[Endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound].

Objective: To evaluate the clinical efficacy of endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound. Methods: The clinical data of 40 patients with non-thrombotic right iliac vein compression syndromereceiving intravascular ultrasound-assisted balloon dilatation combined with stent implantation from January 2012 to December 2018 were retrospectively analyzed. There were 32 males and 8 females, the average age of whom was 63 (46-81) years old. The patients were classified according to the CEAP (Clinical-Etiology- Anatomy-Pathophysiology) classification: 7 cases as C3, 18 as C4, 10 as C5 and 5 as C6. All patients underwent percutaneous right femoral vein puncture, intravascular ultrasound, and balloon dilatation combined with stentimplantation in the right iliac vein lesion location. Results: The success rate of clinical operations was 100%. There were no serious complications during the perioperative period. All patients were followed up for 4-58 months. During the follow-up period, the relief rate of limb edema was 88.6% (31/35), the pain relief rate was 86.7%(13/15), and the healing rate of ulcers was 100% (6/6). After the stent implantation, the endovascular area of the compression site was significantly enlarged (34.5mm(2)± 11.1mm(2)vs129.8 mm(2)±17.2 mm(2), P<0.001). The follow-up of color Doppler and/or anterograde angiography for deep veins of lower limb with digital subtraction angiography showed that the blood flow in the stentsweres mooth in all patients. Three cases were observed that the intimal hyperplasia led to mild in-stent restenosis, no obvious in stent restenosis (>50%). The abdominal X-ray plain film showed no obvious displacement and fracture of the stents. The venous clinical severity score (VCSS) was statistically significant (13.0±2.4 vs 6.2±2.0, P<0.001). The statistical results of short-form health surver SF-36 showed that the scores of life quality in all dimensions of the affected limb were significantly improved after operation (P=0.000). Conclusion: Intravascular ultrasound-assisted balloon dilatation combined with stent implantation is not only a safe and effective treatment for non-thrombotic right iliac vein compression syndrome, but also has a good mid-term patency rate.

[Cardioversion efficacy of nifekalan in patients with sustained atrial fibrillation after radiofrequency ablation].

Objective: To evaluate the efficacy and safety of nifekalan (NIF) on cardioversion in atrial fibrillation (AF) patients post radiofrequency ablation, and investigate the relevant factors related to the cardioversion efficacy of NIF. Methods: We screened patients with sustained AF rhythm after radiofrequency ablation between November 2016 and July 2018. Participants were treated with intravenous NIF 0.4 mg/kg within 5-10 minutes after ablation. We observed the adverse reaction, and monitored the rhythm, heart rate, QT interval and QTc interval before the medication and at 5, 10, 20, 120 min after the medication. According to the drug outcome of NIF, patients were divided into conversion group and non-conversion group, related factors affecting conversion efficacy were evaluated using logistic regression analysis. Results: (1)A total of 116 patients were enrolled in the study (63 males and 53 females, mean age was (64±18) years). Among them, 72 patients were converted to sinus rhythm, and the overall successful rate was 62.1%. There were 84 patients with persistent AF, of which 50 cases (59.2%) were restored to sinus rhythm. There were 32 patients with paroxysmal AF, 22 cases (68.8%) of them were restored to sinus rhythm. The conversion time was 1.5 to 12 (6.8±3.4)min. (2) In 116 patients, the QT interval and QTc interval were significantly longer after medication than before the drug administration (P<0.01), and peaked at about 10th min, and restored to the level before drug administration at about 120th min. (3) There were 8 cases of bradycardia (6.9%), 3 cases of frequent and short ventricular tachycardia (2.6%). (4) The duration of atrial fibrillation was shorter and left atrial diameter was smaller in the cardioversion group than in the non-cardioversion group (both P<0.05). There were no significant differences in gender, disease history, atrial fibrillation type and structural heart disease between the two groups (P>0.05). (5) Multifactorial logistic regression analysis showed that the duration of atrial fibrillation (OR=0.980, 95%CI 0.966-0.994, P=0.004) and the left atrial diameter (OR=0.888, 95%CI 0.814-0.967, P=0.007) were the factors that influence the cardioversion efficacy of NIF on atrial fibrillation post ablation. Conclusions: The total effective rate of NIF was 62.1% in patients witrh sustained AF post radiofrequency ablation, was 68.8% in patients with paroxysmal AF. Besides, NIF has the advantage of short conversion time and few adverse reactions. Left atrium diameter and AF duration were relevant factors that influence the efficacy of NIF of cardioversion in patients with sustained AF after radiofrequency ablation.

