Objective To investigate the effect of smoking on large arterial stiffness in patients with essential hypertensive.Methods The aortic,carotid and brachial arterial dimension,intimal-medial thickness were determined by vascular ultrasound technique.Wall cross sectional area and indices of compliance and distensibility were calculated in essential hypertensive patients with smoking(n=75) or without smoking(n=70).Results Hypertensive patients with smoking have increased wall intimal-medial thickness and wall cross sectional area in aortic,carotid and brachial arteries associated with decreased compliance and distensibility.After adjusting for the confounding effects of other variables including Age,BMI,HR,BP,PP,FPG,LDL-C and TG,covariance analysis show smoking remained as predisposed factors for vascular remodeling.Conclusion Smoking aggravates large arterial stiffness in essential hypertensive patients.

BACKGROUND:Bone marrow is the main source of mesenchymal stem cells(MSCs)at present,but its application has been limited,because of some reasons such as inconvenience of isolation,and the quantity of cells decreases with human increased age.Umbilical cord as a new source of MSCs has been widespread concerned recently.OBJECTIVE:To explore the approach of isolating and culturing MSCs from Wharton's jelly of human umbilical cord,and the methods of identifying the surface antigens and the differentiation potential.METHODS:MSCs were isolated and amplified via tissue-cultivation,and cultured by FasGrow medium.Morphology of MSCs from Wharton's jelly of human umbilical cord was observed under the optical microscope.Its immunophenotypes were detected using immunohistochemistry.The differentiation of MSCs into the osteoblasts was determined utilizing Gomori calcium-cobalt alkaline phosphatase staining,von Kossa calcium node staining,and tetracyclinefluorescence labeling.The differentiation of MSCs into the adipocytes was detected using oil red O staining.RESULTS AND CONCLUSION:MSCs were easily obtained from Wharton's jelly of human umbilical cord via the proposed approach.The primary cells grew up to 70%-80% confluence after 12-16 days of culture,and meanwhile the undifferentiated state was maintained and proliferation was stabilized after passage.The cell cycle of double increase was about 2 days,and proliferation in vitro reached twenty generation above.Surface antigen analysis showed that CD44,CD105,CD133,MHC-I were positively expressed,while CD34,CD45 were negatively expressed.Experiments of differentiation in vitro indicated that the obtained cells were capable of differentiating into fat,osteoblast and nerve-like cells.

Animal models of pulmonary artery hypertension (PAH),aiming to simulate human characteristics of the disease,have contributed extensively to understanding the pathophysiology of PAH and the investigation of experimental treatments.The classical models include monocrotaline models,chronic hypoxia model and so on,more new models were investigated in recent years.These animal models were not able to perfectly mimic human pathological characteristics of PAH because of the defect in different aspects.In this review,both typical and novel methods of PAH modeling were summarized and evaluated to provide a suitable guidance for the settlement of animal models which can meet human characteristics comprehensively.

Objective To discuss the effect of “practice teaching methods ” in musculoskeletal ultrasound diagnosis training process .Methods Thirty refresher doctors for a month with the method training .The effect training is evaluated by objective exam and questionnaire survey .Results Thirty refresher doctors received tests before and after the training .Test results showed that the accuracy after the training was significantly higher than that of before ( P<0.05 ) .Refresher doctors survey about satisfaction of the training method showed that whole satisfaction is 100%, in which 70%were very satisfied , 30%were satisfied .The self-assessment results for the improvement of the level of diagnosis musculoskeletal ultrasound showed that 45%doctors are very satisfied ,40%doctors are satis-fied, and 15%is not satisfied .Conclusions With the implementation of “teaching by practice” method, refresher doctors could master the knowledge of musculoskeletal anatomy as soon as possible , and have the ability to diagnose common musculoskeletal diseases independently .

