Objective To evaluate the clinical feature of the aldosterone-producing adenoma(APA) and idiopathic hyperaldosteronism(IHA)in primary hyperaldosteronism.Methods Retrospectively analyzed clinical feaures of 76 patients with APA and 17 patients with IHA.Results (1)Compared with the patients with IHA,the patients with APA had higher plasma and urinary aldosterone,lower serum potassium.(2)Furosemide provocation test(FPT)in 48 patients with APA and 14 patients with IHA were carried out.It was found that the plasma aldosterone after FPT was increased or no changed in 27 patients with adenoma,and increased in the others.It was increased in all IHA patients.(3)The diagnostic accuracy rate of CT was 84.2% in 88 patients with computed tomography imaging(CT).Conclusion The anomalies of laboratory in patients with APA are more evidence than those of IHA.The results of FPT are overlapped in a considerable amount of APA and IHA.Now those with elevation of serum aldosterone after the FPT can not exclude the adenoma.The diagnostic accuracy rate can be improved according to FPT and CT.

Objective To investigate the current status of self-efficacy and care ability among stroke patients′ family caregivers and explore the correlation between them. Method A total of 79 stroke patients and family caregivers were engaged in the investigation by demographical data questionnaires, general self-efficacy scale and questionnaire for assessing the comprehensive care-giving ability of stroke caregivers. Results The score on self-efficacy of the family caregiver was (27.16 ± 5.64) and the total score on care ability was (90.01 ± 16.57). There was a positive correlation between self-efficacy and care ability of family caregivers(P<0.05). Conclusions The self-efficacy and care ability of stroke patient′s family caregivers are at middle level. Their self-efficacy is positively correlated with their care ability. The nurses can improve the ability of daily caring of family caregivers by enhancing their self-efficacy.

Objective To assess the additional diagnostic value of mesenteric CT angiography (MCTA) for localization of intestinal diseases detected by 64-slice helical CT. Methods Pretreatment abdominal CT data from 60 cases of intestinal diseases confirmed surgically and pathologically were analyzed retrospectively. Two radiologists blindly evaluated the images in group A (including axial and multi-plane reconstructive images) and group B (including images in group A and CT angiography). Both the localization and qualitation of intestinal diseases were evaluated by comparison of the surgical and pathological findings. Results The accuracy of localization of intestinal diseases in groups A and B was 83.3% and 98.3%, respectively. Conclusion Mesenteric CT angiography can obviously increase the accuracy in localization of intestinal diseases.

Objective To investigate the protective effect of n-butanol extract from the roots of Potentilla anserina (NP) on hypoxic hippocampal neurons in neonatal rats.Methods Primary cultured hippocampal neurons were pretreated with different concentration of NP (0.25,0.0625,and 0.0156 mg/mL) before incubation in a low oxygen (0.1％) environment for 4 h.Cell viability was evaluated by Trypan blue staining assay.Lactate dehydrogenase (LDH) released by neurons into the medium was measured.The activity of superoxide dismutase (SOD) in cell cytosol was determined using nitroblue tetrazolium.Morphological changes and mitochondrial function were observed by transmission electron microscopy.Results Hypoxic injury could decrease the cells viability of neuron,enhance LDH release (P ＜ 0.05),decrease SOD activity,and increase mitochondrial injury.Pretreatment with NP significantly increased cell viability,decreased LDH release (P ＜ 0.05),promoted SOD activity (P ＜ 0.05),and remarkably improved cellular ultra-microstructure compared with the model group.Conclusion NP could protect the primary hippocampal neurons from hypoxic injury by attenuating mitochondrial cell death.

AIM: To observe the dynamic changes of myocardial collagen metabolism in pressure-overloaded rats.METHODS: The pressure-overloaded rat model was established by partial abdominal aortic coarctation.The rats underwent surgery but not constrictive were used as sham-operated control group.The rats were euthanized at 3, 4, 8 and 12 weeks.The body mass, heart mass and left ventricular mass were weighed, and the heart mass index (HMI) and left ventricle mass index (LVMI) were calculated.Masson trichrome staining was used on the myocardial sections, alkaline hydrolysis was used to detect the content of myocardial hydroxyproline (HYP), and the serum levels of procollagen type I carboxy-terminal peptide (PICP), procollagen type III amino-terminal peptide (PIIINT), and collagen C telopeptide type I (CTX-I) were also measured.RESULTS: Compared with sham-operated control group, the collagen deposition was evident, and collagen volume fraction (CVF) was increased significantly in model group (P<0.01), which further increased over time.HMI, LVMI and HYP significantly increased in model group (P<0.05), and HYP showed a tendency to increase over time.In addition, the serum concentration of PICP was increased significantly in model group, and the difference was significant at 4, 8 and 12 weeks (P<0.05).The serum concentration of PIIINP was increased significantly, but CTX-I was lowered significantly in model group (P<0.01).CONCLUSION: In the state of pressure overload, myocardial collagen metabolism is in disorder, and myocardial fibrosis is the major pathological change, which further increases over time.

