Objective To determine the efficacy and safety of acarbose in the treatment of senile postprandial hypotension (PPH). Methods Forty three senile in-patients with PPH were recruited. Blood pressure and heart rate(HR) were recorded for 120 minutes by using non-invasive ambulatory blood pressure monitoring system. The participants had semiliquid standard meals with or without acarbose on two following days. The ejection fraction(EF) and fractional shortening(FS) were measured by two dimensional echocardiography before treatment. Results The magnitudes of the falls in systolic, diastolic and mean arterial blood pressure (SBP、DBP、MAP) (all P

Objective To study the effects of high salt intake on blood pressure and renin-angiotensin in male rats with different plasm androgen levels.Methods Thirty male Wistar rats were randomized to sham(n=10)or operated(n=10),or castration(n=10),or testosterone replacement after castarion(26.7 mg/kg,n=10)and fed with 8% NaCl for 8 weeks.Tall arterial pressure were recorded before,4 and 8 weeks after experiment.Serum PRA,plasma angiotensin Ⅱ(Ang Ⅱ)and testosterone(T)were determined by radioimmunoassey respectively. Results After 8 weeks high salt dietary,blood pressure was significantly increased in sham and testosterone replace ment rats(Sham operation group:137.3?4.0 vs the basal line:117.5?5.9 mmHg,testosterone replacement group: 134.4?5.2 vs the basal line:116.6?7.7 mmHg,P0.05).Concomitantly,sham operation or testosterone re placement rats had higher PRA and plasm Ang Ⅱ content compared with castrated rats(PRA:Sham operation 5.90 ?0.77 vs testosterone replacement group:5.69?0.47 vs castrated rats:4.90?0.55 mol/(L?h),P

OBJECTIVETo define the ideal time window for intubation after rocuronium administration during target-controlled infusion (TCI) ofpropofol and sulfentanil.

METHODSOne hundred and twenty elective surgical patients (age range 18-55 years) were randomized into 4 groups (n=30) according to the intubation time after administration of the muscle relaxant. Patients with predicted difficult airway were excluded. General anesthesia was induced by TCI of propofol and sulfentanil. A senior anesthesiologist blinded for the randomization performed the intubations at 1, 2, 3, or 4 min after injection of rocuronium, and the vocal card visibility was evaluated upon full exposure of the vocal cord and the intubation conditions assessed according to Cooper's score.

RESULTSThe intubation conditions were excellent or good in all patients, but the vocal cord visibility at 2-4 min differed significantly from that at 1 min after rocuronium administration (P<0.01). Suppression of the neuromuscular function 1 min after rocuronium administration differed significantly from that at other time points (P<0.01).

CONCLUSIONThe condition of vocal cord can be more suitable for intubation at 2-4 min than at 1 min after rocuronium administration as the ideal time window for intubation during TCI of propofol and sulfentanil.

Adolescent ; Adult ; Androstanols ; administration & dosage ; Anesthetics, Intravenous ; administration & dosage ; Humans ; Infusions, Intravenous ; Intubation ; methods ; Middle Aged ; Neuromuscular Nondepolarizing Agents ; administration & dosage ; Propofol ; administration & dosage ; Single-Blind Method ; Sufentanil ; administration & dosage ; Time Factors ; Vocal Cords ; drug effects ; Young Adult

OBJECTIVETo investigate the changes in the systemic inflammatory response and T cell induced immunity after systemic administration of recombinant human growth hormone (rhGH) during early postburn stage.

METHODSForty Sprague-Dawley (SD) rats were randomly divided into three groups for the study. The rats in control group (C, n = 6) were only used for the determination of plasma levels of the cytokines, such as TNFalpha, IL-2, IL-6 and CD4(+) and CD8(+) cells. The SD rats in burn with rhGH treatment group (BT, n = 18) and burn without treatment group (B, n = 18) were inflicted with III degree scalding injury on the back. rhGH was injected subcutaneously on the abdomen of the rats in a dose of 6 IU/kg for 10 days in BT group. The blood samples were harvested from the rats in the two groups for the evaluation of the above indices.

