Objective To evaluate the effectiveness of renal sympathetic denervation (RDN) for hypertensive heart dis-ease combined with systolic heart failure. Methods Two patients (mean age 35 years) with hypertensive heart disease com-bined with systolic heart failure on maximal tolerated heart failure therapy underwent bilateral renal denervation. Echocar-diography, the six minute walk distance, renal function, glycosylated hemoglobin and NT-proBNP were assessed at baseline and 1 year after renal denervation. Results Renal artery angiography showed that no stenosis and dissection. After 1 year follow up, the left ventricular ejection fraction (LVEF), six minute walk distance and NT-proBNP were significantly im-proved, and the size of left ventricular decreased. Conclusion RDN is effective and feasible for the treatment in patients with hypertensive heart disease and systolic heart failure.

Objective To explore the factors that could affect plasma level of D-dimmer test in acute aortic syn-drome. Methods Blood samples (2 mL) from acute aortic syndrome patients (n=76) obtained immediately after admission to detect D-dimmer using ELISA. Blood routine test and biochemical indicators tests including creatinine were also performed. White blood cell (WBC), serum value of creatinine, aortic contrast-enhanced CT, incidence of Shock and death were all re-corded. The receiver-operating characteristic curve (ROC) was established to assess the potency of D-dimmer to predict hospital mortality. Results According to ROC analysis, the optimal cut-off value of D-dimmer to predict hospital mortality was >2 988.6 μg/L (FEU), with 86.7% sensitivity and 70.5% specificity. The patients were divided into group A (D-dim-mer<2 988.6μg/L FEU, n=45) and group B (D-dimmer≥2 988.6μg/L FEU,n=31). Onset timing was longer in group A than that in group B(P<0.01). Involvement of ascending aorta was less common in group A than in group B(P<0.05). Aortic intramural hematoma was less common in group A than in group B(P<0.05). Logistic analysis demonstrated that short time of onset, involvement of ascending aorta, non-aortic intramural hematoma were all independent factors of higher D-dimmer (≥2 988.6μg/L FEU). Conclusion Patients with long time of onset, without involvement of ascending aorta, with intramural hematoma are liable to have lower values of plasma D-dimmer.

To elucidate arsenic-induced oxidative DNA damage, the genotoxicity of arsenic in human cells was comparatively studied with single cell gel electrophoresis (SCGE) assay in combination with the observation of the protective effects of dimethyl sulfoxide (DMSO) and catalase. Arsenic, at the concentration of 2.4 μM by coincubation for 24 hours, significantly induced DNA damage in HL60, a human promyelocytic leukemia cell line. In contrast, significant DNA damage was found in human mononucleocytes at the concentration of 4.8 μM or above. The cells were incubated separately with DMSO (12 mM/l), a well-known hydroxyl radical (OH-) scavenger, and catalase (1,300 U/ml), a hydrogen peroxide (H2O2) scavenger, for 6 hours and then further coincubated with various concentrations of arsenic for 24 hours at 37°C and 5% CO2. The findings showed that both DMSO and catalase significantly reduced the arsenic-induced tail moment, a parameter of total damaged DNA, in HL60 and mononucleocytes. Hence our findings indicate that arsenic, with micromolar concentrations, induces typical and various extents of DNA damage in human cells via reactive oxygen species in a dose-dependent manner.
Human ; DNA Damage ; Arsenic ; Dimethyl Sulfoxide ; Arsenic measurement

