Objective To compare the effect of right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing on ventricular systolic synchrony using gated blood pool SPECT (GBPS).Methods A total of 50 patients implanted with pacemaker due to high degree or complete atria-ventricular block were enrolled in the study. Twenty-three patients were RVOT paced ( Group A, n = 23) and 27 were RVA paced (Group B, n=27). Twenty-four patients with malignancy, normal echocardiographic findings and no history of cardiac diseases were scheduled for pre-chemotherapy evaluation of cardiac structure and function and were enrolled as control group ( Group C, n = 24). All patients underwent GBPS imaging and the values of phase angle (PS), mean phase of each wall, standard deviation (SD) of mean phase of each wall, lateral-septal motion delay of left ventricle ( LV Sep-Lat Delay), septal-right ventricular (RV) delay of LV ( LV Sep-RV Delay) and LV-RV Delay were acquired. The parameters of ventricular systolic synchrony among the three groups were compared using one-way ANOVA. Results The mean phase of LV lateral wall in Groups A and B were significantly higher than that in Group C: Group A (120.50 ±40.58) ms; Group B (103.23±28.34) ms; Group C (84.63 ±22.38) ms (F=7.72, P ＜0.05). There was no significant difference between Groups A and B ( t = 1.30, P ＞ 0.05 ). The mean phase of RV in Group A was significantly larger than those in Groups B and C: Group A ( 137.05 ± 39.27) ms, Group B ( 100.85 ± 23.79) ms,Group C (59. 13 ±30.52) ms (F=35.55, P＜0.05). PS, SD and LV Sep-Lat Delay in Groups A and B were significantly higher than those in Group C: (85.73 ± 12.00)°vs (89.85 ± 15.61 )°vs (58.95 ±9.87)°, (27.68±10.66) ms vs (26.15 ±13.02) ms vs (15.63 ±8.35) ms, (25.06±34.23) ms vs (2. 62 ± 60. 31 ) ms vs ( - 23.66 ± 31.39) ms, F = 41.54,8.55,6.81, all P ＜ 0.01 ), however, there was no significant difference between Groups A and B ( t = 0. 68, 0.68, 1.30, all P ＞ 0.05 ). LV Sep-RV Delay and LV-RV Delay were significantly different among the three groups ( LV Sep-RV Delay: Group A (57.60 ±56.77) ms, Group B (6.36 ±61.88) ms, Group C ( -41.89 ±35.78) ms; LV-RV Delay:Group A (47.36 ±42.59) ms, Group B ( 3.08 ± 38.81 ) ms Group C ( - 26.50 ± 20.99 ) ms, F = 20. 32,25.38, both P ＜ 0.01 ). Conclusion Both RVA and RVOT pacing increase the segmental phases detected by GBPS, causing inter- and intra- ventricular asynchrony compared with patients without pacemakers.

OBJECTIVE The present study was aimed to investigate the role of Wnt/β-catenin sig-naling in spinal VGLUT2 regulation and neuropathic pain. METHODS To elucidate the association be-tween VGLUT2 and neuropathic pain,we determined the expression and distribution characteristics of VGLUT2 in mice subjected to spared nerve injury(SNI),and then observed the effects of two VGLUT2 targeting shRNAs on mechanical allodynia and glutamate release.The effects of Wnt/β-catenin signal-ing on VGLUT2 expression and pain behavior were investigated by using Wnt agonist,Wnt1,and Wnt/β-catenin pathway inhibitor XAV939 in SNI mice.RESULTS SNI surgery induced significant up-regula-tion of VGLUT2 on postoperative days 7,14,and 21.Double immunofluorescence labeling of VGLUT2 with NeuN,MAP2,Iba-1,or GFAP showed that VGLUT2 was mainly expressed in neurons in the dor-sal horn of the spinal cord after SNI(NeuN,MAP2).Intrathecal administration of VGLUT2 shRNAs be-fore or after SNI surgery significantly decreased mechanical allodynia and glutamate release. Mean-while,Wnt1/β-catenin signaling increased significantly after SNI surgery.Over-expression of β-catenin in PC12 cells increased VGLUT2 protein level,intrathecal administration of Wnt agonist or Wnt1 signifi-cantly increased VGLUT2 protein expression in spinal cord, while Wnt/β-catenin pathway inhibitor XAV939 decreased VGLUT2 expression in PC12 cells and spinal cord.Additionally,intrathecal admin-istration of XAV939 7 days after SNI significantly attenuated mechanical allodynia in mice, which was in accordance with down-regulation of VGLUT2 protein levels.VGLUT2 shRNAs significantly attenuat-ed Wnt agonist or Wnt1 induced mechanical allodynia. CONCLUSION Wnt1/β-catenin signaling path-way up-regu-lates the spinal VGLUT2 expression,and this regulation is involved in neuropathic pain behavior.

