OBJECTIVE:To investigate therapeutic efficacy and safety of levamlodipine and telmisartan combined with hydro-chlorothiazide in the treatment of anti-dipper hypertension. METHODS:Totally 150 patients with anti-dipper hypertension were ran-domly divided into group A,B,C,with 50 cases in each group. Group A was given Telmisartan tablet 40 mg+Hydrochlorothiazide tablet 10 mg,once a day,in the morning. Group B was given Levamlodipine tablet 5 mg,once a day,in the night. Group C was given Telmisartan tablet(usage and dosage same as group A)+Hydrochlorothiazide tablet(usage and dosage same as group A)+Le-vamlodipine tablet(usage and dosage same as group B). Treatment courses of 3 groups lasted for 8 weeks. The changes of electro-lyte and 24 h ambulatory blood pressure were observed and compared among 3 groups before and after treatment. The incidence of adverse reactions was recorded. RESULTS:There was no statistical significance in the electrolyte indexes in 3 groups before and af-ter treatment(P>0.05). Before treatment,there was no statistical significance in 24 h blood pressure among 3 groups(P>0.05). Af-ter treatment,the 24 h blood pressure of the patients in the 3 groups after treatment was lower than before treatment,and group C was lower than that of the group A and group B(P<0.05). After treatment,the rate of anti-dipper rhythm reversal in group C was significantly higher than group A and B,with statistical significance(P<0.05). There was no statistical significance in the inci-dence of ADR among 3 groups(P>0.05). CONCLUSIONS:Levamlodipine and telmisartan combined with hydrochlorothiazide show good therapeutic efficacy for anti-dipper hypertension,and can reduce 24 h blood pressure and effectively reverse anti-dipper rhythm with good safety.

0.05).?2-MG mass concentration was significantly increased in the cerebrospinal fluid(P

Objective To investigate the correlation factors of neonatal lenticulostriate vasculopathy. Method Four hundred and forty-seven newborns from Guangdong Women and Children Hospital were enrolled in this study. Clinical data of the newborns were obtained . Brain ultrasound studies of lenticulostriate artery were performed on the newborns. The logistic regression was performed for screening the correlation factors of neonatal lenticulostriate vasculopathy (P < 0.05). Results Results of the univariate logistic regression reveal the correlation factors tcontributing to LSV include congenital cytomegalovirus infection、neonatal asphyxia、congenital heart disease (CHD),hypertensive disorder in pregnancy (P < 0.05, respectively). Multivariate logistic regression analysis was performed on these factors. The congenital cytomegalovirus infection, neonatal asphyxia, CHD,hypertensive disorder in pregnancy were significantly associated with LSV (P < 0.05). Conclusion The congenital cytomegalovirus infection,neonatal asphyxia,CHD,hypertensive disorder in pregnancy are the correlation factors of neonatal lenticulostriate vasculopathy. LSV could be a predictive marker for the future development of neuropsychiatric disorders. The brain ultrasound studies of lenticulostriate artery is suggested to be performed on all infants with the correlation factors.

Objective To evaluate the safety and efficacy of endoscopic ultrasonography(EUS) guided ethanol ablation in patients with insulinoma. Methods The data of 10 patients with insulinoma trea-ted at the First Affiliated Hospital of Guangxi Medical University from December 2013 to January 2015 were prospectively analyzed. Results The patients were given EUS-guided ethanol ablation with dose of 0. 10 to 2. 00 ml(average 0. 70 ± 0. 62 ml)in pancreatic lesions for 15 times. No complications were observed dur-ing and after the procedure. The blood glucose improved after the procedure[4. 8(3. 9-5. 5)mmol/ L VS 2. 4 (1. 9-2. 5)mmol/ L,P < 0. 05]and the serum insulin level significantly decreased[83. 7(40. 1-143. 5) pmol/ L VS 177. 3(66. 5-200. 6)pmol/ L,P<0. 05]. The average hospital stay was(4. 3±1. 5)days. The patients were followed up for 6-12 months. EUS indicated that the echo of pancreatic lesions changed from high to low. CE-EUS revealed low enhancement and lack of blood supply. Conclusion EUS-guided ethanol ablation may become a promising minimally invasive treatment for insulinoma because of its safety,efficacy and low price. Trail registration Clinical Trial.gov,NCT02121366.

