Pulsed Doppler Echocardiography in Patients with Aorto-pulmonary Connection

ABSTRACT. The pulsed Doppler principle enables us to study the bloodflow velocity at specific points in the heart and great vessels. In such aorto-pulmonary connections as patent dnctus arteriosus, aorto-pulmonary window and truncus arteriosus the bloodflow velocity patterns are typical of the malformation. Based on knowledge of these abnormal flow patterns the diagnoses of these malformations can be made.     

中国大陆地区妇女骨质疏松筛选工具探讨

目的建立适用于中国大陆地区40岁及以上妇女的骨质疏松（osteoporosis，OP）筛选工具。方法以20～39岁妇女腰椎骨密度的均数和标准差作为参考值计算T—score。以双能X线骨密度仪（dual—energy X—ray absorptiometry，DxA）的测量结果作为金标准，采用二分类的Bayes判别分析，建立判别函数。结果我国大陆地区40岁及以上妇女OP筛选工具（osteoporosis screening tool for Chinese，OSTC）为：体重-2×年龄＋50。判别准则为OSTC〉0为无OP危险性，OSTC≤0为有OP危险性。OSTC的正判率为75．78％，灵敏度为76．8％，特异度为75．1％，Kappa值为0．51（P=0．000），说明OSTC与DXA的判定结果一致性尚可。结论OSTC是一个简便的OP筛选工具。根据年龄、体重两个变量的简单计算，即可对我国大陆地区40岁及以上的妇女进行OP危险性的筛选。但OSTC没有得到外部数据的验证，其优劣还有待进一步评价。     

Cerebral proton magnetic resonance spectroscopy of neonates after extracorporeal membrane oxygenation

During venoarterial extracorporeal membrane oxygenation the right carotid artery is ligated in a hypoxic neonate. The aim of the present study was to compare the morphology and metabolism of the left and right basal ganglia in 10 neonates after extracorporeal membrane oxygenation, using proton magnetic resonance imaging and spectroscopy. Data could be obtained in 9 neonates. No significant metabolic differences were found between either the left or right basal ganglia, despite a small right-sided thalamic infarct in one child. Metabolism was normal in all cases. All the infants showed symmetrical neurodevelopment.

Conclusion: Ligation of the right carotid artery for venoarterial extracorporeal membrane oxygenation did not produce persistent changes in brain metabolism in the basal ganglia in this small group of patients.     

C-reactive protein in migraine sufferers similar to that of non-migraineurs: the Reykjavik Study

C-reactive protein (CRP), a marker of inflammation, has been associated with cardiovascular disease. Risk of cardiovascular disease is increased in migraineurs with aura. Results from a clinical report, case–control and a cohort study suggest that CRP is elevated in migraineurs compared with non-migraineurs. We examined the proposed association in a case–control study nested within two large population-based studies. The relationship between migraine and CRP (high-sensitivity CRP) was studied in 5906 men and women aged 55.0 ± 8.5 years in the Reykjavik Study and 1345 men and women aged 27.7 ± 5.5 years from the Reykjavik Study for the Young. A modified version of the International Headache Society's criteria was used to categorize people into migraineurs (two or more symptoms) or non-migraineurs. Migraineurs with visual or sensory symptoms were further defined as having migraine with aura (MA) or without aura (MO). Multivariable-adjusted CRP levels were similar in migraineurs and non-migraineurs for men (0.83 vs. 0.79 mg/l, P  = 0.44) and for women (0.87 vs. 0.87 mg/l, P  = 0.90). When further stratified by migraine aura and age, no differences were found between non-migraineurs, MO and MA among men. In women, CRP levels were borderline higher in those with MO compared with non-migraineurs and those with MA (1.01 mg/l vs. 0.81 and 0.75 mg/l, P  = 0.08 and P  = 0.08) in age group 19–34 years, but significantly lower in age group 60–81 years (0.52 mg/l vs. 1.07 and 1.01 mg/l, P  = 0.007 and P  = 0.03). CRP levels were not increased among migraine sufferers compared with non-migraineurs. Older women migraineurs without aura had lower CRP values than non-migraineurs and migraineurs with aura.     

Strengthen international academic cooperation and exchanges: prospects in the 21st century Summary of the First World Chinese Congress of Digestion

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The RAR-RXR as well as the RXR-RXR pathway is involved in signaling growth inhibition of human CD34+ erythroid progenitor cells

Previous studies have shown that retinoic acid (RA), similar to tumor necrosis factor-alpha (TNF-alpha), can act as a bifunctional regulator of the growth of bone marrow progenitors, in that it can stimulate granulocyte-macrophage colony-stimulating factor (GM-CSF)- or interleukin-3 (IL-3)-induced GM colony formation, but potently inhibit G-CSF-induced growth. The present study, using highly enriched human CD34+ as well as Lin- murine bone marrow progenitor cells, demonstrates a potent inhibitory effect of 9-cis-RA on burst-forming unit-erythroid (BFU-E) colony formation regardless of the cytokine stimulating growth. Specifically, 9-cis-RA potently inhibited the growth of BFU-E response to erythropoietin (Epo) (100%), stem cell factor (SCF) + Epo (92%), IL- 3 + Epo (97%), IL-4 + Epo (88%), and IL-9 + Epo (100%). Erythroid colony growth was also inhibited when CD34+ progenitors were seeded at one cell per well, suggesting a direct action of RA. Using synthetic ligands to retinoic acid receptors (RARs) and retinoid X receptors (RXRs) that selectively bind and activate RAR-RXR or RXR-RXR dimers, respectively, we dissected the involvement of the two retinoid response pathways in the regulation of normal myeloid and erythroid progenitor cell growth. Transactivation studies showed that both the RAR (Ro 13- 7410) and RXR (Ro 25-6603 and Ro 25-7386) ligands were highly selective at 100 nmol/L. At this concentration, Ro 13-7410 potently inhibited G- CSF-stimulated myeloid as well as SCF + Epo-induced erythroid colony growth. At the same concentration, Ro 25-6603 and Ro 25-7386 had little or no effect on G-CSF-induced colony formation, whereas they inhibited 75% and 53%, respectively, of SCF + Epo-stimulated BFU-E colony growth. Thus, the RAR-RXR response pathway can signal growth inhibition of normal bone marrow myeloid and erythroid progenitor cells. In addition, we demonstrate a unique involvement of the RXR-RXR pathway in mediating growth inhibition of erythroid but not myeloid progenitor cells.