A family with early onset myopathy caused by MEGF10 gene defect and literature review / 中华儿科杂志

Objective: To summarize the genetic and clinical phenotypic characteristics of patients with early-onset myopathy, areflexia, respiratory distress and dysphagia (EMARDD) caused by multiple epidermal growth factor 10 (MEGF10) gene defect. Methods: The clinical data of 3 infants in 1 family with EMARDD caused by MEGF10 gene defect diagnosed in the Department of Neonatology, Xiamen Children's Hospital in April 2022 were analyzed retrospectively. Using "multiple epidermal growth factor 10" "myopathy" or "MEGF10" "myopathy" as the key words, and searching the relevant literature reports of CNKI, Wanfang Database and PubMed Database from the establishment of the database to September 2022. Combined with this family, the main clinical information and genotype characteristics of EMARDD patients caused by MEGF10 gene defect were summarized. Results: The proband, male, first infant of monozygotic twins, was admitted to hospital 7 days after birth "due to intermittent cyanosis with weak sucking". The infant had dysphagia accompanied with cyanosis of lips during feeding and crying after birth. Physical examination on admission revealed reduced muscle tone of the extremities, flexion of the second to fifth fingers of both hands with limited passive extension of proximal interphalangeal joints, and limited abduction of both hips. He was diagnosed as dysphagia of newborn, congenital dactyly. After admission, he was given limb and oral rehabilitation training, breathing gradually became stable and oral feeding fully allowed, and discharged along with improvement. The younger brother of the proband was admitted to the hospital at the same time, and his clinical manifestations, diagnosis and treatment process were the same as those of the proband. The elder brother of the proband died at the age of 8 months due to the delayed growth and development, severe malnutrition, hypotonia, single palmoclal crease and weak crying. A whole exon sequencing of the family was done, and found that the 3 children were all compound heterozygous variations at the same site of MEGF10 gene, with 2 splicing variants (c.218+1G>A, c.2362+1G>A), which came from the father and mother respectively, and the new variation was consistent with the autosomal recessive inheritance model. Three children were finally diagnosed as EMARDD caused by MEGF10 gene defect. There are 0 Chinese literature and 18 English literature that met the search conditions. Totally 17 families including 28 patients were reported. There were 31 EMARDD patients including 3 infants from this family. Among them, there were 13 males and 18 females. The reported age of onset ranged from 0 to 61 years. Except for 5 patients with incomplete clinical data, 26 patients were included in the analysis of phenotypic and genotypic characteristics. The clinical features were mainly dyspnea (25 cases), scoliosis (22 cases), feeding difficulties (21 cases), myasthenia (20 cases), and other features including areflexia (16 cases) and cleft palate or high palatal arch(15 cases). Muscle biopsy showed non-specific changes, with histological characteristics ranging from slight muscle fiber size variation to minicores change which was seen in all 5 patients with at least 1 missense mutation of allele. In addition, the adult onset was found in patients with at least 1 missense variant of MEGF10 gene. Conclusions: MEGF10 gene defect related EMARDD can occur in the neonatal period, and the main clinical features are muscle weakness, breathing and feeding difficulties. Patients with myopathy who have at least 1 missense mutation and muscle biopsy indicating minicores change may be relatively mild.

Research advances in the treatment strategies for severe pertussis in children / 中国当代儿科杂志

At present, effective antibiotics and comprehensive symptomatic/supportive treatment as early as possible are mainly used for the treatment of severe pertussis in clinical practice. However, some children with severe pertussis have unsatisfactory response to commonly used drugs and treatment measures in the intensive care unit and thus have a high risk of death. Studies have shown that certain treatment measures given in the early stage, such as exchange transfusion, may help reduce deaths, but there is still a lack of uniform implementation norms. How to determine the treatment regimen for severe pertussis and improve treatment ability remains a difficult issue in clinical practice. This article reviews the advances in the treatment of severe pertussis, in order to provide a reference for clinical treatment and research.

Effect of pertussis vaccination on clinical manifestations of infants and young children with pertussis / 中国当代儿科杂志

OBJECTIVE@#To study the effect of pertussis vaccination on the clinical manifestations of infants and young children with pertussis.@*METHODS@#A retrospective analysis was performed to investigate the differences in clinical manifestations and peripheral blood cell levels between pertussis children with different pertussis vaccination status.@*RESULTS@#A total of 1 083 children with pertussisat at age of < 3 years were enrolled, with 551 children in the unvaccinated group and 532 in the vaccinated group. Of all the children, 392 had an age of onset of < 3 months (372 were unvaccinated and 20 were vaccinated) and 691 children had an age of onset of ≥ 3 months (179 were unvaccinated and 512 were vaccinated). Compared with the vaccinated group, the unvaccinated group had a longer length of hospital stay and a higher incidence rate of respiratory failure (@*CONCLUSIONS@#Pertussis vaccination can reduce the incidence of severe pneumonia and respiratory failure and alleviate the severity of respiratory complications in infants and young children with pertussis.

