Objective To investigate the echocardiographic determination of uremic patients with myocardial weight and in the evaluation of cardiac function in patients with uremia heart the significance of the damage.Methods 70 cases of uremic patients and 30 normal physical were examined by routine echocardiography,cardiac measurements through the menu of uremic patients with myocardial weight and heart function.The patient group and the normal control group were compared.Results 70 patients with uremic echocardiography resuits of the analysis showed,respectively,12.8%and 84.3%existence of left ventricular systolic dysfunction and left ventricular diastolic dysfunction.left ventricular mass in patients with significant increase are significantly higher than those in healthy control group(P＜0.01).Conclusion Uremic patients left ventricular diastolic dysfunction and left ventricular hypertrophy most of echocardiography is the detection of cardiac damage in patients with uremia practical,sensitive,non-invasive examination will be able to clinical diagnosis and treatment provide guidance in the clinical widely used.

Objective To study the clinical valne of color Doppler ultrasound for the diagnosis of primary ureteral carcinoma. Methods 15 patients with pathologically confirmed primary ureteral carcinoma by color Doppler ultrasound were retrospectively analyzed. Results 15 patients with lesions above the ureter and renal pelvis and varying degrees of expansion,water, of which 11 cases of solid mass within the probe and ureter. Color Doppler showed lesions could be detected, and dot, stripe and dendritic arterial blood flow signal, resistance index (RI) 0. 58 ～ 0. 67.Conclusion Color Doppler ultrasound screening of primary ureteral carcinoma has important diagnostic value, can increase the rate of preoperative diagnosis,and can provide reference for clinical staging.

Aim To explore the effect of survivin in PC12 cells against injuries induced by cobalt chloride(CoCl_2).Methods PC12 cells were exposed to CoCl_2 at different doses in different time to set up the chemical hypoxia induced PC12 cells injuries model.Cell viability was tested by using cell counter kit-8.Dose-effect(200～1 000 μmol·L~(-1))and time-effect(0～48 h)relationship between hypoxia induced by CoCl_2 and the expression of survivin was evaluated by western blot.Results PC12 cells viability was inhibited significantly by CoCl_2 in a dose and time dependent manners;At the concentrations from 200 to 600 μmol·L~(-1) CoCl_2 for 24 h,survivin expression was upregulated in a dose dependent manner,peaking at 600 μmol·L~(-1) CoCl_2 treatment,exceeding this concentration of CoCl_2,with dose increasing,survivin expression decreased.At the dose of CoCl_2 up to 1 000 μmol·L~(-1),survivin did not express basically;Treatment with 600 μmol·L~(-1) CoCl_2 in different time,within the range of 0～36 h,the expression of survivin enhanced in time dependent manner.But with the extension of time,survivin expression was declining; 17-allylamino-17-demethoxygeldanamycin (2 μmol·L~(-1)),an inhibitor of Hsp90,not only decreased survivin overexpression but also obviously enhanced the injuries of PC12 cells induced by CoCl_2,which didn't damage PC12 cells alone.Conclusion Upregulation of survivin expression may be one of the endogenous defense mechanisms for PC12 cells against chemical hypoxia.

[Objective] To explore the cytoprotecfion of hydrogen sulfide (H_2S) against cobalt chloride (CoCl_2)-induced apeptosis in PC12 cells and the underlying mechanisms. [Methods] CoCl_2 (a chemical hypoxia-mimetic agent) was used to establish the chemical hypoxia-induced PC12 cell injuries model. Sodium hydrosulfide (NaHS) was used as a H_2S donor. The viability of PC12 cells was measured by CCK-8 assay. The percentage of apeptotic cells was assessed by propidium iodide stain flow cytometry (FCM). The morphological change of apeptotic cells was tested by using the chromatin dye Hoechst 33258. The mitochondrial membrane potential (MMP) was analyzed by rhodamine 123 staining and photofluorography. The level of reactive oxygen species (ROS) in PC12 cells was measured by DCFH-DA staining and photofluorography. [Results] CoCl_2 induced a decrease in cell viability and an increase in percentage of apeptosis in PC12 cells along with dissipation of MMP as well as overproduction of ROS. When PC12 cells were treated with Naris 30 min before CoCl_2 treatment a decrease in viability of PC12 cells induced by 600 μmol/L CoCl_2 was concentration-dependently blocked by NaHs (100, 200, and 400 μmol/L). Pretreatment with NaHS at 200 and 400 μmol/L obviously reduced the apepetotic percentage of PC12 cells induced by 600 μmol/L CoCl_2 and inhibited the dissipation of MMP and overproduction of ROS. [Conclusion] H_2S protected PC12 cells against CoCl_2-induced apeptosis, which may be associated with the inhibition of H_2S on the dissipation of MMP and overproduction of ROS induced by CoCl_2.

