Objective To observe the expression changes of peripheral endothelial progenitor cells (EPCs) and Ang-1/Tie2 in patients with pulmonary arterial hypertension (PAH).Methods From Jun 2011 to Dec 2012,45 patients with PAH charged in Affiliated Hospital of Hangzhou Normal University were divided into 3 groups according to mean pulmonary arterial blood pressure (15 per group):mild(Group L),moderate(Group M),and severe(Group S),with another 15 normal people as control group(Group C).The EPCs were isolated from peripheral blood of every patient,number counting using fluorescence activated cell sorter (FACS),function test using cell culture in vitro.Expression of Ang-1 and Tie2 in the peripheral EPCs were measured by RT-PCR or Western-blot.Non normal data was analyzed by non parametric statistical test.Results The statistical discrepancy existed among Group L,M,S and the control in the number of EPCs [32.0 (27.0,37.0),26.0 (19.0,31.0),24.0 (22.0,26.0) vs 40.0 (37.0,51.0),P ＜ 0.05].The ability of migration [32.1 (26.5,37.5),26.8 (22.4,35.4),21.0 (17.8,34.0) vs 39.0 (33.3,42.4),P＜0.05] and adhesion of the EPCs [57.1(50.9,61.8),51.8(45.2,58.7),46.0 (37.2,55.1) vs 64.1 (56.2,75.0),P ＜ 0.05] among study groups and control group was different in statistic,the same with the proliferation activity of EPCs in different groups [0.6 (0.5,0.7),0.5 (0.4,0.6),0.4(0.3,0.5) vs 0.7(0.6,0.8),P ＜0.05].The mRNA expression of Ang-1 and Tie2 in Group M & S were significantly reduced compared with control [4.33 (2.49,4.62) and 2.89 (2.39,3.44) vs 5.31(3.78,6.22),P＜0.05],Tie2 mRNA[1.32(1.23,1.34)and 1.23(1.08,1.42)vs 1.49(1.25,1.66),P ＜ 0.05],and the protein expression of the phosphorylated Tie 2 in Group M &S were decreased [0.16 (0.15,0.24) and 0.12 (0.08,0.18) vs 0.22 (0.19,0.28),P ＜ 0.05].No significant difference of Ang-1 and Tie2 expression was observed between Group L and control [5.42 (4.72,5.95),1.54 (1.43,1.66) and0.23(0.19,0.33),P=0.674,0.867 and 0.674].Conelusion With the severity of PAH,the number and function of circulating EPCs decreased,as consistent with Ang-1 and Tie2 expression changes,suggesting that function decrease of EPCs in patients with PAH may be associated with the decrease of Ang-1/Tie2 expression.

ObjectiveTo discuss the effect of surgical treatment of varicose vein on primary chronic venous insufficiency(PCVI) in the lower extremities.MethodsBetween August 2007 and August 2008,128PCVIpatients underwenthighligationof the greatsaphenousveinandendovenous electrocoagulation of the varix superficial vein. Spectrum Doppler ultrasound was used to measure the superficial femoral vein blood flow hemodynamic information beneath the first pair of valve including quiet breathing condition and the Valsalva action (reflux time、caliber、reflux velocity). Reflux index (RI) was used as guide line.ResultsClinical sympotoms improved in 54 out of 60 mild PCVI cases, in 29 of 45 moderate PCVI patients, while only in 6 out 23 cases in whom severe preoperative clinical symptom with PCVI was present.The effective rate respectively was 90％, 64％, and 30％.The mild reflux index significantly improved than that before operation ( t = 21. 484, P = 0. 000 ), the moderate reflux index improved than that before operation ( t = 2. 173, P = 0. 035 ), while the serious reflux index were not statistically improved than that before operation( t = 1. 888, P = 0. 078 ). In all cases reflux index improved after the surgery ( x2 = 8. 266,P = 0. 004).ConclusionsMinimally invasive surgical treatment of varicose veins can improve the reflux of the deep vein in PCVI cases with mild to moderate clinical symptom.

