Objective To study the effect of the cord blood stem cell transplantation therapy in patients with severe hepatitis. Methods Forty patients with severe hepatitis were randomly divided into control groups (n=20) and observed group (n=20). The patients in two groups were treated with the conventional liver protective therapy respectively, such as compound glycyrrhizin and glutathione. The patients in observed groups were performed with the cord blood stem cell trans-plantation therapy. After isolation and purification, the cells were transplanted into the liver via hepatic artery and then were transplanted via peripheral veins. The biochemical indices of albumin (ALB), prothrombin activity (PTA),alpha-fetoprotein (AFP)and clinical symptoms were detected at different times after therapy. Results After 4-week therapy, the levels of PTA (%)and AFP(μg/L)were significantly increased in observed group compared with those of control group (53.56 ± 5.15 vs 48.26±5.53,92.16±9.09 vs 43.57±11.33,P＜0.01). After 8-week therapy, the levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and AFP were significantly decreased in observed group than those of control group. The level of PTA was sig-nificantly higher in observed group than that of control group (62.61±4.35 vs 54.95±3.01,P＜0.05 or P＜0.01). There were no significant differences in levels of ALB and blood ammonia between two groups (P>0.05). There were no serious complications and adverse reactions in two groups of patients. There was no significant difference in mortality between two groups ( 20%vs 35%,χ2=0.818,P>0.05). Conclusion Cord blood stem cell therapy has a good effect on treating severe hepatitis, which is safe and no significant adverse reactions, and can be used as a new method for treating the severe hepatitis.

Objective To compare the difference between volume computed tomography dose index (CTDIvol) and size-specific dose estimates (SSDE) in evaluating the radiation dose of abdominal CT scan.Methods Abdominal CT scan were performed on 180 patients with a Philips 256-slices spiral CT.The anterior-posterior dimension (AP) and lateral dimension (LAT) of each patients were measured at the level of left renal vein, and the effective diameter (ED) and SSDE were calculated with recorded CTDIvol Patients were categorized into 3 groups depending on body mass index (BMI): group A, BMI ＜ 20.0 kg/m2;group B, 20.0-24.9 kg/m2;group C, BMI ＞ 24.9 kg/m2.The differences between CTDIvoland SSDE of 180 patients and three different BMI groups were compared respectively.Results There was a significant difference between CTDIvol and SSDE of the 180 patients (t =-13.354, P ＜ 0.01), CTDIvol and SSDE were (9.91 ± 2.91) and (14.01 ± 2.82) mGy, respectively.For group A, CTDIvol and SSDE were (7.96 ± 1.83) and (12.83 ± 2.52) mGy, respectively (t =-8.417, P ＜ 0.01).Group B, CTDIvol and SSDE were (9.28 ± 1.76) and (13.62 ±2.18) mGy, respectively (t =-15.051, P ＜ 0.01).Group C, CTDIvol and SSDE were (12.19 ± 3.65) and (15.39 ± 3.47) mGy, respectively (t =-4.535, P ＜ 0.01).In addition, the mean percentage values of difference between CTDIvol and SSDE for the three groups were 62.83％, 47.80％, 28.40％, respectively, which meant CTDIvol underestimated the radiation dose compared to SSDE.With the BMI increasing, the values of difference between CTDIvol and SSDE decreased.Conclusions SSDE can be used to estimate the radiation dose of abdominal CT scan for a given size person.

Objective To investigate the clinical application value of selective arterial embolization in the treatment of iatrogenic hemorrhage.Methods 32 cases with iatrogenic hemorrhage were retrospectively analyzed.The location and feature of bleeding were identified by selective percutaneous artery angioraphy,and then super-selective interventional embolization were performed.The embolic agents inclued gelfoam medical line,steel coils or polyvinyl alcohol (PVA)particles.Results In 32 patients,26 cases with active bleeding signs were found by angiography,they mainly presented contrast medium overflow,6 cases with pseudo-aneurysms,1 case with ar-teriovenous fistula.All patients underwent interventional embolization successfully.Only 1 case underwent twice procedure because of rehaemorrhagia on the 8 days after embolization.Follow-up for a month after arterial embolization,25 cases had no severe compli-cations,1 case died by multiple organ failure.In 6 negative cases,3 cases died by hemorrhagic shock,3 cases stopped hemorrhage after medical treatment.Conclusion Selective angiography is a safe and effective measure for the treatment of iatrogenic hemor-rhage.