Genotype and genetic variation of HCV infections with low-risk factors in Putian coastal regions, China.

Hepatitis C virus (HCV) infection is one of the leading causes of death and morbidity associated with liver disease. Risk factors identified for the transmission of HCV include contaminated blood products, intravenous drug use, body piercing, an infected mother at birth, sexual activity, and dental therapy, among others. However, the exact diversity of the HCV genotype and genetic variation among patients with low-risk factors is still unknown. In this study, we briefly described and analysed the genotype distribution and genetic variation of HCV infections with low-risk factors using molecular biology techniques. The results suggested that genotype 1b was predominant, followed by genotypes 2a and 1a. Genetic variations in the 5' UTR sequences of HCV were identified, including point mutations, deletions, and insertions. The frequency of genetic variations in 1b was higher than in 2a. This study provides considerable value for the prevention and treatment of liver disease caused by HCV among patients with low-risk factors and for the development of HCV diagnostic reagents and vaccines.

HMGB3 small interfere RNA suppresses mammosphere formation of MDA-MB-231 cells by down-regulating expression of HIF1α.

OBJECTIVE: Breast cancer has been proven as the most common malignancy influencing the health of females. This research aimed to clarify the effects of high-mobility group box 3 (HMGB3)-small interfere RNA (HMGB3-siRNA) on the proliferation of breast cancer cells. MATERIALS AND METHODS: HMGB3-mimic and HMGB3-siRNA lentiviral vectors were structured. The above lentiviral vectors were then transfected into normal breast cells (MCF10A) and breast cancer cells (MDA-MB-231). Cell counting kit-8 (CCK-8) analysis was employed to assess proliferative viabilities of cells. The formation of the mammosphere in breast cancer cells was examined using mammosphere-forming assay. The mRNA expression of Nanog, Sox2, and OCT-4 genes was evaluated using quantitative real time-PCR (qRT-PCR). CD44 positive/CD24 negative (CD44+/CD24-) cell levels were evaluated using flow cytometry assay. The correlation between HMGB3 and hypoxia-inducible factor 1α (HIF1α) was analyzed using Linear-Regression analysis. The interaction between HMGB3 and HIF1α expression was determined using the Dual-Luciferase assay. RESULTS: HMGB3 expression was remarkably enhanced in breast cancer cells compared to that in normal cells (p<0.05). HMGB3-siRNA significantly decreased the proliferative activity and remarkably suppressed the mammosphere formation compared to that in single MDA-MB-231 cells (p<0.05). HMGB3-siRNA remarkably reduced Nanog, SOX2, and OCT-4 and significantly enhanced CD44+/CD24- cells compared to single MDA-MB-231 cells (p<0.05). HMGB3-siRNA significantly weakened the expression of HIF1α in MDA-MB-231 cells compared to single MDA-MB-231 cells (p<0.05). HMGB3 was positively correlated with HIF1α expression (p<0.05). There was an interaction between HMGB expression and HIF1α expression. CONCLUSIONS: HMGB3 small interfering RNA suppressed the formation of mammosphere in MDA-MB-231 cells by downregulating the expression of HIF1α.

MiR-124 regulates osteoblast differentiation through GSK-3ß in ankylosing spondylitis.

