Objective To evaluate the feasibility and efficacy of catheter-directed thrombolysis (CDT) for the treatment of non-acute (history ＞ 14 days) deep venous thrombosis (DVT) of the lower extremity.Methods Clinical data of 63 patients of non-acute DVT of lower extremities treated by CDT and adjunctive angioplasty and stenting from July 2009 to August 2013 were analyzed retrospectively.Venous recanalization was graded by a thrombus score based on pre-and post-treatment venography.Follow-up was performed by Doppler ultrasound and clinical evaluation.Results A total of 63 limbs with DVT with a mean symptom duration of (22 ± 5) days were treated by a continuous combined with pulse-spray infusion of urokinase of (1.21 ± 0.69) million IU/d for (74 ± 21) hours.Significant recanalization was achieved in 77％ (48 of 63) of the treated limbs.After thrombolysis,percutaneous angioplasty was done for 15 residual lesions and stent placement was performed in 11 iliac veins and 1 femoral vein.Minor bleeding occurred in 6 (10％) patients,no patients suffered from major bleeding or symptomatic pulmonary embolism.During follow up (mean:15 ±6 months),the veins were patent in 45 (71％) limbs.15 (24％) limbs developed mild post-thrombotic syndrome (PTS),and none had severe PTS.Conclusions CDT combined with adjunctive angioplasty and stenting is safe and effective for removal of the clot burden and for restoration of the venous flow in patients with non-acute lower extremity DVT.

OBJECTIVE: To observe the effects of Guben Huatan Tongmai Recipe (GBHTTMR), a compound Chinese herbal recipe, on expressions of macrophages and cell adhesion molecules (CAMs) of aortic endothelia in rats with syndrome of phlegm blocking blood vessel, and to explore the pathogenesis of the phlegm-pathogen. METHODS: Fifty normal male Wistar rats, 7-week in age, were randomly divided into five groups: normal control group, untreated group, high-dose GBHTTMR-treated group, low-dose GBHTTMR-treated group and simvastatin-treated group, with 10 rats in each group. Syndrome of phlegm blocking blood vessel was induced in rats of the latter 4 groups by feeding the rats with high lipid diet. Levels of blood lipid were compared among the 5 groups. The expressions of macrophages and CAMs in aortic endothelia were tested by immunohistochemical staining method. RESULTS: The level of blood lipid, and the expressions of macrophages and CAMs showed statistical differences between the normal control group and the untreated group (P<0.01), and between the untreated group and the low-, high-dose GBHTTMR-treated and simvastatin-treated groups as well (P<0.05). CONCLUSIONS: GBHTTMR can decrease the level of serum cholesterol and triglycerides, and increase the level of high density lipoprotein. It also can inhibit the expressions of macrophages, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, P-selectin, and E-selectin.

Objective To evaluate the therapeutic effect of catheter-directed thrombolysis (CDT) for the treatment of acute deep venous thrombosis (DVT) of the lower extremity.Methods Clinical data of 195 patients of acute DVT treated by CDT and adjunctive angioplasty and stenting from August 2010 to February 2014 were analyzed retrospectively.CDT by antegrade puncture of popliteal vein,CDT by great saphenous vein and CDT by retrograde puncture of contralateral femoral vein were used in these cases.Venous recanalization was graded by a thrombus score based on pre-and post-treatment venography.Results Technique success rate,clinical success rate,in popliteal vein group,great saphenous vein group and contralateral femoral vein group were 94.6％,72.2％ and 90.3％,97.3％,83.3％,and 90.0％.Patent rate of deep venous,patent rate of stenting and mild post-thrombotic syndrome (PTS) rate were 88.6％,66.7％ and 75.0％,83.3％,57.1％ and 88.9％,8.3％,26.7％ and 20.8％.Conclusion CDT by antegrade puncture of popliteal vein group combined with adjunctive angioplasty and stenting is safe and effective with higher clinical success rate and better long term results than other approaches for the treatment of DVT patients.