Objective To estimate the influences of N-acetyl cysteine (NAC) on a chemical hypoxiamimetic agent CoCl2 induced-injury to, and expressions of inflammatory factors by, an immortal human skin keratinocyte line HaCaT. Methods HaCaT cells were treated with CoCl2 of 2000 μmol/L for 4 hours to set up a chemical hypoxia-induced cell model of skin injury. NAC of various concentrations ( 1000, 2000, 3000 μmol/L)was used to pretreat HaCaT cells for 2 hours prior to the establishment of cell model. After these treatments,cell viability was detected by cell counting kit 8 (CCK-8), the levels of interleukin 6 and 8 (IL-6 and -8) and tumor necrosis factor α (TNF-α) in culture supernatant by ELISA kits, mitochondrial membrane potential (MMP) by rhodamine 123 (Rh123) staining and photofluorography, intracellular reduced glutathione (GSH)content by glutathione detection kit. Results An obvious decline was observed in HaCaT cell viability after pretreatment with various concentrations of NAC for 2 hours. The treatment with CoCl2 of 2000 μmol/L for 4 hours induced an elevation in the supernatant levels of IL-6, IL-8 and TNF-α and a decrease in GSH content and MMP, while the pretreatment with NAC for 2 hours retarded the CoCl2-induced increase in IL-6 and IL-8 levels as well as decrease in GSH content and MMP. Conclusion The reactive oxygen species (ROS) scavenger NAC can protect against CoCl2-induced injury to and inflammatory reaction in HaCaT cells, which may be associated with a decrement in oxidative stress.

Objective To detect the mutations of COL7A1 gene in three cases of dystrophic epidermolysis bullosa pruriginosa (DEBP). Methods Clinical data were collected from 3 patients with DEBP. Skin lesions were obtained from these patients and subjected to transmission electron microscopy. DNA was extracted from the peripheral blood of the 3 patients, their 16 relatives, and 150 unrelated normal human controls, and PCR was performed to amplify all the exons and flanking sequences of COL7A1 gene followed by sequencing.Results The patient 1 and 2 had family history, whereas the case 3 was sporadic. Transmission electron microscopy showed tissue cleavage beneath lamina densa in case 1 and slightly decreased anchoring fibrils in some areas of the lesions in case 1 and 3. Three heterozygous mutations of COL7A1 gene, i.e., c. G6734T, c.G6859A and c. G5318T, which leaded to three amino acid mutations, i.e., p. G2245V, p. G1773V and p. G2287R, were found in patient 1, 2 and 3 respectively. Of them, p. G2245V and p. G1773V were novel mutations. The mutations strictly cosegregated with the phenotype in the patients of family 1 and 2. No mutation was detected in the unaffected parents of patient 3 or the 150 unrelated healthy controls. Conclusions The p. G2245V, p. G2287Rand p. G1773V mutations of COL7A1 gene may be responsible for the phenotype of DEBP in the three cases,and of them, p. G2245V and p. G1773V have never been reported.

Objective To explore a surgical method for the treatment of lumbosacral spinal tuberculosis by combination of one-stage focus debridement with anterolateral incision, bone graft fusion with titanium mesh cage and internal fixation with double pedicle crew system.Methods From Sep.2009 to Dec.2012, a total of 8 patients with lumbosacral spinal tuberculosis which included 5 cases of male, 3 cases of female.The age ranged from 20 to 65 years, with a mean of 51.6 years.All patients presented with persistent back pain, 4 patients with radiating pain of unilateral lower limb, 3 with weakness and numbness and 5 with constitutional symptoms including low-grade fever and weight loss.All patients were not associated with active tuberculosis in oth er parts of the body.The patients were given regular anti-TB treatment for at least 4 weeks.By anterolateral incision, common iliac and iliac arteries and veins were dissociated extraperitoneally.The focus was completely debrided through the inferior part of vessels.Then the bone graft fusion was performed with the titanium mesh cage and the internal fixation with a double pedicle crew system was accomplished.After the surgery, patients were treated with continuous anti-TB drugs and with antibiotics to prevent infection.Patients were allowed to move with the protection of waist early and regular follow-up.Results Operation time was 180-360 min, with an average of 225 min.Operative blood loss was 624 ml and drainage volume was 150 ml on average.All cases were cured after surgery.No severe complications were observed during the surgeries.After follow-up of 8 to 30 months (averaged 12months), no recurrence of the tuberculosis was found.The lumbocrural pain improved in all the patients.Complications such as migration, loosening and breaking of the implants were not observed.The vertebral bodies were fused in all patients with an average time of 8.3 months.No case occurred angiemphraxis or internal bleeding.Conclusion The method debrids the focus of lumbosacral spinal tuberculosis thoroughly and implements titanium mesh cage and double pedicle crew system simultaneously.The pedicle screw system is implemented in anterior lumbosacral vertebrae through the inferior part of iliac arteries and veins, which will not lead to angiemphraxis or vascular injuries.The early term outcome is encouraging.This technique is safe and effective to treat severe lumbosacral spinal tuberculosis.

