Child ; Female ; Gastric Mucosa ; pathology ; Gastritis, Hypertrophic ; diagnosis ; Humans ; Hypertrophy ; diagnosis

OBJECTIVETo compare the effects of different contrast media on the renal function in children, and to investigate the prophylactic efficacy of hydration.

METHODSSixty patients on whom either intravenous pyelography (IVP) or enhanced CT scan was required were divided into high osmolality contrast media (HOCM) group (n = 27) and low osmolality contrast media (LOCM) group (n = 33), and each group was randomly subdivided into hydration group (HG) and non-hydration group (NHG). In HOCM group, HG had 14 cases and NHG had 13 cases; while in LOCM group, HG had 18 cases and NHG had 15 cases. A 1/5-tonic solution at a dose of 20 ml/kg was intravenously given immediately after the exposure to a contrast medium within 3 hours in the HG, while the NHG cases were not given any infusion.

RESULTSThere were no significant difference between HG and NHG in baseline serum creatinin (SCr) and creatinin clearance (Ccr). After exposure, in HOCM group, SCr of NHG (59.71 +/- 12.49) micromol/L significantly increased as compared with baseline (49.91 +/- 6.09) micromol/L (P < 0.05), while Ccr (97.81 +/- 15.10)ml/(min x 1.73 m(2)) decreased compared with baseline (71.33 +/- 7.51) ml/(min x 1.73 m(2)) (P < 0.05). No significant changes of SCr and Ccr were observed in the HG before (48.37 +/- 7.11) micromol/L, (99.81 +/- 15.41) ml/(min x 1.73 m(2)) and after (49.63 +/- 6.84) micromol/L, (88.29 +/- 12.75) ml/(min x 1.73 m(2)) (P > 0.05) the exposure to contrast medium. Contrast medium-associated nephropathy (CAN) was found in 3 cases in NHG (23.1%, 3/13) but none in HG (P > 0.05). In the LOCM group, there was no significant difference in SCr and Ccr before and after the exposure to the contrast media. The incidence of CAN was 6.7% (1/15) in the NHG and 11.1% (2/18) in the HG (P > 0.05). The average increase of SCr in HOCM group was significantly higher than that in LOCM group (Z = -2.42, P < 0.05). The average decrease of Ccr in HOCM group was significantly higher than that in LOCM group (Z = -2.83, P < 0.05). The SCr and Ccr of the 6 CAN cases in both HOCM and LOCM groups returned to baseline level within 2 weeks.

CONCLUSIONS(1) Children can develop reversible CAN after the exposure to high or low osmolality contrast medium. (2) The high osmolality contrast medium seemed to have more serious toxicity in renal function than low osmolality contrast medium. (3) The prophylactic use of hydration can effectively prevent CAN in patients who will expose to high osmolality contrast medium. (4) Children can develop reversible CAN after the exposure to low osmolality contrast medium even after hydration.

Child ; Contrast Media ; adverse effects ; Creatinine ; blood ; Fluid Therapy ; Humans ; Infusions, Intravenous ; Kidney Diseases ; chemically induced ; prevention & control ; Kidney Function Tests ; Osmolar Concentration

The purpose of this study is to investigate the transdermal delivery characteristics of Gentiana macrophylla complex components system through different parts of the skin under micro-needles conditions. Two-chamber diffusion cells were used, different parts of isolated skin and micro-needle pretreated isolated mouse skin were applied separately, high performance liquid chromatography (HPLC) similarity evaluation methods were used to evaluate transdermal delivery characteristics of Gentiana macrophylla complex components system on receiving pool and the permeation rate and penetration amount of Gentiopicroside at different parts of mouse skin. In the 24 h, the similarity between receiving fluid which was on passive transdermal delivery and micro-needle transdermal delivery conditions and original fluid were ranged from 83.0% to 98.9%; By the micro-needle pretreatment with different parts of the mouse skin, the time that Gentiana macrophylla complex components system though abdominal skin to the receiving fluid which reached 90% similarity compared with that of original fluid was 4 h, which was 18 h at back skin and 12 h at neck skin separately. Micro-needles can be used as the ideal ingredients for traditional Chinese medicine complex transdermal delivery; transdermal absorption time delay could be greatly reduced and its bioavailability was improved. The permeation rate and similarity to original liquid of Chinese medicine complex components increased significantly in the abdominal skin relative to the neck and back skin under micro-needle conditions.
Administration, Cutaneous ; Animals ; Biological Availability ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacokinetics ; Gentiana ; chemistry ; Iridoid Glucosides ; pharmacokinetics ; Mice ; Needles ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Skin Absorption

OBJECTIVETo investigate the diagnostic value of acoustic radiation force impulse (ARFI) imaging technology for the assessment of liver fibrosis in chronic hepatitis C (CHC) patients.

