Objective To explore the characteristics and the clinical application of MR perfusion weighted imaging(PWI)in the normal kidneys and the renal diseases.Methods Thirty-one subjects including 9 cases without urinary diseases,14 cases with renal carcinoma,6 cases with renal cyst and 2 cases witll renal tuberculosis who had been examined with T1WI,T2WI and PWI were analyzed retrospectively.All the data were processed by a workstation to obtain time-signal intensity curves,color perfusion maps and relative perfusion value.The relative renal blood volume(RBV),relative renal blood flow(RBF),mean transition time(MTT)and the time to peak(TTP)in the normal renal cortex and medulla and the renal lesions were calculated.Comparisons between the right and the left normal kidneys,and between the cortex and the medulla of the normal kidneys were performed using t test,and comparisons between the normal and the abnormal kidneys were performed using q test.Results Relative RBV and relative RBF of the cortex were 1.33±0.08 and 1.44±0.09 respectively,and for medulla were 0.58±0.05 and 0.78±0.13 respectively(t=9.2241 and 5.0336,P＜0.01);MTT(1.11±0.08)and TTP (1.04±0.06)of the cortex has no difference with that of the medulla(0.97±0.04 and 0.94±0.03)in the normal kidneys(t=2.2551 and 2.2613.P＞0.05).The values of relative RBF of the renal carcinoma (1.35±0.34)were significantly higher than that of the normal tissues(1.02±0.06)(q=3.0882,P＜0.01).Conclusion PWI is able to demonstrate the hemodynamic change of the normal renal tissues and the renal lesions,and it maybe an ideal method for showing the functional changes of the kidney and for differentiating the renal diseases.

Animals ; Aortic Valve ; surgery ; Aortic Valve Stenosis ; congenital ; therapy ; Balloon Valvuloplasty ; methods ; Cardiac Surgical Procedures ; adverse effects ; methods ; Catheterization ; adverse effects ; methods ; Female ; Fetal Diseases ; therapy ; Fetal Heart ; surgery ; Heart Defects, Congenital ; therapy ; Humans ; Postoperative Complications ; epidemiology ; Pregnancy ; Pregnancy Trimester, Second ; Ultrasonography, Interventional ; methods

Objective: To study the effects of total flavonoids of Astragalus on apoptosis of bovine retinal capillary pericytes(BRPs) under high glucose.Methods: The third generation of nearly symphysic bovine retinal vessel pericytes cultivated in vitro were divided into normal control group,high glucose group,and Astragalus total flavonoids groups(0.25,0.5,1.0,2.0 mg/ml) at random.After being incubated for 6 days,apoptosis of BRPs were detected by TUNEL method.TBA method was used to detect the contents of MDA.Xanthine oxidase method was used to detect the SOD activities.Results: Compared with high glucose group,the apoptosis,MDA contents,SOD activity,MDA content/SOD activity of BRPs reduced markedly in total flavonoids of Astragalus groups(0.5,1.0,2.0mg/ml)(P

OBJECTIVE:To study the ADR mechanism of conjunctival hyperemia in model rats with prostacyclin-induced high intraocular pressure. METHODS:50 rats were randomly divided into normal control group,model group,prostacyclin low-dose, medium-dose,high-dose groups(100,200,400 mg/kg),10 in each group. Except for normal control group,right eyes of rats in other groups were established high intraocular pressure model,dropping corresponding medicine once a day,for 1 week. After last administration,the right eyes cornel peripheral corneal endothelial cells of rats in each group were isolated in vitro and cultured. Vascular endothelial cell viability,cell apoptosis and proliferation-related factor(Ki-76),apoptosis-related factors(Bad,Bax),in-hibito of apoptosis-related factors (Bcl-2,Bcl-xl) protein expressions were detected. RESULTS:Compared with normal control group,vascular endothelial cell viability in model group were obviously decreased;apoptosis rate was obviously increased;Bad, Bax protein expressions were obviously enhanced;Bcl-2,Bcl-xl,Ki-76 protein expressions were obviously weakened,with statisti-cal significances (P<0.05 or P<0.01). Compared with model group,vascular endothelial cell viability in prostacyclin low-dose,medium-dose,high-dose groups were obviously decreased;apoptosis rate was obviously increased;Bcl-2,Bcl-xl protein expres-sions were obviously weakened,with statistical significances(P<0.05 or P<0.01);the Bad,Bax protein expressions in prostacy-clin medium-dose,high-dose groups were obviously enhanced(P<0.05 or P<0.01),the other indexes had no statistical differenc-es(P>0.05). CONCLUSIONS:Prostacyclin may cause conjunctival hyperemia through promoting the apoptosis of cornel peripher-al corneal endothelial cells of model rats with high intraocular pressure and decreasing the cell viability.

