Objective To systematically evaluate the effectiveness and safety of renal sympathetic denervation (RSD) for treatment of patients with resistant hypertension.Methods English and Chinese literatures of controlled clinical trials on RSD in treatment of resistant hypertension were searched from the Cochrane Library,PubMed,Web of Science,Wanfang Database and CNKI up to February 2013.Metaanalysis was performed with the selected studies by using software Rev.Man 5.0.Results Seven studies involving 354 cases with RSD and 146 controls were included for analysis.Compared with control group,RSD significantly lower both systolic and diastolic blood pressure in patients with resistant hypertension (systolic,1 month:MD =-18.04,95％ CI:-19.94--16.14,P ＜0.01; 3 months:MD =0.01,95％CI:-28.10--17.98,P＜0.01; 6 months:MD=-25.59,95％CI:-34.08--17.11,P＜0.01; diastolic,1 month:MD=-7.53,95％ CI:-8.60--6.45,P＜0.01; 3 months:MD =0.01,95％CI:-12.5--4.47,P ＜ 0.01; 6 months:MD =-10.54,95％ CI:-16.44--4.63,P =0.000 5).In addition,there was no significant difference in adverse reactions between RSD treatment group and control group (OR =1.13,95 ％ CI:0.34-3.76,P =0.84).Conclusions Renal sympathetic denervation can effectively reduce blood pressure in patients with resistant hypertension 1-6 months postoperatively,without increase of adverse reactions.The long-term efficacy and safety need to be further observed.

Objective To evaluate the efficacy of percutaneous transluminal septal myocardial ablation (PTSMA) and septal myectomy (SM) for treatment of hypertrophic obstructive cardiomyopathy.Methods We searched all clinical controlled trials of PTSMA and SM in treatment of hypertrophic obstructive cardiomyopathy in Cochrane Library,PubMed,Web of Science,Wanfang Database and CNKI update to August,2012.The selected studies in Chinese and English were used for Meta-analysis with software RevMan 5.0.Results Five studies including 286 cases (PTSMA:149,SM:137) were included in the study.Left ventricular outflow tract pressure was significantly reduced by SM treatment compared with PTSMA (OR =9.07,95％ CI:0.96-17.18,P =0.030).There were no significant differences in interventricular septum thickness (OR =1.15,95％ CI:-0.79-3.10,P =0.240),left atrial diameter (OR =1.95,95％ CI:-0.16-4.07,P =0.070),left ventricular end-diastolic (OR =0.70,95％ CI:-0.79-2.19,P =0.360),end systolic diameter (OR =1.14,95 ％ CI:-1.65-3.93,P =0.420),degree of symptom improvement (chest pain:OR =1.07,95 ％ CI:0.35-3.23,P =0.910;syncope:OR =0.32,95％ CI:0.08-1.23,P =0.100),and postoperative mortality (OR =1.63,95％CI:0.46-5.76,P =0.450) between PTSMA and SM treatment; but the rates of pacemaker implantation (OR =5.91,95％ CI:2.04-17.11,P =0.001) and reintervention treatment (OR =6.62,95％CI:1.20-36.62,P=0.030) in patients with PTMSA were significantly higher than those with SM.Conclusions There is no evidence to indicate that PTSMA can completely replace SM,as an alternative choice the therapy can be used according to left ventricular out flow tract pressure,symptoms,anatomy of target vessel and other conditions.

Two patients underwent liver transplantation of blood type incompatibility were collected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. Case 1: A male who had primary hepatic carcinoma underwent classic orthotopic liver transplantation; the blood of donor was type A, and the blood of recipient was type O. Case 2: A female having history of type B hepatitis underwent classic orthotopic liver transplantation due to pregnancy combining with severe liver disease and coagulation disorder; the blood of donor was type B, and the blood of recipient was type O. Immunohistochemistry staining was used to observe pathological changes and deposition of various immunoglobulin and complement in two cases following liver transplantation of blood type incompatibility under optic microscope and to investigate diagnostic standard of humoral rejection. The results showed that linear or granular depositions of IgG, IgM, IgA, C4c, C4d, and Clq were found in endothelial cells of hepatic sinusoid, suggesting that IgG and other immunoglobulin exhibited a strongly positively diffused deposition on the endothelial cells of hepatic sinusoid, while expression of C4d and other complements was also found. All those mentioned above could be considered as evidences to prove onset of humoral rejection in transplanted liver tissue.

