Cardiomyopathy, Hypertrophic ; genetics ; Humans ; Mutation

Objective To investigate the effects of nitric oxide (NO) and cholecystokinin (CCK) on the regulation of the motility of sphincter of Oddi (SO).Methods The basal pressure,action rate and contraction range of the SO were examined before and after the injection of CCK,sodium nitroprusside (SNP) and NG-nitroL-argininemethyl ester hydrochloride (L-NAME).The expression of neurons with positive expression of NO synthase was detected by immunohistochemical staining.The measurement data were analyzed by using the t test.Results The basal pressure,contraction rate and contraction range of the SO were (27 + 10)mm Hg (1 mm Hg =0.133 kPa),( 10 ± 3 ) times/minute and (32 + 8 ) mm Hg before injection of CCK,and (61 + 14) mm Hg,(64 +21 ) times/minute,(44 ± 15 ) mm Hg after injection of CCK of 20 ng/kg.After injection of CCK of 100 ng/kg,the basal pressure,contraction range and contraction rate of the SO were (77 ± 31 )mm Hg,(69 ± 18 ) times/minutes,(79 + 14) mm Hg when the inhibition effect of CCK reached peak,and were ( 140 ± 21 ) mm Hg,( 129 ± 25 )times/minutes,( 173 ± 63 ) mm Hg when the excitatory effect of CCK reached peak.After injection of SNP into the common bile duct,the basal pressure,contraction range and contraction rate of the SO decreased significantly ( t =3.706,5.183,P ＜ 0.05),while the 3 indexes increased significantly after injection of SNP (t =5.859,3.588,P ＜O.05).Conclusion Different from physiological dose (20 ng/kg) of CCK,large dose of CCK enhances motility of SO intensively.NO relaxes SO,which may play an important role in the inhibitor pathway of CCK.

Objective To explore the effect of Yiqi-jianpi-jiedu recipe decoction containing serum on Oxaliplatin-induced HepG2 Human hepatoma cell survivin, caspase-3, caspase-9 expression. Methods The serum pharmacological method was used to prepare nourishing Qi and invigorating spleen decoction containing serum of rat. The HepG2 human hepatoma cells were divided into Chinese herb containing serum group, chemotherapy with Oxaliplatin (OXA) group and the combination group (medicine containing serum and OXA), and the blank group without drugs. Apply MTT assay, Western Blotting method and RT-PCR method to detect the cell inhibition rate and survivin, caspase-3, caspase-9 protein and gene expression changes. Results Compared with the blank group, the inhibition rate of HepG2 Human hepatoma cell was significantly higher in Chinese herb containing serum group, chemotherapy group and the combination group (P < 0.05). Compared with thechemotherapy group and Chinese herb containing serum group, the Survivin (0.151 ± 0.054 vs. 0.288 ± 0.089, 0.375 ± 0.063) and the expression of Survivin mRNA (0.205 ± 0.091 vs. 0.487 ± 0.073, 0.725 ± 0.092) of the conbination group downgraded significantly lower (P < 0.05 or P< 0.01). Compared with chemotherapy group and Chinese herb containing serum group, the caspase-3 (0.821 ± 0.079 vs. 0.634 ± 0.098, 0.487 ± 0.102), caspase-9 (0.901 ± 0.047 vs. 0.709 ± 0.054, 0.402 ± 0.012) expression, caspase-3 mRNA (1.928 ± 0.226 vs. 1.564 ± 0.195, 1.287 ± 0.312) and caspase-9 mRNA (2.063 ± 0.517 vs. 1.536 ± 0.084, 1.019 ± 0.182) expression of the conbination group upgraded significantly higher (P < 0.05 or P < 0.01). Conclusions Nourishing-Qi and invigorating spleen decoction containing serum may affect Oxaliplatin-induced HepG2 apoptosis mechanism through increasing the suppression on Survivin and promoting the expression of caspase-3 and caspase-9 protein and genes. This research provided important experimental basis for clinical application of traditional Chinese medicine treating liver cancer.