Effect of Ultrafine Powder of Gastrodiae Rhizoma in Improving Learning and Memory Ability of Vascular Dementia Rats by Regulating Cholinergic System / 中国实验方剂学杂志

Objective:To investigate whether ultrafine powder of Gastrodiae Rhizoma （UPG） can alleviate the learning and memory impairment of vascular dementia rats and delay the process of VD， and whether this effect is related to the release of acetylcholine （Ach） through the regulation with acetylcholinesterase （AChE） and choline acetyltransferase （ChAT） and control of cholinergic system. Method:SD rats were randomly divided into sham operation group， UPG low dose group （0.45 g·kg-1）， UPG high dose group （1.8 g·kg-1） and Huperzine A group （80 μg·kg-1）， with 12 rats in each group. The drug administration groups were given orally drugs once a day for 8 weeks， and sham group and model group were given orally the same amount of distilled water. The learning and memory ability of the rats with VD were evaluated by the Morris water maze. Htoxylin eosin（HE） staining was used for pathomorphological observation of hippocampus CA1 area of the rats. The content of Ach was determined by enzyme-linked immunosorbent assay（ELISA）， AChE and ChAT protein expressions were detected by Western blot， and expression of ChAT in hippocampus CA1 area was observed by immunohistochemistry. Result:Compared with the sham operation group， the escape latency of the model group was significantly increased （P<0.01）， and the frequency of crossings platform and the time of staying in the target quadrant were reduced significantly （P<0.01）. HE staining of hippocampal tissues from VD rat showed neuron disorders， loss and degeneration and necrosis， pyknosis of the nucleus and light coloration of the cytoplasm. The level of acetylcholine in the hippocampus was significantly decreased by ELISA （P<0.05）， the expression level of AChE protein was significantly up-regulated， and the expression level of ChAT protein was significantly down-regulated （P<0.01）. Compared with model group， each administration group could significantly reduce the escape latency of the model rats， and significantly increase the frequency of crossing platform and the time of staying in the target quadrant （P<0.01）， the content of Ach was significantly increased （P<0.05）， the expression of AChE protein was significantly down-regulated （P<0.01）， while the expression of ChAT protein was significantly up-regulated （P<0.01）. Conclusion:UPG improves the learning and memory ability of vascular dementia rats， and its mechanism may be related to the increase of Ach， ChAT level and the decrease of AChE level.

Comparison of Aspirin and Naoxintong Capsule () with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compared the therapeutic effect of a Chinese patent medicine Naoxintong Capsule (, NXT) and aspirin with adjusted-dose warfarin in Chinese elderly patients (over 65 years) with nonvalvular atrial fibrillation (NVAF) and genetic variants of vitamin K epoxide reductase (VKORC1), who are at high-risk of thromboembolism.</p><p><b>METHODS</b>A total of 151 patients, with NVAF and AA genotype of VKORC1-1639 (a sensitive genotype to warfarin) and a CHADS-VASc clinical risk score of 2 or above, were chosen for this study. Patients were randomized into two groups and orally treated with a combination of aspirin (100 mg/day) and NXT (1.6 g thrice a day) or adjusted-dose warfarin [international normalized ratio 2.0-3.0). The primary end points including ischemic stroke and death as well as the secondary end points including hemorrhage events were followed up for at least 1 year.</p><p><b>RESULTS</b>Baseline clinical data and the rates of primary end points were similar between groups. However, the rate of serious bleeding (secondary event) in the combination therapy group was lower than that in the adjusted-dose warfarin group (0% vs. 7.9%, odds ratio: 0.921, 95% confidence interval: 0.862-0.984, P=0.028).</p><p><b>CONCLUSIONS</b>Aspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However, as compared with warfarin, the combination therapy reduced the rate of serious bleeding. Therefore, aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596).</p>

