Objective To study the effect of nickel-titanium stent(NTS) and consequent anti-allergy dexamethasone therapy on macrophage cells reactivity to lipopolysaccharide (LPS) from gram-negative bacterium .Methods The macrophage cell line Raw 264 .7 and dexamethasone-pretreated Raw264 .7 were co-cultured with NTS for 4 days ,and stimulated with LPS for 24 hours .The surface marker CD molecules of CD80 ,CD86 and FasL were detected with flowcytometr method ,the supernant cytokine production of proinflammatory cytokines IL-6 and TNF-αwas valued with ELISA method ,and intracellular inflammatory signal pathway acti-vation of NF-κB ,GAS ,ISRE and STAT3 was checked with signal molecule specific promoter lunciferase analysis .Results The stent pre-treatment improved LPS-mediated CD80 expression ,suppressed FasL production ,decreased IL-6 secretion and NF-κB ac-tivation ,the results have statistical significance (P<0 .05) .The dexamethasone treatment improved stent-mediated up-regulated ex-pression of CD80 ,FasL and TNF-α,and suppressed the activation of intracellular inflammatory signal pathway of NF-κB ,ISRE and STAT3 ,the results have statistical significance(P<0 .05) .Conclusion NTS inhibit macrophage cells Raw264 .7 react to TLR4 ag-onist LPS ,and dexamethasone treatment improved the function .

Objective To observe the mechanism of action of different extracts ofTangwang Mingmu Granules on high glucose induced VEGF and IL-1α gene and protein expressions in vascular endothelial cells.Methods Human umbilical vein endothelial cells EA.hy926 were divided into six groups: blank, high glucose,Tangwang Mingmu Granules, extract 1 (glycoside and flavonoid), extract 2 (organic acid and polysaccharides) and extract 3 (alkaloids) groups. High concentration glucose was used to establish the high glucose model in EA.hy926 cells. The expressions of VEGF and IL-1α mRNA were detected by semi-quantitative RT-PCR. The contents of VEGF and IL-1α protein were tested by ELISA.Results The gene expression and protein levels of VEGF and IL-1α were significantly up-regulated under the high glucose condition (P<0.05). However, the above indicators were significantly reduced after the treatment ofTangwang Mingmu Granules. The activity of different parts ofTangwang Mingmu Granules was as follows: extract 1> extract 3> extract 2.Conclusion The action intensity of glycosides and flavonoids, alkaloids, organic acids and polysaccharides on VEGF and IL-1α expression inTangwang Mingmu Granules weakens in sequence.

ObjectiveTo investigate the epidemiology of senile dementia in Shanghai.Methods15158 residents aged 65 or over were selected by stratified random cluster sampling from 3 districts in Shanghai. Two stages was carried to ascertain dementia: in the first stage, Mini Mental State Examination (MMSE) and Activity of Daily Living Scale (ADL) were used as screening tools; in the second stage, DSM-Ⅳ criteria for dementia was applied to diagnosis.ResultsScreening positive rate of MMSE and ADL are both 9.9%. 1271 cases of elderly with dementia were identified. The crude and age-standardized prevalence in residents aged 65 or over was 8.1% and 6.1%. The female, older age, lower education and worse marriage seemed to be more susceptible to senile dementia(P<0.01).ConclusionSenile dementia has become one of major diseases harmful to elderly's health.

ObjectiveTo evaluate probability and severity of behavioral and psychological symptoms in dementia (BPSD) in elderly with dementia in Shanghai.MethodsOn the basis surveyed before, total 1271 elderly with dementia were investigated with the international neuropsychiatric inventory (NPI) to evaluate BPSD.ResultsThe proportion of elderly with dementia that had BPSD was 50.95% , it was 32.17% for clinical significant disturbance (CSD). The symptoms had greatest impact on the caregivers were paranoia (2.32±1.48), followed by abnormal motor behavior (2.30±1.31) and hallucinations (2.16±1.25). The severity rating included mild 620 cases, moderate 238 cases, and severe 406 cases.ConclusionThe incidence rate of BPSD in elderly with dementia was high. The standard of severity grading should be selected with purposes.

ObjectiveTo analyze burden and tolerance of caregivers of elders with dementia in Shanghai.MethodsOn the basis of surveyed before, total 1271 caregivers of elders with dementia were investigated with the questionnaire that concerned the demographic characteristics, influence on body, psychology, life and tolerance.ResultsNearly 60% of the caregivers felt stress, nearly 40% of the caregivers thought that mental pressure had a negative impact on their health as a result of caring patients. Most of the caregivers responded with tolerance to non-adaptive behavior.ConclusionDementia caregivers are old, the burden is heavy. It is necessary to establish a social support system for elderly with dementia as soon as possible.

Objective To improve the success of the urethral stricture repair in males. Methods Chose 101 males of urethral stricture,their median age was 9 years old (range 3 to 57 years old). Of the patients,61 patients had anterior urethral stricture and the posterior urethral stricture occurred in 40 patients. The length of the stricture varied from 0.5 to 2.0 cm. All patients were repaired with the only genital flap suturing the strictural urethra. Results All repairs were completed in 1 stage, follow-up was from 12 to 18 months, excepted for patients with 3 fistula and 3 urethral stricture, 95 patients were voiding a straight stream, the other 6 patients need another surgery. Conclusion It is a good technique to treat urethral stricture with genital flap ff there is short urethral stricture with sufficient genital skin.

