Objective To observe and evaluate the effect of ultrasound guided percutaneous ethanol injection for hyperparathyroidism secondary to chronic renal failure. Methods Fifty-three patients with secondary hyperparathyroidism in Nanjing General Hospital Military Command from January 2011 to May 2013 were treated by percutaneous ethanol injection. The echogenicity, size and blood supply of parathyroid glands were observed by color Doppler ultrasound before and after treatment. Parathyroid hormone (PTH) and volumes of parathyroid glands were analyzed and compared with non-paired t test. Results Before treatment, the parathyroid gland volume was (5.28±0.84) cm3. The enlarged parathyroid glands had homogeneous hypoechogenicity and abundant blood supply, and the PTH was (1041.6±37.1) ng/L. After treatment, the size of solitary parathyroid gland was (3.93±0.67) cm3 which did not change significantly compared with that before treatment. The echogenicity of parathyroid glands enhanced and blood supply decreased after injection ethanol into solitary parathyroid. PTH [(509.2±27.6) ng/L] decreased obviously (t=3.792, P < 0.05). Conclusion Color Doppler ultrasound guided percutaneous injection of ethanol has an important role in the treating of secondary hyperparathyroidism and the curative effect can be observed timely.

Purpose:Thalamic hemorrhage breaking into ventricles (THBIV) is a devastating disease with high morbidity and mortality rates.Endoscopic surgery (ES) may improve outcomes,although there is no consensus on its superiority.We investigated the efficacy and safety of ES and compared the outcomes of different management strategies by ES,hematoma puncture and drainage (HPD),and external ventricular drainage (EVD) in patients with THBIV.Methods:We retrospectively analyzed patients with THBIV treated by ES,HPD,or EVD at our hospital from June 2015 to June 2018.Patients were categorized into anteromedial and posterolateral groups based on THBIV location,and then the two groups were further divided into ES,HPD,and EVD subgroups.Individualized surgical approach was adopted according to the location of the hematoma in the ES subgroups.Patient characteristics and surgical outcomes were investigated.Results:We analyzed 211 consecutive patients.There were no significant differences in clinical characteristics or incidence of perioperative procedure-related complications (postoperative rebleeding and intracranial infection) in either anteromedial or posterolateral groups.Compared with other therapeutic methods,the ES subgroups had the highest hematoma evacuation rate,shortest drainage time,and lowest incidence of chronic ventricular dilatation (all p ＜ 0.05).Among the three anteromedial subgroups,ES subgroup had the best clinical outcomes which was assessed by the modified Rankin Scale,followed by HPD and EVD subgroups (p ＜ 0.01);while in the posterolateral subgroups,clinical outcomes in the ES and HPD subgroups were similar and better than that in the EVD subgroup (p =0.037).Conclusion:Individualized surgical ES approach for removal of thalamic and ventricular hematomas is a minimally invasive,safe,and effective strategy for the treatment of THBIV with a thalamic hematoma volume of 10-30 mL.

Objective To investigate use of oral antihypertensive drugs among community hypertensive patients in Shanghai and find out factors related to their unreasonable use to direct their clinical use. Methods Seven hundred and three hypertensive patients were surveyed with questionnaire by stratified cluster sampling at three neighborhoods and one village of Dahua community, Baoshan district, Shanghai during April to June 2009 to understand their use of antihypertensive agents, including kinds and forms of drugs, rationale of drug use. Results Five hundred and eighty-two (82. 8% ) of 703 hypertensive patients interviewed were using antihypertensive drugs, 271 (38. 5% ) of them used only one kind of non-compound antihypertensive drug, 182 (25.9%) used one kind of compound agent, 311 (53.4%) used two or more kinds of drugs in combination, including 117 patients ( 16. 8% ) used two kinds of agents combined and 12 patients ( 1.6% ) used three kinds of agents combined. Two hundred and sixty-six (47.5%) patients took orally calcium-channel blockers and 205 ( 35.2% ) used compound agents. Conclusions Frequency of combined use of two or more kinds of antihypertensive agents is reasonable and significantly higher than that of use of one kind of drug at Dahua community in Shanghai. Calcium channel blocker plays a predominant role in treatment for hypertension, non-long-acting compound agents are used in a higher proportion. But,guidelines for hypertension prevention and treatment are not so well complied with in local hypertensive patients. So, it is suggested that training for community physicians and management for standard use of antihypertensive agents at community should be strengthened further.

AIMTo evaluate the effects of atria-His bundle sequential pacing on cardiac electrophysiology and heamodynamics in dogs.

METHODSIn 20 opening chest anesthetized dogs, platinum electrodes were fixed at the epicardium of right atria (RA) and the right ventricular apex (RVA) respectively, pacing right atria and the right ventricle. A special lead was located at His bundle (based on a optical "H" wave and narrow duration of the QRS complexes recorded in ECG), pacing His bundle. Cardiac electrophysiology and hemodynamics parameters were compared in the different pacing models RA(AAI, RVA-(VVI), HisB-(VVI) single chamber pacing and RA-RVA(DDI), RA-HisB(DDI) dual chamber pacing.

RESULTSThe threshold of His B pacing is similar to that of RVA pacing. Cardiac output (CO) is increased in pacing of RA(AAI), His B-(VVI) and RA-His B(DDI). It is increased by 29.64% in pacing of RA-His B(DDI) (P < 0.01) and by 0.25% (P > 0.05) in pacing of RA-RVA(DD1) While CO is decreased by 5.41% in RVA-VVI) pacing (P > 0.05). SV, LVSW and RVSW of RA-HisB(DDI) pacing are superior to those in RVA-VVI) and RA-RVA(DDI) pacing.