Adult ; Blood Pressure ; Environmental Exposure ; Female ; Heart Rate ; Humans ; Hyperbaric Oxygenation ; adverse effects ; Male ; Middle Aged ; Occupational Exposure ; Personnel, Hospital ; Young Adult

Anemia, Hemolytic, Congenital ; etiology ; Female ; Hepatitis ; complications ; Humans ; Infant ; Syndrome

Objective To investigate the effects of trace element strontium on the improvement of rat lipid metabolism disor‐der ,prevention and treatment effects on non‐alcoholic fatty acid liver disease (NAFLD) and its possible mechanism .Methods Fifty SD rats were randomly divided into 5 groups .The control group used the common fodder and the other four groups adopted the high fat fodder for 13‐week feeding .During the final 9 weeks ,the strontium 18 mg/L group and the strontium 36 mg/L group were sepa‐rately fed with 18 mg/L and 36 mg/L of strontium water .During the final 4 weeks ,the simvastatin group was gavaged with simvas‐tatin 10 mg/kg .The rats were killed at the end of 14 weeks and the liver index ,serum ALT ,AST ,TG ,TC ,LDL‐C and HDL‐C ,and liver TG ,TC levels were measured .The liver tissue frozen section was performed .The fatty change and its distribution were ob‐served by oil red O staining .Results Compared with the control group ,the liver indexc ,liver TG and TC levels ,serum TC and LDL‐C in the NAFLD model group were statistically increased (P<0 .05);compared with the NAFLD model group ,the levels of serum TC and LDL‐C in the strontium 18 mg/L group were decreased ,but serum HDL‐C was also decreased(P<0 .05);in liver in‐dex ,liver TC and TG levels ,serum TC and LDL‐C in the strontium 36 mg/L group were decreased(P<0 .05) .The oil red O stai‐ning showed that the liver tissue in the NAFLD model group contained a large amount of red staining fat particles ;but which in the strontium 18 mg/L group ,strontium 36 mg/L group and the simvastatin group were decreased to some extents .Conclusion The long term high concentration trace element strontium intake has the effect for improving the rat lipid metabolic disorder and preven‐ting and treating NAFLD .

OBJECTIVETo investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).

METHODSFifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated.

RESULTSThe long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4 ± 8.6 minutes, and the mean radiation exposure time 18.9 ± 6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.

CONCLUSIONSUsing the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies

Objective To study the effect of single chain variable fragment (ScFv) antibody to EC3-4 fragment of desmoglein (Dsg) 3 in a mouse model of pemphigus vulgaris.Methods The ScFv an- tibody to EC3-4 fragment of Dsg-3 was injected subcutaneously into neonatal BALB/c mice at different time points;the mice were then evaluated clinically,histopathologically and by direct immunoflorescence exami- nation for the development of lesions.Results When injected alone,the ScFv antibody did not induce the appearance of key clinical features of pemphigus vulgaris.The antibody also did not prevent the develop- ment of pemphigus vulgaris features induced by sera of patients with pemphigus vulgaris,regardless of the time point of injection of ScFv antibody.Conclusion The ScFv antibody to EC3-4 fragment of Dsg-3 lacks pathogenicity in neonatal BALB/c mice,and also could not inhibit the development of lesions induced by sera from patients with pemphigus vulgaris.

Objective To compare the Bama minipig and Juema minipig models of high altitude multi-organ dysfunction syndrome.Methods Six plateau-origin Juema minipigs and plain-origin Bama minpigs in each group received intravenous infusion of 0.35 mg/kg lipopolysaccharide ( LPS) , respectively.Blood samples were taken at 0 h, 3 h, 6 h, 12 h, 24 h, 48 h and 72 h after LPS infusion.Routine blood test was performed, blood CK, AST, ALT, TBIL, CRE were assayed, and histopathological examination of the lung tissues was performed at 24 h, 48 h after LPS infusion.Results The mortality of Bama minipigs was 33.3%, higher than that of 16.7%of Juema minipigs.The trend of physiological and biochemical changes was similar, but was milder in the Juema minipigs than in Bama minipigs.The lung injuries of the Bama minipigs at 24 h and 48 h were more severe than those in the Juema minipigs.Conclusions Both Bama and Juema minipig models of high altitude multi-organ dysfunction syndrome can be successfully established.Juema minipig models can be more closely and safely established, due to its own plateau biological properties, and avoid the influence by extrinsic injurious effects of plateau environment.

