Objective To explore the impact of total parathyroidectomy(tPTX)on carotid-femoral pulse wave velocity(cfPWV)in hemodialysis patients. Methods A total of 35 patients undergoing hemodialysis with refractory secondary hyperparathyroidism and treated with tPTX were studied. Before tPTX and 1 year after the oper-ation,cfPWVwas measured and hepatic and renal function,serum calcium,serum phosphorus,intact parathyroid hormone and hemoglobin were measured. The impact of tPTX on cfPWV in hemodialysis patients was analyzed. Results Serum calcium,serum phosphorus and intact parathyroid hormone decreased(P < 0.01),while hemo-globin and serum albumin increased(P < 0.01)and cfPWV decreased 1 year after the operation,which showed statistical significance(P<0.01). The cfPWV of the patients with tPTX was still higher than that of healthy indi-viduals(P<0.01). Conclusion tPTX can effectively reduce cfPWV in hemodialysis patients with refractory sec-ondary hyperparathyroidism.

AIM: To clone and express the gene of SLC24A6, which provide the basis to illuminate the relationship between the SLC24A6 and insulin release. METHODS: The gene expression of SLC24A6 was analyzed in the insulinoma and normal pancreatic tissues by RT-PCR. The full-length cDNA sequence was subcloned into pET32a vector, and induced expression and purified in ROSSET (DE3) strain. At the same time, the ORF of SLC24A6 was cloned into green fluorescence protein vector pEGFP-C3 to study the location of SLC24A6 in the mouse insulinoma ?-TC3 cells. RESULTS: The mRNA expression of SLC24A6 in the human insulinoma tissue was significantly higher than that in normal pancreatic tissue. The fusion protein of SLC24A6 was a 80 kD protein and was purified successfully by prokaryotic vector in ROSSET strain. The localization of SLC24A6 in the mouse insulinoma ?-TC3 cells was located in the membrane of the cells. CONCLUSION: SLC24A6 might be related with insulin release. The prokaryotic expression of SLC24A6 provides the basis for the study on biological function and protein structure, and the location of SLC24A6 in the insulinoma cell will throw light on the relationship with insulin release.

Objective To assess the safety and efficacy of tirofiban in stent-assisted coil embolization of intracranial aneurysms.Methods Totally 31 patients who were treated using stent-assisted coil embolization were analyzed retrospectively.All the patients were divided into aspirin combined clopidogrel group (double resistance group,n=18) and tirofiban group (n=13).Tirofiban was injected after the stent was semi-released or released completely.The patients were followed-up after operation to assess whether the patient had a new infarction,stent patency and aneurysm embolization effect.One day before operation and 3 days after operation,platelet count and activated thromboplastin time (APTT) were detected respectively.Score Glasgow (GOS) was used to evaluate the clinical outcome of patients and the operative complications were recorded.Results A total of 34 aneurysms were found in 31 patients,and 32 aneurysms were treated.Urinary tract hemorrhage was founded in 1 case and recurrent aneurysms were founded in 7 cases after embolization.None of the patients developed thrombocytopenia,retroperitoneal and gastrointestinal bleeding related to tirofiban administration.There were no postoperative cerebral infarction and thrombosis events.GOS of 27 cases were ≥4.Platelet count and APTT 1 day before and 3 days after operation had no statistically significance between two groups (both P＞0.05).Conclusion It is safe and effective for tirofiban in stent-assisted aneurysm embolization and can be used as an alternative to the dual resistance.

OBJECTIVETo investigate the density and distribution of nerve endings and neuropeptide Y (NPY) in lumbar facet joints of patients with low back pain.

METHODSFifteen patients without low back pain were selected as control group (group A). Facet joint samples in group A were obtained during the operation or lumbar spinal canal tumor they suffered from. Those patients with low back pain were divided into three groups according to their different origins of pain, such as not from facet joint (group B, 15 patients) ,from facet joint only (group C, 20 patients), or from facet joint partially (group D, 20 patients). Different origins were determined by VAS after facet joint block. The density and distribution of nerve ending and neuropeptide in the capsular tissues were analyzed by a modified gold chloride staining and immunochemistry respectively.

RESULTSCompared with the ones in group A and B, the fact joints in group C and D were more inclined to be degenerated and got more nerve endings. NPY was expressed mainly in the facet joint of patients with low back pain in group C and D. In addition, there was a significant relationship between the distribution of nerve endings and NPY expression,while none of them were related with MRI Fujiwara grade of facet joint.

CONCLUSIONThese results suggest that the number of mechanoreceptors, neural sprouting and secreted peptides in the facet joint capsules vary with the change of mechanical or nociceptive stimulation, which may promote the development of low back pain in return.

Adult ; Aged ; Case-Control Studies ; Chronic Pain ; etiology ; metabolism ; pathology ; Female ; Humans ; Low Back Pain ; etiology ; metabolism ; pathology ; Male ; Mechanoreceptors ; physiology ; Middle Aged ; Nerve Endings ; pathology ; Neuropeptide Y ; analysis

Objective To evaluate the feasibility of plasma NT-pro brain natriuretic peptide guided therapy of β1-blocker to patients with moderate and severe heart failure.Methods A total of 1 95 patients with moderate and severe heart failure were ran-domized to the clinical group and the BNP group.The use of β1-blocker was guided by monitoring clinical representation and the changes of BNP values respectively.The duration of initiative use ofβ1-blocker,the recurrence of heart failure,the mortality due to heart failure and the mean dosage ofβ1-blocker were observed and analysed.Results Compared with the clinical group,the time of initiative use ofβ1-blocker was significantly shorter in NT-proBNP group[(5.89±1.76)d vs .(7.03±2.08)d,P <0.01].The mean dosage ofβ1-blocker is significantly higher in BNP group than that in clinical group[(47.65 ± 13.09 )mg/d vs .(35.08 ± 1 1.08) mg/d,P <0.01].The recurrence and mortality of heart failure were similar in two groups(P >0.05).Conclusion NT-proBNP-guided therapy ofβ1-blocker might contribute to early use and tolerance of higher dosage ofβ1-blocker in patients with NYHA Ⅲ-Ⅳ class heart function,with no extra adverse event.

