Aneurysm, Dissecting ; complications ; Coronary Aneurysm ; complications ; Coronary Artery Disease ; complications ; Female ; Humans ; Middle Aged

Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; Death, Sudden ; Humans ; Male ; Middle Aged

Ten pregnant rats randomly chosen from the total twenty rats on day 9 ofprognancy were injected a high dosage of LRH-A.The other ten were used ascontrol group.After one day and two days the ultrastructure of the luteal cell wasobserved by transmission electron microscope.Compared with the control group,theexperimental group showed an increase of lipid droplets,and a lot of large lipiddroplets appeared.The smooth endoplasmic reticulum decreased,dissolved and lostits regular array.Mitochondria degenerated,Autophagocytic vacuole,lysosome,myelin figure,multivesicular body as well as residual body increased.Golgi appa-ratus swelled in the first day after injection,and then shrank.Microvilli on thesurface of the cell decreased.The above results all suggest that with the injection of high dosage of LRH-Ainto the pregnant rats,luteal cell shows morphologic regression and decrease insecretive function.

OBJECTIVETo examine the efficacy and safety of dual blockade of the renin-angiotensin-aldosterone system (RAAS) among patients with type 2 diabetic kidney disease.

DATA SOURCESWe searched the major literature repositories, including the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE, for randomized clinical trials published between January 1990 and October 2015 that compared the efficacy and safety of the use of dual blockade of the RAAS versus the use of monotherapy, without applying any language restrictions. Keywords for the searches included "diabetic nephropathy," "chronic kidney disease," "chronic renal insufficiency," "diabetes mellitus," "dual therapy," "combined therapy," "dual blockade," "renin-angiotensin system," "angiotensin-converting enzyme inhibitor," "angiotensin-receptor blocker," "aldosterone blockade," "selective aldosterone blockade," "renin inhibitor," "direct renin inhibitor," "mineralocorticoid receptor blocker," etc.

STUDY SELECTIONThe selected articles were carefully reviewed. We excluded randomized clinical trials in which the kidney damage of patients was related to diseases other than diabetes mellitus.

RESULTSCombination treatment with an angiotensin-converting enzyme inhibitor supplemented by an angiotensin II receptor blocking agent is expected to provide a more complete blockade of the RAAS and a better control of hypertension. However, existing literature has presented mixed results, in particular, related to patient safety. In view of this, we conducted a comprehensive literature review in order to explain the rationale for dual blockade of the RAAS, and to discuss the pros and cons.

CONCLUSIONSDespite the negative results of some recent large-scale studies, it may be immature to declare that the dual blockade is a failure because of the complex nature of the RAAS surrounding its diversified functions and utility. Further trials are warranted to study the combination therapy as an evidence-based practice.

Angiotensin Receptor Antagonists ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Animals ; Antihypertensive Agents ; therapeutic use ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Nephropathies ; drug therapy ; Humans ; Renin-Angiotensin System ; drug effects

Objective To analyze the efficacy and safety of suprapubic arc sling (SPARC) and transobturater vaginal tape (TOT) for female stress urinary incontinence (SUI). Methods A retrospective study was conducted on 275 women ( 139 in TOT group and 136 in SPARC group) in our institute from September 2008 to January 2011.We had compared the complications of the two groups.All the patient's ICI-Q-SF scores and PISQ-12 scores were collected.We compared the pre- and post-operative Qmax and PVR to find out if SPARC or TOT tap cause bladder outlet obstruction (BOO). Results The operative time was 25.1 ± 3.3 min for TOT and 34.8 ± 5.6 min for SPARC.There was statistical difference between the two groups in the aspects of operative time (P =0.00).The improvements of average symptom and QOL scores in patients undergoing TOT and SPARC were statistically significant (P =0.00).The improvements of the PISQ-12 scores in the two groups were statistically significant (P ＜0.05 ) as well.There was no significant difference (P ＞ 0.05 ) in the total cure rate of TOT and SPARC.The complications post SPARC and TOT were low.In the TOT group,the Qmax changed from 30.2 ± 8.7 ml/s per-operatively to 24.9 ± 8.6 ml/s post-operatively in a week.PVR changed from 1.6 ± 4.2 ml pre-operatively to 3.2 ± 6.5 ml post-operatively in a week.In the SPARC group,the Qmax changed from 31.7 ±9.4 ml/s pre-operatively to 26.9 ± 8.9 ml/s post-operatively in a week.PVR changed from 1.4 ± 3.7 ml pre-operatively to 3.5 ± 6.3 ml postoperatively in a week.All the changes were significant ( P ＜ 0.05 ).And in the SPARC group,the Qmax changed from 31.2 ± 10.0 ml/s pre-operatively to 26.2 ± 9.1 ml/s post-operatively; the PVR changed from 1.8 ± 3.2 ml pre-operatively to 4.7 ± 8.8 ml post-operatively (P ＜ 0.05). Conclusions Both the TOT sling and the SPARC sling have high cure rates for SUI.But the retropubic sling may lead to BOO and other complications,so the transobturate sling is a better treatment option for SUI.

