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Volume 0 ， Issue 3 ， 2006
- Abstract：Objective To evaluate the feasibility and accuracy of measurement of myocardial perfusion defects with intravenous contrast-enhanced real-time three-dimensional echocardiography （CE-RT3DE）. Methods RT3DE was performed in 21 open-chest mongrel dogs undergoing acute ligation of the left anterior descending artery （LAD, n=14） or distal branch of the left circumflex artery （LCX, n=7）. A perfluorocarbon microbubble contrast agent was injected intravenously to assess the resulting myocardial perfusion defects with Philips Sonos-7500 ultrasound system. Evans blue dye was injected into the occluded coronary artery for subsequent anatomic identification of underperfused myocardium. In vitro anatomic measurement of myocardial mass after removal of the animal’s heart was regarded as the control. Blinded off-line calculation of left ventricular mass and perfusion defect mass from RT3DE images were performed using an interactive aided-manual tracing technique.Results Total left ventricular （LV） myocardial mass ranged from 38.9 to 78.5 （mean±SD: 60.0±10.1） g. The mass of perfusion defect ranged from 0 to 21.4 （mean±SD: 12.0±5.0） g or 0 to 27% of total LV mass （mean±SD: 19%±6%）. The RT3DE estimation of total LV mass （mean±SD: 59.8±9.9 g） strongly correlated with the anatomic measurement （r=0.98; y=2.01+0.96x）. The CE-RT3DE calculation of the mass of underperfused myocardium （mean±SD: 12.3±5.3 g） also strongly correlated with the anatomic measurement （r=0.96; y=-0.10+1.04x） and when expressed as percentage of total LV mass （r=0.95; y=-0.20+1.04x）. Conclusions RT3DE with myocardial contrast opacification could accurately estimate underperfused myocardial mass in dogs of acute coronary occlusion and would play an important role in quantitative assessment of myocardial perfusion defects in patients with coronary artery disease.Keywords：real-time three-dimensional echocardiography;contrast;perfusion defects;myocardial infarction4|16|5Updated：2024-04-10
- Abstract：Objective To investigate the distribution and clinical manifestations of intracranial arterial occlusive lesions （IAOLs）, and their correlation with thyroid function.Methods We enrolled 7 patients who had Graves’ disease （GD） with IAOLs screened and evidenced by transcranial Doppler, then further confirmed with digital substract angiography in 2 patients and magnetic resonance angiography in 5 patients. Brain magnetic resonance imaging （MRI） was performed in all 7 patients. Three patients were followed up. Results Among 7 patients, 1 was male and 6 were females. The mean age was 32.0±5.5 （range from 11 to 49） years old. Six of them had symptoms of GD but one was asymptomatic with abnormality of T3, T4, and thyroid stimulating hormone. The lesions of intracranial arteries were symmetrical bilaterally in the internal carotid artery system in 6 patients, as well as asymmetrical in 1 patient. Terminal internal carotid artery （TICA） were involved in all 7 patients. Middle cerebral artery （MCA） were involved in 3, anterior cerebral artery in 2, and basilar artery in 1 patient. Net-like collateral vessels and mimic moyamoya disease were observed in the vicinity of the occlusive arteries in 2 patients. All patients presented symptoms of ischemic stroke including transient ischemic attack and/or infarction while IAOLs were found. Three patients had obvious involuntary movements. Brain MRI revealed infarctions located in the cortex, basal ganglion, or hemiovular center in 5 patients. The remaining 2 patients had normal brain MRI. The neurological symptoms were improved concomitant with relief of the thyroid function in 2 patients, while IAOLs were aggravated with deterioration of the thyroid function in 1 patient.Conclusion IAOLs in patients with GD mainly involve intracranial arteries, especially the TICA and MCA, which is similar to moyamoya disease. The neurological symptoms and severity of involved arteries may relieve while the hyperthyroidism is gradually under control.Keywords：Graves’ disease;transcranial Doppler;intracranial arterial stenosis;occlusive disease4|46|16Updated：2024-04-10