METHODSOne-hundred-and-eight CHC patients were examined by real-time ultrasound elastography using the Acuson S2000 ARFI instrument (Siemens Healthcare) and underwent liver biopsy for pathohistological analysis. The correlation between liver fibrosis grades determined by the two approaches was analyzed. The cut-off values for diagnosis by ARFI (S more than 2, S more than 3 and S = 4) were determined by generating a receiver operating characteristic (ROC) curve.

RESULTSThe spectrum of liver stiffness detected by ARFI sonoelastography included S1 at (1.26+/-0.27) m/s (n = 36), S2 at (1.45+/-0.51) m/s (n = 31), S3 at (2.01+/-0.54) m/s (n = 27), and S4 at (2.28+/-0.82) m/s (n = 14). The ARFI values were significantly different among the four different stages of liver fibrosis (P less than 0.001). The liver stiffness detected by ARFI sonoelastography was significantly correlated with the liver fibrosis stage determined by the gold standard pathohistological analysis (Spearman's rank coefficient: 0.61, P less than 0.001). Using the ARFI technology for assessment of liver fibrosis gave areas under the ROC curve of 0.779 for S more than 2 patients, of 0.863 for S more than 3 patients, and of 0.0880 for S = 4 patients.

CONCLUSIONThe real-time ultrasound elastography ARFI technology can show the elasticity modulus of liver, and its data values positively correlate with the patho-histology grade of liver fibrosis in CHC patients. ARFI technology is easy to operate, non-invasive, and quantitative, and has potential clinical value for assessing liver fibrosis in CHC.

Adolescent ; Adult ; Aged ; Elasticity Imaging Techniques ; Female ; Hepatitis C, Chronic ; complications ; diagnostic imaging ; Humans ; Liver Cirrhosis ; diagnostic imaging ; etiology ; Male ; Middle Aged ; Young Adult

OBJECTIVEIn this study, we assayed promoter hypermethylation and protein expression of the mismatch repair gene (MMR) hMLH1 and hMSH2 in gestational trophoblastic diseases to understand the significance of MMR promoter methylation and expression in the pathogenesis and malignant transformation of hydatidiform mole.

METHODSDNA was extracted from chorion of early pregnancies, partial hydatidiform moles, complete hydatidiform moles, and invasive moles were over digested by methylation sensitive endonuclease Hpa II. Then the promoters were amplificated by polymerase chain reaction. The protein was detected by immunohistochemistry.

RESULTSIn the normal placenta, neither hMLH1 nor hMSH2 promoter methylation was detected. Expression of hMLH1 and hMSH2 in cytotrophoblasts was strongly positive, and that was negative or weakly positive in syncytiotrophobasts. In all normal chorion, expression of hMLH1 and hMSH2 in cytotrophoblasts was strongly positive. In partial hydatidiform mole and complete hydatidiform mole, the methylation of hMLH1 and hMSH2 promoters was significantly higher than that of early placenta (P < 0.05), and the protein expression in cytotrophoblasts was significantly lower (P < 0.05). In the invasive mole, hMLH1 and hMSH2 promoter methylation were not significantly different as compared with the partial hydatidiform mole and complete hydatidiform mole (P > 0.05). Expression of hMLH1 in the invasive mole (54.5%, 6/11) was not significantly different as compared with the partial hydatidiform mole and complete hydatidiform mole (P > 0.05). But expression of hMSH2 in the invasive mole (36.4%, 4/11) was weaker than that in complete hydatidiform mole (P = 0.044). Promoter methylation and less expression of hMSH2 had correlations in complete hydatidiform mole or invasive mole.

CONCLUSIONSStrong expressions of hMLH1 and hMSH2 in the cytotrophoblasts of normal placenta may keep the genome stability. Promoter methylation and down-regulation of hMLH1 and hMSH2 are probably involved in the pathogenesis of hydatidiform mole.

