Antihypertensive Agents ; therapeutic use ; Endothelin Receptor Antagonists ; therapeutic use ; Familial Primary Pulmonary Hypertension ; Humans ; Hypertension ; drug therapy ; Hypertension, Pulmonary ; drug therapy

Objective To investigate the risk factors of type 2 diabetes mellitus(T2DM) in patients with nonalcoholic fatty liver disease (NAFLD) and correlations with carotid atherosclerosis.Methods The clinical data of 51 cases of N AFLD with T2DM (NAFLD with T2DM group),43 cases of NAFLD(NAFLD group) and 45 healthy objects (control group) were collected.The clinical biochemical features,carotid intima-media thickness (IMT) were observed.Results The BMI and smoking rate in NAFLD with T2DM group and NAFLD group were significandy higher than those in control group [(27.25 ±3.16),(26.31 ± 2.63) kg/m2 vs.(23.12 ±3.44) kg/m2,43.1％(22/51),37.2％(16/43) vs.13.3％(6/45)](P＜0.05).The ratio of family history of T2DM in NAFLD with T2DM group was significantly higher than that in NAFLD group and control group[66.7％(34/51)vs.32.6％(14/43),8.9％(4/45)](P ＜ 0.05).Compared with control group,the level of total cholesterol (TC),trigalloyl glycerol (TG),low density lipoprotein cholesterol (LDL-C),alanine transaminase(ALT),aspartic transaminase(AST),IMT in NAFLD with T2DM group and NAFLD group were significantly higher [(5.39 ± 0.85),(5.12 ± 0.77) mmol/L vs.(4.11 ± 0.64) mmol/L,(2.77 ± 1.11),(2.32 + 1.04) mmol/L vs.(1.21 ± 0.52) mmol/L,(2.98 ±0.93),(2.76 +0.78) mmol/L vs.(2.15 ±0.57) mtmol/L,(48.4 ± 18.9),(43.3 ± 16.5) U/L vs.(21.4 ± 13.6) U/L,(46.2 ± 16.7),(42.1 ± 17.5) U/L vs.(20.5 ± 12.6) U/L,(1.95 ±0.93),(1.26±0.51) mmvs.(0.71 ±0.22) mm](P＜ 0.05),while the level of high density lipoprotein cholesterol (HDL-C) was significantly lower [(1.01 ± 0.35),(1.13 + 0.22) mmol/L vs.(1.31 ± 0.26) mmol/L] (P ＜ 0.05).The level of above mentioned index,there were no significant difference between NAFLD with T2DM group and NAFLD group (P ＞ 0.05).The level of fasting blood glucose (FBG),2-hour postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS),2-hour postprandial insulin (2 h PINS) and insulin resistance index of HOMA (HOMA-IR) in NAFLD with T2DM group were significantly higher than those in NAFLD group and control group [(8.15 ± 1.48) mmol/L vs.(5.10 ± 1.32),(5.62 ± 0.88) mmol/L,(13.67 ± 1.59) mmol/L vs.(7.31 ± 1.25),(8.64± 1.35) mmol/L,(7.03 ±0.84)％ vs.(5.16 ±0.72)％,(5.53 ±0.61)％,(13.32 ±4.55) mU/L vs.(6.06 ±3.11),(9.13 ±4.37) mU/L,(106.37 ±21.45) mU/L vs.(33.21 ± 18.87),(46.34 ± 16.39) mU/L,3.88 + 2.14 vs.1.13 ± 0.36,2.23 ± 1.15] (P ＜ 0.05).Carotid IMT,the incidence of carotid plaque and Crouse scores of plaque in NAFLD with T2DM group were significandy higher than those in NAFLD group [(1.95 ±0.93) mm vs.(1.26 ±0.51) mm,64.7％(33/51) vs.30.2％(13/43),(3.11 ±0.57) nn vs.(1.35 ± 0.49) mm] (P ＜ 0.05).The regression analysis showed that family history of T2DM,FBG,2 h PBG,FINS,2 h PINS were independently associated with T2DM.Conclusions Family history of T2DM,FBG,2 h PBG,FINS,2 h PINS are the main risk factors for the onset of T2DM in NAFLD.The risk of carotid atherosclerosis is increased in patients of NAFLD with T2DM.

