Objective To investigate the relationship among ultrafiltration (UF), diurnal rhythm of blood pressure (BP) and cardiac structure and function in hemodialyzed(HD) patients. Method 42 hemodialyzed patients were studied. Intensified UF during routine HD were given to them for 4 weeks. Before and after 4 weeks, everyone received 24 hours ambulatory blood pressure monitoring and cardiac doppler and recorded diameter of left atrium (LAD) ,left ventricle (LVEDD), thickness of posterior wall of left ventricle during end stage of diastolic period (LVPWT) ,thickness of interventricular septum(IVST) ,ejection fraction (EF). Result In hemodialyzed patients, non-dipper hypertension was much more than dippers (P < 0.05). There was significant difference between nocturnal BP and cardiac structure before and after 4 weeks of hemodialysis ( P < 0.05 ). Conclusion Nocturnal hyperten- sion of hemodialyzed patients is related to hypervolemia. Intensive ultrafihration can improve nocturnal hypertension and eardiac function.

Objective To investigate the clinical characteristics,pathogenic causes and treatment outcomes of acute kidney injury (AKI) in very old patients in order to improving the diagnosis and treatment.Methods 39 AKI patients aged ≥80 years in the department of geriatric medicine of our hospital were enrolled and followed up for 3 months.Clinical and laboratory data were analyzed and the pathogenic causes as well as the treatment outcomes were summarized.Results Among the 39 very old patients,31(79.5％) were male,8(20.5％) were female,and the mean age was (93.5±4.6) years.33 (84.6％)patients had chronic kidney diseases.The pathogenic causes of AKI were mainly as follows:urological infections (71.8％),blood volume deficiency (48.7％),cardiac dysfunction (23.1％) and hypotension (15.4％).2 to 4 pathogenic causes were co present in 64.1％ patients.Renal function was improved and recovered in 69.2 ％ patients and the death rate was 25.6％ after treatment.The main causes of death were septic shock (30.0％),multiple organ failure (20.0％),massive gastrointestinal hemorrhage (20.0％) et al.Conclusions Most of the very old patients may suffer from AKI on the basis of chronic kidney disease.AKI is often induced by multiple pathogenic causes.The main factors leading to AKI are urological infections,followed by blood volume deficiency and cardiac dysfunction.Most patients with AKI can recover after the precipitating factors are removed and supportive treatments are administered in time.Septic shock is the main cause of death.

This study is to establish a method for simultaneously determination of five nucleosides and nucleobases, including hypoxanthine, uridine, adenine, guanosine and adenosine in Rehmannia glutinosa Libosch. which was collected from different regions in China. A Diamonsil C18 column (250 mm x 4.6 mm, 5 microm) was used. Acetonitrile and 0.04 mol L(-1) potassium dihydrogen phosphate solution were adopted as mobile phase with gradient elution. The flow rate was 1 mL min(-1) and column temperature was 30 degrees C. The detection wavelength was at 254 nm. The method had good linearity over the range of 1.0 - 16.0 microg mL(-1) (r2 = 0.999 8), 5.0 - 80.0 microg mL(-1) (r2 = 0.999 8), 1.0 - 16.0 microg mL(-1) (r2 = 0.999 5), 1.25 - 20.0 microg mL(-1) (r2 = 0.999 8) and 1.0 - 16.0 microg mL(-1) (r2 = 0.999 8) for hypoxanthine, uridine, adenine, guanosine and adenosine, respectively. The average recoveries were between 98.8% and 100.7%. The content of hypoxanthine, uridine, adenine, guanosine and adenosine in Rehmannia glutinosa Libosch. from different regions was significantly different. This established method was sensitive and reliable for the quantification of five chemical constituents in Rehmannia glutinosa Libosch.

