Objective To explore the therapeutic effects of carvedilol on renal and heart function,and on heart structure of patients with uremic cardiomyopathy.Methods One hundred and four patients with uremic cardiomyopathy were randomly divided into two groups(52 each).Patients in control group were treated with routine therapy,and in carvedilol group were treated with carvedilol 12.5-50mg/d in addition to routine therapy.The total course of treatment was 6 months.The related data of left ventricle were determined by echocardiography,and blood urea nitrogen(BUN),serum creatinine(Scr)and clearance rate of creatinine(Ccr)were measured before and after the treatments.Results After the treatment,the stroke volume(SV),cardiac output(CO)and ejection fraction(EF)were increased,and left ventricular end-diastolic diameter(LVEDD),left ventricular mass(LVM),left ventricular mass index(LVMI),end-diastole interventricular septum thickness(IVST)and end-diastolic left ventricular wall thickness(LVPWT)were decreased in both groups compared with those before the treatment(P0.05).Conclusion Carvedilol may effectually inhibit the ventricular remodeling of the patients with uremic cardiomyopathy,improve their left ventricular function and structure,but has no obvious effect on the renal function.

BACKGROUND:Recent studies have shown that platelet rich plasma has strong osteogenic ability and it has been widely used in the field of department of orthopedics and department of stomatology, but experimental study on avascular necrosis of the femoral head has been not reported.
OBJECTIVE:To observe the effect of platelet rich plasma gel combined with marrow core decompression in the repair of aseptic necrosis of rabbit femoral head.
METHODS:A total of 25 New Zealand white rabbits were obtained. Without dislocation of the hip joint, aseptic necrosis model was established by using liquid nitrogen cryotherapy on bilateral femoral head of rabbits. At 2 weeks after model establishment, rabbit models were randomly assigned. Model group with nine rabbits did not receive any treatment. Core decompression group with eight rabbits underwent core decompression treatment. Combination group with eight rabbits underwent core decompression combined with platelet rich plasma gel treatment. At 8 weeks after model induction, tissue sections of femoral head specimens were col ected and subjected to MRI and hematoxylin-eosin staining.
RESULTS AND CONCLUSION:(1) MRI examination:The model group showed low signal area of different forms in femoral head fat high signal, exhibited annular, ribbon and focal shapes. No evident changes in osteogenesis, no apparent minification of the defect cavity were detected at defect site in the core decompression group, showing long T1 and T2 signals. Defect cavity disappeared, and new bone of short T1 and T2 signals fil ed in the combination group. (2) Hematoxylin-eosin staining:Articular cartilage defect and repair existed in the model group, showing osteoarthritis-like changes. Empty bone lacuna of bone trabecula, hematopoietic celland adipocyte necrosis in bone marrow were detected in the core decompression group. Empty bone lacuna of bone trabecula, focal necrosis scattered in bone marrow were visible in the combination group. Results suggested that the outcomes of platelet rich plasma gel combined with core decompression were better than core decompression alone in treatment of rabbit models of femoral head necrosis.

Objective: To study the characteristics of peripheral nerve conduction (PNC) in advanced-stage amyotrophic lateral sclerosis (ALS) patients undergoing mechanical ventilation. Methods: The sensory conduction velocity(SCV), motor conduction velocity (MCV), distal motor latency (DML) and amplitude of compound muscle action potential (CMAP) were determined in three ALS patients undergoing mechanical ventilation. The clinical data and PNC characteristics of the patients were analyzed. Results: The 12 motor nerves were abnormal in all the three patients, including absence of responsive wave (66.7%, 8/12), decreased amplitude of CMAP(33.3%, 4/12), prolongation of DML(16.7%, 2/12) and reduction of MCV (16.7%, 2/12). The CMAP amplitude of patients gradually decreased with the progression of disease, and finally led to adverse reactions. The SCV and amplitude of sensory nerve action potential were normal in all the three patients. Conclusion: ALS patients undergoing mechanical ventilation may have severely damaged motor nerve conduction, and their sensory nerve is generally not affected, with the specific reason remains to be further studied.

