Secondary hyperparathyroidism is the most common complication of patients with chronic kidney disease.For patients poorly responding to medical treatment,parathyroidectomy would be the best choice.This article reviews the indications and modalities of surgical treatment for secondary hyperparathyroidism in patients with chronic kidney disease.

Objective To investigate the clinical characteristics,diagnosis and treatment for Graves' disease associated with papillary thyroid microcarcinoma(PTMC) by retrospectively analyzing domestic and foreign literatures.Methods 32 patients of Graves' disease associated with PTMC treated at the Department of Thyroid Surgery,the First Bethune Hospital of Jilin University from Jun.2008 to Jun.2013 were collected.32 cases of PTMC with normal thyroid function were randomly selected by a random number table method from the same period as control.Results The experimental group had 32 patients aging from 24 to 71 years old,among whom 3 were males,and 29 were females with the male to female ratio was 1∶9.7.15 cases in the experimental group had positive central lymph node metastasis and the other 17 cases were negative,while in the control group 7 cases were positive and 25 cases were negative.The mean number of positive lymph nodes was 3 ± 2.88 in the experimental group and 1.71 ± 1.25 in the control group.The ratio of positive lymph node metastasis(the number of positive lymph nodes/the total number of lymph nodes,and the total number of central lymph nodes was ＞3)was (50.34 ±27.09) ％ in the experimental group and(33.5 ±30.79)％ in the control group.For the above 3 values of central lymph node metastasis,the experimental group were all higher than those of the control group (P =0.035,0.039,0.018 respectively).Conclusions Compared with patients of PTMC,patients of Graves' disease associated with PTMC are more likely to have central lymph node metastasis,more number of positive lymph node and higher metastasis ratio.In order to prevent the postoperative recurrence of Graves' disease and thyroid carcinoma local lymph node,total thyroidectomy plus central lymph node dissection should be the ideal operation method.

The severe acute syndrome coronavirus 2(SARS-CoV-2)is responsible for the global pandemic of 2019 novel coronavirus disease(COVID-19). Understanding the pathogenic mechanisms of SARS-CoV-2 is of great significance to the prevention and control of the COVID-19 epidemic. The spike(S)protein of SARS-CoV-2 is a major target of protective immunity. The mutations of S protein impact the transmission and pathogenic capacity of SARS-CoV-2. In addition, angiotensin-converting enzyme 2(ACE2)is the receptor of SARS-CoV-2 S protein and mediates viral entry into target cells. The genetic polymorphisms of the ACE2 gene may lead to the difference of incidence of COVID-19 among different populations. Protease can promote the infection of SARS-Cov-2 by activating the S protein. This review summarized the current understanding of the function and genetic variants of S protein, ACE2, and the related proteases. The synergistic effect of these three molecules on the susceptibility of SARS-CoV-2 infection was further discussed.

Objective To investigate the predictors of long-term remission of type 2 diabetes induced by short-term intensive insulin treatment.Methods Fifty-four cases of diabetes mellitus with the duration of illness less than 5 years received an intensive insulin treatment for 2 weeks.The standard meal test and intravenous glucose tolerance test were performed at the baseline and 24 h after treatment completion respectively.Long-term remission meant that the diabetic patients should maintain the target glyeaemic control without any hypoglyeaemie agent within one year.Results The remission rate was 57.4% (31/54) overall,and even reached to 80.6% (29/36) in patients with the duration of illness less than 6 months,whereas,the remission rate was only 11.1% (2/18) in those with the duration of illness more than 12 months.In another view,the remission rate was significantly higher in the patients with fasting plasma glucose (FPG) level of less than 7 mmol/L (78.8%,26/ 33) 24 h after intensive treatment than those with FPG level of more than 7 mmol/L (23.8%,5/21,P

Objective:To establish a mouse model of the abdominal aortic aneurysm by elastase perfusion and to provide a reference for the study of the mechanism related to abdominal aortic aneurysm formation.Methods:AAAs were induced by porcine pancreatic elastase (PPE) infusion in male C57BL/6 mice. The control group was perfused with normal saline (Saline). The changes in abdominal aortic diameter were compared at 14 days after perfusion. The diameter of the abdominal aorta stained with HE was measured. The destruction of the elastic plate in the abdominal aortic wall was observed by elastic plate staining. TUNEL assay was used to evaluate the apoptosis in aneurysm tissues.Results:Porcine pancreatic elastase (PPE) perfusion successfully established the mouse model of abdominal aortic aneurysm, in which an aneurysm formation rate was 100% at 14 days after the operation. After modelling, the abdominal aorta diameter in the mouse was significantly increased, higher than that in the control group perfused with normal saline ( P<0.05). In the PPE group, the elastic plate of the aortic wall was straightened and thinned, and interrupted. The proportion of TUNEL-positive cells in the PPE group was significantly higher than that in the control group perfused with normal saline ( P<0.05). Conclusion:Elastase perfusion can stably establish the abdominal aortic aneurysm model, and we observe the destruction of the elastic plate in the medial layer of the abdominal aortic wall and the up-regulation of the apoptosis process in the model. It provides a reference to study the pathogenesis of abdominal aortic aneurysm further.

