OBJECTIVE:To observe therapeutic efficacy and safety of amlodipine besylate combined with valsartan in the treatment of hypertension. METHODS:158 patients with hypertension were randomly divided into control group (n=78) and treatment group (n=80). Control group was treated with amlodipine besylate,2.5 mg/time,3 times/d;treatment group was addi-tionally treated with valsartan,80 mg/time,once a day. A treatment course lasted for 4 weeks,and both received 5 courses. Clini-cal efficacy,blood pressure,plasma concentrations of ET-1,NT-proBNP and Ang Ⅱ were compared between 2 groups. RE-SULTS:The compliance rates of treatment group after 4,8,12,16,20 weeks were higher than that of the control group(P<0.05). Compared with control group,SBP and DBP of treatment group were decreased significantly after 4,8,12 and 20 weeks,with sta-tistical significance(P<0.05). After 20 weeks,the serum levels of ET-1,NT-proBNP and Ang Ⅱwere decreased significantly,es-pecially treatment group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR be-tween 2 groups (P>0.05). CONCLUSIONS:Amlodipine besylate combined with valsartan can effectively control the blood pres-sure in patients with hypertension,which may be related to the inhibition of ET-1,NT-proBNP and AngⅡ.

OBJECTIVE: To discuss the efficacy and safety of simultaneous bilateral endoscopic surgery (SBES) for bilateral upper urinary tract calculi, and to summarize the initial experience. METHODS: Patients diagnosed with bilateral upper urinary tract calculi who underwent SBES in the Department of Urology, Beijing Chao-Yang Hospital from January 2019 to January 2020 were enrolled retrospectively. The demographic and clinical data of the patients were recorded, and the operation status, stone free rate (SFR) and peri-operative complications were analyzed. The primary end point was SFR, and second end point was peri-operative complications. RESULTS: A total of 23 patients underwent SBES, of which SBES was completed in 19 patients (12 males, and 7 females). The mean age was (41.3±12.0) years. Fourteen patients underwent modified supine position surgery and 4 patients in prone split-leg position. There was no statistical difference in the demographic and baseline clinical data of the patients in different positions. One patient underwent right percutaneous nephrolithotomy (PCNL) and left endoscopic combined intra-renal surgery (ECIRS) in the prone split-leg position, while 18 patients received simul-taneous surgery with PCNL and contralateral retrograde intra-renal surgery (RIRS). The mean anesthesia and operation time was (128.7±26.5) min and (70.7±20.3) min, respectively, which was significantly longer in the patients with prone split-leg position than in the patients with modified supine position, anesthesia time in the patients with prone split-leg position and modified supine position: (148.4±20.4) min vs. (121.6±25.3) min, respectively, t=－2.121, P=0.049, while the operation time in the patients with prone split-leg position and modified supine position: (86.4±21.1) min vs. (65.1±17.4) min, respectively, t=－2.222, P=0.040. There was no significant difference between the two groups in indwelling of nephrostomy [prone split-leg position and modified supine position: (2.6±0.9) d vs. (2.1±1.0) d, respectively; t=－0.880, P=0.391] and the length of hospital stay [prone split-leg position and modified supine position: (6.0±2.7) d vs. (5.2±1.8) d, respectively; t=－0.731, P=0.475]. One month after the operation, the SFR was 78.9%, and 3 patients had minor peri-operative complications (Clavien-Dindo grades Ⅰ/Ⅱ) without any serious complications (Clavien-Dindo grades Ⅲ/Ⅳ/Ⅴ). CONCLUSION The simultaneous bilateral endoscopic surgery would decrease the operation time and anesthesia exposure under the premise of ensuring the SFR, which is helpful to reduce the risk of peri-operative complications, especially to the patients who can not tolerate the second-stage or long-time operation.
Adult ; Calcinosis/surgery* ; Endoscopy ; Female ; Humans ; Kidney Calculi ; Male ; Middle Aged ; Nephrolithotomy, Percutaneous ; Nephrostomy, Percutaneous ; Retrospective Studies ; Treatment Outcome ; Urologic Diseases/surgery*