Esters ; urine ; Humans ; Phthalic Acids ; urine

Objective To assess the concordance of MRI diagnosis for patients suspected of lumbar disk herniation by using Kappa statistic.Methods One hundred patients(48 males and 52 females)with lumbosaeral radicular pain,aged from 17 to 86(average 61).All patients underwent fast spin-echo T1 and T2 weighted imaging on a 3.0 T MR scanner and spine surface coil.Two radiologists(doctor A and doctor B)evaluated the lumbar disks from L3-4,L4-5.and L5-S1 in 50 out of the 100 patients independently.The presence of a bulging disk or a herniation was reported.Images were interpreted twice:once before and once after disclosure of clinical information.And disks of 52 patients out of the 100 samples were interpreted by the two radiologists independently without clinical information as well.The Kappa statistics was employed to assess the concordance of each radiologist's diagnoses as well as the observer variation of the two radiologists.Results Diagnoses before and after disclosure to clinical information were concordant in 114 disks for doctor A and in 109 for doctor B.respectively.Diagnoses before and after disclosure to clinical information were not concordant in 36 disks for doctor A and in 41 disks for doctor B,respectively.The Kappa values were 0.60±0.06 and 0.57±0.06 for doctor A and doctor B,respectively.The concordance was moderate.After disclosure to elinical information.the numbers of reported bulging disks increased significantly.by 10 and 31 for doctor A and doctor B,respectively.Without clinical information,the diagnoses of the two radiologists were concordant in 77 disks,while not concordant in 79 disks.The interobserver agreement was poor(Kappa=0.24±0.06).The diffcrence on diagenoses made between with and without clinical information mainly happened on the differential diagnosis of normal disks and bulging disks.The different,diagnoses made between with and without clinical information were on 20 disks and on 30 disks for doctor A and doctor B,respectively;that accounted for 55.6%(20/36)and 73.2%(30/41)of total variation respectively.The diagnostic difference between the 2 doctors happened mainly on differentiation of bulging disks and normal disks,which happened in 56 disks,aceountiong for 70.9%(56/79)of total variation.Conclusion Variation on diagnoses of the same radiologist or between tworadiologists was mainly caused by disagreement on bulging disks.

OBJECTIVETo confirm that arsenic (As) induces oxidative DNA damage in phytohemagglutinin (PHA)-stimulated and unstimulated human lymphocytes.

METHODSThe alkaline comet assay combined with specific enzyme (Formamidopyrimidine-DNA glycosylase, FPG) digestion was used to measure As-induced base damage.

RESULTSThe enzyme-sensitive sites were readily detected with the alkaline comet assay after the cells were treated with 10 micromol As for 2 hours. The repair patterns observed for FPG-created DNA single strand breaks (SSBs) in As-treated cells were comparable to those in hydrogen peroxide (H(2)O(2))-treated cells. The enzyme-created SSBs, As-induced base damage, were more significantly revealed in PHA-stimulated lymphocytes. About 63% and 68% of SSBs induced by As and H(2)O(2), respectively, were repaired in PHA-stimulated lymphocytes by 2-hour repair incubation, but about 34% and 43%, respectively, were repaired in unstimulated cells. About 40% and 49% of base damage induced by As and H(2)O(2), respectively, were repaired in PHA-stimulated lymphocytes, but about 19% and 21 %, respectively, were repaired in unstimulated cells.

CONCLUSIONSAs induces oxidative DNA damage in human lymphocytes within micromolar concentrations. Like the damage induced by H(2)O(2), As-induced DNA damage was more slowly repaired in unstimulated lymphocytes.

Adult ; Arsenic ; pharmacology ; DNA Damage ; DNA Repair ; DNA, Single-Stranded ; drug effects ; DNA-Formamidopyrimidine Glycosylase ; Electrophoresis ; methods ; Humans ; Hydrogen Peroxide ; pharmacology ; Lymphocytes ; drug effects ; N-Glycosyl Hydrolases ; Oxidation-Reduction ; Phytohemagglutinins ; pharmacology

