Objective To investigate the independent risk factors of cerebral white matter lesions (WML) of different degrees in the elderly aged 80 years and over,and provide the evidences for forecasting the prognosis of WML.Methods Brain magnetic resonance images (MRI) findings in 151 people aged 74 to 93 years were collected and analyzed.According to the severity of WML in brain MRI using the Fazekas Scale,the persons were divided into non-WML (control) group,mildWML (grade 1 WML) group and moderate-to-severe WML (grade 2 WML) group.The cognitive score,vascular risk factors,cerebral hemodynamic and arteriosclerotic index,and radiological features were compared among the three groups.Subsequent one-way ANOVA and multivariate logistic analysis were performed to determine the statistically significant factors and the independent risk factors among groups.Results The statistically significant factors with one-way ANOVA analysis among the three groups were cognitive performance (F = 48.595,P = 0.000),hypertension (x2 =7.052,P=0.029),cigarette history (x2 = 19.476,P= 0.000),cholesterol (TC) (F= 3.086,P=0.049),Crouse score (F=3.968,P=0.021) and multiple cerebral atrophy indexes.When compared with control group,cigarette history (OR 2.031,95%CI 1.244-1.317),lacunar infarction (LI)numbers (OR 2.031,95%CI 1.316-4.015) and cholesterol (OR 1.610,95%CI 0.972-2.668) were independent risk factors in grade 1 WML group (all P＜0.05).The independent risk factors between grade 1 and 2 WML group were cognitive performance (OR 0.276,95%CI 0.143-0.532),cigarette history (OR 2.262,95% CI 1.260-4.059),and sylvian fissure ratio (SFR) (OR 1.954,95% CI 1.013-3.768) (all P＜0.05).The independent risk factors between the grade 2 WML group and control group were cognitive performance (OR 0.091,95%CI 0.030-0.273),bicoudate ratio (BCR)(OR 2.511,95%CI 1.147-5.499),Crouse score (OR 2.304,95%CI1.127-4.712)and LI numbers (OR 2.200,95%CI 1.028-4.707) (all P＜0.05).Conclusions Mild WML patients have no significant abnormalities in cognition,brain atrophy and cerebral atherosclerosis.Moderate to severe WML patients manifest remarkable cognitive disorder,cerebral atherosclerosis and brain atrophy.Compared with the controls,cognitive performance,BCR,Crouse score,LI numbers were the independent risk factors for moderate-severe WML patients.

Objective To compare two different revascularization methods in type 2 diabetes mellitus (T2DM) patients with multivessel coronary artery disease treated by percutaneous coronary intervention (PCI) and coronary artery bypass graft ( CABG) .Methods T2DM patients with multivessel disease undergoing success-ful PCI or CABG were enrolled in the study .They were diagnosed by coronary angiography ( CAG) in Tianjin Chest Hospital from May 2009 to May 2010 whose.The patients were followed up for 3 years.The information of patients including physical performance , clinical features , and laboratory examination results were collected .The major ad-verse cardio cerebral events(MACCE)including death, myocardial infarction(MI), revascularization, angina pecto-ris, heart failure, and stroke were collected.Results During the 3 years of follow-up, MACCE(31.58% vs 17.68%, P<0.01), death(4.82%vs 1.10%, P<0.05), MI(4.39%vs 1.10%, P<0.05), angina pectoris (17.27%vs 10.50%, P<0.05)occurred more frequently in PCI group than in CABG group .Conclusion Evi-dences now tend to support CABG for revascularization in T 2DM patients with multivessel disease .

AIM: To study the synergic antitumor effect of verapamil (VPL) and tumor necrosis factor alpha (TNF?). METHODS: In the presence of verapamil or verapami plus tumor necrosis factor, the proliferation, the expressions of c-myc and PCNA, the mean vessel density(MVD)of human hepatoma cell line(HepG 2) were studied in vivo and in vitro. RESULTS: It was demonstrated that the growth of HepG 2 was inhibited remarkably, under the presence of verapamil and TNF? simutaneously, the expressions of c-myc , PCNA and the MVD were also decreased. CONCLUSION: The calcium channel blocker can inhibit the proliferation of tumor and has a remarkable synergy with TNF?. [

