Objective The aim of this article is to discuss the relation between serum uric acid and prehypertension, and to evaluate the influence of age, obesity, fasting plasma glucose (FPG) and lipids in Chinese adults. Methods All the 14 451 non-hypertensive samples were analyzed for blood pressure, body mass index (BMI), FPG, lipids and serum uric acid. Results The serum uric acid levels were stratified by quintiles, after adjustment for relevant factors, OR values of prehypertcnsion increased with the elevated uric acid levels. Serum uric acid level was 200-380 μmol/L, it had a linear relationship with the risk of prehypertension, 200 μmol/L as a turning point for this linear relationship, FPG could affect their correlation (P ＜ 0.0001 ). Conclusions Serum uric acid was associated with prehypertension, independent of metabolic risk factors. The associations were not significant in old individuals. FPG may modify the associations.

The interactions between genetic variations and dietary factors in type 2 diabetes mellitus have attracted some attention. Several studies revealed that dietary carbohydrate quality and quantity and increased dietary fat intake might interact with genetic variations of type 2 diabetes mellitus and increase risk of this disease. Genome-wide association studies suggest that genetic variance may modulate the association between dietary pattern and type 2 diabetes mellitus.

Objective:To investigate the antitumor effect of CpG-ODN combining non-replicating recombinant vaccinia virus in tumor immunotherapy.Methods: CpG-ODN and constructed vaccinia virus v△11?75 were combined to study the antitumor effects in the walker′s rat tumor model.Results: Recombinant vaccinia virus v△11?75 lost the replicating capacity on human cell line,143TK - cell.The genes between HindⅢ C & K fragment of vaccinia virus TianTan strain were deleted,verified with Southern-blot. In the Walker′s tumor model of Wistar rats,Combinational immunotherapy with CpG-ODN and non-replicating vaccinia virus-modified WRC256 oncolysates resulted in prolonged life span and reduced tumor hyperplasia. Conclusion: CpG-ODN can enhance the antitumor effects of non-replicating vaccinia virus-modified oncolysates,providing a new route of tumor therapy.

OBJECTIVETo investigate the clinicopathological characteristics, diagnosis and treatment of primary testicular yolk sac tumor (YST).

METHODSWe studied 8 cases of primary testicular YST by microscopy and immunohistochemistry.

RESULTSThe 8 cases of primary testicular YST, including 2 consultation cases, were confirmed from 1998 to 2013, accounting for 10.7% (8/75) of all the testicular germ cell tumors diagnosed in our hospital. The patients ranged in age from 7 to 43 years, 23.9 years on average. The main clinical manifestation of the patients was painless unilateral testis swelling. Microscopically, reticular tissues, schiller-duvaI (S-D) bodies, and eosin-stain transparent bodies were seen in the tumors. One of the cases was confirmed to be simple YST, while the other 7 mixed YST. AFP was a characteristic immunophenotype marker of the tumors.

CONCLUSIONPrimary testicular YST is a rare malignancyr with poor prognosis. Its diagnosis depends on preoperative AFP test and postoperative pathology. Comprehensive treatment, including orchiectomy, chemotherapy, and radiotherapy, can prolong the survival of the patients.

Adolescent ; Adult ; Child ; Endodermal Sinus Tumor ; metabolism ; pathology ; therapy ; Humans ; Immunohistochemistry ; Male ; Neoplasms, Germ Cell and Embryonal ; metabolism ; pathology ; therapy ; Orchiectomy ; Rare Diseases ; metabolism ; pathology ; therapy ; Testicular Neoplasms ; metabolism ; pathology ; therapy ; Young Adult

Objective To evaluate the efficacy of tibial bone-skin flap grafts in the management of se- vere traumatic osteomyelitis complicated with bone and skin defect in leg to avoid amputation.Methods From March 1998 to Aug.2004,12 cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap graft.The longest flap was 17cm,widethest 10cm, The longest bone flap was 12cm.They were followed up for 0.6 to 5 years.Results All the tibial bone-skin flaps survived completely,2 cases of osteomyelitis recurred.The followed-up,from 0.5 to five years,showed good bone union in all cases,averageing 15 weeks.The infection was under control.The leg function and con- tour were satisfactory.Conclusion The tibial bone-skin flap has the advantages of having distinguished sign of anatomy,highly vascularized,easy to obtain,simply and flexible procedure,improving circulation,short- ens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.