OBJECTIVE: To compare the outcomes of endoscopic combined ultrasound-guided access (EUGA) with the conventional ultrasound-guided access (UGA) to achieve percutaneous renal access in endoscopic combined intrarenal surgery (ECIRS). METHODS: A retrospective review of 53 patients undergoing ECIRS to treat upper urinary tract calculi between January 2017 and October 2019 was con-ducted. All of the cases were of complex upper urinary tract stones larger than 2 cm in diameter. The com-plex stone situations, such as multiple renal calyces calculi or staghorn calculi necessitated ECIRS. Under general anesthesia, the patients were placed in the galdakao-modified supine valdivia (GMSV) position, thus allowing both antegrade and retrograde accesss. The patients were divided to UGA and EUGA groups according to the protocol of achieving percutaneous renal access. In 28 cases, endoscopic combined ultrasound-guided accesss were obtained. Puncture and dilation were performed under direct flexible ureteroscopic visualization, while percutaneous renal access of 25 cases were performed with the conventional technique employing ultrasound guidance. Demographic and perioperative information, such as stone burden, presence of hydronephrosis and number of calyces involved was compared. Primary outcomes included total operative time, renal access time, repeat puncture, hemoglobin level, perioperative complications, and stone-free rate. RESULTS: No major intra-operative complication was recorded in all the 53 ECRIS. No significant difference was observed between the groups in age and gender. There was no significant difference in body mass index[BMI (29.21±3.14) kg/m² vs.(28.53±2.56) kg/m²], stone burden (37.68±6.89) mm vs. (35.53±6.52) mm, number of calyces involved 2.72±0.68 vs. 2.86±0.71, presence of hydronephrosis (56.0% vs. 46.4%), total operative time (93.0±12.2) min vs. (96.8±14.2) min, hemoglobin level reduction (6.56±2.16) g/L vs. 97.54±2.64) g/L, stone-free rate (92.0% vs. 92.8%), hospital stay (5.52±0.59) d vs. (5.64±0.62) d, perioperative complication rate (8.0% vs. 7.2%). Two patients in EUGA group experienced perioperative complications (one urinary tract infection and one hematuria) while two patients in UGA group experienced perioperative urinary tract infection. None in both groups received blood transfusion. The patients undergoing EUGA had shorter renal access time [(4.0±0.7) min vs. (6.8±2.6) min, P < 0.01] and less repeat puncture (0 vs. 4 cases, P < 0.05). CONCLUSION EUGA is an optimal technique to establish percutaneous renal access in ECIRS, which minimizes access time and repeated procedures.
Humans ; Kidney Calculi ; Nephrostomy, Percutaneous ; Retrospective Studies ; Treatment Outcome ; Ultrasonography, Interventional ; Ureteroscopy

Objective To explore the types, degree and distribution regularities of axial direction in astigmatism preschool children and the relationship of astigmatism and amblyopia. Methods Mydriasis optometry was performed for preschool children in our hospital outpatient reception from 2010 to 2011,and the astigmatism in 831 eyes of 477 cases were statistically analyzed. Results The compound hyperopic astigmatism was the most, accounting for 65.8%,followed by mixed astigmatism (13.8%),simple hyperopia astigmatism (9%),compound myopia astigmatism (8.7%) and simple myopia astigmatism (2.3%). Preschool children astigmatism degree distribution was distributed among 0.50 D and 2.00 D, accounting for 42%. For astigmatism axial, the astigmatism with rule, astigmatism against the rule and oblique astigmatism was accounted for 95.9%, 2.4% and 1.7%, respectively. Conclusion Compound hyperopic astigmatism is a main type of astigmatism in preschool children, and astigmatism is closely related to the formation of amblyopia.

Objective To establish the xenotransplanted tumor model of Craniopharyngioma in chick chorioallan?toic membrane (CAM) and detect the angiogenesis ability, microvessel density (MVD) and cell proliferation of the xeno?graft. Method Craniopharyngioma tissues from surgical craniopharyngioma patients were transplanted on the CAM. An?giogenesis assay was performed and the MVD and PCNA were evaluated using immunohistochemistry following the trans?plantation. Results The tumor formation rate of adamantinomatous craniopharyngioma (ACP) and squamous papillary cra?niopharyngioma (SPCP) was 47.14% and 43.33%, respectively. There was no significant difference in tumor formation rate between ACP and SPCP(χ2=0.123,P=0.726). The CAM angiogenesis, MVD and expression of PCNA were higher in ACP than in SPCP. The expression of PCNA was positively correlated with MVD (Pearson r=0.639,P<0.001) and CAM assay score (Spearman r=0.490,P=0.001 ) in CP. Conclusion The model of human craniopharyngioma can be es?tablished in the CAM. The angiogenesis of the xenograft in the CAM can be evaluated and the craniopharyngioma xeno?graft of CAM possesses a new blood circulation and cell proliferation ability.