OBJECTIVETo assess the influences of continuous femoral nerve block (CFNB) and patient-controlled intravenous analgesia (PCIA) on postoperative pain scores,knee rehabilitation,and stress response after total knee arthroplasty (TKA).

METHODSTotally 32 adult patients scheduled for elective total knee arthroplasty were equally randomized into CFNB group or PCIA group. Intraoperative hemodynamics and fentanyl dose were recorded. Pain was assessed at rest and during continuous passive motion (CPM) using a visual analog scale at post-anesthesia care unit (PACU) and 4, 8, 12, 24, and 48 hours postoperatively. Morphine consumption was also recorded. As indicators of stress and inflammatory response,the leukocyte count, serum lactic acid, blood glucose, serum C-reactive protein (CRP), and serum cortisol were determined on admission, to operation room, immediately after skin incision, before extubation,on post-operation day 1 (POD1), and on POD2.

RESULTSCFNB group showed significantly lower heart rate compared with PCIA group 60 minutes and 90 minutes intraoperatively (Pü0.05). Intraoperative consumption of fentanyl was significantly lower in CFNB group (137.5∓44.4) μg than in PCIA group (264.1∓67.1) μg (Pü0.01). The CFNB group showed significantly lower VAS scores both at rest and during CPM compared with PCIA group at all time points (Pü0.05). Morphine consumption was significantly lower in CFNB group than in PCIA group at different time points (Pü0.05 or Pü0.01). The maximal continuous passive motion amplitude of CFNB group were significantly larger than that of PCIA group on POD1 [(55.0∓9.4) vs.(44.6∓9.9), P[(76.3∓11.0) vs. (67.5∓10.3), P<0.05]. The incidences of somnolence and nausea/vomiting in CFNB group were 37.5% and 37.5%, respectively,which were significantly lower than those of PCIA group (75.0% and 81.3%) (Pü0.05). Patient satisfaction scores on anesthesia and post-operative analgesia was significantly higher in CFNB group than in PCIA group (93.1∓7.9 vs. 79.1∓11.9, respectively) (Pü0.05).

CONCLUSIONAfter TKA,CFNB technique provides more stable intraoperative hemodynamics than PCIA, with better pain relief,faster postoperative knee rehabilitation,less side effects,and higher patient satisfaction.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analgesia, Patient-Controlled ; methods ; Arthroplasty, Replacement, Knee ; Female ; Femoral Nerve ; Humans ; Male ; Middle Aged ; Nerve Block ; methods ; Young Adult

OBJECTIVETo assess the clinical effect and safety of the Chinese medicine Longbishu Capsule combined with mesylate doxazosin in the treatment of benign prostatic hyperplasia (BPH) of the kidney deficiency and blood stagnation type.

METHODSThis was a randomized, double-blind, double-simulation control study. We equally assigned 60 men diagnosed with BPH of the kidney deficiency and blood stagnation type to an experimental and a control group, the former treated with mesylate doxazosin plus Longbishu Capsule and the latter with mesylate doxazosin plus placebo. We compared the International Prostate Symptom Score (IPSS), quality of life (QOL), Chinese symptom score (CSS), maximal urinary flow rate (Qmax), and prostate volume between the two groups of patients before and after 6 months of medication.

RESULTSAfter treatment, there were 5 cured cases, 13 markedly effective cases, 9 effective cases, 1 ineffective case, and 2 eliminated cases in the experimental group, as compared with 2 cured cases, 8 markedly effective cases, 10 effective cases, 7 ineffective cases, and 3 eliminated cases in the control group. The total effectiveness rate was obviously higher in the former (96.4%) than in the latter (74.1%). IPSS, Qmax, and CSS were improved in both of the groups after medication, even more significantly in the experimental than in the control group (IPSS: 15.22 ± 2.98 vs 18.15 ± 5.88, P <0.05; Qmax: [13.56 ± 2.26] ml/s vs [11.78 ± 2.97] ml/s, P <0.05; CSS: 6.18 ± 2.13 vs 9.52 ± 3.15, P <0.05). Because of the difference in the QOL score between the two groups at the baseline (P = 0.038 <0.05), no more comparison was made in this aspect after treatment.