Adaptor Proteins, Signal Transducing ; Adult ; Base Pair Mismatch ; genetics ; Carrier Proteins ; DNA Methylation ; DNA Repair ; DNA-Binding Proteins ; biosynthesis ; Female ; Humans ; Hydatidiform Mole ; genetics ; pathology ; Hydatidiform Mole, Invasive ; genetics ; pathology ; Middle Aged ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; Neoplasm Proteins ; biosynthesis ; Nuclear Proteins ; Pregnancy ; Promoter Regions, Genetic ; genetics ; Proto-Oncogene Proteins ; biosynthesis ; Uterine Neoplasms ; genetics ; pathology

italic>Artemisia argyi (A. argyi) is a Chinese herbal medicine in China. The main active components are volatile oils, flavonoids, and other compounds, which have various pharmacological activities. Methoxylated flavonoids are the main active ingredients in A. argyi. Flavonoid O-methyltransferase (FOMT) is a key enzyme in the O-methylation of flavonoids. In order to further understand the function and characteristics of FOMT proteins, this paper carried out the whole genome mining and identification of FOMT genes in A. argyi and performed phylogenetic, chromosomal localization, gene sequence characterization, subcellular localization prediction, protein structure, gene structure analysis, and expression pattern analysis. The results showed that a total of 83 FOMT genes were identified in the genome of A. argyi. The phylogenetic tree shows that FOMT genes are divided into two subgroups, CCoAOMT (caffeoyl CoA O-methyltransferase) subfamily (32 genes) and COMT (caffeic acid O-methyltransferase) subfamily (51 genes). Gene sequence analysis showed that the number of amino acids encoded by FOMT was 70-734 aa, the molecular weight was 25 296.55-34 241.3 Da, and the isoelectric point was 4.51-9.99. Compared with 32 members of the CCoAOMT subfamily, nearly 1/3 of the 51 members of the COMT subfamily were hydrophobic proteins and 2/3 were hydrophilic proteins. Subcellular localization prediction showed that more than 80% of CCoAOMT subfamily members were located in the cytoplasm, and 96% of COMT subfamily members were located in the chloroplast. COMT subfamily members have more motifs than CCoAOMT subfamily members. The N-terminal motifs of COMT subfamily proteins are relatively variable, while the C-terminal motifs are relatively conserved. Expression pattern analysis showed that CCoAOMT subfamily members were mainly expressed in roots, while COMT members were mainly expressed in leaves. Some FOMTs showed the tissue expression specificity by real-time quantitative PCR analysis, especially in leaves. In this study, we identified and analyzed the FOMT gene family in A. argyi, and provided a theoretical basis for further research on the function of FOMTs and the biosynthesis of methylated flavonoids in A. argyi.

Objective To investigate the short-term effect of particulate matter in air on the mortality of stroke. Methods Using time-stratified case-crossover study design,an association was examined between stroke mortality and particulate matter with aerodynamic diameter of ＜10μm(PM10) of 2002- 2004 in Hangzhou city.Meanwhile,the acute health effect of other gaseous pollutants (sulfur dioxide,SO2 and nitrogen dioxide,NO2) was also analyzed.Results A total of 9906 deaths of stroke were included.The crude stroke mortality was 83.54 per 100 000.After being adjusted for meteorological factors,when an increase of 10 μg/m3 in PM10,SO2 and NO2 in three days was noticed,it appeared that the increases of mortality of stroke were 0.56%(95%CI:0.14%-0.99%),1.62%(95%CI:0.26%-3.01%) and 2.07%( 95%CI:0.54%-3.62%) respectively.There was no distinct association in multipollutant models.In sensitivity analysis,the associations were found in all single-pollutant models but not statistically significant in multi-pollutant models after replacing the missing values.Conclusion It is suggested that the short-term elevation in PM10 as well as SO2 and NO2 daily concentrations were related to the increase of stroke mortality in Hangzhou city.

OBJECTIVETo evaluate operative technique, patient selection and perioperative management of single-lung transplantation for a patients with end-stage emphysema.

METHODSA 56-year-old patient with end-stage emphysema underwent left-lung transplantation on September 28, 2002. The surgical technique used was similar to that mentioned in the literature. The donor lung was perfused by LPD solution with a cold ischemic time of 260 minutes. Cardiopulmonary bypass was not performed.

RESULTSThe patient weaned from a ventilator at the 93th hour after operation. Immunosuppressants included cyclosporine, mycophenolate mofetil and corticosteroid. Acute rejection occurred on the ninth day after operation and was cured by bolus methylprednisolone given intravenously. Lung function was improved significantly and the patient was discharged from the hospital on the 47th day after operation.

