Objective To investigate the correlation between plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and haemodynamics evaluated by right-heart catheterization in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods Fifty-three patients with CTEPH were retrospectively reviewed.All patients underwent right-heart catheterization to detect haemodynamics.The level of plasma NT-proBNP was measured by electrochemical luminescence.The indexes were analyzed.Results Pulmonary artery systolic pressure was (84.9 ± 21.6) mmHg (1 mmHg =0.133 kPa).Pulmonary artery diastolic pressure was (31.1 ± 9.7) mmHg.Pulmonary artery pressure was (49.3 ± 13.4) mmHg.Pulmonary vascular resistance was (1 047.4 ± 86.1) dyn ·s/cm5.Pulmonary capillary wedge pressure was (8.16 ± 3.02) mmHg.Right cardiac output was (3.36 ± 1.42) ml.Right cardiac work was (1.97 ± 0.95) kg·m.The level of plasma NT-proBNP in CTEPH was (2 301.5 ± 1 787.3) ng/L.The level of plasma NT-proBNP in CTEPH had positive correlation with pulmonary vascular resistance (r =0.429,P =0.02),and had negative correlation with right cardiac output (r =-0.583,P＜ 0.01) and right cardiac work (r =-0.521,P ＜ 0.01).The level of plasma NT-proBNP in CTEPH had no correlation with pulmonary artery systolic pressure,pulmonary artery diastolic pressure,pulmonary artery pressure,pulmonary capillary wedge pressure (P ＞ 0.05).Conclusion The level of plasma NT-proBNP can be used as a better predictor for evaluating pulmonary vascular resistance and right cardiac function in CTEPH.

Objective To investigate the expression of succinate dehydrogenase subunit A(SDHA)and subunit B (SDHB) in patients with renal cell carcinoma (RCC),and its relationship with the clinicopathologic characteristics. Methods The expression of SDHA and SDHB was detected in 179 cases of RCC by immunohisto-chemistry and the relationship between the SDHA ,SDHB expression and the clinicopathologic characteristics of RCC were analyzed. Results In 179 cases of RCC,18 cases(10.1%)were shown with negative or suspicious-negative expression of SDHA and SDHB,including 2 cases(1.1%)with suspicious-negative expression of SDHA and SDHB. 12 cases(66.7%)had tumor located in left kidney and 6 cases(33.3%)had tumor located in right kidney. The well-differentiation group contained 15 cases(83.3%),moderate-differentiation group contained 1 case (5.6%)and poor-differentiation group contained 2 cases(11.1%). Most of SDH negative and suspicious negative RCC had the following characteristics that the normal renal tubule could be seen within the tumor. The tumor was composed of polygonal cells arranged in nest ,and the polygonal cells were separated by a fine fibrovascular stroma. The nuclei were shown around with vesicular chromatin. The eosinophilic flocculet material ,vacuole and eosino-philic inclusion body could be seen in the cytoplasm of tumor cells. Conclusion The RCC cases with negative expression of SDHA and SDHB protein have unique histological features ,with significantly higher incidence in the left kidney than that in the right kidney.

To study the level of macrophage migration inhibitory factor (MIF) in serum and the expression of MIF mRNA in abdominal subcutaneous adipose tissue,and to investigate its impact on insulin resistance and islet β-cell dysfunction in gestational diabetes mellitus (GDM).120 pregnancy women from the Affiliated Hospital of Qingdao University Medical College and Taian Central Hospital were enrolled,including 60 GDM women and 60 women with normal glucose tolerance (NGT).The serum MIF in GDM group was higher than that of NGT group [(3.58±1.02 vs 1.23±0.62) ng/ml,P<0.01].Multiple stepwise regression analysis showed that body mass index was an independent affective factor of the serum levels of MIF (r2 =0.516).The serum levels of MIF and the expressions of MIF mRNA in abdominal subcutaneous adipose tissue were significantly higher in GDM group than NGT group.MIF may contribute to insulin resistance and β-cell dysfunction in GDM.Body mass index seems to be an independent factor in affecting the serum levels of MIF.

