Objective Study of pulmonary hypertension (PAH) during pregnancy has characteristics of the high risk factors for patient death and its clinical characteristics.Methods Death in patients with clinical data was collected from January 2006 to October 2013 in Beijing Anzhen Hospital Affiliated to Capital Medical University treated 8 cases of pregnancy complicated with PAH in hospital. According to the mechanism of PAH patients will be divided into two categories, Idiopathic pulmonary arterial hypertension (IPAH) in 4 cases, 4 cases of secondary PAH [are secondary to congenital heart disease, also known as congenital heart disease associated PAH (CHD-PAH)]. Analyze the clinical features of 8 cases of patients and pregnancy outcome.Results (1) In 8 patients,4 cases were IPAH, none of them with primary diseases, and they were complicated with severe tricuspid regurgitation. 4 cases were CHD-PAH, all with Eisenmenger′s syndrome. 8 patients were not preconception counseling and regular prenatal examination. (2) The pregestational cardiac function of 8 cases was gradeⅠ-Ⅱ, and it was gradeⅢ-Ⅳon admission. The estimation pressure (sPAP) of pulmonary artery systolic by echocardiography was 101 mmHg (1 mmHg=0.133 kPa). In 8 patients, 7 cases were in pregnancy 27 weeks and beyond for treatment since the clinical symptoms increased, 1 case of pregnant 18 weeks for treatment caused by the increased clinical symptoms. (3) In 8 patients, 1 patient with CHD-PAH secondary to patent ductus arteriosus, its sPAP was 170 mmHg, dead at 12 hours after admission; the remaining 7 cases termination with cesarean section. 4 patients with IPAH were continuous epidural anesthesia, including 1 case for the intraoperative PAH crisis and respiratory and cardiac arrest with general anesthesia, 3 cases of CHD-PAH patients in 1 case with continuous epidural anesthesia, 2 cases of general anesthesia.(4) In 8 patients, 7 cases of median death time were 3 days after delivery, including 4 cases of IPAH patients death for 2.5 days after delivery;the causes of death were PAH crisis and heart failure. Time of death in 4 cases of CHD-PAH, 1 case was dead at 12 hours after admissions, the remaining 3 cases median death time were 13 days after delivery;the death causes for 4 cases of CHD-PAH were PAH crisis and multiple organ failure. (5) In 8 patients, 1 patient with CHD-PAH secondary to patent ductus arteriosus in gestational week 31 stillbirths occur. 1 case of pregnant 19 weeks had treatment of caesarean operation, the remaining 6 cases respectively at 28-30 weeks of gestation live birth, neonatal survival. (6) Before delivery, 4 cases of IPAH and 3 cases of CHD-PAH patients treated with alprostadil, iloprost, sildenafil, reduction of pulmonary artery pressure treatment, 1 case of CHD-PAH patient was dead after 12 hours in hospital, no drug treatment.Conclusions (1) PAH in patients need for consultation prior to conception, pregnancy must conduct regular prenatal examination, symptoms occur during pregnancy, the cardiac function was significantly decreased, and no improvement of drug treatment should be early terminated the pregnancy. (2) Compared with the pregnant women with CHD-PAH, faster progress and poor prognosis in patients with IPAH disease. (3)The patients during cesarean operation or intrapartumare easy to cause PAH crisis and heart failure or multiple organ failure. Taking active measures to maintain stability of hemodynamics is the key to prevent the occurrence of death of pregnant women with PAH.

Objective To investigate the feasibility and clinical effects of suture anchors technique for acute distal avulsion fracture of patella. Methods From January 2007 to July 2009, 33 patients(18males and 15 females, ranging from 28 to 72 years, with an average of 49.3 years) were treated with the suture anchors technique. The average time from injury to surgery was 3.5 days(2 to 7 d). Injury reason: traffic accident in 12 cases, injured in daily life in 11 cases, sports injury 9 cases, no clear trauma history in one case. The Bostman evaluation system, follow-up X-ray, and knee mobility were used to analyze the clinical effects of suture anchors technique. Results All patients obtained the follow-up and the average time was 16.5 months(12 to 23 months ). One patient suffered foreign body reaction, and his wound healing was good after operation. The remaining patient wound healing was good. No complications were found in all patients,such as popliteal fossa artery, tibial nerves or peroneal nerve complication. Bostman patella fracture functional score 27.3±2.3 points at the sixth months follow up, 28 cases were rated as excellent, 5 cases were good, and the excellent and good rate was 100%. Six months later, X-ray showed bone healing, knee activity recovered well. The Range of Motion was extension for -2.5°±2.1° and flexion for 122°±5.3°. Conclusion Suture anchors fixation in treatment of acute distal avulsion fracture of patella has a good efficacy, safety and reliability advantages, and without the second operation. This technique provides an alternative in lower pole patella fracture.

