Objective To invesgate the safety and efficacy of the second generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL2) stent in diabetic patients by a subgroup analysis of of the CREDITⅡand CREDIT Ⅲ trials. Methods All patients who were implanted with the EXCEL2 stent were enrolled in the CREDITⅡand CREDIT Ⅲ trials. The primary endpoint was target lesion failure at 24-month, defi ned as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization(TLR). The secondary endpoint was endpoints including all-cause death, all myocardial infarction (MI) or any revascularization.Results A total of 828 patients were included from the patients who were implanted with the EXCEL2 stent in the CREDIT II and CREDIT Ⅲ trials. 24-month follow-up rate was 99.5%. There was no significant difference in the primary endpoint (P>0.05) and event rates of the secondary endpoints(P>0.05) between the diabetic and non-diabetic group, which included all-cause death[diabetics (2.5%)vs.non-diabetics(1.4%),P>0.05],myocardial infarction(MI)(7.5% vs.5.0%,P>0.05),all from of revascularization(5.0% vs.3.9%,P>0.05),and stent thrombosis(0.6% vs.0.4%,P>0.05).Conclusions EXCEL 2 stent met the objective performance goal on effcacy and safety, which can reduce make stent restenosis, target vessel revascularization ,with 160 diabetic cases among them, and stent thrombosis in diabetic patients.

BACKGROUNDCandidal esophagitis is the primary infection among all digestive tract opportunistic ones in acquired immunodeficiency syndrome (AIDS) cases. X-ray manifestation reports of it are still rare. This study aimed to conduct a retrospective analysis on the X-ray data of 6 AIDS cases complicated with candidal esophagitis, and to study the X-ray characteristics of it combined with the findings from gastroscopy.

METHODSAmong 6 cases in this series, all cases were confirmed by Shenzhen Center for Disease Control and Prevention (CDC) to be HIV positive and all of them had CD4 cell counts less than 150 × 10(6)/L. All cases underwent X-ray and gastroscopy, and mycelium were found in the mucous membrane of the esophagus.

RESULTSIn this series, the findings of the X-ray were as follows: (1) Affected areas: Four cases in the whole esophagus, 2 cases in the middle and lower part of esophagus; (2) Abnormal motivity: Six cases had decreased tension, loose walls, weakened peristalsis, decreased number of peristalsis waves and delayed emptying of barium; (3) Abnormal contour: Six cases had the sign of "decorative border" or "brush", two cases had narrowed canal; (4) Abnormal membrane and "cobblestone sign": Six cases had thickened membrane and "cobblestone sign" on the surface of the abnormal membrane. The hyperemia of mucosa was covered tightly with yellow-white pseudomembrane spots. This was in accordance with the small cobblestone-like filling defect found by X-ray.

CONCLUSIONSIf the AIDS cases have dysphagia, and X-ray shows that more than two sections of the esophagus are affected, with decreased motility, the walls in the sign of "brush" or "decorative edges", thickened membrane with "cobblestone sign", candidal esophagitis is highly possible.

Acquired Immunodeficiency Syndrome ; diagnosis ; diagnostic imaging ; Adult ; Candida ; pathogenicity ; Candidiasis ; diagnosis ; diagnostic imaging ; microbiology ; Esophagitis ; diagnosis ; diagnostic imaging ; microbiology ; Female ; Humans ; Male ; Radiography

BACKGROUNDDermatomyositis (DM) and polymyositis (PM) are common inflammatory myopathies whose immunopathogenic mechanisms remain poorly understood. The NOD-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome is a type of cytoplasmic multiprotein inflammasome and is responsible for the activation of inflammatory reactivations. Responding to a wide range of exogenous and endogenous microbial or sterile stimuli, NLRP3 inflammasomes can cleave pro-caspase-1 into active caspase-1, which processes the pro-inflammatory cytokines pro-interleukin (IL)-1β and pro-IL-18 into active and secreted IL-1β and IL-18. The NLRP3 inflammasome is implicated in infectious and sterile inflammatory diseases. However, it remains unclear whether it is involved in the pathogenesis of DM/PM, which we aim to address in our research.

METHODSIn this study, 22 DM/PM patients and 24 controls were recruited. The protein and RNA expression of IL-1β, IL-18, NLRP3, and caspase-1 in serum and muscle samples were tested and compared between the two groups.

