To explore the clinicopathological characteristics of parathyroid crisis.The data of 3 cases from our hospital and 125 cases reported domestically were retrospectively analyzed.All 3 cases were male.And their disease course was 3 months to 10 years.The serum calcium ranged from 3.72 to 5.19 mmol/l.Among 177 retrieved cases,125 had complete basic data.The male/female ratio was 1∶ 1.17,average age (46 ± 14) (15-75) years and average serum calcium (4.30 ± 0.58) (3.75-7.28) mmol/L.There was no difference between genders or benign and malignant pathological types.Among 117 eases with pathological diagnosis,the most common type was adenoma (74.4％).The ratio of parathyroid carcinoma was higher in males than that in females (33.3％ vs.11.7％).Misdiagnosis rate was 25.0％ upon initial presentations.Case fatality rate stood at 9.4％ (17/180) and half of them died preoperatively.

To analyze the correlation between fragmented QRS complexes( fQRS) and inflammation in 136 patients with acute coronary syndromes(ACS). Patients with fQRS had increased hs-CRP levels (P<0.01) in comparison to patients with non-fragmented QRS. The higher hs-CRP levels was,the more the number of leads in the fQRS on ECG was(P<0.01). When we performed multiple logistic regression analysis, fQRS was found to be related to in-creased hs-CRP levels [ OR:1.507 , 95% CI:1.172~1.936 , P<0.01 ] . fQRS was independently related to in-creased hs-CRP. fQRS that may result as an end effect of inflammation at cellular level can represent increased car-diac risk in patients with ACS.

Objective To investigate the routine ultrasound and contrast-enhanced ultrasound (CEUS) features of hepatic nodules in Budd-Chiari syndrome(BCS) after portacaval anastomosis.Methods Routine ultrasonography and CEUS were performed in 18 BCS patients with hepatic nodules after portacaval anastomosis.Results Appearance after portosystemic anastomosis,multiplicity,small size,presence of peripheral rim and hypervascularization were important ultrasound imaging features of hepatic regenerative nodules in patients with BCS.Nodules showedquick wash-in and slow wash-out pattern in CEUS.Sixteen cases showed center-to-periphery enhancement pattern in arterial phase and hyper-enhancement in portal phase and late phase.Two cases showed periphery-to-center enhancement pattern in arterial phase and periphery enhancement in portal phase and late phase.Conclusions Hepatic regenerative have different features on routine ultrasound and CEUS in patients with BCS after portacaval anastomosis,which are useful for differential diagnosis.

The risk of stroke increases significantly after transient ischemic attack (TIA). TIA is an independent risk factor for cerebral infarction. This article review s the advances in prediction models of stroke risk after TIA in order to conduct rapid and accurate risk assessment and stratification in patients w ith TIA and develop timely reasonable treatment strategies, thereby reducing the risk of stroke.

AIM: To investigate the frequency of P459H(CCC→CAC) in exon 10 of CYP21 gene among normal population.METHODS: The exons 3-10 of CYP21 gene were amplified with polymerase chain reaction(PCR).The PCR round products were digested by restriction enzyme Pst I to confirm that CYP21 gene was specifically amplified.PCR-based amplification-created restriction site(PCR-ACRS) was performed using the first round PCR products as template.After the second PCR products were digested by restriction enzyme Fsp I,10% polyacrylamide gel electrophoresis was used to screen the frequency of P459H in exon 10.RESULTS: The codon 459 in exon 10 of CYP21 gene was all CCC among 100 normal cases tested.CONCLUSION: P459H(CCC →CAC) of CYP21 gene might be a novel point mutation causing CAH.Furthermore,PCR-ACRS was a fast and safe method for gene mutation screening.

AIM:To determine four bioactive components in Tongda Granule ( Radix Paeoniae alba,Flos Carthami,Radix Scutellariale,etc. ),namely hydroxy safflower yellow A,peoniflorin,ferulic acid,and baicalin. METHODS:The isolation was performed on an Alltech Apollo C18 (250 mm ? 4. 6 mm,5 ?m) with the mobile phase consisting of methanol-0. 2% (w)phosphoric acid for gradient elution. The flow rate was 1. 0 mL/min and the column temperature was set at 30 ℃. RESULTS:This method was successfully applied to determining four bio-active components in Tongda Granule. The standard curves were linear over the ranges of 5. 20 -104 mg/L for hydroxy safflower yellow A(r =0. 999 1),25. 6 -512 mg/L for peoniflorin (r =0. 999 6),7. 72 -154. 4 mg/L for ferulic acid (r =0. 999 5),32. 5 -650 mg/L for baicalin (r = 0. 999 5),respectively. The average recoveries were 101. 1% ,99. 6% ,98. 9% and 101. 9% ,RSD were 2. 3% ,1. 8% ,2. 6% and 1. 3% ,respectively. CONCLUSION:The method is simple and can be used as a quality control method for Tongda Granule.

OBJECTIVETo establish a miniature pig model of mandibular osteoradionecrosis (ORN).

METHODSA single dose of irradiation (IR25 Gy, 28 Gy) was delivered via an electronic linear accelerator to the right mandible of 24 miniature pigs by utilizing three dimensional conformal radiotherapy (3D-CRT). The first molar of the mandible was extracted 2 months after radiation. Mandibular ORN was diagnosed through gross observation, X-ray film, CT, and histopathologic examination.

RESULTSAt 3-4 months after radiation, all animals suffered from mandibular ORN after dental extraction. The symptoms of ORN were more severe in the 28 Gy group than in the 25 Gy group.

CONCLUSIONA miniature pig model of mandibular ORN can be established through 25 Gy irradiation + dental extraction.

