Objective To assess the risk factors of intradialytic-hypotension (IDH) among maintaining hemodialysis (MHD) patients and to explore the relation between NT-proBNP and IDH,thus to provide clinical evidence for the prevention and treatment of IDH.Methods A total of 202 MHD patients during March 2009 to May 2009 in our dialysis center were enrolled in the study.Intradialytic blood pressure (BP) was measured during a 3-month period.IDH was defined as an event characterized by a sudden drop in systolic BP more than 20 mm Hg or in mean artery pressure (MAP) more than l0 mm Hg.Logistic regression analysis was used to assess the risk factors of IDH.ROC curve was used to evaluate the diagnostic efficacy of serum NT-proBNP.Results The incidence of IDH was 42.1％.One hundred and seventeen patients with no-IDH (＜1/10 hypotensive events per 3 months) were served as controls.Fifty-five patients with o-IDH (≥ 1/ 10 but ≤1/3 hypotensive events per 3 months) and 30 patients with f-IDH (＞1/3 hypotensive events per 3 months) were identified among 202 patients.Multivariate regression analysis showed that age,gender,ultrafiltration rate,serum NT-proBNP,serum albumin,aortic root dimension (AoRD) were associated with IDH among MHD patients.Serum NT-proBNP was positively correlated with IDH.The area under the ROC curve (AUC) of NT-proBNP was 0.76 (95％ CI 0.69 to 0.83,P＜0.01).The cut-off value of serum NT-proBNP for IDH was 1746.5 ng/L,with a sensitivity of 88.61％ and a specificity of 51.10％.Furthermore,the AUC of NT-proBNP for f-IDH was 0.65 (95％ CI 0.53 to 0.763,P＜0.01).The cut-off value of serum NT-proBNP for f-IDH was 8208.0 ng/L,with a sensitivity of 33.33％ and a specificity of 91.30％.Conclusions Elderly,female,high ultrafiltration rate,high level of serum NT-proBNP,hypoalbuminemia,shorter AoRD are independent risk factors of IDH among MHD patients.Serum NT-proBNP can be used as a predictor of IDH.

Objective To assess the risk factors of intradialytic-hypotension (IDH) and the prognosis of IDH among maintenance hemodialysis (MHD) patients for the prevention and treatment of IDH.Methods 276 MHD patients were enrolled during Jan.2009 to Mar.2009.Intradialytic blood pressure was monitored during a 3-month period.IDH was defined as an event characterized by a sudden drop in systolic BP more than 20 mmHg or in mean artery pressure (MAP) more than 10 mmHgassociated with clinical events and need for interventions.Dialysis-related information was collected.Kaplan-Meier method,log-rank test,logistic regression and Cox regression analyses were performed to examine the association between IDH and survival,using a follow-up through 31 May 2014.Results A total of 276 patients were recruited.The incidence rate of IDH was 40.9％.163 patients with no-IDH (＜ 1/10 hypotensive events/3 months) served as controls.113 patients with IDH (≥ 1/10 hypotensive events/3 months) were identified among all 276 patients.Multivariate logistic regression analysis showed that age,ultrafiltration rate,gender,serum NT-proBNP,serum albumin and aortic rool inside dimension (AoRD) were associated with IDH among MHD patients.During the 5-year follow-up,74 patients died,with a mortality rate 5.2 per 100 person-year.Kaplan-Meier survival curve showed significant difference of overall and CV mortality rates between 2 groups.The multivariate Cox regression model indicated that IDH increased the risk of death (HR=1.572,95％CI 1.077-2.293,P=0.019).So did the rise of LVMI (HR=1.010,95％CI 1.009-1.085,P=0.020).Conclusion Elderly,female,high ultrafiltration rate,high level of serum NT-proBNP,hypoalbuminemia and shorter AoRD are independent risk factors for IDH among MHD patients.LVMI can predict the outcome of MHDpatients.Intradialytic hypotension is an independent risk factor for long-term mortality in MHD patients.