Cutaneous Fistula ; Digestive System Abnormalities ; therapy ; Endoscopy, Gastrointestinal ; methods ; Female ; Humans ; Infant ; Treatment Outcome

Objective To explore the effects of the extracellular regulated protein kinase’s (ERK1/2) inhibitor PD98059 and ino-sitol triphosphate kinase (PI3K/PKB) signaling pathway’s inhibitor LY294002 on extracellular matrix (ECM) deposition in pulmonary arterial smooth muscle cells (PASMCs) stimulated by connective tissue growth factor (CTGF). Methods PASMCs of SD rat were cul-tured in vitro. The PASMCs were divided into control group, CTGF group, CP (CTGF+PD98059) group, CL (CTGF+LY294002) group and CPL (CTGF+PD98059+LY294002) group. Real-time lfuorescent quantitative RT-PCR was used to detect the expression of colla-gen III and ifbronectin mRNA of PASMCs, and the expression of collagenШprotein of PASMCs was detected by immunohistochem-istry and western-blot. Results The expressions of collagenШand ifbronectin mRNA of PASMCs stimulated with CTGF (50 ng/ml) for 48 h were signiifcantly higher than those in control group, and the collagen proteinШof PASMCs was decreased signiifcantly after stimulation with CTGF (50 ng/ml) for 72 h (P<0.05). The expressions of collagenШand ifbronectin mRNA in PASMCs cultured with PD98059 (20μmol/L) and/or LY294002 (10μmol/L) for 48 h was signiifcantly lower than those in CTGF group (P<0.05). The collagen proteinШin PASMCs cultured with PD98059 (20μmol/L) and/or LY294002 (10μmol/L) for 72 h was increased (P<0.05). The expres-sions of collagenШand ifbronectin mRNA of PASMCs stimulated with both PD98059 and LY294002 were more signiifcant. Conclu-sions CTGF may increase the expression of collagenШand ifbronectin mRNA in PASMCs, which may contribute to the deposition of ECM in PASMCs during pulmonary vascular remodeling. PD98059 and LY294002 may repress ERK1/2 and PI3K/PKB signaling pathways and interfere with the biological effect of CTGF.

AIM: To observe the effect of hypoxia on cardiaomyocytes apoptosis and the role of ALDH2 in the process. METHODS: Cultured cardiomyocytes of neonatal rats were used. Hypoxia was imposed to the cardiomyocytes with or without daidzin pretreatment. ALDH2 activity was measured by the method of acetaldehyde metabolism. Apoptosis was measured by Hoechest 33324 staining, fluorescence activated cell sorting (FACS) and the DeadEnd~ TM fluorometric TUNEL system. RESULTS: ALHD2 enzyme activity in myocytes was inhibited by daidzin (24 h, 60 ?mol/L) without induction of apoptosis. When exposed to hypoxia, however, the apoptisis was significantly increased in the cells pretreated with daidzin compared to those without the pretreatment. CONCLUSION: The reduction of ALDH2 activity might increase the susceptivity of myocytes to apoptosis following hypoxia, suggesting a protective role of ALDH2 in hypoxia-induced myocardial injury.

Objective To screen protective antigen genes and construct the T7 phage display library from adult worms of Schistosoma japonicum.Methods Total RNA was extracted from adult worms of S.japonicum by Trizol reagent and mRNA was isolated from the total RNA.The ds cDNA was synthesized by reverse transcription using random primer.Directional EcoRⅠ/HindⅢ linkers were ligated into the ends of ds cDNA and the ds cDNA was digested with EcoRⅠand HindⅢ,which resulted in ds cDNA with EcoRⅠand HindⅢ adhering ends.The digested ds cDNA fragments longer than 300 bp in length were fractionated and ligated into T7 Select 10-3b vector.After packaging in vitro,the T7 Select 10-3b vector was transformed into BLT5403 to construct the T7 phage display cDNA library.Plaque assay and PCR were used to evaluate the library.Seven known objective genes of S.japonicum were screened by PCR to detect the representation of the library.Result Primary library capacity was 4.98?106 pfu,and the titer of amplified library was 3.85?1011 pfu/mL.The PCR identification result of 96 clones picked at random showed that recombination rate was 93.8%,in which 95.6% inserted cDNA fragments were longer than 300 bp in length.All the seven known objective genes of S.japonicum were amplified from the library.Conclusion The T7 phage display library from adult worms of Schistosoma japonicum was constructed.

OBJECTIVETo observe the therapeutic effect of the low molecular weight heparin calcium (LMWHC) combined with Yinxin Damo Injection (YDI) on the prevention of deep venous thrombosis (DVT) after the operation of intertrochanteric fracture.