Objective To investigate the effects of ropivavaine on gamma -aminobutyric acid(GABA)-activated membrane cur-rents in isolated dorsal root ganglion(DRG) neurons of the rats with ischiadic nerve chronic constriction injury (CCI) and to discuss the possible analgesia mechanism of ropivacaine .Methods The whole-cell patch clamp technique was used to record and compare the changes of GABA receptor activation currents of acute isolated DRG neurons after 30 s of ropivacaine preperfusion in the oper-ating side and the operative opposite side of the CCI model rats and the sham-operation group .Results (1)Compared with the oper-ative opposite side ,the sham-operation group and the control group ,the thermal withdrawal latency in the operative side group of the CCI model rats was notablely shortened(P<0 .05);(2)the amplitude of GABA-activated currents with different concentration GABA(0 .1-1 000μmol/L) in the operative opposite side group of the CCI operation was significantly greater than that of the op-erative side group and the sham-opeartion group ;(3)DRG neurons after ropivacaine preperfusion (0 .1-1 000μmol /L) showed va-rying degrees of enhancement effect on the 100 μmol/L GABA-activated currents ,the enhancement amplitude in the CCI operative opposite side group was significantly greater than that in the operative side group and the sham-operation group ;(4)The dose-re-sponse curve of DRG neurons GABA (0 .1-1 000μmol/L) activated current in the operative side group of the CCI rats after ropiva-caine pre-perfusion (100 μmol/L) was shifted to the left ,the difference between two EC50 had no statistical significance (P>0 .05) .Conclusion Ropivacaine has the enhancement effect on GABA activated currents in the DRG neurons of the CCI model rats , which could be one of reasons for ropivacaine producing the anesthetic and analgesic effect .

Objective To investigate the effects of midazolam on GABAA receptor-activated currents in isolated dorsal root ganglion (DRG) neurons in rats.Methods Sprague-Dawley rats of both sexes,weighing 200-250 g,aged 4 weeks,were used in the study.The DRG neurons were isolated and GABAA receptor-activated currents were recorded using the whole-cell patch-clamp technique.GABAA receptor-activated currents were recorded after administration of the mixture of midazolam 3.00 μmol/L (final concentration)and the different final concentrations (0.03,0.10,1.00,10.00,100.00 and 1000.00 μmol/L) of GABA,after different concentrations of midazolam (0.03,0.10,1.00,3.00,10.00 and 100.00 μmol/L) was given,after administration of the mixture of different final concentrations(0.03,0.10,1.00,3.00,10.00 and 100.00 μmol/L) of midazolam and GABA 100.00 μmol/L (final concentration),and after administration of the mixture of midazolam 1.00μmol/L (final concentration) and GABA 100.00 μmol/L (final concentration)at the preset time points of perfusion with different concentrations of midazolam (0,20,40,60 and 120 s of perfusion).The enhancement rate of the currents was calculated.Results No change in the membrane currents was found after midazolam was perfused in the neurons sensitive to GABA.GABAA receptor-activated currents were enhanced after administration of the mixture of different concentrations of GABA and midazolam.GABAA receptor-activated currents were enhanced after different concentrations of midazolam were given compared with that before administration,and the enhancement rate of the GABAA receptoractivated currents was gradually increased with the increase in the concentration of midazolam and reached the peak at the concentration of 3.00 μmol/L.The enhancement rate of the GABAA receptor-activated currents was gradually increased with the prolongation of perfusion time and peaked at 40 s of perfusion.Conclusion Midazolam can enhance the GABAA receptor-activated currents in rat dorsal root ganglion neurons,indicating that midazolam increases the role of GABA through increasing the activity of GABAA receptors and has analgesic effect at the spinal cord level.

