Objective To compare iso-osmolar iodixanol and low-osmolar iohexol for the incidence of contrast- induced nephropathy(CIN) in patients with chronic congestive heart failure undergoing coronary interventional therapy. Methods The study included 220 consecutive patients with chronic congestive heart failure and undergoing coronary angiography (CAG) with or without percutaneous coronary intervention (PCI) bewteen Janurary 2015 and May 2016. Study participants were divided into two groups by random digits table:iso-osmolar group (110 patients) and low-osmolar group (110 patients). The patients in iso-osmolar group were given iodixanol, and the patients in low-osmolar group were given iohexol. Serum creatinine (SCr), glomerular filtration rate (GFR) and cystatin C (CysC) were detected before the procedure and on the first, third day after the procedure. Then, the incidence of contrast-induced nephropathy (CIN) in two groups within 72 h of the procedure were observed and compared. Results The levels of SCr, GFR, CysC before operation had no significant differences (P>0.05). The levels of SCr in two groups on the first day after operation were increased, but there was no significant difference between two groups (P>0.05). On the first day after operation, the level of GFR in iso-osmolar group was higher than that in low-osmolar group, the level of CysC in iso-osmolar group was lower than that in low-osmolar group, and there were significant differences (P<0.05). On the third day after operation, the level of GFR in iso-osmolar group was higher than that in low-osmolar group, the level of CysC in iso-osmolar group was lower than that in low-osmolar group, and there were significant differences (P<0.01). The overall incidence of CIN was 20.9%(46/220). The incidence of CIN in low-osmolar group was 29.1%(32/110), in iso-osmolar group was 12.7%(14/110), and there was significant difference (P<0.05). Conclusions In chronic congestive heart failure patients undergoing coronary interventional therapy, the iso-osmolar contrast iodixanol is associated with a lower incidence of CIN compared with low-osmolar iohexol.

Diabetic Nephropathies ; drug therapy ; Glucosides ; pharmacology ; therapeutic use ; Humans ; Paeonia ; chemistry ; Phytotherapy

Background and purpose:The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology,physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation.We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods:A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocarcinoma who were treated between January 1995 and December 2005 in our hospital.Results:3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival time. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months.Conclusions:Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.

Objective To explore the effects of chronic fluorosis on neurons in the cerebral cortex of rats,and to provide some morphological evidence of damage in the central nervous system induced by chronic fluorosis.Methods Male Wistar rats 40 days after birth were fed with high fluoride contented water(100 mg/L)for inducing chronic fluorosis.Immunocytochemistry and in situ hybridization were used to detect c-fos and Caspase 8 at cerebral cortical neurons respectively.Results c-fos positive cells rate and gray scale in the cerebral cortex of chronic fluorosis were 35.8%and 0.2756±0.0241,respectively,and that of control group were 32.1%and 0.2774±0.0331with statistical difference(χ2=0.305,t=0.826,P＞0.05).Caspase 8 positive cells rates of fluorosis group and control group were 18.7%and 14.1%,respectively,the difference being statistically significant(χ2=0.419,P＞0.05).The gray scale of fluorosis group and control group were 0.3874±0.0329 and 0.3884±0.0323,respectively,the difference being statistically significant(t=0.641,P＞0.05).Conclusion Chronic fluorosis had no significant influence on apoptosis of cerebral cortical neurons.