BACKGROUND: Monoamine hypothesis has been demonstrated by researches. However, the correlation between the metabolite of plasma monoamine neurotransmitter and anti-depression treatment in patients with depression has less been reported.OBJECTIVE: To study the effect of different drugs on metabolite of plaama monoamine neurotransmitter, and the correlation between the metabolite of plasma monoamine neurotransmitter and anti-depression treatment in patients with depression.DESIGN: Case controlled study.SETTING: Neurological Department and Brain Institute of Nanjing Medical University.PARTICIPANTS: Forty patients with depression hospitalized in Nanjing Brain Hospital (depression group) were diagnosed with the second revised edition of China classification of mental diseases(CCMD-2) and the tenth edition of International classification of diseases. And the total score of Hanmilton rating scale for depression(HAMD) was more than 17. Healthy voluntary blood donators in the control group were from Nanjing Municipal Central Blood Station( n = 20).INTERVENTIONS: Antidepressant was used in the depression for 4 weeks: fluoxetine 20 mg per day; 5-serotonin selective reuptake inhibitor (SSRI) paroxetine 20 mg per day; venlafaxime 50- 100 mg per day;5-serotonin and morepinephrine selective reuptake inhibitor(SNRI) fluvoxamine 50-100 mg per day. High performance liquid chromatograpy(HPLC)was used to measure the level of metabolite of plasma monoamine neurotransmitter in patients with depression before and 42 week after treatment, and the HAMD was used to evaluate clinical effect of the patients.MAIN OUTCOME MEASURES: The levels of metabolites of plasma monoamine neurotransmitters in patients with depression: 5-hydroxyindoleace tic acid(5-HIAA), 3-methoxy-4-hydroxyphenylglycol(MHPG) and homovani llic acid(HVA) were measured before and 4th week after treatment.RESULTS: The levels of 5-HIAA, MHPG and HVA of the metabolites of plasma monoamine neurotransmitters in patients with depression before treatment [ (20.3±14.6), (124.8±103.6), (54.7±32.1) μg/L] were all lower than those in the normal control group[ (39.5±28.4), (334.5 ±107.3), (88.5±37.2) μg/L], with statistically significant differences (P＜0.05). After SSRI treatment, the 5-HIAA content[ (37.1±21.9)μg/L]was significantly increased as compared with that before treatment, whose difference indicated significant meaning ( P＜0.05), but the differences in MHPG and HVA had no significant meaning as compared with those before treatment(P＞0.05) . After SNRI treatment, 5-HIAA and MHPG contents [(35.4±25.2 ), (291.2±120.4) μg/L] both were significantly increased, which indicated significant difference as compared with those before treatment( P＜0.05); but HVA level had no significant changes.CONCLUSION:'The peripheral neurotransmitter metabolites in plasma can reflect their states in brain. The change of neurotransmitter metabolite in plasma can be regarded as an important reference index for the evaluation of depression.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Apolipoproteins E ; blood ; genetics ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Venous Thromboembolism ; blood ; genetics ; Young Adult ; alpha-2-Antiplasmin ; analysis ; genetics

Objective To investigate the nursing experience of caring patients with second total aortic arch replacement with stent“trunk”.Method The nursing data of 28 patients undergoing total aortic arch replacement with stenttrunkwere analyzed to summarize the perioperative nursing experience.Results The operations were successful in all 28 patients.None of them died. Conclusion The nursing measures such as strengthened preoperative evaluation,strengthened body position and skin management, preparation of articles,strengthened blood recollection during operation to reduce blood loss and enhanced temperature monitoring are key to the success of total aortic arch replacement with stenttrunk.

AIM To investigate the protective effect of GSTT on myocardial injury induced by ischemia reperfusion. METHODS The content of lactic dehydrogenase(LDH),creatine kinase(CK),methylenedioxyamphetamine(MDA),superoxide dismutase(SOD),tumor necrosis factor alpha(TNF ?) and interleukine 6(IL 6) were determined in medium after reperfusion by simulating model of ischemia reperfusion; The content of nitric oxide(NO) was determined in medium by TNF ? injury myocardium,and mitochondrial activity was determined by MTT after TNF ? stimulated. RESULTS Compared with the model control,in the GSTT, the content of LDH,CK,MDA,TNF ? and IL 6 in medium decreased and activity of SOD increased after reperfusoin,the level of NO in medium decreased and OD 490 increased after TNF ? injuried. CONCLUSION It is suggested that GSTT can mitigate injury of ischemia reperfusion on myocardium, and has a direct protective effect on injuried myocardium.

