OBJECTIVETo investigate the differences in central hemodynamic indices between hypertensive and normotensive subjects and identify the blood pressure index that the most strongly correlate with arterial stiffness and vascular damage markers.

METHODSA cohort of 820 hypertensive patients and 820 normotensive individuals matched for age and gender were enrolled in this study. We measured carotid-femoral and carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) and central blood pressures using pulse wave analysis and applanation tonometry. Plasma homocysteine (HCY), high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also tested in these subjects.

RESULTSIn both hypertensive and normotensive subjects, the central systolic blood pressure (SBP) and pulse pressure (PP) were significantly lower than brachial SBP and PP; this PP amplification was significantly lower in the normotensives (9.85∓6.55 mmHg) than in the hypertensives (12.64∓6.69 mmHg), but the amplification ratios were comparable between the two groups. Blood pressure and age were closely related with aortic arterial stiffness. Compared with normotensive subjects, hypertensive subjects had higher carotid-femoral PWV and AIx, and showed significantly lowered PP amplification ratio with age. Central PP was more strongly related to arterial stiffness and vascular damage markers than the other pressure indices. Multivariate analyses revealed that carotid-femoral PWV and aortic AIx were strongly influenced by central PP but not by the mean blood pressure or brachial PP.

CONCLUSIONThe central PP is a more direct indicator of central arterial stiffness and a better marker of vascular aging than other blood pressure variables. These findings support the use of central blood pressure as a treatment target in future trials.

Aorta ; physiopathology ; Arterial Pressure ; Blood Pressure ; Case-Control Studies ; Hemodynamics ; Humans ; Hypertension ; Pulse Wave Analysis ; Vascular Stiffness

OBJECTIVETo investigate the application of the Chinese Urological Association (CUA) Guidelines on Prostatitis and its effects on the clinical practice patterns of diagnosing and treating chronic pelvic pain syndrome (CPPS) among Chinese urologists and andrologists.

METHODSWe conducted a questionnaire investigation on the application of the CUA Guidelines on Prostatitis among the urologists and andrologists of 173 hospitals in 21 cities of China, and performed statistical analyses on all the eligible questionnaires collected.

RESULTSOf the 1 056 questionnaires distributed, 851 (80.6%) were eligible, of which 71.6% were from the urologists or andrologists in grade 3 hospitals, 80.7% of them with senior or intermediate professional titles and 97.5% had studied the CUA Guidelines. Most of the subjects agreed that Type III prostatitis is a clinical syndrome, whose diagnosis should exclude other conditions with similar symptoms, and whose treatment should aim at relieving pain, alleviating urination symptoms and improving the quality of life. Those who had and those who had not studied the CUA Guidelines differed in their viewpoints on CPPS as illustrated in the book. In clinical practice, the most common treatment options for CPPS were psychological therapy (80.7%), medication (80.4%) and life style adjustment (79.6%), and the most frequently used drugs were phytotherapy (80.0%), alpha-blockers (68.9%) and antibiotics (61.0%).

CONCLUSIONCUA Guidelines on Prostatitis has gained a nationwide application and promoted the standardization of the management of CPPS in China.

Humans ; Male ; Pelvic Pain ; diagnosis ; therapy ; Physicians ; Practice Guidelines as Topic ; Prostatitis ; diagnosis ; therapy ; Surveys and Questionnaires

Objective To investigate the regulatory actions of Intestines-unblocking, Turbid-purging Recipe (ITR) on colonic 5-hydroxytryptamine (5-HT) and its receptor 5-hydroxytryptamine 3 (5-HT3) in rats with constipation-dominant irritable bowel syndrome (IBS-C), and to explore the therapeutic mechanism of ITR in treating IBS-C. Methods Forty-two male SD rats were randomly divided into 6 groups, namely normal group, model group, western medicine group, high-, middle- and low-dose Chinese medicine groups, 7 rats in each group. IBS-C rat model was established by intragastric administration of ice water. After establishment of the model, western medicine group was given intragastric administration of Cisapride Tablets (at the dosage of 3.6 mg·kg-1·d-1), Chinese medicine groups were given intragastric administration of various dosages of ITR granules (18.5, 9.25, 4.625 g·kg-1·d-1 respectively) , and the model group was given intragastric administration of normal saline, the treatment lasting 14 d. The rats in various groups were given normal feeding and drinking. After treatment, HE staining method was used to observe pathological changes in the intestinal tissue, immunohistochemistry method was used to observe the expression levels of intestinal 5-HT and 5-HT3 receptor. Results Compared with the normal group, the expression level of rat intestinal 5-HT was increased (P < 0.05) and that of 5-HT3 receptor was decreased (P < 0.05) in the model group and the medication groups. Compared with the model group, 5-HT expression level was decreased significantly (P<0.05) and 5-HT3 receptor expression level was increased (P < 0.05) in the medication groups, and the improvement of the middle-dose Chinese medicine group was more obvious (P < 0.05). Conclusion ITR has therapeutic efficacy for IBS-C rats through lowering 5-HT expression and increasing 5-HT3 receptor expression, which results into the improvement of intestinal sensitivity and abnormal dynamic of the rats.

