Animals ; Calcium ; metabolism ; Cell Hypoxia ; Cells, Cultured ; Hippocampus ; cytology ; Neurons ; drug effects ; metabolism ; Rats ; Rats, Wistar ; omega-Conotoxins ; pharmacology

Objective To analyze the safety and clinical efficacy of three types stents of transjugular intrahepatic portosystemic shunt (TIPS) in treatment of cirrhosis with portal hypertension.Methods Totally 1 086 patients with cirrhotic portal hypertension underwent TIPS for the first time.All patients were divided into bare stent group (group A),covered stent-group (group B) and combined stents group (group C).The rates of symptom improvement,shunt insufficiency,re bleeding,survival and major complications in 2 years after TIPS were analyzed and compared.Results Totally 1 690 stents were placed in 1 086 patients.The overall technical success rate was 100％;2.53％ (10/396) emergency patients dead due to uncontrolled gastrointestinal bleeding,and 2.78％ (11/396) emergency patients,0.84％ (5/593) bleeding stopped patients dead with acute liver funtional failure.In 2-year following-up,the overall survival rate of group A,group B,group C were 83.78％ (186/222),88.36％ (281/318),96.34％ (526/546),and the difference was statistical significant (x2=4.15,P=0.04).The shunt insufficiency rates of group A,group B,group C were 39.64％ (88/222),22.33％ (71/ 318),11.17％ (61/546),and the difference was statistical significant (x2 =4.15,P=0.04),The rates of rebleeding of group A,group B,group C were 31.53％ (70/222),16.89％ (54/318),7.14％ (39/546),and the difference was statis tical significant (x2 =9.91,P=0.01).The rates of hepatic encephalopathy of group A,group B,group C were 21.62％ (48/222),22.96％ (73/318),19.23％ (105/546),and the difference had no statistical significant (x2 =1.00,P=0.06).Conclusion TIPS is an effective way to relieve portal hypertension and complications in patients with cirrhosis.The safety and clinical efficacy can be improved by 8 mm shunt with double stent technique.

OBJECTIVE:To evaluate the efficacy and safety of dronedarone for atrial fibrillation or atrial flutter.METHODS:The publicly published literatures about the clinical trials on dronedarone for atrial fibrillation or atrial flutter were retrieved from PubMed.The quality analysis of included studies and extraction and cross-check of data were conducted by two reviewers independently using Meta-analysis.Response indexes were tested in tests for heterogeneity and summarized and analyzed using RevMan 5.0.The safety of dronedarone was evaluated.RESULTS:Five RCTs were included.As compared with placebo,dronedarone reduced the hospitalization rate due to cardiovascular events and all-cause mortality(RR=0.76,95%CI=0.72～0.79,P

To explore the effects of dietary conjugated linoleic acid(CLA) on body fat accumulation in male Wistar rats. The obese rat model was established by feeding high lipid forage. The rats were fed a semi-purified diet containing 0.5,1.0,3.0g?kg -1 CLA for 36 days. Low dose group, middle dose group and high dose group all could remarkably reduce the gain of body weight. Low dose group could reduce the body adipose, middle and high dose group could remarkably decrease the body adipose. There were significant differences in the fat and protein contents in the rats thigh between the control group and the group fed high dose CLA. These results suggested that CLA can reduce the body fat in obese Wistar rats.

Objective To estimate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) level for early diagnosis of acute kidney injury (AKI) in patients with sepsis.Methods One hundred and twenty-six sepsis patients admitted to intensive care unit (ICU) in Baoshan Branch Hospital of Shuguang Hospital Affiliated to Shanghai University ofTraditional Chinese Medicine from June 2014 to December 2015 were enrolled, and they were divided into two groups according to whether complication of AKI was present. The levels of urinary NGAL in the two groups of septic patients were evaluated immediately and at 12, 24 and 48 hours after the definite diagnosis, and the levels were compared between the two groups; the receiver operating characteristic curve (ROC curve) was performed and the value of urinary NGAL level in early diagnosis of sepsis AKI was evaluated.Results There were 60 septic cases complicated with AKI (AKI group), with the prolongation of time after definite diagnosis, the urinary NGAL (g/L) levels were gradually increased at 12, 24 and 48 hours, the levels were significantly higher than those at the corresponding time points in the group without AKI [non AKI group (66 cases), 12 hours: 178.2±32.8 vs. 53.8±10.4, 24 hours: 228.4±24.6 vs. 54.1±9.0, 48 hours: 186.1±43.6 vs. 52.5±9.4, allP < 0.05]. The area under ROC curve (AUC) of urinary NGAL level at 24 hours after definite diagnosis and 95% confidence interval (CI) were 0.863 (0.766-0.929) and 0.686 (0.466-0.696), respectively, when the cutoff value of urinary NGAL was 65.9μg/L, the sensitivity was 81.9% and specificity 76.1%; when the cutoff value of urinary NGAL was 57.9μg/L, the sensitivity was 70.2% and the specificity 57.2%.Conclusion Urinary NGAL level can be used as a reference marker for the early diagnosis of sepsis concomitant AKI.