Objective To explore the characteristics of hereditary spastic paraplegia with thin corpus callosum (HSP-TCC). Methods Clinical, electrophysiological, MRI features of 3 patients with HSP-TCC were reported. The genetic characteristics were reviewed. Results 3 patients revealed difficulty in walking, slowly progressive weakness, spasticity of the lower limbs and mental impairment. The electromyogram in 2 cases showed neurogenic damage in lower limbs muscle, and 1 case showed peripheral nerve damage. Cerebral MRI showed an extremely thin corpus callosum on sagittal image. The locus of 15q13-15 has been identified for HSP-TCC, but some HSP-TCC families have not been linked to this locus.Conclusion HSP-TCC is a common subtype of complicated HSP inherited by autosomal recessive mode. Brain MRI showed extremely thin corpus callosum. Electromyogram many reveal neurogenic damage.

Objective To investigate the concentration of monocyte chemoattractant protein-1 (MCP-1) and interleukin-18 (IL-18) in the urinary of children with primary nephrotic syndrome(PNS) at different time points,and to explore their correlation with occurrence,development,progression,and prognosis of PNS.Methods A total of 65 pediatric cases from our hospital was enrolled in this study,and was divided into three groups based on the retrospective the follow-up results including steroid-sensitive NS (SSNS) (n =35),steroid-resistant NS (SRNS) (n =15),and frequent-relapse NS (FRNS) (n =15) groups.Another 20 healthy children served as normal controls.Peripheral blood samples and urine specimen were collected at three time points (without glucocorticoids,treatment after 8 weeks,and treatment after 16 weeks or recurrence).The levels of MCP-1 and IL-18 in the urine were assayed by enzyme-linked immunosorbent assay (ELISA).The levels of blood urea nitrogen,creatinine,and 24-hour urinary protein excretion were assayed by full-automatic biochemical study appliance.Results (1)In SSNS group,the levels of urinary IL-18 before treatment and treated for 8 weeks were higher than the normal control group [before treatment:(160.30 ±27.29) pg/ml; treated for 8 weeks:(157.62 ±26.85) pg/ml; normal control group:(70.88 ± 14.43) pg/ul].However,after treated for 16 weeks,the levels of urinary MCP-1 and IL-18 were markedly decreased compared with that of control group and those before treatment and treated for 8 weeks [treated for 16 weeks:(20.98 ±4.53) pg/ml,and (79.09 ±7.23) pg/ml,P ＜0.05].(2)In SRNS group,the levels of urinary MCP-1 and IL-18 before treatment were remarkably higher than that of control group and that of SSNS group before treatment[SSNS group before treatment:(76.84 ± 5.58) pg/ml,and (252.37 ± 25.34)pg/ml,P ＜0.05],but no significant difference was found when it was compared with that treated for 8 weeks [treated for 8 weeks:(72.32 ±4.30) pg/ml,and (243.70 ±35.43) pg/ml,P ＞0.05] ; However,its level was markedly decreased after treated with immunosuppressants of CTX for 16 weeks when it was compared with those before treatment and treated for 8 weeks[treated for 16 weeks:(34.03 ± 2.56) pg/ ml,and (114.42 ± 21.33)pg/ml,P ＜ 0.05].(3)In FRNS group,the levels of urinary MCP-1 and IL-18 were no remarkable difference between control and SSNS groups [before treatment:(30.43 ± 4.61) pg/ml,and (156.65 ± 34.39)pg/ml; treated for 8 weeks:(29.41 ± 4.76) pg/ml,and (152.21 ± 34.73) pg/ml,P ＞ 0.05],but its level was markedly lower than SRNS group (P ＜ 0.05).When it was recurred,the levels of urinary MCP-1 and IL-18 were significantly increased compared with before treatment and treated for 8 weeks[recurred:(72.92 ±3.01)pg/ml,and (224.33 ±26.07)pg/ml,P ＜0.05].(4)No correlation was found between the levels of MCP-1 and IL-18 and the levels of blood urea nitrogen and creatinine (P ＞0.05).Positive correlation was found between the levels of MCP-1 and IL-18 and the 24-hour urinary protein excretion (r =0.706,0.556,P ＜0.01).There's a correlation between urinary MCP-1 and IL-18 (r =0.811,P ＜ 0.01).Conclusions For children with PNS,the detection of urinary MCP-1 and IL-1 8 contributed to the early prediction of children'sensitivity on glucocorticoid.The elevated levels of urinary MCP-1 and IL-18 in combination with clinical symptoms and proteinuria can be used as an important noninvasive marker to monitor PNS recurrence.