Objective To evaluate the efficacy of ancient classical prescriptions treating middle and advanced primary liver cancer.Methods Articles were searched from Pubmed, Embase, SCI, Cochrane Liarary and CNKI, VIP, WanFang Data, CBM databases. Randomized controlled trials about ancient classical prescriptions treating advanced primary liver cancer were collected. Results 17 studies were included, a total of 994 patients. The recent efficiency of ancient classical prescription combined with symptomatic therapy increased by 28% compared with single supportive and symptomatic therapy;the stable rate of life quality increased by 23%;the efficiency of TCM syndrome increased by 29%;the survival rates of 3 months, 6 months and 1 year increased by 16%, 36.7% and 58.5% respectively;the life quality score of later increased by 6.29 on average. Conclusion Ancient classical prescription combined with supportive and symptomatic therapy in advanced primary liver cancers is superior to single supportive and symptomatic therapy on recent efficiency, survival rate (3 months/6 months/1 year), quality of life and TCM syndrome. The conclusion of this study needs randomized controlled trials with larger samples, multicenter and high quality for further verification.

Objective To investigate our early results of robot-assisted esophagectomy (RAE) and present our learning curve experience with the largest study from one-single institution of China.Methods Between November 2015 and April 2017,a series of consecutive patients undergoing RAE at Shanghai Chest Hospital were reviewed.The patients'demographics,operative and postoperative outcomes were demonstrated.Results A total of 154 patients underwent RAE during the study.All patients received Mckeown esophagectomy and extensive thoraco-abdominal two-field lymph node dissection.Of these,122 were male and 32 were female.The mean total operative duration was 179-445 (271.0 ±61.5) min and the operative duration of the thoracic phase was 51-142 (96.7 ± 27.0)min.The mean estimated blood loss was 100 -1 000 (230.4 ±74.4)ml.The pathological results showed that 150 had squamous cell carcinoma,2 had adenocarcinoma,and 2 had small cell carcinoma.The R0 resection was 92.2％.The mean number of lymph node dissection was 11-64 (20.4 ± 8.5) and the lymph node sampling rate along left and right recurrent laryngeal nerve (RLN) were 92.2％ and 88.3％.The morbidity was present in 64 of 154 patients (41.6％).The major complications rate was anastomotic leak (12.3％),and vocal cord paralysis (16.9％).Intensive care unit (ICU) hospital stay time was 0-27 (2.7 ± 3.6) d,the median length of hospital stay was 7-81 (15.8 ± 11.6)days.There was no 90-day mortality.Conclusions RAE is a safe and feasible alternative for treatment of esophageal cancer.RAE can improve the efficacy of lymph node dissection,especially for the lymphadenectomy along recurrent laryngeal nerve.

OBJECTIVETo investigate the genetic pathogenesis of dilated cardiomyopathy (DCM) by examining the heterogeneity of Coxsackievirus binding domain (exon 4) of Adenovirus receptor (CAR) in DCM patients and healthy adults, and to detect possible mutation site in exon 4.

METHODSUsing polymerase chain reaction (PCR), we amplified exon 4 of CAR DNA extracted from blood samples obtained from 50 DCM patients and 40 healthy adults. The PCR products were screened with single-strand conformation polymorphism (SSCP) and then sequenced alternatively based on the SSCP results.

RESULTSThe segment of CAR exon 4 was successfully amplified and there was no single strand conformational disparity in all samples examined by SSCP. Sequence analysis demonstrated that all amplified sequences of CAR exon 4 from samples of the two groups were identical and there was no genetic heterogeneity of CAR exon 4 between the two groups.

CONCLUSIONThe genetic heterogeneity of CAR exon 4 might not be responsible for the pathogenesis of DCM.

Adult ; Base Sequence ; Cardiomyopathy, Dilated ; genetics ; virology ; Coxsackievirus Infections ; genetics ; Enterovirus ; genetics ; Exons ; Female ; Genes, Viral ; Humans ; Male ; Molecular Sequence Data ; Polymorphism, Single-Stranded Conformational ; Receptors, Virus ; genetics ; Sequence Analysis, DNA

OBJECTIVETo study the allele genetic polymorphism of five short tandem repeat (STR) loci on X-chromosome in Ewenke population of north China and to provide basic data for forensic identification.

