Controlling serum phosphorus levels is critical in patients with renal failure. Currently phosphate-binding agents are widely used to reduce phosphate absorption in patients with end-stage renal disease. If possible, serum phosphorus level should be reduced without disturbing calcium homeostasis or increasing accumulation of potentially toxic elements. Aluminum hydroxide and traditional calcium-based phosphate binders are commonly used to control serum phosphorus level. Aluminum hydroxide can effectively lower serum phosphorus level, but aluminum can accumulates in the body and results in toxic effect. Traditional calcium-based phosphate binders tend to promote hypercalcemia and calcium overloading, and accelerate cardiovascular calcification. Therefore aluminum-free and calcium-free phosphate-binding agents have become the focus of study; however, agents like sevelamer hydrochloride and lanthanum carbonate are not widely used due to high price, although they are effective in controlling serum phosphorus level. New generation of phosphate binders, such as colestilan, nicotinic acid and magnesium salt, are cheaper than their previous counterparts, but their long-term effect still needs to be observed. This article summarizes the progress of non-calcium phosphate binders in treatment of end-stage renal diseases, hoping to help clinical drug usage.

Objective To evaluate safety and efficacy of a fractional microneedle radiofrequency device in the treatment of axillary osmidrosis.Methods A total of 24 patients with moderate to severe axillary osmidrosis were enrolled from Department of Dermatology of Peking Union Medical College Hospital between June 2015 and June 2016,and treated with the Body TiteTM fractional microneedle radiofrequency device for 1 session.Visual analogue scale (VAS) was used to evaluate the intensity of axillary odor in patients,36-item short-form health survey (SF-36) to assess health-related quality of life (HRQoL),and axillary skin tissues were resected for histopathological examination before and after the treatment.Results VAS showed that 22 of 24 patients achieved persistent remission for more than 12 weeks,and rates of decrease in odor score ranged from 50％ to 100％.However,1 patient experienced recurrence at 12 weeks after the treatment,and another 1 patient did not achieve clinical remission.SF-36 revealed that scores of social functioning (SF),role-emotional (RE) and mental health (MH) scales were all significantly increased after the treatment [M (P0-P100):100.00 (62.00-112.50),100.00 (33.30-110.00),68.00 (48.00-80.00),respectively] compared with those before the treatment [77.50 (62.50-100.00),66.67 (33.30-100.00),55.00 (48.88-72.00),respectively,all P ＜ 0.05].Histopathological examination showed obvious degeneration and necrosis of sweat gland cells in 22 cases,and epidermal damages in 2 patients after the treatment.Unilateral upper-limb pain occurred in 1 case,and small-area burn-like skin changes were observed in 2 cases after the treatment.The postoperative recovery time ranged from 7 to 14 days.Conclusion The fractional microneedle radiofrequency device has shown high clinical response rate,good safety,and favorable application prospects in the treatment of axillary osmidrosis.

Microscopy, Electron, Transmission ; methods ; Negative Staining ; methods ; Viruses ; ultrastructure

Objective To describe common dermoscopic features of primary cutaneous amyloidosis (PCA),and to explore the application value of dermoscopy in assisting the diagnosis of PCA.Methods Seventeen patients with PCA were collected from Department of Dermatology of Peking Union Medical College Hospital between April 2014 and December 2016.A total of 45 skin lesions were subjected to dermoscopy,and their dermoscopic features were analyzed.Results The common dermoscopic features of PCA included central hubs,which could be white,brown or scar-like areas,various pigment structures and shiny white streaks.Dermoscopy showed that central hubs could be observed in all the lesions (100％),while white center hubs alone were observed in 14 (31％) lichenoid lesions,both white center hubs and scar -like areas in 5 (11％) lichenoid lesions,brown center hubs alone in 8 (18％) macular lesions,both white and brown center hubs in 6 (13％) lichenoid lesions and 17 (38％) macular lesions.All the lesions showed various pigment structures.Shiny white streaks were observed in 4 (9％) lichenoid lesions.Conclusion Dermoscopy has good application value in assisting the diagnosis of PCA.

Objective To compare and evaluate fractional flow reserve (FFR) by intravenous infusion of adenosine 5’-triphosphate (ATP) through femoral veins and hand dosal veins. To find the feasibility of measuring FFR through ATP infusion at hand dosal veins. Methods A total of 27 patients receiving coronary angiography (CAG) were enrolled. FFR was measured by intravenous injection of ATP through femoral veins and hand dosal veins separately in 31 stenosed coronary arteries. Results A linear correlation between ATP infusion measuring FFR through femoral and hand dosal veins was observed. Heart rates, PR intervals and side effects were of no difference between the 2 routes of ATP infusion (P=0.79, P=0.56, P=0.85). It indicated that ATP infusion[160μg/(kg·min)]measuring FFR through hand dosal veins was compatable to which measuring FFR though femoral veins (y=0.945x+0.0043, R2=0.904, P=0.001). Compared with ATP infusion by femoral vein[from (53.7±15.8) s to (58.2±11.6) s], the time to FFR by infusion ATP measurement by hand dosal veins was longer[(48.7±17.9) s, P=0.015]. Conclusions The FFR measurement through ATP infusion at hand dosal veins has similar results with the FFR measured by femoral veins ATP infusion.

