Objective To investigate the clinical value of virtual touch tissues quantification in the evaluation of kidney stiffness in patients of diabetic nephropathy .Methods A total of 90 cases of diabetic nephropathy were divided into 3 groups:infinitesimal albuminuria ,microalbuminuria and massive proteinuria groups.And other 30 health subjects were taken as control group.The shears wave velocity ( Vs) which reflected the tissue elasticity was measured.The Vs values were compared among different groups.Results In all groups,the highest Vs was present in renal cortex .And compared with the renal cortex ,the Vs of the renal medulla and renal sinus have statistically significant differences [ the normal control group:( 3.65 ± 0.26)m/s,(2.72 ±0.35) m/s,(1.83 ±0.54) m/s,t =9.30,18.20,both P <0.05;Infinitesimal albuminuria group:(2.98 ±0.28)m/s,(2.47 ±0.33)m/s,(1.65 ±0.31)m/s,t=5.97,15.57,both P<0.05;microalbuminuria group:(2.55 ±0.22) m/s,(2.22 ±0.28) m/s,(1.54 ±0.21) m/s,t =3.86, 11.83,both P<0.05;massive proteinuria group:(1.99 ±0.28)m/s,(1.49 ±0.30)m/s,(1.01 ±0.39)m/s, t=5.85,11.48,both P<0.05].The renal cortex Vs of Infinitesimal albumonuria group ,microalbuminuria group and massive proteinuria group show a gradually decreasing trend .And the renal cortex Vs of microalbuminuria group and massive proteinuria group have statistically significant differences compared with the normal control group(t=11.79,17.79,both P<0.05).Conclusions Virtual touch tissues quantification technique can reflect the renal tissue elasticity .It will contribute to the assessment of renal function in patients with early diabetic nephropathy .

Objective To investigate the expression of serum angiopoietin-2 (Ang-2 ) and its clinical significance in patients with chronic heart failure (CHF).Methods The levels of serum Ang-2,N-terminal pro-B-type natriuretic peptide (NT-proBNP)and left ventricular ejection fraction (LVEF)were detected in 1 1 3 patients with CHF,who were divided into four groups according to New York Heart Association (NYHA:class Ⅰ,n=3 2;Ⅱ,n=30;Ⅲ,n=26;Ⅳ,n=25).Another 20 healthy volunteers for physical check-up were chosen as the control group.Results With the change of cardiac function (from Ⅰ to Ⅳ),the levels of plasma Ang-2 and NT-proBNP were increased significantly (P<0.05 ).The level of serum Ang-2 was positively correlated with NT-proBNP (r=0.774,P<0.001),but negatively correlated with left ventricular ejection fraction (r=-0.725,P<0.001).Conclusion The level of serum Ang-2 has a significant correlation with the severity of heart failure.Ang-2 is expected to be used to predict and evaluate the severity of CHF.

OBJECTIVETo investigate the chemical constituents of the root barks of Periploca sepium.

METHODColumn chromatographic techniques were used to isolate the chemical constituents. NMR and MS methods were employed for their structural elucidation.

RESULTEight compounds were isolated and identified as isovanillin (1), vanillin (2), 4-methoxysalicylic acid (3), (24R)-9, 19-cycloart-25-ene-3beta, 24-diol (4), (24S)-9, 19-cycloart-25-ene-3beta, 24-diol (5), cycloeucalenol (6), beta-amyrin acetate (7) and alpha-amyrin (8).

CONCLUSIONCompounds 1-6 were isolated from this plant for the first time.

Benzaldehydes ; chemistry ; isolation & purification ; Molecular Structure ; Periploca ; chemistry ; Phytosterols ; chemistry ; isolation & purification ; Plant Bark ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Triterpenes ; chemistry ; isolation & purification

OBJECTIVETo study the chemical constituents of Lygodium japonicum.

METHODColumn chromatographic techniques were used for isolation and purification of chemical constituents of this plant and their structures were identified by spectroscopic analysis.

RESULTEight compounds were isolated and identified as tilianin (I), kaempferol-7-O-alpha-L-rhamnopyranoside (II), kaempferol (III), p-coumaric acid (IV), hexadecanoic acid 2, 3-dihydroxy-propyl ester (V), daucosterol (VI), beta-sitosterol (VII, and 1-hentriacontanol (VIII) respectively.

CONCLUSIONCompounds I, II, V, VI, VII, VIII were isolated from L. japonicum for the first time, compounds I, II, V were isolated from genus Lygodium for the first time.