Objective To investigate the polymorphism of human cytomegalovius UL143 gene of low passage clinical isolates in Guangzhou,China.Method PCR was performed to amplify the entire HCMV ULl43 gene region of 3 clinical isolates,which had been proven by multiplex PCR.The amplification products were cloned into pMD18-T-Vector and subjected to sequencing.The result of DNA sequences were analyzed together with the one of published homologous sequences in GenBank from 14 clinical isolates.Result There were several stop codons in UL143 gene due to a base deletion in open reading frame (ORF) of D3 isolate,which could lead to produce non-functional protein.UL143 ORF of Toledo isolate consisted of 279 nueleotides,encoding a protein with 92 amino acids.UL143 ORFs of other isolates consisted of 252 nueleotides,encoding a protein with 83 amino acids.The DNA sequences were quite conserved and all the variations were base substitution.The amino acid sequences of different isolates were highly conserved.with variation of 1.2%-2.4%.There were no additional or deleted sites of post translational modification of UL143 protein in all clinical isolates except Toledo isolate.There were some differences in the secondary structure among different isolates.The isoelectric point of UL143 protein of all clinical isolates except Toledo isolate was 8.75.Conclusion All DNA and deduced amino acid sequences of UL143 gene shared great similarity among HCMV clinical strains regardless of their polymorphism.

Adult ; Antimetabolites, Antineoplastic ; administration & dosage ; therapeutic use ; Azacitidine ; administration & dosage ; analogs & derivatives ; therapeutic use ; Female ; Humans ; Karyotype ; Leukemia, Myeloid, Acute ; drug therapy ; genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes ; drug therapy ; genetics ; Treatment Outcome

Blood Cell Count ; Bone Marrow Cells ; metabolism ; Child ; Cord Blood Stem Cell Transplantation ; Cytokines ; therapeutic use ; Histocompatibility Testing ; Humans ; Male ; Myelodysplastic Syndromes ; blood ; therapy ; Treatment Outcome

BACKGROUND:Among many transplanted cells,adult autologous bone barrow-derived mononuclear cells have beenused in clinical practice because they are easy to be obtained,without immunological rejection and ethical disputationand other advantages.How to distinguish donor cells from receptors and observe the survival of donor cells following stem cell transplantation still trouble people.OBJECTIVE: superparamagnetic iron oxide (SPIO)particles-labeled bone marrow-derived mononuclear cells from minipigs were used to observe the feasibility of in vivo tracking with magnetic resonance imaging(MRI).DESIGN:A controlled observation experiment.SETTING:Institute of Cardiovascular Disease,Zhongda Hospital Affiliated to Southeast University.MATERIALS:This experiment was carried out in the Institute of Cardiovascular Disease,Zhongda Hospital Affiliated to Southeast University between April 2006 and August 2006.Healthy Chinese minipigs,aged 3 to 4 months,weighing from 20 to 30 kg,were provided by the Experimental Animal Center of Southeast University[SYXK(Su)2002-0012].METHODS: Autologous bone marrow-derived mononuclear cells of minipigs were isolated and cultured. Bone marrow-derived mononuclear cells in the suspension were traced with SPIO particles.Ferrum in the cells were shown by Prussian blue staining, and cell viability was evaluated by trypan blue exclusion method. Eleven minipigs used for preparation of model of myocardial infarction were divided into experimental group(n=9)and control group(n=2).By means of percutaneous left or right cervical artery or femoral artery puncturation, 1.5 to 2.0 mm balloon was used to occlude 1/3 left anterior descending branch,304 to 405 kPa,60 minutes later,ischemic preconditioning was conducted 3 tO 4 times before operation. When pig models of myocardial infarction were successful that was proved by surface electrocardiogram,bone marrow-derived mononuclear cells were percutaneously injected into coronary artery.Coronary arteriography was performed through femoral artery acupuncture at 24 hours after establishing infarction models.Suspension of bone marrow-derived mononuclear cells was perfused into coronary artery with OTW catheter.Then,the injector and OTW catheter for containing cells were rinsed with normal saline containing heparin and infused with the residual cells within 10 minutes.Non-labeled cells were perfused in 2 minipigs of control group by the same method.Postoperatively, bone marrow-derived mononuclear cells were traced by magnetic resonance and compared with Prussian blue-stained myocardial tissue sections.RESULTS: Seven minipigs of experimental group and one minipig of control group were Involved in the final analysis.One of each group was used for preparation of model of myocardial Infarction.One minipig of experimental group died from anesthetic accident before magnetic resonance.①Bone marrow-derived mononuclear cells all were nearly labeled by SPIO particles. Bone marrow-derived mononuclear cells could further proliferate in culture medium containing Fe2O3-PLL without obvious changes of cellular shape. ②T2+WI showed that 5 of 8 models of myocardial infarction presented fuzzy low-echo signal region in peripheral myocardial infarction after transplantation of labeled cells and the low-echo signal disappeared 4 weeks Iater. Ex vivo T2+WI sequence showed there was a dot-distributed low-echo signal region in the peripheral infarction region.③It was found in histological examination that 5 models(cell number over 106) had Prussian blue-positive cells,which distributed the same as those in magnetic resonance signal reducing region.CONCLUSION:SPIO particles-labeled bone marrow-derived mononuclear cells are safe and effective;T2+ WI is sensitive to tracing SPIO particles-labeled bone marrow-derived mononuclear cells;Magnetic resonance can in vivo trace SPIO particles-labeled stem cells transplanted through coronary artery,magnetic resonance signal change is related with the number of stem cells and division growth.

