Objective:To explore epidemiologic features of primary aldosteronism (PA) in northern Jiangsu and using plasma aldosterone/renin activity ratio (ARR) combined plasma aldosterone level to screen PA patients among pa-tients with hypertension .Methods:A total of 2014 inpatients and outpatients with hypertension were collected from our hospital .Radioimmunoassay was used to measure plasma levels of renin and aldosterone and blood biochemical indexes ,then ARR was calculated .PA was diagnosed when ARR>240 and aldosterone>150 pg/ml .Results:A to-tal of 239 patients (11. 87% ) were complicated with PA among the 2014 patients with hypertension ,and it occupied 23.69% (145/612) among patients with refractory hypertension .Compared with pure hypertension group ,there were significant reductions in renin activity [ (2.18 ± 2.54) ng?ml-1 ?h-1 vs .(0.68 ± 0.49) ng?ml-1 ?h-1 ] and serum potassium level [ (3.96 ± 0.45) mmol/L vs .(3.54 ± 0.45) mmol/L] ,significant rise in aldosterone level [ (132.99 ± 104.25) pg/ml vs .(272.55 ± 154.68) pg/ml] and ARR [ (118.40 ± 109.4) vs .(463.19 ± 251.85)] ,P<0.05 or <0.01 ,and significant reduction in onset age of hypertension [ (49.37 ± 9.31) years vs .(39.69 ± 7.59) years] ,P<0.01. Patients complicated with hypokalemia occupied 33.47% among PA patients ,linear correlation a-nalysis indicated that serum potassium level was correlated with aldosterone level (r= -0.706 , P=0.001) .Conclu-sion:In northern Jiangsu ,PA occupies 11.87% among patients with hypertension and it occupies 23.69% among pa-tients with refractory hypertension .Therefore ,plasma ARR should be regularly detected to screen PA patients in patients with hypertension ,especially those with refractory hypertension .

Objective To analyze the clinical and pathological characteristics of children with lupus nephritis(LN).Methods The data of 116 inpatients from Mar.2000 to Nov.2008 with LN were retrospectively analyzed.The clinical,immunochemical and pathological data were recorded.Renal tissue was observed by light microscopy and electron microscopy after HE,PAS,Masson and PASM staining according to WHO standards.Follow-up results showed complete remission,partial remission,disease activity,renal insufficiency and death.Results Of the 116 cases of LN,there were 27 male and 89 female with a ratio of male to female 1.03.3,and the mean age was(12.0?2.2) years.The incidence of nephrotic syndrome was 63.8 %(74 cases),and acute nephritis was 21.5%(25 cases).Class Ⅳ LN was the most frequent type(14 cases,50%) and classⅢ was next(25 cases,21.5%).In view of the outcome,rapidly progressive glomerulonephritis and class Ⅳ LN were the worst.LN was initially controlled in 96.5% of the patients.Relapses of LN were most caused by the intermittent treatment.Totally 32 cases showed different renal injury,and 6 cases progressed to death.Conclusions Renal biopsy is important to diagnosis,treatment and prognosis evaluation of LN.Long and regular treatment is important for children with LN.

OBJECTIVETo observe the long-term apparent and structural change of the neo-urethra inner wall reconstructed with different kinds of tissue. To compare the difference between normal and reconstructed urethra for urethra reconstruction with more appropriate materials.

METHODSThe neo-urethra inner wall was observed during operation, through urography and urethroscope. The tissue section of neo-urethra inner wall was observed through light microscope and electron microscope.

RESULTSWith unchanged structure, the appearance of neo-urethra reconstructed with skin or mucosa could be close to normal urethra after a long time. Neo-urethra made of buccal mucosa possesses some of the most important basic structures for normal urethral microenvironment to form. The structure of neo-urethra made of bladder could be close to normal urethra after a long time.

CONCLUSIONSBuccal and bladder mucosa may be a better material than skin for urethra reconstruction.

