Objective: To explore the methodology and efifcacy of transcatheter induced closure in patients with small patent ductus arteriosus (PDA). Methods: A total of 717 PDA patients treated in our hospital from 2005-11 to 2014-08 were summarized and there were 8 patients with small PDA were treated by transcatheter induced closure method including 3 male and 5 female from (1-6) years of age at the mean of (3.9±1.4) years with the body weight of (10-21) kg at the mean of (15.2±3.7) kg. The procedures were performed under local or general anesthesia with right cardiac catheterization and descending aortic arch angiography to observe PDA morphology and to measure PDA diameter at aortic and pulmonary aterial lateral and ductus length. Right catheter along the guide wear was pushed to the narrowest part of PDA and the motion was repeated for several times to stimulate the local area and then, the catheter was kept at PDA aortic lateral about 20 minutes thereafter. Results: Descending aortic arch angiography indicated that no residual shunt at 20 min after catheter partial blockage in all 8 patients, the immediate closure rate was 100%. No patient suffering from re-canalization by 1 year follow-up examination. Conclusion: Transcatheter induced closure of small PDA has minor trauma, no foreign material implantation, with low cost and good effect. It provides a new method for treating such particular type of PDA patients in clinical practice.

Objective To observe the effects of palmitic acid (PA) and fenofibrate (FF) on rat islets. Methods Rat islets were isolated with collagenase digestion and divided into 6 groups: control group, PA0.2 group (with 0.2 mmol/L PA), PA0.4 group(with0.4mmol/LPA),FF group (with 5?10 -6 mol/L fenofibrate), PA0.2+FF group and PA0.4 +FF group. After being cultured 24 hours with PA in the presence or absence FF, baseline insulin secretion (BIS) and glucose stimulated insulin secretion (GSIS) were examined. The mRNA levels of insulin(INS), pancreas-duodenum homeobox-1 (PDX-1), glucose transport protein 2 (GLUT-2) and PPAR? were determined by RT-PCR or real-time PCR. Results (1)In both PA0.2 and PA0.4 groups, BIS was increased and GSIS increase was impaired as compared with control group (P0.05). Expressions of INS, PDX-1 ,GLUT2 and PPAR? mRNA were enhanced in PA0.2 +FF group and PA0.4 +FF group as compared with the two groups without FF respectively (all P

Objective To obtain more information concerning polymorphism of the thyrotropin (TSHR) in Graves diseases(GD). Methods (1)A family of GD was studied (including 3 patients and 9 healthy family members)to examine SNPs of TSHR through direct sequencing of all 10 exons and part of introns. (2)In the current case-control study, 30 patients with familiar GD, 48 sporadic patients and 96 healthy control individuals were used to assess whether SNP of TSHR was associated with GD. Genomic DNA was extracted from peripheral leukocytes isolated from ACD-anticoagulated blood. Ten exons were amplified by PCR, using primers designed by ourselves. After purifying, the products were sequenced. Results Eight polymorphisms were found. There was a novel polymorphism in exon 8. There were no significant differences between patients and controls. Conclusions These findings suggested that the novel and other polymorphisms of the TSHR gene may not be responsible for GD. There are racial differences in the distribution of polymorphisms of TSHR gene.

Objective To explore the factors affecting blood level of elderly hypertensive patients, using a multilevel analysis model. Methods 927 elderly hypertensive patients from 23 communities were studied, through a multi-stage random sampling method. The influencing factors on systolic blood pressure (SBP) and diastolic blood pressure (DBP) were analyzed through a two-level linear multilevel model, respectively. Results The average blood pressure of subjects appeared as: SBP (139.2±11.7) mm Hg ( 1 mm Hg=0.133 kPa), DBP (85.6±8.6) mm Hg. Ratio of physician versus patients was the factor affecting blood level of subjects from the community level. SBP and DBP of the subjects from the higher physician/patient ratio communities were 3.86 mm Hg and 2.51 mm Hg, lower than the subjects in the lower ratio communities, after controlling the other related factors. Age, gender,overweight/obesity were the individual risk factors of hypertension, while factors as regularl medicine taking, reducing salt intake and related self-efficacy to manage disease could reduce the blood pressure.Reducing salt intake could lower the SBP for 2.44 mm Hg and DBP for 2.03 mm Hg, after controlling the other factors. Conclusion Multilevel analysis model could effectively analyze the hierarchically structured data while both factors from the community and individual levels could affect the blood level among elderly patients with hypertension.