Objective To explore the sleep quality and its influencing factors among the patients with schizophrenia of Hui and Han populations in the rural areas in Ningxia Hui Autonomous Region.MethodsTotally 296 patients with schizophrenia of Hui and Han populations in the rural areas were selected from 2 counties of Wuzhong and Zhongwei in Ningxia Hui Autonomous Region by using cluster random sampling method.Self-made general information questionnaire was used to collect the demographic and clinical characteristics of the patients with schizophrenia.The Pittsburgh Sleep Quality Index(PSQI) was used to evaluate the sleep quality.Brief Psychiatric Rating Scale(BPRS),Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA) were used to measure the psychotic symptoms,depressive symptoms and anxiety symptoms,respectively.ResultsIn the rural areas,the incidence of sleep disorder in the patients with schizophrenia of Hui and Han populations was 84.5%.The influencing factors of sleep disorder in the patients with schizophrenia in the rural areas were age(B=0.055,P=0.012,OR=1.057,95%CI:1.012-1.103),nationality(B=2.250,P<0.01,OR=9.485,95%CI:2.701-33.319),marital status(B=-1.506,P=0.003,OR=0.222,95%CI:0.081-0.605),course of disease(B=-0.003,P=0.089,OR=0.997,95%CI:0.993-1.001),the total score of HAMD(B=0.079,P=0.007,OR=1.083,95%CI:1.021-1.148)and the total score of HAMA(B=0.060,P=0.036,OR=1.061,95%CI:1.004-1.122).ConclusionSleep disorders are common and associated with multiple factors in patients with schizophrenia of Hui and Han populations in Ningxia rural area.In clinical practice,more attention should be paid to the identification and intervention of sleep disorders,so as to improve the sleep quality for the patients with schizophrenia.

Objective: To investigate the characteristic of nasal mucosa absorption in vivo of tetramethylpyrazine hydrochloride (TMP HCl) in rats. Methods: The nasal circulatory perfusion test of TMP HCl was performed in rats.Results: The absorption rate constants was increased with the increasing of the concentration of TMP HCl; The absorption rate constants was increased with the elevating of pH values at the pH value range of 4.70～7.00. Conclusion:When the pH value of nasal circulatory perfusion liquid of TMP HCl is 7.00, the nasal mucosa absorption is optimal.

Objective To analyze quantitatively the multiple parameters of iterative Dixon water-fat separation with echo asymmetric and least-squares estimation (IDEAL) MR imaging sequence, in order to realize safe, noninvasive and accurate observation of intervertebral disc degeneration, and to predict early degeneration in time, improve image quality, and to realize precision medical treatment by providing personalized examinations and optimized imaging protocols.Methods A total of 40 volunteers, 23 males and 17 females, with 20-84 years of age (mean (53.4±16.5) years), were participated in our study to accept lumbar spine MRI examination, including sequences of OSAG T2 FSE, OSAG T1 FSE, OAX T2 FSE, OSAG T2 FSE FS and OSAG IDEAL T2.Lumbar intervertebral disc degeneration was evaluated by Pfirrmann classification.The water signal fraction (WSF) of each disc was measured and calculated accurately with IDEAL in phase and IDEAL out phase images.The differences between Pfirrmann grade and WSF were analyzed statistically.The signal-to-noise ratio (SNR) measurements were carried out on equal size region of interest (ROI) from the same levels of vertebral body (L3) and background zone of T2 FSE FS and T2 IDEAL water image mid-sagittal planes, respectively, and the average value of vertebral body signal strength and the standard deviation of background signal were measured.SNRs of the two sequences were calculated, and the image qualities were compared statistically.Results Of all 200 lumbar discs that measured using Pfirrmann classification, 39 discs were classified as Pfirrmann grade Ⅰ, 42 as grade Ⅱ, 27 as grade Ⅲ, 53 as grade Ⅳ, and 39 as grade Ⅴ.The SNR of T2 FSE FS images was (11.42±6.17) dB, while that of the IDEAL water images was (20.63±9.44) dB, and there was a statistically significant difference between them (P＜0.05).The WSF decreased along with the increase of Pfirrmann grade.The significant differences of WSF were found in all grades (P＜0.05) except for the grade Ⅳ and Ⅴ (P＞0.05).Conclusions The SNR of the IDEAL water images is significantly higher than that of T2 FSE FS images, which bring about better image quality.The WSF calculated based on the IDEAL in phase and IDEAL out phase images will make possible the quantitative, noninvasive and accurate analysis of lumbar disc degeneration, especially on the early stage of disc degeneration.

