Objective To analyze the characteristics of bone scintigraphy in 117 cases with primary hyperparathyroidism (PHPT).Methods Of these 117 cases (50 males and 67 females),there were 116 parathyroid adenomas and 1 parathyroid cancer.Mean age was 61.1(12-86) years old.All had ~(99)Tc~m-methylene diphosphonate (MDP) bone scintigraphy.The bone images could be classified into 4 categories.Category Ⅰ:normal;category Ⅱ:localized abnormal,which could be subcategorized as Ⅱ A with skull and mandible involvement,and Ⅱ B with Ⅱ A characteristics plus metabolic derangement;category Ⅲ:systemic,whole-body incmased tracer uptake;category Ⅳ:systemic plus localized metabolic derangement.Data were analyzed statistically with X~2 and t-test (isolated samples).Results According to the scintigraphic findings,there were 47 cases(40.17%)of category Ⅰ,35 cases(29.91%) category Ⅱ (21/35cases Ⅱ A and 14/35 cases Ⅱ B),30 cases (25.64%) category Ⅲ,and 5 cases (4.27%) category Ⅳ.Combining categories Ⅱ、Ⅲ and Ⅳ together,there were 70 abnormal cases.These patients had history of abnormal bone images such as bone fracture (39 cases,55.71%),calculus (8 cases,11.43%),bone fracture plus calculus(7 cases,10.00%),osteoporosis (51 cases,72.86%) or ostalgia(26 cases,37.14%);however,in the 47 cases of category Ⅰ,only 1 (2.13%),0,0,10(21.28%)and 10 cases (21.28%),respectively,were found.Therefore.these case history characteristics were statistically significant (X~2=11.152,P=0.01).The tumor size,parathyroid hormone (PTH),blood calcium,blood phosphorus in the patients of abnormal PHPT categories Ⅱ to Ⅲ were(14.52±13.72)cm~3,(731.67±618.40)ng/L,(3.05±0.29) mmol/L and (0.71±0.14) mmol/L,respectively.with statistically significant difference compared to category Ⅰ:(0.78±1.33) cm~3,(112.04±62.98)ng/L,(2.56±0.42) mmol/L and (1.03±0.36)mmol/L(t=-5.724,-5.741,-7.274 and -6.451;all P＜0.01).Conclusions (1)Bone scintigraphy was normal in 40% of PHPT patients.(2)The bone images of PHPT could be classified into 4 categories and each could reflect the duration and severity of the disease status on bone.(3)The bone imaging characteristic could be useful for differential diagnostic purposes.

In this study, UPLC-MS/MS was adopted to determine the contents of five ephedrine alkaloids (Norephedrine, Norpseudoephedrine, Ephedrine, Pseudoephedrine, Methylephedrine) in plasma and urine in rats after the combined administration of Ephedrae Herba-Gypsum Fibrosum and calculate relevant pharmacokinetic parameters, in order to discuss the effect of the combined administration of Ephedrae Herba-Gypsum Fibrosum on plasma pharmacokinetics and urinary excretion characteristics. According to the results, after being combined with Gypsum, the five ephedrine alkaloids showed similar pharmacokinetic changes, such as shortened t(max), accelerated absorption rate, but reduced AUC(0-t) and V(z)/F, which may be related to the increase in urine excretion. Besides, Gypsum was added to enhance C(max) of Pseudoephedrine and prolong MRT(0-t) of Methylephedrine, so as to enhance the anti-asthmatic effect of Ephedrae Herba and resist the toxic effect of Norephedrine and Ephedrine. This study proved the scientific compatibility of Ephedrae Herba-Gypsum Fibrosum and provided a reference for studies on the prescription compatibility regularity and relevant practices.
Alkaloids ; blood ; pharmacokinetics ; urine ; Animals ; Calcium Sulfate ; pharmacokinetics ; Drugs, Chinese Herbal ; pharmacokinetics ; Ephedra ; chemistry ; Male ; Rats ; Rats, Sprague-Dawley ; Urine ; chemistry