Diagnostic Value of IGF-I, β2-MG and SF for Patients with Multiple Myeloma and Their Relationship with Clinical Staging / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic value of insulin like growth factor I(IGF-I), β2-microglobulin (β2MG) and serum ferritin (SF) in patients with multiple myeloma (MM) and their ralationship with clinical staging.</p><p><b>METHODS</b>Seventy-seven patients with MM treated in Depertment of Hematology of Shanghai 10th hospital and Oncology of Shanghai Armed Police Hospital from August 2016 to June 2017 were enrolled in MM group, at same period 77 healthy volunteers were enrolled in normal control group. The diagnostic value of IGF-I, β2-MG and SF for MM, and their levels in different stages of MM were compared.</p><p><b>RESULTS</b>The ROC analysis showed that β2-MG and SF alone as well as their combination had the diagnostic significance for MM, moreover the diagnostic value of IGF-I, β2-MG and SF combination was highest, but the single IGF-I did not possess diagnostic significance for MM. The comparison of IGF-I, β2-MG and SF levels in different stages of MM showed that the β2-MG and SF levels in I stage were higher than those in normal control group (P<0.05), but lower than those in II and III stages (P<0.05). The IGF-I level in I stage was not statistically and significantly different from IGF-I level in normal control group (P>0.05), but lower than those in II and III stage (P<0.05). The relationship analysis between IGF-I and β2-MG, SF in different stages showed that the IGF-I related with SF in I stage (r=0.417), but did not relate with β2-MG; the IGF-I in II stage related with β2-MG and SF in II stage (r=0.543, r=0.426); IGF-I related with β2-MG and SF in III stage (r=0.425 and r=0.672).</p><p><b>CONCLUSION</b>The diagnostic value of IGF-I, β2-MG and SF alone does not high for MM, but their combination can significantly enhance the occurate rate of MM diagnosis. The levels of IGF-I, β2-MG and SF in II and III stages of MM all increase, moreover the level of IGF-I correlates with the levels of β2-MG and SF.</p>

Clinical effects of partial rectus muscle transportation procedure for paralytic strabismus / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM: To analyze the clinical effects of partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis.?METHODS:The conditions of 22 patients (25 eyes) who underwent partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis were retrospectively reviewed. The following data were analyzed:1 ) the angle of deviation of primary position; 2 ) the presence of diploma in the primary position;3) the presence of compensatory head posture;4) the motility of the affected eye.All of the patients attended 6mo postoperative follow-up examinations.?RESULTS: According to the results of examinations before and during operation, different operations were performed:2 eyes were treated with partial rectus muscle transportation, 20 eyes were treated with recession of antagonistic muscle of paralytic rectus muscle combined with partial rectus muscle transportation, 3 eyes were treated with recession of antagonistic muscle, partial rectus muscle transportation and recession of yoke muscle.Twenty patients were orthotropia in the primary position, the diploma and abnormal head posture were eliminated. Two patients with binocular lateral rectus muscles paralysis were in mild undercorrection which were resolved by wearing 8△and 10△prisms respectively. The procedure improved strabismus of 25 eyes from 100.23△ ± 42.61△ preoperatively to 0.82△ ± 2.67△postoperatively ( t=10.797,P<0.001).Ocular movement was improved from -4.52 ±0.51 preoperatively to -2.68 ± 0.63 postoperatively (t=-19.468, P<0.001).? CONCLUSION: Partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis can effectively correct the primary position in paralytic strabismus, eliminate the presence of diploma in primary position and abnormal head posture, and improve the ocular motility, which provides content clinical effects.

A randomized controlled trial of adjunctive Bunchang Naoxintong Capsule (步长脑心通胶囊) versus maintenance dose clopidogrel in patients with CYP2C19*2 polymorphism / 中国结合医学杂志

<p><b>OBJECTIVE</b>To determine the impact of adjunctive Buchang Naoxintong Capsule (, NXT) on dual antiplatelet therapy in patients with cytochrome P450 2C19*2 (CYP2C19*2) polymorphism undergoing percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Ninety patients with CYP2C19*2 polymorphism were enrolled, and their genotypes were confirmed by polymerase chain reaction (PCR). The patients were randomly assigned to receive either adjunctive NXT (triple group, 45 cases) or dual antiplatelet therapy (dual group, 45 cases) using a computer-generated randomization sequence and sealed envelopes. Platelet function was assessed at baseline and 7 days after treatment with conventional aggregometry. Subsequent major adverse cardiovascular events (MACE, including sudden cardiac arrest and acute coronary syndrome) were recorded during a 12-month follow-up.</p><p><b>RESULTS</b>Baseline platelet function measurements were similar in both groups. After 7 days, percent inhibitions of maximum platelet aggregation and late platelet aggregation were significantly greater in the triple versus dual group (42.3%±16.0% vs. 20.8%±15.2%, P<0.01, and 54.7%±18.3% vs. 21.5%±29.2%, P<0.01, respectively). During the 12-month follow-up, the rate of subsequent MACE (6/45) was significantly lower in the triple group compared with the dual group (14/45; P<0.05).</p><p><b>CONCLUSION</b>Adjunctive NXT to maintenance dose clopidogrel (75 g) could enhance the antiplatelet effect and decrease subsequent MACE in patients with the CYP2C19*2 polymorphism undergoing PCI.</p>

