Objective To observe the effect of therapeutics of invigorating spleen and kidney, removing blood stasis and clearing away turbidness on lipid metabolism and renal function in patients with chronic renal failure (CRF). Methods Fifty-eight patients with CRF were randomly divided into the treated group (30 cases) and the control group (28 cases). Both groups were treated with low-protein diets, controlling hypertension and symptomatic treatment. And Chinese drugs for invigorating spleen and kidney, removing blood stasis and clearing away turbidness were given additionally to the treated group. The curative effect, renal function and lipid metabolism were observed after two months. Results TC, TG and APOB in the treated group lowered significantly, HDL-C and APOAⅠraised significantly after treatment (P0.05). The total effective rate and the improvement of renal function in the treated group were better than those in the control group (P

Objective To evaluated the correlations between MSCT features and expression of VEGF-C,lymphatic vessel density (LVD)in gastric carcinoma.Methods Both plain MSCT and triphasic dynamic contrast-enhanced scan were performed in 58 patients with gastric carcinoma.All patients underwent total/subtotal gastrectomy after MSCT scanning.All specimens were collected into liquid nitrogen or deep freeze refrigerator.Detection procedure for VEGF-C mRNA was performed using RT-PCR,and the LVD was detected with 5’-nucleotidase (5’-Nase)histochemistry.Results The VEGF-C positive rate and the LVD in tumor tissue were high-er than those in normal tissue (P < 0.05 ).In the tumors between diffused and intestinal groups and between non-metastasis and lymph node metastasis groups,the VEGF-C positive rate was 87.1% and 59.3%,87.8% and 41.2%,and the LVD was 8.04±4.58 and 4.08±2.44,8.50±4.70 and 3.64 ± 1.41,respectively,indicating statistically significant differences (P <0.05 ).Conclusion Over-expression of VEGF-C and higher LVD are closely correlated with the lymph node metastasis and Lauren types of MSCT fea-tures of gastric carcinoma.VEGF-C can promote the lymphangiogenesis in carcinoma and further lymph metastasis.

In recent years,laparoscopic total gastrectomy (LTG) with lymphadenectomy is increasingly utilized for the management of gastric cancer located in the middle or upper third of the stomach.However,esophagojejunostomy is the key technical difficulty in operation.Compared with conventional extracorporeal esophagojejunostomy via mini-laparotomy,pioneers are attempting to perform intracorporeal anastomosis in order to gain better manipulation and minimally invasive benefits,as well as reducing the difficulties in digestive tract reconstruction.

AIM:To explore the effect of long-term (6 months) endogenous testosterone deprivation by orchidectomy on the function of voltage-dependent potassium channels of vascular smooth muscle cells in rats. METHODS:Wistar rats were raised for 6 months after castration. Isometric tension measurement of aortic rings,whole-cell patch-clamp technique and Western blotting analysis were employed to examine the functional and posttranscriptional alterations of voltage-dependent potassium channels. RESULTS:Voltage-dependent potassium channel blocker,4-aminopyridine,significantly decreased the constriction of aortic artery rings from male rats after 6-month castration. In castrated rats the amplitude of voltage-dependent potassium currents of aortic artery smooth muscle cells was significantly decreased compared with that in control rats. Meanwhile,the expression of Kv 1.5 channel protein,which plays an essential role in mediating vasomotor function,was also reduced. The functional and molecular alterations of voltage-dependent potassium channels were both restored when the rats were concomitant applied with physiological level of testosterone after castration. CONCLUSION:Long-term deprivation of endogenous testosterone in rats significantly attenuates the function of voltage-dependent potassium channels,and the decreases in expression of Kv1.5 channel protein accounts for this alteration. Long-term application of physiological concentration of testosterone,which recovered the impaired function of voltage-dependent channels,may be beneficial for male gender with hypotestosteronaemia.