RESULTSThe plasma levels of TNFalpha, IL-2, IL-6 and CD4(+) and CD8(+) cells were increased on the 3(rd) postburn day (PBD) and decreased on the 6(th) PBD in B group, while the CD4(+) and CD8(+) cells were increased significantly and the plasma levels of TNFalpha, IL-2, IL-6 decreased obviously on the 3(rd) PBD in BT group. And the plasma levels of IL-2 and IL-6 in BT group on the 6(th) PBD showed no difference from those in C group. But the plasma TNFalpha level in BT group was evidently higher than that in B and C group on the 6(th) PBD. Furthermore, the plasma levels of TNFalpha, IL-2 and IL-6 in BT group were still increased gradually on the 10(th) PBD, while the IL-2 and IL-6 levels were decreased obviously in B group, but the TNFalpha level was increased.

CONCLUSIONSystemic administration of rhGH during different states of stress exerted different effects on T cell induced immunity and systemic inflammatory response.

Animals ; Burns ; blood ; drug therapy ; immunology ; CD4-Positive T-Lymphocytes ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; Female ; Human Growth Hormone ; therapeutic use ; Interleukin-2 ; blood ; Interleukin-6 ; blood ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; therapeutic use ; Tumor Necrosis Factor-alpha ; blood ; Wound Healing ; drug effects

BACKGROUNDSeveral genetic polymorphisms in the endothelial nitric oxide synthase (eNOS) gene are associated with the pathogenesis of rheumatoid arthritis (RA). The objective of the present study was to investigate whether the two SNPs (T-786C and G894T) of the eNOS gene are associated with rheumatoid arthritis risk in a northern Chinese population.

METHODSIn this study, the eNOS genes T-786C and G894T were studied in 196 cases with rheumatoid arthritis and 201 healthy controls with gender, age and ethnicity matched. The two SNPs were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The analyses of association were statistically compared using the chi-square test with SPSS software for Windows.

RESULTSThe frequency of the -786C allele was significantly higher in the rheumatoid arthritis patients than in the healthy controls (19.64% vs. 14.18%, P < 0.05). However, the 894T allele of the eNOS gene was not increased in the rheumatoid arthritis patients compared to the healthy controls.

CONCLUSIONSIndividuals with the -786CC genotype have an increased risk of rheumatoid arthritis. Further study with an increased sample size is necessary for the study of the role of this SNP in rheumatoid arthritis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthritis, Rheumatoid ; genetics ; Asian Continental Ancestry Group ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; Nitric Oxide Synthase Type III ; genetics ; Polymorphism, Single Nucleotide ; Risk

BACKGROUNDPostprandial hypotension (PPH) occurs frequently in elderly people and may lead to syncope, falls, dizziness, weakness, angina pectoris, and stroke. Some studies suggest that the magnitude of the postprandial fall in blood pressure (BP) is influenced by the rate at which glucose enters the small intestine. We hypothesized that acarbose (alpha-glucosidase inhibitor), a hypoglycemic agent that decreases the rate of glucose absorption in the small intestine, would attenuate PPH in the elderly, and would be safe in the treatment.

METHODSForty-three elderly in-patients with PPH were recruited. All of them were in relatively stable conditions. They had semi-liquid standard meals without and with acarbose for the two following days: screening day and intervention day. Blood pressure and heart rate (HR) were recorded at baseline and every 15 minutes for 120 minutes using a non-invasive ambulatory blood pressure monitoring system during the study, and ejection fraction (EF) and fractional shortening (FS) were measured by two dimensional echocardiography.

RESULTSCompared with the screening day, the falls in systolic, diastolic and mean arterial blood pressure (SBP, DBP, MAP) (all P < 0.05) were significantly attenuated after taking acarbose during breakfast, so were MAP (P < 0.05) during lunch, DBP (P < 0.05) and MAP (P < 0.05) during supper. The change of HR was not statistically significant after taking acarbose in three meals. EF and FS were positively correlated with the relief rate. The effective power was 63%, and the incidence of adverse drug reaction (ADR) was 9%.

CONCLUSIONAcarbose is effective and safe in the treatment of elderly patients with PPH.

Acarbose ; adverse effects ; therapeutic use ; Aged ; Aged, 80 and over ; Blood Pressure ; drug effects ; Enzyme Inhibitors ; therapeutic use ; Female ; Heart Rate ; drug effects ; Humans ; Hypoglycemic Agents ; therapeutic use ; Hypotension ; drug therapy ; Male ; Postprandial Period ; physiology

OBJECTIVETo evaluate the effect of adenosine on endothelin-1 (ET-1) after acute myocardial infarction (AMI) and reperfusion and explore the possible mechanism of no-reflow.