Objective To investigate the causes of re-fractures of non fracture vertebral body after percutaneous kyphoplasty (PKP).Methods 512 patients (618 vertebral bodies) treated with PKP because of osteoporosis VCFs were recruited from June 2010 to June 2014.There were 107 males (121 vertebral bodies) and 405 females (497 vertebral bodies) with the mean age of 70.38±7.59 years old (51 to 91 years).There were 406 single segment fracture and 106 double segment fractures cases,and the fracture segments were T4 to L5.The T value of the patients' bone mineral density (BMD) was from-1.0 to-5.2 SD.The clinic characteristics of all the patients including age,sex,body weight,body height,body mass index (BMI),BMD score of the spine,volume of bone cement,restoration rate of anterior/middle vertebral height,postoperative complications (pulmonary embolism,bone cement leakage,nerve injury),and treated vertebral level were analyzed.Results 52 patients (10.16％,52/512) experienced refractures of non fracture vertebral body after kyphoplasty,and 4 experienced re-fracture of the fracture vertebral body after kyphoplasty.The average age of the 52 patients was 71.88±7.74 years old,meanwhile,the ratio of female was 94.23％ (49/52),the mean T value of BMD-4.03±0.60 SD,the ratio of initial double segment fractures 51.92％ (27/52).In addition,among the 456 cases with no fracture,the average age was 70.21±7.56 years,the ratio of female was 77.19％ (352/456);the mean T value of BMD was-2.89±0.55 SD;the ratio of initial double segment fractures was 17.32％(79/456).The data above (age,T value of BMD and initial double segment fractures) were all with statistical significant differences.Whereas the BMI,volume of bone cement,intervertebral disc leakage and restoration rate of anterior/middle vertebral height had no significant difference between the two groups.Furthermore,in the re-fracture of non fracture vertebral body group,32 cases (61.54％,32/52) were nonadjacent fractures,and 20 (38.46％,20/52) were adjacent fractures.Conclusion Osteoporosis degree,female and initial double segment fractures were major risk factors in the development of re-fracture of non fracture vertebral body after PKP.

Objective To explore the clinical characters, diagnosis and treatment methods of placenta accreta. Methods A retrospective analysis was made of 47 cases of placenta accreta admitted during May 1997 to May 2007 into Peking Union Medical College Hospital. They included 17 cases in the second trimester and 30 cases in the third. Results Among all the patients, the incidence of placenta accreta was 0. 262% ( 47/17 918 ). Most of these cases ( 81%, 38/47 ) experienced a uterine procedure.30% (14/47) of the cases were found with placenta previa and 11% ( 5/47 ) with myoma in the current pregnancy. 11% (5/47) of all the cases suffered postpartum hemorrhage. In the 17 cases in the second trimester, 12 were diagnosed by uhrasonography and 5 by clinical evidence . While in the 30 cases in the third trimester, 8 were diagnosed by biopsy, 2 by uhrasonography, and 20 by clinical evidence. 45 cases were cured by conservative treatment, which included dilatation and curettage, uterine artery embolization (UAE) with or without methotrexate (MTX), tamping B-lynch suture, singly with MTX, and mifepristone. Only 2 cases received cesarean hysterectomy. Conclusions The incidence of placenta accreta seems on the rise. The incidence in the second trimester is higher than that in the third. In the second trimester, most cases can be diagnosed by uhrasonography after labor, and presently UAE is the best conservative management. While in the third trimester clinical evidence is the most frequent diagnostic approach. A majority of the cases could be cured by conservative therapies, which help them avoid a hysterectomy.