OBJECTIVETo construct a short hairpin (sh)RNA targeting aquaglyceroporin 9 (AQP9) that effectively silences gene expression in liver cells in order to investigate of the role of AQP9 in nonalcoholic fatty liver disease (NAFLD) pathogenesis using an in vitro cell model system.

METHODSSmall interfering (si)RNAs were designed against the human gene sequences encoding AQP9 (NCBI GenBank Accession No. AB008775) and unrelated control sequences, synthesized, annealed to form double-strands, and inserted into the pGenesil- 1 shRNA-expression plasmid. The silencing effects of the four pshRNA-AQP9 constructs (a-d) and the pshRNA-negative control construct were investigated by transfecting into the L02 human normal liver cell line and detecting expression of AQP9 mRNA and protein (relative to beta-actin) by reverse transcription-PCR and western blotting. The NAFLD cell model was established by treating L02 cells with oleic acid to induce fatty degeneration. After transfecting the NAFLD cell model with various constructs, the effects on NAFLD-related features were investigated by staining with Oil Red O (to detect lipid droplets) and performing enzymatic assays (to quantitate triglyceride (TG), free fatty acid (FFA) and glycerol content). The significance of intergroup differences was assessed by analysis of variance test.

RESULTSOf the four pshRNA-AQP9 constructs, pshRNA-AQP9a produced the most robust silencing effect on AQP9 mRNA (25.1 - 1.2% vs. untransfected: 39.3 +/- 1.7% and pshRNA-negative control: 39.4 +/- 1.5%, P < 0.01) and protein (25.4 - 2.0% vs. untransfected: 35.1 +/- 1.9% and psh-RNA-negative control: 35.6 +/- 2.3%, P < 0.01). Oleic acid-induced L02 cells showed enhanced AQP9 mRNA and protein expression, and increased intracellular content of lipid, TG, FFA, and glycerol, which were significantly reduced by pshRNA-AQP9a transfection (all P <0.05).

CONCLUSIONThe new pshRNA-AQP9a construct can efficiently reduce AQP9 expression in cultured human liver cells and relieve steatosis-related features in an NAFLD cell model, pshRNA-AQP9a represents a novel tool for studying the role ofAQP9 in NAFLD pathogenesis and its potential as a gene therapy strategy.

Aquaporins ; genetics ; Cell Line ; Fatty Liver ; genetics ; Gene Expression ; Genetic Vectors ; Hepatocytes ; metabolism ; Humans ; Non-alcoholic Fatty Liver Disease ; Plasmids ; RNA Interference ; RNA, Messenger ; RNA, Small Interfering

Objective To study the effect of HCV receptors′sequence on virus entry based on the two-dimensional structure and via tandem expression of HCV receptors on mouse hepatocytes.Methods The construced recombinant expression vectors pCDH-hLDLR-hSR-BⅠ-hCD81-GFP, pCDH-hLDLR-hCD81-hSR-BⅠ and pCDH-hCLDN-1-hOCLN-DsRed were cotransfected into 293FT cells with package vectors.The collected recombinant lentivirus expressing hCLDN-1-hOCLN was concentrated and attacked mouse hepatocytes.The transgenic mouse hepatocytes with tandem overexpression of CLDN-1 and OCLN were established after G418-selection.The transduced cells LSCCO/Hepa1-6 and LCSCO/Hepa1-6 were sorted via flow cytometry and puro-G418-selection after recombinant lentivirus expressing hLDLR-hSR-BⅠ-hCD81 and hLDLR-hCD81-hSR-BⅠattacked Hepa1-6 respectively.The infectivity of transduced mouse hepatocytes LSCCO/Hepa1-6 and LCSCO/Hepa1-6 to HCV was analyzed via direct-infection of serum-derived virus.Furthermore, the effect of HCV receptors′sequence on virus entry was studied.Results Both LSCCO/Hepa1-6 and LCSCO/Hepa1-6 enhanced HCV-cell binding.The transduced mouse hepatocytes LSCCO/Hepa1-6 had more HCV endocytosis.Conclusion SR-BⅠhas priority over CD81 in HCV entry in the early stage.