Lipoproteins are biological lipids carriers. The natural and reconstituted lipoprotein based drug delivery systems have been extensively developed in recent years. This article reviews the development of natural and reconstituted low-density lipoprotein and high-density lipoprotein based vehicles in the antitumor area.
Animals ; Antineoplastic Agents ; administration & dosage ; chemistry ; Apolipoproteins B ; administration & dosage ; chemistry ; Drug Carriers ; administration & dosage ; chemistry ; Humans ; Lipoproteins ; administration & dosage ; chemistry ; Lipoproteins, HDL ; administration & dosage ; chemistry ; Lipoproteins, LDL ; administration & dosage ; chemistry ; Nanoparticles ; Neoplasms ; drug therapy ; Peptides ; administration & dosage ; chemistry ; Pharmaceutical Vehicles ; chemistry

Objective To evaluate contrast-enhanced endoscopic uhrasonography(CE-EUS)in the differential diagnosis of pancreatic diseases.Methods Eighteen patients with suspected pancreatic neoplasms and chronic pancreatitis,which would be finally affirmed with EUS-FNA or histophathologic examinations,as well as five normal control subjects were enrolled and underwent CE-EUS by using ultrasonic contrast agent(sonovue,Bracco Co.,Italy).Characteristics of enhancement including form,echo and enhanced blood perfusion of the target areas were investigated in normal pancreas and various diseased ones.Results By CE-EUS,five cases of normal pancreatic parenchyma were presented as punctiform or claviform enhancement pattern with homogeneous distribution(type Ⅰ-Ⅱ);while two chronic pancreatitis cases were presented as claviform or plaquelike enhancement pattern with inhomogeneous distributition(type Ⅱ-Ⅲ).In addition,thirteen pancreatic carcinomas were presented as inhomogeneous punctiform or claviform enhancement(typeⅠ-Ⅱ)partially with border enhancement and with slow enter-in and fast wash-out phase.However,three benign insulinomas were presented as holo-plaquelike enhancement(type Ⅲ),and 2 with fast enter-in and fast washout phase.Besides,different enhancement intensity was identified in different diseases.Conclusion CEEUS,from which different enhancement pattern,phase and intensity would be shown in various pancreas,is a safe and feasible imaging modality in the differential diagnosis of pancreatic diseases.

Objective: To investigate the preparation procedure of Zhenjing Xiehuo granules. Methods: Using the dry extract yielding rate and the contents of liquiritin and salvianolic acid B as the indices, an orthogonal test was adopted to choose the best ex-traction and purification technology. Using the qualified ratio of granules as the index, an orthogonal test was adopted to choose the best preparation process of the granules. Results:The optimized preparation conditions were as follows:Pulvis ferri was decocted first for 60 min. The other medicines were dipped in 8-fold amount of water for 90 min, and then added into pulvis ferri extracts and decocted for 3 times with 90 min for each time. The extracts were collected and concentrated till the relative density was 1. 3 (measured at 60℃), water was added with the dilution ratio of 1:2, ethanol was added till the percentage of ethanol was 50%, and then the mixed liquid was filtered after 24 hours. After ethanol was recycled from the filtrate, the filtrate was concentrated till the relative density was 1. 3 (measured at 60℃), and then dried at 60℃. Starch as the diluent, the ratio of extract to excipient was 1:0. 8, and the wet granules were prepared with 90% ethanol as the wetting agent, dried 3 hours at 60℃ followed by size stabilization to obtain the products. Con-clusion:The optimized preparation procedure of Zhenjing Xiehuo granules is stable and feasible.