METHODSGenomic DNA was extracted from EDTA-whole blood of Ewenke population by Chelex-100. The DNA samples were amplified by PCR and were analyzed by polyacrylamide gel electrophoresis and silver staining. The sequence length variations of DXS6799, DXS8378, DXS101, HPRTB, and DXS6789 loci on X-chromosome in 98 unrelated Ewenke individuals were investigated.

RESULTSAll five loci analyzed showed high polymorphism and genetic stability. The data of the five X-chromosome STR loci in Ewenke ethnic group of China was in accordance with Hardy-Weinberg equilibrium by Chi-square test.

CONCLUSIONAllele polymorphism of five X-chromosome STR loci can be used as a genetic marker for forensic identification and population genetic research.

Asian Continental Ancestry Group ; China ; ethnology ; Chromosomes, Human, X ; genetics ; DNA ; genetics ; Female ; Forensic Medicine ; Gene Frequency ; Genetic Markers ; Humans ; Male ; Microsatellite Repeats ; Polymerase Chain Reaction ; Polymorphism, Genetic

OBJECTIVETo investigate the stress distribution in three ferrule designs in a maxillary central incisor restoration using PFM crown with post, and evaluate the biomechanical mechanism of the ferrule effect in the post crown by 3D finite element dynamic analysis.

METHODSThe 3D finite element model of a maxillary central incisor restored with post and PFM crown was established. By simulating three types of ferrule effect [crown wrapping dentine (A), core collar wrapping (B), and contrabevel (C)] under dynamic loading, the dentin stress was analyzed.

RESULTSDuring dynamic loading, the stress distribution tended to increase from the cervical part to root middle and radical part of the tooth, and greater high stress area was found around the apex of the post, where the peak stress was observed value. The stress of the labial dentin of the root inferior segment increased obviously. The high stress areas were invariable at every loading step during dynamic loading. The peak stress was sigma(vonA)

CONCLUSIONSWhen the ferrule is 2 mm, the ferrule effect maintained by crown wrapping cervical dentine (A) and core collar wrapping (B) is greater than that maintained by contrabevel (C),but there is no significant difference between A and B. The post with higher elastic modules may cause restore failure due to the high stress at the post apex and labial dentin.

Compressive Strength ; Crowns ; standards ; Dental Stress Analysis ; methods ; Finite Element Analysis ; Humans ; Incisor ; Post and Core Technique

Objective To investigate the effects of mercury on T lymphocytes and serum immune indexes of workers with Methods occupational mercury exposure. A total of 45 workers with occupational mercury exposure were selected as the ， mercury exposure group and 47 workers without occupational mercury exposure were selected as the control group using the judgment sampling method. Cold atomic absorption spectrometry was used to detect the urinary mercury level of the two groups. （ ） +， + +， + + - + Flow cytometry was used to detect the proportion of cluster of differentiation CD 3 CD3CD4 CD3CD8 and CD3CD19 ， - （ - ） - （ - ） cells in peripheral blood and the levels of tumor necrosis factor α TNF α and interleukin 8 IL 8 in serum. The levels of （ ） ， Results immunoglobulin Ig A IgG and IgM in serum were measured by immune nephelometry. The urinary mercury level of （ ： vs ，P ） individuals in the mercury exposed group was higher than that of the control group median 92.7 13.2 μg/g Cr <0.01 . The +， + +， - + proportion of CD3 CD3CD4 CD3CD19 cells in peripheral blood and serum IgG level in the mercury exposed group （ P ）， - - （ P ） decreased all <0.05 and the serum TNF α and IL 8 levels increased all <0.01 compared with the control group. Urinary - + mercury level was negatively correlated with the proportion of CD3CD19 cells in peripheral blood and serum IgG level in the ［ （r） ， ， P ］， study subjects Spearman correlation coefficient S were −0.21 and −0.31 respectively all <0.05 and positively - - （r ， ， P ） ， correlated with serum TNF α and IL 8 levels S were 0.36 and 0.39 respectively all <0.05 . However the urinary mercury （ P ）， +， + +， level was neither correlated with IgA and IgM levels in serum all >0.05 nor with the proportion of CD3 CD3CD4 + + （ P ） Conclusion CD3CD8 cells in peripheral blood all >0.05 . Occupational exposure to mercury can lead to abnormal ， changes in peripheral blood T lymphocyte subsets B lymphocytes and serum immune factors in workers. The mercury load of occupational mercury exposure workers may impact their immune function.