Analysis of the children's dynamic and static stereopsis of intermittent exotropia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare and analyze the stereopsis of intermittent exotropia children under the different backgrounds of dynamic stimuli and static stimuli. METHODS: We collected 56 children ( male 26, female 30 with intermittent exotropia at the age from 5y to 12y and examined their stereopsis under the different backgrounds of dynamic stimuli and static stimuli using a multidimensional sense perception training software. The differences between the dynamic stereopsis and static stereopsis were compared. RESULTS: Totally 17 cases ( 30%) had both dynamicstereopsis and static stereopsis, 39 cases ( 70%) had either dynamic or static stereopsis deficit, only 10 cases ( 26%) had dynamic stereopsis, 25 cases ( 64%) static stereopsis left and 4 cases ( 10%) were without any form of stereopsis. The positive rate of dynamic stereopsis was better than the positive rate of static stereopsis, with statistical significance (P CONCLUSION: Dynamicstereopsis is better than the static stereopsis to intermittent exotropia children.

Clinical analysis of 28 cases of bronchiolitis obliterans / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features of bronchiolitis obliterans (BO) in children.</p><p><b>METHODS</b>The clinical data of 28 children with BO between July 2007 and April 2012 was retrospectively reviewed.</p><p><b>RESULTS</b>All patients presented with persistent or repeated cough and wheezing. Twenty-three cases were post-infectious bronchiolitis obliterans (PIBO), among whom the etiology were adenovirus (12 cases), measles (2 cases), influenza virus A (2 cases), mycoplasma pneumoniae (1 case), mycoplasma pneumoniae coinfection with adenovirus (1 case), respiratory syncytial virus coinfection with Parainfluenza type 3 virus (1 case) and pulmonary tuberculosis (1 case). The etiology of 3 cases was not associated with infection. The etiology was unknown in 2 cases. Pulmonary HRCT revealed that decreased density in 25 cases, mosaic perfusion in 21 cases, bronchial wall thickening in 15 cases, bronchiectasis in 12 cases and air retention in 6 cases. Lung function test was performed on 21 cases and demonstrated that obstructive ventilation disorder in all 21 cases. Bronchodilation test was performed on 18 cases and 17 cases showed a negative result. All 28 cases received corticosteroid treatment, and 24 cases were orally administered with low doses of azithromycin. One case died during hospitalization. Eighteen cases were followed up for 4 months to 4 years and seven months. Clinical manifestations were improved in 12 cases and one case died.</p><p><b>CONCLUSIONS</b>Low respiratory infection is the most common cause of pediatric BO and adenovirus is a major pathogen. Persistent wheezing and cough were main clinical manifestations. Pulmonary HRCT imaging is important for diagnosis and follow-up of BO. Lung function test can typically show obstructive ventilation disorder. Corticosteroid and methotrexate may be effective for treatment of BO. Prognosis of this disease is unsatisfactory. Early diagnosis and treatment, and avoidance of repeated respiratory tract infection may be helpful to improve the prognosis.</p>

Detection of weak D antigen by flow cytometry / 中国实验血液学杂志

Flow cytometry was previously applied for analysis of Rh(D) antigen density, therefore it was suggested that the flow cytometry may be used for routine detection of weak D positive phenotypes. This study was purposed to evaluate its practicability. Six weak D positive and 7 DEL individuals were detected by using saline, IAT and absorption/elution test from 2010 to 2011 years. By RHD genotyping, zygosity analysis and sequencing, 3 cases of weak D type 15, 3 cases of partial D type DVI-III and 7 cases of DEL carrying RHD1227A alleles were identified. Taking 2 normal Rh(D)-positive and 2 D-negative samples as controls, all the samples were tested by using flow cytometry, and the median fluorescence intensities were observed as well. The results indicated that all weak D type 15 and partial D type DVI samples were detected to be positive by flow cytometry, as compared with 2 Rh(D)-negative samples (P < 0.05). Seven 7 DEL samples were tested to be negative (P > 0.05), although one of 7 DEL was tested as "±" in IAT and strong positive in absorption/elution. The RHD zygosity analysis showed this DEL individual as RHD(+)/RHD(+) homozygote. It is concluded that the sensitivity of detecting D antigen by flow cytometry is similar to that of IAT, but lower than absorption/elution test. As for detecting weak D or partial D antigens, IAT is easier than flow cytometry; as for identifying DEL, the flow cytometry is not sensitive enough.