OBJECTIVE: Ankylosing spondylitis (AS) is a spastic and spinal joint disease with the characteristic of pathological ossification. Bioinformatics analysis demonstrated that there is a complementary binding site between microRNA-124 (miR-124) and the 3'-UTR of glycogen synthase kinase-3ß (GSK-3ß) mRNA. We aimed to investigate the role of miR-124 in regulating GSK-3ß expression, Wnt/ß-catenin pathway activity, and osteoblast differentiation of spinal ligament fibroblasts. PATIENTS AND METHODS: The ligament tissues of AS and the femoral neck fracture patients were collected. MiR-124 and GSK-3ß mRNA expressions were detected by using quantitative Real-time PCR (qRT-PCR). GSK-3ß and ß-catenin protein expressions were detected by using Western blot. Ligament fibroblasts were isolated and induced to differentiate into osteoblasts. Alizarin red S staining (ARS) was used to identify osteoblast differentiation. Expressions of miR-124, GSK-3ß, ß-catenin, Osterix, and runt-related transcription factor 2 (RUNX2) were detected during differentiation. The cells were divided into two groups as agomiR-normal control (NC) transfection group and agomir miR-124 transfection group. Alkaline phosphatase (ALP) activity and Alizarin Red S staining were detected. RESULTS: MiR-124 and ß-catenin expressions in the ligament of AS patients increased, while GSK-3ß level reduced compared with control. MiR-124, ß-catenin, Osterix, and RUNX2 expressions gradually elevated, whereas GSK-3ß level gradually declined following increased osteoblasts differentiation. Antagomir miR-124 transfection significantly up-regulated the expression of GSK-3ß in osteoblast differentiation, significantly decreased the expression of ß-catenin, Osterix, and RUNX2, and significantly inhibited osteoblast differentiation. CONCLUSIONS: MiR-124 decreased and GSK-3ß elevated in AS ligament tissue. Down-regulation of miR-124 expression enhanced GSK-3ß expression, weakened Wnt/ß-catenin pathway activity, and inhibited the differentiation of ligament fibroblasts into osteoblasts.

[Clinical features of recurrences in benign paroxysmal positional vertigo].

Objective:To study the clinical features of patients with recurrent benign paroxysmal positional vertigo (BPPV) and to analyze potential related factors of recurrences.Method:Eighty patients who suffered recurrent BPPV were enrolled in this study. Patients were divided into three groups: young group (21 cases), middle-aged group (25 cases) and old-aged group (34 cases). Theclinical data including age, gender, pathological pattern and canal type of BPPV were collected. We further analyzed the efficacy of repositioning treatment for recurrent BPPV.Result:In this study, there are 62 cases of primary BPPV(77.50%) and 18 cases of secondary BPPV(22.50%). In patients with recurrent BPPV, the laterior semicircular canal BPPV and posterior semicircular canals BPPV were the most common, and there was no differences on the aspects of age and gender in the two groups of patients with recurrent HSC BPPV and PSC BPPV (P>0.05).Compared with the primary diagnosis, we found that 48.75% cases relapsed in the same semicircular canals, 21.25% cases relapsed in other canals of the same ear, and 30.00% cases relapsed in a different ear. In this study, 96.25% patients with recurrent BPPV were cured in a month and one-time reset success rate was 56.25%.Conclusion: The age, gender, pathological pattern and canal type show certain clinical features of recurrent BPPV. The evidence of long term of recurrence course and high variability of problematic location support the approval opinion based on new otolith.

Assessment of muscle fatigue using sonomyography: muscle thickness change detected from ultrasound images.

Muscle fatigue is an exercise-induced reduction in maximal voluntary muscle force. As the surface electromyography (SEMG) can be used to estimate the features of neuromuscular activations associated with muscle contractions, it has been widely employed as an objective tool to evaluate muscle fatigue. On the other hand, ultrasound imaging can inherently provide the morphological information of individual muscle, thus the architectural changes of muscles during fatigue can be obtained. In this study, we demonstrated the feasibility of using the dimensional change of muscles detected by ultrasound images, named as sonomyography (SMG), to characterize the behavior of muscles when they were in fatigue. The SEMG signals of the muscles were also recorded simultaneously and used for comparison. The right biceps brachii muscles of 8 normal young male adult subjects were tested for 30s under 80% of the maximal voluntary isometric contraction. The muscle fatigue was indicated by the change of the root-mean-square (RMS) and median frequency (MDF) of the SEMG signals. The results showed that the SEMG RMS had a linear increase with time with a rate of 2.9+/-1.9%/s (mean+/-S.D.), while the MDF decreased linearly with a rate of -0.60+/-0.26Hz/s. The muscle thickness, detected from the ultrasound images, continuously increased during the muscle fatigue but with a nonlinear increase with time, which was rapid during the initial 8.1+/-2.1s with a mean deformation rate of 0.30+/-0.19%/s and then became slower with a rate of 0.067+/-0.024%/s up to 20s after the contraction. The muscle deformation at 20s was 3.5+/-1.6%. The results demonstrated that the architectural change of muscles detected using SMG could potentially provide complementary information for SEMG for the muscle fatigue assessment.

