Hypertension is an important risk factor for cardiovascular and cerebrovascular diseases,which can damage structure and function of vital organs such as the heart,brain and kidney.Pseudo hypertension (PHT) refers to the blood pressure measured by ordinary cuffmanometry is higher than that of the arterial puncture,which is an essential factor of refractory hypertension.Recent findings have suggested that the elderly patients with concomitant history of atherosclerotic disease,renal insufficiency,and diabetes mellitus have the highest risk of pseudohypertension.The incidence rate ofpseudohypertension is about 1.7％-50％ in domestic and international studies.In the clinical treatment,the misdiagnosis of hypertension of patients with excessive blood pressure will lead to severe perfusion defects.In this review,we will focus on the diagnosis and pathogenesis of pseudohypertension.

Objective To explore the effects of the β3 adrenergic receptor (β3-AR) agonist BRL37344 on cardiac fibroblast proliferation and collagen fiber hyperplasia in Wistar rats by promoting the phosphaticlylinositol 3 kinase-protein kinase B(PI3K-Akt) signal transduction pathway. Method Cardiac fibroblasts(CFbs) were isolated from 1 - 3 day-old Wistar rats under the sterile environment in the laboratory of the First Affiliated Hospital of Hasbin Medical University, by using enzyme digestion and an modified technique of differential anchoring velocity.The cultured myocardial cells were randomly (random number) divided into five groups. ① In blank group, rats were not treated with drug; ②in BRL group, rats were treated with BRL37344; ③in LY group, rats were treated with LY294002(PI3K antagonist) for one hour before treated with BRL37344;④in Akt-Ⅰ group,rats were treated with Akt-Ⅰ (Akt antagonist) for one hour before treated with BRL37344;⑤in L-A group, rats were treated with LY294002 and Akt-Ⅰ for one hour before treated with BRL37344. MTT colorimetric method and RT-PCR were used to observe the role of β3-AR agonist with or without PI3K antagonist and/or Akt antagonist in cardiac fibroblast proliferation (CFP) and collagen fiber hyperplasia (CFH). Comparisons between groups were made by one-way ANOVA and Tukey test. Results ①β3-AR was present in the CFbs. ②Compared with BRL group, the CFP and CFH in LY and Akt-Ⅰ groups were lower (P ＜0.01) and those in L-A group were lowest (P ＜ 0.01). ③Compared with blank group,the expressions of type Ⅰ and type Ⅲ fiber mRNA obliviously increased in BRL group (P ＜ 0.01),and at 48 hours,the expressionrs reached peak. At 48 hours,compared with BRL group,the expressions in LY and Akt-Ⅰ groups were lower, and were lowest in L-A group ( P ＜0.01). Conclusions BRL37344 promotes cardiac fibroblast proliferation and expressions of type Ⅰ and Ⅲ collagen fiber mRNA by activating the PI3K-Akt signal transduction pathway.

Objective To investigate the frequency of c-kit mutation and prognosis in t (8;21) acute myeloid leukemia (AML) patients with trisomy 4. Methods A total of 145 de novo t(8;21) AML patients from February 2005 to January 2013 were analyzed retrospectively. Detection of exons 8 and 17 mutation of c-kit by PCR and cytogenetic analysis by R-banding technologies were performed on bone marrow samples of all patients at diagnosis. Clinical data were collected and analyzed statistically. Results Among 145 t (8;21) AML patients, 12 cases (8.3 %) were trisomy 4, 91.7 % (11/12) of them were identified with c-kit mutation, which was significantly higher than that without trisomy 4 [26.3 % (35/133), P< 0.01]. The follow-up data showed that the patients with trisomy 4 were correlated with the lower overall survival (OS) rate (15 % vs 56 %, P< 0.01) and disease-free survival (DFS) rate (0 vs 51 %, P< 0.01) when compared with patients without trisomy 4. Furthermore, the subgroup of patients with both trisomy 4 and c-kit mutation had a worse OS and DFS (P< 0.05). Conclusions Trisomy 4 is associated with high frequency of c-kit mutation and demonstrates poor prognosis in t(8;21) AML patients. Trisomy 4 or it combined with c-kit gene mutation is the main influencing factor on the survival of the patients with t(8;21) AML.

Objective To observe the effect of Jingujian Granule (Granule for strengthening the bones) No.1,2,and 3 on primary osteoporosis in the TCM syndromes of liver-kidney deficiency,both spleen and kidney deficiency,and spleen and kidney deficiency accompanied with blood stasis,and the influence on the bone metabolism indices.Methods Totally 210 primary osteoporosis cases were differentiated according to the TCM differentiation and administered Jingujian Granule No.1,2,3 or Caltrate D accordingly.The observation was carried out for 3 months on the improvement of clinical symptoms,changes in bone mineral density and bone metabolism indices,and safety indices.Results The total effective rate of Jingujian Granule No.1,2,and 3 was 89.92%,while that of Caltrate D was 33.3% (P