Objective To study the effects of constant and intermittent high glucose on the apoptosis of cultured bovine retinal capillary pericytes (BRPs), and to investigate the role of mitochondrial apoptotic pathway in the apoptosis of BRPs. Methods After being cultured under glucose with different concentrations tot 6 days, the change of uhrastructure of BRPs was observed under electronmieroscope, the apoptosis of pericytes was detected by TUNEL method, the mitochondrial inner transmembrane potential (△Ψm) was detected by laser scanning confocal microscopy, the change of cytochrome c (cyt-c) was assayed by spectrophotometer and the expression of apoptotic genes was detected by immunohistochemical method and RT-PCR. Results (1) BRPs showed typical changes of apoptosis in constant and intermittent high glucose concentrations. The apoptosis induced by constant high glucose concentration was more obvious than that by intermittent high glucose. (2) Constant and intermittent high glucose concentrations obviously decreased △Ψm compared with control group. The △Ψm of BRPs was correlated negatively with the apoptotie rate of BRPs (r = - 0.89, P < 0.01) ; (3) Constant and intermittent high glucose concentrations increased the release of cyt-c from mitochondria to cytoplasm, and the concentration of cyt-c in the cytoplasm was correlated positively with the apoptotic rate of BRPs (P < 0.01) ; (4) Constant and intermittent high glucose concentrations increased the expression of proapoptotie gene Bax and decreased the expression of prosurvival gene Bcl-2, resulting in increased Bax/Bcl-2 ratio. Bax/Bcl-2 ratio was negative correlatied with the △Ψm of BRPs, and positively eorrclaticd with the concentration of cyt-c in cytoplasm and apoptotic rate (both P < 0.01).Conclusion Constant and intermittent high glucose concentrations could decrease △Ψm, increase the release of cyt-c and induce the apoptosis of BRPs, the effects being stronger with constant high glucose concentration. The mitochondrial apoptotic pathway plays an important role in the apoptosis of BRPs, in which Bax and Bcl-2 are involved.

From the current situations and problems on communication between doctors and patients,the paper discusses the necessity of strengthening the training of interns' communication ability between doctors and patients and explores its ways and development trend in the future.

BACKGROUND:The umbilical cord blood is rich of mesenchymal stem cells, which can be used as a new source of seed cells in tissue engineering. OBJECTIVE:To compare two methods for culturing, expanding and purifying the mesenchymal stem cells in vitro isolated from the human umbilical cord blood. METHODS:The ful-term birth cord blood of 40 cases was col ected under sterile conditions with heparin anticoagulation. Ficol density gradient centrifugation was used to isolate the mononuclear cells from the umbilical cord blood. The cases were randomly divided into two groups according to the different culture media. Twenty cases of umbilical cord blood were cultured in MesenGro human mesenchymal stem cells culture medium (group A), and the remaining 20 cases of umbilical cord blood were cultured in Dulbecco’s modified Eagle’s medium (group B). The occurrence time of fusiform mesenchymal stem cells and cell colony, culture time and the number of primary cells in the two groups were compared. Cells which grew well were selected to detect the surface markers by flow cytometry. RESULTS AND CONCLUSION: The mean occurrence time of fusiform mesenchymal stem cells and cell colony, culture time and number of primary cells in group A were better than those in group B (P < 0.01). The strong expression of the surface markers of mesenchymal stem cells (CD73 and CD105) was found by flow cytometry, of which the positive rate was 99.1%. No expression of the surface markers of hematopoietic stem cells (CD45 and CD34) was seen, of which the negative rate was 99.3%. The number, morphology, growth rate and culture time of umbilical cord blood mesenchymal stem cells cultured in MesenGro human mesenchymal stem cells culture medium were better than those cultured in Dulbecco’s modified Eagle’s medium. Cells cultured in MesenGro human mesenchymal stem cell culture medium can better express surface markers of mesenchymal stem cells.