Preliminary Experience with Stent-Assisted Coiling of Aneurysms Arising from Small (<2.5 mm) Cerebral Vessels Using The Low-Profile Visualized Intraluminal Support Device.

BACKGROUND AND PURPOSE: The Low-Profile Visualized Intraluminal Support (LVIS) stent is a new device recently introduced for the treatment of wide-neck intracranial aneurysms. This single-center study presents the authors' preliminary experience using the LVIS stent to treat saccular aneurysms with parent arteries smaller than 2.5 mm. MATERIALS AND METHODS: Aneurysms with a LVIS stent used in a small parent vessel (<2.5 mm in diameter) between October 2014 and April 2016 were included. Procedure-related complications, angiographic results, clinical outcomes, and midterm follow-up data were analyzed retrospectively. RESULTS: A total of 22 patients was studied, including 5 ruptured and 17 unruptured aneurysms. Most of the aneurysms were located in the anterior circulation (90.9%). Stent placement in the parent arteries measuring 1.7-2.4 mm in diameter (mean, 2.1 mm) was successful in 100% of cases. Procedure-related complication developed in 1 patient (4.5%) who presented with aneurysm rupture. No permanent morbidity and mortality occurred. Immediate angiographic outcome showed complete occlusion in 8 aneurysms (36.4%), neck residual in 8 (36.4%), and residual aneurysm in 6 (27.3%). All patients underwent angiographic follow-up at a mean of 8.3 months, which revealed complete occlusion in 18 (81.8%) patients, neck remnant in 3 (13.6%), and residual sac in 1 (4.5%). No recanalization of the target aneurysm was observed. There was 1 case with asymptomatic in-stent stenosis. CONCLUSIONS: Our preliminary results show that the deployment of LVIS stents in small vessels is feasible, safe, and effective in the midterm. Larger studies with long-term follow-up are needed to validate our promising results.

Viscous and fermentable nonstarch polysaccharides affect intestinal nutrient and energy flow and hindgut fermentation in growing pigs.

Two experiments were conducted to determine the effects of viscosity and fermentability of purified nonstarch polysaccharides (NSP) on intestinal nutrient and energy flow and hindgut fermentation in growing pigs. In Exp. 1, 15 ileal-cannulated pigs (50.5 ± 2.9 kg BW) were allotted to 5 diets in a 2-period incompletely randomized design. Pigs were provided a cornstarch N-free diet (CST) or a diet containing 5% inulin (INU), carboxymethylcellulose sodium (CMC), microcrystalline cellulose (MCC), or Solka-Floc (SFC). Apparent ileal digestibility (AID) of DM, ash, and GE were greater ( < 0.05) in the MCC and SFC diets than in the INU and CMC diets. Apparent total tract digestibility (ATTD) of DM, carbohydrates (CHO), and GE and the DE content in the CST and INU diets were greater ( < 0.01) than in the CMC, MCC, and SFC diets. Hindgut disappearance of DM, CHO, and GE in the INU diet was greater ( < 0.05) than in the other N-free diets. The ileal endogenous flow of His, Ile, Leu, Met, Thr, Val, and all dispensable AA in the CMC diet was greater ( < 0.05) than in the other diets. In Exp. 2, 6 ileal-cannulated pigs were allotted to 3 diets containing either a corn-soybean meal control diet or the control diet with 5% INU or CMC in a replicated 3 × 3 Latin square design. Standardized ileal digestibility (SID) of Ala, Arg, Asp, Cys, Gly, His, Ile, Leu, Lys, Phe, Ser, Thr, and Val were greater ( < 0.05) in the CMC diet than in the control and INU diets. Incorporation of 5% INU or CMC in the control diet reduced ( < 0.01) the AID of arabinoxylan and insoluble and total NSP. The ATTD of NSP and cellulose and the hindgut disappearance of NSP, ß-glucan, and cellulose in the CMC diet were less ( < 0.01) than in the control and INU diets. Inclusion of 5% INU in the diet increased ( < 0.01) hindgut fermentation of insoluble and total NSP compared with the control and CMC diets. In conclusion, depending on the viscosity and fermentability of the NSP, different sources will have different effects on nutrient digestibility and hindgut fermentation. Addition of 5% INU to a corn-soybean meal diet reduced digestibility of the NSP component in the ileum and increased hindgut fermentation of total NSP. In contrast, the inclusion of CMC increased the AID and SID of the diet and reduced total tract digestion and hindgut fermentation of NSP component. Carboxymethylcellulose sodium is not recommended as a source of synthetic fiber in a N-free diet to determine the SID of AA of diets.