Adolescent ; Adult ; Biocompatible Materials ; Child ; Female ; Graft Survival ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tissue Culture Techniques ; Tissue Engineering ; Tissue Transplantation ; methods ; Urethra ; surgery ; Young Adult

Objective To assess the safety and efficacy of domestic sirolimus-eluting stent(SES)compared with bare metal stent(BMS)in the primary percutaneous coronary intervention(PCI)for patients with ST-segment elevation AMI in a real-world scenario.Method From January 2005 to March 2006,a total of 143 patient with ST-segment elevation AMI were enrolled in this study,and all of them underwent primary percutaneous coronary intervention(PCI).Among the 143 patients,74 were treated with domestic SESs(Firebird stent)and 69 with BMSs.The incidence of major adverse cardiovascular events(MACE:death,reinfarction,and target vessel revascularization[TVR])was evaluated at 30 days and 180 days.Continuous variables were compared using Student's unpaired t test.Categorical variables were compared using Fisher's test.Cox proportional hazard survival models were used to assess risk reduction of adverse events.P value

OBJECTIVETo assess the effect of beta blocker on blood flow velocity and reserve on the intramural coronary artery of patients with myocardial bridging.

METHODSIn 8 patients with myocardial bridge, intracoronary Doppler was performed before and after esmolol was given intravenously. The basic average peak velocity (bAPV), hyperaemic average peak velocity (hAPV) of blood flow, and coronary flow reserve (CFR) proximal and distal to the mural myocardial bridging was measured and compared.

RESULTSAfter esmolol injection, the mural coronary diameter systolic reduction decreased from (58.0 +/- 14.7)% to (26.0 +/- 9.8)% (P < 0.01); the bAPV proximal and distal to myocardial bridging separately decreased from (19.4 +/- 4.9) cm/s and (18.4 +/- 3.6) cm/s to (4.7 +/- 3.9) cm/s (P < 0.01) and (15.1 +/- 1.5) cm/s (P < 0.05). Under hyperemization, esmolol changed the hAPV of proximal and distal to myocardial bridging separately from (54.1 +/- 14.9) cm/s and (44.7 +/- 9.4) cm/s to (49.7 +/- 16.4) cm/s and (48.9 +/- 10.1) cm/s (all P > 0.05); thus, the value of CFR both proximal and distal to myocardial bridge increased separately from 2.8 +/- 0.3 and 2.5 +/- 0.5 to 3.4 +/- 0.5 and 3.2 +/- 0.6 (all P < 0.01).

CONCLUSIONEsmolol can decreased the compression of the intramural coronary artery and increased the CFR to normal level of it.

Adrenergic beta-Antagonists ; pharmacology ; therapeutic use ; Coronary Circulation ; drug effects ; physiology ; Coronary Vessels ; diagnostic imaging ; drug effects ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Bridging ; drug therapy ; physiopathology ; ultrastructure ; Propanolamines ; pharmacology ; therapeutic use ; Ultrasonography, Interventional

OBJECTIVEThis paper presents the experience in using the reverse buccinator musculomucosal flap for repairing the defect following excising inverted papilloma of the nose.

METHODSAfter the inverted papilloma of the nose was excised through an endonasal approach, the reverse buccinator musculomucosal flap supplied by the retrograde blood flow of the anterior buccal artery was harvested and sutured to the defect through the ora-nasal tunnel. The procedure was performed on three patients.

RESULTSThe postoperative course was uneventful. All the flaps survived completely.

CONCLUSIONSThe technique provides the solution to prevent nasal stricture from cicatricial contracture after excising inverted papilloma. In the operation, excising the inverted papilloma and repairing the defect was performed simultaneously, saving another operation for the secondary deformity. The technique is also applicable to the treatment of existing cicatricial stricture of the nose.

Humans ; Male ; Middle Aged ; Mouth Mucosa ; transplantation ; Nose Neoplasms ; pathology ; surgery ; Papilloma, Inverted ; pathology ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

BACKGROUNDIncomplete stent apposition (ISA) has been demonstrated to be more common after drug-eluting stent (DES) implantation than after bare metal stent (BMS) implantation. Clinical outcomes of ISA remain controversial and the predictive accuracy of previous studies was limited by the short follow-up period of only 12-18 months. In the present study, we present the outcomes of a more than 2-year follow-up in patients with ISA after DES implantation.

