Peroxisome proliferators-activated receptor-gamma(PPAR?),one of members of the nuclear hormone receptor superfamily of ligand-activated transcription factors,may affect the ocurrence and development of atherosclerosis(AS) through effective modulate lipocyte differentiation,improve glucose and lipoprotein decompensation and control inflammation reaction and so on.This review will focus on the recently development that relation on PPAR? and AS.

Objective To investigate the relationship between carotid artery calcification and ischemic stroke.Methods The demographic data,vascular risk factors and clinical features of patients with acute ischemic stroke and non-acute stroke patients admitted in the same period were collected retrospectively.All the patients received 64-slice spiral CT examination,and the scan data were transmitted to a GE workstation.A smart score software was used to evaluate carotid artery calcification.Multivariate logistic regression analysis was used to identify the independent risk factors for ischemic stroke.Receiver operator characteristic (ROC) curve was used to analyze and determine the predictive value of carotid artery calcification in acute ischemic stroke.Results A total of 86 patients with acute ischemic stroke and 89 with non-acute stroke (control group) were enrolled.In addition to the previous stroke history,there were no significant differences in age,gender,and vascular risk factors between the ischemic stroke group and the control group.The calcium score (338.57 ± 77.35 vs.147.79 ± 64.52; t =4.065,P =0.045),total calcified volume (372.22 ± 78.73 mm3 vs.197.27 ±61.12 mm3; t =4.740,P =0.031),and calcification quality (70.33 ± 13.83 mg vs.32.44 ± 12.27 mg; t =6.673,P =0.011) of the ischemic stroke group were significantly higher than those of the control group.In patients with ischemic stroke,there were no significant differences in the carotid artery calcification score (335.50 ± 85.95 vs.312.73 ± 90.61; t =0.052,P =0.820),total calcified volume (357.91 ± 88.93 mm3 vs.311.71 ± 81.43 mm3; t=0.071,P=0.791),and calcium quality (59.68± 17.36 mg vs.51.29 ± 18.69 mg; t =0.071,P =0.791) between the symptomatic sides and non-symptomatic sides.Multivariate logistic regression analysis showed that the carotid artery calcification score (odds ratio [OR] 4.963,95％ confidence interval [CI] 5.932-18.994; P=0.019),total calcified volume (OR 5.967,95％ CI 3.940-14.993; P =0.015),and calcium quality (OR 6.815,95％ CI 4.703-21.946; P =0.007) were the independent risk factors for ischemic stroke.The ROC curve analysis of carotid artery calcification score showed that when it was 231.25,it had a predictive value for acute ischemic stroke.The sensitivity was 85.4％,specificity was 89.9％,positive predictive value was 87.1％,and negative predictive value was 89.1％.The area under the ROC curve was 0.891 (95％ CI 0.808-0.913; P =0.027).Conclusions Carotid artery calcification is one of the independent risk factors for ischemic stroke.Carotid artery calcification score has some predictive value for acute ischemic stroke.

Objective To report a retroperitoneal laparoscopic surgery for ureteropelvic junction obstruction (UPJO) by double renal veins.Methods A 28-year-old male patient with left low back pain for 6 months was diagnosed as left hydronephrosis and UPJO.A ureteral stent had been placed 3 months before and failed to improve hydronephrosis,so the ureteral stent was pulled out.CT scan showed that left UPJ went through the two renal veins,suggesting UPJO.Nephrogram showed that left GFR and right GFR were 35 ml/min and 34 ml/min,respectively.These results indicated mechanical obstruction of left upper urinary tract.The patient underwent retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty.Results The surgical procedure was successful.Two left renal veins were found,and the ventral one was in front of ureter,compressing the ureter.An aberrant renal artery went into left kidney with the ureter.0.5 cm stenosis of ureteropelvic junction was excised,and pyeloplasty was performed.A ureteral stent was placed into the ureter,then the pelvis and the ureter were sew up in front of the ventral renal vein.The surgical time was 240 min,and blood loss was 50 ml.Postoperative hospital stay time was 4 d.During 4 months' follow up,hydronephrosis was attenuated significantly.Conclusion Retroperitoneal laparoscopic surgery for UPJO with aberrant two renal vein might be a minimally-invasive and effective procedure.

0.01). The tumor volume and the tumor weight were also significantly decreased in the treated group (P

Objective To evaluate the efficacy of Qingkailing injection for cerebrovascular diseases by systematic review of clinical trials. Methods Meta-analysis was used to evaluate the efficacy of Qingkailing injection on cerebrovascular diseases from 38 articles on clinical trials published from 1994 to 2008 in Chinese journals with the software RevMan5.0. Sensitivity analysis was taken to analyze the results of trails with different inclusion criteria. Results 38 clinical control trails were included for efficacy analysis, a fixed effects model was chosen and the value of odds ratio (OR) was 3.26 with the 95% confidence interval from 2.71 to 3.92. Conclusions Qingkailing injection may have positive effect on cerebrovascular diseases, its efficacy need to be confirmed with high-quality randomized controlled trials.

OBJECTIVETo observe the intervention of Shenkangling Decoction (SD) on the renal injury of primary nephrotic syndrome (PNS) children patients of Shen deficiency blood stasis syndrome (SDBSS) and to explore its mechanism.