Objective To study the relationship between a CAG repeat polymorphism of the androgen receptor (AR) gene and postmenopausal osteoporosis (PMO). Methods Genotypes for the AR polymorphisrn were determined by gene scan and DNA sequence methods in a case-control study,including 78 cases of PMO at femoral neck and 73 cases as controls, and 108 cases of PMO at lumbar spine (L2-4) and 60 cases as controls. Bone mineral density for the proximal femur and L2-4 was measured by NORLAND XR-46 dual-energy X-ray absorptiometry. The relationship between the CAG repeat polymorphism and PMO was investigated. Results Eleven different allelic variants,containing 18, 20, 21, 23, 24, 25, 26, 27, 28, 29, and 30 CAG repeats were detected, 16 genotypes were present in the subjects. There were no significant differences in the genotype and allele distributions of (CAG) n polymorphism between PMO group (SS : 25.6 %, SL : 39.7%, LL : 34.6 % ;S:45.5%,L:54.5%) and control group (SS: 23.3%,SL=45.2% ,LL:31.5%;S:45.9%,L:54.1%) at the femoral neck site (all P＞0.05). The risk of PMO at femoral neck in females with the genotypes of SL (0R:0.798,95%CI:0.335～1.797), the LL (0R:0.998,95%CI:0.425～2.341), and the combined SL and LL (OR:0.880, 95% CI: 0.419～1.852) were not significantly increased in comparison with those of females with the SS genotype (all P＞0.05). There were no significant differences in the genotype and allele distributions of (CAG)n polymorphism between PMO group(SS: 18.5%, SL: 49.1%, LL: 32.4%;S:43.1%, L: 56.9%) and control group (SS: 21.7%, SL:45.0% ,LL:33.3% ;S:44.2% ,L:55.8%) at the L2-4 site (P＞0. 05). The risk of PMO at L2-4 in females with the genotypes of SL (OR:1. 276,95%CI:0. 552～2. 950), the LL (OR:1. 137,95%CI:0.468～2.766), and the combined SL and LL (OR: 1. 217,95% CI: 0. 556 ～2. 663 ) were not significantly increased in comparison with those of females with the SS genotype (all P＞0.05). After adjustments for age, postmenopausal period, menopausal age, and body mass index, the logistic regression analyses revealed the (CAG)n polymorphism was not significantly associated with PMO at the femoral neck and L2-4 site (all P＞0.05). Conclusions The CAG repeat polymorphism in the AR gene may not be associated with PMO at the femoral neck and L2-4 site.

Objective To develop a simple model for the noninvasive diagnosis of liver fibrosis in patients with chronic hepatitis B and to testify its diagnostic value. Methods One hundred and ninety patients with chronic hepatitis B who had undergone liver biopsy were divided into 2 groups:one for developing the model(n=110) and one for validation(n=80). Histological staging of liver fibrosis,assessed blindly and independently by 2 pathologists,was determined according to Scheuer fibrosis score.Twenty markers involved in the study were analyzed initially in the estimation group to derive a predictive model to discriminate the stages of fibrosis.The model created was then assessed with receiver operating characteristic curve(ROC)analysis. It was also applied to the validation group to test its accuracy. Results Haptoglobin(HPT),γ-glutamyl transpeptidase(GGT)and platelet were identified by logistic regression analysis as independent factors of fibrosis. A model developed from the above three markers was established to predict the stage of fibrosis(S). In ROC analysis,the area under curve(AUC) for identifying S≥1,S≥2,S≥3 and S=4 was 0.832,0.835,0.820 and 0.843 respectively. The model had a similar AUC in the vatidation group without statistically significant difierence. Using a cut-off of ＜0.18, significant fibrosis (S≥2)could be excluded in 27 patients of the total patient population(negative predictive value 90%).Similarly,applying a cut-off ≥0.70,significant fibrosis could be identified correctly in 67 patients of the total patient population(positive predictive value 82.7%).The model had a high level of diagnostic value in patients with HBeAg-positive chronic hepatitis B as well as in patients with HBeAg-negative chronic hepatitis B(AUC for identifying S≥2,0.857 vs 0.802). Restricting biopsy to patients with intermediate scores(≥0.70 and ＜0.18) may prevent liver biopsies in 58.4% of the patients while maintaining 84.7% accuracy. Conclusions A model including HPT,GGT and platelet is a simple and reliable index for predicting significant fibrosis in patients with HBeAg-positive chronic hepatitis B as well as in patients with HBeAg-negative chronic hepatitis B.