METHODSTwenty-four mini-swine were randomized into three study groups: control group (n=8), adenosine treated group (n=8), and sham-operated group (n=8). The mini-swine in the groups were subjected to 3 hours of coronary occlusion, followed by 60 minutes of reperfusion except those in the sham-operated group. The levels of ET-1 in blood sample, normal, infracted reflow and no-reflow myocardium were evaluated by radioimmuno-assay (RIA). The gene expressions of ET-1 in normal, infracted reflow and no-reflow myocardium were quantified by reverse transcription-polymerase chain reaction.

RESULTSIn both control group and adenosine group, compared with that at the baseline, ET-1 in blood sample significantly increased at 5 minutes and 180 minutes of left anterior descending coronary artery occlusion, as well as 5 and 60 minutes of reperfusion (all P < 0.01). In adenosine group, the levels of ET-1 were significantly lower than those in the control group (P < 0.05, P < 0.01). In both control group and adenosine group, compared with that in normal myocardium, ET-1 levels in both infarcted reflow and no-reflow myocardium significantly increased (both P < 0.01), with the level of ET-1 in no-reflow myocardium significantly higher than that in infarcted reflow myocardium (P < 0.01). In adenosine group, the level of ET-1 in infarcted reflow myocardium was significantly lower than that in the control group (P < 0.01). In both control and adenosine groups, compared with that in normal myocardium, the gene expression of ET-1 in infarcted reflow myocardium was significantly up-regulated (P < 0.01), while that of ET-1 in. no-reflow myocardium significantly down-regulated (P < 0.01). In adenosine group, the level of ET-1 in infarcted reflow myocardium was significantly lower than that in the control group (P < 0.01).

CONCLUSIONThe endothelium injury may be one of the important mechanisms for no-reflow phenomenon. Adenosine cay prevent endothelium from injury to reduce no-reflow.

Adenosine ; pharmacology ; therapeutic use ; Animals ; Disease Models, Animal ; Endothelin-1 ; genetics ; metabolism ; Female ; Male ; Myocardial Infarction ; drug therapy ; physiopathology ; Myocardial Reperfusion ; Swine ; Swine, Miniature

OBJECTIVE: To investigate the relationship among 3 polymorphisms of GP IIb and the function of GP IIb T13959 G in the platelet transfusion refractoriness(PTR). METHODS: The 26th exon, the 30th exon and the 21st intron of gene GP IIb in 110 individuals were amplified by polymerase chain reaction (PCR), and the PCR products were analyzed with single-strand conformation polymorphism(SSCP) and sequenced to investigate whether there was linkage among the polymorphisms of the gene. Human platelet antigen-3 (HPA-3) gene frequency was detected by Fok I enzyme in 147 patients with hematologic diseases, and was compared with that in 110 normal individuals. Forty-four patients who received apheresis platelet transfusion repeatedly were randomly divided into the HPA-3 homotype group and the control group. The antibodies of the platelet were detected after 3 times of platelet transfusion. RESULTS: There were polymorphisms of gene GP IIb in the 26th, 30th exon and the 21st intron, and the mutations were: T changed into G in 13,959 th of the 26th exon; C changed into T in 16,997 th of the 30th exon; the 9 bps deletion occurred in 11,996-12,004 th of the 21st intron. The 3 polymorphisms had synchronization in the individuals. The results of Fok I enzyme indicated that the frequency of HPA-3a was 83.6% (92/110)and 81.9%(119/147), and that of HPA-3b was 16.4%(18/110) and 19.1%(28/147) in the normal individuals and the patients respectively. There was no significant difference between the patients and normal individuals (P>0.05). After the platelet transfusion, the antibodies of all the cases of the homotype platelet transfusion were negative, but the antibodies in 2 cases of the control group were positive, and there was antibody to HPA-3a in one of the antibodies positive cases. CONCLUSION (1)There is close linkage among the polymorphisms of gene GP IIb, which is T->G in 13 959 th of the 26th exon, C->T in 16,997 th of the 30th exon, and the 9 bps deletion in 11,996-12,004 th in the 21st intron. (2)The gene frequency of HPA-3a/3b is similar in the normal individuals and patients with hematologic diseases. (3) HPA-3 system may be one of the reasons for PTR in Chinese.
Adolescent ; Adult ; Aged ; Antigens, Human Platelet ; immunology ; physiology ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Child ; Exons ; Female ; Gene Frequency ; Genotype ; Humans ; Immune Tolerance ; Introns ; Male ; Middle Aged ; Platelet Membrane Glycoprotein IIb ; genetics ; immunology ; Platelet Transfusion ; Polymorphism, Single-Stranded Conformational ; Young Adult

OBJECTIVECystic fibrosis (CF) is rare in Chinese mainland. We present two cases of CF patients diagnosed by gene analysis. Their clinical manifestations and genetic mutation features are analyzed in this article. It will be of special interest to pediatricians in recognition of CF.