Objective To investigate the operative technique and efficacy of PPH for severe hemorrhoids. Methods The clinical data of 153 cases of severe hemorrhoids treated by PPH, individualized according to size and nature of the piles, concomitant morbidities and conditions at the dentate line, and analysis of the relevance between operative technique and clinical efficacy as well as postoperative complications, were revieuled retropectively. Results All of the prolapsed tissue retracted immediately. Bleeding at the anastomotic site occurred in 49 cases, pulsatile bleeding in 12 cases, all of which were sutured under direct vision with cessation of bleeding. The width of excised-tissue was 2.1~4.6cm(average 3.5cm). The main symptoms of patients on the 1st post-operation day were abdominal distention caused by dysuria, pain, and tenesmus and burning sensation. At followup of 1-40 months, there was no stenosis of stoma, anal incontinence or recurrence of prolapse. After operation, a very satistactory result was achieved in 87 cases, satisfactory in 63 cases and mostly satisfactory in 3 cases. Conclusions In order to achieve ideal results with good retraction of tissues, avoidance of complications and improve patient satisfactory rate, the use of PPH for severe hemorrhords must be individualized and technical skill during operation are important.

Objective To analyze the current research focus of solid organ transplantation in order to provide information for Chinese clinicians and researchers for research direction and topic selection.Method By using bibliometric method,the Chinese Science Citation Database and Web of Science were thoroughly searched and highly cited papers concerning solid organ transplantation were summarized and analyzed from 2010 to 2013.With the year of publication,national and institutional distribution,source journals,column type,research content as indicators,all the keywords of high-frequency were analyzed via co-word analysis method in order to summarize the characteristics of hot research subject in the field of solid organ transplantation.Result From 2010 to 2013,top100 highly cited articles in Chinese had a preference for liver transplantation,followed by kidney transplantation,immunosuppressant,organ donation,postoperative complication and rejection,while articles in English mainly focused on surgical technique,recipient survival,transplant immunity and rejection.Top 100 highly cited articles were from 50 and 58 institutions for Chinese and English,respectively.There were 47 papers from top 10 institutions in Chinese,accounting for 45.6％ of the total citations.There were 43 papers from top 10 institutions in English,accounting for 47.4％ of the total citations.Top 100 highly cited papers in Chinese were distributed in 27 journals.The top 10 journals published 75 papers,which have been cited for 316 times.Top 100 highly cited papers in English were distributed in 36 journals.The top 10 journals published 70 papers,which have been cited for 7 694 times.Conclusion Domestic experts and scholars should pay continuous attention to the organ donation issues related to research in the future,with reference to the advanced experience of Europe and the United States and other countries.Solid organ transplantation registry,data center report and update,transplant recipient prognosis and long-term survival should be highly focused.

Aristolochic Acids ; adverse effects ; Child ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Male ; Nephrosis ; chemically induced

The study is to explore the effect of total glucosides of paeony (TGP)on Wnt/β-catenin signal transduction pathway expression in kidney of diabetic rats, and discuss the protection of TGP in diabetic nephropathy and possible mechanism. Ninety male SD rats of 8 weeks age were randomly divided into normal control group (n = 10) and model group (n = 80). Rats of the normal control group were fed with regular diet, while rats of the model group were fed with high-fat high-sugar diet and 4 weeks later were given an intraperitoneal injection of 35 mg x kg(-1) streptozotocin (STZ). The successfully induced type 2 diabetic rat models were then randomly divided into DM group, three TGP (50, 100, 200 mg x kg(-1) x d(-1)) treatment group and tripterygium wilfordii glycosides (8 mg x kg(-1) x d(-1)) control group. Rats of DM group and each treatment group were given high-fat high-sugar diet. At week 14, the levels of blood sugar, 24 hour urine protein, serum creatinine and blood urea nitrogen were tested. The rats were then sacrificed. Renal pathological changes were examined. Renal tissue Wnt-1 and β-catenin expressions were detected by immunohistochemical assay. Wnt-1 mRNA and β-catenin mRNA expression was semi-quantified by RT-PCR. Wnt-1 protein and β-catenin protein expression was semi-quantified by Western blot. The Result show that Wnt-1 and β-catenin expression increased in kidney of high-fat high-sugar induced type 2 diabetic rats. Compared with diabetic group, the level of serum creatinine, blood urea nitrogen, 24 h urine protein, mean glomerular area and mean glomerular volume were decreased, renal histopathology were improved, expression of Wnt-1 and β-catenin mRNA and protein was reduced in TGP group. Tripterygium wilfordii glycosides had the similar effect. In conclusion, these results showed that Wnt/β-catenin abnormal activation in kidney of type 2 diabetic rats, TGP can improve kidney damage in diabetic rats and delay the development of diabetic nephropathy by inhibit the Wnt/β-catenin signaling pathway.
Animals ; Blood Glucose ; metabolism ; Blood Urea Nitrogen ; Diabetic Nephropathies ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Glucosides ; administration & dosage ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Paeonia ; chemistry ; Rats ; Rats, Sprague-Dawley ; Wnt Signaling Pathway ; drug effects ; Wnt1 Protein ; genetics ; metabolism ; beta Catenin ; genetics ; metabolism