Objective To explore the anatomical characteristic of the third palmar interosseous mus- cle as well its dominate nerve,and to investigate the anatomical basis of difficult recovery of digitus minimus adduction.Methods Twenty aduh fresh hands without deformity and trauma were obtained.Dissect and observe the third palmar interosseous muscle and its dominate nerve and adjacent structure under surgical mi- croseope,measure the size of the third pahnar interosseous muscle and its dominate nerve,the data were pro- cessed by stastistics method.Results Among palmar interosseous muscles and its dominate nerves,the third palmar interosseous muscle and its dominate nerve is the smallest.There are conspicuous tendon bundle on the surface of the third palmar interosseous muscle partly,which have a potential compression on the third palmar interosseous muscle dominting nerve.Conclusion The third palmar interosseous muscle is the smal- lest among palmar interusseous muscles and it is the only digitus minimus adduction muscle.The sominating nerve of the third palmar interosseous muscle is small anti the tendon bundle of the third palmar interosseous muscle have a potential compression.All these can cast light on diffcult recovery of digitus minimus adduction.

Objective To investigate the risk factors and outcomes of acute kidney injury (AKI) in patients after intra--coronary stent implantation.Methods A retrospective and case control study was done with data analysis in 325 patients who underwent intra-coronary stent implantation from January 2010 to March 2011.The patients were divided into two groups as per the criteria of AKI identified on the 7th day after implantation of stent.The variables to be studied included:(1) age,gender,hypertension,diabetes,cerebrovascular disease,left ventricular insufficiency,peripheral angiopathy,creatinine,urea nitrogen,estimated glomerular filtration rate,hyperuricemia,proteinuria,emergency operation,hydration,and medication (ACEI/ARB,statins) before operation; (2) dose of contrast media,operation time,hypotension during intra-operative period; and (3) postoperative:hypotension.The variables were analyzed with the process of One-way ANOVA and multivariate Logistical regression analysis.Consequently,the independent risk factors of AKI in patients after intra-coronary stent implantation could be found.Further,the prognosis of AKI patients was analyzed.Results Of the 325 patients,51 (15.7％) developed AKI.Compared the normal group,hospital stay (P ＜ 0.01 ) and in-hospital mortality (P ＜ 0.05) increased significantly in the AKI group.Monofactorial analysis showed that age,pre-operative laboratory and clinical data including left ventricular insufficiency,peripheral angiopathy,creatinine,urea nitrogen,estimated glomerular filtration rate, hyperuricemia, proteinuria, hydration and emergency operation, and intraoperative information such as operation time and hypotension,and postoperative hypotension in AKI patients group were significantly different in comparison with control group ( P ＜ 0.05 ). Multivariate logistic regression analysis revealed that elderly age (OR =0.253),pre-operative proteinuria (OR =5.351 ),preoperative left ventricular insufficiency ( OR =8.704),eGFR ≤ 60 ml/ ( min · 1.73 m2 ) ( OR =6.677 ),prolonged operation time ( OR =1.017),intra-operative hypotension ( OR =25.245 ) were independent risk factors of AKI ( P ＜ 0.05 ).Conclusions AKI is a common complication and associated with increase in mortality after intra-coronary stent implantation.Increase in age,pre-operative proteinuria,pre-operative left ventricular insufficiency,pre-operative low estimated glomerular filtration rate,prolonged operation time,intra-operative hypotension are the independently risk factors associated with AKI.