METHODSSixty-two patients with intertrochanteric fracture were randomly assigned to the control group and the combined group, 31 in each group. Patients in the control group were subcutaneously injected with 6 000 IU LMWHC, twice daily. On this basis of the aforesaid treatment, patients in the combined group were intravenously dripped with YDI at the daily dose of 20 mL, once daily. The treatment lasted for 10 days in both groups. The DVT incidence rate, postoperative drainage amount of blood, activated partial thromboplastin time (APTT), plasma prothrombin time (PT), platelet count, and the maximal swelling rate of lower limbs after surgery were compared between the two groups after operation.

RESULTSIn the control group DVT occurred in 5 cases (16. 1%) while it occurred in 2 cases (6.5%) in the combined group, showing significant differences (P < 0.05). Both APTT and PT were shortened in the two groups on the 2nd day after medication (P < 0.01). Compared with the control group, it was more obvious in the combined group, showing statistical significance (P < 0.05). Both APTT and PT were shortened in the control group on the 10th day after medication when compared with before treatment (P < 0.01). But they were postponed in the combined group when compared with before medication, showing statistical difference when compared with the control group (P < 0.05). The platelet count increased in the combined group on the 10th day after medication. Besides, it was higher than that in the control group, showing statistical difference (P < 0.05). The platelet counts were in the normal range.

CONCLUSIONSLMWSC combined with YDI could not only reduce the incidence of DVT after the operation of intertrochanteric fracture, but also change the state of higher blood coagulation. It showed significant effect on preventing DVT after the operation of intertrochanteric fractures.

Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ginkgo biloba ; Heparin, Low-Molecular-Weight ; therapeutic use ; Hip Fractures ; surgery ; Humans ; Injections ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Venous Thrombosis ; prevention & control

Objective To compare the efficacy and safety of a new low-dose oral contraceptive pill (YAZ) containing drospirenone 3 mg and ethinylestradiol 20 μg with placebo in reducing symptoms of premenstrual dysphoric disorder (PMDD). Methods This multicenter, double-blind, randomized clinical trial consisted of 2 run-in and 3 treatment cycles (84 days) with daily symptom charting; 187 women with symptoms of PMDD were randomized to either placebo group (n=94) or YAZ group (n=93), and assessed with daily record of severity of problems scale (DRSP) and clinical global impressions scale (CGI) before, during and after the treatments. Hormones were administered for 24 days, followed by 4 days of inactive pills. Results Compared with baseline level of DRSP, both groups got improvement after treatment; the YAZ group (median-28.7, range:-82.5 to 2.3) had greater improvement than that in the placebo group (median-23.7, range:-86.0 to 11.8), while there was not significant difference (P>0.05). The main adverse effects of YAZ included intermenstrual bleeding [13% (12/93) versus 3% (3/94)], menorrhagia [9% (8/93) versus 1%(1/94)], nausea [5%(5/93) versus 4%(4/94)] and skin rash [4%(4/93) versus 2%(2/94)]. Conclusions YAZ could improve symptoms of PMDD better than placebo, while without statistic significance in this study. The most common adverse effects are intermenstrual bleeding, menorrhagia, nausea and rash.