- Abstract：Objective To investigate the optimal dosage of pirfenidone for the treatment of pulmonary fibrosis induced by bleomycin in Wistar rats, and the alteration of expressions of transforming growth factor beta-1 （TGF-β 1）, tissue inhibitor of metalloproteinase-1 （TIMP-1）, and matrix metalloproteinase-13 （MMP-13） in lung tissue. Methods Male Wistar rats were endotracheally instilled with bleomycin or normal saline. Pirfenidone （25-[KG*8]800 mg·kg -1·d -1）, dexamethasone （3 mg/kg）, or 1% carboxymethylcellulose sodium were given daily by feed 2 days before instillation of bleomycin. Groups T7 and T14 were fed pirfenidone 50 mg·kg -1·d -1 at 7 days or 14 days after bleomycin instillation. Lungs were harvested at 28 days after bleomycin instillation. Patholological changes in lung tissues were evaluated with HE staining. Lung collagen was stained by sirius red and measured by content of hydroxyproline. Expression of proteins of TGF-β 1, TIMP-1, and MMP-13 were detected by Western blotting. Results At doses of 25, 50, and 100 mg·kg -1·d -1, pirfenidone had significant anti-fibrotic effects for bleomycin-induced rat pulmonary fibrosis, and these effects were most significantly attenuated at the dosage of 50 mg·kg -1·d -1 （HE: P<0.01, P<0.01, and P=0.064; sirius red: P<0.05, P<0.01, and P<0.05; hydroxyproline: P=0.595, P<0.01, and P=0.976）. Pirfenidone at a dosage of[KG*3]50 mg·kg -1·d -1 inhibited protein expression of TGF-β 1 and TIMP-1 in lung tissue in the early phase （0.79 and 0.75 times of control group）, but had no effect on expression of MMP-13. Conclusion Low dose pirfenidone, especially at dosage of 50 mg·kg -1·d -1, has significant anti-fibrotic effects on bleomycin-induced rat pulmonary fibrosis. Pirfenidone partially inhibits the enhancement of the expression of TGF-β 1 and TIMP-1 in lung tissue.Keywords：pulmonary fibrosis;bleomycin;pirfenidone;transforming growth factor beta-1;tissue inhibitor of metalloproteinase-14|60|39Updated：2024-04-10
- Abstract：Objective To investigate the role of CXC chemokine receptor 3 （CXCR3） in bleomycin-induced lung injury by using CXCR3 gene deficient mice. Methods Sex-, age-, and weight-matched C57BL/6 CXCR3 gene knockout mice and C57BL/6 wide type mice were challenged by injection of bleomycin via trachea. Lung tissue was stained with HE method. Airway resistance was measured. Bronchoalveolar lavage （BAL） was performed using phosphate buffered saline twice, cell number and differentials were counted by Diff-Quick staining. Interleukin（IL）-4, IL-5, IL-12p40, and interfon-γ in BAL fluid and lung homogenate were measured by enzyme-linked immunosorbent assay. Unpaired t test was explored to compare the difference between two groups. Results On day 7 after bleomycin injection via trachea, CXCR3 knockout mice were protected from bleomycin-induced lung injury as evidenced by fewer accumulation of inflammatory cells in the airway and lung interstitium compared with their wild type littermates （P<0.05）. Airway resistance was also lower in CXCR3 knockout mice compared with wild type mice （P<0.01）. Significantly lower level of inflammatory cytokines release, including the altered production of IL-4 and IL-5 both in BAL fluid and lung tissue was seen in CXCR3 knockout mice than in wild type mice （both P<0.05）.Conclusion CXCR3 signaling promotes inflammatory cells recruiting and initiates inflammatory cytokines cascade following endotracheal bleomycin administration, indicating that CXCR3 might be a therapeutic target for pulmonary injury.Keywords：chemokine receptor;bleomycin;lung injury;inflammation4|12|0Updated：2024-04-10