Objective To identify the effect of both high glucose and high insulin on miR-145 level.Methods The human vascular smooth muscle cells ( VSMCs) were cultured and the proliferation of VSMCs was induced by high glucose and high insulin medium.The samples were divided into 4 groups: normal group, high glu-cose group (25 mmol/L), high insulin group (300 mU/L), high glucose and high insulin group.The ex-pression of miR-145 in VSMCs was assayed by real-time PCR.Proliferation of VSMCs was determined by MTT method After 72 h cultivation.The migration of VSMCs was analyzed by cell scratch test .VSMCs in each group was transfected by miR-145 virus ( lentiviral vector ) .Proliferation and migration were assayed after 48 h transfection.Results The expression of miR-145 in VSMCs of other three groups was decreased ( P<0.05 ) , especially the expression in the high glucose and insulin group was the lowest ( P<0.01 ) .Prolifera-tion and migration of VSMCs was promoted by high glucose and/or high insulin medium.Under fluorescent, transfection rate of VSMCs was about 80%after 48 h transfection.Proliferation and migration of VSMCs in each group after transfection were significantly lower than before ( P<0.05 ) .Conclusions High glucose and high in-sulin could decrease the expression of miR-145 in VSMCs, The overexpression of miR-145 may inhibit the prolif-eration and migration of VSMCs .

Objective:To analyze the correlation between preoperative parametres and positive surgical margin after robot-assisted laparoscopic radical prostatectomy.Method:From October 2014 to January 2019, the clinical data of 310 patients who underwent robot-assisted laparoscopic radical prostatectomy(RARP) by single surgeon were collected retrospectively. The median age, PSA, f/t PSA and PSAD was 68(62-72)years, 26(13-63) ng/ ml, 0.12 (0.07-0.18) and 0.36(0.20-0.75) ng/ml 2, respectively. There were 115 cases with clinical T 1, 100 with clinical T 2, 41 with clinical T 3, and 15 with clinical T 4. Based on the MRI or ultrasound examination, the median value for the transverse diameter, anteroposterior diameter, vertical diameter, and volume of the prostate is 44(35-50)mm, 45(40-51)mm, 41(36-50)mm, and 76(54-118)ml, respectively. In this study, 84(27%)cases were diagnosed pathologically by transurethral resection of the prostate, and 226(73%)cases by prostate biopsy. The biopsy technique was transrectal ultrasound-guided systematic 12-point biopsy, and additional 1-5 needles were performed in regions with abnormal ultrasound echoes. The median for total number of puncture needles, number and percentages of positive needles were 12(12-13), 9(4-12)and 85%(35%-100%), respectively. Of all the patients, there were 61 cases with Gleason score≤6, 95 with Gleason score=7 and 84 with Gleason score≥8. There were 237(76%)patients undergoing neoadjuvant endocrine therapy. The patients were divided into the negative surgical margin group and positive surgical margin group. The correlation between positive surgical margin and general clinical data, PSA derivates, prostate size (transversal diameter, anteroposterior diameter, vertical diameter, and prostate volume), percentage of positive biopsy cores, Gleason score, method of pathological diagnosis, and endocrine therapy were analyzed. Results:Of all the 310 enrolled patients, the overall positive surgical margin rate was 34.2%(106/310). Univariate analysis showed that tPSA(41.3 ng/ml vs.24.8ng/ml, P=0.029), f/tPSA(0.14 vs.0.10, P=0.004), transversal diameter of prostate(46 mm vs.38mm, P=0.049), percentage of positive biopsy cores(100% vs.58%, P=0.001), and biopsy Gleason score(Gleason score≤6, =7 and ≥8: 14, 31 and 32 cases vs. 47, 64 and 42 cases, P<0.05)exhibited significant correlation with postoperative positive surgical margin. Multivariate analysis showed that transversal diameter of prostate( P=0.026) and percentage of positive biopsy cores( P=0.048) were independent risk factors for positive surgical margin. Conclusions:Transversal diameter of prostate and percentage of positive biopsy cores were independent risk factors, which help to predict the occurrence of postoperative positive surgical margin.

OBJECTIVETo explore the role and mechanisms of FOXO3a nuclear translocation in neuronal apoptosis after hypoxia-ischemia (HI).

METHODSOne hundred and sixty 10-day-old Sprague-Dawly rats were randomly divided into two groups: HI and sham-operated. The right common carotid artery was ligated followed by hypoxia exposure for 2.5 hours in the HI group. The sham-operated group rats were not subjected to carotid artery ligation or hypoxia treatment. Rat cerebral cortex was collected at 0.5, 2, 4, 8 and 24 hours after hypoxia. Western blot was used to detect expression of total FOXO3a protein, pnuclear and cytoplasmic FOXO3a and Bim. TUNEL staining was used to detect apoptotic cells.