Clinical training together emphasized the combination of theory and practice. It not only improved students'clinical thinking and skills and enhanced their communication skills and medical treatment writing skills but also demanded the teachers to have higher sense of responsibility and teaching skills.

AIM: To verify and localize the expression of nicotinamide N-methyltransferase (NNMT) in pancreas of streptozotocin(STZ)-induced diabetic monkeys and understand its important role in ?-cell destruction in the pathogenesis of diabetes. METHODS: Through an olig-microarray gene chip, NNMT was identified as the most obviously up-regulated genes in pancreas of STZ-induced diabetic monkeys versus controls. Semiquantitative RT-PCR and Western blotting were performed to verify the differential expression at mRNA and protein level respectively. Then the cellular localization of NNMT expression within pancreas was identified by immunohistochemical(IHC) staining.RESULTS: An obvious high expression of NNMT at both mRNA and protein levels was shown in pancreas of STZ-induced diabetic monkeys compared to that of controls. Further localization of the protein by IHC staining in pancreas specimens showed that its altered expression was restricted to central islets, most of which were ? cells.CONCLUSION: Expression of NNMT is increased in islets of STZ- induced diabetic monkeys, which infers that NNMT might participate in the process of ? cell damage in diabetes probably through the mechanism of energy metabolism disturbance.

Objective To investigate the correlation of plasma N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) level with echocardiographic indicators and P wave terminal force of lead V 1 (PtfV1) in the patients with hypertension and paroxysmal atrial fibrillation(PAF) .Methods Fifty‐six outpatients and inpatients with hypertension were divided into the PAF group (n=26) and the sinusrhythm group (n=30) .Thirty age‐matched and gender‐matched healthy volunteers were taken as the control group . The plasma NT‐proBNP level was determined .Left ventricular enddiastolic diameter (LVEDD) ,left atrial diameter(LAD) and left ventricular ejection fraction(LVEF) were examined by echocardiography .the 12‐lead electrocardiogram was routinely performed Pt‐fV1 was calculated .Results The plasma NT‐proBNP level in the PAF group was higher than that in the sinusrhythm group and the control group ,the difference was statistically significant (P<0 .05) .The plasma NT‐proBNP level in the PAF group was de‐creased significantly after successful cardioversion .The plasma NT‐proBNP level in the PAF group was positively correlated with LVEDD(r=0 .543 ,P<0 .05) and LAD (r=0 .606 ,P<0 .01) .The plasma NT‐proBNP level was negatively correlated with LVEF (r= -0 .750 ,P<0 .01) and positively correlated with the PtfV 1 absolute value (r= 0 .513 ,P< 0 .01) .Conclusion The plasma NT‐proBNP level can better reflect the heart structure and function in the patients with atrial fibrillation .Detecting the plasma NT‐proBNP level combined with echocardiographic indicators and PtfV 1 is conducive to comprehensively assess the heart function in the patients with hypertension and PAF .

Objective To observe the effect of acetylated low-density lipoprotein (AcLDL) on the expression of adipophilin and the effect of adipophilin on AcLDL uptake and lipid accumulation in human vascular smooth muscle cells (HVSMCs)in order to approach the role played by adipophilin in genesis of macroangiopathy. Methodse HVSMCs were treated with various amount of AcLDL. Adipophilin expression levels were detected by Northern blot and Western blot. The effects of adipophilin on AcLDL uptake and lipid accumulation in HVSMCs were observed by the methods of siRNA, flow cytometry, enzymatic method and oil red stain. Results AcLDL dose-dependently increased adipophilin expression in HVSMCs. Silence adipophilin by siRNA decreased AcLDL uptake (decreasing by 38.7%, P<0. 05) and lipids accumulation (tfiglyceride and total cholesterol decreasing by 30.6% and 29.8% respectively, both P<0. 01) in HVSMCs, Conclusion Adipophilin is able to increase AcLDL uptake and lipid accumulation in HVSMCs, suggesting that it might play a role in enhancing atherosclerosis.

Objective To observe expression of resistin gene in adipose tissue of SD rats fed with high-fat diet and its correlation to insulin resistance, diabetes mellitus and leptin. Methods Using RT-PCR to mRNA from adipose tissue, the products were obtained, purified, constructed and squenced. Once its squence was verified, semi-quantitative RT-PCR and Northern Blot were employed to study its expressions in adipose tissues of rats with different diets. Oral glucose tolerance test and insulin release test were performed in 2 groups of rats. Results (1) The resistin gene was successfully constructed and sequenced, which was in accordance with the data of genbank. (2) Compared with the control, the expression of resistin in adipose tissue of high-fat diet rats was significantly enhanced, and blood glucose, serum insulin and leptin levels were also elevated in high-fat diet rats (P