METHODThe clinical material of two CF patients who were diagnosed by gene analysis was retrospectively analyzed.

RESULTThe first patient is a 13-year-old girl. She had a complaint of recurrent fever and cough for 6 months, expectoration for 2 months and hemoptysis for 20 days. After 3 months of her birth, she was operated on for bullae of lung. She was susceptible to upper respiratory tract infection. There was no family history of recurrent wheeze and other special diseases. Aspergillus fumigatus specific IgE was at grade 3 and aspergillus fumigatus IgG was high. Pseudomonas aeruginosa was positive in sputum culture. Sweat testing was performed and Na+ was higher. Pulmonary CT indicated bronchiectasis. Nasal sinus CT showed optical density of soft tissue within maxillary sinus and chronic bilateral sinusitis. The electron microscopy of cilia suggested immobile cilia syndrome. A heterozygotic mutation (263T > G, 2909G > A) was found after CFTR genetic mutation analysis. Both her parents were carriers. She was treated with inhalation of nebulized hypertonic saline and postural drainage for a long time. And she got better during a follow up period of 1 year. The second patient was a 10-year-old girl who complained of recurrent expectoration for 3 years and shortness of breath for half a year. She had a history of sinusitis and steatorrhea. The family history was normal. Both the lipase and insulin level in blood serum was lower.Pseudomonas aerugino and Aspergillus fumigatus were both positive in sputum culture. Aspergillus fumigatus IgE was normal. Pulmonary CT indicated bronchiolitis and bronchiectasis. Nasal sinus CT showed bilateral maxillary sinusitis. CFTR genetic mutation analysis revealed a homozygous mutation (3196C > T). Her parents and relatives did not participate in this study. Unfortunately, this child died of respiratory failure 3 months after discharge.

CONCLUSIONCFTR gene mutation was a main cause of CF. Common symptoms are those of bronchiectasis, pancreatitis and sinusitis. The two Chinese patients were diagnosed by gene analysis. One had a heterozygous mutation (263T > G, 2909G > A) and the other had a homozygous mutation (3196C > T), not ΔF508 which is common in western countries.

Adolescent ; Asian Continental Ancestry Group ; genetics ; Bronchiectasis ; etiology ; genetics ; Child ; Cystic Fibrosis ; complications ; diagnosis ; genetics ; Cystic Fibrosis Transmembrane Conductance Regulator ; genetics ; DNA Mutational Analysis ; Female ; Heterozygote ; Homozygote ; Humans ; Mutation ; Retrospective Studies ; Sinusitis ; etiology ; genetics

OBJECTIVETo discuss the safety and feasibility of aneurysm repair in vitro and renal revascularization and renal autogenous transplantation for complex renal artery aneurysm in solitary kidney.

METHODSA complex hilar renal artery aneurysm involving the bifurcation of renal artery and its branches in a solitary left kidney was diagnosed by computed tomography angiography (CTA). After temporary nephrectomy, aneurysm repair in vitro and renal revascularization were done with the kidney protected by hypothermia and continuous perfusion with preservation solution, and then the kidney was replanted into the right iliac fossa.

RESULTSThe operation was done successfully and there were no significant perioperative complications. Although a serum creatinine level temporarily exceeded above 200 micromol/L after the surgery, it recovered gradually within half a month. CTA two weeks later demonstrated patent reconstructed renal arteries and its branches and patent renal vein in the right iliac fossa, and also a patent reconstructed ureter.

CONCLUSIONSThis technique is safe and feasible to manage complex renal artery aneurysm in solitary kidney and provide an alternative for similar complex renal diseases.

Aneurysm ; surgery ; Humans ; Kidney ; blood supply ; pathology ; surgery ; Kidney Transplantation ; methods ; Male ; Middle Aged ; Renal Artery ; pathology ; surgery ; Transplantation, Autologous ; Treatment Outcome