BACKGROUNDPrevious researches about necrotic pancreatic tissue infections are numerous, but the study on systemic infection related to the severe acute pancreatitis (SAP) treatment period is limited. This study aimed to investigate the distribution and drug resistance of pathogenic bacteria in patients who had hepatobiliary surgery for SAP during the past three years.

METHODSA retrospective study was conducted on the distribution, category and drug resistance of pathogenic bacteria in patients who had hepatobiliary surgery for SAP from 2008 to 2011.

RESULTSA total of 594 pathogenic bacteria samples were isolated. Among them 418 isolates (70.4%) were Gram bacteria negative, 142 isolates (23.9%) were Gram bacteria positive, and 34 isolates (5.7%) were found fungi. The most common Gram negative bacteria were Escherichia coli (19.8%), and the dominant Gram positive pathogenic bacteria were Enterococcus faecium. The distribution of SAP-related infectious pathogens was mainly in peritoneal drainage fluid, sputum, bile, and wound secretions. Almost all the Gram negative pathogenic bacteria were sensitive to carbapenum. Extended-spectrum β-lactamases (ESBLs) producing strains were more resistant to penicillins and cephalosprins than the ESBLs non-producing strains. Staphylococcus was sensitive to vancomycin and linezolid. The drug resistance of meticillin-resistant staphylococcus (MRS) to commonly used antibiotics was higher than meticillin-sensitive streptococcus (MSS). Enterococcus sp. exhibited lower drug-resistance rates to vancomycin and linezolid.

CONCLUSIONSGram negative bacteria were the dominant SAP-related infection after hepatobiliary surgery. A high number of fungal infections were reported. Drug resistant rates were high. Rational use of antibiotics according to the site of infection, bacterial species and drug sensitivity, correctly executing the course of treatment and enhancing hand washing will contribute to therapy and prevention of SAP-related infection and decrease its mortality.

Anti-Bacterial Agents ; pharmacology ; Gram-Negative Bacteria ; drug effects ; Gram-Positive Bacteria ; drug effects ; pathogenicity ; Humans ; Microbial Sensitivity Tests ; Pancreatitis ; microbiology

OBJECTIVETo construct the expression vectors of vWF73 and vWF114 fragments of von Willebrand factor (vWF) A2 domain, and to express glutathione S-transferase (GST) fusion proteins in E. coli, and to explore their values in measuring ADAMTS13 activity as substrates.

METHODSThe DNA fragments encoding vWF73 and vWF114 were generated using PCR and separately cloned into pGEX-6P-1, a Schistosoma japonicum GST fusion expression vector. The expression of GST-vWF73-H and GST-vWF114-H was induced in liquid culture, followed by purification with Ni-NTA agarose column. The cleavage of two GST fusion proteins by recombinant ADAMTS13 (rADAMTS13) or plasma from normal individuals and thrombotic thrombocytopenic purpura (TTP) patients were identified by Western blot. Based on an enzyme-linked immunosorbent assay (ELISA) with anti-GST and anti-His monoclonal antibodies, GST-vWF73-H and GST-vWF114-H were used to measure plasma ADAMTS13 activity as substrates.

RESULTSTwo small molecular substrates of ADAMTS13, GST-vWF73-H and GST-vWF114-H, are expressed and purified, which could be specifically cleaved by rADAMTS13 or plasma from healthy individuals, but not by plasma from congenital or idiopathic TTP patients. An ELISA assay was established to detect plasma ADAMTS13 activity using GST-vWF73-H and GST-vWF114-H as substrates.

CONCLUSIONSTwo GST fusion proteins in vWF A2 domain, vWF73 and vWF114, were expressed effectively using a prokaryotic expression system and could be used to detect ADAMTS13 activity as substrates.

ADAM Proteins ; blood ; genetics ; ADAMTS13 Protein ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; metabolism ; Glutathione Transferase ; metabolism ; Humans ; Male ; Purpura, Thrombotic Thrombocytopenic ; blood ; genetics ; metabolism ; von Willebrand Factor ; genetics ; metabolism