Objective To investigate the expression of peroxisome proliferator-activated receptor-γ(PPAR-γ) and angiotensin receptor (AT2R) in chronic pancreatitis tissue. Methods Between April 2006 and February 2009, 24 patients were pathologically diagnosed as chronic pancreatitis were enrolled and 12 samples of normal pancreatic tissues were treated as controls. Immunohistochemical staining was used to detect PPAR-γ and AT1R, AT2R expression in pancreatic tissues. Results PPAR-γ and AT1R were mostly negatively expressed in normal pancreatic tissues, the positive scores were 0.33±0.49 and 0.42 ± 0. 51, respectively, while AT2R were weakly positively or negatively expressed in acinus and islet cell, and it was weakly positively expressed in ductal epithelial cells, the positive score was 2. 33 ± 1. 37. In chronic pancreatitis tissue, PPAR-γ, AT1R and AT2R were positively expressed in acinus, ductal epithelial cells, and islet cell, the positive scores were 3.28 ± 2.46, 4.36 ± 2.80 and 4.61 ± 2.89, which were significantly higher than those in the normal group (P<0.01, P <0.01, P<0.05). Conclusions PPAR-γ, AT1R and AT2R were positively expressed in chronic pancreatitis tissue, and they may be the treatment target of chronic pancreatitis.

Objective To explore the expression and significance of hedgehog signal molecules (Ptch,Smo and Gli1 ) in chronic pancreatitis tissues in rats.MethodsSixty SD rats were randomly divided into CP group (n =50) and control group (n =10).DBTC solvent (8 mg · ml-1 · kg-1 ) was injected into the rat via tall vein in CP group.In control group,rats were treated only with the solvent at a dose of 1ml/kg body weight.All rats were sacrificed 6 weeks later to observe the pancreatic pathologic changes.Collagen accumulation in pancreatic sections was determined by staining for Sirius red.Expressions of Ptch,Smo,Gli1 mRNA and protein in pancreatic tissues were assessed by RT-PCR and immunohistochemistry.ResultsThe rate of chronic pancreatitis development in rats in CP group within six weeks was 73.9％.Collagen content was markedly higher in CP group than that in control group [ ( 38.52 ± 6.49 ) ％ ~s (7.37 ± 2.28 ) ％,P ＜ 0.05 ].No Path,Smo,Gli1 protein expression was observed in normal pancreatic tissues in control group.The positive rate of Ptch,Smo,Gli 1 expression was 73.5％,64.7％ and 52.9％ in CP group,and the difference between the two groups was statistically significant (P ＜ 0.05).The expressions of Ptch,Smo,Gli1 mRNA were 2.38 ±0.42,3.85 ± 1.03,4.63 ± 1.49 in CP group,which were significantly higher than those in control group (0.23 ±0.16,0.14 ±0.05,0.57 ±0.12,P ＜0.05).ConclusionsThe Ptch,Smo,Gli1 was highly expressed in pancreatic tissues in CP rats,suggests hedgehog messenger pathway may play an important role in the chronic inflammation and fibrosis of chronic pancreatitis.

Objective To analyze the significance of global end-diastolic volume index (GEDVI) in acute kidney injury (AKI) after septic shock.Methods A retrospective analysis of 61 patients was performed.The patients were diagnosed of septic shock in emergency ward of Shenyang Military Hospital from 2012 March to 2013 May and were monitored by pulse indicator continuous cardiac output (PiCCO).The patients were divided into two groups:low GEDVI group (GEDVI ＜ 700 ml/m2,29 cases) and high GEDVI group (GEDVI≥700 ml/m2,32 cases) by evaluating GEDVI of 24 hour after PiCCO.Several physiologic and biochemical indexes were recorded,including the hemodynamic parameters at the beginning and the 24 h of PiCCO monitoring,Scr,BUN,lactic acid,incidence and mortality of AKI,baseline glomerular filtration rate,baseline Scr,APACHE Ⅱ scores,mortality during the period of emergency ward or within 28 d after the diagnosis.Results A total of 26 cases in high GEDVI group (81.3％) were attacked with AKI,while 16 cases in low GEDVI group (55.2％) were attacked with AKI,the incidence of AKI in high GEDVI group was significantly higher than that in the low GEDVI group.A COX regression analysis of mortality was performed between the patients staying at emergency ward and during 28 d after diagnosis.The results indicated that AKI and GEDVI had no relation with patients' death.Therefore,AKI and GEDVI could not be considered as the risk factors for the prognosis.Conclusions High GEDVI can significantly increase the incidence of AKI after septic shock,therefore high GEDVI should be avoided as much as possible in the course of clinical treatment.