METHODSFrom the clinical and core intravascular ultrasound (IVUS) database of the hospital, we identified 76 patients who had undergone DES implantation in de novo lesions between January 2004 and June 2005 and had received IVUS examination at a scheduled 6-month follow-up. A total of 13 (17.1%) patients had documented ISA at the follow-up by IVUS. Clinical follow-up was available up to 41 months after DES implantation and up to 33 months after identification of ISA.

RESULTSOver a mean follow-up of (34+/-5) months (range 24-41 months), 3 of the 13 patients (23.1%) suffered from ST elevated myocardial infarction with one death. Angiography confirmed the very late stent thrombosis (ST) in the area with ISA. All the 3 patients were implanted with sirolimus eluting stents in left anterior descending artery (LAD) and the very late ST occurred at 29, 31 and 32 months after DES implantation, and separately at 20, 23 and 23 months after the identification of ISA. All of the 3 patients had antiplatelet therapy continued before suffering from ST, and had been apparently stable on antiplatelet monotherapy with aspirin for a long period following dual antiplatelet therapy with aspirin and clopidogrel for more than 12 months.

CONCLUSIONISA of DES may be associated with a high incidence of very late stent thrombosis, even in clinically stable patients with dual antiplatelet therapy of at least 12 months after the procedure.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Drug-Eluting Stents ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Thrombosis ; etiology ; Ultrasonography, Interventional

AIMTo investigate the chemical constituents of the bulbs of Fritillaria wabuensia.

METHODSChromatography techniques were used to isolate the chemical constituents. EI-MS, 1HNMR, 13 CNMR and DEPT were used to determine the structures of the isolated constituents.

RESULTSThree alkaloids were isolated from the bulbs of Fritillaria wabuensia, and were identified as imperialine (I), imperialine-beta-N-oxside (II), isoverticine-beta-N-oxide (III).

CONCLUSIONIsoverticine-beta-N-oxide was isolated from the bulbs of Fritillaria wabuensia for the first time. Isoverticine-beta-N-oxide is a new alkaloid.

Cevanes ; chemistry ; isolation & purification ; Cyclic N-Oxides ; chemistry ; isolation & purification ; Fritillaria ; chemistry ; Molecular Structure ; Plants, Medicinal ; chemistry ; Triterpenes ; chemistry ; isolation & purification

Objective To examine whether androgen deprivation therapy (ADT) is associated with increased risk of diabetes in men with prostate cancer (Pca).Methods The study data were systematically searched from Medline,Embase,and Cochrane Library Central Register.Studies comparing ADT vs control aimed at treating Pca,reporting diabetes as outcome were included.Results Eight studies met inclusion criteria with a total of 65 695 ADT users and 91 893 non-ADT users investigating the relationship between ADT and diabetes.The incidence of diabetes was 39％ higher in ADT groups,and significant association was observed in overall analysis [RR =1.39,95％CI(1.27-1.53),P ＜ 0.01].In subgroup-analyses stratified by ADT types,diabetes was found to be significantly associated with gonadotropin-releasing hormone (GnRH) alone [RR =1.45,95％CI(1.36-1.54),P ＜ 0.01),GnRH plus oral anti-androgen (AA) [RR =1.40,95％CI(1.01-1.93),P ＜ 0.01] and Orchiectomy [RR =1.34,95％CI(1.20-1.50),P ＜ 0.01],but not with AA alone [RR =1.33,95％CI(0.75-2.36),P =0.33].Conclusions ADT,especially GnRH alone,GnRH plus AA and orchiectomy can increase the incidence of diabetes in patients with Pca.

OBJECTIVETo investigate the middle and distal circum peeling with bleeding control technique for redundant prepuce.

METHODSThe middle and distal part of prepuce was circum peeled with bleeding control and electrical scalpel. More preputial inner plate was reserved.

RESULTSFrom January 2004 to July 2008, 51 patients with redundant prepuce were treated with this procedure. The average blood loss was 1 to approximately 2 ml with minimal edema. The proportion of inner and outer plates was suitable.

CONCLUSIONSThis technique has the advantages of minimal blood loss and slight edema. The cosmetic result is also satisfactory.

Adolescent ; Adult ; Blood Loss, Surgical ; prevention & control ; Child ; Child, Preschool ; Circumcision, Male ; methods ; Humans ; Male ; Middle Aged ; Premedication ; Young Adult