OBJECTIVE: To seek a exact method of estimating postmortem interval (PMI). METHODS: This study detected the concentration of magnesium (Mg) and iron (Fe) in vitreous humor of rabbit at 96 h after death and explored the relationship between their concentration and PMI using a method ICP-MS. RESULTS: The concentra-tion of Mg in vitreous humor of rabbit at 48 h after death and Fe in vitreous humor of rabbit at 6-48 h after death were related to PMI significantly. The formulae of the relationship between PMI and Mg concentrations is y = 0.0738x2 + 0.6997x + 11.45 (within 48 h, R2 = 0.9119). The formulae of the relationship between PMI and Fe concentrations is y = 0.0411x2 - 0.3148x + 1.4113 (within 6-48 h, R2 = 0.9594). CONCLUSION The concentration of Mg in vitreous humor of rabbit at 48 h after death and Fe in vitreous humor of rabbit at 6-48 h after death may be as reference indicator to estimate PMI.
Animals ; Iron/analysis* ; Magnesium/analysis* ; Mass Spectrometry/methods* ; Postmortem Changes ; Rabbits ; Time Factors ; Vitreous Body/chemistry*

OBJECTIVE: To seek a precise method for estimating postmortem interval (PMI) in forensic medicine practice. METHODS: This study detected the concentration of 21 elements in the vitreous humor of rabbit within 96 hours after death and explored the relationship between their concentration and PMI using the method of ICP-MS. RESULT: It was shown that the concentration of 9 elements in vitreous humor of rabbit within different intervals after death were correlated to PMI available as a reference indicator to estimate PMI. CONCLUSION The changes in the concentration of certain elements in vitreous humor of vitreous humor are correlated with PMI and determination of such changes can be used to estimate the time of death.
Animals ; Calcium/analysis* ; Forensic Medicine ; Iron/analysis* ; Magnesium/analysis* ; Postmortem Changes ; Potassium/analysis* ; Rabbits ; Time Factors ; Vitreous Body/chemistry*

Objective To explore the potential neurotrophic effect of bone marrow-derived mesenchymal stem cells (BMSCs) on the proliferation and differentiation of ventral mesencephalic precursors (VMPs).Methods VMPs from E 11 inbred rat embryos and BMSCs from adult rats were cultured in 2 separate groups.Moreover,a co-cultured group was also established.Afterwards,the 3 different differentiation mediums obtained from these 3 defined groups were used to influence the differentiation procedures of normal VMPs that had amplification in vitro for 7 d.The growth of cells was observed;immunocytochemical staining was performed on these cells at the late differentiation phase.Relative yields of TH+ cells were calculated and compared.Results Seven d after the inducing differentiation,the total cell numbers multiplied about 44.13±4.75,60.63±5.25 and 64.00±7.63 folds in the VMP control group,the BMSCs group and the VMP+BMSCs co-cultured group,respectively,as compared with those before the differentiation.Correspondingly, the ratios of TH+ cells in the total cell population were (18.76±5.20)%, (23.49±4.10)% and (28.08±5.42)% in the VMP control group,the BMSCs group and the VMP+BMSCs co-cultured group,respectively; significant differences betwwen each 2 groups were found (P<0.05).Conclusion BMSCs can secret nutritional factors to promote the proliferation and committed differentiation of VMPs into dopaminergic neurons.