- Abstract：Objective To evaluate the efficacy of “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with mitomycin C （MMC） on reducing intraocular pressure （IOP）, complications, and corneal astigmatism in patients with primary angle-closure glaucoma （PACG）. Methods Totally 217 acute or chronic PACG patients with occludable angle above 180° and IOP above 21mmHg were divided into 3 groups. Patients in group A （98 cases, 128 eyes）, B （71 cases, 95 eyes）, and C （48 cases, 60 eyes） were treated with “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and surgically induced astigmatism （SIA） were evaluated preoperatively and up to 12 months postoperatively. [JP+2]Results IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups （all P<0.001）. Success rates （IOP≤20 mmHg） in group A, B, and C were 87.91%, 89.23%, and 83.72% respectively at 12 months after treatment （P=0.256）. The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C （P<0.05）. There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A （1.71±1.47D） was higher than that before operation （1.28±1.05D,P=0.126）. With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C （1.99±1.20D and 2.22±1.39D） were significantly higher than those before operation （1.20±0.85D and 1.18±0.93D,P=0.002, P=0.001）, respectively. With 12 months gone, the mean astigmatisms in group B and C （1.87±0.91D and 1.90±1.16D） were still significantly higher than those before operation （ P=0.001, P=0.003）. The highest astigmatic polar values in group A, B, and C （1.00D, 1.89D, and 1.77D） occurred after 2 weeks, 1 month, and 1 month postoperation, respectively, which were significantly higher than those before operation （0.19±1.32D, 0.12±1.22D, and 0.17±1.25D,P<0.01）, respectively. With 12 months gone, they were 0.03D, -0.18D, and -0.13D higher than those before operation, respectively. The rates of function bleb and thin-wall bleb were 71.43% and 26.37% in group A, 75.38% and 29.23% in group B, 72.09% and 25.58% in group C, respectively at 12 months after treatment. There were no significant differences among the 3 groups.Keywords：angle-closure glaucoma;trabeculectomy;incision;postoperative complications;surgically induced astigmatism4|5|1Updated：2024-04-10
- Abstract：Objective To evaluate the effect of midazolam alone on sedation in young children for dental restorative care. Methods Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0.5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment. All patients received painless local anesthetic injection and were restrained with children’s board and bands. Blood pressure （BP）, heart rate （HR）, oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Buttner scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child.Results HR in intervention group （82.5±5.1 bpm） was much lower than that in control group （95.2±8.9 bpm; F=31.20, P<0.001）. Intervention group had a significantly lower systolic BP level （94.8±5.6mmHg） than control group （98.5±5.5mmHg; F=4.34, P=0.04）, but the diastolic BP （63.0±3.5mmHg） was not significantly lower than control group （65.5±4.8mmHg; F=3.31, P=0.07）. Children in intervention group showed more compliance. The patients’ scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group （1.37±0.96, 1.37±0.83, 1.32±0.67, and 2.32±1.49, respectively） were significantly lower than those in control group （3.71±1.23, 2.71±0.96, 2.71±0.90, and 4.71±1.19; F=44.66, 22.36, 30.39, and 31.88, respectively, all P<0.001）. Conclusions Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.Keywords：midazolam;oral administration;dental anxiety;dental restoration4|24|0Updated：2024-04-10