Objective:To investigate the long-term therapeutic effects and safety of renal denervation (RDN) on hypertensive patients with different cardiovascular risks, as well as its impact on adverse events, cardiovascular death and all-cause mortality.Methods:This was a single-center, single-arm, real-world retrospective study. Patients with refractory hypertension who underwent RDN at Tianjin First Central Hospital from July 6, 2011 to December 23, 2015 were enrolled and divided into either a high or intermediate-low risk group based on baseline cardiovascular risk. The treatment responsiveness of hypertensive patients with different cardiovascular stratification to RDN was assessed by comparing the results of office blood pressure, home blood pressure, and 24-h ambulatory blood pressure monitoring at 1, 5, and 11 years after RDN. Long-term safety of RDN was assessed by creatinine, and estimated glomerular filtration rate (eGFR) at 1 and 11 years after RDN. In addition, the total defined daily dose (DDD) of antihypertensive medications and the incidence of long-term adverse events, cardiovascular deaths, and all-cause deaths after RDN were followed up 11 years after RDN in person or by telephone.Results:A total of 62 patients with refractory hypertension, aged (50.2±15.0) years, of whom 35 (56.5%) were male, were included. There were 35 cases in high-risk group and 27 cases in low and medium risk group. The decrease in clinic systolic blood pressure (high risk vs. low-medium risk: (-38.0±15.1) mmHg vs. (-25.0±16.6) mmHg(1 mmHg=0.133kPa), P=0.002), home self-measured systolic blood pressure ((-28.4±12.7) mmHg vs. (-19.7±13.1) mmHg, P=0.011) and clinic systolic blood pressure 11 years after RDN ((-43.0±18.4) mmHg vs. (-27.8±17.9) mmHg, P=0.003) in the high-risk group was significantly higher than that in the low-medium risk group. The differences in heart rate and the decrease in total DDD number of antihypertensive drugs between the two groups were not statistically significant (all P>0.05). Creatinine and eGFR levels in the two groups at 1 and 11 years after RDN were not statistically significant when compared with the baseline values (all P>0.05). The cumulative cardiovascular mortality rate was 1.6% (1/62) and 8.1% (5/62), and the cumulative all-cause mortality rate was 3.2% (2/62) and 11.3% (7/62) at 5 and 11 years after RDN, respectively. The differences in the incidence rate of adverse events, cardiovascular mortality, and all-cause mortality rate between the two groups were not statistically significant (all P>0.05). Conclusions:RDN has long-term antihypertensive effect and good safety. Hypertensive patients who belong to the high-risk stratification of cardiovascular risk may respond better to RDN treatment.

Objective To investigate the effects of renal denervation (RDN) on left atrial fibrosis in rats with chronic heart failure.Methods Sixty healthy male Sprague Dawley rats were randomly assigned to control group (n =10,intraperitoneal injection with 5 mg/kg normal saline daily for 3 consecutive weeks),sham group (n =25) and RDN group (n =25).Rats in sham and RDN group were intraperitoneally injected with 5 mg/kg isoproterenol daily for 3 consecutive weeks.RDN and sham RDN procedure was implemented at week 5.The renal arteries and veins were not isolated and the nerves were left intact in sham group.The experiment ended at week 10.Cardiac function,diastolic interventricular septal thickness (IVSD) and left atrial dimension (LAD) were evaluated by echocardiography at baseline,week 5 and 10.The rats of all three groups were sacrificed at week 10 and the left atrial tissue was used for following analysis:fibrosis was detected by Masson staining,plasma BNP was measured by ELISA kit,the protein expression of Ang Ⅱ,TGF-β1,MMP2 and collagen Ⅰ was determined by Western blot.Results (1) Cardiac function:compared with control group,LVEF decreased (P ＜ 0.01),IVSD (P ＜ 0.01) and LAD (P ＜0.01) increased significantly in the sham and RDN group at week 5.Compared with sham group at week 10,LVEF and IVSD significantly improved (P ＜ 0.05) and LAD tended to be smaller (P ＞0.05) in RDN group.(2) The degree of left atrial tissue fibrosis:Masson staining (collagen volume fraction,CVF) showed significantly decreased fibrosis of left atrial tissue in RDN group compared with that in sham group (P ＜ 0.01).(3) Plasma BNP level:ELISA assay revealed that plasma BNP in sham group was significantly increased compared with that in control group (P ＜ 0.05) and was similar between RND group and control group at week 10.(4) Protein expression of AngⅡ,TGF-β1,MMP2 and collagen Ⅰ in rats left atrial:Western blot analysis demonstrated that the expression of Ang Ⅱ,TGF-β1,MMP2 and collagen Ⅰ was significantly down-regulated in RDN group compared to sham group (all P ＜ 0.05) but still significantly higher than in control group (all P ＜ 0.05).Conclusions RDN can effectively attenuate the left atrial fibrosis in rats with isoproterenol induced chronic heart failure.The attenuation of left atrial fibrosis by RDN in these rats may be attributed to improved cardiac function and downregulated pro-fibrogenic factors (Aug][,TGF-β1,MMP2 and collagen Ⅰ).