UNLABELLEDTo investigate the relationship between imbalance of cardiac autonomic nervous system and sudden death in fetuses of rats with intrahepatic cholestasis of pregnancy (ICP), the animal model of ICP was induced by hypodermic injection of 17-alpha-ethinylestradiol and progesterone. The electrocardiograms and frequency domain analysis of heart rate variability (HRV) including low frequency (LF), high frequency (HF) and the ratio between low and high frequencies (LF/HF) of fetal rats by the 21st day of gestation were evaluated with Chart 5 software of Powerlab biologic signal extracting and analyzing system.

RESULTS(1) The serum total bile acids (TBA) levels of pregnant rats were (78.5 +/- 4.5) micromol/L in Group ICP and (24.6 +/- 3.6) micromol/L in Group control; significant difference was noted between the two groups (P < 0.01). (2) In Group ICP, fetal rats arrhythmias appeared after (29.3 +/- 6.4) minutes' observation, and fetal rats died suddenly after (23.5 +/- 4.6) minutes' arrhythmias; However, the fetal rats in Group control all showed normal electrocardiograms over 90 minutes' continuous observation. (3) The values of LF and LF/HF of fetal rats in Group ICP within 20 minutes before fetal rats arrhythmias were significantly higher than those in Group control (LF 48.45 +/- 4.11 nu vs. 33.87 +/- 4.31 nu, and LF/HF 0.99 +/- 0.14 vs. 0.61 +/- 0.10, respectively, P < 0.01). (4) Dynamic power spectral analysis of HRV indicated that the values of LF and LF/HF of fetal rats in Group ICP increased progressively within 15 minutes before the sudden death of fetal rats. These demonstrated that autonomic imbalance in association with increased sympathetic activity has been strongly implicated in the pathophysiology of fetal arrhythmogenesis and sudden death in ICP. HRV analysis could be a useful tool for fetal surveillance, especially for ICP.

Animals ; Cholestasis, Intrahepatic ; physiopathology ; Death, Sudden ; etiology ; Electrocardiography ; Female ; Fetal Death ; etiology ; Heart Rate, Fetal ; Male ; Pregnancy ; Pregnancy Complications ; physiopathology ; Rats ; Rats, Sprague-Dawley

Objective To raise the level of clinical diagnosis for the patients with pituitary stalk interruption syndrome (PSIS). Methods Five patients (4 males) with PSIS were retrospectively analyzed with respects to the clinical features, endocrine status and image characteristics. Magnetic resonance imaging (MRI) scan was performed at hypothalamic-pituitary region. Results The clinical manifestations of all patients consisted of growth retardation and delayed puberty without polyuria. Deficiency of multiple anterior pituitary hormones was revealed in all patients by the evaluation of endocrine status. The features of MRI included a lack of visible pituitary stalk, absence of posterior lobe hypersignal in the sella turcica and a hyperintense spot in the region of the thalamus opticus. Conclusion The clinical characteristics of patients with PSIS are growth retardation and delayed puberty. The evaluation of anterior pituitary function is necessary. The detection of an anatomical abnormality around hypothalamic-pituitary region by MRI is important diagnostic evidence.

UNLABELLEDThis investigation was made to explore the chaotic characteristics of cardiac system and differences of autonomic nervous system development of normal pregnant rats and fetuses. The electrocardiograms, chaotic graphics and digital characteristics of heart period signal (HPS) of normal pregnant rats and fetuses by day 21st were evaluated with a computerized HPS extracting and analyzing system.