We expressed 17-hydroxysteroid dehydrogenase10 (17β-hsd10) recombinant protein, prepared anti-17β- hsd10 polyclonal antibodies and established sandwich enzyme linked immunosorbent assay (ELISA) test for detection of 17β-hsd10. RT-PCR was used to get the gene of 17β-hsd10 of mouse liver, and a prokaryotic protein expression system pET 15b-17β-hsd10/Escherichia coli BL21 (DE3) which induced with isopropyl-1-thio-β-galactopyranoside (IPTG) for recombinant protein expression was constructed subsequently. The target protein purified using His-Binding-resin column was used to immunize BALB/c mice and rabbits, serum total IgGs from immunized animals were purified by ammonium sulfate precipitation method. We established a Double-antibody Sandwich enzyme linked immunosorbent assay about 17β-hsd10 using the two antibodies we prepared. We got the concentration of 1.5 mg/mL of 17β-hsd10 protein with molecular weight of 29.5 kDa, and polyclonal antibodies from mouse and rabbit with the tite 1.25 x 10(4) and 2.5 x 10(4) respectively. The concentration of 0.1 g/mL of 17β-hsd10 can be detected by the Double-antibody Sandwich ELISA we established, and the assay was sensitive and specific. It can be widely used in clinical and experimental study.
3-Hydroxyacyl CoA Dehydrogenases ; genetics ; immunology ; Animals ; Antibodies ; immunology ; Cloning, Molecular ; Enzyme-Linked Immunosorbent Assay ; methods ; Escherichia coli ; Immunization ; Mice ; Mice, Inbred BALB C ; Rabbits ; Recombinant Proteins ; genetics ; immunology

Objective To investigate the expression and significance of serum soluble fms-like tyrosine kinase 1 ( sFlt-1 ) in preeclampsia placenta. Methods Immunohistochemistry and semi-quantitative RT-PCR were used to investigate the expression of sFlt-1 and sFlt-1 mRNA in placenta of 30 women with preeclampsia (including mild and moderate preeclampsia 11 cases, severe preeclampsia 19 cases) and 45 normal pregnant women (including first trimester pregnancy 18 cases, 2nd trimester pregnancy 12 cases, and 3rd trimester pregnancy 15 cases). The levels of vascular endothelial growth factor(VEGF) and sFlt-1 in serum were detected by enzyme linked immunosorbent assay. Results (1) The expression of sFlt-1 mRNA was significantly higher in preeclampsia group (0. 90?0. 11) compared with the third trimester group (0. 80?0. 06; P

Objective To understand the epidemiological characteristics of imported malaria cases in Neijiang City in 2013,so as to provide the references for malaria elimination in the city. Methods The epidemiological data of malaria cases were collected from the Parasitic Diseases Information Management System of Chinese Center for Disease Control and Preven?tion,and the data were analyzed with the descriptive epidemiological method. Results Totally 19 cases of imported malaria cases were reported in Neijiang City in 2013,which was increased by 375% comparing to that in 2012(4 cases),and all the cases were confirmed by the laboratory. Among these cases,14 were(73.68%)falciparum malaria cases,5(26.32%)were vivax malaria cases;13 cases(68.42%)were from African countries,and the other 6(31.58%)were from Southeast Asia. These cases were distributed throughout each quater,which had no significant seasonality. All the cases were male aged from 20-49 years,and the majority of them(16 cases,84.21%)were farmers and workers. Conclusions The prevention and con?trol situation of imported malaria is severe in Neijiang City. The capacity construction of malaria diagnosis and treatment of basic medical institutions as well as the health education and monitoring and management to floating population should be strength?ened.

