Objective To explore the correlation between heart rate variability ( HRV ) and multiple system atrophy( MSA) .Methods HRV was performed in 34 MSA patients and 32 healthy controls.The parameters of HRV study was compared, parameters studied included time domain and frequency domain.Single factor analysis andreceiver operating characteristic ( ROC ) curves were used to analyze the detection of parameters of HRV. ResultsThe HRV of MSA showed significant decreased from the health controls: root mean square successive difference of intervals (rMSSD) [(51.6 ±29.4)ms vs (70.1 ±34.1)ms,P=0.023],percentage of interval differences of successive N-N intervals greater than 50 ms(pNN50%) [ 4.2% (1.8%,9.5%) vs 9.6%(5.1%, 16.2%),P=0.005], coefficient of variation(CV) [(0.06 ±0.01) vs(0.08 ±0.02),P=0.005],very low frequency(VLF) [1003.4(586.5,1702.9)ms2vs1825.5(1407.2,2670.1)ms2,P=0.000],lowfrequency(LF) [162.9(90.6,337.4) ms2 vs 375.5(210.4,559.5) ms2,P=0.001], high frequency(HF) [164.9(77.5,470.7) ms2 vs 349.1(209.7,738.5)ms2,P=0.005].The areas under ROC in patients with MSA for VLF was 0.703(S=0.053), while the areas for CV, LF, HF and pNN50%were 0.667(S=0.054), 0.660 (S=0.055), 0.650( S=0.055) and 0.640( S=0.055) ,the results all have statistical significance(all P<0.05).The cutoff value of VLF for diagnosing MSA in the early stage was 1240.85, the sensitivity and specificity were 86.7 and 55.4(95%CI:0.599-0.807,P=0.002) .Conclusion MSA has sympathetic and vagus nerve involvement at the early stage disease, resulting dysfunction of cardiovascular autonomic system,VLF may have high drgree of assessing accuracy of its dysfunction.

Adolescent ; Adult ; Anemia, Iron-Deficiency ; diagnosis ; etiology ; Child ; Female ; Hemoglobinuria, Paroxysmal ; complications ; diagnosis ; Humans ; Male ; Middle Aged ; Young Adult

Objective To investigate the diagnostic and therapeutic characteristics of prostate cancer with prostate specific antigen(PSA)4-10?g/L. Methods The data of prostate biopsies for the patients with PSA 4-10?g/L from May 1998 to February 2004 and the treatment and prognosis of these patients were retrospectively analyzed. Results In the 141 cases, 34 were diagnosed as prostate cancer, including 3 cT1, 21 cT2, 6 cT3 and 4 cT4. Mean Gleason score was 5.8, and the mean Gleason scores of cT1 and cT2 were significantly lower than those of cT3 and cT4. Twenty-four cases of cT1 and cT2 underwent radical prostatectomy. Four cases of cT3 recieved radical prostateetomy after 4 months of neoadjuvant endocrine therapy. Two cases of cT3 and 4 cT4 received castration. Pathological section from radical surgeries showed that 21 cases were organ confined and 7 were locally invasive. The difference of mean Gleason score between these two groups was significant in statistics. After 18 to 69 months (mean 42 months)follow-up, 21 organ confined cases were free survived, 4 locally invasive cases had biochemical recurrence and 1 case had multifocal bone metastasis. No cancer-specific death happened. Two of 4 cT4 cases were still alive and 2 died of the tumor. Conclusions Routine needle biopsy is necessary for the cases with“grave area”PSA of 4～10 ?g/L. Prostate cancers with PSA 4～10/?g/L are not always early diseases. Gleason score is a very important index for determine the stage of pathology after surgery. Radical prostatectomy is an effective treatment for organ confined disease.

