Objective To analyze the risk factors of post-operative respiratory failure in elderly cardiac carcinoma patients.Methods 28 elderly patients with respiratory failure (respiratory failure group) after the resection of cardiac carcinoma and 56 controls (control group) were studied.Preoperative respiratory function,the other complications,the site of incision,intravenous infusion,age of patients and smoking between two groups were compared by Logistic regression.Results Univariate risk factors included MVV<50% ,RV/TLC>50% ,FEV1<1.5L,PEF<70% ,DLCO<80% ,V75<70% ,the venous input,incision at chest.Multivariate logistic regression analysis identified that MVV<50% ,RV/TLC>50% ,FEV,<1.5 L,DLCO<80% were risk factors.Conclusion These results suggested that the patients with risk factors described above need more careful pre and post operative surveillance and management.

Objective To investigate the activation of NF-κB and regulation by ubiquitin (Ub)-proteasome pathway in the aorta of rats with chronic renal failure(CRF).Methods The CRF rat model was established by right nephreetomy and left branch renal artery ligation.The CRF rats were were randomly divided into simple CRF group(n=20)and CRF+M used as control group(CON).The NF-κB and the Ub mRNA expression were detected by RT-PCR,and its protein expression was analyzed by immunohistochemistry method.The activity of NF-κBwas mesured by EMSA method.The concentration of IL-1 and TNF-α was detected by ELISA.Results Compared with the CON group,the concentration of serum IL-1 and TNF-α was increased significantly in CRF group [IL-1:(9.02±1.29) vs (2.74±0.96)mg/L,P＜0.01;TNF-α:(50.02±9.52) vs (14.04±1.29)mg/L,P＜0.01]at month 4 after operation.The mRNA expression of NF-κB and Ub in the aorta of CRF group was 1.38 and 1.29 times as that of CON group(P＜0.01).and the protein expression of NF-κB and Ub was 3.75 and 20.5 times as that of CON group(P＜0.01).Compared with the CON group,the activity of NF-κB in the aorta of rats of CRF group was elevated markedly at month 4 after operation(P＜0.01).All the indices were further increased at month 6 after operation.Compared with CRF group,the concentrations of serum IL-1and TNF-α were decreased significantly in CRF+M group[IL-1:(2.94±0.33)mg/L,P＜0.01;TNF-α:(12.80±2.12)mg/L,P＜0.01].The mRNA and protein expression of NF-κB and Ub were also decreased markedly(P＜0.01),and the activity of NF-κB was decreased significantly at month 4 to 6 after operation(P＜0.01).But the amount of ubiquitnative protein was increased significantly in the aorta of CRF+M group as compared to CRF group(P＜0.01). Conclusion The inflammatory signal pathway of ubquitin-proteasome-NF-κB pathway was activated in the aorta of CRF rats,and the proteasome was probablely an important pharmacological intervention target to regulate the activation of NF-κB.

Objective To retrospectively analyze the clinical characteristics of acute renal failure ( ARF) induced by crush syndrome after Wenchuan earthquake,and summarize the rational and effective treatment managements of this kind of ARF. Methods The case histories of 12 patients diagnosed as ARF related to the crush syndrome in Wenchuan earthquake were pigeonholed. In order to evaluate the curative effects of the clinical features,laboratorial examination,continuous renal replacement therapy ( CRRT) and cure time were ana- lyzed. Results Anaemia,fever and lung infection were frequently happened in the patients diagnosed as ARF,and the frequency was 91. 67% ,66. 67% and 58. 33% respectively. Pleural effusion and acute respiratory distress syndrome ( ARDS) were noted in 41. 67% of the patients,and the increase of transaminase was noted as 91. 67% . Hypocalcaemia,hypoproteinemia and marked increase of creatine kinase ( CK) appeared in all patients. The patients with CK value exceeded 3 000 IU/L were received CRRT,and there was marked relativity between these 2 variables ( r =0. 845) for the treatment of ARF. Although the proportion of CRRT practiced highly in patients with oliguria,fasciotomies and amputations,there was no significant difference when compared with closed injury and non-oliguria patients ( P = 0. 522 7) . Compared with patients without infections,wound infections were obviously delayed the cure time of ARF ( P = 0. 025 5) . Conclusion As compared with ARF from other causes,ARF related to the crush syndrome has unique characteristics,and easily complicates with multiple organ dysfunction syndrome. Among the treatments, heteropathy and renalreplacement therapy are frequently used. Thorough debridement and infection control are beneficial to renal function recovery.

Objective:To analyze the clinical features and SCN4A gentic background of a family with hypokalemic periodic paralysis.Methods:Peripheral blood samples and clinical data were collected from the proband, his brother and parents, and genomic DNA was extracted from these blood samples. Genome-wide exome sequencing was conducted to determine the mutation site in the proband and then allele-specific oligonucleotide primers were designed based on the mutation site. Polymerase chain reaction (PCR) was performed to detect the mutation site to further identify the causative gene in the family.Results:The patient was a 19-years-old male, Han nationality. The patient presented with periodic paralysis while hypokalemia at the same time. His father and grandpa have a similar medical history in the family. A hybrid missense variation (p.R672H) was identified in exon 12 of SCN4A gene in the proband. The same mutation was also detect in the proband's father.Conclusions:The heterozygous missense variation of SCN4A gene (p.R672H) found in this study resulted in familial hypokalemic periodic paralysis. Our research provided reference for the future genetic counseling of this patient and enriched the research data on the relationship between genotype and clinical manifestations.

Androgen insensitivity syndrome (AIS) is a recessive single gene disease of X chromosome, which is rare clinically and has a very low incidence in newborn boys. This is mainly due to the abnormal pathway in which androgens play a role, resulting in sexual differentiation disorder in patients. A pair of identical twins were admitted to our hospital, and a new pathogenic mutation site of the androgen receptor gene was found, resulting in an androgen insensitivity phenotype.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.