Objective To investigate the value of cystatin CysC on early renal damage in patients with essential hypertensive.Methods Hundred-four patients who were diagnosed as essential hypertensive with microalbuminuria (Urinary microalbumin:20-200 mg/L) with essential hypertensive (58 males and 46 females) were enrolled and 54 healthy subjects (30 males and 24 females) were selected as controls.Serum CysC (CysC)、Crea(Cr) 、BUN、uric acid (UA) were measured and ROC curve was established based on the examination.Results There were significant difference on the level of Serum CysC[1.22(0.91,1.51 ) mg/L vs 0.73 (0.61,0.79 ) mg/L,Z=3.30,P＜0.01],BUN [6.40 ( 4.43,9.06 ) mmol/L vs 5.10 ( 4.34,5.93 ) mmol/L,Z=5.94,P＜0.01],Cr [96.3 (72.6,122.0 ) μmol/L vs 70.5 (56.2,76.0 ) μmol/L,Z=8.30,P＜0.01],UA [375.7 ( 312.3,431.8 ) μmol/L vs 328.7 ( 271,379.3 ) mmol/L,Z=3.28,P＜0.01] between essential hypertensive group and control group.According to ROC curve,the area of CysC under the ROC curve (AUC) in 104 patients was 0.87,significantly different with CR(0.78),BUN(0.66),UA(0.66) (P＜0.05 or P＜0.01 ) The Youden index of CysC was 0.69,and the corresponding sensitivity and specificity of CysC were 76％ and 93％ respectively.Conclusion The diagnostic value of serum CysC on early renal damage in patients with essential hypertensive is superior to Cr,BUN and UA,and changes of renal function can be found earlier according to the level of serum CysC,It plays a key role in the diagnosis,treatment and prognosis of the early renal damage in patients with essential hypertension.

BACKGROUND:Recent studies have demonstrated that growth factor, as a molecular signal, regulates cellular proliferation, differentiation, immigration and metabolism. Its expression and regulation play an important role in the chronic wound healing.OBJECTrVE: To observe the effect of vascular endothelial growth factor (VEGF) on the expression of VEGF receptor (VEGFR), basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) mRNA in wound tissue, and elucidate the mechanism of VEGF in promoting wound healing.DESrGN: Controlled animal experiment.SETTING: Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA. MATERIALS: Six New Zealand rabbits, aged 48-60 months, were involved in the experiment. Nanosphere-coated recombinant plasmid DNA eukaryotic expression vector pcDNA3.1/myc-hisA-VEGF166 was donated by Master Jia Ning, who was from Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA. METHODS: This experiment was carried out in the laboratory of Department of Plastic Surgery, Xijing Hospital from October 2004 to June 2005. ①VEGF (VEGF165) was taken as target gene to construct eukaryotic expression vector pcDNA3.1/myc-hisA- VEGF165. Nanosphere- VEGF165 complex was used. Three round excisional wounds, 6 mm in diameter, were created over the ventral surface of ears of anesthetized rabbits, and cartilage was exposed. Gelatin sponge thin slice dipping 100 μL nanosphere-VEGF165 complex was spread on unilateral wounds of each rabbit, and aseptic sealing membrane was spread on outer layer, serving as VEGF group; Gelatin sponge thin slice dipping 100 μL nanosphere without plasmid load was spread on contralateral wound, serving as control group; Skin of rabbit ear subterminal to circumcise region served as normal group. ② At postoperative 14 days, reverse transcription-polymerase chain reaction (RT-PCR) was used to observe the changes in the expression of VEGFR, bFGF and PDGF mRNA in wound tissue. ③ At postoperative 14 days, wound was took as center, and square tissue mass with size of 1 cm×1 cm (full-thickness rabbit ear included) was excised and prepared into sample, then which was stained by haematoxylin & eosin (HE). Under the optical microscope, the growth of newly regenerated granulation tissue was observed. MAIN OUTCOME MEASURES: Expression of VEGFR, bFGF and PDGF mRNA in wound tissue. RESULTS: ①HE staining results showed the growth speeds of granulation tissue and epithelium tissue in VEGF group were obviously faster than those in the control group. ②RT-PCR detected a significantly higher expression of VEGFR, bFGF and PDGF mRNA in the wound tissues in VEGF group than that in the control group (P ＜ 0.05) and normal group (P＜ 0.01).CONCLUSION: Exogenous VEGF up-regulates the expression of VEGFR, bFGF and PDGF mRNA in wound tissue. VEGF may act on its receptor and play an important role in promoting wound healing through its interaction with other cytokines.