Impact of index finger force on motor unit recruitment pattern in flexor digitorum superficialis / 医用生物力学

Objective To detect the recruitment pattern of motor unit in human flexor digitorum superficialis (FDS) at different force levels produced by the index finger. Methods Eight subjects were recruited to produce a certain force level with the index finger to match the ordered force level (20%, 40%, 60% maximum voluntary contraction). During the force tracking task, the multi-channel surface electromyography (sEMG) signals were recorded on FDS using 8×1 (row×column) electrode-array. The motor unit action potential (MUAP) information was extracted by Fast Independent Component Analysis (FastICA), and then the correlation between MUAP pattern and force level was analyzed. Results Four different types of MUAP were extracted successfully by FastICA from original sEMG signals and the total number of MUAP showed an increasing trend with the force level increasing. At different force levels, the proportion of different types of MUAP was different, showing different trends with change of the force level. ConclusionsAt different levels of the finger force, the recruitment pattern of motor unit in FDS will be changed so as to produce the force accordingly.

Efficacy of dual antiplatelet therapy combined with Naoxintong capsules see text following coronary microembolization induced by homologous microthrombi in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the effificacy of dual antiplatelet therapy combined with Naoxintong Capsule ([see text], NXTC) in a rat model of coronary microembolization (CME).</p><p><b>METHODS</b>A total of 95 rats were randomly divided into 6 groups: control, sham-operation, CME model, NXTC, dual antiplatelet (clopidogrel and aspirin) intervention (DA), and NXTC combined with DA (NDA) groups. The complete data in 69 rats were obtained. The number of CME, myocardial apoptosis rate, bleeding time, clotting time, and adensosine diphosphate (ADP)-induced platelet aggregation were assessed.</p><p><b>RESULTS</b>Compared with the CME group, the number of CME and myocardial apoptosis rates were signifificantly decreased in the NXTC, DA, and NDA groups (P <0.01). Compared with other intervention groups, the number of CME and myocardial apoptosis rates were the least in the NDA group (P <0.01), and the incidence of surgical bleeding was the highest in the DA group (P <0.01). Compared with the CME group, ADP-induced maximum platelet aggregation rate was significantly inhibited in the NXTC, DA, and NDA groups (P <0.01), both bleeding time and clotting time were signifificantly increased in the NXTC, DA, and NDA groups (P <0.01), while the above parameters were the highest in the DA group (P <0.05).</p><p><b>CONCLUSION</b>The combination therapy of NXTC and DA enhanced the anti-CME effect of either therapy alone and reduced the risk of the DA therapy-associated bleeding, demonstrating an improved benefifit/ risk ratio in the rat model of CME.</p>

Effects of levodopa On visual evoked potential and visual cortex neuron in monocular deprivation rat / 中华实验眼科杂志

Background Nearly over 40 years have elapsed since the original findings of visual cortical plasticity,but none of drug has been found for curing amblyopia effectively. Objective The goal of this study was to investigate the effects of different dose of levodopa on flash visual evoked potential(F-VEP)and morphology of visual cortex cells in monocular deprivation rat and explore the possible mechanism of curing amblyopia.Methods Monocular deprivation model were established by suturing eyelids of 30 2-week-old Sprague Dawley(SD)rats for 4 weeks.The 30 SD rats were then divided into 3 groups randomly and 10 rats for each group.Normal saline.20 ms/kg levodopa,80 ms/kg levodopa were intragastrically administered once per day after modeling respectively for 4 weeks.F-VEP was recorded after establishment of model and administration of drug respectively.The rats were sacrificed and the visual cogex was obtained for histological examination,and TUNEL technique was used to assess the structural change of visual cortex.Results The latency of P1 wave was significantly longer in the deprived eye than the normal eyes(P<0.05).After administration of levodopa,the latent periods of Pl wave in the deprived eye were obviously shortened in comparison with before administration of levodopa in 20 ms/kg and 80 mg/kg levodopa group (P<0.05).The difference values of latent period of P1 wave between before and after administration of drug showed statistically significant change in three groups(P<0.05).No evidently alterations were found in the amplitude differences of N1 P1 and P1 N2 waves among three groups(P>0.05).The number and structure of neurons in contralateral visual cortex of non-deprived eye were normal.However,the numbers of neurons in deprived eye were significantly less and presented the signs of para-apoptosis in normal saline group.In 20 mg/kg levodopa groups,the alterations of number and morphology in neurons of rat visual eogex were slight.TUNEL assay revealed that the numbers of positive neurons in contralateral visual codex of non-deprived eye were 2.20±1.23.while those in deprived eye were 53.7±9.36,27.20 4±5.96 and 10.70±3.23 in normal saline group,20 mg/kg and 80 mg/kg levodopa group respectively,showing a significant difference among them(P>0.05).After usage of levodopa,the numbers of positive neurons was negatively correlated with the difference value of P,latent period of VEP(r=-0.815,P=0.000).Conclusion Levodopa has a therapeutic effect on rat deprived eye,and its possible mechanism is inhibiting the para-apoptosis of neurons and participating in the development and plasticity of visual system.