Objective To investigate the protective effect of dexamethasone on stress response induced by intraute-rine balloon aortic valvuloplasty (IUBAV) in a fetal lamb model. Methods Twenty-four near term twin pregnant goats were randomly assigned to control group (n=12) and dexamethasone group (intracardiac injection of dexamethasone) (n=12). Ultrasound guided IUBAV model was established. According to the combination of treatment and operation, 48 fetal lambs were divided into four groups. The following parameters were dynamically monitored by ultrasound, which were fetal and neonatal heart rate (HR), cardiac rhythm, aortic resistance index (RI) and pulsatility index (PI). On established IUBAV model, blood samples and liver tissue specimens were taken from fetal/neonatal goats for detection of blood glucose (Glu), lactate acid (LA), plasma epinephrine (E), norepinephrine (NE), cortisol (Cort), hepatic glycogen staining. Results IUBAV resulted in increased values of Glu, LA, E, NE and Cort levels, and decreased pH value, there were significant differences between pre-and 3h-post procedure (P<0.05), and significant differences were also existed in these values between pre-and 3d-post procedure (P<0.05). After administrating dexamethasone, the changes of Glu, LA, E, NE, Cort and pH levels were suppressed effectively. Fetal hepatic glycogen was consumed in large amounts due to IUBAV while recovered 3 days after IUBAV by glycogen staining. After administrating dexamethasone, hepatic glycogen consumption related to IUBAV was obviously inhibited. After IUBAV, fetal aortic RI was increased, and there was significant differences compared with pre-procedure (P<0.05). Up to 3d-post procedure, the values of RI recovered to some extent, but statistical difference was exist-ed compared with pre-procedure (P<0.05). After administrating of dexamethasone, increased aortic RI was effectively sup-pressed. Conclusions IUBAV could lead to reversible stress response and increased aortic RI in a fetal lamb model which could be alleviated by dexamethasone.

OBJECTIVE:To compare anticoagulant efficacy and safety of dabigatran etexilate and warfarin in the treatment of non-valvular atrial fibrillation(NVAF). METHODS:In retrospective analysis,360 NVAF patients were divided into control group (180 cases)and observation group(180 cases)according to therapy plan. Control group was given Warfarin sodium tablet with ini-tial dose of 2.5 mg orally,once a day,adjusted dosage according to INR. Observation group was given Dabigatran etexilate cap-sule 150 mg with warm water,twice a day,during or after meal. The levels of ALT,AST and INR,the occurrence of ADR were observed in 2 groups before treatment and 1,3 month after treatment. RESULTS:There was no statistical significance in the levels of ALT or AST between 2 groups before and after treatment (P>0.05). Before treatment,there was no statistical significance in INR between 2 groups (P>0.05),1,3 months after treatment,INR in control group was significantly higher than before treat-ment,with statistical significance(P<0.05);there was no statistical significance in the INR of observation group before and after treatment(P>0.05);but INR of 2 groups ranged were in normal range. There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Anticoagnlant efficacy of dabigatran etexilate is significantly better than war-farin for NVAF. Both have similar safety.

BACKGROUND: Pertuzumab has been approved for application in China by the National Medical Products Administration, and both national and international guidelines make recommendations for the use of neoadjuvant treatment with trastuzumab or trastuzumab + pertuzumab plus chemotherapy regimens for patients with indications. The goal of this study was to investigate the short-term clinical efficacy of the neoadjuvant therapies trastuzumab and trastuzumab+pertuzumab for patients with early human epidermal growth factor receptor 2 (HER2)-positive breast cancer in China. METHODS: A real-world study was conducted using the clinicopathological data of patients with early HER2-positive breast cancer who were admitted to the member hospitals of the Chinese Society of Breast Surgery, Chinese Surgical Society of Chinese Medical Association between March 2019 and December 2020. This study analyzed the efficacy and tolerance of trastuzumab+chemotherapy and trastuzumab+pertuzumab+chemotherapy in patients with early HER2-positive breast cancer. The Response Evaluation Criteria in Solid Tumors 1.1 was adopted to evaluate clinical efficacy. The pathological efficacy was evaluated using the MillerPayne grade. The Common Terminology Criteria for Adverse Events (version 5.0) was adopted to evaluate adverse events (AEs). The propensity scores were subjected to propensity score matching using the R language (1:1 matching with a maximum allowable difference of 0.05 between the two groups). Efficacy was compared using the chi-square test, and correlation analysis was performed using linear regression. RESULTS: A total of 1032 patients with early HER2-positive breast cancer met the enrollment criteria and were included in this study. Among these patients, 472 received neoadjuvant trastuzumab+chemotherapy (the trastuzumab group), and 560 received neoadjuvant trastuzumab+pertuzumab+chemotherapy (the trastuzumab+pertuzumab group). The overall pathologic complete response (pCR) rate was 47.2% (487/1032), while the pCR rates of the trastuzumab and trastuzumab+pertuzumab groups were 34.5% (163/472) and 57.9% (324/560), respectively, and the difference was significant (P < 0.001). The incidence of grade 4 AEs was 24/321 (7.5%) in the trastuzumab+pertuzumab group, and there were no cases in which the left ventricular ejection fraction decreased by more than 10%. CONCLUSIONS Patients in the trastuzumab+pertuzumab group had a higher pCR rate than those in the trastuzumab group, and the toxic side effects were tolerable.
Humans ; Female ; Breast Neoplasms/metabolism* ; Neoadjuvant Therapy ; Stroke Volume ; Ventricular Function, Left ; Receptor, ErbB-2/metabolism* ; Trastuzumab/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*