CONCLUSIONRight atria-His bundle sequence pacing significantly improves cardiac function compared with the other model pacing because it maintains normal physiological electronic activity sequence and systolic synchrony. It will be adapted to clinical application.

Animals ; Bundle of His ; physiology ; Cardiac Electrophysiology ; Cardiac Pacing, Artificial ; methods ; Dogs ; Female ; Heart Atria ; Hemodynamics ; Male

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 measure the renal tissue texture or flexibility with virtual touch quantization (VTQ) and to tentatively examine its clinical application in patients with chronic kidney disease(CKD).Methods A total of 750 patients (1500 kidneys) were performed with VTQ,including 400 cases in the control group,and 350 cases in the CKD group.A conventional ultrasound examination (two-dimensional,color Doppler) were first taken,and then the shear wave velocity (Vs) was measured which reflected the textural elastic.Results In both groups the Vs was the highest in renal cortex with significant difference (P<0.05); renal cortical region Vs in CKD group was lower than those in control group (P<0.05),while Vs of renal medulla and renal sinus had no significant difference in the two groups.The severity of renal dysfunction was increased along with a Vs decrease of renal cortex.Conclusion VTQ is helpful to assess renal function of patients with CKD.

The purpose of the present study was to investigate the effects of advanced glycation end products (AGEs) modified protein on the permeability of endothelium monolayers and morphological changes of actin cytoskeleton. The roles of receptor for AGEs (RAGE), oxidant stress and the activation of p38 MAPK pathway in this pathological procedure were elucidated. Human umbilical vein endothelial cells (HUVECs)-derived cell line (ECV304) were incubated with AGEs modified human serum albumin (AGE-HSA) in concentrations of 12.5, 25, 50, and 100 microg/ml respectively, for 2, 4, 8, 12 and 24 h. As control, HSA of the same concentration was administered to cells. Then TRITC-albumin was added to evaluate Pa value that reflects the permeability of endothelial monolayer. Furthermore, to visualize the morphological changes of actin cytoskeleton, the treated cells were incubated with rhodamine-phalloidin to stain F-actin. The results showed that the trans-endothelial membrane flux of albumin was significantly increased in a concentration- and time-dependent manner upon the stimulation of AGE-HSA, accompanying with actin reorganization. The blockage of AGE and RAGE binding with anti-RAGE IgG and the pharmacological inhibition of NADPH oxidase or p38 MAP kinase greatly attenuated the AGE-induced hyperpermeability response, respectively. These results indicate that RAGE, NADPH oxidase and p38 MAPK are possibly involved in the mediation of AGEs-induced barrier dysfunction and actin cytoskeleton reorganization in endothelial cells.
Actin Cytoskeleton ; physiology ; Capillary Permeability ; physiology ; Cell Line ; Cells, Cultured ; Endothelium, Vascular ; cytology ; Glycation End Products, Advanced ; physiology ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; Oxidative Stress ; physiology ; Receptor for Advanced Glycation End Products ; Receptors, Immunologic ; physiology ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo construct and identify a adenovirus vector of the expression of connective tissue growth factor (CTGF) and to explore the role of CTGF in the metabolism of glucose and lipid.

METHODSThe over-expressed plasmid of CTGF was cloned, and then the CTGF sequences were cloned into pAdTrack-CMW vector. The reformed E. coli BJ5183-sensitive bacteria that contain pAdEasy-1 were transformed with lined vector cut by Pme I enzyme. The recombinant adenovirus vector was cut with Pac I enzyme and obtained, then transfected 293A cells to produce virus. Through three times of amplification, the adenovirus infected the primary hepatocytes to determine the infection efficiency and CTGF expression. The mice were starved for several time periods, and then the liver RNA was extracted for real-time PCR to detect the expressions of CTGF under different nutritional conditions.

RESULTSThe adenovirus of CTGF was successfully produced with an infection efficiency of 90%. The expressions of the CTGF were different under different nutritional conditions and showed a coincidence with the expression of peroxisome proliferators-activated receptor gamma coactivator 1 alpha. After the mice were starved for 24h, the expression of CTGF increased by (2.38 +/- 0.51) folds; after the mice were starved for 48 h, the expression of CTGF increased by (2.95 +/- 0.57) folds (P < 0.05).

CONCLUSIONCTGF is speculated to be involved in the metabolism of glucose and lipids.

Adenoviridae ; genetics ; Animals ; Cell Line ; Connective Tissue Growth Factor ; genetics ; Escherichia coli ; genetics ; Genetic Vectors ; Mice ; Mice, Inbred C57BL ; Plasmids ; Transfection

Action Potentials ; Animals ; Electromyography ; Environmental Exposure ; Hypothermia ; Rats ; Rats, Wistar ; Seawater ; Thigh ; physiology ; physiopathology

This study was aimed to investigate one case with rare type B(A) in ABO blood group by using serological and molecular biological methods, and analyze the cause of inconsistency resulting from multiple detections. The serological method was used to identify the serum type of ABO blood group, at the same time the PCR sequencing method was used to detect the genotypes. The results indicated that the group typing and reverse typing for the blood donor were inconsistent, the group typing was AB, the reverse typing was B. The ABO genotype was B(A) 04 /001. This genotype was involved in nt640A > G point mutation which caused valine replacing methionine at 214. It is concluded that the sample inconsistent between the group typing and reverse typing could be typed by molecular biological method, and the molecular basis of weak expression of ABO blood group is elucidated too.
ABO Blood-Group System ; genetics ; Blood Donors ; Blood Grouping and Crossmatching ; methods ; Genotype ; Humans ; Serologic Tests