- Abstract：Objective To investigate the correlation between plasma fibrinogen level and cerebral infarction （CI） as well as the difference of fibrinogen among subtypes of CI. Methods A case-controlled study was conducted with 131 cases of CI and 148 controls. Plasma fibrinogen levels were detected by the Clauss method. Results High fibrinogen level （3.09±0.94 g/L） was correlated with CI （OR=2.47, 95%CI: 1.51-4.04, P<0.005） at the onset stage of the disease. Persistent high fibrinogen level （3.14±0.81 g/L） at 6-month after stroke onset was detected and correlated with CI（OR=4.34,95% CI:1.80-10.51, P=0.001）. Higher fibrinogen level was correlated with total anterior circulation infarction （TACI）, partial anterior circulation infarction （PACI）, and posterior circulation infarction （POCI） （OR=4.008, P<0.001）. Higher fibrinogen level was correlated with extracranial atherosclerosis （OR=3.220, P<0.05）, but not with intracranial atherosclerosis.Conclusion Fibrinogen level may be a risk factor of CI and probably correlates with subtypes of CI and distributions of atherosclerosis.Keywords：cerebral infarction;fibrinogen4|16|3Updated：2024-04-10
- Abstract：Objective To study the incidence of leukocytosis and retinoic acid （RA） syndrome in newly diagnosed and relapsed acute promyelocytic leukemia （APL） patients treated with arsenic trioxide （ATO）. Methods Thirty patients with newly diagnosed or relapsed APL received ATO for remission induction at the dose of 10 mg/d. RA syndrome was defined when patient was with one or more of the following signs or symptoms: fever, dyspnea, serous cavity effusion, muscular pain, pulmonary infiltration, weight gain, or pulmonary infiltration on chest X-ray.Results Twenty-three （77%） patients achieved complete remission, mean time to remission was 37.1 days. Leukocytosis was observed in 14 （47%） patients, mean time to leukocytosis was 12.7 days, median baseline leukocyte count for patients with leukocytosis was 3.1×10 9/L, which was higher than that for patients who did not develop leukocytosis （2.6×10 9/L, z=-2.635, P=0.008）. No other cytotoxic therapy was administered, and the leukocytosis resolved in all cases. The RA syndrome was observed in 9 （30%） patients, mean time to diagnose of RA syndrome was 13.9 days, median baseline leukocyte count for patients with RA syndrome was 3.6×10 9/L, which was higher than that for patients who did not develop RA syndrome （2.6×10 9/L, z=-1.909, P=0.046）. No patient died of RA syndrome. Conclusion Leukocytosis and RA syndrome are associated with ATO and baseline leukocyte count respectively, and there is distinct link between leukocytosis and RA syndrome.Keywords：arsenic trioxide;acute promyelocytic leukemia;leukocytosis;retinoic acid syndrome4|11|4Updated：2024-04-10
- Abstract：Objective To explore the role of serum fibrotic indices including hyaluronic acid （HA）, procollagen type III NH 2-terminal peptide （PCIIIP）, and laminin （LN） in assessing the severity of myocardial fibrosis in chronic congestive heart failure （CHF）.Methods Serum levels of HA, PCIIIP, and LN in 39 patients with CHF[14 with New York Heart Association （NYHA） functional class II, 21 with class III, 4 with class IV]and in 46 patients with NYHA functional class I were assessed by radioimmunoassay.Results The serum concentrations of HA, PCIIIP, and LN were 359.75±84.59 μg/L, 77.88±24.67 μg/L, 86.73±23.90 μg/L in CHF group, and 211.60±54.80 μg/L, 64.82±23.99 μg/L, 82.26±23.98 μg/L in NYHA functional class I group, respectively. The HA level was significantly higher in CHF patients as compared with NYHA functional class I group （P<0.05）. However, no difference was found in the levels of PCIIIP and LN between CHF group and NYHA functional class I group. The serum HA concentration was negatively correlated with left ventricular ejection fraction （r=-0.71, P<0.05）.Conclusion Serum HA level may act as an indicator for myocardial fibrosis.Keywords：congestive heart failure;hyaluronic acid;procollagen type III NH 2-terminal peptide;laminin4|18|11Updated：2024-04-10
