Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Imipenem ; pharmacology ; Infant ; Klebsiella pneumoniae ; drug effects ; isolation & purification ; Ventilation ; methods

A total of 115 patients with Hoshimoto thyroiditis were classified under 2 groups: one group being treated with selenium and L-throxine (L-T4) and other group with L-T4 alone.All patients were followed up for 3 months.In the selenium treated group thyroid peroxidase antibody level was decreased in 33 patients (56%) and thyroglobulin antibody level was decreased in cases.

Objective: To explore the changes of right heart structure in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 194 T2DM patients were recruited in our research including those complicated with hypertension (HP). The patients were divided into 2 groups: T2DM+HP group and T2DM group,n=97 in each group. In addition, there was a Control group composed by 97 healthy subjects from regular physical examination at the same period of time. Right heart structure was assessed and compared by echocardiography in all participants. Results: The pulmonary artery diameter (PAD), right atrial short axis diameter (RA-D1), right atrial long axis diameter (RA-D2) and right atrial area (RAA) were different among 3 groups, allP<0.05. Right ventricular (RV) basal diameter (RV-D1) and RV out flow tract diameter (RVOT1) were similar among different groups,P=0.066 andP=0.059. Compare with Control group, T2DM+HP group had increased RA-D1, RA-D2, RAA and PAD, allP<0.05, while right ventricular free wall thickness was similar between 2 groups; T2DM group showed increased PAD,P<0.05, while RA-D2 was similar,P=0.061. Linear correlation analysis indicated that RV-D1, RVOT1, PA, RA-D1, RA-D2 and RAA were positively related to BMI (r=0.123-0.380) and waist-to-hip ratio (r=0.136-0.325), allP<0.05; RA-D2 and RAA were positively related to natural logarithm of urinary albumin excretion rate (lnUAER) (r=0.172 andr=0.130),P<0.05; PAD was positively related to diastolic blood pressure and E/E' (r=0.154 andr=0.172), negatively related E/A (r=-0.118),P<0.05. Multi regression analysis presented that gender and BMI were independently related to RV-D1, RVOT1, RA-D1, RA-D2 and RAA; BMI and diastolic blood pressure were independently related to PAD; lnUAER was independently related to RAA. Conclusion: T2DM+HP patients had broadened PA and RV basal part, increased RA-D and RAA; the changes of right heart structure were relatively mild in T2DM patients. Elevated blood pressure, BMI and UAER were closely related to the changes of right heart structure in T2DM patients.

Objective To evaluate the variables which can be used as prognostic factors in predicting the outcome of Graves disease(GD)after treatment with antithyroid drugs.Methods We performed a retrospective audit of 204 patients with newly diagnosed Graves disease consecutively at the Ruijin Hospital.Results Overall,110 patients(53.9%)were considered to be treatment failures.Age at the time of diagnosis was(31.0±12.2)years in the successful group and(36.3±14.0)years in the failure group.Free T3(FT3)was(25.60±9.52)pmol/L and(19.16±6.38)pmol/L in the failure and the successful group(P=0.001).FT3 to FT4 ratio and thyrotrophin recptor antibody(TRAb)levels were higher in the failure group(P=0.001).Logistic regression analysis showed that thyroid size,FT3 to FT4 ratio and TRAb at the time of diagnosis were associated with failure outcome.The patients reached euthyroid state at 3,6,9 and 12 months respectively and in the failure group the patients with continued thyrotropin suppression were more than those in the successful group(P=0.001).Conclusions Graves disease patients with large thyroid size,high levels of TRAb and FT3 to FT4 ratio before drug treatment are more likely to fail to respond to antithyroid drug treatment.We also found that patients with continuing thyrotropin suppression and attainmen of euthyroid state in the course of treatment had low remission rate and prolonged therapy.

Objective To explore the mechanism of persistent thyrotropin suppression in euthyroid patients with Graves′ disease after antithyroid drugs (ATD) treatment. Methods A prospective clinical study was performed in 122 patients with newly diagnosed Graves′ disease. All the patients were treated with 30 mg methimazole or 300 mg propylthiouracil daily, to whom L-T4was added, aiming at normalizing FT3 and FT4 but avoiding elevated TSH level. When the patients were clinically and biochemically euthyroid for at least 3 months, their blood levels of thyroid hormones, TSH, TSH receptor antibody(TRAb) and thyroid peroxidase antibody(TPOAb) were detected again and the cases were divided into two groups according to negative or positive TRAb. Results After treatment as long as (7.1±1.1) months, stable euthyroid status was restored for 3 months. When the patients reached the euthyroid state, 64 of them still had detectable TRAb levels, and 58 became negative TRAb. The two groups had similar levels of FT3 and FT4, but patients with positive TRAb had lower TSH level than patients with negative TRAb[0.044 mIU/L(0.001-4.163 mIU/L) vs 1.749 mIU/L(0.079-4.646 mIU/L),P＜0.01]. In addition, the TSH level was negatively correlated with TRAb level (r=-0.539, P＜0.01), and not with FT3, FT4 levels or other factors. Conclusion The present study showed that elevated TRAb level is associated with persistent suppression of TSH in patients with Graves′ disease after being rendered euthyroid. This finding may be due to the binding of TRAb to pituitary TSH receptor.