ObjectiveTo investigate the prognostic value of fluid responsiveness in patients with acute respiratory stress syndrome (ARDS).Methods Fifty-nine mechanically ventilated patients with ARDS were enrolled.Their stroke volume variations (SVV) were detected by pulse contour continuous cardiac output (PiCCO) analysis device,and then the patients were subsequently divided into fluid responsive group (SVV≥15％) and fluid non-responsive group (SVV ＜ 15％ ).The differences in 28-day survival,length of ICU stay and duration of mechanical ventilation between the 2 groups were compared.Thereafter,the 28-day survival of patients was analyzed by Kaplain-Meier survival model and the relationship between SVV and mortality within 28 days was analyzed by logistic regression model.Results In comparison with fluid non-responsive group,the 28-day survival of fluid responsive group was significantly increased (85.3％ vs.56.0％,P =0.012),the length of ICU stay was significantly shortened [( 13.1 ±5.2 ) d vs. (21.6±9.0) d,P=0.008],and the duration of mechanical ventilation was significantly shortened as well [( 11.4 ± 5.3 ) d vs.( 18.3 ± 4.9) d,P =0.022] ; Logistic analysis revealed that SVV ＜ 15％ increased the risk of 28-day mortality ( OR =4.82 ; 95％ CI:2.67 ～ 11.71,P =0.009 ).ConclusionsSVV-based fluid responsiveness can be served as a prognostic predictor for ventilated patients with ARDS.

ObjectiveTo observe the expressions of PPAR-γ protein during the course of pancreatic fibrosis of chronic pancreatitis (CP) in Wistar rats and its significance.Methods Bibutyltin dichloride ( DBTC,8 mg/kg body weight) in a volume of 200 ml solvent was injected into the tail vein to establish the CP rat's model.Wistar rats were randomly divided into control group and 1,3,5,7,14,42 d group according to weights.Pancreatic tissue underwent routine pathological examination,and collagen accumulation in pancreatic sections was determined by staining for Sirius Red.Pancreatic myeloperoxidase (MPO)activity was determined.Expressions of α-SMA and PPAR-γ proteins were assessed by immunohistochemical method.Results Light microscopy showed signs of acute pancreatitis with interstitial edema and infiltration of neutrophilic granulocytes 7 d after DBTC injection.Acinar cells necrosis,atrophy,lymphocytes and monocytes infiltration,fibrosis within lobule and peri-lobule as well as pancreatic duct changes were found,which was in accord with the course from AP to CP.One days after induction,the activity of MPO,expressions of α-SMA was significantly increased[ (0.78 ±0.71) vs (0.15 ±0.05)U/g,6.67 ±3.14 vs 0,P＜0.05],then it did not increase with time of induction.Seven days after induction,collagen level reached the peak [ (45.42 ±15.99)％ ],which was significantly higher than that in control group [ (10.87 ± 2.28 )％,P ＜ 0.05 ].Collagen fibers accumulated from periductal to intra-acinar and/or inter-acinar areas.In control rats,the expression of PPAR-γ protein was positive only in vessel walls,and the expression level was 0.17±0.41 and increased with time of induction,then reached the peak of 4.83 ± 2.71 at 42 d.ConclusionsDuring the course of pancreatic fibrosis in rats,the expression of PPAR-γ protein is gradually increased,and plays a limited anti-inflammation and anti-fibrosis role.

Objective To investigate and compare the effect and safety of levocetirizine and cetirizine for the treatment of chronic idiopathetic urticaria (CIU). Methods A multi-center, randomized and double-blind comparative clinical trial was employed. The patients with CIU were divided into levocetirizine group and cetirizine group. Levocetirizine (5mg/day) or cetirizine (10mg/day) were taken once daily for 28 days, and were followed up on the 7th day, 14th day and 28th day after starting treatment. Results One hundred and thirty cases were evaluable for the effect and safety at the end of the study. The effective rates in levocetirizine group and in cetirizine group were 73.44% and 77.27% on the 7th day after treatment, 82.81% and 81.82% on the 14th day, and 89.06% and 81.82% at the end of the therapy respectively. There was no significant difference between the two groups. The drug adverse reaction for levocetirizine group and cetirizine group were 14.06% and 18.18% respectively, which include mouth dryness, dizziness etc. Conclusion Levocetirizine is an effective and safe agent for the treatment of CIU.