Objective To observe the effects of dexmedetomidine on some hemodynamics indexes and the total dosage of propofol and remifentanil of laparoscopic total hysterectomy.Methods Sixty cases patients with total intravenous anesthesia in laparoscopic total hysterectomy were randomly divided into two groups,30 cases in each group.After induction of anesthesia,in the dexmedetomidine group,10 min before anesthesia induction pumping load dexmedetomidine 0.5 μg/kg,and then continue pumped into the maintenance dose of 0.2 μg/(kg · h),stop the medicine in 40 min before the end of operation.The control group were given the same capacity normal saline.The heart rate (HR),systolic blood pressure (SBP),mean arterial pressure (MAP),the total dosage of propofol and remifentanil at different time of before anesthesia(T0),tracheal intubation (T1),beginning of the operation (T2),extubation (T3) were recorded.Results Compared with the control group,hemodynnmic stability(HR,SBP,MAP) of each time of the dexmedetomidine group were better than the control group's,there were statistically significant differences (P＜0.05).The total dosage of propofol,remifentanil of the dexmedetomidine group were (0.11.3 ± 0.013) mg/(kg · min),(0.098 ± 0.009) μg/(kg · min),of the control group were (0.151±0.012) mg/(kg · min),(0.131±0.011) μg/(kg · min),the total dosage of dexmedetomidine group was less than the control group's,there were significant differences(P=0.038,0.045).Conclusion Small dose of dexmedetomidine used in laparoscopic total hysterectomy patients can reduce the total dosage of propofol and remifentanil,more stable hemodynamics at each point,and can be used as a viable programme for clinical application.

BACKGROUND/AIMS: Stem cell therapy has been applied to treat a variety of autoimmune diseases, including Crohn's disease (CD), but few studies have examined the use of umbilical cord mesenchymal stem cells (UC-MSCs). This trial sought to investigate the efficacy and safety of UC-MSCs for the treatment of CD. METHODS: Eighty-two patients who had been diagnosed with CD and had received steroid maintenance therapy for more than 6 months were included in this study. Forty-one patients were randomly selected to receive a total of four peripheral intravenous infusions of 1×106 UC-MSCs/kg, with one infusion per week. Patients were followed up for 12 months. The Crohn's disease activity index (CDAI), Harvey-Bradshaw index (HBI), and corticosteroid dosage were assessed. RESULTS: Twelve months after treatment, the CDAI, HBI, and corticosteroid dosage had decreased by 62.5±23.2, 3.4±1.2, and 4.2±0.84 mg/day, respectively, in the UC-MSC group and by 23.6±12.4, 1.2±0.58, and 1.2±0.35 mg/day, respectively, in the control group (p < 0.01, p < 0.05, and p < 0.05 for UC-MSC vs control, respectively). Four patients developed a fever after cell infusion. No serious adverse events were observed. CONCLUSIONS: UC-MSCs were effective in the treatment of CD and produced mild side effects.
Autoimmune Diseases ; Crohn Disease ; Fever ; Humans ; Infusions, Intravenous ; Mesenchymal Stromal Cells ; Stem Cells ; Umbilical Cord

Objective To comparatively analyze the clinical characteristics of thyrotropin-secreting pituitary adenomas (TSH-omas).Methods The clinical features, laboratory variables, imaging and pathological Results were retrospectively compared and analyzed of 26 cases with TSH-omas admitted in Chinese PLA General Hospital from Feb. 2006 to Oct. 2016 and 20 cases with TSH-omas admitted in Shanghai Huashan Hospital from Apr. 2006 to Apr. 2013.Results The female ratio was slightly higher in patients of Chinese PLA General Hospital than in Huashan Hospital [(57.7%(15/26)vs. 45.0%(9/20)], while the mean age was similar [39.5±14.1(18-67 years)vs. 40.0±14.5(17-74 years)]. The most common chief complaint was thyrotoxicosis [73.1%(19/26)vs. 55.0%(11/20)], and mild-to-moderate goiter was the most common symptom. The mean serum TSH levels in Chinese PLA General Hospital and in Huashan Hospital were 5.06(2.97-6.27)mU/L and 6.16(3.76-10.91)mU/L respectively, and patients with normal serum TSH levels were more common in Chinese PLA General Hospital than in Huashan Hospital [57.7%(15/26)vs. 40.0%(8/20)]. Microadenoma was more common in Chinese PLA General Hospital than in Huashan Hospital [34.62%(9/26)vs. 20.0%(4/20)], while macroadenoma was more common in Huashan Hospital than in Chinese PLA General Hospital [20.0%(4/20)vs. 7.7%(2/26)]. Microadenoma was more common in female patients of the both groups [66.7%(6/9)vs. 75.0%(3/4)], while macroadenoma was all found in male patients. Tumor invasion of surrounding tissue and structure was often found in macroadenoma. In terms of octreotide inhibition test, the range of 24h TSH inhibition rate was roughly the same in the two groups (37.4%-91.8% and 46.5%-94.1%, respectively). Mixed adenoma was rare among all the pathologically confirmed cases. In Chinese PLA General Hospitals, TSH immunoreactive negative neoplastic cells were found in 3 of 8 cases, and octreotide scanning showed negative in 2 of 12 cases.Conclusions Patients with TSH-omas in the two hospitals show similarities but also some significant differences in the clinical features. Overall, the domestic patients with TSH-omas are diagnosed without gender difference according to the reports in China. The mean age at diagnosis is significantly younger than that in foreign data. Microadenoma is more common in females, while macroadenoma is more common in males. Serum TSH levels can be normal in patients with TSH-omas. Immunostaining and/or octreotide scanning for TSH can be negative.