Objective To investigate the effect of rosuvastatin on myocardial reperfusion and the recent clinical efficacy of patients with ST-segment elevation myocardial infarction (STEMI)after primary percutaneous coronary intervention (PCI) with/without the chronic pre-treatment of statins.Methods A total of 170 STEMI patients after primary PCI were enrolled.According to the history with the pre-treatment of statins,the patients were divided into long-term intervention group (pre-treatment of statins more than 3 months,n =45) and no long-term treatment group (without pre-treatment of statins or with less than 3 months pre-treatment of statins,n =125) patients.The no long-term treatment group was then randomly divided into the high dose group(n =64) and conventional dose group(n =61).The patients in high dose group were orally given treated with rosuvastatin 20 mg orally before PCI,and treated with rosuvastatin 10 mg qn after PCI,while the patients in the other two groups were treated with 10 mg rosuvastatin orally before PCI,and given rosuvastatin 10 mg qn after PCI.The three groups were treated for 40 d.All patients were orally given aspirin 300 mg + clopidogrel 600 mg before PCI,and treated with aspirin 100 mg qd + clopidogrel 75 mg qd after PCI for at least 12 months.Myocardial reperfusion,left ventricular end-diastolic dimension (LVEDD),fractional shortening (FS) and Left ventricular ejection fraction (LVEF),major adverse cardiovascular events(MACEs) and adverse drug reactions were compared among the three groups.Results In the high dose group,long-term intervention group and the conventional dose group,the rates of TIMI 3 grade were 93.75％,95.56％ and 85.25％ respectively,while the rates of STR were 93.75％,95.56％ and 86.89％,and the incidence of reperfusion arrhythmia was 60.94％,57.78％ and 36.07％.Significant differences were found in all the parameters above among all groups (P ＜ 0.05).Forty days after PCI,in the three groups LVEDD were (52.80 ± 4.82),(51.88 ± 4.79) and (52.85 ± 4.72) mm,FS were (39.65 ± 2.89) ％,(40.05 ± 2.25) ％ and (34.05 ± 2.89) ％,and LVEF were (53.78 ± 6.92)％,(54.08 ± 6.22)％ and(47.05 ± 6.10)％,the differences were statistically significant (P ＜ 0.05) when compared with the parameters measured 7 days after PCI.MACEs in the group with pre-treatment of statins were recurrent angina pectoris(1 case),cardiogenic shock (3 cases),heart failure (1 case) and severe ventricular arrhythmia(2 cases),and the incidence of cardiovascular adverse event was 15.56％ (7/45 cases).In high-dose group,MACEs were recurrent angina (3 cases),cardiogenic shock (1 case),heart failure (4 cases),severe ventricular arrhythmia (3 cases),death (1 case);the incidence of cardiovascular adverse events was 18.75％ (12/64 cases),and statistically significant differences were found when compared with the conventional dose group (P ＜ 0.05).Conclusion Conventional dose pre-treatment of rosuvastatin was able to further alleviate the ischemic myocardial reperfusion and improve the recent clinical efficacy for STEMI patients with long-term pre-treatment of statins after primary PCI.

OBJECTIVETo evaluate the clinical application and discuss the operative indication of the reverse dorsal metacarpal flap and its compound flap on the skin defects of hand.

METHODSFrom 1990 to 2003, we applied the reverse dorsal metacarpal flap and its compound flap to repair soft tissue defects of fingers in 122 cases, which included 90 cases of the reverse metacarpal flap and 32 cases of its compound flaps with tendon grafts, nerve grafts or bone grafts. Based on the follow-up observations, we analyzed the indications of the reverse metacarpal flap and its compound flaps, the postoperative contours, flap colors and textures in comparison to contralateral fingers retrospectively.