Ferns ; chemistry ; Flavonoids ; chemistry ; isolation & purification ; Glycosides ; chemistry ; isolation & purification ; Kaempferols ; chemistry ; isolation & purification ; Plant Components, Aerial ; chemistry ; Plants, Medicinal ; chemistry

OBJECTIVESTo investigate the relationship of the transforming growth factor beta1 (TGF-β1) mRNA expression in atrial myocardium and the effectiveness of radiofrequency Maze procedure in patients with rheumatic valvular disease (RHD) and permanent atrial fibrillation (AF).

METHODSBetween January 2008 and September 2008, 40 patients with RHD and AF underwent a radiofrequency Maze procedure with concomitant valvular surgery. The patients were assigned to normal sinus rhythm (SR) group (group A) and persistence AF group (group B) according to the results of the 6-month follow-up. Another 10 patients with SR and RHD undergone valvular surgery alone were assigned to control group (group C). Left atrial appendage were obtained in all patients. Expressions of TGF-β1 mRNA were detected by semiquantitative RT-PCR technique. CVF-I and CVF-III were observed by sirius red staining.

RESULTSAt 6-month follow-up, there were 28 patients in group A and 12 in group B. Patients in group A and group B had higher mRNA expressions of TGF-β1, CVF-I and CVF-I/CVF-III compared with group C (P < 0.05). Also, the group B had higher mRNA expressions of TGF-β1, CVF-I and CVF-I/CVF-III than group A (P < 0.05). The patients who had return of functional atrial contraction in group A had lower mRNA expression than the non-return patients (39 ± 12 vs. 60 ± 12, P < 0.05). The TGF-β1 mRNA expression had a correlation with both the contents of CVF-I and left atrial diameter (r = 0.786, P < 0.05; r = 0.858, P < 0.05). Multiple logistic regression analysis revealed that the risk factors which independently associated with the postoperative persistence of atrial fibrillation at 6-month follow-up includes mRNA expression levels of TGF-β1 (OR = 1.13, 95%CI 1.05 - 1.18, P = 0.031), CVF-I (OR = 1.07, 95%CI 1.00 - 1.13, P = 0.037) and lett atrial diameter (OR = 2.23, 95%CI 1.08 - 4.59, P = 0.042).

CONCLUSIONSThe atrial TGF-β1 mRNA expression level could predict the persistence of AF and the return of the functional atrial contraction at 6-month follow-up in patients who underwent rheumatic valvular surgery and concomitant radiofrequency Maze procedure.

Atrial Fibrillation ; etiology ; metabolism ; surgery ; Catheter Ablation ; Follow-Up Studies ; Heart Atria ; metabolism ; Humans ; Rheumatic Heart Disease ; complications ; Transforming Growth Factor beta1 ; metabolism ; Treatment Outcome

OBJECTIVETo investigate the relationship between tobacco smoking, drinking and p53 alteration in esophageal carcinoma.

METHODSLiterature on the relationship between p53 alteration in esophageal carcinoma and tobacco smoking, drinking through Meta-analysis were reviewed.

RESULTSIn 14 selected papers related to tobacco smoking, pooled odds ratio (OR) of tobacco smoking with P53 overexpression and p53 alteration were 1.99 (95% CI: 1.30- 3.06) and 1.64 (95% CI: 1.13 - 2.37), respectively (P < 0.05). Pooled OR of tobacco smoking with p53 mutation was 1.11 (95% CI: 0.47 - 2.76) (P > 0.05). In 11 selected papers on alcohol drinking, pooled OR of drinking with P53 overexpression, p53 mutation and p53 alteration were 1.30 (95% CI: 0.83 - 2.04), 1.13 (95% CI: 0.67 - 1.90) and 1.22 (95% CI: 0.87 - 1.72) respectively (P > 0.05).

CONCLUSIONThere were significant relations between tobacco smoking and p53 alteration while there were no significant relations between alcohol drinking and p53 alteration.

Alcohol Drinking ; Esophageal Neoplasms ; etiology ; genetics ; Female ; Genes, p53 ; genetics ; Humans ; Male ; Mutation ; Risk Factors ; Smoking ; adverse effects ; Tumor Suppressor Protein p53 ; biosynthesis ; genetics

Acute Disease ; Adolescent ; Adult ; Apolipoprotein A-I ; blood ; Apolipoproteins B ; blood ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Female ; Humans ; Insecticides ; poisoning ; Lipids ; blood ; Lipoproteins ; blood ; Male ; Middle Aged ; Organophosphorus Compounds ; Poisoning ; blood ; Triglycerides ; blood

OBJECTIVETo introduce a new flap for the repair of soft tissue defects in the hand.

METHODSThe distally pedicled ulnar flap is based on the ascending branch of the upper-wrist cutaneous branch of the ulnar artery. The retrograde flow is ensured by the dorsal carpal arch via the descending branch.