Long-Term Outcome of Tubridge Flow Diverter(S) in Treating Large Vertebral Artery Dissecting Aneurysms-A Pilot Study.

BACKGROUND AND PURPOSE: The experience of flow diverters (FDs) in treating large vertebral artery-dissecting aneurysms (VADAs) is still limited. This study was conducted to present our long-term outcome of VADAs treated with a Tubridge flow diverter (TFD), a new device developed in China. MATERIALS AND METHODS: The clinical and angiographic data of six patients harboring large VADAs and treated with TFDs were prospectively collected and analyzed. RESULTS: A total of nine TFDs were successfully implanted in six patients. Angiographic follow-up images were available for all patients at a median of 26.0 (18.5, 37.5) months after treatment. Five of the six VADAs were completely occluded, and the last was improved (near complete occlusion). In-stent stenosis was detected in one case and was handled appropriately by angioplasty and stenting. All covered branches and parent arteries remained patent. There were no complications or new neurological deficits observed in any of the patients. At the latest clinical follow-up (36.5 (26.0, 44.5) months), all patients achieved 0 in the modified Rankin scale score. CONCLUSIONS: Our preliminary experience suggests that the Tubridge flow diverter might be an alternative treatment for large and recurrent dissecting aneurysms derived from the vertebral artery.

SLC11A1 (formerly NRAMP1) gene polymorphisms and tuberculosis susceptibility: a meta-analysis.

OBJECTIVE: Although many case-control studies have investigated the association between the SLC11 A1 gene polymorphisms and tuberculosis (TB) susceptibility, results were conflicting due to limited power. We reviewed the literature systematically by means of meta-analysis, provided a quantitative summary estimate on the association with TB, and examined some sources of between-study heterogeneity. DESIGN: We searched databases (MEDLINE, PUBMED and OVID) from January 1995 to December 2004 using 'gene' or 'SLC11A1' or 'NRAMP1', in combination with 'tuberculosis', performed a manual search of citations from relevant original studies and review articles, or corresponded with authors. RESULTS: The summary ORs for studies with 3'UTR, D543N, INT4 and 5'(GT)n loci allele variants in the SLC11A1 gene were 1.33 (95%CI 1.08-1.63), 1.67 (95%CI 1.36-2.05), 1.14 (95%CI 0.96-1.35) and 1.32 (95%CI 1.03-1.68), respectively, compared with their corresponding common alleles. The pooled ORs by sub-group analyses for the four loci described above were 1.20 (95%CI 0.86-1.68), 1.69 (95%CI 1.14-2.50), 1.50 (95%CI 1.17-1.91), and 1.31 (95%CI 1.05-1.64) in subjects of African descent, 1.46 (95%CI 1.10-1.94), 1.65 (95%CI 1.29-2.12), 0.91 (95%CI 0.66-1.25) and 1.86 (95%CI 1.33-2.62) in Asian subjects, 1.81 (95%CI 0.66-4.93), 1.79 (95%CI 0.72-4.47), 0.87 (95%CI 0.61-1.22) and 1.02 (95%CI 0.35-2.99) in European subjects. CONCLUSIONS: Polymorphisms at the four loci had no statistically significant association between the SLC11A1 variants and susceptibility to TB in subjects of European descent, while they showed a statistically significant association in Asian subjects (except the INT4 variant), African subjects (except the 3'UTR variant) and the population as a whole (except the INT4 variant).

Sonomyography: monitoring morphological changes of forearm muscles in actions with the feasibility for the control of powered prosthesis.