Bone Marrow Cells ; pathology ; Bone Marrow Neoplasms ; pathology ; physiopathology ; Humans ; Neoplasm Metastasis ; pathology ; physiopathology ; Tumor Cells, Cultured

Objective To explore the relationship between the risk of amyotrophic lateral sclerosis (ALS) and exposure to rural environments and pesticide.Methods Studies relevant to rural residence,farmer occupation,pesticide exposure and ALS were identified from the databases including Embase,Ovid Medline,Pubmed,Cochrane Library,Wanfang data,Chinese BioMedical Literature Database,Chinese National Knowledge Infrastructure,China Science and Technology Journal Database up to March 2015.Quality of studies was assessed according to the Newcastle-Ottawa Scale (NOS).Analysis of data and publication bias was performed with software Revman 5.3.Results A total of 24 case-control studies and 3 cohort studies were included into the analysis.The NOS scores of all studies were ≥6.The risk of ALS was associated with pesticide exposure (OR =1.41,95％ CI 1.28-1.56) and farmer occupation (OR =1.42,95％ CI 1.29-1.57),but not associated with rural residence (OR =1.21,95％ CI 0.97-1.51).Subgroup analysis of pesticide exposure and ALS revealed that males (OR =1.75,95％ CI 1.39-2.21) had a higher risk than females (OR =1.53,95％ CI 1.13-2.08),and the risk estimate was higher in studies using E1 Escorial standard (OR =1.68,95％ CI 1.45-1.95) than studies not (OR =1.23,95％ CI 1.08-1.40).The meta analysis had a slight publication bias.Conclusions Our findings support pesticide exposure might increase the risk of ALS.Given that farmers always have high levels of pesticide exposure in their work,they should decrease their exposure level or take proper precautions to lower the risk of ALS.

The expression patterns of 5-hydroxytryptamine(5-HT),gastrin(Gas),β-endorphin(End),somatostatin(SS),vasoactive intestinal peptide(VIP),glucagon(Glu) and neuropeptide Y(NPY)-positive cells in the duck thymus were studied by the immunohistochemical method associated with image analysis.The result shows that these 7 kinds of neuroendocrine cells with strong intensity were differentially detected in the duck thymus.The End-positive cells were abundantly expressed in the thymic cortex,whereas the Gas,5-HT,SS,VIP,Glu and NPY ones were more frequent in the medullary and around the corticomedullary junction.Except Glu,the other 6 kinds of neuroendocrine substances with various intensity were expressed in the cells of thymic corpuscles.The observation demonstrated that the duck thymus is not only a primary lymphatic organ,but also has important neuroendocrine functions.The End-positive cells in the thymus may play crucial roles in the development of immature T-lymphocytes.The neuroendocrine cells with a predominant distribution in the medulla and around the corticomedullary junction might facilitate exerting their influence via an endocrine,autocrine or paracrine pathways on the function of mature T-cells.The possible roles of thymic corpuscles are also discussed.

OBJECTIVE To realize the present resistance characteristics of enterococci to common antimicrobial agents,and to provide reference for clinical therapy. METHODS A total of 79 isolates of enterococci were collected from samples during the period of 2000-2003.The broth microdilution test and ?-lactamase determination were performed for each of the strains.The laboratory data were analyzed. RESULTS The rates of Enterococcus faecalis and E.faecium were 73.4%,and 26.6% of all enterococci isolates.The most common sites of infection were urinary tract(35.4%),surgical secretion(24.1%),and sputum(15.2%).The rate of E.faecium approached 50% of enterococci in urinary tract.The antibiotic resistance of E.faecium was more than E.faecalis to ampicillin,penicillin,and rifampin.The ratio of HLAR enterococci and VRE to total enterococci isolates were 61.9% and 0;?-lactamase producing rate was 6.3%. CONCLUSIONS Urinary infection caused by enterococci is most frequent.E.faecium is found more easily in urinary tract than in the others and very resistant to antibiotics.Vancomycin shows fairly high activity against enterococci.The different regimens should be adopted for different enterococci.

Along with the rapid development of globalization,the international medical aid enterprise is drawing more and more attention with its bright humanitarianism standpoint,non-national boundary,and non-political orientation characteristics.From the angle of medical ethics,this article encloses ethical issues and contradictions in realistic international medical service aid,reflects on relevant ethical principles,and comes up with feasible countermeasures to solve current problems.