RESULTSThe nuclear protein of FOXO3a obviously increased from 0.5 to 24 hours after HI in a time-dependent manner compared with the sham-operated group (P<0.01). On the contrary, cytoplasmic protein evidently decreased from 0.5 to 24 hours in the HI group compared with the sham-operated group (P<0.01). Bim protein increased from 0.5 hour, peaked at 2 hours, started to decline at 4 hours (P<0.01), and returned to baseline level at 8 and 24 hours after HI in the HI group compared with the sham-operated group. TUNEL positive cells started to express at 4 hours, and peaked at 24 hours after HI (P<0.01). However, TUNEL positive cells were rarely found in the sham-operated group.

CONCLUSIONSHI induces FOXO3a translocation from cytoplasm to nucleus, and enhances protein expression of its target gene Bim in the neonatal rat brain. The upregulation of Bim expression might be related to neuronal apoptosis.

Animals ; Animals, Newborn ; Apoptosis ; Apoptosis Regulatory Proteins ; analysis ; Bcl-2-Like Protein 11 ; Female ; Forkhead Box Protein O3 ; Forkhead Transcription Factors ; genetics ; physiology ; Hypoxia-Ischemia, Brain ; pathology ; Male ; Membrane Proteins ; analysis ; Neurons ; pathology ; Proto-Oncogene Proteins ; analysis ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the effect of S-adenosyl-L-methionine (SAMe) on vascular smooth muscle cells (VSMCs) proliferation and migration and neointima formation in rat carotid artery balloon injury model.

METHODSRat VSMCs were divided into control group, TNF-α (10 ng/ml) group, SAMe (0.2 mmol/L) group and TNF-α + SAMe group. VSMC migration distance and proliferation were examined by cell scrape tests and MTT method. NF-κB activity was analyzed by EMSA. PDGF mRNA expression was detected by Northern blot. SD rat were divided into control group, carotid balloon injury group treated with saline or SAMe (15 mg×kg(-1)×d(-1) for 14 d), then blood vessel proliferation was observed histologically in rat carotid artery.

RESULTS(1) In vitro, the VSMCs migration distance, absorbance at 490 nm, PDGF mRNA expression, NF-κB activity were all increased in TNF-α group compared to the control group (P < 0.01), and decreased in TNF-α + SAMe group compared to the TNF-α group (P < 0.01). (2) In the balloon injury in vivo models, the intima area of saline group and SAMe group was increased compared to the control group, while the lumen area was larger and the intima area was smaller in the SAMe group than in the saline group (all P < 0.05).

CONCLUSIONSAMe could reduce TNF-α induced VSMC proliferation and migration possibly through inhibiting NF-κB activity and downregulating PDGF gene expression.

Animals ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Male ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Myocytes, Smooth Muscle ; drug effects ; metabolism ; NF-kappa B ; metabolism ; Platelet-Derived Growth Factor ; genetics ; Rats ; Rats, Sprague-Dawley ; S-Adenosylmethionine ; pharmacology ; Tumor Necrosis Factor-alpha ; pharmacology ; Tunica Intima ; drug effects

AIMTo study the effects of tacrine on IK and IA potassium current in primary cultured rat hippocampal neurons.

METHODSWhole cell patch clamp and primary rat hippocampal neuron cultures were used.

RESULTSTacrine was shown to reduce the amplitude of IK and IA, in concentration-dependent manners. The IC50s at +40 mV for reduction of IK and IA were 23 and 52.6 mumol.L-1, respectively. Tacrine (30 mumol.L-1) shifted the steady state activation of IK and IA to negative potentials by 12 and 15 mV, respectively. The V1/2 of activation curves for IK current before and after the application of tacrine were (6.7 +/- 1.4) mV and (-5.4 +/- 1.3) mV, respectively. The k of activation curves for IK current was 13.4 + 1.3 and 12.5 + 1.4 without and with tacrine, respectively. The V1/2 of activation curve for IA current were (-9.9 +/- 2.6) mV and (-24 +/- 5) mV in the absence and presence of tacrine, respectively, and the k value was not changed.

CONCLUSIONTacrine inhibited IK and IA currents in rat hippocampal neurons and it is more potent for blocking IK.

Animals ; Animals, Newborn ; Cells, Cultured ; Cholinesterase Inhibitors ; pharmacology ; Female ; Hippocampus ; cytology ; physiology ; Male ; Neurons ; cytology ; physiology ; Patch-Clamp Techniques ; Potassium Channels ; drug effects ; Potassium Channels, Inwardly Rectifying ; drug effects ; Rats ; Rats, Wistar ; Tacrine ; pharmacology