Objective To investigate the relationships between hyperuricaenia,serum uric acid (SUA) level and the chronic kidney disease (CKD) in adult residents of Pudong New Area,Shanghai.Methods 3326 residents aged 20-80 years were randomly selected from Pudong New Area,Shanghai through multistage sampling and interviewed between April and July of 2008.Fasting blood sample and morning ovid urine sample were collected for each participant for testing of SUA,serum creatinine,urinary albumin and creatinine.Both urine albumin to creatinine ratio (ACR)and glomerular filtration rate (GFR) were calculated to estimate the renal function.Results The overall prevalence of CKD was 16.0％ (age standardized 13.2％ ).The mean values of estimated GFR in participants with CKD and without CKD were (89.19 ± 27.25) and ( 105.88 ± 98.37) ml· min-1 ·(1.73 m2) -1,respectively.The prevalence rates of CKD in serum uric acid quartiles:first quartile,less than 4.2 mg/dl; second quartile,4.2-5.0 mg/dl; third quartile,5.0-6.0 mg/dl; and fourth quartile,6.0 mg/dl or more were 13.9％,15.0％,15.8％and 19.4％ (P＜0.05) respectively,increasing along with the increase of SUA among both sexes.Compared to the serum uric acid first quartile,the multivariate-adjusted odds for CKD of the second,third and fourth quartiles were 1.19 [95％ confidence interval (CI):0.90-1.58],1.27 (95％ CI:1.02-1.70),1.28 (95％ CI:1.10-1.68),respectively. Conclusion Hyperuricaemia was independently associated with the increased prevalence of CKD among population living in the Pudong New Area,Shanghai.

Objective To investigate the changes of quantitative parameters of dynamic enhanced CT in non-small cell lung cancer before and after targeted therapy,and compare them with the traditional evaluation criteria,in order to find the parameters which can be exploited for timely,objective evaluation of the effect of targeted therapy.Methods The study included 21 patients with targeted therapy who had received dynamic enhanced CT before and after treatment.Enhancement time-density curves were obtained based on the CT values of the lesion at individual time points,and the functional indices:peak height (PH),the time to peak height (Tp),the ratio of PH of the mass to aorta (M/A) and perfusion value were calculated.The effects of the treatment on these indices were evaluated and compared with the effect of the treatment on lesion diameter. Results Twenty-one patients had 33 rechecking results. There was a statistically significant agreement between lesion diameter-based treatment evaluation and perfusion-based treatment evaluation ( U =8.761,P ＜ 0.01 ). The perfusion value decreased in patients with disease regression[before treatment:(0.28 ±0.11 ) ml · min-1 · ml-1,after targeted therapy(0.18 ±0.09) ml ·min-1 · ml-1,t =- 3.2722,P =0.0042],but increased in patients with disease progression[before treatment(0.21 ±0.08) ml · min-1 · ml-1,after targeted therapy:(0.34 ±0.11 ) ml · min-1 · ml-1,t =2.6064,P =0.0403].Conclusions On dynamic enhanced CT in non-small cell lung cancer patients after targeted therapy,perfusion value changed in the same trend as the diameter of tumor.The effectiveness of targeted therapy may be evaluated by perfusion value changes.