RESULTSIn the series of 122 cases, flaps survived and the donor site defects were closed directly. The follow-up period ranged from 1-12 years. The postoperative contours, colors and textures of the flaps and its compound flaps were similar to those of normal fingers, although linear scar remained. According to standards of sense recovery (British Medical Research Council, BMRC), the sense function of the flaps resumed S3 after operation for 1 year. In 10 cases with the tendon defects treated by the flap with tendon grafts, function of flexion-extension of fingers resumed 50%-75% in comparison to the contralateral fingers using the method of measurement of total active motion. In 7 cases with the phalangeal nonunion or bone defects treated by the flap with bone grafts, union occurred after operation for 3 months.

CONCLUSIONSTo soft tissue defects on fingers with bone or tendon exposure, the reverse metacarpal flap and its compound flap are a better choice for repairing. The range of repairing is up to the distal interphalangeal joint of fingers. The second dorsal metacarpal artery is more consistent and larger as the choice of vascular pedicle, in comparison with other dorsal metacarpal arteries. Postoperative flap color and texture are similar to normal fingers.

Adolescent ; Adult ; Aged ; Child ; Female ; Finger Injuries ; surgery ; Graft Survival ; Humans ; Male ; Metacarpus ; surgery ; Middle Aged ; Retrospective Studies ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Treatment Outcome

OBJECTIVETo evaluate the efficiency of navigation system for orbital wall reconstruction in unilateral orbital fractures.

METHODSFifteen patients (7 male and 8 female) with unilateral orbital fracture underwent orbital reconstruction with the help of intraoperative navigation system. The average age was 34.3 ± 9.5 years. All patients underwent spiral CT scanning preoperatively, and the CT data was imported to the BrainLab navigation system (Germany, BrainLab company). The orbit of the intact side was mirrored to the opposite side as the reference for pre-operative planning. The titanium mesh was mounted on the resin template made by rapid prototyping machine based on the mirrored CT data. When the injury was limited, the hydroxyapatite sheet was used for the orbital wall reconstruction. During the operation, the real-time navigation helped to ensure precise placement. The re-establishing result was assessed based on the postoperative CT data with the following four variables: the volumetric difference between the bilateral orbit, the volume of the herniated soft tissue, the global projection and the discrepancy between the simulated and the achieved position of the reconstructed orbital wall. The reconstructive discrepancy was measured only in the titanium plate grafting cases.

RESULTSThere were no serious complications such as infection, graft rejection and optic nerve injury in any case. Preoperatively, the average degree of enophthalmos was (3.5 ± 1.6) mm, the average volumetric difference between the injured and the unaffected orbit was (4.5 ± 1.8) ml, and the average volume of the herniated orbital soft tissue was (2.1 ± 0.7) ml. Postoperatively, the three values were respectively reduced to (1.3 ± 0.6) mm, (1.8 ± 0.9) ml and (0.7 ± 0.3) ml. The discrepancy of the medial and inferior wall were (2.5 ± 0.6) mm and (2.1 ± 0.4) mm.

CONCLUSIONSThe intraoperative use of navigation system for the orbital wall reconstruction in unilateral orbital fractures can provide reliable accuracy and achieve satisfactory results.

Adult ; Computer Simulation ; Enophthalmos ; diagnostic imaging ; etiology ; surgery ; Female ; Humans ; Male ; Orbit ; diagnostic imaging ; surgery ; Orbital Fractures ; complications ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; Surgical Mesh ; Titanium ; Tomography, X-Ray Computed