Objective: To evaluate the efficacy of bilateral erector spinae plane block (ESPB) in improving intraoperative wake-up quality in the patients undergoing thoracolumbar scoliosis correction with general anesthesia. Methods: Forty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients of both sexes, aged 18-60 yr, scheduled for elective posterior approach thoracolumbar scoliosis correction, were divided into 2 groups (n=20 each) using a random number table method: control group (C group) and bilateral ESPB group (E group). Bilateral ESPB was performed through injecting 0.375% ropivacaine 15-20 ml to each site in group E. Anesthesia was induced by intravenously injecting propofol, sufentanil and cisatracurium after dexmedetomidine was intravenously infused for 10 min.Anesthesia was maintained by intravenously infusing remifentanil, propofol and dexmedetomidine.Propofol infusion was stopped and the infusion rate of remifentanil and dexmedetomidine was decreased during intraoperative wake-up test.Wake-up test was performed every 30 s starting from 5 min after stopping propofol infusion.The wake-up time, occurrence of agitation and coughing, hemodynamic changes (△MAP and △HR, the difference between MAP while stopping administration before wake-up test and maximum MAP during wake-up test, the difference between HR while stopping administration before wake-up test and maximum HR during wake-up test) and blood loss were recorded.The wake-up quality was assessed during operation. Results: Compared with C group, the wake-up time was significantly shortened, the incidence of agitation and coughing was decreased, blood loss was reduced, △MAP and △HR were decreased, and the wake-up quality was increased in E group (P<0.05). Conclusion Bilateral ESPB can increase the intraoperative wake-up quality in the patients undergoing thoracolumbar scoliosis correction with general anesthesia.

Background Parabens, a widely used class of preservatives, are suspected to be potential obesogens as emerging endocrine disrupting chemicals with reproductive and developmental toxicity. Objective To analyze five urinary parabens (PBs) and estimate the associations of exposure to PBs with adiposity measures in 10-year-old school-age children. Methods A total of 471 school-age children aged 10 years from the Sheyang Mini Birth Cohort were enrolled in this study. A questionnaire survey was conducted to collect socio-demographic information, physical activity, and dietary intake. Weight, height, and waist circumference of children were measured, and age- and sex-adjusted body mass index (BMI-Z score) was calculated. Spot urine samples were collected during the follow-up visits. Urinary concentrations of five PBs including methyl-paraben (MeP), ethyl-paraben (EtP), propyl-paraben (PrP), butyl-paraben (BuP), and benzyl-paraben (BzP) were detected by gas chromatography-tandem mass spectrometry (GC-MS/MS). Generalized linear models (GLMs) and Bayesian kernel machine regression (BKMR) models were applied to estimate associations of individual/overall urinary PBs concentrations with BMI Z-score and waist circumference. Results The positive rates of selected five urinary PBs were in the range from 78.98% to 98.94%. The urinary PBs concentrations (geometric mean) were in the range of 0.31-5.43 μg·L⁻¹. The children's BMI Z-score and waist circumference (mean ± standard deviation) were (0.56±1.40) and (67.62±10.07) cm respectively. The GLMs results showed that the urinary BzP concentration was negatively associated with waist circumference (b=−0.08, 95%CI: −0.14, −0.02; P=0.01). In sex-stratified analysis, the urinary concentration of BzP was negatively associated with BMI-Z score (b=−0.59, 95%CI: −0.88, −0.30; P<0.001) and waist circumference (b=−0.80, 95%CI: −1.23, −0.37; P<0.001) in boys, but not in girls. The BKMR results also found significant negative correlations of urinary BzP concentrations with BMI-Z score and waist circumference, which were consistent with the GLM results. Conclusion The selected 10-year-old children are extensively exposed to PBs in the study area. Furthermore, childhood PBs exposure may have potential impacts on childhood adiposity measures with sex-specific effects.