Asymmetric dimethylarginine(ADMA)is a natural L-arginine analogue that reduces the bioavailability of nitric oxide in plasma and various types of tissues,acting as an endogenous NO synthase inhibitor in vivo.ADMA is considered a common pathway mediating the adverse vascular effects of traditional and nontraditional risk factors.These preclinical findings are thought to be of major importance as ADMA predicts cardiovascular events and mortality in patients with chronic kidney disease(CKD).Also,ADMA uniformly predicts the progression of moderate and severe CKD.The present study summarizes the latest developments in this field.

Adolescent ; Anemia, Aplastic ; complications ; therapy ; Anemia, Hemolytic ; chemically induced ; complications ; Antilymphocyte Serum ; adverse effects ; therapeutic use ; Female ; Humans

Objective:To enhance the ability of organizing, commanding, decision-making and contingency-meeting of campaign medical support commanding officers so as to qualify them for their positions by simulation training. Methods: Based on the decision support theory, modern medical support theory, health service optimized decision support system and medical support command simulation training system, we designed and constructed a simulation training platform for medical support decision optimization. Results: A network-based simulation training platform was successfully constructed, which gives a strong support to the simulation training in medical support decision optimization under the network circumstance. Conclusion: The application of the simulation training platform has enriched the content and renewed the pattern of training in decision optimization for campaign medical support commanding officers.

This study was aimed to observe the effects of Gui Curcuma extract on proliferation, collagen production, and matrix metalloproteinase (MMP) expression by hepatic stellate cells (HSC-LX2). HSC-LX2 were cultured in DMEM broth (10% FBS), then treated with Gui Curcuma extract (with the concentration of 0, 22.5, 45, 90 μmol·L-1) for 24 h. The proliferation of HSC-LX2 was measured by MTT assay; injury in HSC-LX2 was indicated with LDH re-lease; collagen I production was detected by ELISA; and MMP-l expression was determined by Western blot. The re-sults showed that Gui Curcuma extract (with the concentration of 22.5, 45, 90 μmol·L-1) dose-dependently inhibited proliferation of HSC-LX2 by 16.2%, 43.9%, 59.4% in MTT assay, respectively. The IC50 was 59.1 μmol·L-1. There was no significant impact on LDH release. The Gui Curcuma extract (with the concentration of 45, 90 μmol·L-1) can significantly reduce the expression of collagen I level (P< 0.01), whereas MMP-1 expression was significantly uplift-ed (P< 0.05) by Gui Curcuma extract (with the concentration of 45, 90 μmol·L-1) in Western blot. It was concluded that Gui Curcuma extract had the potential to prevent hepatic fibrosis, through inhibiting proliferation and collagen I production, and increasing MMP-1 protein expression.

Objective To evaluate the changes of β cell function in critically ill surgical patients and its re- lationship with prognosis.Methods 32 patients>16 years age with no history of diabetes who were admitted to sur- gical intensive care unit(SICU)were divided into two groups according to APACHE Ⅱ score.Blood sample Was taken on preoperative and postoprative 1st day for measures of fasting insulin(FINS)and fasting C peptide(FCP). The HOMA-β Was calculated.Results The level of FINS,FCP and HOMA-β were significantly decreased on first day after operation than preoperative in critical group.Compared with control group,The level of FINS.FCP and HO- MA-βwere significantly reduced on first day after operation-which had negative correlation with APACHE Ⅱ score, APACHE Ⅲ score and in charge days of ICU.Conclusion There is β cell dysfunction in critically ill Surgical pa- tients.β cell function in surgical critically ill patients is negatively correlated with APACHE Ⅱ SCOre-APACHE Ⅲ score and days of ICU.

Objective To report the clinical and pathological features of the sensory neuropathy caused by a combined therapy of telbivudine and pegylated interferon α-2a in 2 patients with hepatitis B virus infection Methods Two male patients aged 48(case 1)and 20(case 2),who suffered from hepatitis B virus infection.were given telbivudine and pegylated interferon α-2a.After 4 months treatment,both patients developed numbness and pain in the lower limbs.The physical examination showed decreased pain sensation in distal extremities.Hypahidrosis appeared in distal extremities.The nails were pale changed in fingers and toes in cage 1.Case 2 presented mild weakness in the proximal muscle of lower limbs and the tendon reflex was decreased in both lower limbs.His 8erunl creatine kinase level was mild elevated.The electromyography examination and sural nerve biopsies were performed on both patients.Results Electromyography examination showed significant decrease of amplitude of sensory nerve action potentials and mild decrease of sensory nerve conduction velocities in both patients.The amplitude of motor nerve action potentials was also decreased in case 2.Light microscope examination revealed middle reduction of myelinated fibers,wallerian degeneration of myelinated fibers and small clusbers of regenerated fibers in sural nerve.Electro microscopy examination revealed the loss of unmyehnated nerve fibers.After the combined therapy was stopped and vitamin B,CoQ10 and L-camitine were administered,the patients recovered gradually.Conclusions Combined therapy of telbivudine and pegylated interferon α-2a may cause sensory neuropathy with electrophsiological and pathological abnormalities of axonal lesions.The sensory neuropathy induced by the combined therapy may be reversible.