OBJECTIVETo observe the protective effect of alcohol extract of Potentilla anserina against myocardial apoptosis induced by acute myocardial ischemia/reperfusion by arteria coronaria ligation and the effect on the expressions of Caspase-3 and Caspase-9 in myocardial apoptosis signal pathway.

METHODMale SD rats were randomly divided into the sham-operated group, the model group, the diltiazem group (30 mg x kg(-1)) and P. anserine alcohol extract intervention groups (0.9, 1.8, 3.6 g x kg(-1)). Rat acute myocardial ischemia/reperfusion model was established by ligating left anterior descending. Apoptosis of myocardial cells were detected by TUNEL (Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay). The expressions of Caspase-3 and Caspase-9 mRNA were assayed by reverse transcription-polymerase chain reaction (RT-PCR). Semi-quantitative analysis was made for the expressions of Caspase-3 and Caspase-9 by immunohistochemistry.

RESULTAccording to TUNEL results, after I/R injury-induced myocardial apoptosis, the apoptotic index (AI) of model group was (31.5 +/- 3.6)%. All P. anserine alcohol extract intervention groups showed obvious inhibition of ischemia/reperfusion-induced myocardial apoptosis. In the model group, myocardial apoptosis caused increased expression of Caspase-3, Caspase-9 mRNA and proteins. After the administration of P. anserine alcohol extract, 1.8, 3.6 g x kg(-1) dose groups showed notable decrease in Caspase-9 mRNA (P < 0.05), while the 0.9 g x kg(-1) dose group showed no significant difference with the model group. Alcohol extract of P. anserina in all dosages showed inhibitory effect on the expression of Caspase-3 mRNA in myocardial cells compared with model group (P < 0.05). Immunohistochemistry showed that administration of all dosages of alcohol extract of P. anserina could significantly reduce Caspase-3 and Caspase-9 protein expressions after I/R injury (P < 0.05).

CONCLUSIONThe administration with alcohol extract of P. anserina can protect the myocardial tissue from apoptosis after acute myocardial ischemia and reperfusion injury in rats and inhibit the expressions of Caspase-9 and Caspase-3 mRNA and proteins.

Animals ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Caspase 9 ; metabolism ; Ethanol ; chemistry ; Male ; Myocardial Reperfusion Injury ; drug therapy ; Plant Extracts ; chemistry ; therapeutic use ; Potentilla ; Rats ; Rats, Sprague-Dawley

Objective: This present study aimed to investigate the relationship between working hours and anxiety/depression mood of medical staff in China during COVID-19 epidemic. Methods: The cross-sectional interview study was conducted during the period between February 14th and February 29th, 2020. A total of 291 Chinese medical professionals were recruited from 4 cities and participated in the study. Results: In 291 participants, 116 (40.0%) medical staff experienced anxiety and 151 (51.8%) underwent depressed mood. In male, the level of GAD-7 and PHQ-9 scores increased with the elevation of working hours per day (WHPD) (β=0.579, p=0.003 and β=0.943;p=0.001) respectively. In female, nonlinear relationship mode was demonstrated. The levels of GAD-7 and PHQ-9 scores increased with the elevation of working hours when it was above 5 hours (β=1.432; p<0.001 and β=1.177; p<0.001), but it did not have a significant association with WHPD when it was less than 5 (p>0.05). Conclusion During the COVID-19 epidemic, we found a strong correlation between the psychological mood and WHPD. The correlation followed different modes in male and female medical workers. Enforcing an upper time limit of WHPD may help decrease the risk of pandemic-related psychological problems in medical workers.