Objective To evaluate the left ventricular diastolic function of patients with normal left ventricular ejection fraction ( LVEF) by echocardiography and real‐time cardiac catheter measurement ,and improve the accuracy and reliability of echocardiographic diagnosis . Methods One hundred and twenty patients with know n or suspected coronary artery disease w ho underwent coronary angiography and left ventricular catheterization were prospectively selected from July 2017 to January 2018 in the Affiliated Hospital of Jiangsu University . According to the left ventricular end diastolic pressure ( LVEDP) real‐time measurement ,the patients were divided into groups of LVEDP ≤15 mm Hg ( 43 cases ) and LVEDP ＞ 15 mm Hg ( 77 cases) . General data were compared and the difference of echocardiographic parameters between the two groups were analyzed ,and the ROC curve of each echocardiographic parameter for diagnosing LVEDP was draw n . Results T he parameters including flow propagation velocity ( VP) ,the ratio of filling fraction of E and A ( E/A) ,early diastolic filling deceleration time ( DT ) ,the duration of mitral A ( A‐dur ,) mitral annulus velocity at the septal side ( e′sep) ,systolic pulmonary venous flow velocity ( PVs) ,diastolic pulmonary venous flow velocity ( PVd ) and PVs/PVd were used to the diagnosis of the increasing of LVEDP ,however their accuracies were low ( AUC between 0 .5～0 .7) . T he parameters including left atrial volume index ( LAVI ) , tricuspid regurgitation ( T Rmax ) ,mitral annulus velocity in lateral wall of left ventricle ( e′lat ) ,average e′,E/e′sep ,E/e′lat ,average E/e′,velocity of pulmonary vein atrial reversal ( PVa) ,pulmonary vein atrial reversal duration ( Pva‐dur) ,the difference between the duration of pulmonary venous A wave and mitral A wave( PvaD‐AD) were also used to the diagnosis of the increasing of LVEDP , but their accuracies were still poor ( AUC between 0 .7～0 .9 ) . According to the real‐time left ventricular pressure measurement and different parameters of echocardiography ,the multivariate regression equation :LVEDP＝ 0 .292 LAVI + 0 .35 PVa + 0 .04 T Rmax + 0 .075 ( PvaD‐AD ) －0 .109 PVs －6 .773 was put forward as a correction standard ,the accuracy of the diagnosis of LVEDP was significantly improved ( AUC ＝0 .922) . Conclusions T he assessment of left ventricular diastolic function needs to be performed comprehensively with multiple parameters . T he multiple regression equation can accurately evaluate left ventricular diastolic function in patients with normal LVEF .

Head and Neck Neoplasms ; surgery ; Humans ; Imaging, Three-Dimensional ; Reconstructive Surgical Procedures

Adenocarcinoma ; Carcinoma, Papillary ; Estrogens ; metabolism ; Humans ; Receptors, Estrogen ; metabolism ; Thyroid Neoplasms ; metabolism

Pleomorphic adenoma ranks first among parotid gland tumors. Surgical procedure, which includes enucleation, ex-tra-capsular resection, partial superficial parotidectomy (PSP), superficial parotidectomy (SP), and total parotidectomy (TP), remains to be the treatment of choice for pleomorphic adenoma. In the last century, physicians lacked understanding on the pathological character-istics of pleomorphic adenoma and facial neurotomia. Thus, simple enucleation of tumors has always been the major therapy for pa-tients to reduce the rate of facial nerve injury. However, postoperative recurrence was frequently observed in patients that have under-gone simple enucleation. In this study, the surgeons attempted to control the relapse rate by enlarging the scope of excision when remov-ing a pleomorphic adenoma, and by performing an extra-capsular resection procedure that was developed in the clinic. Although the tu-mor peplos was excised, the surgeons failed to control the relapse rate. SP and TP apparently decreased the relapse rate of the pleomor-phic adenomas. However, these therapies seem to be overcorrected by the aggravation of facial nerve injuries. PSP is a relatively ad-vanced technique that is currently used in parotid surgery. PSP reduces the rate of relapse and facial nerve injury, as verified by basic pa-thology research. Nevertheless, the controversy between advanced PSP and classic SP still exists. Plastic surgery, pathology research, and gene testing were used to evaluate the advantages of advanced PSP and classic SP. However, the research failed to derive a con-firmed result that can determine which treatment method is fit and unfit to treat pleomorphic adenoma. Our study reviews the trend of parotid surgery from a historic point of view.