BACKGROUND:It is still a research focus on constructing substitution of the human tissues and organs, or producing the alliance for grafting by engineering methods in tissue engineering. Among these researches, it is pivotal to choose appropriate materials. The prepared scaffolds should have suitable tensile strength and mechanical toughness to withstand the various outside forces without being damaged. So, it is very necessary to evaluate the biomechanical properties of candidated materials in tissue engineering, which can supply the references for selecting materials for tissue scaffolds and their designation.OBJECTIVE: To investigate the biomechanical properties of nine kinds of scaffold materials, in order to supply a biomechanical basis for the selection and design of scaffold materials for tissue engineering.DESIGN: A repetitive measurement study.SETTING: College of Bioengineering, Chongqing University.MATERIALS: The materials involved in this study were poly (DL-lactic-co - glycolic acid) (PLGA), sodium polymannuronate, gelatine, chitosan, collagen, acellular porcine dermis (APD), acellular vascular matrix (AVM),APD-PLGA, AVM-PLGA, modified gelatine and chitosan.METHODS: All the experiments related to this study were completed in the Biorheology laboratory of the College of Bioengineering, Chongqing University from April 2006 to March 2007. The nine materials above were prepared, gelatine and chitosan were modified. Stress-strain testing was performed at 10 mm per minute by a material testing machine (INSTRON 1011, USA). The Yang's modulus was calculated in the range of 0.005 to 0.02, the ultimate strain and stress were also obtained.MAIN OUTCOME MEASURES: The ultimate strain, ultimate stress and Yang's modulus of the nine materials were analyzed.polymannuronate ＞ AVM-PLGA ＞ collagen ＞ gelatine (P ＜ 0.05). The rate of burst straining of chitosan and PLGA were greater than those of other materials, 133% and 276% respectively (P ＜ 0.05). In addition, after being combined with ultimate stresses of APD and APD-PLGA were greater than that of other materials, i.e., their burst strengths were greater than those of other materials. The data also indicated that the burst strength of APD-PLGA was a little greater than that of APD (P ＞ 0.05). The burst strengths of gelatin, chitosan, and collagen were similar at the range of 7.67 to 9.51 MPa (P ＞ 0.05). The burst strengths of collagen and sodium polymannuronate were from 1.16 to 1.40 MPa, which were the least among all the materials. At the same time, being combined with PLGA, the burst strength of AVM-PLGA greatest, i.e., its rigidity was the greatest. The rigidity of APD was the least. After combined with PLGA, the rigidity of AVM and APD were increased (P ＜ 0.05), and corresponded with PLGA (P＞ 0.05). Except for gelatin, the order of rigidity in the materials was AVM-PLGA ＞ PLGA ＞ APD-PLGA ＞ AVM ＞ chitosan ＞ sodium polymannuronate ＞ collagen ＞ APD.CONCLUSION: AVM and APD have good biomechanical properties, which are very different from the water-soluble collagen. It is promising to improve the biomechanical properties of sodium polymannuronate, gelatin and chitosan by the complex of PLGA.

Objective To investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with CT-guided thermal ablation (radiofrequency ablation or microwave ablation) in treating intrahepatic cholangiocarcinoma.Methods The clinical data of 14 patients with pathologicallyproved intrahepatic cholangiocarcinoma,who were admitted to authors' hospital during the period from September 2009 to July 2013 to receive TACE with subsequent radiofrequency ablation (RFA) or microwave ablation (MWA),were retrospectively analyzed.A total of 18 lesions were detected in the 14 patients.The maximal diameter of the lesion (or the sum of maximal diameters if there were multiple lesions) ranged from 2.2 cm to 7.2 cm (mean 4.2±1.4 cm).After TACE,the lesion's complete ablation rate,surgical complications,tumor-free survival time and overall survival time were evaluated.Results Complete ablation was obtained in 15 lesions (83.3％,15/18).The incidence of moderate complications was 6.2％,and no severe complications or death occurred.After the treatment,the patients were followed up for 6-14 months,with a mean of (16.0±10.3) months.At the end of follow-up,6 patients (42.9％,6/14) died.The median tumor-free survival time in patients whose lesions obtained complete ablation was 17 months.The median survival time of all patients was 20 months.The 1-,2-and 3-year overall survival rates were 82.5％,41.3％ and 20.6％ respectively.Conclusion TACE combined with thermal ablation can be regarded as one of the treatment options for intrahepatic cholangiocarcinoma.