OBJECTIVETo examine the correlation between the health-related quality of life measured by the St. George's Respiratory Questionnaire (SGRQ) and the commonly used physiological measures in lymphangioleiomyomatosis (LAM).

METHODSThis study retrospectively analyzed the SGRQ scores and other measures (the Borg scale of breathlessness at rest, 6-minute walking distance, blood oxygen levels, and pulmonary function) of patients diagnosed and confirmed with LAM. Altogether 38 patients between June 2007 and November 2009 were included.

RESULTSThe mean values of the SGRQ three components (symptoms, activity, and impacts) and total scores in the LAM patients were 46.95 +/- 28.90, 58.47 +/- 25.41, 47.89 +/- 29.66, and 51.11 +/- 26.35, respectively. The SGRQ total or component scores were correlated well with the Borg scale of breathlessness, 6-minute walking distance, partial pressure of oxygen in arterial blood, spirometry and diffusion capacity of lung. There were poor correlations between SGRQ score and residual volume or total lung capacity. In our preliminary observation, sirolimus improved the SGRQ total and three component scores and the Borg scale of breathlessness significantly after 101-200 days of treatment (n = 6).

CONCLUSIONSThe SGRQ score in LAM is correlated well with physiological measures (Borg scale of breathlessness, 6-minute walking distance, blood oxygen levels, and pulmonary function tests). The SGRQ could therefore be recommended in baseline and follow-up evaluation of patients with LAM. Treatment with sirolimus, an inhibitor of mammalian target of rapamycin, may improve the quality of life and patient's perception of breathlessness in LAM.

Adult ; Forced Expiratory Volume ; Humans ; Lymphangioleiomyomatosis ; physiopathology ; psychology ; Middle Aged ; Quality of Life ; Residual Volume ; Surveys and Questionnaires ; Vital Capacity

Objective To establish a comprehensive evaluation system for the patient monitor clinical application based on real world data(RWD)to provide references for levels of medical institutions to purchase patient monitors.Methods RWD method was used to collect clinical application data of the monitors from 14 medical institutions in Guangxi Zhuang Autonomous Region,and a Chinese brand X(including X1 series for mid-end products and X2 series for high-end products)and a foreign brand Y(including Y1 series for mid-end products and Y2 series for high-end products)with the highest market share were selected to construct a monitor clinical application evaluation system involving in five indicators such as clinical efficacy,applicability,reliability,instrument function and service system.Data processing was carried out with Mantel-Haenszel analysis,propensity score analysis and pairwise comparison method to calculate the clinical application evaluation scores of X and Y brands of monitors.Results In the mid-end products,X series gained advantages over Y series in clinical efficacy,reliability and applicability(P＜0.05),while the differences between the service systems were not statistically signifi-cantly(P＞0.05);in the high-end products,there were no significant differences between the clinical efficacy,applicability,reliability and service systems(P＞0.05).Brand X and Y monitors were equipped with similar basic and advanced functions.Conchision The evaluation system established based on real-world data can be able to effectively evaluate the clinical appli-cation of the monitor,which provides references for clinical application evaluation of medical devices in China.[Chinese Medical Equipment Journal,2023,44(11):71-78]

OBJECTIVETo evaluate wound healing after types of pancreaticojejunostomy.

METHODSAfter resection of the pancreatic head, 38 domestic piglets were divided into two groups according to the types of anastomoses: group I: binding pancreaticojejunostomy, a new technique designed and advocated by professor Peng Shuyou; group II: end-to-end pancreaticojejunal invagination. Anastomotic strength in vivo and histopathological findings were assessed on operative day and postoperative day 5 and 10.

RESULTSBursting pressure was 139.7 +/- 8.0, 178.7 +/- 9.7 and 268.8 +/- 12.8 mm Hg in group I on day 0, 5 and 10, whereas 67.3 +/- 7.9, 96.2 +/- 10.4 and 130.6 +/- 9.3 mm Hg in group II. The gain on day 0 to 5 and 5 to 10 was 27.9% and 50.5% in group I and 42.9% and 35.7% in group II, respectively. A significant difference was observed between group I and group II, and between 5 and 10 day after anastomoses (P < 0.01). Breaking strength was 4.5 +/- 0.4, 6.6 +/- 0.4 and 10.0 +/- 0.6 N in group I on day 0, 5 and 10 and 4.6 +/- 0.6, 5.8 +/- 0.5 and 7.1 +/- 0.6 N in group II. Although a similar value was shown in both types of anastomoses on day 0, a rapider gain was demonstrated on day 0 to 5 and 5 to 10 in group I (44.8% and 52.9%) than in group II (25.4% and 22.0%). A significant difference was found on day 5 and 10 between the two types of anastomoses (P < 0.05 and P < 0.01). Anastomotic site was well repaired by connective tissue and the cut surface of pancreatic stump was covered by mucosal epithelium in group I on day 10, but the cut surface was incompletely repaired by granulation tissue and no, regeneration of the epithelium was found in group II.