Objective To evaluate the usage of renoportal anastomosis in the liver transplanta- tion.Method The successful experience about renoportal anastomosis for portal vein reconstruction in liver transplantation was reported,and related literature reviewed.Results Including our case,there have been 13 cases of liver transplantation using renoportal anastomosis for portal vein reconstruction. Among these patients,8 cases were complicated with diffuse portal vein thrombosis,and 10 cases had a splenorenal shunt(spontaneous shunt in 3 and surgical shunt in 7).Complications related to portal vein hypertension occurred in 3 cases(transient ascites in 2 cases and severe digestive bleeding in 1 case)after liver transplantation.There were 3 deaths which were not related to renoportal anastomo- sis.Conclusion Renoportal anastomosis is a safe and feasible technique in liver transplantation for the patients with diffuse portal vein thrombosis or with splenorenal shunt(spontaneous or surgical shunt).

Objective To analyze the epidemiographic features of malignant tumors of urinary system in renal allograft recipients in our center.Methods A retrospective analysis was performed on 3150 patients who received renal transplantation between June 1978 and Autumn 2006.Twelve cases of urinary tumors were selected for study.Results Among 3150 recipients,33(1.05%)were diag- nosed as malignancies including 12(0.38%)cases in urinary system.The mean age of these patients when diagnosed as urinary tumors was 58.3?4.6(range 48-66).The mean duration of immunosup- pressive treatment was 62?18(range 26-120)months.Six cases received cyclosporine A+azalthio- prine+prednisone(CsA+Aza+Pred),5 cases cyclosporine A+mycophenolate mofetil+prednisone (CsA+MMF+Pred),and one case tacrolimus+mycophenolate mofetil+prednisone(FK506+MMF +Pred).Surgical treatment was carried out in 11 patients.Ten of them were still alive.One case died of cerebral hemorrhage.Conclusions Malignant tumors of urinary system,especially TCC is an im- portant complication in renal transplantation in our center.The occurrence of malignant tumors is inti- mately related to immunosuppressive treatment.The immunological status of patients after renal transplantation should be evaluated in follow-up studies.The treatment consists of complete resection of the mass,decreases of immunosuppressants,chemotherapy or radiotherapy.

OBJECTIVETo observe the clinical effect of acupuncture on acute heart failure (AHF) patients.

METHODSTotally 60 patients who were diagnosed as AHF were assigned to the acupuncture group and the control group, 30 in each group. Those in the control group received inotropic agents, preload and afterload reducing therapy, anti-infection and so on. Besides, those in the acupuncture group received needling at relative points, once daily for 5 consecutive days. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SI), left ventricle working index (LCWI) were monitored by thermodilution pulse-indicated continuous cardiac output (PiCCO) technique. Changes of the aforesaid data were compared between before and after treatment. The ICU length of stay, readmission rate,and the 28-day mortality were also compared between the two groups.

RESULTSAfter 5 days of the treatment, CI, SI, and LCWI increased more obviously (P < 0.01), HR and MAP decreased significantly (P < 0.05). Of them, CI, SI, and LCWI increased more obviously in the acupuncture group (P < 0.05).There was no obvious difference in HR or MAP between the two groups (P > 0.05). Compared with the first day of admission in the same group, CI, SI, and LCWI obviously increased in the acupuncture group from the second day (P < 0.05). HR started to decrease since the fourth day (P < 0.05), and MAP began to decrease until the fifth day (P < 0.05). CI, SI, and LCWI started to increase in the control group from the third day (P < 0.05); HR and MAP both began to decrease since the fifth day (P < 0.05). Compared with the control group, the ICU length of stay was obviously shortened in the acupuncture group (P < 0.05). The readmission rate and the 28-day mortality rate were lower than those of the control group (P < 0.05).

CONCLUSIONThe combination of acupuncture and Western medical therapy might strengthen acute heart failure patients' heart functions, elevate the therapeutic effect, and improve the prognosis.

Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Heart Failure ; physiopathology ; therapy ; Heart Rate ; Humans ; Male ; Middle Aged ; Stroke Volume

Postoperative pancreatic leakage remains a persistent problem after pancreaticoduodenectomy.For patients with a soft and nonfibrotic pancreas,double binding continuous hemstitch suture is an optimal method for anastomosis.From January 2011 to June 2012,92 cases of periampullary carcinoma with a soft pancreas underwent pancreaticoduodenectomy,and then a modified technique of pancreaticogastrostomy was performed with 2 continuous hemstitch sutures placed in the mucosal and seromuscular layers of the posterior gastric wall,respectively.The median time for pancreaticogastrostomy was 12 minutes,and only 15 patients had postoperative complications.Two patients developed pancreatic leakage(1 grade A and 1 grade B)postoperatively.Pancreaticogastrostomy with double binding continuous hemstitch sutures is a simple and safe reconstruction procedure for patients with a soft and fragile pancreas who received pancreaticoduodenectomy.

Adult ; Chemical and Drug Induced Liver Injury ; Dimethylformamide ; poisoning ; Humans ; Male

Objective To observe the role of rosiglitazone in unclipped kidneys of two-kidney- one-clip hypertensive rats and examine its relationship to angiotensinⅡreceptors.Methods Two- kidney-one-clip hypertensive rats were divided randomly into 4 groups as follows:positive control group (CONT),traditional antihypertensive drugs group (TAHD,reserpine 50?g?kg~(-1)?d~(-1), dihydralazine 6.25 mg?kg~(-1)?d~(-1) and hydrochlorothiazide 6.25 mg?kg~(-1)?d~(-1),regular-dose rosiglitazone group (RRGL,rosiglitazone 5 mg?kg~(-1)?d~(-1)),and high-dose rosiglitazone group (HRGL, rosiglitazone 20 mg?kg~(-1)?d~(-1)).Sham operation rats were as negative controls.Each group had 8 rats. Animals were monitored and sacrificed at 10th week.Results Blood systolic pressure in TAHD group and HRGL group was significantly lower than that in CONT group [TAHD(137?27 ) mm Hg and HRGL (143?16) mm Hg vs CONT (191?25 ) mm Hg,P＜0.05],but no significant difference between the former two groups was found.Nor did the blood systolic pressure between RRGL group [(176?18) mm Hg] and CONT group.At 10th week,rats in SHAM group and treated groups had lower urinary urinary protein excretion rate,glomerular injury score and wall-to-lumen ratio of arteriole than those in CONT group [vs CONT urinary protein excretion rate (44.60?17.40) mg/24 h,P＜0.05; vs CONT glomerular injury score 60.85?33.05,P＜0.05;vs CONT wall-to-lumen ratio of arteriole 2.33?1.01,P＜0.01,except TAHD group].Though with the similar level of blood pressure,blood glucose and lipid,HRGL,compared with TAHD group showed lower urinary protein excretion rate [HRGL (16.78?3.50) mg/24 h vs TAHD (27.94?12.79) mg/24 h,P＜0.05],decreased glomerular injury score (HRGL 18.04?7.76 vs TAHD 27.92?6.39,P＜0.05) and wall-to-lumen ratio of arteriole (HRGL 1.75?0.38 vs TAHD 2.16?0.90,P＜0.05) in the cortexes of unclipped right kidneys.The expression of type 1 angiotensinⅡreceptor (AT1R) mRNA was no difference in HRGL group and TAHD group,but the expression of type 2 angiotensinⅡreceptor (AT2R) mRNA was more intensive in HRGL group.Conclusion Rosiglitazone can protect the kidneys from hypertensive injury,especially in high dose.The beneficial effects seem incompletely dependent on the metabolism modulating and reduction of blood pressure,but in relationship to the upregulation of AT2R mRNA.

By using cup culture, influence of different strains (ammonium-resistant N2-fixing type, wild type, none N2-fixing type) of Klebsiella oxytoca on the growth of rice seedling was compared. It was discovered that ammonium-resistant N2 -fixing bacteria could excrete some plant growth promoting substance, which could be adsorbed by cation resin. It' s activity wouldn't be affected at 80℃. At optimal concentration, the weight of rice root and seedling were increased by