Objective:To study the impact of rotary cell culture system(RCCS) on the quality and activity of fetal islets of pancreas after cryopreservation and resuscitation.Methods:The fetal islets of pancreas were assigned into three groups averagely,experiment group 1,2 and control group.In experiment group1 and 2,fetal islets of pancreas were cultivated in RCCS and common culture respectively.While in control group,fresh fetal islets of pancreas were cultivated in RCCS all the time.We resected the fetal pancreas and digested with Collagenase V and purified with ficoll solution.Then standard cryopreservation step was adopted,and after resuscitation,the islets of pancreas were cultivated continuously.And the quantity,quality and activity of the islets of pancreas,and insulin stimulation test results in all groups were detected.Results:After purification,islets got from one fetal pancreas reached 2,331.98-5,115.43 IEQ(average 3,551.27? 253.76 IEQ) .The survival rate,the insulin release and stimulation index in islets of pancreas of group 1 incubated in RCCS were higher than those in common culture.Conclusion:RCCS are good for the growth and proliferation of islets of pancreas,and the islets of pancreas cultivated in RCCS have better insulin secreting capacity.RCCS combined standard cryopreservation method may further improve the cryopreservation effect.

Objective To explore clinicopathological features and prognosis of juvenile granulosa cell tumor (JGCT).Methods Patients were divided into JGCT group (n=10) and the adult granulosa cell tumor (AGCT) group (n=10).The tumor samples were examined by HE and immunohistochemical methods.Results Age of JGCT group ranged from 7-31 years (average 20.5 years);90% occurred before 30 years old.Diameter of the tumors ranged from 5.5 cm to 15.0 cm,average 9.8 cm.Characteristic features included nodular arrangement,irregular formation of follicles containing muein and luteinization, atypical hyperplasia of ceils and high mitotic activity.Nuclei grooved and Call-Exner bodies were absent or rare.Survival rate was 90% in 5 years.Age of AGCT group ranged from 14-74 years (average 45.1 years);AGCT occurred mostly in over 40 years old.Atypical hyperplasia of cell,mitotic activity and luteinization were absent or rare.Nuclei grooved and eall-Exner bodies were common.Survival rate was 100% in 5 years.Immunohistochemical staining were positive for p53 at 70%,PCNA at 90% in 10 cases of JGCT and p53 at 10%,PCNA at 20% in 10 cases of AGCT(P

Adult ; Aged ; Brucellosis ; diagnosis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; diagnosis ; microbiology ; therapy

Objective To identify a unique protein as a novel genetic marker for rapid molecular typing of Mycobacteriutn tuberculosis Beijing genotype strains by comparing the proteome of Beijing genotype strains with non-Beijing strains.Methods Fifty-six clinical isolates of Mycobacterium tuber- culosis were analyzed by spoligotyping to determine genotypes.The two-dimensional electrophoresis (2 DE)was used to compare the global protein patterns between Beijing genotype strains and non Bei jing strains.Differential expressed proteins were measured by matrix assisted laser desorption ioniza tion lime of flight mass spectrometry(MALDI-TOF-MS).The data obtained from peptide mass fingerprinting were compared in protein database.The genes encoding differential expressed proteins and their upstream were sequenced.Results Forty nine of the 56 isolates were Beijing genotype strains and 7 isolates were non-Beijing strains.A unique protein Rv0927c was identified,which is absent in Beijing genotype strains compared with 7 non Beijing strains and H37Rv.There were two characteristic mutations in Beijing genotype strains,a deletion of AGC at nucleotide position 421 of Rv0927c and a 127 G→A muta- tion in the upstream of Rv0927c.but not in non Beijing strains and H37Rv.Conclusion Characteris tic mutations of Rv0927c in Beijing genotype strains can be used as a novel genetic marker for rapid molecular typing of Mycobacteriuln tuberculosis Beijing genotype strains and non Beijing strains.