RESULTSFrom 2000 to 2003, the flap was used to treat 8 cases of hand defects, including 3 dorsal defects, 2 palmar defects and 3 the first web defects. All flaps survived and the appearance was satisfactory.

CONCLUSIONSThe reverse forearm flap pedicled with the ulnar branch of the ulnar artery provides a long vascular pedicle. The donor site scar is aesthetically acceptable.

Adult ; Female ; Forearm ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Ulnar Artery ; surgery ; Wrist

OBJECTIVETo summarize the etiology and treatment of gynecomastia in male children.

METHODSThe clinical data of 38 boys with gynecomastia at ages of 2-14 years were retrospectively studied.

RESULTSIn the 38 cases, 17 cases were identified as adolescent breast hyperplasia, 2 cases were relevant to primary disease, 4 cases were caused by ingestion of drugs containing hormone, and 15 cases did not show identifiable causes and were diagnosed as idiopathic gynecomastia. For the 3 children with breast development in B3 stage, oral rupixiao was administered (1.34 g, tid) for one month. For 16 children at ages of over 12 years with breast development in B2 stage and with obvious clinical symptoms, oral rupixiao was administered (1.34 g, tid) for 3-5 days. The other patients did not receive drug treatment. In a one month to one year follow-up, most of the patients recovered well.

CONCLUSIONSThe etiology of gynecomastia in male children includes adolescent breast hyperplasia, ingestion of drugs containing hormone and secondary causes. Most gynecomastia can be attributed to physiological reasons. Only a few children with obvious clinical symptoms need drug treatment.

Adolescent ; Child ; Child, Preschool ; Gynecomastia ; etiology ; therapy ; Humans ; Male ; Retrospective Studies

OBJECTIVETo observe the effect of sirolimus-based immunosuppression administered on heart transplant recipients with chronic renal dysfunction.

METHODSFrom June 2004 to December 2008, standard calcineurin inhibitors (CNI)-based immunosuppressive regimen was changed to reduced-dose CNI plus sirolimus due to CNI-related chronic renal dysfunction in 20 out of 138 cardiac transplant recipients at Fuwai Hospital. The standard immunosuppressive regimen included steroid, CNI (cyclosporine or tacrolimus), and mycophenolate mofetil or azathioprine. Sirolimus was started at 0.75 - 1.50 mg/d with titration to achieve levels of 5 - 15 µg/L, and CNI dose was reduced gradually to 1/2-2/3 of the baseline level. Patients were followed for changes in renal function, lipid level and clinical side effects related to immunosuppressive therapy. Endomyocardial biopsy (EMB) was performed routinely at 3 weeks, 3, 6 and 12 months after transplantation. EMB was also performed at 3 months after regimen change within 1 year post-transplantation or when rejections were suspected in patients beyond 1 year post-transplantation. Echocardiography was performed for monitoring purpose.

RESULTSThe mean follow-up after regimen change was (7.9 ± 6.3) months. Final sirolimus dose was (0.89 ± 0.22) mg/d and blood drug level was (7.6 ± 3.8)µg/L. Cyclosporine dose was reduced from (191.7 ± 60.0) mg/d to (123.6 ± 34.8) mg/d, with blood drug concentration reduced from (175.5 ± 58.0) µg/L to (111.9 ± 56.0) µg/L in 18 patients (P < 0.01). Tacrolimus average dose was reduced from 4.25 mg/d to 3.00 mg/d, with blood drug concentration reduced from 13.5 µg/L to 10.5 µg/L in 2 patients. Serum creatinine level fell from (160.4 ± 25.5) µmol/L to (134.4 ± 26.8) µmol/L (P < 0.01) and urea nitrogen fell from (13.8 ± 4.7) µmol/L to (10.4 ± 3.0) µmol/L (P < 0.01) at one month after regimen change. Twenty two EMBs were performed in 11 patients within 1 year post-transplant, there were 4 episodes of acute rejected (ISHLT grade 2). Twenty patients are all alive and cardiac function was normal. The most common side effect was hyperlipidemia, and triglycerides, total cholesterol and low density lipoprotein levels were significantly increased at 1 month post regimen change (P < 0.05 or P < 0.01). Leukocyte, hemoglobin and platelet as well as liver function remained unchanged at 1 month post regimen change (all P > 0.05).

CONCLUSIONOur results show that change from CNI-based immunosuppressive regimen to reduced-dose CNI plus sirolimus is an effective and safe approach for the management of patients with CNI-related chronic renal dysfunction, leading to an improvement in renal function without compromise in anti-rejection efficacy and with tolerable side effects.

Calcineurin Inhibitors ; Female ; Heart Transplantation ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Kidney Failure, Chronic ; drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Sirolimus ; therapeutic use