Objective To observe the expressions of inducible nitric oxide synthase(iNOS) in the progress of rat subchronic fluorosis,and analyse the mechanism of nitric oxide(NO) free radical injnry in bone.Methods Male wistar rats were divided randomly by body weight into two groups.i.e.sodium fluoride group and control group.Sodium fluoride group was given drinking water with 150 mg/L sodium fluoride,and control group was given tap water only.The animals were bred for 24 weeks.Every four weeks some rats were killed.The contents of serum and bone fluoride were examined and analyzed.The levels of serum NO were determined by Griess Reagent.The expressions of iNOS mRNA and protein were analyzed by RT-PCR and immunohistochemistry.Results The serum NO contents significantly increased(t=9.36,P＜0.01) in NaF-treated rats after 8 weeks[(19.94±3.04)nmol/L],but significantly decreased(t=10.47,4.46,P＜0.01) after 20 weeks[(11.55±3.54)nmol/L]and 24 weeks[(20.83±2.49)nmol/L],compared with control group[(9.11±1.21,31.13±3.93,33.10±7.37)nmol/L].The expression of iNOS mRNA significantly increased(t=13.09,4.82,14.23,4.64,7.82,5.29,P＜0.01)in rats treated with sodium fluoride[(1.87±0.11),(1.87±0.78),(1.90±0.29),(1.93±0.67),(1.88±0.38),(1.84±0.03)],compared with control group[(0.41±0.25),(0.30±0.17),(0.18±0.06),(0.63±0.15),(0.66±0.04),(0.65±0.55)],and these proteins mainly appeared in hyperplasie zone and hypertrophic zone cells of epiphyseal plate,cartilages,articular cartilage cells,osteoblasts and ligament cells.Conclusions High dose fluoride might persistentlv induce the expressions of iNOS and catalyze synthesis of NO,then regulates osteoblast and osteoclast activitv and finally influences bone turnover.

Objective To observe the expressions of matrix metal proteinases-13(MMP-13) mRNA and tissue inhibitor of metal protease- 1 (TIMP- 1) mRNA and analyse the molecular mechanism of bone matrix degradation in the progress of rat subchronic fluorosis. Methods Male Wistar rats were randomly divided into two groups according to body weight, i.e. sodium floride group and control group. Rats in the sodium fluoride group were given drinking water containing 150 mg/L F-, and the animals in the control group were given tap water. The animals were bred for 24 weeks. Every 4 weeks some rats were killed. The change of obsteoclst was observed by transmission electron microscope. The expression levels of MMP-13 mRNA and TIMP-I mRNA were analyzed by RT-PCR. Results The number of lysesome and the synthesis of lysosoma enzyme in osteeclast were decreased. The expression of MMP-13 mRNA was significantly increased(t=2.29,2.41,3.07,2.52, 3.15,2.22, P<0.05) in rats treated with sodium fluoride (1.87±0.67,1.87±0.75,1.90±0.73,1.93±0.86,1.88±0.61,1.84±0.53), compared with control group(1.24±0.39, 1.19±0.27,1.07±0.22, I. 15 ~ 0.17, 1.17±0.18, 1.20±0.62). The expression of TIMP-1 mRNA was significantly increased (t=2.69,2.19,2.68,2.46,2.43,2.96, P<0.05) in rats treated with sodium fluoride(1.89±0.77,1.70±0.85,1.61±0.82,1.81±0.84,1.70±0.74, 2.06±0.96), compared with control group (1.07±0.39,0.87±0.49,0.71±0.48,0.99±0.43,0.95±0.46,0.89±0.57). Conclusion High dose fluoride might persistently induce the expressions of MMP-13 mRNA and TIMP-1 mRNA and may be involved in bone turnover.

Objective To investigate the effect of aluminum on hair loss induc ed by fluoride in fluorosis mice.Methods Sixty male C57BL mice were divided into four groups according to body mass:control group,fluoride (F) group (F-100 mg/L),aluminum(Al) group(Al3+ 270 mg/L) and F + Al group(F-100 mg/L + Al3+270 mg/L).Mice were killed 1 month and 3 months after the experiment,respectively.Bone F content was detected by ion-selective electrode method.The level of bone Al was measured through inductively coupled plasma emission spectrum.Dental fluorosis and hair loss of mice were evaluated by visual method.Results One month after the experiment,no dental fluorosis and hair loss was found in all four groups.The content of bone F was the highest in F group [(2401.649 + 86.835) mg/kg],and the lowest in A1 group [(427.006 + 11.878) mg/kg].The levels of bone F in F + Al group and control group were (1210.332 + 19.531)mg/kg and (538.001 + 33.337)mg/kg,respectively.The difference was statistically significant between any two groups (all P ＜ 0.05).Three month after the experiment,all mice of F treatment group had dental fluorosis and hair loss(10/10).Alopecia areas were found in the neck and back regions only.There was no hair loss in control group,Al group and F + Al group.No dental fluorosis was found in both control and Al groups.Only 2 mice were found with dental fluorosis in F + Al group.The levels of bone F in F group,F + Al group,control group and Al group were (4098.645 + 58.842),(1888.165 ± 12.187),(876.258 + 14.462) and (662.385 ± 8.966) mg/kg,respectively.The difference was statistically significant between any two groups (all P ＜ 0.05).Conclusions The hair loss is found in fluorosis mice.Hair loss of mice is closely associated with the level of F exposure.Al can prevent the occurrence of hair loss induced by F in mice through reducing the accumulation of F.