OBJECTIVE:To evaluate the biological compatibility and clinical therapeutic effect of the medical sterilized bone wax.METHODS:Embedding test and pathological test as well as hemolytic test were performed by using rabbits as test animal.12531case-times were investigated in respect to the therapeutic effect,prognosis and satisfactory rate.RESULTS:The embedded bone wax was coated by connective tissue and has not been absorbed without surrounding inflammation,edema or necrosis.The bone wax could not be absorbed after stanching bleeding of the bone broken surface.No hemolytic phenomena were observed.The wound healing obtained a satisfactory rate of99.1%.CONCLUSION:The sterilized medical bone wax has good biological compatibility and is safe and effective to stanch bleeding.It is convenient to use due to its singer dose sterilized packaging.

BACKGROUND: Although regulatory T cells (Tregs) are key to the maintenance of immunologic homeostasis and tolerance, little is known about Treg-mediated immunosuppression in the stage of sepsis. This article aimed to review the current literature on the role of Tregs in the pathophysiology of septic response, attempting to investigate the role of Tregs in immune dysfunction during sepsis. DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure and PubMed. Articles on the role of Tregs in immune dysfunction during sepsis were identified. RESULTS: The identified articles indicated that Treg levels can be used for the assessment of the course of sepsis. The inhibition of Treg activity can promote the recovery of immune function. CONCLUSION: Since the mechanism of Tregs is complex during the sepsis, more studies are needed.

Objective To investigate the characteristics of minimal fat renal angiomyolipoma (MFAML)and clear cell renal cell carcinoma(CCRCC)in high resolution multi-slice spiral CT(MSCT)and to improve the diagnosis accuracy for the renal tumors.Methods A retrospective analysis was performed on 24 MFAML patients(16 females,8 males)with mean age of 43(19-74)years and 24 CCRCC patients(16 females,8 males)with mean age of 44(21-76)years.All patients had undergone MSCT and proved histopathologically after surgery.The characteristics included tumor location,tumor attenuation on unenhanced CT,enhancement characteristics(degree of tumor enhancement in the early corticomedullary phase,homogeneity of enhancement,amount of enhancement,enhancement pattern over time),tumor margin,intratumoral calcification,and perinephric changes.The predictive value of each CT characteristic was determined by using multivariate logistic regression analysis.Results The tumor location in the kidney (upper pole:MFAML,6 cases,CCRCC,6 cases;middle:MFAML,7 cases,CCRCC,9 cases;lower pole:MFAML,11 cases,CCRCC,9 cases)and smooth tumor margin(MFAML,n=21;CCRCC,n=19)were not significantly different between MFAML patients and those with CCRCC,P＞0.05.Twenty-one cases of both MFAMLs and CCRCCs had the significant enhancement in the early corticomedullary phase,which were hypovascular tumors,whereas the mean amount of tumor enhancement was greater in CCRCC than in MFAML in both the early corticomedullary and the corticomedullary phases(CCRCC:175 HU,196 HU;MFAML:125 HU,145 HU;P＜0.05.MFAML usually showed homogeneous enhancement(n=15)rather than heterogeneous enhancement(n =9),whereas most CCRCC showed heterogeneous enhancement(n =17)rather than homogeneous enhancement(n =7),P＜0.05).Enhancement pattern was not a significant predictor.Within the 13 MFAML cases,8 cases had sufficient blood supply(6 cases showed obvious wash-in-and-wash-out,2 cases were with prolonged enhancement),5 cases with hypovascular showed a pattern of prolonged or gradual enhancement,while 21 CCRCC cases had sufficient blood supply and 71％ of them showed obvious wash-in-and-wash-out.High tumor attenuation on unenhanced scans(MFAML:17 patients (75％);CCRCC:2 patients(8％),P=0.002,OR=0.010)and threshold enhancement values of 129.5 HU in the corticomedullary phase(MFAML:5 patients(20％);CCRCC:20 patients(83％),P =0.004,OR =0.057)were valuable predictors for differentiating MFAML from CCRCC at multivariate logistic regression analysis.Conclusions MSCT is useful in differentiating MFAML from CCRCC,with high tumor attenuation on unenhanced scans and threshold enhancement values of 129.5 HU in the corticomedullary phase being the most valuable CT findings.75％ of MFAMLs with sufficient blood supply also show a pattern of wash-in-and-wash-out,which can easily misdiagnosed as a renal cancer.