Objective:Facial nerves can be dissected using anterograde and retrograde approaches. The optimal technique for the facial nerve dissection of a patient with benign parotid tumor has not yet been determined. This study focused on facial nerve dysfunc-tion and recovery rate after anterograde and retrograde facial-nerve dissections. Methods:The data of 110 patients with benign carotid adenoma from the Head and Neck Department of this hospital who were hospitalized between January 2011 and January 2013 were col-lected. These patients were divided into groups A (n=52) and B (n=58). Anterograde and retrograde dissections of the facial nerve were performed on group A and group B patients, respectively. Based on the preferential order of dissection, group B was divided into groups B1, B2, and B3 representing the zygomatic, buccal, and marginal mandibular branches, respectively. The patients were postoperatively observed to check for potential symptoms, such as facial paralysis along with its severity and recovery. The House-Brackmann grading system was used to assess all patients. Results:The operation could be successful, with better nerve exposure, using these approaches. Statistical differences were observed in the nerve injury and recovery rates between the groups, with group A better than group B, and group B2 better than the other two groups (P<0.05). Conclusion:Anterograde facial nerve dissection should be routinely used in be-nign parotid tumor, and the buccal branch of facial nerve dissection should be preferentially considered when no other option apart from retrograde dissection is available.

Objective To observe the effects of Yishen Tongluo Decoction (YTD) on the renal mRNA expression of transforming growth factor-β1 ( TGF-β1) and collagen Ⅳ ( ColⅣ) in membranous nephropathy ( MN) rats. Methods SD rats were randomly divided into normal group, model group, benazepril group (in the dosage of 10 mg·kg-1·d-1) , YTD group ( in the dosage of 20 g·kg-1·d-1) . The rats in various groups were given intragastric administration of corresponding agents. At the end of the fourth week, 24-hour urinary protein quantity, albumin ( ALB) , total protein ( TP) , triglyceride ( TG) , total cholesterol ( TC) , blood urea nitrogen ( BUN) , and creatinine (Cr) levels were observed. The mRNA expression levels of TGF-β1 and ColⅣ in renal tissue of rats were detected by immunofluorescence method, electron microscopy and real-time polymerase chain reaction (PCR) method. Results In the model group, urinary protein quantity in rats was increased, serum levels of TP and ALB were significantly lowered, serum levels of TC and TG were significantly increased, renal pathological changes were present, and mRNA expression levels of TGF-β1 and ColIV in renal tissue were up-regulated (P<0.05 compared with normal group). Compared with the model group, 24-hour urinary protein quantity, TC and TG levels were significantly lowered, TP and ALB levels were significantly increased, rat renal injury was relieved, mRNA expression levels of TGF-β1 and ColIV in renal tissue were down-regulated in the treatment groups ( P<0.05) . However, the differences between benazepril group and YTD group were insignificant ( P>0.05) . Conclusion The therapeutic mechanism of YTD for MN is probably related with the inhibition of mRNA expression of TGF-β1 and ColⅣin renal tissue.

Objective To compare the differences in recurrence rates and surgical complications between thyroidectomy alone and thyroidectomy combined with central neck dissection as initial treatments to differentiated thyroid cancer and evaluate the clinic significance of central neck dissection for these patients.Methods The literatures published in 1998-2013 were searched in Wanfang database,Chongqing VIP database,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,Pubmed,Medline and Beijing Kangjian foreign medical journal full text service.According to the inclusion and deletion criteria,30 articles were included.Of them 26 articles involved in complications,hypocalcemia and recurrent laryngeal nerve palsy as two major complications were involved in 26 articles and 24 articles respectively,and 26 articles involved in recurrence rate.RevMan5.0 software package was used to perform meta-analysis.Results Total complication rate in experimental group (plus central neck dissection) was 13.08％ higher than that in control group (thyroidectomy only),the odds ratio (OR) [95％ confidence interval (95％ CI)] was 2.32 [2.02,2.67],Z value was 11.80,P ＜ 0.01.Hypocalcemia in the experimental group was 11.80％ higher than that in control group,OR value [95％ CI] was 2.58[2.21,3.02],Z was 11.98,P ＜ 0.01.The rates of recurrent laryngeal nerve paralysis were low in both experimental group (5.26％) and control group(3.95％),and OR value [95％ CI] was 1.22 [0.94,1.58],Z was 1.48,P =0.14.Recurrence rate in experimental group was 2.23％ lower than that in control group,OR value [95％CI] was 0.78 [0.63,0.97],Zwas 2.35,P=0.03.Conclusion Central compartment dissection as initial treatment to differentiated thyroid cancer may reduce the risk of recurrence,but increases the incidence of total complications and hypocalcemia,and has no significant effect on the rate of the recurrent laryngeal nerve paralysis.