Objective:To explore the association of its polymorphism of TFRC with the susceptibility, clinical and pathologic phenotypes of IgA nephropathy. Methods: A total of 380 patients with IgA nephropathy and 250 normal controls were enrolled in the study. The regions with 424G/A and -5184C/T polymorphism sites of TFRC were amplified by PCR from genomic DNA and then the PCR-RFLP were performed by restriction enzymes, BanⅠ and BsmA Ⅰ, respectively. The genetic association of genotypes with the clinical and pathologic phenotypes was analyzed. Results: The distribution of frequency in TFRC was consistent with Hardy-Weinberg equilibrium; however, we found no significant difference in genotypes distribution between patients and controls. There were no differences between genotypes in age, blood pressure, 24 h urine protein excretion, serum creatinine, creatinine clearance and serum IgA. 424G/A and -5184C/T polymorphisms were associated with immunofluorescent intensity of IgA deposit in mesangial area, though there was no difference in pathological lesions evaluated by HAAS grade. Conclusion: The polymorphisms of TFRC in 424G/A and -5184C/T sites were not associated with susceptibility to IgA nephropathy, but associated with density of immunofluorescence of IgA in mesangium in our large population based Chinese patients. The association of IgA nephropathy and other polymorphism sites, as well as interaction between TFRC polymorphism and other genes' polymorphisms, neededs to be further investigated.

AIM: To investigate the mechanism of AngRem104-mediated regulation of fibronectin gene in human mesangial cells. METHODS: A series of deleted FN promoter sequences was constructed, which fuse to a luciferase reporter gene, and then the potential active regions that respond to AngRem104 in the upstream regulatory sequence of human FN gene was screened by detecting the luciferase activity of promoter-reporter gene. RESULTS: The detection of relative luciferase activity revealed that there was no significant differences when the HMC were transfected with FN122-reporter gene together with sense AngRem104 construct, but the luciferase activity significantly increased when transfection of FN507-reporter gene construct together with sense AngRem104 construct. However, no increase in luciferase activity was observed when transfection of FN1280-reporter gene construct together with sense AngRem104 construct. The potential regulatory region responds to AngRem104 is in the upstream sequence (-122 to -507) of human FN gene. CONCLUSION: Our preliminary study provided the evidence that AngRem104 may mediate the transcription of the FN gene via the activation of its promoter.

Objective:To explore the diagnostic value of serum cytokines and autoantibodies in children with central diabetes insipidus.Methods:A retrospective study was used.A total of 52 children diagnosed with central diabetes insipidus who were hospitalized in Qingdao municipal hospital affiliated to Qingdao Universityfrom January 2016 to January 2020 were selected as the study group, and 60 healthy children with similar gender and age were selected as the control group.The general data of the study group and the control group, 24 h urine volume, urine specific gravity and urine osmotic pressure before the start of water deprivation test, the results of pituitary magnetic resonance imaging (MRI), and the concentration of serum cytokines and autoimmune antibodies were compared to evaluate the value of serum cytokines and autoimmune antibodies in the prediction of central diabetes insipidus.Results:The 24 h urine volume in the study group (201.6 ± 9.9 mL/kg)was significantly higher than that in the control group(9.06±12.5 mL/kg). The urine specific gravity(1.006±0.002) and urine osmotic pressure((116.4±23.5) mOsm/L)were significantly lower than those in the control group((1.013±0.004) and (649.6±72.4) mOsm/L)( t=15.378, 13.298, 45.625, all P<0.001). MRI examination showed that the proportion of disappearance of high signal in posterior pituitary (46.1%(24/52)), the proportion of thickening of the pituitary stalk(32.7%(17/52))and abnormal signal in pituitary(7.7%(4/52)) in study group were significantly higher than the control group(0%(0/0)) (all P<0.05); the levels of serum IL-6, TNF-α, IFN-γ, IL-1β ((117.0±7.8), (234±21.4), (178.6±15.1), (87±6.5) ng/L)and autoimmune antibodies ((654.1±194.3) ng/L) in study group were significantly increased compared to the control((12.5±2.3), (32.5±9.7), (37.8±7.3), (22.6±4.7), (98.0±23.7) ng/L) ( t value were 17.031, 27.490, 15.670, 12.360 and 109.984, respectively; all P<0.05). Conclusion:The concentration of serum cytokines and autoimmune antibodies has a significant clinical value in the evaluation of central diabetes insipidus in children.Combined with head MRI examination, it has a certain value in the diagnosis, treatment and prognosis of central diabetes insipidus in children.