Objective To explore the computed tomography (CT) features of gastric cancer invasion to the pancreas and significance in the assessment of resectability of primary lesions.Methods The retrospective cohort study was conducted.The clinical data of 31 gastric cancer patients who were admitted to the Peking University Cancer Hospital between February 2011 and August 2016 were collected.Of 31 patients receiving CT examinations,11 who were diagnosed with suspected pancreas invasion by preoperative CT examinations but operation confirmed no invasion were allocated into the pancreas negative (PN) group,11 who were confirmed as pancreas invasion and under vent radical gastrectomy of gastric cancer combined with pancreas resection were allocated into the pancreas invasion (PI) group,and 9 who were confirmed as pancreas invasion and had unresectable primary lesions were allocated into the pancreas invasion non-resected (PI-NR) group.Observation indicators:(1) morphologic type of contact surface between gastric cancer and pancreas;(2) comparison of CT findings among the 3 groups:primary lesion location,tunor thickness,Borrmann type,serosa pattern of gastric cancer,judging obvious region invaded by gastric cancer,contact or invasion site with pancreas,contact length between gastric cancer and pancreas,pattern,clarity and CT values of contact surface or peripancreas invaded and normal peripancreas;(3) treatment or follow-up situations.All the patients underwent radical resection and palliative resection for gastric cancer or non-operation according to results of exploration.Telephone interview was performed to detect the survival of patients up to February 2017.Measurement data with skewed distribution were described as M (Qn),and comparisons among groups were done by the Kruskal-Wallis test.Comparison of count data were done by the Fisher exact probability.Results (1) Morphologic type of contact surface between gastric cancer and pancreas:there were 4 types according to results of CT examination.Type Ⅰ.pancreas contacted with gastric cancer and there was no change in the morphology and radian of contact surface.Type Ⅱ:pancreas contacted with gastric cancer and radian of contact surface became flattened or shallow depression.Type Ⅲ:contact surface showed a inserted sign or obvious depression.Type Ⅳ:pancreas didn't contact with gastric cancer and there was increased density in fat space between pancreas and gastric cancer,with a smudge sign or strip-and sheet-like opacity.Of 31 patients,type Ⅰ,Ⅱ,Ⅲ and Ⅳ were detected in 5,10,4 and 12 patients,respectively.(2) Comparison of CT findings among the 3 groups:nodular protrusion,spiculation and strip shape,clounding patch opacity of serosa panern of gastric cancer were detected in 1,6,4 patients in the PN group and 5,4,2 patients in the PⅠ group and 0,2,7 patients in the PI-NR group,respectively,with a statistically significant difference (X2=10.054,P＜0.05).Two,8 and 8 patients in the PN,PI and PI-NR groups had obvious tumor invasion located at a adjacent region between stomach and pancreas,with a statistically significant difference (X2 =11.259,P＜0.05).Contact or invasion site with pancreas located at head,body and tail of pancreas was detected in 6,5,0 patients in the PN group and 1,7,3 patients in the PI group and 5,4,0 patients in the PI-NR group,respectively,with a statistically significant difference (X2=8.390,P＜0.05).Type Ⅰ,Ⅱ,Ⅲ and Ⅳ of contact surface between gastric cancer and pancreas were detected in 5,6,0,0 patients in the PN group and 0,4,4,3 patients in the PI group and 0,0,0,9 patients in the PI-NR group,respectively,with a statistically significant difference (X2=29.291,P＜0.05).Number of patients with clear and ambiguous contact surface was 10,1 patients in the PN group and 0,11 patients in the PI group and 0,9 patients in the PI-NR group,respectively,with a statistically significant difference (X2 =26.227,P＜ 0.05).CT values of contact surface or peripancreas invaded were-46 HU (-57 HU,-20 HU) in the PN group and-34 HU (-41 HU,-25 HU) in the PI group and-10 HU (-15 HU,-10 HU) in the PI-NR group,respectively,with a statistically significant difference (Z=15.306,P＜0.05).CT values of normal peripancreas were-87 HU (-96 HU,-76 HU) in the PN group and-88HU (-70 HU,-1 HU) in the PI group and-83 HU (-98 HU,-74 HU) in the PI-NR group,respectively,with statistically significant differences in CT values between contact surface or peripancreas invaded and normal peripancreas among the 3 groups (Z=12.581,13.780,7.793,P＜0.05).(3) Treatment or followup situations:of 31 patients,22 underwent radical gastrectomy and 9 underwent simplex exploration or short surgery.All the 31 patients were followed up for 6.0-71.0 months,with a median time of 13.5 months.Postoperative 1-and 2-year survival rates were 82.6％ and 77.1％.Conclusions There are significant differences in pancreatic invasion and resectability between CT features of contact surface of gastric cancer and pancreas and tumor classification.CT features include that pancreas contacts with gastric cancer in the PN group,radian of contact surface becomes flattened and with a inserted sign in the PI group,and there are increased density in fat space between pancreas and gastric cancer and a smudge sign or strip-and sheet-like opacity in the PI-NR group.