ObjectiveTo explore the relationship between glial growth factor (GGF), nerve growth factor (NGF) and growth characteristics of prolactinoma (PRL) and to evaluate pre and postoperative growth of PRL. MethodsImmunohistochemistry was used to analyze expression of GGF and NGF in 86 cases of PRL and to analyze the relationship between expression of GGF, NGF and PRL level, invasion, stroke, microvessel density. Cells were cultured with GGF and NGF to observe cell growth, cell cycle and angiogenesis. The relationship between proliferation, growth rate and GGF, NGF was evaluated by rank correlation and Chi-square test. Results GGF expression was significantly higher in invasive, stroke and recurrent pituitary adenomas ( P ＜ 0.05 ).Microvessel density increased significantly ( P ＜ 0.01 ). NGF expression was significantly lower in invasive, apoplexy and recurrent adenomas ( P ＜ 0. 05 ). Microvessel density decreased dramatically with NGF interruption ( P ＜ 0.05 ). GGF showed a positive correlation with growth rate of PRL. NGF showed a negative correlation with invasion and stroke. ConclusionsGGF is one of the factors facilitating growth and invasion of PRL while NGF can partly restrain proliferation of PRL cells. Expression of GGF and NGF indirectly reflects proliferation activity of PRL and can be used as markers to evaluate invasion, recurrence, treatment response and prognosis of PRL.

Objective To evaluate the efficacy of Lianhua Dingchuan Tablets in bronchial asthma.Methods Fifty BALB/C mice were randomly and equally divided into control (Con) group,ovalbumin (OVA) group,dexamethasone (DEX) group,high-dose Lianhua group,low-dose Lianhua group.The mice were sensitized and challenged with OVA plus aluminium hydroxide to establish asthmatic model and were pre-treated 30 minutes before challenge.Specific airway resistance (sRaw) was used to evaluate airway hyperresponsiveness,and airway inflammatory changes were measured.ELISA and Magnetic Luminex(R) were used to quantified the levels of IL-4,IL-13 and INF-γ.Results Airway resistance significantly decreased in DEX group and High-dose Lianhua group (P＜0.05).Levels of inflammatory cells and IL-13 in BALF evidently reduced in DEX group,high-dose Lianhua group and low-dose Lianhua group (P ＜ 0.05),while IL-13 level in serum only decreased in DEX group.There was no significant changes in the levels of IL 4 and INF γ among those groups.Conclusions Lianhua Dingchuan Tablets might relieve the symptoms of asthma by reducing IL-13 level and inhibiting the airway inflammation.

Accidents, Occupational ; Adolescent ; Adult ; Arsenic Poisoning ; Child ; Female ; Humans ; Male ; Middle Aged ; Water Pollution, Chemical

The cyanuric chloride linkers have been used for cyclizing polypeptide, but not used for α-conotoxin, the peptides with rich disulfide bonds and more amino acid residues. In this study, cyclic peptides c[A10L]PnIA-1-4 were synthesized efficiently by lysine assisted cyanuric chloride linkers with 28.92%-52.00% yields. The activity evaluation showed that the IC₅₀ values of c[A10L]PnIA-1 against α7 and α3β2 nAChR subtypes were 5 and 7 times higher than [A10L]PnIA respectively, and the subtype selectivity was maintained. The results of circular dichroism show that this cyclization method had no significant effect on its secondary structure. Compared with the commonly used head-to-tail cyclization in conotoxin cyclization, this method has the advantages of rapid reaction and high yield, which is expected to be further applied to the cyclization study of various α-conotoxins.