CONCLUSIONSingle-lung transplantation for patients with end-stage emphysema is effective for long-term improvement of pulmonary function.

Adult ; Emphysema ; surgery ; Graft Rejection ; prevention & control ; Humans ; Lung Transplantation ; methods ; Male ; Middle Aged

OBJECTIVETo analyze the clinical data and result of voiding cystourethrography (VCUG) in high-risk children with vesicoureteral reflux (VUR) for better awareness of VUR, and to assess the usefulness of non-radioactive voiding ultrasonography (VUS) in the diagnosis of VUR.

METHODNinety-three high-risk children with VUR who were hospitalized from July 2007 to April 2010 were studied. The study included 58 cases of urinary tract infection (UTI) and 35 cases of fetal or postnatal hydronephrosis detected on a B ultrasound scan. The results of urinalysis, urine culture, renal function, B ultrasound and VCUG were evaluated. Part of patients underwent VUS followed by VCUG immediately.

RESULT(1) Sixty-two boys and 31 girls (aged 1 month to 11.5 years, mean age 2 years) were included. VUR was detected in 26 patients (28%) by VCUG. In terms of kidney-ureter units, VUR was detected in 36 of 186 kidney-ureter units, including 6 grade I, 3 grade II, 6 grade III, 15 grade IV and 6 grade V. (2) VUR was detected in 20 of 58 UTI patients (34.5%) by VCUG. The proportion of VUR in recurrent UTI group was 61.1%, much higher than that in first UTI group (22.5%). Thirteen of 20 VUR (65%) occurred in UTI patients under 1 year of age (M/F 10/3), with more bilateral VUR and severe grades of VUR than the older group. VUR was detected in 6 of 35 fetal or postnatal hydronephrosis patients (17.1%) by VCUG. (3) Twenty-two patients underwent both VUS and VCUG. VUR was detected in 4 patients and 6 kidney-ureter units by VCUG, while in 6 patients and 9 kidney-ureter units by VUS. Taking VCUG as the reference standard, VUS had a sensitivity of 100%, specificity of 92.1%, positive predictive value of 66.7%, and negative predictive value of 100%. There was a concordance rate of 93.2% between VUS and VCUG.

CONCLUSIONIt is important to early screen VUR in UTI, fetal or postnatal hydronephrosis patients. There are more VUR, especially more bilateral VUR and severe grades of VUR, occurred in UTI patients under 1 year of age compared to older children. The incidence of VUR in recurrent UTI group was much higher than that in first UTI group. VUS is an accurate, reliable and radiation-free technique for the detection of VUR. It could be used to screen high-risk children for VUR and do the evaluation in the follow-up of VUR.

Child ; Child, Preschool ; Diagnostic Imaging ; Female ; Humans ; Hydronephrosis ; diagnosis ; diagnostic imaging ; Infant ; Male ; Ultrasonography ; Urinary Tract Infections ; diagnosis ; diagnostic imaging ; Urography ; Vesico-Ureteral Reflux ; diagnosis ; diagnostic imaging

Objective To evaluate and study percutaneous nephrolithotomy (PCNL) related factors in the treatment of renal calculi caused postoperative fever and its prevention measures. Methods Making a retrospective analysis of the clinical records of 150 patients who underwent PCNL, including age, gender, diabetes history and previous ipsilateral renal surgery, stone type, stone size, whether the complication of upper ureteral stones, preoperative urinary tract infection, hydronephrosis and pyonephrosis, preoperative renal fistula, postoperative centering vein pressure, intraoperative perfusion and the operation time from January 2015 to June 2017. After the operation, the patients were divided into two groups: fever group and non-fever group, and analyzed the related factors of the fever. Results Among the 150 cases, fever occurred in 27 cases after PCNL, taking up 18%. Gender, history of diabetes, staghorn calculi or staghorn stone, stone size, with ureteral calculi, preoperative urine leukocyte count, renal abscess, preoperative renal fistula, postoperative central venous pressure, intraoperative perfusion and operation time between the two groups, the differences that were statistically significant (P < 0.05). Logistic that multivariate analysis showed that female patients with upper ureteral calculi, perfusion, intraoperative volume,preoperative pyonephrosis, long operation time are independent risk factors of fever after operation (OR^>1, P<0.05). Conclusion Routine bacterial culture of urine should be performed before percutaneous nephrolithotomy, urinary tract infection and kidney empyema should be treated thoroughly. The reasonable shorter operative duration and perfusion fluid volume could significantly reduce the incidence of fever after PCNL.