Objective To analyze the clinical application value of serum homocysteine(Hcy) detection in diagnosing acute myo-cardial infarction .Methods 78 cases of acute myocardial infarction in the hospital from January to December 2013 were selected as the acute myocardial infarction group ,69 cases of unstable angina as the unstable angina group and contemporaneous 78 healthy per-sons undergoing the physical examination as the control group .The serum Hcy ,myoglobin and creatine kinase isoenzyme were de-tected and the detection results were performed the statistical analysis .Results The serum Hcy levels and the positive rate in the a-cute myocardial infarction group were significantly higher than those in the unstable angina group (P<0 .05) ,but serum myoglobin and creatine kinase isoenzyme had no statistical differences in the concentration and positive rate between these two groups (P>0 .05) .The serum Hcy concentration and the positive rate in the acute myocardial infarction group and the unstable angina group were higher than those in the control group(P<0 .05) .The ROC curve analysis showed that the efficiency for diagnosing acute my-ocardial infarction from high to low in turn was MYO ,Hcy and CK-MB .Conclusion Serum Hcy may be used as a routine index for diagnosing acute myocardial infarction ,which has certain clinical value for the condition monitoring and prognosis of the disease ,and also has certain clinical significance for the differential diagnosis between acute myocardial infarction and unstable angina .

Objective To investigate the infection situation of HIV in patents in hospital ,and to provide basis for the prevention of AIDS in the hospital .Methods Three kinds of enzyme‐linked immunosorbent assay(ELISA)kits(Beijing wantai ,Beijing kewei , French BIO‐RAD)were used for screening HIV antibody and antigen in 240 781 samples from Jan .2011 to Dec .2013 .All HIV re‐peated positive screening samples were confirmed by western blotting in Chongqing shapingba Center for Disease Control and Pre‐vention .Results Among 240 781 samples from 2011 to 2013 ,593 samples(0 .246% ) were HIV positive at the first screening ,558 samples(0 .231% ) were HIV positive in at the repeated screening ,29 samples(0 .012% ) were HIV indeterminate ,6 samples(0 . 002% ) were HIV negative.Male and female ratio was 3 .39:1 .Conclusion Screening in hospital patients could be an important way to discover cases with HIV infection .It is nesscessary to strengthen the promotion and propaganda of HIV detection ,and new technology of HIV detection could be used to strengthen the inspection of HIV .Moreover ,the consciousness of self protection should be promoted in the treatment of HIV patients .

Objective To observe the effect of transfer factor on immunity in patients with varruca plana and the clinical effect of treatment. Methods Sixty patients with varruca plana were randomly divided into a treatment group (treated with transfer factor) and a control group (treated with routine therapy). Before and after the treatment, T-lymphocyte subgroups in peripheral blood of all the patients were determined by flow cytometry and serum levels of interleukin-10 (IL-10)and in-terferon-gamma (INF-γ)were detected by ELISA. The same detections were done to the twenty healthy volunteers as healthy controls. Results Effective rates in the treatment group and control group were 76.67 % and 43. 33 %, respectively (x2=5. 63,P<0.05). Decrease of CD3+ cells, CD4+ cells, CD4+/CD8+ ratio and increase of CD8+ cells were found in varruca plana group as com-pared with the healthy controls(P<0.01 ). After the treatment of transfer factor, increase of CD3+ cells ,CD4+ cells (P<0.05), CD4+/CD8+ ratio (P<0. 01)and decrease of CD8+ cells(P<0.01)were found in the treatment group as compared with those before treatment, while there were no significant difference in the control group before and after the treatment. Higher IL-10 and lower INF-γ in serum were found in varruca plana group as compared with the healthy controls (P<0.05). After the treat-ment of transfer factor, decrease of IL-10 and increase INF-γ in serum (P<0. 05)were found in the treatment group as compared with those before treatment, while there were no significant difference in control group before and after the treatment. Conclusion The results reveal that immunity is im-paired in patients with varruca plana. Transfer factor can enhance the immunity of the patients. Therefore, varruca plana patients treated with transfer factor receive better effects.