Objective:To investigate the normal sonographic anatomic characteristics of the pectoralis major and the clinical value of ultrasound in diagnosing the extent and location of the pectoralis major tears.Methods:High frequency transducer was used in scanning the pectoralis major.The ultrasono-graphic images of 40 normal pectoralis major were obtained from 20 healthy volunteers with both sides. Longitudinal and transversal views were performed and stored.The distal tendon was identified in the transverse plane coursing superficially to the long head of the biceps brachii tendon inferior to the level of the subscapularis tendon.Eighteen cases of pectoralis major tears were analyzed retrospectively,with MRI,surgical and ultrasound follow-up results correlation respectively.Results:High-frequency ultra-sound could clearly show the anatomic orientation of the normal pectoralis major.The fibers converge was like a fan into three laminae that twisted upon each other at 90°before coalescing into a single tendon of insertion.In the study,1 8 patients of pectoralis major muscle tears [average age:(37.2 ±1 5.6)years] sustained injuries during weightlifting,basketball and impact.Three of the eighteen patients had MRI re-sults;nine had surgical correlation;six were followed by ultrasound.Eleven were injured on the left side,and 7 on the right side.Seven were involved in the distal tendon (1 in sternal head,2 in clavicular head,4 in both sternal and clavicular head),five were involved the musculotendinous junction,6 were involved muscle belly.Twelve cases were partial-thickness petoralis major tears(4 in the distal tendon, four in the muscle tendon junction,4 in the muscle belly),with the partial fiber intact,echogenicity de-creased and the internal structure disordered;6 cases (3 in the distal tendon,1 in the muscle tendon junction,2 in pectoralis major muscle belly)were completely disrupted,with fiber fracture and retrac-tion,accompanied with or without hematoma formation.Conclusion:High-frequency ultrasound can clearly show the anatomic structure of the pectoralis major.Ultrasonography can diagnose the pectoralis major tears with the extent and location of injuries,and can be used to help the clinical treatment.

OBJECTIVETo explore the effects of the simultaneous activation of liver X receptor (LXR) and peroxisome proliferator-activated receptor alpha (PPARalpha) on bile acid biosynthesis in rats.

METHODSTotally 36 male SD rats were divided into three groups with 12 rats in each group: control group, high cholesterol (HC) group, and high cholesterol + fenofibrate (HC + FENO) group. Total bile acids (serum bile acids plus fecal bile acids) level was assayed. The levels of mRNA for peroxisomal palmitoyl-CoA oxidase (Acox1), LXR, cholesterol 7alpha-hydroxylase (CYP7A1), D-bifunctional protein (DBP), trihydroxycoprostanoyl-CoA oxidase (Acox2), sterol 12alpha-hydroxylase (CYP8B1), and sterol 27-hydroxylase (CYP27A1) in liver were detected by RT-PCR.

RESULTSTotal bile acid level was significantly higher in HC + FENO group than in HC group (P < 0.01), and both were significantly higher than that in control group (P < 0.01). Compared with HC group, the mRNA expression of Acox1 and DBP was significantly higher in HC + FENO group (P < 0.01), but no statistical differences was found between HC group and control group. The mRNA levels of LXR and CYP7A1 in HC + FENO group and HC group were not significantly different but were both significantly higher than that in control group (P < 0.01, P < 0.05). No changes were observed in Acox2, CYPSB1, and CYP27A1 mRNA levels among these three groups.

CONCLUSIONSimultaneous activation of LXR and PPARalpha can increase of CYP7A1 and DBP mRNA exDression and thus accelerates the biosynthesis of bile acid.

Animals ; Bile Acids and Salts ; biosynthesis ; Cholesterol ; pharmacology ; Fenofibrate ; pharmacology ; Hypolipidemic Agents ; pharmacology ; Liver ; drug effects ; enzymology ; Liver X Receptors ; Male ; Orphan Nuclear Receptors ; agonists ; PPAR alpha ; agonists ; Rats

Objective: To observe the effects of acupoint thread-embedding therapy and low-carbohydrate diet therapy on obese patients with food addiction. Methods: Sixty-five eligible patients were randomized into a thread-embedding group of 33 cases and a diet group of 32 cases to respectively receive 12-week treatment. Before treatment, after treatment and at 6-month follow-up, the two groups were observed and compared in terms of body mass (BM), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body mass index (BMI), body fat rate (BFR), basal metabolic rate (BMR) and Yale food addiction scale version 2.0 (YFAS 2.0). Results: At the end of treatment, there were no significant differences in the general efficacy, and the improvements in BM, BMI, WC, HC, WHR and BFR between the thread-embedding group and diet group (all P>0.05). At follow-up, the thread-embedding group showed more significant improvements in all the aforementioned indicators compared with the diet group except HC (all P<0.05). At the end of treatment and follow-up, BMR and YFSA 2.0 had more significant improvements in the thread-embedding group than in the diet group (all P<0.05). Conclusion: Acupoint thread-embedding therapy can produce significant efficacy in treating obese patients with food addiction; it can improve the food addiction state and work better in maintaining the efficacy compared with low-carbohydrate diet therapy.