Effects of dopamine on gamma-amino-butyric acid-activated currents in neutron of visual cortex of rat / 中华实验眼科杂志

Background As a main suppressing neurotransmitter in visual system,gamma-aminobutyric acid (GABA) participates in the transmission and regulation of visual information.GABA and dopamine (DA) coexist in the visual cortex,and their mutual effects should be clarified.Objective This study was to investigate the effect of DA on GABA-activated current in vitro in cultured visual cortical neurons of rats.Methods Neutrons from visual cortex of clean neonatal rats were isolated and cultured by explant culture method.The neutrons cultured for 11 -to 14- days were collected for the record of whole cell currents of GABA-A (IGABA) channels in vitro using patch clamp technique.The DA solution (100mmol/L),SKF38393 (10mmol/L) solution and quinpirole solution(10mmol/L) were prepared with double distilled water and then the extracellular fluid was added to different concentrations.The IGABA changing rate under the action of SKF38393+SCH23390,SKF38393+Quinpirole for different time was recorded respectively and compared with that of action of DA,SKF38393,SCH23390,Quinpirole.The IGABA activated by extracellular fluid along served as control.Results The IGABA was significantly attenuated after activated by ≥10μmol/L of DA or SKF38393 separately in comparison to that of extracellular fluid action (P＜0.05).In various time of action,there were obviously differences in IGABA between DA or SKF38393 action and extracellular fluid (P＜0.05,P＜0.01).No evident change in IGABA changing rate was found after only SCH23390 action in comparison with extracellular cells (P＜0.05).However,after combination of SCH23390 and SKF38393,IGABA changing rate reduced by 19.49%.No significant differences were found in the changing rates of IGABA among different concentrations of quinpirole action groups compared with extracellular fluid group (P＞0.05);while when quinpirole was combined with SKF38393,the IGABA was elevated in comparison with only SKF38393 action group (P＜0.05).Conclusion Dopamine participates in the transfer and regulation of visual information through suppressing GABA-activated currents from neutrons of visual cortex at time-dependent manner in vitro.

Relationship between gene polymorphism and haplotype of SLC6A2 promoter and blood-stasis pattern in patients with essential hypertension / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the relationship between the genetic variants of the norepinephrine transporter gene solute carrier family 6 member 2 (SLC6A2) and blood stasis pattern (BSP) in patients with essential hypertension (EH).</p><p><b>METHODS</b>DNA was extracted from the peripheral blood of 830 EH patients (532 were typed as BSP and 298 as non-BSS) and 512 persons with normal blood pressure (for control), to detect the polymorphisms of SLC6A2 promoter-3 and 2 by PCR-RFLP, and estimate the haplotype frequency adopting SHEsis program.</p><p><b>RESULTS</b>Chi2 partition showed that frequency of promoter-2-GG genotype in EH patients of BSP was lower than that in the EH patients of non-BSP and the normal control (P = 0.001); while that of promoter-3-GG/GA in the EH patients with severe BSP was the highest (P < 0.001). Logistic regression analysis showed that after the miscellaneous factors being rectified, with the reference category of EH-non-BSP, the relative odds ratio (OR) of promoter-2-GC/CC genotype for EH-BSP was 1.535 (95% CI: 1.094-2.155, P = 0.013); that of promoter-3-AG/GG genotype for EH with severe BSP was 1.925 (95% CI: 1.199-3.091, P = 0.007); while OR of G-C haplotype (promoter-3-promoter-2) for EH-BSP was 2.127 (95% CI: 1.202-3.765, P = 0.010), showing the strongest intensity.</p><p><b>CONCLUSION</b>SLC6A2 promoter-3-GA/GG genotype may be a susceptibility gene for patients of EH with severe BSP; promoter-2-GC/CC and G-C haplotype might be the susceptible factors to EH-BSP.</p>