CONCLUSIONAnastomotic strength of binding pancreaticojejunostomy was stronger than end-to-end pancreaticojejunal invagination and the healing was better and rapid.

Anastomosis, Surgical ; methods ; Animals ; Female ; Male ; Pancreaticojejunostomy ; methods ; Swine ; Wound Healing

BACKGROUND: The application of mesenchymal stem cells (MSCs) in the treatment of cartilage damage has become a hot spot of research. Further studies on the distribution of MSCs in the body after injection and on the underlying mechanism of action are needed. OBJECTIVE: To observe the migration of bone marrow mesenchymal stem cells (BMSCs) after injection into the region of osteochondral defect. METHODS: Thirty Sprague-Dawley rats were randomized into two groups (n=15 per group). In the control group, the femoral tochlear was exposed but an osteochondral defect was not made; and after the suture, PKH26-labeled BMSCs were directly injected into the articular cavity of rats. In the experimental group, a cartilage defect of 1 mm in diameter and 1 mm in depth was made in the rat femoral trochlea, and 5×106PKH26-labeled BMSCs were injected into the defect after operation. At 1, 3 and 7 days after injection, the femoral condyle was taken to make frozen sections followed by DAPI staining. The distribution of BMSCs was observed under laser scanning confocal microscope. RESULTS AND CONCLUSION: In the control group, PKH26-labeled BMSCs were not transferred to the subchondral bone. In the experimental group, BMSCs were detected in the subchondral bone area at 1, 3 days after injection of PKH26-BMSCs in the bone cartilage defect area, and the BMSCs were also found in the bone marrow cavity at 7 days after injection. In conclusion, BMSCs in the articular cavity cannot migrate into the subchondral bone and bone marrow cavity unless the cartilage of the femoral condyle is damaged.

Objective:To investigate the protective mechanism of TAK242, a specific inhibitor of Toll-like receptor 4 (TLR4), on the liver of septic rats.Methods:Eighteen male Sprague-Dawley (SD) rats were randomly divided into three groups ( n = 6 in each group). The septic model was established by intraperitoneal injection of lipopolysaccharide (LPS) 15 mg/kg. The rats in the TAK242 intervention group received intraperitoneal injection of TAK242 (5 mg/kg) before modeling, while the rats in the septic model group and the control group were injected with the same amount of solvent [10% dimethyl sulfoxide (DMSO) + 90% corn oil]. Six hours later, the blood of abdominal aorta was collected and the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured by enzyme linked immunosorbent assay (ELISA). The rats were sacrificed to obtain liver, the expression levels of TLR4, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), cysteinyl aspartate-specific proteinase-3 (caspase-3), nuclear factor-κB p65 (NF-κB p65) and phosphorylated NF-κB p65 (p-NF-κB p65) were detected by Western blotting. Immunohistochemical staining was used to observe NF-κB p65 protein expression in liver, and hepatocyte injury was assessed by hematoxylin-eosin (HE) staining. Results:Serum ALT and AST levels in the septic model group were significantly higher than those in the control group [ALT (μg/L): 26.639±7.814 vs. 2.847±2.150, AST (μg/L): 28.442±8.417 vs. 5.779±3.019, both P < 0.01]. The ALT and AST levels in the TAK242 intervention group were significantly lower than those in septic model group [ALT (μg/L): 7.269±3.398 vs. 26.639±7.814, AST (μg/L): 3.580±3.115 vs. 28.442±8.417, both P < 0.01]. Light microscopy showed that the hepatocytes in the septic model group were disordered, with obvious cell edema and increased inflammatory cells infiltration; the hepatocytes in the TAK242 intervention group were more neatly arranged, with significantly reduced hepatocyte edema and reduced inflammatory cells infiltration. Western blotting results showed that caspase-3 protein expression in hepatic tissue of septic model group was significantly higher than that in the control group (caspase-3/GAPDH: 0.794±0.164 vs. 0.482±0.055, P < 0.05), and caspase-3 protein expression in the TAK242 intervention group significantly decreased than that in the septic model group (caspase-3/GAPDH: 0.482±0.056 vs. 0.794±0.164, P < 0.05), which indicated that TAK242 could attenuate hepatocytes apoptosis of septic rats. The expression of IL-6, TNF-α and TLR4 protein and the ratio of p-NF-κB p65/NF-κB p65 in hepatic tissue of septic model group were significantly higher than those in control group (IL-6/GAPDH: 1.442±0.204 vs. 1.019±0.024, TNF-α/GAPDH: 1.089±0.098 vs. 0.806±0.005, TLR4/GAPDH: 1.292±0.085 vs. 0.941±0.087, p-NF-κB p65/NF-κB p65 ratio: 1.936±0.081 vs. 1.579±0.183, all P < 0.05), IL-6, TNF-α and TLR4 protein expression and p-NF-κB p65/NF-κB p65 ratio in the TAK242 intervention group were significantly lower than those in septic model group (IL-6/GAPDH: 1.035±0.042 vs. 1.442±0.204, TNF-α/GAPDH: 0.572±0.096 vs. 1.089±0.098, TLR4/GAPDH: 0.984±0.078 vs. 1.292±0.085, p-NF-κB p65/NF-κB p65 ratio: 1.484±0.255 vs. 1.936±0.081, all P < 0.05), it is suggested that LPS-induced sepsis could activate the inflammatory response mediated by TLR4/NF-κB pathway in liver, and the activation of TLR4/NF-κB pathway was inhibited by TAK242 through the TLR4 pathway, therefore, the inflammation of liver in septic rats was reduced. Immunohistochemical staining showed that the positive expression of NF-κB p65 in liver was significantly increased in the septic model group compared with the control group; the positive expression of NF-κB p65 was significantly reduced in the TAK242 intervention group compared with the septic model group, and there was almost no positive expression in the nucleus. Conclusion:TAK242 could reduce liver function injury and protect the liver by inhibition TLR4/NF-κB pathway in septic rats.