Objective To analyze the prognostic factors of nasopharyngeal carcinoma treated with radiotherapy.Methods 135 preliminary diagnosed patients were selected and treated with radiotherapy to a total dose of 68～80 Gy in 7～8 weeks. In order to analyze the factors affecting prognosis of NPC,SPSS analysis and Cox regression analysis were used to identify the prognostic factors.Results The overall 10-year survival rate was 48 9%; Univariate analysis suggested that 8 out of 13 items were significant factors for prognosis (P

[Objective]To modify posterior lumbar interbody fusion for improvement of convenient manipulation and safety in the operation,and solid fusion. [Methods]After total decompression of the spinal nerve through posterior medline approach,discectomy of the slipping segment was performed with a circular saw with diameter of 1.0 centmeter.Under direct visualization through the hole of the circular saw,the disc tissue including cartilage of upper and lower end plates was removed with a long handle curette.After pedicle screw and rod system was placed,a bone block harvested from the posterosuperior iliac with a circular saw with diameter of 1.2 centmeter was implanted into the intervertebral space.Then compression of the intervertebral space to catch the bone lock firmly was conducted by regulating and fixing the the pedicle screw and rod system.[Results]Forty-eight patients in this report were followed up from 6 to 24 months.Based on JOA low back pain score,there were 36 patients was in excellent result,8 in good and 4 in fair,the satisfactory rate was 91.67% and effective rate was 100%.[Conclusion]Using circular saws in posterior lumbar interbody fusion has advantagas of good visualization profit removing disc tissue,preventing neurovascular injuries,and making good bone grafting bed.Convenient and secure bone harvesting decrease blood loss,time consume during the operation and prevent donor site complication.Futhermore,follow up results of the patients in this report demonstrate that posterior interbody fusion with circular saw for treatment of lumbar spondylolisthesis have satisfactory outcome and high fusion rate.

Objective: To study the impact of vascular injury on neointimal hyperplasia and the expressions of nuclear transcription factor-κb (NF-κb), tissue factor (TF), endothelin-1 (ET-1) and matrix metalloproteinase-3 (MMP-3) in experimental rabbit model.
Methods:A total of 32 male New Zealand big-eared white rabbits were used to establish vascular injury model by femoral artery puncture, balloon was sent to abdominal aorta via the wire followed by balloon dilatation to strain abdominal aorta. Blood sample was taken from femoral artery sheath 1 minute after operation, and the rabbits were killed at 4 weeks after operation, meanwhile blood sample was taken from the heart. Injured arteries were isolated, ifxed and embedded; slices were stained by HE, basic fuchsine and NF-κb immunohistochemical methods for light microscope observation; slices were also stained by lead and uranium for transmission electron microscope observation. Neointimal thickness was measured by computer analysis, vascular injury integral and NF-κb positive cell rate were determined, blood levels of TF, ET-1 and MMP-3 were examined by ELISA. The relationship between vascular injury integral and the contents of TF, ET-1, MMP-3 and NF-κb positive cell rate were analyzed by SPSS statistical software.
Results: The optimal iftting curve between vascular injury integral and neointimal thickness was S-shaped cubic curve. NF-κb was mainly expressed in neointima, vascular injury integral was positively related to NF-κb positive cell percentage, Pearson correlation coeffcient was 0.916,P<0.05. Vascular injury integral was positively related to the contents of 1 min post-operative TF; 1 min and 4 weeks post-operative ET-1; 1 min and 4 weeks post-operative MMP-3; Pearson correlation coeffcients were 0.925, 0.957, 0.947, 0.914 and 0.940 respectively, allP<0.05.
Conclusion: Vascular injury may activate NF-κb pathway, promote ET-1 and MMP-3 expression, therefore accelerating neointimal hyperplasia, leading negative vascular remodeling, TF was an initiating factor for neointimal hyperplasia. Internal elastic lamina was the key structure reflecting vascular injury, it is the only barrier hindering neointimal hyperplasia in experimental rabbit model.

Objective To explore the technique outcome of fixing the ventral stress pedicle screws into the injured vertebrae, as a method to enhance the posterior internal fixation. Methods From March 2002 to March 2005, 33 single thoracolumbar fractures were studied retrospectively. Among which, 16 cases were treated with the above method(group A), and the other 17 were treated with traditional two-level fixation(group B). Group A involved 11 males and 5 females, aged 48 years averagely(range, 32-74 years); and group B included 12 males and 5 females, aged from 21 to 61 years(mean, 40 years). All the patients underwent the operation within up to 3 weeks after fracture. For the injured vertebral bodies, their pedicles were intact on either unilateral or bilateral side, and their lower half and endplate were free from split. In group A, the pedicle screws in the injured vertebrae were used to achieve the ventral press vertical to the distraction for the stress neutralization, and also with the routine distraction and lordosis restoration, simultaneously. The mean follow-up period was 11 months with a range from 6 to 24 months. Results After operation, the optimal Cobb angle and anterior column restoration were achieved through the ventral reduction from the injured vertebral body, which was the contribution from the vertical stress pedicle screw. The degree in anterior movement of injured vertebrae pre- and postoperatively was much more in group A than group B, and the difference was of statistical significance(P