Relationships of blood stasis syndrome, CYP2C19 gene polymorphism with clopidogrel resistance and post-PCI prognosis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the relationships of blood stasis syndrome (BSS), CYP2C19 gene polymorphism with clopidogrel resistance (CR) and post-PCI prognosis.</p><p><b>METHODS</b>Materials of 415 patients (Han nationality) with coronary atherosclerotic heart disease (CAHD) hospitalized between January 2008 and July 2009 were collected. The CYP2C19*2 gene distribution in patients with different degrees of BBS was observed, and the relationships of BSS, CYP2C19*2 with the laboratory CR [LCR, percentage of patients with ADP-induced maximal platelet aggregation (MPA) rate reduced for < or = 10% after a 10-day clopidogrel treatment] were analyzed. Besides, an assay on the relations of maximal platelet aggregation suppressive rate (MPAS), LCR, recurrent cardiovascular events (RCEs) with BSS and CYP2C19*2 gene mutation was performed in a 7-month (in median) follow-up study on 180 post-PCI patients who received conventional treatment by clopidogrel and aspirin.</p><p><b>RESULTS</b>(1) The frequency of 681G>A mutation in patients with severe BSS and in those who received PCI was higher than that in those with mild BSS (P<0.01); (2) After clopidogrel treatment, LCR was 45.06% (187/415) in total patients, 61.63% (143/232) in patients with severe BSS, 53.24% (115/216) in patients carrying 681A allele; (3) The MPA was less decreased and the LCR was higher in patients with severe BSS than in those with mild BSS (P<0.01); (4) After clopidogrel treatment, the MPA was less decreased and the LCR was higher in carrying CYP2C19 681A allele than in those carrying 681 GG type gene (P<0.01); (5) Follow-up study showed that not only the MPA suppressive rate was lower, LCR was higher in patients with severe BSS or those carrying CYP2C19 681A allele, but a higher RCEs was also shown in them (P<0.01). Moreover, after the various risk factors had been adjusted, the RCEs in patients with severe BSS or carrying CYP2C19 681A allele was higher than in those with mild BSS (OR: 4.01; 95% CI: 1.79-8.99) or carrying GG type gene (OR: 6.89; 95% CI: 2.97-15.97).</p><p><b>CONCLUSION</b>Severe BSS and CYP2C19*2 gene mutation are associated with LCR, and could increase the risk of post-PCI cardiovascular events recurrence in patients with CAHD.</p>

Serum uric acid prevalence and changes post various antihypertensive agents in patients with essential hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To survey the prevalence of hyperuricacidemia and serum uric acid (SUA) changes and electrolyte changes after 6 weeks antihypertensive treatment with thiazide diuretics, losartan or losartan+hydrochlorothiazide (Hyzaar) in patients with essential hypertension (EH).</p><p><b>METHODS</b>A total of 1080 consecutive EH patients [662 males, mean age (60.9 +/- 12.3) years] who seeked for medical consultation in study hospitals in Fuzhou city during October 2004 and October 2006 were included in this study. The blood pressure before and after antihypertensive treatments were obtained in 1000 patients, and the renal function and electrolyte before and after antihypertensive treatments were obtained in 600 patients. Patients with SBP > 140 and/or DBP > 90 mm Hg 2 weeks after initial antihypertensive agents were cotreated with felodipine, patients with SBP > 140 and/or DBP > 90 mm Hg 4 weeks after initial antihypertensive agents were cotreated with beta and/or alpha blockers.</p><p><b>RESULTS</b>The prevalence of hyperuricacidemia in EH patients was 25.83% (279/1080). Body mass index (BMI) and creatinine were significantly higher while creatinine clearance rate (Ccr) calculated by Cockcroft-Gault equation was significantly lower in EH patients with hyperuricacidemia than EH patients without hyperuricacidemia (all P < 0.05). Similar antihypertensive effects were observed in EH patients treated with thiazide diuretics (n = 200), losartan (n = 324) or losartan + hydrochlorothiazide (Hyzaar, n = 476) and SBP was lower than 140 mm Hg in 69.40% and DBP was less than 90 mmHg in 85.30% EH patients 6 weeks after antihypertensive treatments. SUA was significantly increased (43.81 micromol/L +/- 71.79 micromol/L) low dose diuretics group (P < 0.01 vs. pretreatment), significantly reduced (44.96 micromol/L +/- 90.63 micromol/L) in losartan group (P < 0.0001 vs. pretreatment) and remained unchanged in Hyzaar group (7.46 +/- 84.72 micromol/L, P > 0.05 vs. pretreatment). Serum potassium was significantly decreased (0.30 +/- 0.44 mmol/L) in diuretic group (P < 0.01 vs. pretreatment) and remained unchanged in losartan group (+0.06 +/- 0.43 mmol/L) and Hyzaar group (-0.04 +/- 0.44 mmol/L, all P > 0.05 vs. pretreatment).</p><p><b>CONCLUSION</b>Hyperuricacidemia prevalence was 25.83% and associated with higher BMI and abnormal renal function in examined EH patients. The low dose thiazide diuretics could further aggravate hyperuricacidemia and induce hypopotassemia while losartan could reduce hyperuricacidemia in EH patients.</p>

