue and the plasmic NO levels of the hypoxic rats were significantly lower than those of the control rats. Breviscapus Injection reduced the contents of MDA and Ca(2+), and increased the levels of SOD, NOS and NO. Ultrastructural examination revealed that the injuries of the ultrastructure of heart in hypoxic rats were improved by treatment with Breviscapus Injection. CONCLUSION: Breviscapus Injection can effectively prevent and treat the hypoxia-induced myocardial damage. One of its mechanisms may relate to its adjusting NO level, anti-damaging of free radicals and inhibiting calcium overload.

Objective To explore the invading mechanism of amebae in lamina porpria and observe the interaction between the cysteine proteinase (CP) of Entamoeba histolytica and laminin. Methods CP was identified by laminin-sepharose affinity chromatography, followed by isolation, purification and inhibitor experiment. The hydrolytic activity was measured by gelatin electrophoresis. Results Purified CP of E.histolytica showed a strong affinity with laminin. The molecular weight of CP is 27 kDa. It can be inhibited by EC-64 and exhibited a protein hydrolytic activity. Conclusion The specific affinity and hydrolytic activity of CP might play an important role in its invasion to the basement membrane of intestinal mucosa.

Epilepsy ; etiology ; Female ; Humans ; Infant ; Tuberous Sclerosis ; complications ; diagnosis ; genetics

ObjectiveTo investigate the efficacy and toxicity of postoperative radiochemotherapy compared with chemotherapy alone in the treatment of locally advanced gastric cancer.MethodsA total of 83 patients with resected adenocarcinoma of the stomach were randomly assigned to postoperative radiochemotherapy group (RCT) ( n =43 ) or chemotherapy alone group (CT) ( n =40 ).Patients in RCT group received radiotherapy concurrent with capecitabine chemotherapy then followed by 4 - 6 cycles of FOLFOX4 chemotherapy.The total dose of radiation was 45 Gy.The dose of capecitabine was 1600 mg/m2per day.In the CT group,patients received 6 - 8 cycles FOLFOX4 chemotherapy.Survival was analyzed using Kaplan-Meier method and Logrank test. Results The follow-up rate was 96％. The number of patients who had a minimum of 2-,3-year follow-up time were 37,12 in the RCT group and 31,10 in the CT group.The 1-,2-,3-year local control rates for RCT and CT groups were 100％,97％,94％ and 95％,87％,73％ (x2 =4.54,P =0.033),respectively.The 1-,2-,3-year survival rates were 98％,86％,81％ in the RCT group,with 93％,80％,64％ in the CT group ( x2 =3.96,P =0.047 ).The incidence of grade 3hematological toxicity in the RCT and CT group was 23％ vs 15％ ( x2 =0.93,P =0.630 ),and grade 3gastrointestinal toxicity was 16％ vs 10％ ( x2 =0.95,P =0.624 ). Conclusions Compared with chemotherapy alone,postoperative radiochemotherapy can improve survival of locally advanced gastric cancer patients with acceptable toxicities.

OBJECTIVETo explore the clinical effects of Dynesys system combined with posterior lumbar interbody fusion (PLIF) in treating multiple lumbar degenerative disease.

METHODSThe clinical data of 46 patients with multiple lumbar degenerative diseases treated by Dynesys system combined with PLIF from September 2010 to May 2013 were retrospectively analyzed. There were 17 males and 29 females, aged from 38 to 68 years old with an average of (56.38±11.63) years. Operation section was in L2-L5 of 16 patients (6 with fusion of L4,5 and 10 with fusion of L4,5,L5S1) and in L3-S1 of 30 patients (11 with fusion of L5S1 and 19 with fusion of L4,5,L5S1). Patients were followed up for three times: postoperative 3 months, 1 year and final follow-up. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at final follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.

RESULTSAll patients were followed up from 16 to 48 months with the mean of (23.23±7.34) months. At third follow-up after operation, ODI and VAS of lumbago and leg pain were significant improved than that of preoperative (P<0.01). DHI of fusion segment was significantly increased than that of preoperative (P<0.05). There was no significant difference in adjacent non-fusion segment between preoperative and postoperative (P>0.05). Postoperative ROM of fusion and non-fusion segments were obviously decreased than that of preoperative. There was no significant difference in ROM of upper adjacent non-fusion segment between 3 months and 1 year after operation (P>0.05), but at final follow-up, the ROM was increased (P<0.05).

CONCLUSIONThe preliminary clinical results of the Dynesys system combined with PLIF in the treatment of multiple lumbar degenerative diseases are satisfactory. It can be determined in fusion or non-fusion according to the individual needs and can reserve the some intervertebral motion, prevent the early degeneration of adjacent segments. However, its long-term clinical efficacy should be verified with long time.

Humans ; Lumbar Vertebrae ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; methods ; Visual Analog Scale

Objective:To investigate the efficiency of Agrobacterium tumefaciensmediated transfor-mation of Aspergillus fumigatus by using pyrG as a recessive selectable marker.Methods: FAP1 and SHO1 genes target sequences,composed of a selectable marker pyrG and the flanking sequences of the FAP1 and the SHO1 genes,were cloned into a binary plasmid pDHt/sk,respectively.The produced plasmids were transformed into A.tumefaciens.The A.tumefaciens and uracil auxotroph A.fumigatus were cocultured in induction medium without uricil and uridine at 24 ℃ for 48 h.To inhibit growth of A.tumefaciens and to select transformants,the cultures were transferred to 37 ℃ and incubated for another 48 h.Results: In this study,A.tumefaciens-medidated transformation of A.fumigatus produced high homologous recombination rates,which was 44%(7 of 16) for FAP1 and 35%(7 of 20) for SHO1.Conclusion: Our study showed that A.tumefaciens-medidated transformation by using pyrG as a recessive selectable marker is an efficient tool for target gene deletion of A.fumigatus.