Electromyography (EMG) has been widely used for the assessment of musculoskeletal functions and the control of electrical prostheses, which make use of the EMG signal generated by the contraction of the residual muscles. In spite of the successful applications of EMG in different fields, it has some inherent limitations, such as the difficulty to differentiate the actions of neighboring muscles and to collect signals from deep muscles using the surface EMG. The majority of current EMG controlled prostheses can only provide sequential on-off controls using signals from two groups of muscles, so the users are required to put many conscious efforts in monitoring the speed and range of motion of the terminal devices being controlled. Recently, many alternative signals based on the detection of dimensional changes of muscles or tendons during actions have been reported. The objective of this study was to investigate the potential of the dimensional change of muscles detected using sonography for musculoskeletal assessment and control. A portable B-mode ultrasound scanner was used to collect the dynamic ultrasound images of the forearm muscles of six normally limbed young adults and three amputee subjects. A motion analysis system was used to collect the movement of the wrist angle during the experiments for the normal subjects. It was demonstrated that the morphological changes of forearm muscles during actions can be successfully detected by ultrasound and linearly correlated (R(2)=0.876+/-0.042, mean+/-S.D.) with the wrist angle. We named these sonographically detected signals about the architectural change of the muscle as sonomyography (SMG). The mean ratio between the wrist angle and the percentage deformation of the forearm muscle was 7.2+/-3.7 degrees /% for the normal subjects. The intraclass correlation coefficient (ICC) of this ratio among the three repeated tests was 0.868. The SMG signals from the residual forearms were also successfully detected when the three amputee subjects contracted their residual muscles. The results demonstrated that SMG had potentials for the musculoskeletal control and assessment.

[The characteristics of the patients with BPPV accompanied byidiopathic sudden sensorineural hearing loss].

Objective:To investigate the characteristics of the patients with BPPV accompanied by idiopathic sudden sensorineural hearing loss(ISSNHL).Method:Retrospective analysis of 150 cases of patients with ISSNHL.All data of the cases were collected,including history,pure tone audiograms and VNG tests.Result:16.0% of all patients had BPPV accompanied by ISSNHL.77.8% of these patients had an abnormal caloric test result.73.9% of them had a profound hearing loss.The hearing outcome between those with and without BPPV had no significant difference.Conclusion:Patients with BPPV accompanied by ISSNHL seem to have a more severe damage than those without BPPV,while the hearing outcomes seem no significant difference between them.

[Scalp surface skin grafts in reconstruction of external auditory meatus in congenital aural atresia].

OBJECTIVE: To investigate the clinical application of scalp skin grafts in reconstruction of external auditory meatus in congenital aural atresia. METHODS: We conducted a retrospective study on 85 patients of congenital aural atresia, all of whom were unilateral, operated from March of 2008 to December of 2010 in ENT department of the Sun Yat-Sen Memorial Hospital. The patients enrolled in the study were between 6 to 37 years old (median age 12 years), 55 male and 30 female. Scalp surface graft in ipsilateral temporal region was harvested to cover the bony external auditory meatus. RESULTS: All of these scalp split-thickness skin grafts survived without necrosis, no restenosis was found in these external auditory meatus. Neither scar nor alopecia was found in the skin-harvesting region, and hairs grew well. Granulations occurred in 27 cases in the first to sixth month posteroperatively, 20 cases recovered after local treatment. In the first year, 30 cases obtained hearing improvement more than 15 dB, 36 cases gained more than 25 dB and 19 cases gained more than 35 dB. Totally 8 patients were lost in the 4 to 5 years of follow-up, 70 cases (70/77, 90.9%) developed new external auditory meatus, 7 cases (7/77, 9.1%) suffered from stenosis in different degrees, but no atresia was found in these patients. CONCLUSION: Scalp split-thickness skin grafts has significant clinical advantage in meatoplasty of congenital aural atresia.

[A clinical study into the vestibular function and therapy of patients with chronic positional symptoms after acute vestibular syndrome].

Objective:To investigate the status of the vestibular function of the patients with chronic positional symptoms after peripheral acute vestibular syndrome (AVS) and the curative effect of the vestibular rehabilitation therapy (VRT). Method:Using caloric test (CT), head shaking nystagmus test (HST), cervical vestibular evoked myogenic potentials as well as ocular vestibular evoked myogenic potentials to estimate the function of semicircular canal and otolith organs. The patients with normal VEMPs are divided as Group A. Otherwise are as Group B. Both groups are treated with VRT. The curative effect is estimated by vestibular symptom index (VSI) and Berg balance scale (BBS). Result:Thirty-three of 37 patients (86.5%) had an abnormal result of CT and HST, with 23 of these patients (65.7%) had an abnormal of both test. Twenty-two patients (59.5%) were in Group A and 15 (40.5%) in Group B. Before the therapy, Group B had a higher score of the balance and dizziness symptoms of VSI (P<0.05), and Group A had a higher score of the BBS (P<0.05). After the therapy, the VSI scores of both groups dropped and scores of the BBS raised. Conclusion:Patients with chronic positional symptoms after peripheral AVS have dynamic vestibular lesions to different extents. Those with otolith organs lesions tend to have a worse function of balance. Nevertheless, patients have a better off after VRT.