Objective To explore the application of low dose of radiation combined with low concentration of contrast medium in the energy spectrum CT of the coronary artery angiography.Methods 60 patients with suspected diagnosis of coronary heart disease were randomly divided into A,B two groups,30 cases in each group.Group A with 350 mg I/mL contrast agent,undergoing conventional CT scanning;Group B using 300 mg I/mL contrast agent,the gems energy spectrum CT scanning with low-dose.Two groups both adopted forward-looking heart switch control scanning mode.After scanning,group A reconstructed conventional images of 40% ASiR sequence,group B rebuilded axial surface images of single energy 65 keV and 40% ASiR sequence,all the reconstruction images were introduced to AW4.6 workstations used for analysis.Double-blind subjective rating was done by two experienced doctors to measure CT values and SD of aortic sinus (AS),left main (LMA),the left anterior descending branch proximal (LAD-p),left circumflex branch proximal (LCX-p), right coronary artery proximal (RCA-p)and pericardial fat,AS the noise (SD),to calculate the signal-to-noise ratio (SNR)and contrast to noise ratio (CNR),to calculate the effective doses of radiation(ED)by recording CTDI and DLP,and to record iodine intake.By using two independent samples t test to compare two groups of patients’the effective radiation doses,iodine intake,the average CT value,SD,SNR and CNR.Results The subjective image quality score differences and coronary measuring section CT values between the two groups had no statistical significance.In the aspects of effective radiation dose,group B reduced about 29% compared to group A,the difference was statistically significant.Iodine intake in group B decreased about 16% than in group A.Conclusion In coronary artery CT imaging, spectral scanning with low dose of radiation and reconstruction images with single energy can effectively reduce the radiation dose and iodine intake,at the same time it can obtain the approximate image quality like conventional scanning.

Objective To investigate the role of human herpesvirus type 7 (HHV-7) in the development of drug eruptions.Methods Venous blood samples were collected from 35 patients with mild drug eruptions at acute stage,15 patients with severe drug eruptions at both acute stage and remission stage,as well as 50 healthy human controls.PCR was performed to detect HHV-7 DNA in peripheral blood mononuclear cells (PBMCs),and enzymelinked immunosorbent assay (ELISA) to determine the titer of anti-HHV-7 IgM antibody in serum.Statistical analysis was carried out by t test,one way analysis of variance,Chi-square test and q test.Results The detection rate of HHV-7 DNA was significantly higher in these patients with drug eruptions than in the healthy controls (82.00％ (41/50) vs.62.00％ (31/50),x2 =4.96,P ＜ 0.05),different among patients with severe drug eruptions (93.33％ (14/15)),patients with mild drug eruptions (77.14％ (27/35)) and the healthy controls (x2 =6.32,P ＜ 0.05),higher in the patients with severe drug eruptions than in the healthy controls (q =3.50,P ＜ 0.05),but not significantly different between the patients with severe drug eruptions at acute stage and those at remission stage (73.33％(11/15),P ＞ 0.05).The anti-HHV-7 IgM antibody titer was significantly increased in the patients with drug eruptions compared with the healthy controls ((69.319 0 ± 25.289 7) ng/L vs.(59.785 3 ± 22.438 2) ng/L,t =1.99,P ＜ 0.05),but no significant difference was observed among the patients with severe drug eruptions (74.340 7 ±31.411 2) ng/L),patients with mild drug eruptions ((65.479 1 ± 21.326 1) ng/L) and healthy controls (P ＞ 0.05) or between HHV-7 DNA-positive patients ((63.748 1 ± 27.239 1) ng/L) and-negative patients ((65.580 2 ± 36.258 4) ng/L,P ＞ 0.05).Conclusions Active HHV-7 infection exists in patients with drug eruptions,and may be associated with the development and aggravation of this entity.

BACKGROUND:Bisphosphonates that can suppress osteoclast activity strongly is a powerful inhibitor for bone resorption, which has been reported to have good effects in the treatment of fibrous dysplasia.
OBJECTIVE:To evaluate the clinical effect of surgical treatment combined with bisphosphonate therapy in the treatment of fibrous dysplasia.
METHODS: Fifteen patients with fibrous dysplasia of the long bone were subjected to surgical treatment and oral bisphosphonate therapy postoperatively. Limb pain, limb function, local X-ray manifestations and blood alkaline phosphatase activity were observed before and at 3, 6, 12, 24 months after treatment. The therapeutic effects were evaluated using modified Macnab standards.
RESULTS AND CONCLUSION:Al the 15 patients were folowed up for more than 24 months, and their pain symptoms were significantly relieved after the combined treatment of surgery and bisphosphonates, excelent in 12 cases and effective in 1 case, and the total efficiency was 100%. X-ray films showed that the density slightly decreased in operation areas after 3 months, but at 6 months after treatment, the cortical bone was thickened and the marrow cavity density increased in the operation areas, and non-focal zone was continuously enlarged. No fractures and recurrence were found in al patients. At 6 months after treatment, the serum alkaline phosphatase activity decreased significantly (P < 0.05). The results suggest that surgical operation with bisphosphonate treatment for bone fibrous dysplasia can effectively inhibit the bone resorption, promote bone formation, increase the intensity of the lesion, reduce fractures and recurrence rate, so as to achieve a better therapeutic effect in clinic.