- Abstract：Objective To investigate the effects of quercetin and X-ray on collagen synthesis of cultured human keloid-derived fibroblast and the mechanism.Methods Collagen synthesis of cultured human keloid and normal fibroblasts were detected by hydroxyproline colorimetric analysis. Immunocytochemical staining was used to investigate collagen I and III expression. mRNA expression of collagen I and III, and transforming growth factor （TGF）-β1 were assayed by reverse transcription-polymerase chain reaction （RT-PCR） and real-time PCR. Results Quercetin inhibited the collagen synthesis of both keloid and normal fibroblasts in a dose-dependent manner. Immunocytochemical staining indicated that collagen I and III were down-regulated by quercetin and X-ray （P<0.05）, particularly collagen I （P<0.05）. mRNA expression of both collagen I and III in quercetin groups significantly decreased compared with that in control group （P<0.05）, especially in the group treated with both quercetin and X-ray （P<0.01）. mRNA level of TGF-β1 gene was down-regulated by quercertin （P<0.05）. Conclusions Quercetin will probably be one of the new medicines which could effectively treat keloid. Quercetin combined with X-ray could reduce the dose of radiation.Keywords：keloid;fibroblast;quercetin;collagen4|31|16Updated：2024-04-10
- Abstract：Objective To investigate whether there is endogenous neural stem cell proliferation and whether these proliferated neural stem cells represent neural plasticity in the adult rats after cerebral infarction.Methods Cerebral infarction models of rats were established and the dynamic expression of bromodeoxyuridine （BrdU）, BrdU/polysialylated neural cell adhesion molecule （PSA-NCAM） were determined by immunohistochemistry and immunofluorescence staining. BrdU was used to mark dividing neural stem cells. PSA-NCAM was used to mark the plasticity of neural stem cells.Results Compared with controls, the number of BrdU-positive cells in the subventricular zone （SVZ） and hippocampus increased significantly at 1[KG-*3]st day after cerebral infarction （P<0.05）, reached maximum at 7th day, decreased markedly at 14th day, but it was still elevated compared with that of the controls （P<0.05）. The number of BrdU-labeled with PSA-NCAM-positive cells increased significantly at 7th day （P<0.05）, reached maximum at 14th day, markedly decreased at 28th day, but it was still elevated compared with that of the controls （P<0.05）. It was equal to 60% of the number of BrdU-positive cells in the same period.Conclusion Cerebral infarction may stimulate the proliferation of endogenous neural stem cells in situ and most proliferated neural stem cells represent neural plasticity.Keywords：cerebral infarction;neural stem cell;proliferation;plasticity4|18|8Updated：2024-04-10
- Keywords：gastroesophageal reflux disease;asthma;cough;laryngospasm;laporoscopy;fundoplasty;proton pump inhibitor;radiofrequency;stretta4|46|34Updated：2024-04-10
- Keywords：extracorporeal membrane oxygenation;fulminant myocarditis;treatment4|15|1Updated：2024-04-10
- Keywords：bilateral;vagal paragangliomas;treatment4|8|0Updated：2024-04-10
- Abstract：Objective To investigate the diagnosis and therapy of mediastinal enterogenous cysts in children. Methods Clinical data of 17 cases with mediastinal enterogenous cysts within 19 years in our hospital were retrospectively analyzed. Results One case was intramural esophageal cyst and 16 cases were enteric cysts, two among which were complicated with abdominal enteric duplications. Most cases presented with symptoms of respiratory distress. Twelve cases were complicated with vertebral anomalies. Ultrasound of 12 cases and magnetic resonance imaging of 4 cases were helpful in confirming the cystic nature of these lesions. Eight cases had technetium-99m pertechnetate scintigraphy of posterior mediastinum.Conclusions Most patients present with symptoms of respiratory distress, complicated with vertebral anomalies. Ultrasonography and magnetic resonance imaging may be helpful in confirming the cystic nature of these lesions. Technetium-99m pertechnetate scintigraphy is the most effective method for differentiation of the disease from other mediastinal cysts.Keywords：mediastinal mass;enteric cysts;diagnosis;therapy4|9|2Updated：2024-04-10
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