A new molecular method for simultaneously rapid detection and differentiation of Mycobacterium tuberculosis, Mycobacterium bovis, Mycobacterium avium and Mycobacterium paratuberculosis was established by using denaturing high-performance liquid chromatography (DHPLC) combined with multiplex nucleic acid amplification. These 4 important pathogenic mycobacteria were identified by separation of 4 specific PCR-amplified target fragments by DHPLC analysis. A total of 51 Mycobacterium strains and 22 other bacterial species were tested to confirm the specificity of the multiplex PCR-DHPLC assay. The sensitivity of the assay was as low as 10~2-10~3 gene copies. This method rapidly identify the positive clinical samples from human and bovine with higher detection ratio than traditional culture method and was able to identify simultaneously four pathogenic Mycobacterium, which provided a new molecular tool for rapid detection of tuberculosis and paratuberculosis in human and animals.

OBJECTIVETo explore the relationship between electrocardiographic (ECG) and genetic mutations of patients with hypertrophic cardiomyopathy (HCM), and early ECG changes in HCM patients.

METHODSClinical, 12-lead ECG and echocardiographic examination as well as genetic examinations were made in a three-generation Chinses HCM pedigree with 8 family members (4 males). The clinical characterization and ECG parameters were analyzed and their relationship with genotypes in the family was explored.

RESULTSFour missense mutations (MYH7-H1717Q, MYLK2-K324E, KCNQ1-R190W, TMEM70-I147T) were detected in this pedigree. The proband carried all 4 mutations and 5 members carried 2 mutations. Corrected QTc interval of KCNQ1-H1717Q carriers was significantly prolonged and was consistent with the ECG characterization of long QT syndrome. MYLK2-K324E and KCNQ1-R190W carriers presented with Q wave and(or) depressed ST segment, as well as flatted or reversed T waves in leads from anterolateral and inferior ventricular walls. ECG results showed ST segment depression, flat and inverted T wave in the gene mutation carriers with normal echocardiographic examination results. ECG and echocardiographic results were normal in TMEM70-I147T mutation carrier.

CONCLUSIONSThe combined mutations of the genes associated with cardiac ion channels and HCM are linked with the ECG phenotype changes in this HCM pedigree. The variations in ECG parameters due to the genetic mutation appear earlier than the echocardiography and clinical manifestations. Variation in ECG may become one of the indexes for early diagnostic screening and disease progression of the HCM gene mutation carriers.

Brugada Syndrome ; Cardiac Conduction System Disease ; Cardiac Myosins ; Cardiomyopathy, Hypertrophic ; Echocardiography ; Electrocardiography ; Exons ; Genetic Testing ; Genotype ; Humans ; KCNQ1 Potassium Channel ; Long QT Syndrome ; Mutation ; Mutation, Missense ; Myosin Heavy Chains ; Myosin-Light-Chain Kinase ; Pedigree ; Phenotype

Objective To evaluate the efficacy and safety of transcatheter hepatic arterial chemoembolization (TACE) combined with CT guided radiofrequency ablation (RFA) for primary liver cancer in the caudate lobe.Methods Sixteen patients with primary liver cancer in the caudate lobe were treated with combination therapy of TACE and RFA.Complet ablation rate,overall and recurrence-free survival,and complications were evaluated.Results A total of 15 cases achieved complet ablation,complet ablation rate was 93.75％ (15/16).Recurrence-free survival time was 19.35 months,overall survival time was 44.62 months.Overall survival rates were 88.23％,66.65％ and 33.18％ at 1,3,5 years after therapy,respectively.Conclusion TACE combined with RFA is a safe and useful therapeutic option for treatment of primary liver cancer in the caudate lobe.

OBJECTIVETo explore the genotype-phenotype correlation of a MYH7-D554Y mutation identified in an ethnic Han Chinese pedigree affected with hypertrophic cardiomyopathy.