Objective To investigate the frequency and mutational status of JAK2V617F mutation in Chinese patients with chronic myeloproliferative disorders(CMPD) and to study the relative quantification of mutated JAK2 mRNA and the clinical significance. Methods JAK2V617F mutation and the mutational status were screened with amplification-refractory mutation system polymerase chain reaction(ARMS-PCR), the relative quantification of mutated JAK2 mRNA was studied by using capillary electrophoresis. Results A higher prevalence of JAK2V617F in either the heterozygotc or homozyote status in essential thrombocythemia (ET) was observed in elderly patients with ET (P<0.05). The presence of JAK2V617F was found to be significantly correlated with the age at diagnosis (P<0.05); patients with age ≥ 60 years showed significantly higher JAK2 mutated RNA levels than those with age < 60 years (P<0.05); the presence of JAK2V617F in polycythemia vera (PV) and ET was found to be significantly associated with higher hemoglobin level and higher leukocyte count (P< 0.05). In addition, higher leukocyte count was observed in homozygous ET patients than in heterozygous ET patients (P<0.05). The frequency of JAK2V617F mutation and the prevalence of homozygote in PV patients were higher than those in ET patients (P<0.05). The differences of JAK2V617F mRNA levels among PV, ET and chronic idiopathic myelofibrosis (IMF) were not significant. Conclusions ARMS-PCR technique can be used to detect the frequency and mutational status of JAK2V617F mutation owing to its sensitivity and along with capillary electrophoresis, quantitative assay for mutated JAK2 mRNA, diagnosis of CMPD and judgement of prognosis become possible.

BACKGROUND:In previous experiments, a polymer-shel ed microbubble contrast agent was successful y prepared using L-polylactic acid-polyethylene glycol methyl-covered liquid fluorocarbon perfluoropentane, which developed wel in vivo and in vitro under a second harmonic contrast-enhanced ultrasound with a low mechanical index OBJECTIVE:To optimize the conditions for preparing polymer-shel ed microbubble contrast agents with high yield and suitable size. METHODS:The polymer-shel ed microbubble contrast agent containing perfluoropentane was prepared by single emulsion method. Three preparation conditions, including polymer mass/perfluoropentane volume ratio (4/1, 2/1, 1/1, 1/2), hemogenate speed (18 000, 26 000, 35 000 r/min) and time (15, 30, 60, 120 seconds), were optimized, and the microbubble yield and size were set as judge standard. The contrast-enhanced ultrasonography of rabbit kidney was performed using the optimized microbubbles, and the arrival time, time to peak, half time of descending and peak intensity were analyzed by TCA software. RESULTS AND CONCLUSION:The preparation conditions were optimized as a polymer mass/perfluoropentane volume ratio of 2/1, homogenate speed of 26 000 r/min and homogenate time of 60 seconds, which presented a high microbubble yield of (1.8±0.4)×109/mL and mean size of (3.7±1.3)μm with uniform distribution. The arrival time, time to peak, half time of descending and peak intensity were detected as (3.1±0.6) seconds, (2.9±0.5) seconds, (4.0±0.7) seconds and (4.7±1.1)×10-5 AU, respectively. The polymeric microbubbles prepared by optimized conditions were of high yield, with suitable size and good contrast-enhanced effect in vivo.

OBJECTIVEThis study aimed to explore the roles of three common single nucleotide polymorphisms in the X-ray repair cross-complementing group-1 gene (XRCC1) and of life style factors and their possible interactions in the risk of esophageal squamous cell carcinoma (ESCC) in China.

METHODSA population-based case-control study of 432 cases and 915 controls was conducted in Yangzhong County, Jiangsu Province, China. Subjects were interviewed by trained interviewers using a structured questionnaire that included questions on demographics and life style. XRCC1 genotypes were analyzed using a polymerase chain reaction based restriction fragment length polymorphism (PCR-RFLP) assay. Unconditional logistic regression analysis was used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations of ESCC with XRCC1 polymorphisms and lifestyle-related factors.

RESULTSBoth the drinking of river water and alcohol intake history were significantly associated [SW1]with an increased risk of ESCC among men with aORs of 4.20 (95% CI: 2.90-6.07) and 2.03 (95% CI: 1.43-2.89), respectively. For women, the corresponding odds ratios were 8.37 (95% CI: 5.09-13.75) for river water drinking and 12.78 (95% CI: 2.69-60.69) for long-term stored rice intake. After the XRCC1 G28152A polymorphism was adjusted for potential confounders, subjects with GA and AA genotypes had an increased risk for ESCC (aOR: 1.21, 95% CI: 0.93-1.56), compared with subjects with a GG genotype, and a positive multiplicative interaction between intake of long-term stored rice and the XRCC1 G28152A polymorphism was observed (P=0.009).

CONCLUSIONSOur findings suggest that both lifestyle-related factors, including drinking river water, long-term stored rice and alcohol intake, and the XRCC1 G28152A polymorphism were possible risk factors for ESCC, and that the XRCC1 G28152A polymorphism modified the effect of long-term stored rice intake on the risk of ESCC among Chinese people.