CONCLUSIONThe combination of Longbishu Capsule with mesylate doxazosin is safe and effective for the treatment of BPH.

Adrenergic alpha-Antagonists ; therapeutic use ; Capsules ; Double-Blind Method ; Doxazosin ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Prostatic Hyperplasia ; drug therapy ; physiopathology ; Quality of Life ; Treatment Outcome ; Urination

Objective To improve the design plan and get a piezoelectric actuator with displacement magnification structure,so as to reduce power consumption of the existing incus-stimulating piezoelectric actuator for middle ear implant.Methods Based on anatomical structure of human ear,the piezoelectric actuator with displacement magnification structure,and the one only composed of piezoelectric stack were designed,respectively,then the corresponding coupled mechanical models of the middle ear with the piezoelectric actuator were established.By comparing the calculation results from the two types of coupled mechanical models,the hearing compensation property and power consumption of the actuator before and after the implantation with the displacement magnification structure were analyzed.Results After adding the displacement magnification structure,the sound pressure level (SPL) at 1 kHz frequency was increased from 100 dB to 113 dB when the piezoelectric actuator was stimulated by 10.5 V effective voltages.In addition,for the piezoelectric stack,its power consumption at the frequency of 1,2 and 4 kHz were 6.42,1.56 and 0.28 mW,respectively;after introducing the displacement magnification structure,the power consumption at the above-mentioned 3 frequencies decreased to 0.39,0.09 and 0.01 mW,respectively.Conclusions Piezoelectric actuator with displacement magnification structure in this study can improve hearing compensation ability of the incus-stimulating middle ear implant,and effectively reduce the power consumption.The research findings will help to further improve the structure design of middle ear implant,thus achieving better hearing compensation effect.

Objective To investigate the protective effect of modified Qianjin Weijing Decoction(MQJWJD)on TNF-α and NF-κB in rats with lung injury induced by particulate matter; To discuss relevant mechanism of action. Methods A tracheal drip 15 mg/kg fine particles of saline solution was used to establish modeling, every other day, three times. Thirty-two Wistar rats were randomly divided into normal group, model group and MQJWJD high-dose and low-dose groups, with eight rats in each group. Medication groups were given relevant medicine for gavage. The level of TNF-α in bronchoalveolar lavage fluid (BALF) was measured by ELISA. The expression of NF-κB protein in lung tissues was measured by immunohistochemistry. The histopathology of the lung injury was observed by light microscope. Results Compared with normal group, the level of TNF-α and the expression of NF-κB protein in the model group were higher than those in the normal group (P<0.01). Compared with model group, the level of TNF-α and the expression of NF-κB protein in MQJWJD low-dose and high-dose groups were lower than those in the model group (P<0.05, P<0.01). Pathological observation showed that, compared with normal group, model group showed intratracheal, alveolar and interstitial bacteria within a large number of fine particles calm, alveolar and pulmonary interstitial visible large amounts of phagocytic fine particles of macrophages and accompanied by more neutrophils and lymphocyte infiltration; Lung tissue pathological changes were significantly lighter in MQJWJD high-dose and low-dose groups than the model group. MQJWJD high-dose group showed mild inflammation, alveolar and pulmonary interstitial visible phagocytic fine particles of macrophages, a small amount of neutrophils and lymphocyte infiltration. Conclusion MQJWJD can reduce the pulmonary injury in rats induced by particulate matter and has protective effects on the rat model through decreasing the levels of TNF-α and the expressions of NF-κB protein in injured lung tissues.

Liver regeneration depends on powerful immune system of ownself. TNF-α,IFN-γ,IL-6,IL-12,etc. that secreted by innate immune cells such as macrophages,dendritic cells,NK cells and NKT cells,could act on the hepatocytes and regulate liver regen-eration (LR) through corresponding signaling pathways. This article summarizes the mechanism of different innate immune cells on hep-atocytes,clarifies the recent advances of liver innate immune cellsduring liver regeneration process,lay the foundation for revealing the molecular mechanism of the development of liver regeneration and liver diseases, and for the research and development of new therapeutic methods for liver diseases.