OBJECTIVE: To observe the adverse effects of specific immunotherapy (SIT) with standardized dust mite allergen preparation in the treatment of allergic rhinitis. METHOD: Three hundred and eighty-six patients with allergic rhinitis who received subcutaneous SIT with a standardized dust mite allergen preparation were enrolled in this study. The patients were treated for at least 15 weeks,adverse effects after each injection from dosing phase to maintenance phase were recorded and incidence of adverse effects were analyzed. RESULT: Of all the patients,adverse reactions occurred in 42 patients (10. 9%),10 local reactions (2. 6%) and 36 systemic side effects (9. 3%) which included 34 mild ,1 moderate and 1 severe side effects (no fatal) were reported respectively. None had anaphylactic shock. Among three treatment options, incidence of routine program was the highest (21.1%),followed by adult cluster program (11. 9%), adverse effects of children cluster program was the least (1. 5%). The adverse effects often happened in the middle and late phase of does addition period and early phase of maintenance period. CONCLUSION SIT with standardized dust mite allergen preparation in the treatment of allergic rhinitis is a safe and effective treatment by complying with the guidelines and taking specific interventions.
Adult ; Animals ; Antigens, Dermatophagoides ; adverse effects ; therapeutic use ; Child ; Desensitization, Immunologic ; Humans ; Immunotherapy ; Pyroglyphidae ; Rhinitis, Allergic ; therapy ; Treatment Outcome

Objective To observe the effect of early goal directed therapy (EGDT) on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.Methods A prospective observational study was carried out in 20 patients with early septic shock admitted to ICU within 24 hours after onset.Patients with one of following conditions,including stroke,brain injury,other types of shock,severe heart failure,acute myocardium infarction,ages below 18,pregnancy,terminal stage of disease,cardiac arrest,extensive bums,mouth bleeding,oromandiblular dyetonia (difficult to open the mouth),and the time elapsed over 24 hours after onset of septic shock,were excluded.The eligible patients were treated with the standard procedure of EGDT.The partial pressure of transcutaneous oxygen and carbon dioxide (PtcO2,PtcCO2) was monitored and hemodynamic data were recorded.Sidestream dark field imaging device was applied to detect the sublingual microcirculation.Hemodynamics,tissue oxygen,and sublingual microcirculation were compared before treatment and after EGDT.When the variables met the normal distribution,t test was applied.Otherwise,Wilcoxon test was used.Correlation between variables was analyzed with Pearson Correlation Analysis.Results Of 20 patients,19 met all 4 elements in criteria of EGDT after treatment and were eligible for study.PtcO2 and PtcCO2 were monitored in 19 patients.Sublingual microcirculation was obtained in four of them.(1) After the criteria of EGDT were entirely met,PtcO2 increased from (62.7 ± 24.0) mm Hg to (78.0 ± 30.9) mm Hg (P ＜ 0.05) ; tissue oxygenation index (PtcO2/FiO2) was (110.7 ± 60.4) mm Hg before treatment and (141.6 ± 78.2) mm Hg after EGDT (P ＜ 0.05).PtcCO2 and PaCO2 gap (difference between PtcCO2 and PaCO2) decreased significantly after EGDT (P ＜ 0.05).(2) Both proportion of small vessels with perfusion (PVP) and microcirculatory flow index of small vessels (MFI) showed a trend of increase after EGDT,but there were no significant differences between pre-and post-EGDT (P was 0.051 and 0.074 respectively).(3) PtcO2,PtcO2/FiO2,and PtcCO2 were not linearly related to central venous saturation,lactate,oxygen delivery,and oxygen consumption (All P ＞ 0.05).Conclusions Peripheral perfusion improved after EGDT in patients with septic shock but those hemodynamic variables might not exactly reflect the authenticity of global perfusion.