METHODSNinety six cardiovascular disease-related genes were detected in the proband by exonic amplification and high-throughput sequencing. Suspected mutations were verified by Sanger sequencing among 300 healthy controls as well as family members of the proband. The pathogenicity and conservation of the detected mutations were analyzed with ClustalX, MutationTaster, PolyPhen-2, Provean and SIFT software.

RESULTSFour of the 5 first-degree relatives of the proband were diagnosed with hypertrophic cardiomyopathy. The proband has featured extremely hypertrophic left ventricular wall with a maximal thickness of 35 mm. Genetic testing showed that four of them have carried a heterozygous c.1660G>T (p.Asp554Tyr) mutation of the MYH7 gene, who the remaining one was phenotypically normal and did not carry the mutation. The mutation has not been recorded by the Human Gene Mutation Database (HGMD) and other databases. Bioinformatics analysis suggested that the mutation site is highly conserved and that the mutation is pathogenic.

CONCLUSIONThe p.Asp554Tyr mutation of the MYH7 gene probably underlies the hypertrophic cardiomyopathy in this pedigree.

Objective To evaluate the characteristics of left ventricular structure ,function ,myocardial mechanics ,hemodynamics and synchrony in different phenotypes of hypertrophic cardiomyopathy ( HCM ) using state‐of‐the‐art echocardiography . Methods A consecutive series of 85 adult HCM patients w ho were admitted to the Xi Jing HCM center from January 2016 to November 2017 were collected . According to the peak left ventricular outflow tract pressure gradient in exercise stress echocardiography ,the patients were divided into three groups :patients with non‐obstructive HCM ( n ＝28) ,those with labile‐obstructive HCM ( n ＝27) ,and those with obstructive HCM ( n ＝ 30 ) . In addition ,16 normal family members of HCM patients were included as control group . T wo‐dimensional speckle tracking imaging ,tissue Doppler imaging and exercise stress echocardiography were used to evaluate the left ventricular function in resting and exercise states . Results ① As compared with the control group ,left ventricular end‐diastolic diameter decreased and left ventricular ejection fraction increased in all three HCM groups ( all P ＜ 0 .05 ) . Left ventricular maximum wall thickness and left ventricular mass index were the highest in obstructive HCM , followed by labile‐obstructive and non‐obstructive HCM ,and the lowest in the control group ( all P ＜0 .05) . ②A t rest ,the left ventricular global longitudinal ,circumferential and radial strain ( GLS ,GCS and GRS) ,as well as the twist of obstructive HCM were significantly lower than the other three groups ( all P ＜0 .05) . As compared with the control group ,the GLS and twist decreased in the labile‐obstructive and non‐obstructive HCM ( all P ＜0 .05 ) ,but there were no significant changes of GCS and GRS ( all P ＞ 0 .05 ) . T he obstructive HCM had the lowest mitral annular plane systolic excursion ( M APSE ) and s′,and the longest systolic peaking time standard deviation( T s‐SD) and early diastolic peaking time standard deviation ( Te‐SD) ( all P ＜0 .05) . T he left ventricular diastolic function of obstructive HCM ( e′,the E/e′ratio and the left atrial volume index ) was the worst ,labile‐obstruction and non‐obstructive HCM were better ,and the control group was the best ( all P ＜ 0 .001 ) . ③ During exercise ,the GLS ,GCS ,GRS ,twist of the left ventricle and the M APSE were the lowest in the obstructive HCM ,which increased in the labile‐obstructive and non‐obstructive HCM ,and were best in the control group . T he T s‐SD and Te‐SD were the shortest in the control group ,were prolonged in non‐obstructive and labile‐obstruction HCM ,and were longest in obstructive HCM ( all P ＜ 0 .05 ) . Additionally ,the exercise time of the control group was the longest , followed by non‐obstructive and labile‐obstruction HCM ,and the shortest in the obstructive HCM ( all P ＜0 .05) . T he M ET s of obstructive HCM were significantly lower than the other three groups ( all P ＜0 .05) . Conclusions In obstructive HCM ,the left ventricular systolic strain and synchronization ,as well as the M APSE ,are significantly impaired in patients both at rest and during exercise . T he patients with labile‐obstructive and non‐obstructive HCM have reduced left ventricular GLS , twist ,and e′,but normal left ventricular GCS ,GRS ,synchrony ,and M APSE at rest ,which are all impaired during exercise .