[A clinical analysis for sudden sensorineural hearing loss withcontralateral sensorineural hearing loss].

Objective:To analyze the clinical characteristics and prognosis,and to learn the impact factors of patients with sudden sensorineural hearing loss with contralateral sensorineural hearing loss(SSHLwCSHL).Method:Clinical data of 63 cases of patients with SSHLwCSHL were analyzed systematically,including all the clinical manifestations,audiologic characteristics and the effect assessment,and compared with that of unilateral sudden sensorineural hearing loss(USSHL) and bilateral sudden sensorineural hearing loss(BSSHL).Base on those,we summarized comprehensively the development and prognosis characteristics of the disease.Result:The incidence of SSHLwCSHL was 8.3 percent of overall patients with SSNHL.SSHLwCSHL occurs more commonly in male patients,with more vertigo,diabetes mellitus,and lipid panel abnormalities compared with other groups.Hearing curve and the degree of hearing loss of the prevalence ear of SSHLwCSHL was statistically significant difference with USSHL(P<0.05).Most common reason of the contralateral hearing loss was sudden sensorineural hearing loss(49%),and 59% patients of SSHLwCSHL suffered hearing loss of other ear after 2-10 years after contralateral hearing loss.The total effective rate was 14.3%,1 in 63 patients cured,1 excellence and 6 effective.The total effective rate was 9.5% in patients with severe or profound sensorineural hearing loss in the contralateral ear,which was lower than that of patients with moderate and moderately severe sensorineural hearing loss in the contralateral-ear(P=0.021).Conclusion:SSHLwCSHL has complex condition.The prognosis for improvement is poor.Recognition of similarities and differences between bilateral and unilateral SSNHL can help in counseling and managing the patients.

Novel BTB/POZ domain zinc-finger protein, LRF, is a potential target of the LAZ-3/BCL-6 oncogene.

BTB/POZ-domain C2H2 zinc(Zn)-finger proteins are encoded by a subfamily of genes related to the Drosophila gap gene krüppel. To date, two such proteins, PLZF and LAZ-3/BCL-6, have been implicated in oncogenesis. We have now identified a new member of this gene subfamily which encodes a 62 kDa Zn-finger protein, termed LRF, with a BTB/POZ domain highly similar to that of PLZF. Both human and mouse LRF genes, which localized to syntenic chromosomal regions (19p13.3 and 10B5.3, respectively), were widely expressed in adult tissues and cell lines. At approximately 9.5-10.0 days of embryonic development, the mouse LRF gene was expressed in the limb buds, pharyngeal arches, tail bud, placenta and neural tube. The LRF protein associated in vivo with LAZ-3/BCL-6, but not with PLZF to which it was more related. Although the LRF, or LAZ-3/BCL-6, BTB/POZ domain could readily homodimerize, no heterodimerization was detected in vivo between the LRF and LAZ-3/BCL-6 BTB/POZ domains and interaction between full length LRF and LAZ-3/BCL-6 required the presence of both the BTB/POZ domain and Zn-fingers in each partner protein. As expected from the above results, LRF and LAZ-3/BCL-6 also colocalized with each other in the nucleus. Taken together, our findings suggest that BTB/ POZ-domain Zn-finger proteins may function as homo and heterodimeric complexes whose formation, and hence the resultant effect on transcription of their downstream target genes, is determined by the levels and expression domains of a given partner protein.

Ventricular excitation maps using tissue Doppler acceleration imaging: potential clinical application.