Aged ; Carcinoma, Squamous Cell ; epidemiology ; genetics ; Case-Control Studies ; DNA-Binding Proteins ; genetics ; Esophageal Neoplasms ; epidemiology ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Humans ; Male ; Middle Aged ; Oryza ; Polymorphism, Genetic ; genetics ; X-ray Repair Cross Complementing Protein 1

Objective:To explore the correlation between preoperative nutritional status and postoperative complications in elderly patients with right-sided colon cancer.Methods:A prospective registry database of 1, 196 patients undergoing curative surgery for right-sided colon cancer was collected from 52 top-tier hospitals nationwide between September 2021 and June 2022. The cohort included 627 males and 569 females, with an age range of 64(53, 71) years. Among these, 136 patients developed complications, while 1, 060 did not. Patients were divided into two groups based on age: the elderly group(≥65 years, n=571) and the middle-aged group(<65 years, n=625). Preoperative nutritional assessment indicators, clinical pathological data, and the incidence of complications within 30 days post-surgery were collected. For normally distributed quantitative data, mean ± standard deviation( ± s) was used, and the t-test was applied for intergroup comparisons. Non-normally distributed quantitative data were represented as M( Q1, Q3) and analyzed using the Wilcoxon rank-sum test; categorical data were compared using the chi-square test or Fisher′s exact test. In the analysis of risk factors for postoperative complications in elderly patients, univariate analysis was first conducted on all potential risk factors, followed by the inclusion of statistically significant variables from univariate regression into a multivariate logistic regression model. Results:The overall incidence of postoperative complications was 11.37%(136/1 196), with common complications includin wound infection(2.26%), intestinal obstruction (2.26%), anastomotic leakage(1.42%), deep vein thrombosis(1.42%), and chylous leakage(1.42%). In the elderly group, the proportion of patients with preoperative nutritional risk who developed complications was significantly higher than those without complications(66.20% vs. 53.40%, P=0.043). In the multivariate analysis, body mass index( OR=1.058, 95% CI: 1.005-1.117, P=0.031) and nutritional risk( OR=1.803, 95% CI: 1.066-3.126, P=0.031) were identified as independent risk factors for postoperative complications in elderly patients. Conclusions:There is a correlation between preoperative nutritional status and the occurrence of postoperative complications in elderly colon cancer patients, particularly with respect to body mass index and nutritional risk. These findings underscore the importance of preoperative nutritional assessment and intervention in elderly patients to reduce the risk of postoperative complications.

OBJECTIVETo explore the clinical and laboratory features of chronic myeloid leukemia (CML) with atypical e14a3 and e19a2 BCR-ABL fusion gene subtypes.

METHODSWe retrospectively analyzed a cohort of CML patients with Ph chromosome positive confirmed by cytogenetic and FISH but classical e13a3(b2a2), e14a2(b3a2)and e1a2 fusion transcripts negative identified by conventional real-time quantification RT-PCR (RQ-PCR). Further RQ-PCR was done with the forward primer and reverse primer designed to detect rare atypical BCR-ABL fusion genes including e14a3 and e19a2 transcripts. Direct sequencing analysis was performed on the PCR products and mutations in the BCR-ABL kinase domain were detected. The clinical data of patients were retrospectively analyzed.

RESULTSSix CML patients were found to carry t(9;22) abnormality and BCR-ABL rearrangement confirmed by FISH but classical BCR-ABL fusion genes negative detected by RQ-PCR. Further RQ-PCR and sequencing analysis confirmed the fusion of BCR exon 14 and ABL exon 3 in five CML patients (case 1-5) and the fusion of BCR exon 19 and ABL exon 2 in one CML patient (case 6). E255K and I293T IM-resistant mutations were detected in case 1 and 2, respectively. Among five cases with e14a3 transcripts, four were CML-CP, one CML-AP. Four patients were male and one was female. The median age was 48 years. The patient (case 6) with e19a2 transcripts was 40-year-old female with a diagnosis of CML-CP and PLT count was more than 1 000×10⁹/L. Imatinib (IM) therapy was administer in case 1, 2, 3, 4 and hematopoietic stem cell transplantation (HSCT) was undergone in case 5 after hydroxyurea (Hu) or interferon failure. Case 1 who had E255K IM resistant mutation, responded poorly to IM but obtained a complete cytogenetic remission (CCyR) after a substitution of dasatinib for IM. Case 2 and 3 achieved CCyR 6 months later after IM treatment and had been maintained well with IM despite I293T mutation in case 2. Case 4 attained CCyR 3 months later after IM treatment but relapsed and died soon. Case 5 was still in CCyR after HSCT. Case 6 with e19a2 transcripts got complete hematologic response after Hu treatment and CCyR was achieved soon after IM therapy.

CONCLUSIONIncidence of CML with atypical transcripts is extremely low. They could benefit from tyrosine kinase inhibitors or HSCT. Rare and atypical BCR- ABL fusion gene subtypes could be missed by conventional RQ-PCR.

Adult ; Female ; Fusion Proteins, bcr-abl ; genetics ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; classification ; diagnosis ; genetics ; Male ; Middle Aged ; Retrospective Studies