Animals ; Mandible ; Mandibular Diseases ; pathology ; Molar ; Osteoradionecrosis ; pathology ; Particle Accelerators ; Radiation Injuries, Experimental ; pathology ; Radiotherapy, Conformal ; adverse effects ; Swine ; Swine, Miniature ; Tooth Extraction

ObjectivesTo evaluate the effect of combination of liraglutide,a glucagon-like peptide-1 analogue and pioglitazone,an insulin sensitizer,on diabetic db/db mice.MethodsThirty-five 8-week old male db/db mice were divided into control group (n = 8 ),pioglitazone group (n =9 ),liraglutide group (n =9) and combined therapeutic group (n =9),which was given normal saline 0.1 ml,2/d,pioglitazone 24 mg· kg-1 · d-1 (feed contained 0.02％ pioglitazone) + normal saline 0.1 ml,2/d,liraglutide 300 mg/kg,2/d,and pioglitazone 20 mg · kg-1 · d -1 ( feed contained 0.02％ pioglitazone) +liraglutide 300 mg/kg,2/d,respectively.Liraglutide were given at 8:00 and 16:00 via subcutaneous injection after having been diluted with sterilized normal saline.Effect on glucose,lipid metabolism and islet β-cell preservation were assessed after 4 weeks.Oneway ANOVA was adopted for statistical analysis.Results Combination therapy displayed promising anti-hyperglycemic[glycosylated hemoglobin Alc: (4.5 ± 0.6)％vs.(7.3 ±0.4)％,P ＜ 0.001].Glucose tolerance were improved assessed by area under curve(AUC) of glucose by intraperitoneal glucose tolerance test (IPGTT)[(1814 ±91 ) mmol · min · L-1 vs.(4042 ±183) mmol · min · L-1,P ＜0.001];insulin release response to glucose were also preserved as AUC of insulin by IPGTT was higher[( 1639 ±372) μg · min · L-1 vs.(834 ±201 )μg · min · L-1].Combination therapy also reduced circulated free fatty acids and TG[( 202.0 ± 20.4 ) μmol/L vs.( 272.5 ± 21.7 )μmol/L,(0.81 ± 0.28) mmol/L vs.( 1.35 ± 0.21 ) mmol/L],and increased plasma adiponectin [(16.7±2.0)mg/L vs.(10.2±1.8)mg/L].All P value ＜0.05.Islet immunohistochemistry showed that combination therapy significantly increased insulin positive area were[( 59.5 ± 1.5 ) ％ vs.( 22.4 ±1.5) ％]and ratio of Brdu positive β-cells was three folds than vehicle-treated mice[( 2.4 ± 0.5 ) ％ vs.(0.8 ±0.3)％],both greater than each single treatment.Combined therapy significantly improved islet β cell/α cell distribution,which led to islet recovery.ConclusionsCombined therapy improves glucose and lipid metabolism,preserves islet β-cell function and stimulates β-cell proliferation,greater than either liraglutide or pioglitazone treatment alone.

ObjectiveTo evaluate the effects of cardiac resynchronization therapy (CRT) on improving left ventricle (LV) function and LV asynchrony in patients with dilated cardiomyopathy(DCM)using three-dimensional ultrasound speckle tracking imaging(3D-STI).MethodsTwenty one patients with DCM and 25 normal subjects were enrolled in this study.Parameters including LV mean longitudinal peak strain (MLS),LV mean circumferential peak strain (MCS),LV mean radial peak strain (MRS),LV ejection fraction(3D-LVEF),maximal temporal difference in area strain of LV 16 segments (A-MaxTs) and its standard deviation (A-Ts-SD) were investigated by 3D-STI.LV ejection fraction (ECT-LVEF) and LV phase angle width (LVW) were obtained by radionuclide ventriculography and phase image analysis.Results The indexes of MLS,MCS,MRS and 3D-LVEF were decreased and A-MaxTs,A-Ts-SD were prolonged in DCM group compared with those of control group.There was a slightly improvement in MRS and ECTLVEF 1 week after CRT,but other Parameters including MLS,MCS,A-MaxTs,A-Ts-SD and 3D-LVEF had no significant change.Compared with corresponding values before and 1 week after CRT,all parameters (MCS,MRS,A-MaxTs,A-Ts-SD,3D-LVEF and ECT-LVEF) were further improved 6 months after CRT.MLS,MCS,MRS and 3D-LVEF had good relationship with ECT-LVEF,and A-MaxTs,A-Ts-SD had good relationship with LVW in DCM group.Conclusions3D-STI is a simple and accurate method for evaluating effects of CRT on improving LV function and LV asynchrony in patients with DCM.

Cultured primary human umbilical vein endothelial cells (HUVECs) were divided into 4 groups:normal control( NG ),persistent high glucose ( HG ),hyperglycemia group ( TG ),and mannitol control ( MA )groups.After 1,4,and 7 days of culture,cells were collected.Cell proliferation,cell apoptosis,ROS,SOD,MDA,and NO level,eNOS mRNA and protein level were measured.Endothelial cell proliferation was inhibited in HG,TG,and MA groups compared with NG group.Hyperglycemia memory induced apoptosis of endothelial cells,increased ROS and MDA generation,and down-regulated intracellular SOD level,findings similar to those in HG group.After 24 h of culturing,eNOS expression and NO generation in both HG and TG groups were higher than those in NG group.However,after 7 days of culturing,eNOS expression and NO generation in both HG and TG groups were lower than those in NG group.These results suggest that in hyperglycemia memory cell model,transient hyperglysemia may lead to persistent imbalance in oxidative stress and reduce endothelium-derived relaxing factor NO level,indicating that hyperglycemia memory may play an important role in persistent vascular endothelial cell injury.