Objective To investigate the risk factors of upper gastrointestinal injury induced by non-steroidal anti-inflammatory drugs (NSAIDs).Methods A total of 1032 patients which used NSAIDs was selected.Patients were divided into two groups based on the condition of dyspepsia,peptic ulcer or upper gastrointestinal bleeding:the adverse drug reaction group (331 cases) and the control group (701 cases).Data of two groups on clinical presentation,laboratory test,medication and treatment were analyzed.Risk factors for the adverse drug reaction were identified by multivariable Logistic regression.Results The two groups had significant difference in age ＞ 65 years old,Helicobacter pylori (Hp) infection,ulcer history,drug overdose,combination with glucocorticoid,addicted to tobacco and alcohol history,non-specific inhibitor of cyclooxygenase(COX)-2,combination with anticoagulant,concomitant chronic cardiopulmonary disease (P ＜ 0.05).Logistic regression analysis by backward elimination method revealed that following variables retained,such as combination with glucocorticoid (OR =3.104,95％ CI 1.936-4.695),Hp infection (OR =2.768,95％ CI 2.047-3.742),drug overdose (OR =2.411,95％ CI 1.683-3.453),ulcer history (OR =1.781,95％ CI 1.278-2.480),age ＞ 65 years old (OR =1.659,95％ CI 1.237-2.225),non-specific inhibitor of COX-2 (OR =1.470,95％ CI 1.103-2.133),addicted to tobacco and alcohol history (OR =1.459,95％ CI 1.032-2.064),concomitant chronic cardiopulmonary disease (OR =1.357,95％ CI 1.008-2.143),P＜0.05.Conclusion Combination with glucocorticoid,Hp infection,drug overdose,ulcer history,age ＞ 65 years old,non-specific inhibitor of COX-2,addicted to tobacco and alcohol history,concomitant chronic cardiopulmonary disease are risk factors of upper gastrointestinal injury induced bv NSAIDs.

Objective To evaluate the clinical application and therapeutic effect of interventional embolization in treating renal pseudoaneurysms. Methods The clinical data of 11 patients with renal pseudoaneurysm, who had received interventional embolization management at authors’ hospital, were retrospectively analyzed. The embolic agents used in the embolization procedure included conventional steel coil, gelatin sponge particles, PVA, etc. All the patients were followed up for 6-24 months. Results Single renal pseudoaneurysm was found in all the 11 patients. Clinically, symptom of bleeding was seen in 3 cases. The renal pseudoaneurysm was located at the upper (n=1), middle (n=4) and lower (n=5) renal artery of the kidney, and in one case the renal pseudoaneurysm was situated at the accessory renal artery. In performing renal artery embolization, pure PVA was used in one case, spring steel coil in one case, PVA together with spring steel coil in one case, and gelatin sponge combined with spring coil in 8 cases. After the embolization, the pseudoaneurysm was no more visualized, the contrast extravasation disappeared, and the parent artery was manifested as a residual root. During the operation the patients had no obvious discomfort. Within one week after embolization therapy, 2 patients developed hemorrhage, and their hemoglobin, white blood cell count and hematocrit were significantly increased. During the follow-up period, all patients showed no recurrence signs, and routine urine tests were normal. Conclusion For the treatment of renal pseudoaneurysms, interventional embolization is minimally-invasive, safe and reliable; this technique can maximally protect the normal kidney tissue, quickly control the bleeding and effectively save the life of patient. Therefore, it is worth promoting this treatment in clinical practice.