Sequential defunctionalization followed by thyroxine supplementation as preoperative preparation of hyperthyroid patients undergoing thyroidectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Preparing hyperthyroid patients for thyroid surgery with a combination of antithyroid drugs and thyroxine has long been controversial because this combination usually results in only partial inhibition of thyroid function. We therefore used large doses of antithyroid drugs to completely inhibit the synthesis of thyroxine and render the thyroid gland defunctionalized. We then administered physiologic doses of thyroxine to inhibit thyroid-stimulating hormone secretion. We have named this treatment "sequential thyroid defunctionalization followed by thyroxine supplementation."</p><p><b>METHODS</b>Four hundred and seventy-one hyperthyroid patients seen at our hospital were divided into experimental and control groups. The control group was treated preoperatively with antithyroid drugs and iodine preparation. The experimental group was further divided into four subgroups and treated with "sequential thyroid defunctionalization followed by thyroxine supplementation". Each of the four subgroups received different doses of antithyroid drugs and thyroxine for differing time periods. Thyroid function was assessed at each stage of treatment, as were operative blood loss volumes and postoperative complications.</p><p><b>RESULTS</b>Compared to the control group, the four experimental groups showed less thyroid congestion and surface varices at surgery. Patients in subgroup A also had thyroid glands that were almost histologically normal. The mean operative blood loss volume of the experimental group was less than that of the control group (326 +/- 163) ml in the control group; (196 +/- 57) ml in subgroup A; (230 +/- 71) ml in subgroup B; (240 +/- 80) ml in subgroup C; and (312 +/- 97) ml in subgroup D). The postoperative complication rate of the experimental group was 8.64% (21/243) whereas that of the control group was 17.54% (40/228).</p><p><b>CONCLUSIONS</b>Sequential thyroid defunctionalization followed by thyroxine supplementation is effective in reducing the bleeding volume and postoperative complication rate in selected hyperthyroid patients undergoing thyroidectomy.</p>

Antisense c-fos oligonucleotides-induced myopia in guinea pigs / 中南大学学报(医学版)

OBJECTIVE@#To characterize the antisense c-fos oligonucleotides that control the expression of immediate-early gene c-fos in retina in order to better understand the mechanism by which antisense c-fos oligonucleotides induced myopia. In this study the signal transduction in the pathway linking visual experience and the regulation of the eye's growth was investigated.@*METHODS@#Thirty-one 3-week guinea pigs were assigned into 3 groups: antisense and sense c-fos oligonucleotides were intravitreally injected every 3 days to the eyes of the experimental guinea pigs at different concentrations; and saline vehicle to control guinea pigs in the same way. The refraction and axial length of the eyes were measured before and after the treatment, and the immediate-early gene c-fos expression in the retina was quantified by immunohistochemistry and RT-PCR.@*RESULTS@#The moderate myopia was induced in high (1 nmol) and low (0.1 nmol) level of antisense c-fos oligonucleotide intravitreous injection (-5.425 D and -5.575 D, respectively) compared with the control ateral eyes. The refraction and axial length of the treated eyes increased, and the expression of immediate-early gene c-fos decreased significantly in the antisense c-fos oligonucleotides intravitreously injected eyes compared with the sense c-fos oligonucleotide intravitreously and saline vehicle injected eyes (P0.05).@*CONCLUSION@#The obvious myopia can be induced by antisense c-fos oligonucleotides in guinea pigs; antisense c-fos oligonucleotides inhibit c-fos expression in the retina. Immediate-early gene c-fos may be a potential factor in the prevention of myopia and plays an important role in the signal transduction of the retina.