Objective To observe the therapeutic effect of Angelica injection in Parkinsonian rats and explore its possible mechanisms. Methods Rat models of Parkinson disease (PD) were established by 6-OHDA injection into the right substantia nigra pars compacta (SNc) and confirmed by weeldy apomorphine-induced rotation test, and the rats with saline injection served as the saline control group (n=8). After the second apomorphine test, the PD rats received daily intraperitoncal Angelica injection at low (12.5%, n=8) or high dose (25%, n=8), or had only saline injection (PD model group, n=8). Another 8 untreated rats were used as the blank control group. After 4 weeks of treatment, the rats were perfused with paraformaldehyde (4%) and the brains were taken for immunohistochemical detection of TH and CD40 expressions in the SNc using SABC method. Results Compared with the rats in the saline control and low-dose Angelica injection groups, those in the high-dose Angelica injection group showed significantly slowed rotation after a 3-week treatment (P<0.05), with further slowing down at 4 weeks (P<0.01). At the fourth week of treatment with high-dose Angelica injection, a significant increase in the numbers of PH- and CD40-positive neurons was found in the right SNc as compared with those in the low-dose Angelica injection group and the PD model group (P<0.01). No CD40-positive microglia were found in the SNc in the saline control or the blank control groups, and the Angelica-treated groups and the PD model group showed no significant difference in the count of CD40-positive microglia in the SNc. Conclusion Angelica injection produces obvious therapeutic effect in Parkinsonian rats possibly by increasing CD40 expression in the neurons.

OBJECTIVETo study the effect of activated microglia grafting on rats' hind limb motor function recovery after spinal cord injury.

METHODSMicroglia were separated from primary culture and subcultured for 3 generations. Lipopolysaccharide was added to the culture medium with the terminal concentration of 10 microl/L for microglia activation 3 days before transplantation. Totally 80 adult Wistar rats were divided into transplantation group and control group, with 40 rats in each group. Spinal cord injury model of rats was set by hitting onto the spinal cord using a modified Allen impactor. With a 5 microl micro-syringe, the activated microglia suspension was injected into the injured area 7 days after the first operation. Basso, Beattie and Bresnahan (BBB) scoring for hind limb motor function was taken on the 1st, 7th, 14th, 21st, and 28th day after microglia transplantation, and 8 rats were sacrificed at each time point mentioned above, respectively. Frozen sections of the spinal cord were made for haematoxylin-eosin (HE) and Naoumenko-Feigin stainings. SPSS 11.0 software was used for statistical analysis.

RESULTSBBB scores for hind limb motor function on the 14th, 21st, and 28th day were significantly higher compared with the control group. Most liquefaction necrosis areas disappeared and only a few multicystic cavities surrounded by aggregated microglia remained in the transplantation group. Naoumenko-Feigin staining for microglia showed that the transplantation group had significantly more positive cells (P < 0.05).

CONCLUSIONSGrafting of activated microglia into the injured spinal cord can significantly promote the hind limb motor function recovery in rats with spinal cord injury and reduce the size of liquefaction necrosis area. The extent of lower limb motor function improvement has a positive correlation with the number of aggregated microglia.

Animals ; Antigens, CD ; analysis ; Antigens, Differentiation, Myelomonocytic ; analysis ; Cells, Cultured ; Flow Cytometry ; Fluorescent Antibody Technique, Indirect ; Hindlimb ; physiopathology ; Immunohistochemistry ; Microglia ; transplantation ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Spinal Cord Injuries ; immunology ; physiopathology ; therapy