Objective To explore the prognosis and management of atrial fibrillation (AF) in patients with atrial septal defect(ASD) accompanied by AF after transcatheter closure of ASD. Methods During the period from July 2010 to May 2013, a total of 24 patients with ASD accompanied by AF were admitted to authors’ hospital to receive transcatheter closure of ASD. Electrocardiogram (ECG), chest X-ray film and transthoracic echocardiography (TTE) were performed before and one day after the operation. Follow-up information was obtained through telephone or at out-patient clinic interview. Results Successful occlusion of ASD was obtained in all patients, and in no patient the AF rhythm turned to sinus rhythm after the procedure. In one patient preoperative AF turned to postoperative atrial flutter, and AF recurred in one case who had received transcatheter ablation of AF before the procedure. One female patient developed gastric bleeding during the course of orally taking warfarin, and she died of cerebral infarction at three days after ceasing the use of warfarin. Of the 24 patients, no anticoagulant drug was used in 5 (20.8%), oral administration of aspirin was given in 7 (29.2%), and oral medication of warfarin was employed only in 11 (45.8%). Conclusion The spontaneous conversion rate of AF is very low in patients with ASD complicated by AF after transcatheter closure of ASD. Postoperative medication of anticoagulation should be strictly standardized and carefully managed.

OBJECTIVETo evaluate safety and efficacy of conversion of calcineurin inhibitors (CNI) to sirolimus (SRL) therapy for treatment of new-onset diabetes after kidney transplantation (NODAT).

METHODSOf 321 kidney transplant recipients, 34 patients who developed NODAT (10.59%) were divided into 3 groups to receive continued CNI therapy at a reduced dose (group A, 14 cases), sirolimus conversion therapy (group B, 12 cases), or oral hypoglycemic drugs (group C, 12 cases). All the patients had dietary and exercise therapies, and insulin injections were given in patients with postprandial (2 h) blood glucose over 14.0 mmol/L. The patients were followed up regularly for 5 years.

RESULTSThe mean blood glucose level was 13.02∓1.74 mol/L upon the diagnosis of NODAT in the 34 patients without significant differences between the 3 groups. At 6 months of therapy, fasting plasma glucose levels in the 3 groups decreased to 8.05 ∓2.45, 7.45∓2.44, and 9.30∓3.89 mmol/L, repsectively; at 12 months, blood glucose became normal in both groups A and B, but the patients in group A needed a greater daily insulin dose (P<0.05). In group B, the mean serum creatinine level was 165.1∓61.82 mmol/L at the conversion and lowered to 150∓53.05 mmol/L at 5 years (P<0.05), which were similar to those in group A at the two time points (152∓43.05 and 145.88∓53.05 mmol/L, respectively; P>0.05). In group C, creatinine level further increased after medication with oral hypoglycemic drugs. At 5 years, the patient and graft survival rates were 100% and 75% in group A, respectively, similar to those in group B (83.4% and 68%, respectively; P>0.05); group C showed lower patient and graft survival rates than groups B and C.

CONCLUSIONConversion from CNI to SLR therapy can significantly the metabolism of patients with NODAT without increasing the risk of acute graft rejection.

Blood Glucose ; Calcineurin Inhibitors ; therapeutic use ; Diabetes Mellitus ; Graft Rejection ; prevention & control ; Humans ; Hypoglycemic Agents ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; Sirolimus ; therapeutic use

Objective: To explore the short and mid-term efficacy of device closure of patent foramen ovale (PFO) for treating the patients with PFO combining cryptogenic stroke (CS) and transient ischemic attack (TIA). Methods: A total of 56 PFO patients with CS and TIA receiving device closure in our hospital from 2009-05 to 2015-12 were retrospectively studied. Transthoracic echocardiography (TTE), electrocardiogram (ECG), chest X-ray were examined at 24h, 1 month, 3 and 6 months after theoperation; telephone visit was conducted every 6 months thereafter. Results: There were 54/56 PFO patients combining CS and 2 combining TIA; 53 (94.6%)patients received PFO occluder from Starway medical technology. Aspirin was used for 6 months after the operation. The patients were followed-up for the average of (34.67±23.24) months. No body suffered from post-operative stroke and TIA; no residual shunt was observed. Conclusion: The short and mid-term efficacy of device closure has been satisfactory for treating the patients with PFO combining CS and TIA; its overall clinical value should be further investigated in large population and long-term study.

Aim To clarify the effect of Borneol on the chloride channels and cell volume in poorly differentia-ted nasopharyngeal carcinoma CNE-2Z cells.Methods The technique of whole-cell patch clamp was used to detect the chloride currents and analyze the character-istics of the currents in CNE-2Z cells.The volume changes caused by Borneol were measured by the meth-od of time-lapse live cell imaging.Results The chlo-ride currents were induced by extracellular application of Borneol (20 μmol·L -1 )isotonic condition.The currents showed a characteristic of outward rectification and did not show voltage-dependent or time-dependent inactivation.The reversal potential of the currents was close to the CI-equilibrium potential. The currents were inhibited by the chloride channel blocker tamox-ifen.The currents were also inhibited by 47% hyper-tonic solution.Borneol decreased the cell volume by 9.4% in 30 min.Tamoxifen completely inhibited the Borneol-induced cell volume decrease.Conclusion Borneol can activate volume-sensitive chloride channels and induce volume decrease in CNE-2Z cells.Chloride channels play a pivotal role in the process of volume decrease caused by Borneol.