OBJECTIVEThe strains of Yersinia pestis isolated in different period and different natural foci in China were analyzed.

METHODSTraditional and molecular biological methods were used. Rhamnose fermentation, rRNA gene copy number, nitrite reduction, and the glycerol fermentation were important characters for typing, and pulse field gel electrophoresis (PFGE) and random amplified polymorphic DNA (RAPD) profile could reflect the genetic distance between the strains.

RESULTSThe strains could be divided into 15 genetic types by those 6 characters with each of them covered an isolated geographical territories.

CONCLUSIONThe characters of strains were described; the genetic relationship of different types, their evolution, and the forming and shift of plague natural foci were analyzed.

China ; Databases, Genetic ; Electrophoresis, Gel, Pulsed-Field ; Genetic Drift ; Geography ; Mutation ; Random Amplified Polymorphic DNA Technique ; Yersinia pestis ; classification ; genetics ; isolation & purification

BACKGROUNDA five-year follow-up study of intensive multifactorial intervention was undertaken to assess the changes of circulating serum amyloid A (SAA) levels and the incidence of atherosclerosis (AS) in patients with short-duration type 2 diabetes mellitus (T2DM) without macroangiopathy, and whether intensive multifactorial intervention could prevent or at least postpone the occurrence of macroangiopathy.

METHODSAmong 150 patients with short-duration T2DM, 75 were assigned to receive conventional outpatient treatment (conventional group) and the others underwent intensive multifactorial integrated therapy targeting hyperglycemia, hypertension, dyslipidemia and received aspirin simultaneously (intensive group).

RESULTSPlasma SAA levels were higher in diabetic patients than those in healthy control subjects, and decreased obviously after intensive multifactorial intervention. The levels of SAA were positively correlated with body mass index (BMI), waist hip ratio (WHR), triglyceride (TG), high sensitive C-reactive protein (hs-CRP) and common carotid intima-media thickness (CC-IMT). The standard-reaching rates of glycemia, blood pressure and lipidemia were significantly higher in intensive group than those of conventional group. The incidence of macroangiopathy decreased by 58.96% in intensive group compared with conventional group.

CONCLUSIONSIntensive multifactorial intervention may significantly reduce the SAA levels and prevent the occurrence of AS in short-duration patients with T2DM. SAA might be one of the risk factors of T2DM combined with AS.

Adult ; Aged ; Antihypertensive Agents ; pharmacology ; therapeutic use ; Blood Glucose ; metabolism ; C-Reactive Protein ; metabolism ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; metabolism ; Diabetic Angiopathies ; etiology ; Female ; Humans ; Hypoglycemic Agents ; pharmacology ; therapeutic use ; Hypolipidemic Agents ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Multivariate Analysis ; Serum Amyloid A Protein ; metabolism ; Triglycerides ; blood ; Tunica Media ; drug effects