The aim of this study was to investigate the effect of Compound Yihe Tea on improving insulin resistance in obesity mice. Thirty-two male C57BL/6J mice were randomly divided into 4 groups: the normal fat diet group(NFD group), high fat diet group(HFD group), Compound Yihe Tea low dosage group［20 mg/(kg ·d), YH-L group］ and high dosage group［40 mg/(kg ·d), YH-H group］. NFD group was given standard feed, and the remaining mice were administered with high fat diet. After 6 weeks, YH-H and YH-L groups were given Compound Yihe Tea for 6 weeks. Blood glucose was measured at week 11 and serum levels of total cholesterol(TC), serum triglyceride(TG), low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were measured at week 12. Liver tissues were prepared for oil red O and HE staining. Immunohistochemical analysis was used to test the protein expression of GLUT4 in liver. Protein expressions of PI3K, Akt and GLUT4 in epididymis white adipose tissue(WAT)were tested by Western blot. The results showed that Compound Yihe Tea could effectively reduce body weights and the serum levels of TC, TG and LDL-C. Furthermore Compound Yihe Tea could improve the histopathological changes of liver, up-regulate the protein expression of PI3K, Akt and GLUT4 in epididymis WAT and the protein expression of GLUT4 in liver. Compound Yihe Tea can reduce the fat accumulation in liver tissue, improve the indexes of blood glucose and lipid levels, and improve insulin resistance via PI3K-AKT-GLUT4 pathway.

Objective: To elucidate the effect of taurine on neurotoxicity induced by Mn by investigating cell cycle and apoptosis in manganese exposed rats. Methods: 156 healthy male SD rats were randomly divided into 1 control group, 3 manganese exposure groups (10, 15, and 20 mg/kg respectively) , and 9 intervened groups based on orthogonal design, with 12 rats in each group. After 12 weeks of exposure, all rats were decapitated and striatums were removed, cell cycle was analyzed by flow cytometry, the apoptosis was detected by TUNEL, level of Mn was determined. Results: The striatum apoptosis index of the 3 dose groups exposed to Mn were significantly higher than control group (P<0.05) . The striatum apoptosis index of the 9 intervened groups were significantly higher than control group (P<0.05) . 150 and 200 mg/kg of taurine could decrease apoptosis index of the group exposed to 10、15、20 mg/kg of Mn (P<0.05) . The striatum Mn content of the 3 dose groups exposed to Mn were significantly higher than that of the control group (P<0.05) . The G0/G1 proportion of the 3 dose groups exposed to Mn were significantly lower than that of the control group (P<0.05) , the S proportion of the 3 dose groups exposed to Mn were significantly higher than that of the control group (P<0.05) . Conclusion Mn could cause cell cycle arrest to S, increase level of apoptosis in striatum, to a certain extent, taurine can protect neurons from apoptosis induced by Mn.

Objective: To elucidate the effect of taurine on neurotoxicity induced by Mn by investigating activities of Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase and content of Mn and active calmodulin in manganese exposed rats. Methods: 156 male SD rats were randomly divided into 1 control group, 3 manganese exposed groups (10, 15, and 20 mg/kg respectively) , and 9 taurine intervened groups based on orthogonal design (doses of taurine intervention were 100, 150, and 200 mg/kg respectively) , with 12 rats in each group. After 12 weeks of exposure, all rats were decapitated and corpus striatums were removed, activities of Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase and content of Mn and active calmodulin were analyzed. Results: The corpus striatum Mn content of the 3 dose groups exposed to Mn and 9 taurine intervened groups were significantly higher than that of the control group (P<0.05) . Active calmodulin content in 10 mg/kg manganese exposed group was significantly higher than that of the control group (P<0.05) . 150 and 200 mg/kg of taurine could decrease active calmodulin content of the group exposed to 10 mg/kg of Mn (P<0.05) . The corpus striatum activities of Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase of the 3 dose groups exposed to Mn were significantly lower than that of the control group (P<0.05) . 150 mg/kg of taurine could increase activities of Na⁺-K⁺-ATPase of the group exposed to 10 mg/kg of Mn (P<0.05) . 150 and 200 mg/kg of taurine could respectively improve activities of Ca²⁺-Mg²⁺-ATPase of the group exposed to 15, 10 mg/kg of Mn (P<0.05) . Conclusion Mn can decrease the rats corpus striatum activities of Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase, effect level of active calmodulin in relation to dose of Mn, to a certain extent, taurine could regulate activities of Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase and improve the level of active calmodulin.