Objective To prospectively evaluate the influence of average heart rate,heart rate variability and ECG editing on image quality of 64-slice CT coronary angiography(CTCA)in patients with atrial fibrillation(AF).Methods Fifty patients who were diagnosed with AF underwent respective ECG-gating 64-slice CTCA Image quality(good,moderate,poor)were evaluated on vessel segment level pre-and post ECG editing.Chi-square test was performed to compare the image quality in patients with various average heart rate,heart rate variability,and pre-and post ECC editing.Pearson correlation analysis was performed to test the relationship between the image quality and average heart rate and heart rate variability.Sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)were calculated by using the conventional angiography as the standard reference.Results The average heart rate of the fifty AF patients was(89±23)beat/min,with variability of(18.2±6.1)beat/min.Finally,24(3.4%)segments were considered to have poor image quality in 6(12.0%)patients.Image quality decreased significantly(P＜0.05)at the average heart rate of over 100 beats per minute(11 segments)or the standard deviation of heart rate of over 24 beats per minute(11 segments).There was significant correlation between the mean heart rate and the image quality for all segments,the RCA,and distal section of coronary artery(r=0.50,0.55,0.53,0.49,0.42,0.44;P＜0.05).Heart rate variability was also significant correlated with the image quality.There was significant difference on image quality pre-and post ECG editing(P=0.013).The respective overall sensitivity,specificity,NPV,PPV values were 100%(6/6),93.2%(41/44),100%(41/41),and 66.7%(6/9).Conclusion ECG editing can improve the success rate and the image quality of 64-slice CTCA effectively in patients with AF within a certain range of average heart rates and heart rate variability.

Objective: To investigate the effects of Anglimingshi Capsules on preventing and treating experimental catarct. Methods: The model of D galactose induced catarct in rats was established. The effects of Anglimingshi Capsules on the catarct advance, lens opacity, lens structure, MDA and the concentrations of disoluble protein and high weight protein of treated rats were examined.Results: Anglimingshi Capsules could delay the advance of catarct, lower lens opacity and lighten the injury of lens structure by D galactose. Anglimingshi Capsules also decreased the concentration of MDA, lightened the injury of lens by lipid peroxidation and decreaseed the concentrations of disoluble protein and high weight protein. Conclusion: The test provided the foundation for application of Anglimingshi capsule.

Objective To compare the therapeutic effect of retrograde ureteroscopic Ho:YAG laser lithotripsy (UHL) and percutaneous nephrolithotripsy (PCNL) in treating patients with renal calculi of ≤3 cm.Methods From Feb.2008 to Apr.2011,a total of 109 cases (117 renal calculi in total) treated by either PCNL (50) or UHL (67) were retrospectively analyzed.Operative time,stone free rate,postoperative hospital stay,hospitalization expenses and complications were compared in the 2 groups.Results The mean stone burden of the UHL group and PCNL group was 2.5 cm (1.5-3.0) cm and 2.4 cm (1.3-3.0) cm,respectively.There was no significant difference in two groups.In UHL group,operations were performed successfully in all 67 calculi,of whom,43 patients needed combination of flexible ureteroscopy to break the stone fragments falling into the renal calices.No serious complication was recorded except postoperative fever in 3 cases.In PCNL group,all patients had been successful operated.Postoperative fever occurred in 2 cases.Obvious intraoperative and postoperative haemorrhage appeared in 1 case,and cured by selective renal artery embolization.The operation time of the UHL group and PCNL group was (117.0±36.5) min and (90.0±18.3) min respectively,and had no significant difference in two groups (P＞0.05).The stone free rate of the UHL group and PCNL group was 94％ (63/67) and 92％ (46/50) respectively,and had no significant difference in two groups (P＞0.05).Hemoglobin decline of the UHL group and PCNL group was (0.3±0.1) g/L and (20.6±8.1) g/L,and had significant difference in two groups (P＜0.05).Postoperative hospital stay of the UHL group and PCNL group was (5.0±2.4) day and (7.0±3.7) day,and had statistical difference in two groups (P＜ 0.05).Hospitalization expenses of the UHL group and PCNL group was (15 477.0±754.3) RMB and (27 453.0± 1763.5) RMB,and had statistical difference in two groups (P＜0.05).Conclusions Although UHL and PCNL have similar curative effect in treating renal stones of less than 3 cm,UHL have the advantages of lcss trauma and complication,lower expenses and fewer hospital stay.In treating renal stones of smaller than 3 cm,especially in the contraindication of PCNL,UHL may be a better choice.