OBJECTIVE:To observe the effects of remifentanil-induced controlled hypotension (CH) on postoperative cogni-tive dysfunction (POCD) and serum S100β protein in elderly patients underwent spinal surgery,and to investigate their relation-ship. METHODS:Sixty elderly patients undergoing selective laminectomy decompression internal fixation of lumbar or thoracic fractures under general anesthesia were selected prospectively from orthopedics department of our hospital during Jan. 2014-Dec. 2015,and then divided into CH group and non-CH group in accordance with random number table,with 30 cases in each group. Both groups received general anesthesia of injection and inhalation via endotracheal intubation. Mean arterial pressure (MAP) of CH group were reduced to 70%-80%of the basic values by adjusting remifentanil infusion rate;those of non-CH group were main-tained at basic level. Surgery duration,anesthesia duration,intraoperative blood loss,the incidence of POCD and serum concentra-tion of S100β protein were observed in 2 groups. The relationship of serum concentration of S100β protein with POCD was ana-lyzed,and the occurrence of ADR was recorded. RESULTS:The intraoperative blood loss of CH group was significantly less than that of non-CH group,with statistical significance (P<0.05). There was no statistical significance in the incidence of POCD be-tween 2 groups on the 1st and 7th day after surgery(P>0.05). The incidence of POCD and serum concentration of S100β protein in CH group were significantly higher than in non-CH group on the 2nd and 3rd day after surgery,with statistical significance(P<0.05). The serum concentration of S100β protein may be related to the incidence of POCD (r=0.992 7,P=0.001 3). CONCLU-SIONS:Remifentanil CH used in elderly patients underwent spinal surgery can reduce intraoperative blood loss,but increase the se-rum concentration of S100βprotein and the incidence of POCD at early stage.

Objective To systematically evaluate the efficacy and safety of amlodipine (A)/hydrochlorothiazide(H) versus val‐sartan(V)/hydrochlorothiazide(H) in treatment of essential hypertension .Methods Literature was retrieved online in Cochrane Li‐brary ,PubMed ,OVID ,MEDLINE ,EMBASE ,CBM ,CNKI ,VIP and Wan fang database up to November 2013 .Relevant magazines were retrieved manually .Quality of the included studies was assessed and Meta‐analysis was performed with RevMan 5 .2 software . Results Seven randomized controlled trials(RCTs) were finally included .Meta‐analyses showed that :in terms of lowering ABP ,V/H group was more effective than A/H group ,the difference was statistically significant (P<0 .05);there was no significant differ‐ence in the decreased value of clinic BP and the control rate of blood pressure between A /H group and V/H group(P>0 .05) .Ad‐verse events occurred less frequently with V/H group compared with A/H group ,the difference was statistically significant (P<0 .05) .Conclusion A/H treatment of essential hypertension is inferior to V/H ,and has more adverse events .

Objective:To investigate the effect of rapamycin on cell growth and migration of gallbladder cancer GBC-SD cells, and to discuss its potential in clinical therapy of gallbladder cancer. Methods: Proliferation of GBC-SD cells treated with different concentrations of rapamycin (12.5, 25, and 50 mmol/L) was examined by MTT assay. Cell cycle distribu-tion and apoptosis of GBC-SD cells treated with different concentrations of rapamycin were determined by flow cytometry. Migration ability of GBC-SD cells was assessed by Transwell assay. The expression of mTOR (mammalian target of rapam-ycin) and its phosphorylation in GBC-SD cells were examined by Western blotting assay. Results: Rapamycin significant-ly inhibited the phosphorylation of roTOR, but had no influence on the expression of roTOR in GBC-SD cells. Rapamycin significantly inhibited the growth of GBC-SD cells in a dose-dependent manner (P < 0.01). Raparnycin induced apoptosis of GBC-SD cells and arrested them at the G_1/S phase. Furthermore, rapamycin also significantly suppressed migration of GBC-SD cells as showed by Transwell assay (P < 0.01). Conclusion: Rapamycin can remarkably inhibit the growth and migration of gallbladder cancer cells, probably by inhibition of p-roTOR pathway, induction of apoptosis and cell cycle ar-rest of gallbladder cancer cells.

Cyclin-dependent kinase 5 (CDK5) is a member of cyclin-dependent kinase family, which does not directly regulate cell cycle. Through phosphorylation of target protein, CDK5 plays an irreplaceable role in the development, reparation and degeneration of neurons. Brain injury refers to the organic injury of brain tissue caused by external force hit on the head. Owing to the stress and repair system activated by our body itself after injury, various proteins and enzymes of the brain tissues are changed quantitatively, which can be used as indicators for estimating the time of injury. This review summarizes the progress on the distribution, the activity mechanism and the physiological effects of CDK5 after brain injury and its corresponding potential served as a marker for brain injury determination.
Brain/physiopathology* ; Brain Injuries/physiopathology* ; Cyclin-Dependent Kinase 5/metabolism* ; Nerve Tissue Proteins/metabolism* ; Neurons ; Neuroprotective Agents/pharmacology* ; Phosphorylation/drug effects* ; Time Factors