Objective To investigate the current status of type 2 diabetic patients who failed to achieve the glycemic control target, and provide theoretic evidences for making corresponding strategies. Methods The 2 diabetic patients who failed to reach the glycemic target were recruited from 181 hospitals in 26 cities and received a standard questionnaire, the conditions of their blood glucose level, lifestyle intervention, blood sugar monitoring, and drug therapy were recorded. Totally 3 861 questionnaires with complete information were collected. And the causes which account for glycemic control status were analyzed. Results Among these patients, the mean HbA1c was 7.9%, the mean fasting plasma glucose was 8.2 mmol/L, and the mean postprandial plasma glucose was 11.5 mmol/L. Only 25.6% of patients take their diet control strictly as prescribed and 44. 5% of patients have little exercise. 35. 8% and 47.8% of patients did not monitor their fasting and postprandial plasma glucose,respectively. Glycemic control in the patients aged ＞ 60 years was similar to the younger patients, but the hypoglycemia incidence in the elder group reached 35.5%, which was higher than those in the other 2 groups (20.8% and 21.4%, both P＜0. 05 ). The proportion of patients with mono-therapy and combination therapy was 46. 1% and 51.7%, while the proportion with combination therapy rose in the patients aged ＞60 years (58.7%;Compared with the other age-groups, all P＜0.05 ). 75 % of patients have adjusted their drug administration regimen since initial treatment. Conclusions Inadequate or inappropriate drug therapy regimen is a major cause responsible for this poor glycemic control status. In addition, the unhealthy life styles, insufficient blood sugar monitoring, and poor compliance were also important causes. Thus, for these patients, it is necessary to further enhance patients' education, to improve life style intervention, as well as to select more effective, safer, and compliant drug therapy regimens. Finally, the glycemic control target for the elder patients should be more flexible.

BACKGROUND: Rat models induced by unilateral nephrectomy combined with adriamycin are widely used in screening anti-drugs of glomerular sclerosis. However, few reports concerning this method on inducing rabbit model of glomerular sclerosisOBJECTIVE: To establish a rabbit model of glomerular sclerosis, and to observe the renal function and histopathological changes during model preparation. DESIGN, TIME AND SETTING: Randomized controlled animal experiment was performed in Laboratory Animal Center of Kunming General Hospital of Chengdu Military Region between December 2008 and May 2009. MATERIALS: Twenty-five Japanese big-ear rabbits, weighing 1.75-2.25 kg, half males and half females, were selected to establish glomerular sclerosis models, and randomly divided into normal (n=10) and model (n=15) groups. METHODS: The left kidney of rabbits in the model group was removed under anesthetized with 30g/L saline solution of sodium pentobarbital (1 mL/kg). Rabbits in the normal group underwent a similar surgical procedure without kidney removing. At 1 week after operation, 5 mg/kg adriamycin was injected into rabbits in the model group, 3 mg/kg adriamycin was reinjected 2 weeks later. Same volume of physiological saline was injected in the normal group. MAIN OUTCOME MEASURES: The renal blood biochemical indexes were detected prior to and at weeks 4, 6, and 8 after model preparation. One nephridial tissue was harvested from each group to undergo pathological observation at week 8 after the second medication. RESULTS: ①Kidney in the normal group presented slightly white, slightly tough texture with smooth surface. ②Pathological features of focal segmental glomerulosclerosis was showed in the model group under a light microscope, presented as extracellular matrix hyperplasia, mesangial region expansion, renal glomerular capillary wall ball mix adhesion, tubule degeneration, or even interstitial fibrosis, as well as interstitial infiltration of inflammatory cells. ③Compared to the normal group, the total protein and albumin was and decreased, triglyceride, total cholesterol, low density lipoprotein cholesterol, urea nitrogen, and creatinine were significantly increased in the model group. The urine protein content of rabbits in the model group was obviously increased at 4 weeks, gradually reached a platform after 8 weeks, which still greater than that of the normal group. ④SPECT showed that the glomerular filtration rate of the model group was notably decreased (33 mL/min) than the normal group (92.6 mL/min).CONCLUSION: The unilateral nephrectomy combined with adriamycin in rabbits results in the formation of glomerular sclerosis, renal function and 24 h urinary protein is more visible in the phase change.