Objective To assess the safety and efficacy of the transohturator tape (TOT) for surgical treatment of female stress urinary incontinence (SUI). Methods Clinical data of 206 TOT procedures for female urinary incontinence from Jan 2007 to Dec 2009 was retrospectively analyzed.Thirty-one women were identified as having mixed stress urinary incontinence.The mean age was 54.29 years(range,32-81 years),themean disease coursewas 10.31 years (range,1-40 years),and the mean follow-up time was 17.3 months (range,3-39 months).Therapeutic effects were assessed by Grouts-Blaivas outcome score.The results of the operation,complications and changes of urodynarnics were observed. Results The TOT operations were conducted under local anesthesia.The mean operative time was 23.9 min (range,16-35 min),Mean blood loss was 17.8 ml(range,15-30 ml).Short-term complications were as follows:thigh pain 14.08%,dysuria 5.83%,urinary posture change 0.97% and urinary retention 0.49%.The long-term complication rate was 0.97%,including vaginal wall defect and tape exposure in one case:the burr of tape exposure and sex life influence in one case.Long-term symptoms disappeared completely in 202 cases.The cure rate was 98.06%,and the rate of satisfaction was 100%. Conclusions Our results demonstrate that TOT procedure is a minimally invasive,safe and effective surgical treatment for stress urinary incontinence.

Adolescent ; Adult ; Ankylosis ; complications ; surgery ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Micrognathism ; complications ; surgery ; Models, Anatomic ; Skull ; anatomy & histology ; Temporomandibular Joint Disorders ; complications ; surgery ; Young Adult

Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cause of Death ; Humans ; Male ; Middle Aged ; Mining ; Pneumoconiosis ; mortality ; Retrospective Studies

Adolescent ; Adult ; Aged ; Facial Nerve ; anatomy & histology ; pathology ; Female ; Humans ; Male ; Microsurgery ; Middle Aged ; Parotid Neoplasms ; surgery ; Young Adult

Objective To explore the influencing factors for the purity and viability of primary cultured cortical neurons of rat,and optimize the separating and cultivating conditions of the cortical neurons.Methods The primary cotical neurons were cultured in a serum-free culture system of B27-supplemented neurobasal medium.The differences in purity and viability of primary cultured neurons between embr-yonic rat group and newborn rat [postnatal 24 h and 5 d] group were evaluated by morphology,immunocytochemistry of neuron-specific enolase(NSE) and trypan blue staining.The changes of neurons purity and viability in different trypsin digestion time(0 min,5 min and 15 min) at different environment temperatures(20 ℃ and 30 ℃) were assessed by immunocytochemistry and trypan blue staining.Results The primary cultured neurons from fetal and newborn rats grew well.There was no significant difference in embryonic rat and postnatal 1 d newborn rat group[(91.30?1.03)%,(89.50?1.78)% respectively in purity;and(98.20?0.58)%,(97.10?0.98)% respectively in viability].The neurons from 5-days newborn rat were inferior to that from fetal and 1-day newborn rat in purity and viability[(82.00?1.25)% and(92.87?1.56)% respectively].Shortening operation time and adjusting digestion time according to the environment temperatures could improve neuronal viability:A digestion for 15min at the environment temperature of 20 ℃ or for 5 min at 30 ℃ could acquired cells with higher viability [(98.20?0.58)% and(96.70?0.64)% respectively].Conclusions It is an easy,practical choice to culture priamry cortical neurons from postnatal 1 d newborn rats.Optimizing the separating and cultivating condition(environment temperatures,digest time,et al.) will improve the neurons purity and viability.