Objective To investigate the association between serum homocysteine (Hcy) level and oxidative stress in elderly patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods The 123 patients from January 2007 to June 2010 were recruited and divided into the elderly OSAHS group (n=55) and the non-elderly OSAHS group (n=68). One hundred healthy subjects were selected and divided into the elderly control group (n=52) and the non-elderly control group (n=48). The PSG variables were recorded and the levels of Hcy, malondialdehyde (MDA) and glutathione (GSH) were detected after sleep in all subjects. Serum Hcy level was measured by cyclophorase, MDA and GSH levels were measured by spectrophotometer. Results There were statistical differences in Hcy concentration between four groups (F=28.26, P=0.000). The Hcy concentration was higher in elderly OSAHS group than in other groups, and was higher in elderly control group than in non-elderly control group, and was higher in non-elderly OSAHS group than in non-elderly control group. There were statistical differences in MDA and GSH concentrations between the four groups (F=5.56, P=0.002;F=4.79, P=0.004). The concentrations of MDA and GSH were higher in elderly OSAHS group than in other groups. Multiple regression analysis indicated a statistically significant relationship of Hcy concentration with age, MDA, GSH and AHI (β=0.07, 0.50, 0.23 and 2.00). Conclusions The concentration of Hcy increases and oxidative stress enhances with aging, especially in the elderly patients with OSAHS. The mechanism of high level of serum Hcy in elderly patients with OSAHS may be the high oxidative stress.

OBJECTIVETo compare therapeutic effects of locking plates for the treatment of Neer 3-and 4-part proximal humerus fractures.

METHODSFrom January 2009 to June 2011, 64 patients with Neer 3-and 4-part proximal humerus fractures were treated with locked plate fixation. There were 39 patients in the 3-part group including 16 males and 23 females, with an average age of (55.12 +/- 12.52) years old; and 25 patients in the 4-part fractures group including 9 males and 16 females,with an average age of (57.92 +/- 13.14) years old. The American Shoulder and Elbow Surgeons score (ASES), visual analogue scale (VAS) and complications were documented for analysis before and after treatment.

RESULTSAll the patients had incision healing at the first stage. All the patients were followed up, and the duration ranged from 12 to 30 months, with a mean of 16.5 months. Comparably better shoulder function recovery was achieved in the 3-part fractures group with regard to the ASES (76.14 +/- 14.10 in the 3-part fractures group vs. 65.93 +/- 11.82 in the 4-part fractures group, P < 0.05). Moreover,a statistical difference (P < 0.05) was observed regarding the VAS pain score (2.12 +/- 1.63 in the 3-part fractures group vs. 3.90 +/- 2.21 in the 4-part fractures group). For the complications rate,no statistical difference was noted between 3-part fractures group and 4-part fractures group (20.51% vs. 36.00%).

CONCLUSIONThe clinical outcomes of the 3-part proximal humerus fractures is better than the 4-part fractures proximal humerus fractures treated with locking plate. Complex proximal humeral fractures treated with locking plates can be achieved a satisfactory outcome when attention is paid to anatomic reduction, stable fixation, proper screws and plate placement, and reasonable functional exercise postoperative.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

This study established a population pharmacokinetics-pharmacodynamics model of clopidogrel in patients with acute coronary syndrome. Fifty-nine patients were enrolled. The plasma concentration of clopidogrel active metabolite and vasodilator stimulated phosphoprotein platelet reactivity index (VASP-PRI) were selected as the pharmacokinetics index and the pharmacodynamics index, respectively. The covariates including demographic characteristics, laboratory indexes, combined medication, complications and genetic polymorphisms of related enzymes were screened for their influence on the pharmacokinetic and pharmacodynamics parameters. Population pharmacokinetic and pharmacodynamics data analysis was performed using NONMEM software. The general linear model and the indirectly effect model-turnover model for pharmacokinetic and pharmacodynamic analysis were selected as the basic model, respectively. The population typical values of K12, CL/F, V/F, EC50, K(in), and E(max) were 0.259 h(-1), 179 L x h(-1), 632 L, 1.57 ng x mL(-1), 4.29 and 0.664, respectively. CYP2C19 was the covariate in the final pharmacokinetic model, and the model was to design a prior dosage regimen.