Objective To study the exact function of human gene 5 transactivated by pre-S1 protein of hepatitis B virus(PS1TP5)by investigating the gene expression of PS1TP5 in yeast cells. Methods Reverse transcription-polymerase chain reaction(RT-PCR)was performed to amplify the gene of PS1TP5 using the mRNA of HepG2 cells as template and the gene was cloned into pGEM-T vector.The gene of PS1TP5 was cut from pGEM-T-PS1TP5 vector and cloned into yeast expressive plasmid pGBKT7,then pGBKT7-PS1TP5 was transformed into yeast cell AH109.The yeast protein was isolated and analyzed with sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) and Western hybridization.Results PS1TP5 gene was successfully amplified and identified by DNA sequencing.The digested fragment was cloned into pGBKT7 vector and transformed into yeast cell AH109.The results of SDS-PAGE and Western assay showed that the relative molecular weight of the expressed product was about 36 950,and PS1TP5 protein existed in yeast cells.Conclusion The findings suggest that PS1TP5 can be successfully expressed in yeast cell.

Objective To report the therapeutic effect of free dursum flap lnbule grafting to repair soft tissue defects in two or three fingers result from electric bum in just one operation.Methods Seven patients with electric injuries in two or three fingers were treated by the dorsum flap (or composite flap) lohule graft- ing.The procedure is followed:after dehridement,a trifoliated flap composed of medial pedal,first dorsal met- atarsal and lateral pedal flaps or a bifoliated flap composed of first dorsal metatarsal and lateral pedal flaps was designed.The combined flap contained anterior tihial artery and dorsal pedal artery as the stem vessel for anas- tomosing with the supplying vessel.The three tributaries of dorsal pedal artery:medial tarsal artery,first dor- sal metatarsal artery and lateral tarsal artery were enntained in the three leaves respectively.They could contain extensor digitorum longus tendons and cutaneous nerves and be used to cover the skin defect of two or three fin- gers,reconstruct the flexor tendons and finger arteries and nerves at the same time.Results All the flaps were survived completely,the wounds in all fingers healed primarily,however,skin graft in two feet necrosised partly,one got to healing required wound dressing for three weeks,another required further operation of trans- ferring medial supramalleolar flap due to tendon exposure.The patients were followed up from 3 to 24 months, all the flaps were of appropriate thickness,good texture and satisfactory sensation,all the fingers recovered good function of flection and extension except two fingers existing little limitation.Conclusion Free dorsum flap lohule grafting is an ideal way to treat electric injuries of multiple fingers because it can recnnstruct the skin,tendons,blood vessels and nerves in two or three fingers in just one operation.

OBJECTIVETo compare the clinical results of single-stranded isometric with double-stranded anatomic reconstruction of medial patellofemoral ligament (MPFL) for recurrent patellar dislocation.

METHODSRetrospective analysis of 60 consecutive patients (72 knees) with recurrent patellar dislocation underwent medial patellofemoral ligament reconstruction between August 2004 and October 2008, 22 cases (27 knees) with single-stranded isometric reconstruction, 38 cases (45 knees) with double-stranded anatomic reconstruction. Postoperatively patellar stability was examined, and recurrent rate was recorded. Patellar lateral shift ratio and tilt were measured on CT scans. Knee function was evaluated with subjective questionnaire and the Kujala score.

RESULTSAll patients were followed up for more than 12 months without recurrent redislocation. (1) Recurrent instability rate was 18.5% in single-stranded group and 2.2% in double-stranded group, with statistical difference (P < 0.05). (2) The patellar tilt and lateral shift ratio returned to normal, without statistical difference between groups (P > 0.05). (3) The Kujala score were 59 ± 9 and 62 ± 9 preoperatively and 87 ± 4 and 94 ± 6 postoperatively in single- and double-stranded group, with statistical difference (P < 0.05). (4) The excellect rate was 85.2% in single-stranded group, 97.8% in double-stranded group, with statistical difference(P < 0.05).

CONCLUSIONBoth reconstruction can improve patellar stability and knee function significantly, with double-stranded anatomic reconstruction better in clinic evaluation.

Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Medial Collateral Ligament, Knee ; surgery ; Patellar Dislocation ; surgery ; Patellar Ligament ; surgery ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Treatment Outcome ; Young Adult