To investigate the immunological and other clinical characteristics in TEL/AML1+ childhood B-acute lymphoblastic leukemia (B-ALL), immunophenotyping was performed with three-color flow cytometry, and the expression of TEL-AML1 fusion gene was detected with nested RT-PCR. Diagnosis was made according to FAB and MIC criteria. The results showed that (1) among 119 children with B-ALL, 22 (18.5%) were TEL-AML1 positive and classified as L2 morphological subtype. In TEL-AML1+ group, positive rate and score of PAS, which were 65% and 121 respectively, were all higher than that of TEL-AML1- group (P < 0.05); (2) compared with TEL-AML1- group, no significant difference was found in age, gender, white cell count and blasts count in peripheral blood of TEL-AML1+; (3) in TEL-AML1+ group, 21 out of 22 (95.5%) were common ALL, as compared with TEL-AML1- group, the positive rate of CD13 was higher (59.1%, 13/22) and the positive rate of CD20 was lower (22.7%, 5/22) than that in TEL-AML1- group, respectively (P < 0.05), and the mean fluorescence index of CD10 and HLA-DR significantly increased to 92.80 and 53.61, respectively (P < 0.05). It is concluded that TEL-AML1 rearrangement is a frequent molecular abnormality in childhood ALL. Leukemic blasts with this anomaly have special immunophenotypic characteristics. These characteristics may be useful in detection of minimal residual leukemia.
Antigens, CD20 ; analysis ; Burkitt Lymphoma ; genetics ; immunology ; CD13 Antigens ; analysis ; Child ; Child, Preschool ; Core Binding Factor Alpha 2 Subunit ; genetics ; Female ; HLA-DR Antigens ; analysis ; Humans ; Immunophenotyping ; Infant ; Male ; Oncogene Proteins, Fusion ; genetics

OBJECTIVETo study changes in the radiographic appearance during weight-bearing and non-weigh-bearing in hallux valgus, and to analyse the correlation between the elasticity of plantar soft tissue of hallux valgus and the pain under the metatarsal head.

METHODSFrom May 2012 to October 2012, 240 feet of 120 patients with hallux valgus were enrolled in the study. The degrees of the pian under the metatarsal head of all the patients were observed. AP and lateral X-ray films of feet were taken on the condition of weight-bearing and non-weight-bearing. So the hallux valgus angle (HVA), the inter-metatarsal angle between the first and second metatarsals (IM1-2), the inter-metatarsal angle between the first and fifth metatarsals (IM1-5), top angle of the medial longitudinal arch (TAOTMLA),and anterior angle of the medial longitudinal arch (AAOTMLA) were measured on the X-ray films. The differences of HVA, IM1-2, IM1-5, TAOTMLA and AAOTMLA between two groups were compared, and the correlation between the changes of IM1-2, IM 1-5, TAOTMLA, AAOTMLA and the degree of the pain under the metatarsal head were analysed.

RESULTSOne hundred and forty-eight feet had the pain under the metatarsal head. The IM1-2, IM1-5 and TAOTMLA increased on weight-bearing position compared with those on non-weight-bearing position, but the HVA and AAOTMLA decreased on weight-bearing position compared with those on non-weight-bearing position. There was a moderate relationship between the changes of IM 1-2,IM1-5 and the degree of the hallux valgus deformity, as well as the relationship between the different of IM1-5 and the degree of the pian under the metatarsal head.

CONCLUSIONThe degree of the collapse of the arch of foot with hallux valgus becomes serious with its deformity increasing. The pain under the metatarsal head of hallux valgus increases with the increased changes of IM 1-2,IM 1-5 and TAOTMLA. Analysis of the X-ray observation indexes of hallux valgus on weight-bearing position and non-weight-bearing position has important significance in evaluating the degree of the collapse of the arch of foot with hallux valgus,preventing and curing the the pain under the metatarsal head.

Adult ; Aged ; Female ; Hallux ; anatomy & histology ; diagnostic imaging ; physiopathology ; Hallux Valgus ; complications ; diagnostic imaging ; physiopathology ; Humans ; Metatarsalgia ; complications ; diagnostic imaging ; physiopathology ; Middle Aged ; Radiography ; Weight-Bearing ; Young Adult