Adult ; Antiviral Agents ; administration & dosage ; adverse effects ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Hepatitis C, Chronic ; drug therapy ; genetics ; Humans ; Interferon Type I ; administration & dosage ; adverse effects ; Interferon-alpha ; Male ; Middle Aged ; RNA, Viral ; blood ; Recombinant Proteins ; Ribavirin ; administration & dosage ; adverse effects ; Safety ; Treatment Outcome ; Viral Load

OBJECTIVETo study the pathologic findings seen in lethal cases due to accidental electrocution.

METHODSThe macroscopic and microscopic findings in 16 autopsy cases died of electrocution encountered during the period from January, 2001 to July, 2008 were retrospectively reviewed.

RESULTSTypical electric marks were found on gross examination in 5 of the 16 cases studied. Histologically, 11 of the 16 cases showed evidence of electric burn. The morphologic features of atypical electric marks varied. Simple epidermal exfoliation and color changes were relatively common. Pathologic changes in internal viscera included disarray of myocardial fibers. Rupture of myocardial fibers was readily identified than in non-electrocution death. Sometimes, focal interstitial hemorrhage and polarization of endothelial cells were seen.

CONCLUSIONSThe electric marks on the skin, as confirmed by histologic examination, remain important sequelae of electrocution. The pathologic changes seen in myocardium provide additional clues to the diagnosis.

Adolescent ; Adult ; Autopsy ; Burns, Electric ; pathology ; Child ; Child, Preschool ; Electric Injuries ; pathology ; Female ; Humans ; Male ; Middle Aged ; Myocardium ; pathology ; Retrospective Studies ; Skin ; pathology ; Young Adult

AIM: To investigate the expression and significance of MAPK-interacting kinase-2 ( Mnk2 ) and eukaryotic initiation factor 4E ( eIF4E) in the patients with resected esophageal squamous cell carcinoma ( ESCC ). METHODS:The protein expression of Mnk2 and eIF4E in ESCC tissues (98 cases) and normal esophageal tissues (20 cases) were assessed by immunohistochemistry (IHC), and their correlations with clinicopathological features were statisti-cally analyzed.RESULTS:The over-expression rate of Mnk2 and eIF4E was 68.4%(67/98) and 61.2%(60/98), re-spectively.The expression of Mnk2 had a positive correlation with eIF4E (P<0.05).Clinicopathologic analysis showed that Mnk2 expression was significantly correlated with T classification ( P<0.05 ) and clinical stage ( P<0.05 ) .CON-CLUSION:The over-expression of Mnk2 was significantly related to the tumor invasive depth , TNM stages and expression of eIF4E in ESCC.Expression of Mnk2 and eIF4E may have a cooperative formation mechanism in the development of ESCC.

Objective To evaluate the efficacy of 131I treatment for bone metastases from DTC and analyze the survival rates after 131I treatment and prognostic factors. Methods One hundred and six DTC patients with bone metastases treated by 131I during January 1991 and January 2009 were retrospectively analyzed. Treatment efficacy was assessed based on serum Tg change, bone pain palliation and changes on medical imaging. Univariate analysis was performed for defining the factors affecting 131I treatment efficacy. Survival curves were estimated using the life table method. Survival analysis was performed using Kaplan-Meier method. Results Serum Tg decreased dramatically in 37/106 (34.9%) patients treated with131I. Thirty-nine of 61 patients (63.9%) with bone pain had pain relief. Age, tumor subtype and presence of non-osseous distant metastases were significant factors affecting 131I treatment efficacy based on serum Tg change (χ2=6.443, 11.455, 6.756, all P<0.05), but had no significant effects on bone pain palliation (χ2=0, 0, 0.060, all P>0.05). There were no imaging changes of bone metastases in 77.4% of patients after 131I treatment. The overall 5-year and 10-year survival rates from initial diagnosis of bone metastases was 86.47% and 57.90%, respectively. Univariate analysis showed that number of metastases, presence of non-osseous distant metastases and pre-131I treatment surgery were significant factors for survival (Log-rank values were 4.05, 5.98, 4.22, all P<0.05). Conclusions 131I treatment for bone metastases from DTC is effective for lowering serum Tg and palliation of bone pain. Single metastasis, absence of non-osseous distant metastases and pre-131I therapy surgery are favorable predictors of prognosis.