RESULTSThe serum IL-1β and IL-18 levels were significantly higher in DM/PM patients than those in the controls by enzyme linked immunosorbent assay (ELISA, DM vs. control, 25.02 ± 8.29 ng/ml vs. 16.49 ± 3.30 ng/ml,P < 0.001; PM vs. control, 26.49 ± 7.79 ng/ml vs. 16.49 ± 3.30 ng/ml,P < 0.001). Moreover, the real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) showed that DM/PM patients exhibited higher RNA expression of IL-1β, IL-18, and NLRP3 in the muscle (for IL-1β, DM vs. control, P= 0.0012, PM vs. control, P= 0.0021; for IL-18, DM vs. control, P= 0.0045, PM vs. control, P= 0.0031; for NLRP3, DM vs. control, P= 0.0017, PM vs. control, P= 0.0006). Moreover, the protein expression of NLRP3 and caspase-1 in muscle samples of DM/PM patients were also significantly elevated compared to that in the muscles of the controls.

CONCLUSIONSOur findings demonstrate that the NLRP3 inflammasome is implicated in the pathogenesis of DM/PM. High NLRP3 expression led to elevated levels of IL-1β and IL-18 and could be one of the factors promoting disease progress.

Adult ; Caspase 1 ; analysis ; genetics ; Dermatomyositis ; etiology ; Female ; Humans ; Inflammasomes ; physiology ; Interleukin-18 ; analysis ; genetics ; Interleukin-1beta ; analysis ; genetics ; Male ; Middle Aged ; NLR Family, Pyrin Domain-Containing 3 Protein ; analysis ; genetics ; physiology ; Polymyositis ; etiology

Hemochromatosis ; metabolism ; Humans ; Iron Overload ; Liver ; metabolism ; Male ; Middle Aged

The objective of this paper is to develop a fast analysis method to determine fingerprints of Radix Glycyrrhizae from different areas of China for identification and quality control. The experiments were carried out under following conditions: Agilent Eclipse Plus C18 (4.6 mm x 50 mm, 1.8 microm) column, acetonitrile and 0. 05% phosphoric acid solution as the mobile phases with gradient elution, flow rate 1.0 mL x min(-1), analysis time 11 min. The run time of the method was obviously decreased from 36 minutes to 11 minutes compared with routine HPLC method. The cluster analyses of the fingerprints of the 70 samples were performed by SPSS. The results showed that all samples were classified into 2 groups, 59 Glycyrrhiza uralensis as well as 11 G. inflata. Three compounds, liquiritin apioside, liquiritin and glycyrrhiza acid should be considered as effective references for quality control of Radix Glycyrrhizae. This method can be used widely for identification and quality control of Radix Glycyrrhizae.
Chromatography, High Pressure Liquid ; methods ; Flavanones ; analysis ; Glucosides ; analysis ; Glycyrrhiza ; chemistry ; Glycyrrhizic Acid ; analysis ; Reproducibility of Results

OBJECTIVETo determine the effects of modified pull-through operation (Badenoch operation) on the treatment of posterior urethral stricture.

METHODSFrom September 2001 to December 2010 traditional pull-through operation was Modified for two times in our center. A total of 129 patients with posttraumatic posterior urethral stricture resulting from pelvic fracture injury underwent the modified urethral pull-through operation. Stricture length was 1.5 to 5.3 cm (mean 2.9 cm). Of the patients 43 had undergone at least 1 previous failed management for stricture. In phase 1 (from September 2001 to January 2008), the improving items include: (1) The distal urethral end was stitched and tied to the catheter. (2) As catheter was inserted into bladder and 20 ml water was injected into catheter balloon, the distal urethral end was fixed in the proximal urethra and an overlaying of 1.5 cm was formed between the two ends. (3) Three weeks later, it was tried to insert the catheter to bladder. After the urethral stump necrosis and the catheter separating from the urethra, the catheter was removed. In phase 2 (from February 2008 to December 2010), based on the above, irrigating catheter was used. After the surgery, urethra was irrigated with 0.02% furacillin solution through the catheter 3 times a day. All patients were followed up for at least 6 months. If patients had no conscious dysuria and maximum urinary flow rate (Qmax) > 15 ml/s, the treatment was considered successful. All complications were recorded.