METHODSTotally 65 PNS children patients were randomly assigned to the combined group (33 cases, treated by SD +Western medicine) and the Western medicine group (32 cases, treated by Western medicine). Meanwhile, 30 healthy children were recruited as the healthy control group from the medical examination center. Those in the Western medicine group were treated with prednisone (5 mg per tablet) at the daily dose of 1.5 -2.0 mg/kg till two weeks after their urine protein turned to negative. Then the dosage was reduced once daily per every other day. The therapeutic course lasted for more than 1 year. For those with no effect of prednisone or partial effect, cyclophosphamide intravenous pulse therapy was additionally applied for 2 successive days per week, a total of 6 times, or they took cyclosporine A. Patients in the combined group additionally took SD while starting treatment of prednisone. SD was decocted in water for oral dose, once daily, taken in two portions until 2 months after prednisone was discontinued. Efficacy was evaluated based on serum levels of chemotactic factor CXCL16, disintegrin metalloproteinase 10 ( ADAM10 ), disintegrin metalloproteinase 17 (ADAM17), albumin (ALB), total cholesterol (TC), and 24-h urine protein excretion (UPE) detected by ELISA before and after treatment.

RESULTSCompared with before treatment in the same group, levels of CXCL16, ADAM10, ADAM17, TC, and 24-h UPE were significantly lower in the two treatment groups (P <0. 01). Compared with the control group, levels of CXCL16, ADAM10, ADAM17, TC, and 24-h UPE significantly increased, and the serum ALB level decreased in the two treatment groups (P <0.01). Compared with the Western medicine group at the same time point, levels of CXCL16, ADAM10, ADAM17, TC, and 24-h UPE significantly decreased in the combined group. The 1 -year recurrence rate and the recurrence times decreased in the combined group (P <0.01). The complete remission rate increased in the combined group (P <0.01).

CONCLUSIONSD could effectively improve the clinical prognosis of PNS children patients possibly by reducing the release of inflammatory mediators such as CXCL16, ADAM10, and ADAM17, decreasing UPE and the TC level, and elevating the serum ALB level.

Objective To improve differential diagnosis between acute disseminated encephalomyelitis ( ADEM) and classical multiple sclerosis ( CMS).Methods All 20 cases of ADEM and 24 cases of CMS were examined.Their epidemiological and clinical findings,laboratory features and magnetic resonance imaging ( MRI) data were analyzed using x2 test for categorical variables,Wilcoxon Rank-Sum tests for continuous variables.Results ADEM and CMS showed no sex predominance.Patients with ADEM ((27 ±15) years) were younger than CMS ((37 ±13) years,Z= -2.218,P =0.027).The following findings were more commonly seen in ADEM compared with CMS:predemyelinating infectious disease (75% vs 4%,x2 =23.652,P = 0.000),fever (65% vs 4%,x2 =18.609,P = 0.000),meningeal irritation sign (40% vs 0,x2 = 9.189,P =0.002),seizure (25% vs 0,x2 =4.514,P = 0.034),and encephalopathy.ADEM patients were more likely to present with blood leucocytosis ( (11.9 ± 5.8) ×109/L vs (8.0±3.2) ×109/L,Z= -2.030,P=0.042),high C-reactive protein (2.74 mg/L vs 0.49 mg/L,Z = - 3.028,P = 0.002),increased erythrocyte sedimentation rate (11.00 mm/h vs 7.00 mm/h,Z= -2.406,P =0.016),and cerebrospinal fluid leucocytosis (9 × 106/L vs 2×106/L,Z =- 2.781,P = 0.005).There were no differences in cerebrospinal fluid protein and oligoclonal band between the two groups.The following MRI lesions were more commonly seen in ADEM patients:cortical gray matter lesions (14/20,x2=15.213,P=0.000),basal ganglia gray matter lesions (14/20,x2 =8.910,P = 0.003),and brainstem lesions ( 14/20,x2 = 5.867,P = 0.015).In contrast,lesions in subcortical white matter (21/24,x2 = 17.628,P =0.000),periventricular area (21/24,x2 =15.213,P=0.000) and corpus callosum ( 14/24,x2 = 8.640,P = 0.003 ) were more common in the MRI image of CMS patients.The lesions in spinal cord were usually centrally distributed in ADEM (83% ),while peripherally in CMS (85%,x2 = 11.542,P = 0.001).The lesions had poorly defined margins in ADEM (95%),but well defined margins in CMS (75%,x2 =21.787,P = 0.000).Conclusion There are differences in epidemiological and clinical findings,laboratory features and MRI appearances between ADEM and CMS.

and adenovirns. The high rate of mixed viral infection brings clinical concern. ELISA combined with PCR improve the diagnostic sensitivity for norovirus, enteric adenovirns and astrovirus.

Objective To evaluate the clinical values of the TR band, analyze the factors about the hemorrhage delay at the same time. Methods Divided 98 patients who had accepted the radial artery interventional radiology into the observation group (52 cases) and the control group (46 cases) randomly. The TR band was used in the observation group and the routine nursing method was used in the control group. Results The incidence rate of complication in the observation group was significant lower than that of in the control group,P

SUMMARY Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen , and it could be an unpre-dictable and life-threatening cause during anesthesia .The main purpose of this paper is to report a case of anaphy-lactic shock during the anesthesia induction and to review the prophylaxis and treatment of anaphylactic reactions and anaphylactoid reactions during the anesthesia period .A 63-year-old man, with a mass on his adrenal , was scheduled to a laparoscopic adrenal tumor excision .During the anesthesia induction period , after administrated sul-fentanil, propofol and rocuronium , the blood pressure was decreased and the heart rate was increased .Then, the patient had rash on his whole body and developed an anaphylactic shock .After being treated with the anti-allergic agents and norepinephrine , the rash disappeared and the vital sign become stable .The patient felt nothing uncom-fortable during the two weeks ’ follow-up.Anaphylactic reactions and anaphylactoid reactions are not rare during the anesthesia period .The most common inducements are muscle relaxant , latex and antibiotics .Anaphylactic reac-tions in the perioperative period are often serious and potentially life-threatening conditions , involving multiple or-gan systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils .Before anesthesia , we should acquire the allergic history .During the anesthesia period , the vi-tal sign and the skin should be observed carefully .