Purpose:An analysis of 27 patients who underwent surgery for their malignant fibrous histiocytoma in the soft tissue of the neck was done to show that compartment dissection of the neck should be the optimal choices of treatment. Methods:From 1 st Jan 1972 through 31 st Dec 1993,27 patients who were referred to the Cancer Hospital for surgical treat- ment were reviewed,including 19 males and 8 females in the age range from 15 to 67,with a mean of 44 years.Surgery was classified as wide resection and compartment dissection of the neck.The two groups were compared for local recurrence and 5 years survival rates.Results:Of the 27 operations,21 were wide resections and 6 compartment dissection of the necks.The average tumor diameter was6 millimeters in patients with compartment dissection of the neck.Local recurrence was encountered in 16 of 21 wide resections (76.2%),and in 1 of 6 compartment dissection of the necks (16.7%).The difference between the two groups was statistically significant (P= 0.015).The 5 years survival was 89% for patients without local recurrence and 52% for patients with local recurrence. The difference between them was significant statistically (Log Rank,P=0.0264).Conclusions:For malignant fibrous his- tiocytoma in the soft tissue of the neck,compartment dissection of the neck is recommended as the optimal operation for its ability to the local control of the disease locally.

Objective To investigate the neuroprotective effects of neurotrophin-3 (NT-3) expression controlled by five copies of the hypoxia-responsive elements after focal cerebral ischemia .Methods Three groups of rats re-ceived RV-5H-NT3, RV-5H-EGFP or saline injection .Three days after gene transfer , the rats underwent 90 min of transient middle cerebral artery occlusion ( tMCAO) , followed by 1-28 days of reperfusion .Immunohistostaining and western blotting were performed to detect ischemia/hypoxia-regulated expression of NT-3 controlled by HRE . The volume of brain infarction and the apoptosis were analysised by TTC and TUNEL staining .The neurological scoring was determined by neurological behavior tests .Results Three days after tMCAO , brain NT-3 expression was significantly increased in the RV-5HNT3-transduced animals compared with the RV-5H-EGFP or saline group (P<0.05), and brain infarct volume was smaller in the RV-5H-NT3-transduced group than the RV-5H-EGFP or saline group ( P<0.05 ) .The percentage of TUNEL-positive cells was reduced in RV-5 H-NT3-transduced brains compared with the RV-5 HEGFP or saline group 3 and 7 days after tMCAO ( P<0.05 ) .Furthermore , the neurolog-ical status of RV-5H-NT3-transduced rats was better than that of RV-5H-EGFP-or saline-transduced animals from 1 day to 4 weeks after tMCAO ( P<0.05 ) .Conclusions HRE may modulate NT-3 expression in the ischemic brain tissue and that the up-regulated NT-3 may effectively improve neurological status following tMCAO due to de-creased initial damage .

Objective To construct and identify the recombinant retroviral vector containing five copies of hypoxia responsive elements (5HRE)and neurotrophin-3 (NT-3 ).Methods Using PCR,enzyme digestion and DNA ligase,5HRE and human derived NT-3 were cloned into the retroviral vector plasmid (pLNCX)to construct the recombinant retroviral vector plasmid pLNCX-5HRE-SV40-NT3-IRES-EGFP.The retrovirus RV-5HRE-NT3 was packaged in the PT67 cells,and then it was purified and concentrated by high-speed centrifugation.After infected for 48 h with the concentrated retrovirus,the number of the EGFP positive cells in the NIH 3T3 cells was counted by fluorescence activated cells and sorted to calculate the retrovirus titer.Results The retroviral vector plasmid,pLNCX-5HRE-SV40-NT3-IRES-EGFP,was successfully constructed,and the retrovirus was packaged and defined as RV-5HRE-NT3.After purification and concentration,the retrovirus titer reached 9.1 × 10 6 cfu/mL. Conclusion The recombinant retroviral vector which carried out hypoxia-regulated expression of NT-3 was successfully constructed.It may provide basis for studies on hypoxia-regulated expression of the exogenous genes.