BACKGROUND: At present, the commercial artificial small vascular grafts (diameter < 6 mm) are still unsatisfactory, due to poor blocompatibility and low long-term patency rate. Therefore, finding a vascular substitute with normal biological function and studying construction and function of tissue-engineered blood vessel have become hot topics recently.OBJECTIVE: To construct a novel tissue-engineered blood vessel by rabbit bone marrow mesenchymal stem cells (MSCs) and vascular acellular matrix, and to investigate the biocompatibility and patency rate of tissue-engineered blood vessels.DESIGN, TIME AND SETTING: An in vitro randomized controlled study at level of cytology and histopathology was performed at the Laboratory of Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2006 to June 2008.MATERIALS: The decellularized vascular acellular matrix was obtained by a detergent-enzymatic procedure. MSCs from rabbits were isolated using density gradient centrifugation method and cultured in culture flasks coated with fibronectin. Subsequently, the expanded MSCs were seeded on the decellularized scaffolds, and then co-cultured in the self-made bioreactor to construct the tissue-engineered blood vessels.METHODS: Sixty rabbits were randomly divided into three groups. A1.0-cm abdominal aorta was sheared, and a tissue-engineered blood vessel was transplanted on the abdominal aorta using 8/0 polypropylene thread. Tissue-engineered blood vessel group: Tissue-engineered blood vessel was considered as the transplanted vessel; vascular acellular matrix group:Xenoma artery treated by vascular acellular matrix was considered as the transplanted vessel; xenoma artery group: Fresh xenoma artery was considered as the transplanted vessel.MAIN OUTCOME MEASURES: Immunocytochemical staining was used to identify the cultured MSCs. After 3 months of transplantation, the grafts were retrieved for digital subtraction angiography, pathological test and scanning electron microscope examination.RESULTS: Rabbits MSCs presented a whirlpool-like appearance at 8 days after culture. The immunocytochemistry results were consistent with the phenotype of MSCs. After high proliferation, MSCs were seeded onto the vascular acellular matrix for 12 days,and seed cells attached to well in the lumen of blood vessels. Three months after implantation, the patency rate was 90% of tissue-engineered blood vessel group and 80% of vascular acellular matrix group, which was superior to xenoma artery group (25%). At three months after transplantation, HE staining and scanning electron microscope demonstrated that internal, middle,and external membrane were clearly observed in the tissue-engineered blood vessel group, and the membrane morphology was similar to normal artery. The endothelial cells were covered completely. However, the endothelial cells were not covered completely in the vascular acellular matrix group, while mural thrombosis, mild proliferation of intima, and inflammatory cell infiltration were observed. The intima was thick and necrotic in the xenoma artery group, while lumens were stenotic and accompanied with a certain degree of thrombus organization.CONCLUSION: This study provides a new strategy to develop a tissue-engineered blood vessel with excellent biocompatibility and high patency rate constructed by rabbit MSCs and vascular acellular matrix.

Objective To investigate the technical details and therapeutic effect in treating StarIdford B aortic dissection by endovaseular aortic repair(EVAR). Methods We retrospectively review 115 type B aortic dissection cases undergoing the procedure of mini-traumatic EVAR from November 1998 to February 2009.There were 71 male patients and 44 female patients with a mean age of55.7 years and follow up period from 7 to 83 months for 75 cases. Results The procedure Was technically successful in 113 cases and 122 stent grafts were placed with hybrid surgery being carried out in 3 cases of carotid artery bypass.Severe perioperative complications included subclavian steal syndrome in 4 eases,pulmonaryinfections in 3 cases.arterial embolism in 2 cases,acute cerebral infarction in 2 cases,kidney tailure in 2 cases.alimentary tract hemorrhage,graft infection,acute intestinal ischemia and type A dissection occurred in one each case respectively.Five cases died perioperatively.Among the 75 cases that were fouowed up,there were 9 eases with type I endoleak and at last 5 cases redid endovaacular repmr.2 cases with secondary type A dissection accepted graft replacement.There were 6 deaths during the follow-up period,4 dying of acute myocardial infarction(2 cases),cerebral hemorrhage(1 case),type A dlssection (1 case)respectively,the causes of other2 deaths were not confirmed. Conclusion EVAR was effective for Standford B aortic dissection as shown by midterm follow up.

Objective To discuss the experience in the diagnosis, treatment, complications and follow up of carotid body tumor. Methods All the 25 cases were diagnosised by DSA and CTA. The tumor was resected under carotid adventitial plane in 18 cases, with external carotid artery resection in 4cases, and in 3 cases, internal carotid artery (ICA) and external carotid artery (ECA) were resected simultaneously in which internal carotid artery was reconstructed in two cases including using self vein bypass in one and anastomosis between ICA and ECA in the other. ICA was ligated in the third case. Results No cases died perioperatively. ALL CBTs were treated successfully. Horner syndrome and trachyphonia were relieved after operation. Postoperative trachyphonia, bucking and lingual paralysis developed in 3 cases, and in one case with vagus resection caused dyspnea tracheotomy was performed. The rate of nerves injuries was 12% but no semiplegia and aphasia occurred. Follow up period was from 4 to 90 months (average 44 ±6 months) for 21 cases. The trachyphonia and bucking were improved during follow up but the lingual paralysis persists, and tumor recurred in two cases with one dying. Conclusions CBT treatment should include active surgery, sufficient preoperative preparation and avoiding the postoperative nervous complications.

OBJECTIVETo evaluate the results of nephron-sparing surgery (NSS) for renal tumors.

METHODSA retrospective analysis was performed for the clinical data of 66 patients who were affected by renal tumors and treated with NSS.

RESULTSAmong 66 cases, 63 were treated with partial nephrectomy and 6 with enucleation. The renal vessel was clamped in 45 cases intraoperative. The histological subtypes included clear cell carcinoma in 40 cases, papillary renal cell carcinoma (RCC) in 2 cases, chromophobe RCC in 2 cases, angiomyolipoma in 24 cases, and adenoma in one case. Surgical margins were negative in all cases. Seven patients had postoperative complications and no perioperative acute renal failure occurred. Among 44 cases with renal cell carcinoma, 42 were followed for mean 55.4 months. The overall and disease-free 5-year survival rates were 97.3% and 90.7%, respectively.