The exact scales of volume and density of human internal organs were measured synchronously with the intelligentized volum-densimeter, which was made. by ourself. These primary values of normal and diffuse pathologic changes can refer easily and used for the diagnosis in human autopsy of pathology and forensic pathology. It is expectated to be co-operated widely in that the basic values of volume and density will be obtained from all organs of the human body with the population of different races. But up to now, we are still lack these primary values in anthropology and medicine.
Anthropometry ; instrumentation ; methods ; Brain ; anatomy & histology ; Forensic Medicine ; Heart ; anatomy & histology ; Humans ; Organ Size

Objective: To investigate the effects of oxLDL and HMG-CoA reductase inhibitor simvastatin on PKC activity, and level of cytosol ic free Ca 2+ in cultured human umbilical vein endothelial cells. Methods: Th e activity of PKC was determined by its ability to transfer phosphate from 32P-ATP to lysine-rich histone and level of cytosolic free calcium［Ca2+ ］i was measured by flow cytometric analysis loading with the Ca2+ dye F luo-3/Am. Results: oxLDL increased PKC total activity in a dose-de pendent manner and peaked after 12 min, then decreased slowly and maintained for at least 30 min, while oxLDL induced biphasic ［Ca2+］i responses includ ing the rapid initial transient phase and the sustained phase. Removal of extrac ellular Ca2+ did not inhibit the rapid transient phase, but abolished the sustained phase. When simvastatin was added, the activity of PKC wasmarkedly dec reased with no impairment to the initial peak response, but significantly reduce d the sustained phase. Conclusion: oxLDL can induced dynamic changes of signal transduction of PKC and level of cytosolic free Ca2+ in HUVEC, these 2 events are closely linked. The change of rapid initial transient phase i s the result of mobilization of Ca2+ from intracellular pool and the chang e of sustained phase is from the influx of extracellular Ca2+. The inhibit ion of PKC activity induced by simvastatin may contribute to the changes of ［Ca 2+］i.

AIM　To investigate the effect of OX-LDL and HMG- CoA reductase inhibitors simvastatin on PKC activity and cytosolic free Ca2+ in cultured human monocy tes. METHOD　The activity of PKC was determined by its ability to tr ansfer phosphate from ［32P］ATP to lysine-rich histone and cytosolic free calcium［Ca2+］i was measured by flow cytometric analysis loading with the Ca2+ dye fluo3/Am. RESULTS　OX-LDL increased PKC tot al activity in a dose-dependent manner with phase peaking at 12 min, then decre ased slowly and maintained for at least 20 min, while OX-LDL induced biphasic ［Ca2+］i responses including the rapid initial transient phase and the sustained phase. Removal of extracellular Ca2+ did not inhibit the rapid i nitial transient phase of OX-LDL-induced rise in ［Ca2+］i,but abolish ed the sustained phase of ［Ca2+］i response to OX-LDL. When simvastati n was added, the activity of PKC was markedly decreased and simvastatin did not impair the initial peak response to OX-LDL but significantly reduced the subseq uent plateau phase. CONCLUSION OX-LDL can significantly activate t he activity of PKC and elevate ［Ca2+］i in monocytes. The rapid initial transient phase was the result of mobilization of ［Ca2+］i from intrac ellular pool and sustained phase resulted from the influx of extracellular Ca 2+. The inhibition of PKC activity induced by simvastatin may be contribute to the changes of intracellular Ca2+.