Crocetin, a naturally occurring carotenoid, possesses antioxidant and antiatherosclerotic properties, of which the underlying mechanism remains unclear. In the present study, we examined the effects of crocetin (0.1, 1, 10 μmol·L(-1)) on angiotensin II (Ang II, 0.1 μmol·L(-1)) induced expression of vascular cell adhesion molecule-1 (VCAM-1) in human umbilical vein endothelial cells (HUVECs) and monocyte-endothelial cell adhesion. The effects of crocetin on the activation of nuclear factor kappa B (NF-κB) and intracellular reactive oxygen species (ROS) were also observed. The results demonstrated that crocetin notably suppressed Ang II induced NF-κB activation (P<0.01) and VCAM-1 expression (P<0.05, P<0.01) in HUVECs, accompanied by a markedly reduced monocyte-endothelial cell adhesion (P<0.05, P<0.01). In addition, preincubation with crocetin resulted in a significant enhancement of cellular antioxidant capacity (P<0.05, P<0.01), while Ang II induced intracellular ROS decreased markedly (P<0.05, P<0.01). These results indicated that crocetin was capable of suppressing Ang II induced VCAM-1 expression and monocyte-endothelial cell adhesion by suppression of NF-κB activation, which might be derived from the enhancement of antioxidant capacity and subsequent reduction of intracellular ROS.
Angiotensin II ; metabolism ; Antioxidants ; pharmacology ; Carotenoids ; pharmacology ; Cell Adhesion ; drug effects ; Human Umbilical Vein Endothelial Cells ; cytology ; drug effects ; metabolism ; Humans ; Monocytes ; cytology ; NF-kappa B ; metabolism ; Reactive Oxygen Species ; metabolism ; Vascular Cell Adhesion Molecule-1 ; metabolism

Objective To establish an simple and convenient animal model of cardiac arrest for studying cerebral resuscitation.Method Clean male Sprague Dawley rats were randomly divided into sham group and experimental group.Cardiac arrest was induced by asphyxiation and ice-cold 0.5 mol KCl with blood flow cut off for 5 minutes.Animals were resuscitated with external cardiopulmonary resuscitation (CPR),mechanical ventilation,and epinephrine injection.Blood pressure,heart rate,successful ratio of resuscitation after 72 hours, time of cardiac arrest (T_(CA)) and return of spontaneous circulation (T_(ROSC)) were recorded.Neural deficit scores (NDS) and levels of maleic dialdehyde (MDA) in plasma were evaluated at 3,6,12,24,48,72 hours after ROSC.The damage score of cortex was measured by transmission electron microscope examination at 3 hours and 72 hours after ROSC.Results All the rats in experimental group had cardiac arrest rapidly.T_(CA) and T_(ROSC) were (137.3?10.2) seconds and (64.4?9.3) seconds,respectively,while the successful rate of resuscitation was 82.5%.The lowest NDS was at 3 hours after ROSC,while the NDS increased gradually.After CPR,the level of MDA in plasma increased significantly,slightly declined at 72 hours after ROSC,but still significantly higher than before the model.Electron microscope examination of cortex showed neuron slightly,organelle and astrocyte,but became better after 72 hours post ROSC.Conclusions The model of cardiac arrest was easy to establish,and the data provided was accurate,which is useful to study the mechanism of cerebral resuscitation.

Medullary thyroid cancer (MTC) is characterized hy the secretion of calcitonin that is derived from parafollicular cells.20％-25％ of MTC are hereditary.Compared with other types of thyroid cancer,MTC is prone to recurrence,metastasis,and younger onset age.RET gene germline mutation accounts for the hereditary MTC,and somatic mutation is responsible for part of sporadic cases.A good correlation between phenotype and genotype is reported.We present in this article a case of medullary thyroid cancer patient with genetic diagnosis and treatment as well as postoperative follow-up together with RET gene screening results in her family members in order to call attention to the diagnosis and treatment of MTC.

Objective To explore the relationship between serum leptin level and the hypothalamuspituitary-gonad ( HPG) axis in female adolescents with anorexia nervosa ( AN). Methods Sixteen newly diagnosed female adolescents with AN in Shanghai and Zhejiang province were investigated, and their serum leptin, FSH, LH and body composition were measured before and after 18 weeks treatment, and their menorrhea cycles were observed. The rhythm of 24 h serum leptin secretion was studied in 4 patients with AN. Twenty-six, healthy females with normal weight and without contraceptive medication were studied as controls. Results (1) All of 16 patients had amenorrhea, 3 primary amenorrhea and 13 secondary amenorrhea. At admission LH in 14 patients and FSH in 12 patients were below the low limit of the normal reference range (1.5 U/L and 4. 6 U/L respectively), and among them 5 patiend had both 15% weight gain and significantly increased serum leptin level (P

Objective To investigate the quality of life and its influencing factors of families primary caregivers of dementia patients .Methods The typically self made questionnaire ,WHO quality of life measurement profile (WHOQOL‐BREF) ,zarit bur‐den of care scale(ZBI) ,social support rating scale (SSRS) et al were adopted to investigate 64 caregivers of AD patients .Results (1) The overall quality of life of family caregivers of total subjective feelings were significantly lower than the general health status of subjective feeling score (t= -2 .217 ,P=0 .030) .The field of physiological and psychology points have no statistically significant difference in comparison with Chinese norm (t= -0 .252 ,-1 .994 ,P=0 .801 ,0 .050);the field of social and environment points have statistically significant difference compared with norm(t= -3 .830 ,3 .658 ,P=0 .000 ,0 .001) .(2) caregiver who have spouse , poor parent child relationship and patients with somatic diseases and mental behavior symptoms have lower quality of life(P<0 .05) .(3)Total score of Quality of life was negatively associated with total score of care burden (r= -0 .433 ,P=0 .000) ,while was significant positive associated with total score of the social support (r=0 .346 ,P=0 .005) .(4)Marital status ,parent‐child rela‐tionship ,physical illness and social support were the main factors affecting the quality of life(r2 =0 .409) .Conclusion Strengthen the social support and psychological intervention of dementia caregivers who has a spouse ,poor parent-child relationship and poor physical condition may help to improve the quality of life .