OBJECTlVE To estabIish a simpIe,sensitive and quick method for determination of B7011 in rat pIasma. METHODS The method of protein precipitation with methanoI was used for pre-treatment of pIasma sampIes determined by Iiquid chromatography mass spectrometer. The Iinear reIa-tionship,intra-batch and inter-batch precision,specificity,matrix effect,recovery rate,the accuracy and stabiIity of the pIasma sampIes were vaIidated. The concentration of B7011 in pIasma was determined by LC-mS/ mS foIIowing a singIe intravenous injection of B7011 0.5 mg·kg-1 to rats. RESULTS The Iinear range of B7011 was 30-20 000 μg·L-1 ,the Iower Iimit of quantification was 30 μg·L-1 in pIasma,the in-tra-batch precision of 60,1000,16 000 and 10 000 ng·mL-1 was 5.61% -13.31%,2.31% -8.35%, 2.02%-9.47% and 4.0%-15.0% respectiveIy,and inter-batch precision was 10.05%,2.55%,3.75% and 8.58% respectiveIy. The recovery of 60,1000,and 16 000 μg·L-1 was 114.12%,109.2% and 101.06%respectiveIy. The average peak concentrations were 8373.28 and 8564.59 μg·L-1 ,the mean AUC was 98 400 and 104 000 μg·L-1·h and the t1/ 2z for B7011 was 41.7 and 63.6 h in bIood of maIe and femaIe rats, respectiveIy. CONCLUSlON The estabIished method is sensitive, fast and simpIe and concentration of B7011 in pIasma is determined by LC-mS/ mS foIIowing a singIe intravenous injection of B7011 0.5 mg·kg-1 to rats. It can satisfy the requirements of pharmacokinetic and toxicokinetic studies.

Objective Background Pulmonary endarterectomy (PEA) is a safe and effective surgical treatment for chronic thromboembolic pulmonary hypertension. University of California at San Diego Medical Center is widely recognized as the world's leading referral center for PEA surgery with extensive surgical experience, which has surgically treated about 2400 patients till 2009, which account for more than 50% of the total cases in the world. Methods During visiting in UCSD, 32 pulmonary endarterectomy operations were performed by Prof. Stuart W Jamieson and Mechel M Madani. In these patients, 17 were males (53%), the average age was (47.56 ± 16.04 ) years, 47% with prior history of pulmonary embolism and/or deep vein thrombosis. Obvious pulmonary hypertension and hypoxemia were observed in all patients. Bilateral pulmonary endarterectomy was performed under cardiopulmonary bypass with profound hypothermic circulatory arrest. Results According to the classification of surgical specimens, 21.8% are type Ⅰ , 28.1% are type Ⅱ and 37.5% are type Ⅲ. The average time of cardiopulmonary bypass (CPB) was (236.32 ± 37.27) mins. The aortic cross clamp time was ( 111.69 ± 28.14) mins. The circulatory arrest time was (38.00±13.58 ) mins [ right side (21.39 ± 9.57 ) mins and left side ( 16.61 ± 6.83) mins]. Postoperatively the average mechanical ventilation time was ( 66.23 ± 99.24) hours, and the ICU stay was (4.62 ± 4.50 ) days.There was no postoperative moorality. All cases had significant decrease in systolic pulmonary artery pressure [(81.03 ± 16.92)mm Hg vs. (51.20±12.16) mm Hg] and pulmonary vascular resistance [(88.91 ±42.32) kPa · s · L-1 vs. (34.38 ±15.68 ) kPa · s · L-1 ], great improvement in cardiac output [(3.65 ±1.08 ) L/min vs. ( 5.85 ± 1.21 ) L/min ] and central venous pressure [(13.07 ± 2.11) cmH2O vs. ( 9.86 ± 3.02 ) cmH2O] postoperatively compared to preoperative data. Shortterm follow-up showed that the cardiac function of all cases returned to NYHA class Ⅰ or Ⅱ, with great improvement in CTPA.Conclusion PEA is definitive treatment of chronic thromboembolic pulmonary hypertension. According the successful experience of UCSD PEA team, first and foremost pulmonary endarterectomy is a bilateral procedure, because chronic thromboembolic pulmonary hypertension is mostly a bilateral disease. Second, cardiopulmonary bypass with the aid of deep hypothermia and circulatory arrest are essential to operator in recognizing the true endarterectomy plane of the media and in following the specimen to its feathered tail end in each branch, using these approaches can effectively reduce pulmonary hypertension and provide good hemodynamic and symptomatic results. Third, PEA remains an uncommon procedure in China. Only a few centers can perform high qualified PEA surgery. In most of inexperienced centers, type Ⅰ and type Ⅱ disease should be choose to operation.Patients with sPAP ≥100 mm Hg, PVR ≥ 100 kPa · s · L-1 or type Ⅲ disease will face more dangers peri-operation.