Objective By analyzing the cesarean delivery rate (CDR) and the indications of cesarean section in Jiangsu Province from 2012 to 2014, to find the strategy to reduce CDR.Methods Data of 40 hospitals whose number of delivery was over 2 400 per year from the database of the Quality Control Center of Gynecology and Obstetrics of Jiangsu Province from 2012 to 2014 were selected.The cohort was divided into two groups, one was specialized hospital including 11 maternal and child health hospitals and the other included 29 general hospitals.After analyzing the current status of cesarean section of the whole province, the average CDR and the distribution of the first indications of cesarean section in two groups were compared using Chi-square test.Results The average CDRs at year 2012, 2013 and 2014 were 53.8％(96 347/178 970), 51.8％ (97 509/188 142) and 48.8％(106 323/217 877), which had a trend of decrease (x2=1 026.2, P ＜ 0.01).CDR without medical indications for each year were 15.7％ (28 098/178 970), 15.5％ (29 162/188 142) and 12.8％ (27 888/217 877).The rate had decreased apparently from both 2012 and 2013 to 2014 (x2=217.6, P ＜ 0.01;x2=341.3, P ＜ 0.01).The CDRs of specialized hospitals for year 2012, 2013 and 2014 were 51.2％ (45 496/ 88 916), 50.6％ (45 853/90 607) and 49％ (55 404/113 105), while the CDRs of general hospitals for each year were 56.6％(50 851/90 054), 53.0％(51 656/97 535) and 48.6％(50 919/104 772).Both showed significant decreasing trend (x2=105.8 and 1 215.7, both P ＜ 0.01).The average CDR of general hospitals was obviously higher than that of specialized hospitals in 2012 and 2013 (x2=505.6 and 104.3, both P ＜ 0.01).However, the difference disappeared in 2014 (x2=3.2, P ＞ 0.05).The three main first indications of cesarean section were associated and postoperative pregnancy complications, and no medical indications.Interestingly, from 2012 to 2014, the CDR for scarred uterus in specialized hospitals raised from 5.4％ to 20.3％, and that in general hospitals increased from 6.7％ to 21.6％, which became the first.Conclusions The average CDR in Jiangsu Province tends to decrease each year, so does the CDR without medical indications.The first indication of cesarean section is associated or postoperative pregnancy complications, while scarred uterus becomes the most common in cesarean section.

Objective: To explore the feasibility and safety of three dimensional (3D) electro-anatomical mapping system (Carto3) in treating the patients with paroxysmal supra-ventricular tachycardia (PSVT) by radiofrequency catheter ablation (RCFA).
Methods: A total of 180 PSVT patients were divided into 2 groups, n=90 in each group. 3-D group, the patients received RCFA with 3-D reconstructed valve ring model under Carto3 guidance. 2-D group, the patients received RCFA under conventional X-ray guidance. The procedural and X-ray exposure times, rates of success and complications, tachycardia recurrence at 6 months after procedure and the cost were observed and compared between 2 group.
Results: The procedural time was similar between 2 groups, P=0.1403. The patients in 3-D group had the lower X-ray exposure time (2.1 ± 0.7 vs 7.8 ± 3.6) min, particularly in those with right-sided accessory pathway (3.4 ± 0.7 vs 20.2 ± 7.1) min, and dual atrio-ventricular (A-V) nodal pathways (1.1 ± 0.3 vs 5.5 ±1.7) min, all P<0.0001. There was 1 patient in 3-D group without RCFA and all the others were successes. 2-D group had 3 patients with failed RFCA including 2 of right-sided accessory pathway, 1 of dual A-V nodal pathways and received 2nd RCFA under Carto3 guidance. 3-D group had no complication, no recurrence. In 2-D group, 1 patient suffered from complete A-V block (AVB) during ablation and 1-year later, the Holter showed II° to III° AVB;2 patients with recurrence including 1 of dual A-V nodal pathways and had successful 2nd ablation. The cost was higher in 3-D treatment.
Conclusion: RFCA was feasible for treating PSVT patients under Carto3 guidance, which had the higher success rate with lower X-ray exposure and complication.