Objective To validate the performance of six enzymatic glycated albumin reagents and evaluate their clinical application.Methods The performance of six enzymatic glycated albumin reagents(labled as A,B,C,D,E,F) from Beijing Jiuqiang Co, Beijing Lideman Co,Ningbomeikang Co, Beijing Haomai Co, Sichuan Maike Co and Asahi Kasei Co were assessed on Olympus AU5800 automatic biochemistry analyzer.According to the standard of CLSI,the precision,interference and linear correlation of these reagents were assessed.To assess the accuracy of GA% ,we used GA standard material whose value had been assigned using ID-LC/MS method provided by ReCCS.To do the method comparison and determine the consistency of assay, 50 fresh serum samples of T2DM outpatient and 80 fresh serum samples of apparently healthy people in Jan 2016 were tested using six kits.According to the EP28-A3C protocol, the reference range for GA%was validated in 122 apparently healthy individuals undertaking medical examination from January to February 2016 in PUMC.Results The precision,and the ability of anti-interference of the six reagents were good.The accuracy percentage deviation of six reagents was-19.3%-9.2%.The correlation coefficient of domestic reagents A to E and imported reagents F in the determination of GA% was 0.966-0.999, the average absolute bias was 7.0%-10.4%.The coincidence rate of A-E and F in determining abnormal GA% was between 88.5% and 96.9%.The coincidence rate was increased after switching to the reference range for preliminary clinical evaluation.Conclusion Six GA enzymatic kits used in automatic biochemical analyzer have high precision and strong anti-interference ability.Accuracy still needs to be improved.

Objective To assess the interference by calcium dobesilatein 7 peroxidase-baseduric acid assays and to determine its clinical significance.Methods In the in vitro experiments, uric acid in pooled serum with final concentrations of calcium dobesilate additions (0, 2, 4, 8, 16, 32, and 64μg/ml) were measured by 7 peroxidase-based assays.Percent Bias (%) was calculated relative to the drug-free specimen.In the in vivo experiments, changes in serum uric acid and calcium dobesilate concentrations were observed before and after calcium dobesilate administration ( baseline, 0 h, 1 h, 2 h, 3 h, 4 h, 6 h ) involunteers.The interference in different assays was assessed compared with LC-IDMS/MS method. Calcium dobesilate levels in 40 specimens from those taking calcium dobesilate were measured by HPLC method.Of the 40 specimens, 10 were selected to analyse the levels of uric acid by both peroxidase and UV measurement method to assess the impact in clinical status.Results In the in vitro study, concentrations of uric acid measured by 7 peroxidase-based assays were reduced by -6.3%to -21.2%compared with drug-free serum, when theconcentration of calcium dobesilate was16μg/ml.In the in vivo study, comparedto UA levels at 0 h, the biasesof serum uric acid determined by peroxidase method after calcium dobesilate administration(1 h, 2 h, 3 h, 4 h, 6 h) were of -3.33%, -6.79%, -7.49%, -6.07%, -4.09%, respectively.The observed uric acid concentrations for 8 participants measured by enzymatic assays were inhibited by -3.75% to -6.89% at 0 hour and by -16.9% to-22.22% at 2 hours relative to the concentrations measured by the LC-IDMS/MS method. Conclusions Calcium dobesilate produced a clinically significant negative interference with uric acid in all peroxidase-based uric acid assays,which may result in false evaluation of uric acid level in clinical status.Significant differences in the degree of interference were observed among the assays.