OBJECTIVES: The purpose of this study is to validate the use of tissue Doppler acceleration imaging (TDAI) for evaluation of the onset of ventricular contraction in humans. BACKGROUND: Tissue Doppler acceleration imaging can display the distribution, direction and value of ventricular acceleration responses to myocardial contraction and electrical excitation. METHODS: Twenty normal volunteers underwent TDAI testing to determine the normal onset of ventricular acceleration. Two patients with paroxysmal supraventricular tachycardia and 30 patients with permanent pacemakers underwent introduction of esophageal and right ventricular pacing electrodes, respectively, and were studied to visualize the onset of pacer-induced ventricular acceleration. Eight patients with dual atrioventricular (AV) node and 20 patients with Wolff-Parkinson-White (WPW) syndrome underwent TDAI testing to localize the abnormal onset of ventricular acceleration, and the results were compared with those of intracardiac electrophysiology (ICEP) tests. RESULTS: The normal onset and the onset of dual AV node were localized at the upper interventricular septum (IVS) under the right coronary cusp within 25 ms before the beginning of the R wave in the electrocardiogram (ECG). In all patients in the pacing group, the location and timing of the onset conformed to the positions and timing of electrodes (100%). In patients with WPW syndrome, abnormal onset was localized to portions of the ventricular wall other than the upper IVS at the delta wave or within 25 ms after the delta wave in the ECG. The agreement was 90% (18 of 20) between the abnormal onset and the position of the accessory pathways determined by ICEP testing. CONCLUSIONS: These results suggest that TDAI is a useful noninvasive method that frequently is successful in visualizing the intramural site of origin of ventricular mechanical contraction.

The impact of differential binding of wild-type RARalpha, PML-, PLZF- and NPM-RARalpha fusion proteins towards transcriptional co-activator, RIP-140, on retinoic acid responses in acute promyelocytic leukemia.

Retinoic acid receptor (RA) heterodimer (RAR/RXR) activities have been shown to be repressed by transcriptional co-repressor, SMRT/N-CoR, in the absence of the ligand while upon all-trans retionic acid (ATRA) treatment, SMRT/N-CoR is dissociated from RARalpha leading to gene expression by the recruitment of transcriptional co-activators to the transcriptional complex. The difference in response to ATRA therapy between acute promyelocytic leukemia (APL) patients with PML-RARalpha fusion and PLZF-RARalpha fusion has recently been found to be partially due to the strong association of the transcriptional co-repressor, SMRT/N-CoR, with PLZF domain. We demonstrate that SMRT association, as with PML-RARalpha, can be released from NPM-RARalpha at pharmacological concentration of ATRA (10-6 M). Moreover, we show for the first time that the interaction between the transcriptional co-activator, RIP-140, and PML-, PLZF- or NPM-RARalpha fusion proteins can be positively stimulated by ATRA although they are less sensitive as compared with the wild-type RARalpha. Our results suggest that the dissociation of transcriptional co-repressors, SMRT/N-CoR, and recruitment of co-activators, eg RIP-140, to APL-associated fusion proteins constitute a common molecular mechanism in APL and underlie the responsiveness of the disease to RA therapy. Leukemia (2000) 14, 77-83.

A new scanning approach for limb extremities using a water bag in freehand 3-D ultrasound.

3-D ultrasound (US) can significantly improve the visualization of musculoskeletal tissues, such as residual limbs, feet and hands. Traditionally, mechanical scanning is normally required to obtain the entire volume of these limb extremities. In this paper, a new scanning approach using a water bag was described to collect the complete volume of various tissues surrounding bones. The water bag was used to contain the limb extremity and the scanning was conducted on its external surface from different directions. The recorded 2-D US images containing complete anatomic information surrounding the bones from different directions were used to form full 3-D volumes of the limb extremities. A plastic auxiliary apparatus was designed to hold the water bag and support the subject's limb part with an armrest. A corresponding algorithm was proposed to remove invalid image information within each sweep by a separating plane defined semiautomatically. Two phantoms were used to test the repeatability and accuracy of the imaging. The distance between two plastic bands attached to a plastic tube filled with US gel measured by a micrometer and from the four reconstructed volumes were 39.03 +/- 0.36 mm and 39.2 +/- 0.5 mm, respectively. The diameter, height and volume of a silicone cylinder phantom measured for the 10 reconstructed volumes were 40.2 +/- 1.4 mm, 12.9 +/- 1.0 mm and 16400 +/- 1600 mm(3), respectively. They agreed with the corresponding results obtained by the micrometer, which were 41.29 +/- 0.13 mm, 12.98 +/- 0.17 mm and 17370 +/- 140 mm(3), respectively. The reconstructed volumes of the two phantoms, a chicken leg in vitro, and human fingers in vivo were also reported. The preliminary results obtained in this study demonstrated that this new scanning approach should have potential for the 3-D US imaging of musculoskeletal extremities using freehand scanning.