Coronary Occlusion ; surgery ; Drug-Eluting Stents ; adverse effects ; Humans ; Male ; Middle Aged ; Sirolimus ; administration & dosage ; Thrombosis ; complications

Retinitis pigmentosa (RP) is a large group of common hereditary eye diseases with highlyheterogeneous genetic background. Over forty genes with diverse functionalities are associated with RP and they include a set of ubiquitously expressed genes. These include five genes involved in the precursor messenger RNA( premRNA) splicing. Recent progress in disease gene identification for RP has established the involvement of pre-mRNA splicing as one important mechanism in the disease etiology and has shed light on the splicing process itself, a fundamental biological process. To this date, studies in this field have been focused on two major issues. First, how do the mutations of the adRP associated splicing factors (adRP-SF) affect the splicing function? Second, how do the mutations in these ubiquitously expressed genes lead to specific retinopathy? The two topics fit with the two continuous important steps of the disease pathogenesis. Recently, researchers have made a dramatic progress in the first topic. The identification of the SNRNP200 gene,the fifth adRP-SF and its relevant functional study has shown significance to the progress in the study of RP. Numerous investigations are also being carried out in addressing the second issue.Generation of a variety of models led to a better description of the pathological process of the disease. However, in respect to the key pathogenic mechanism,researchers are still puzzled with a number of confusing questions. In this commentary,the results from the latest investigations were summarized, and in particular,the difficulties in studying the molecular mechanism by which the pre-mRNA splicing deficiency causes RP were detailed.

Objective To study the clinicopathologic characteristics of sarcomatoid carcinoma of the lung.Methods Clinicopathologic characteristics and immunohistochemical results of 42 cases with sarcoma- toid carcinoma of the lung were analyzed.Results Forty-two cases were pathologically proved to be spindle cell carcinoma,1 cases;giant cell carcinoma,1 case;carcinosarcoma,4 cases;pleomorphic carcinoma,36 cases.The tumors were composed of both carcinomatous and sarcomatous elements.Immunohistochemistry showed that CK was positive in 24 of 24 cases,EMA was positive in 18 of 20 cases,Vim was positive in 25 of 25 cases.Eighteen cases were survival One-year survival rate was 61.2 %,with mean survival 13.3 months. Conclusion Diagnosis of sarcomatoid carcinoma of the lung depends on pathologic and immunohistochemical results.

Objective To evaluate the outcome of liver transplantation (LT) or combined liver-kidney transplantation (CLKT) for acute-on-chronic liver failure (ACLF) patients with renal dysfunction.Method From January 2001 to December 2009,133 patients underwent LT for ACLF at our center.Among them,30 had both ACLF and renal dysfunction.Of the 30 patients,12 underwent CLKT for end-stage renal disease (ESRD),and the other 18 with hepatorenal syndrome type 1 (HRS1) underwent LT alone.Their clinical data were reviewed and their survival outcomes were compared.Result The median model for end-stage liver disease scores (MELD) of the patients with ACLF were 28.133 patients received deceased donor liver grafts and 12 patients also received the same deceased donor kidney grafts,The hospital mortality rate was 21.8％ for all patients with ACLF.The 5-year survival rates were 72.8％ for patients without renal dysfunction and 70％ for patients with renal dysfunction.The curative effectiveness of the patients with ESRD who underwent CLKT was better than that of the patients without renal dysfunction or the patients with HRS1 who underwent LT alone.Conclusion LT alone improved renal function in most patients with HRS1.Simultaneous liver-kidney transplantation is an excellent strategy in patients with both ACLF and ESRD.It provides protection to kidney allograft in liver-based metabolic diseases affecting the kidney.

Abstract: The activities of four CYP450 enzymes (CYP3A, 1A2, 2El and 2C) and the mRNA expression levels of CYP1A2, 2El, 2Cll and 3A1 in rat liver were determined after Wistar rats were orally administered with brucine (BR) at three dosage levels (3, 15 and 60 mg.kg-1 per day) and the high dose of BR combined with glycyrrhetinic acid (GA, 25 mg.kg-1 per day) or liquiritin (LQ, 20 mg.kg-1 per day) for 7 consecutive days. Compared with the control, brucine caused 24.5% and 34.6% decrease of CYP3A-associated testosterone 6beta-hydroxylation (6betaTesto-OH) and CYP2C-associated tolbutamide hydroxylation (Tol-OH), respectively, and 146.1% increase of CYP2El-associated para-nitrophenol hydroxylation (PNP-OH) at the high dose level. On the other hand, (BR+GA) caused 51.4% and 33.5% decrease, respectively, of CYP2El-associated PNP-OH and CYP1A2-associated ethoxyresorufin-O-de-ethylation (EROD) as compared with the high dose of BR group. Meanwhile, (BR+LQ) caused 41.1% decrease of CYP2El-associated PNP-OH and 37.7% increase of CYP2C-associated Tol-OH. The results indicated that the co-administration of BR with GA or LQ had effect on mRNA expression and activities of the CYP450 enzymes mentioned above to some extent, and the in vivo antagonism of LQ on BR-induced CYPs adverse effects and the in vivo inhibitory action of GA on CYP2E1 and 1A2 might play an important role in the detoxification of Radix Glycyrrhizae against Strychnos nux-vomica L.