Objective: To examine the association of hyperglycemia and postoperative complications in non-diabetic patients underwent pancreaticoduodenectomy(PD). Methods: The clinical data of 209 non-diabetic patients who underwent PD from January 2012 to June 2018 at Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University and met the inclusion criteria were retrospectively analyzed. According to the diagnostic criteria of postoperative hyperglycemia, the patients were divided into postoperative hyperglycemia group (167 cases, 79.9%) and control group(42 cases, 20.1%). The propensity score matching(PSM) method was used to eliminate the difference between groups(caliper value=0.02; 38 cases in control group including 30 males and 8 females with age of 59.0 years; 38 cases in postoperative hyperglycemia group including 32 males and 6 females with age of 61.0 years; 37 cases of pancreatic head carcinoma, 30 cases of periampullary carcinoma and 9 cases of benign diseases). A comparative analysis was applied for preoperative data, surgical related indicators and postoperative complication rates.The receiver operating characteristic(ROC) curve was used to calculate the area under the curve(AUC) of blood glucose values on postoperative day 1,3 and 5(POD1, POD3, POD5), to determine the high-risk blood glucose cutoff value of complications and to evaluate its sensitivity and specificity for the prediction of postoperative complications. Results: Univariate analysis showed that the differences in gender, body mass index, preoperative blood glucose, and serum urea nitrogen levels were statistically significant before PSM.There was no significant difference in the preoperative data between the two groups after PSM. Compared with the control group, the incidence of postoperative pancreatic fistula (31.6% vs. 5.3%), abdominal infection(29.0% vs. 7.9%) and Clavien-Dindo Ⅲ-Ⅴ complications(31.6% vs.7.9%) were statistically different(χ²=7.092, P=0.008; χ²=4.290, P=0.038; χ²=5.316, P=0.021), respectively. According to the AUC on POD3, the blood glucose value≥8.860 mmol/L was an independent risk factor for pancreatic fistula with sensitivity of 58.3% and specificity of 76.9%, the blood glucose value ≥9.130 mmol/L was an independent risk factor for abdominal infection with sensitivity of 54.5% and specificity of 81.5% and the blood glucose value ≥7.685 mmol/L was independent risk factor of Clavien-Dindo Ⅲ-Ⅴcomplications with sensitivity of 75.0% and specificity of 57.7%. Conclusions Postoperative hyperglycemia in non-diabetic patients is associated with postoperative pancreatic fistula, abdominal infection, and Clavien-Dindo Ⅲ-Ⅴ complications.According to the early postoperative blood glucose value, the occurrence of postoperative pancreatic fistula, abdominal infection and Clavien-Dindo Ⅲ-Ⅴ complications can be effectively predicted.

Objective:To evaluate thrombo-pretreatment in AngioJet mechanical thrombectomy.Methods:68 acute DVT patients were randomized into two groups: thrombo-pretreatment with low-dose urokinase via popliteal vein before operation (experimental group)comparing with those undergoing upfront surgery.Results:After pretreatment, the immediate thrombus clearance grade in the experimental group was higher than that in the control group( Z=2.446, P=0.014), the procedure time was shorter [(289.1±57.9) s vs. (342.3±75.2) s] and less hemoglobin decreased after operation [(7.2±2.4) g/L vs. (11.4±2.1) g/L]. There was no difference in the deep vein patency and the incidence of PTS between the two groups at 3 , 12 and 24 months after operation. Conclusion:Pre-treatment with low dose urokinase before operation can improve the efficiency of PMT, effectively reduce the time of AngioJet activation and the destruction of red blood cells.