RESULTS(1) The mean values of frequency and voltage of fetal rats electrocardiograms were lower than those of pregnant rats significantly (P < 0.01). (2) Being similar to those in human, the chaotic graphics showed three-amplitudes spectral features in both normal pregnant rats and fetuses. However, the second amplitude and third amplitude were lower in fetal rats than in pregnant rats. (3) The Heart Relative Dispersion, Lyapunov Exponent and Fractional Dimension were significantly lower in fetal rats than in pregnant rats (P < 0.01). These findings demonstrated that the autonomic nervous system development of fetal rat was still immature and it exhibited lower complexity of HPS and chaotic degree than that of pregnant rat did.

Animals ; Autonomic Nervous System ; embryology ; physiology ; Electrocardiography ; methods ; Female ; Fetal Heart ; physiology ; Heart ; physiology ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Signal Processing, Computer-Assisted

Objective:To investigate the multi-sites high frequency ultrasound features of rectus diastasis (RD) in early postpartum women and their relationships with different delivery modes.Methods:Total of 571 primiparas who gave birth in the Obstetrics and Gynecology Hospital Affiliated to Zhejiang University Medical College from March to May 2020 and underwent 6-week postpartum examination were chosen, they were divided into vaginal delivery group (336 cases) and the cesarean section group (235 cases). The inter-rectus distance(IRD) of five loci (umbilical on 4.5 cm, umbilical on 3 cm, umbilical edge, edge of umbilical, umbilical down 3 cm) at resting state and two loci (umbilical edge, edge of umbilical) at curling state as well as the rectus thickness on the right side of umbilical level were observed by high frequency ultrasound. The impacts of the two delivery modes on IRD at each site and the changes of IRD under the two conditions were analyzed. Spearman correlation analysis was used to evaluate the correlation between the thickness of rectus abdominis and IRD at each site.Results:The incidence of early postpartum RD was 79.7% (455/571), most of which occurring at 3 cm above the umbilicus and the umbilicus levels. At resting state, the IRDs at the 5 loci of vaginal delivery group were (1.62±0.79)cm, (2.03±0.84)cm, (2.65±0.94)cm, (2.09±0.93)cm, and 0.54(0.00, 1.13)cm respectively, while the IRDs at 5 loci of the cesarean section group were (1.75±0.85)cm, (2.26±0.99)cm, (2.99±1.14)cm, (2.57±1.21)cm, and 1.00(0.41, 1.59)cm, with statistical differences at all the levels between groups ( P<0.05). Under the curling state, the IRDs at the 2 loci of vaginal delivery group were (2.10±0.84)cm and (1.66±0.86)cm respectively, while the IRDs at the 2 loci of cesarean section group were (2.28±0.87)cm and (1.91±0.87)cm, with statistical differences between groups( P<0.05). The incidences of increased IRD when compared between resting and curling states at the upper and lower umbilicus in the vaginal delivery group were 16.1% and 26.5%, with 17.4% and 20.4% in the cesarean section group. At the resting state, there was a significant difference in the thickness of rectus abdominis between the vaginal delivery and cesarean section groups [(0.74±0.12)cm vs (0.67±0.12)cm, P<0.05]. At the curling state, the difference between two groups was statistically significant [(1.11±0.23)cm vs (0.99±0.22)cm, P<0.05]. The thickness of rectus abdominis was negatively correlated with IRD(all the 5 loci at resting state, rs=-0.116, -0.140, -0.185, -0.143, -0.144, all P<0.01; and the upper umbilical loci at curling state, rs=-0.091, P<0.05). There was no significant correlation between the thickness of rectus abdominis and IRD at the lower umbilical edge at the curling state ( P>0.05). Conclusions:High frequency ultrasound can evaluate the morphological characteristics of the abdominal rectus muscle in early postpartum stage. Compared with vaginal delivery, rectus abdominis thickness, the IRD is larger in cesarean section primiparas, but less affected by the curling state.