RESULTSIn phase 1, the 96 patients (101 times) underwent the procedure. The treatment was successful in 88 patients (success rate 92%). Within 1 to 13 days after removal of the catheter, urethral stricture was recurred in 8 patients. They had to undergo cystostomy once more for 3 to 11 months before reoperation (the 3 patients' reoperation was in phase 2). The 8 cases were treated successfully. In phase 2, 33 patients (total 36 times) underwent the procedure. One patient was failed (success rate 97%). The actual follow-up time is 7 to 93 months (An average of 37.6 months). Qmax is (22 ± 5) ml/s. No complications such as urinary incontinence, erectile pain, urinary shortening happened.

CONCLUSIONSThe modified urethral pull-through operation is effective for the surgical treatment of posttraumatic posterior urethral stricture. It has a high success rate with durable long-term results. Complications are few. The procedure is simple, less demanding and especially suitable in patients who had previously undergone failed surgical treatments.

Adult ; Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Urethra ; surgery ; Urethral Stricture ; surgery ; Young Adult

OBJECTIVETo investigate a non-syndromic deafness family in which potential interaction between the GJB2 gene and a mitochondrial gene appeared to be the cause of hearing impairment.

METHODSAudiological examination was performed by pure-tone audiometry (PTA). Blood samples from 8 members of the pedigree were obtained. DNA was extracted from the leukocytes. The coding region of the GJB2 gene and mitochondrial DNA target fragments were amplified by polymerase chain reaction (PCR). The PCR products were analyzed by sequencing.

RESULTSDirect sequencing showed that the proband had both a heterozygous mutation of 235delC in the GJB2 gene and a mitochondrial 1555 A to G mutation. The proband had profound hearing loss. The maternal relatives had sensorineural hearing loss in the higher frequencies or no hearing loss.

CONCLUSIONThe GJB2 mutations may be an aggravating factor in the phenotypic expression of the non-syndromic hearing loss associated with the A1555G mitochondrial mutation.

Adolescent ; Adult ; Alleles ; Base Sequence ; Child ; Connexin 26 ; Connexins ; genetics ; DNA Mutational Analysis ; DNA, Mitochondrial ; genetics ; Female ; Genotype ; Hearing Loss ; genetics ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation ; Pedigree ; Phenotype ; Polymorphism, Single Nucleotide

Adult ; Aged ; Aged, 80 and over ; Angiomyolipoma ; diagnostic imaging ; Carcinoma, Renal Cell ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, Spiral Computed ; methods ; Young Adult

AIDS-Related Opportunistic Infections ; diagnostic imaging ; drug therapy ; etiology ; Adult ; Bone Marrow Examination ; CD4 Lymphocyte Count ; Female ; Humans ; Male ; Middle Aged ; Mycoses ; diagnostic imaging ; drug therapy ; etiology ; Penicillium ; isolation & purification ; Prognosis ; Radiography

OBJECTIVETo investigate the application of percutaneous endoscopic gastrostomy (PEG) to patients with severe craniocerebral injury for the purpose of nutritional support therapy and pulmonary infection prevention.

METHODSA total of 43 patients with severe craniocerebral injury admitted to our department from January 2008 to December 2012 received PEG followed by nutritional therapy. There were other 82 patients who were prescribed nasal-feeding nutrition. Nutrition status was evaluated by comparing serum albumin levels, and the incidence of pulmonary infection 1 week before and 2 weeks after operation was identified and compared.

RESULTSBoth PEG and nasal-feeding nutrition therapies have significantly elevated serum albumin levels (P<0.05). Serum albumin levels before and after nutritional therapies showed no significant difference between the two groups (P>0.05). The incidence of pulmonary infection in PEG group was significantly decreased compared with that in nasal-feeding nutrition group (P<0.05).

CONCLUSIONPEG is an effective method for severe craniocerebral injury patients. It can not only provide enteral nutrition but also prevent pulmonary infection induced by esophageal reflux.

Craniocerebral Trauma ; therapy ; Gastroesophageal Reflux ; prevention & control ; Gastroscopy ; Gastrostomy ; methods ; Humans ; Lung Diseases ; prevention & control ; Nutritional Support ; Serum Albumin ; analysis