OBJECTIVE In this study we explored the role of Epac1-Rap1 pathway in the acute myocardial ischemia/reperfusion injury (MIRI) in vitro and in vivo. METHODS An acute myocardial ischemia/reperfusion injury model was established by the ligation of left anterior descending coronary. Myocardial architecture, fibers and apoptosis was evaluated by the Masson trichrome staining, Sirius red staining and TUNEL assay.H9c2 cells were subjected to hypoxia for 5 h followed by 1-h reoxygen-ation in vitro.Cell viability was measured by MTT assay and cellular injury was evaluated by measuring the release of lactate dehydrogenase (LDH). Western blot, real-time PCR and immunofluorescence were used to detect the expressions of Epac1 and relative downstream molecules.RESULTS Myocardial IR-induced cardiac apoptosis and accumulation of Epac1 and Rap1 in rat IR injury model.Direct Epac activation by 8-CPT(8-(4-chlorophenylthio)-2′-O-methyl-cAMP)exacerbated cardiomyocyte death and dysfunction following hypoxia-reoxygenation(H/R),selective activation of Epac in response to H/R was evident which enriched for cytosolic/membrane proteins and mRNA. Harmacological inhibitor of Epac (ESI-09)significantly ameliorated myocardial injury with the decline of Epac expression.Epac inhibitor and agonist studies also implicated the effect of Rap1, which is downstream of Epac in this pathway. The expression of Rap1 elevated when activated by Epac agonist and was blocked by Epac inhibitor. The same result was true for myocyte CaMK-II and intracellular calcium ions activation.Moreover,ESI-09 also increased ERK1/2 phosphorylation. CONCLUSION Our study reveal that Epac1/Rap1 signaling pathway is involved in the pathogenesis of myocardial I/R injury in rats,which provides evidence on the development of therapeutic strategies target this pathway for myocardial I/R injury.

Objective To investigate the therapeutic effects of electroacupuncture (EA) on post stroke depres- sion (PSD) after lacunar infarction (LI).Methods Seventy-five PSD patients with lacular infarction were recruited and randomly divided into a control group and an EA group.All patients were treated with Fluoxetine,in addition to EA treat- ment in the EA group.Then all patients were evaluated using the Hamilton Depression Scale (HAMD),the Chinese stroke scale (CSS) and the Barthel Index (BI).The evaluations were carried out at 0,14 and 28 days.Results Depression symptoms (DSs) in the EA group were improved by day 14 of the treatment,and their HAMD scores had decreased.DSs in both groups had improved significantly by day 28,and the HAMD scores in the EA group were then significantly lower than those in the control group.Improvements in neurological impairment and in the activities of daily living were observed earlier in the EA group.Conclusion The combination of EA and Fluoxetine is helpful for PSD with complex patho- genesis and clinical symptoms.Therapeutic effects are enhanced and side effects are reduced.

Quality control of traditional Chinese medicine is of great importance to ensure its safety and effectiveness in clinic,and is also an obstacle impeding the modernization of traditional Chinese medicine.Though,the complexity of traditional Chinese medicine resulted in some relative weakness of quality standard researches.The critical point need addressing is to establish a sound quality standard system conforming to the characteristics of traditional Chinese medicine in the process of the modernization of Chinese medicine.In this paper,in regard to Dan Hong injection,discriminant strategy of Q-Markers from traditional Chinese medicine injection was clarified from three aspects:what ingredients,which to control and how to control,providing a new vision in the field of the quality standard researches of traditional Chinese medicine.