CONCLUSIONNSS is a effective and safe operation for selected patients with renal tumors, providing functional advantage gained by the maximal preservation of unaffected renal parenchyma without sacrificing cancer control.

Adult ; Aged ; Angiomyolipoma ; surgery ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; surgery ; Male ; Middle Aged ; Nephrectomy ; methods ; Nephrons ; Retrospective Studies

Objective To evaluate the forecasting capability of serum N-terminal pro-brain natriuretic peptide ( NT-proBNP) level for Left ventricular ( LV) remodeling of patients with acute myocardial infarction (AMI) through observation of the relationship between serum NT-proBNP on the 3rd day and LV remodeling following onset of AMI. Methods Electrochemilumin-escence was adopted to determine the serum NT-proBNP level on the 3rd day after AMI attack for 106 cases of patients with anterior, anteroseptal and anterolateral AMI, with echocardiography performed to detect LV end-diastolic diameter (LVDd) and leftventricular ejection fraction (LVEF) respectively on the 3rd day and 3 months after the attack. Results The serum NT-proBNP level of AMI patients on the 3rd day averaged 1039. 28 (241. 50-1 184. 25) ng/L For AMI patients on the 3rd day and 3 months after, LVDd rose to (53?7) mm (P 0.05) from (53?8) %. NT-proBNP concentration on the 3rd day after AMI onset was positively correlated with△LVDd significantly, r =0. 403 (P 5mm during the 3 months and LVEF at the 3rd month≤40 % , AUC was 0. 893. Conclusion The test results showed serum NT-proBNP level for AMI patients on the 3rd day may be used as one of forecasting indexes of LV remodeling for AMI of advanced stage.

OBJECTIVE: To summarize the pattern and main characteristics of fatal cases related to medical disputes in Yancheng area. METHODS: Sixty fatal cases of medical disputes were retrospectively analyzed to elucidate the annual incidence, characters of distribution of hospitals, gender and age of the decedents, types of diseases, and cause of death. RESULTS: Among 60 fatal cases, most cases happened in health clinics of county, township and village. There were more males than females. The major medical specialties involved included internal medicine, surgery, gynecology and pediatrics, with the internal medicine specialty having the highest incidence. CONCLUSION Police institutions have advantages in investigation of these cases in their jurisdictions, which could enhance the ability of local medicolegal examination.
Autopsy ; Cause of Death ; Dissent and Disputes ; Environment ; Female ; Forensic Medicine ; Humans ; Incidence ; Male ; Medicine ; Police ; Retrospective Studies

OBJECTIVETo compare the method of detecting heat-sensitive (HS) condition of Neiguan (PC 6) with moxibustion sensation and with infrared in heart-qi deficiency patients (HQD), and to find an objective detection method for HS condition of acupoints.

METHODSThe study was performed on 74 HQD patients. Take infrared thermograph of the tested skin area in natural state. Then thermosensitive test was taken after infrared thermograph acquisition (suspended moxibustion for 10 min). After moxibustion infrared radiometry was implemented for the second time. The infrared radiation information of the forearms was collected and the major axis of the moxibustion reaction area was recorded. The effect of moxibustion sensation and infrared detection on HS Neiguan (PC 6) in HQD patients was compared.

RESULTSWhen the Neiguan (PC 6) in HQD patients was on HS condition, most of the infrared intensity was high temperature and compared with moxibustion sensation method, the sensitivity was 66.7%, the specificity 76.9%, and the accuracy 70.3%. After moxibustion on the HS Neiguan (PC 6) area, the infrared intensity diffused longitudinally along inner side of forearms. Compared with the result of the moxibustion sensation method, its sensitivity was 87.5%, the specificity 92.3%, and the accuracy 89.2%.

CONCLUSION(1) The state of HS condition of Neiguan (PC 6) in HQD patients could be detected objectively by infrared radiation. (2) After moxibustion, the HS condition of acupoints produced thermal phenomena as thermal expansion, heat transfer, which could be demonstated objectively by the infrared radiation image as well as the sensation of subjects.

Acupuncture Points ; Aged ; Female ; Heart ; physiopathology ; radiation effects ; Hot Temperature ; Humans ; Infrared Rays ; Male ; Middle Aged ; Moxibustion ; Qi ; Radiometry ; Sensation ; Thermography