Objective To assess the left ventricular(LV)segmental function by velocity vector imaging(VVI)in uremic patients with diffferent quantity of parathyroid hormone(PTH).Methods Sixty patients with uremia were divided into 2 groups according to the value of PTH:group A with PTH less than 3 times of upper normal limit,group B with PTH more than 3 times of upper normal limit.Normal control group was 30 healthy subj ects.All people were evaluated by VVI.The parameters,including the longitudinal systolic strain rate(SSR),diastolic strain rate(DSR),were analysed among the three groups.Results Compared with normal group,in group A and B,SSR,DSR in all segments were lower.Compared with group A,in group B,DSR were all significantly lower(P＜0.05),SSR in apex of laternal wall,medium of anterior septum wall,posterior wall,medium and apex of posterior septum wall and superior wall,base,medium and apex of anterior wall were significantly lower(P＜0.05).There was no statistically significant difference of left ventricular ejection fraction between the two groups(P＞0.05).Conclusions VVI is a viable objective tool to quantitatively assess LV segmental function damaged by different quantity of PTH.

Objective To investigate the causes of acute renal failure(ARF)after orthtopic liver transplantation(OLT)in patients of acute liver failure(ALF)and the effects of systemic therapy based on continuous renal replacement(CRRT).Methods Clinical data of 412 patients who underwent liver transplantations between January 2001 and June 2006 were analyzed retrospectively (all the cases were followed up to June 2007).According to UNOS grading scale,54 patients were of acute liver failure(UNOS 1 and 2A).Posttransplant ARF developing in 17 cases underwent a systemic therapy based on CRRT as well as anti-rejection,anti-infection and nutrition support.The perioperative courses,complications,causes of death and follow up results were analyzed.Results There were no severe complications during CRRT.Perioperative mortality was 5.4%and 58.8%in patients without ARF and those with ARF respectively.the rate of complications was 35.1%vs 100%.1 year survival rate Was 89.2% vs 41.2%.3 year survival rate was 81.1% vs 41.2%.Condusions The effect of surgery mainly depends on the function of liver and other vital organs.The ALF recipients suffered from a high perioperative mortality,especially those with posttransplant ARL.The systemic therapy based on CRRT benefits patients with postoperative ARF.

Objective To evaluate the clinical application values of 64-row MSCT for apical hypertrophic cardiomyopathy(AHCM).Methods Twenty-one patients with AHCM were included in this study,14 patients were diagnosed by echocardiography(UCG),and 7 patients were diagnosed by MRL AU patients underwent MSCT exam,and 5 patients also had ventriculography and coronary angiography.The left ventricular wall thickness in end-systole and end-diastole phases were measured at MSCT workstation,the left ventricular apex thickening rate(LVAT)and the ratio of maximum wall thickness of the left ventrieular apex(LVA)to the left ventricular posterior wall thickness(LVA/LVPW)in end-diastole phase were calcdated.The left ventricular end-diastolie volume(LVEDV)and left venueular ejection fraction (LVEF)were quantitively evaluated with cardiac functional analysis software.The results were compared with the measurement results from the normal control group(30 volunteers).The independent-samples t test was used for the statistics.At the same time.the coronary stenosis was measured.Results Diffuse or partial thickening of the LV apical myocardium were found in the four-chamber view and two-chamber view of MSCT images.which leaded to the deformation of the left ventricle chamber.The LVEDV were(82.6±11.4)and(108.5±10.6)ml in the AHCM group and the control group,respectively;the LVA were (20.6±3.4)and(9.9±1.5)mm;LVA/LVPW were 2.1±0.5 and 1.1±0.2;the LVAT were(25.6±4.7)%and(81.5±8.5)%.There were significant differences in LVEDV,LVA,LVA/LVPW and LVAT between the two groups(t=8.32 and 15.29,P＜0.05;t=9.91 and 27.30,P＜0.05;respectively),but there were no statistical differences in LVPW and LVEF between the two groups(t=0.26 and 1.13.P＞0.05).Five patients had myocardium bridging and 4 patients had coronary stenosis.Conclusion AHCM can be diagnosed accurately with MSCT,and the cardiac anatomy.function and coronary artery are also assessed simultaneously.

Objective To identify the genetic loci associated with bipolar disorder in Chinese population by the ge?nome scan on chromosome 20 in bipolar disorder patients and healthy people from Shandong peninsula. Method Geno?typing was conducted on DNA pool samples of 104 bipolar disorder patients and 1000 controls using thirteen microsatel?lite markers on chromosome 20 spaced at intervals of approximately 10 cM and GeneMapper 4.0 software. CLUMP soft?ware was used to analyze multiallelic markers. Result Significant difference of allele frequencies was found at marker D20S186 (20p12.2) between patients and controls (P=0.022). Conclusion The data suggest that the D20S186 locus (20p12.2) is significantly associated with susceptibility to bipolar disorder in a Chinese Han population in Shandong pen?insula. Future studies should focus on the fine mapping of this region and assessment of candidate genes.

Objective To obtain the peptide mass fingerprintings(PMF)of serums of the patients with bone metastasis and with-out metastasis and to filtrate and identify the differential serum proteins of patients with bone metastasis after radical mastectomy . To establish diagnostic models for diagnosis of bone metastasis after breast cancer operation .Methods Two groups of serum sam-ples were analyzed by ClinprotTM MALDI-TOF MS and gain PMF ,18 samples from patients with merely bone metastasis and 18 samples from patients without metastasis .Characteristic protein peaks were analyzed and selected by analyses software within Clin-prot system .Every group was repeated 2 times .Results All serum samples were repeated after 5 days and the fingerprintings were similar to the former .4 protein peaks were selected randomly to compute coefficient of variation which are less than 30% .The Clin-prot system has excellent repeatability .No differential protein was detected by analyzing PMF (P>0 .05) .Conclusion No differen-tial serum protein exists in patients with bone metastasis and without metastasis and detecting differential protein in peripheral blood may be impossible .