ObjectiveTo analyze the perioperative risk factors of right heart failure (RHF) in human heart transplantation, and to summarize the efficacy of targeted agent especially on pulmonary hypertension.Methods Patients underwent heart transplantation were selected by exclusion criteria : (1) acute heart or other organ failure, or supported by mechanical assist device ; (2) the difference between the body weight of donor and recipient was ＞ 20％ ; (3) the ischemic time of donor was＞ 6 h; (4) acute rejection episode after transplantation; (5) perioperative death.The clinical data of 96 patients were collected, including gender, age, body weight, protopathy, history of heart failure, preoperative systolic pulmonary arterial pressure (SPAP), left ventricle end diastolic diameter (LVEDD), preoperative ejection fraction(LVEF), preoperative blood creatinine, donor ischemic time and preoperative application of 5-PDEs.The diagnosis standard of RHF was established.The risk factors were analyzed through Logistic Regression.Patients were divided into two groups according to the systolic pulmonary arterial pressure (SPAP).In group A, SPAP was ＜40 mm Hg, and in group B with SPAP≥40 mm Hg.The correlation between two groups was tested byχ2 test.ResultsIn the multivariable analysis, age, history of valve disease, length of heart failure,and preoperative SPAP were the risk factors of RHF with the coefficient of 1.051, 1.351, 1.712 and 6.725, respectively.SPAP seems to be the most important risk factor.Coronary artery disease and preoperative application of 5-PDEs-I were the favorable factors with the coefficient of 0.056 and 0.034, respectively.Parameters regarding age, history of valve disease, length of heart failure between the two groups were significantly different.There were no significant differences in gender, body weight, diagnosed as dilated cardiomyopathy or coronary artery disease and other etiologies, preoperative LVEDD, preoperative EF, preoperative blood creatinine, isehemic time and RHF, though the incidence of RHF in group B was higher than in group A (67.6％ vs 45.8％).There was also no statistic difference in using of ECMO and the mortality rate between two groups.ConclusionPreoperative PAP was the main risk factor of the RHF after heart transplantation.Although there was no statistic difference, the incidence of RHF in patients with SPAP≥40 mm Hg was higher than in patients with SPAP ＜40 mm Hg .The application of targeted agent therapy and ECMO may be helpful in treating RHF after heart transplantation.

Adolescent ; Adult ; Blood Pressure ; Gravity Suits ; Heart Function Tests ; Humans ; Male ; Positive-Pressure Respiration ; Young Adult

Objective To study the effects of helicase-like transcription factor (HLTF)transfection on DNA repair protein level in radiation-induced apoptotic cells.Methods Human lung carcinoma A549 cells were cultured and transfected with FLAG-tagged wild type HLTF (wild type HLTF transfection group),RING structure domain (ubiquitin conjugating region) mutatation HLTF expressing plasmid (mutant transfection group),empty plasmid (congtrol group) respectively.And the other cells were used as mock transfection group.All cells were irradiated with 15 Gy of 60Co γ-rays to induce apoptosis.Western blotting was used to detect the protein levels of the DNA repair proteins HRAD17 and HRAD52 in the transfected cells.Results The levels of HRAD17 and HRAD52 in the wild type HLTF transfection group was significantly lower than that of the control group.There was no significant difference in HRAD17 and HRAD52 levels between the mock transfection group and ubiquity in conjugating region mutation group.complexes of HLTF and HRAD17 and HRAD52 could be found in the irradiation-induced cells.Conclusions HLTF mediates the degradation of HRAD17 and HRAD52 in the irradiation-induced apoptotic cells possibly by the interaction of the protein complex causing ubiquitination of the repair proteins.

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.

Objective To approach the effective treatment for simple bone cyst in adult. Methods Forty-eight cases were divided into two groups by visiting order, 20 cases (steroid group) were treated by prednisolone acetate and 28 cases (open resection and allograft group) were treated by open resection and allograft. The curative effect were contrasted between two groups. Results The follow-up time was 5-46(26.58 ± 10.81) months. Aecording to the Chigira's healing criteria for simple bone cyst, grade Ⅰ , Ⅱ , Ⅲ,V were 1, 2, 10 and 7 cases respectively in steroid group, contrasting to 0, 3, 5 and 20 cases respectively in open resection and allograft group. The recovery rate was 85.0%(17/20) in steroid group and 89.3%(25/28) in open resection and allograft group, which was no statistically significant difference between two groups (P＞0.05). Conclusions Although the two remedies are no obvious difference in curative effect,simple bone cyst at lower extremity of weight-bearing with obvious osteolysis in adult is recommended to open resection and allograft, otherwise or at upper extremity to steroid injection.

Objective To obtain the Cyclin D1 through cloning and prokaryotic expression of Cyclin D 1 gene.Methods The total RNA was extracted from liver cancer tissue .The Cyclin D1 cDNA was obtained by reverse transcriptase polymerase chain reaction (RT-PCR).The Cyclin D1 cDNA was sequenced, and sub-cloned to the PET32a+.The prokaryotic expressed was used to obtain the Cyclin D1.Results The 483 bp Cyclin D1 cDNA was obtained.The sequence of Cyclin D1 was corrected.The 36 KD CyclinD1 was obtained by prokaryotic expression .Conclusions The Cyclin D1 cDNA was obtained.Cyclin D1 was expressed in BL21.

Objective To observe the effects on rabbit corneas and retinas after single intravitreal injection of voriconazole at different doses.Methods According to the randomization table,25 healthy rabbits were randomly divided into control group,and voriconazole 50,100,200,and 400 μg groups.Therefore,there were 5 rabbits in each group.The eyes of control group received intravitreal injection of 0.1 ml balanced saline solution,and those treatment groups received 0.1 ml voriconazole injection of corresponding dose.Before the injection and 1,7,and 14 days after the injection,endothelial cell counts and corneal thicknesses were measured;full-field electroretinogram were performed and b-wave amplitudes in maximal combined reaction (Max-R) were recorded.On 14 days after the injection,histologic structures were observed by light microscope and transmission electron microscope.Results There was no significant difference in endothelial cell counts (F=0.320,0.291,0.467,0.649) and corneal thicknesses (F=0.214,0.284,0.360,0.225) with those of control group at any time points (P＞0.05).Before and 1 day after the injection,b-wave amplitudes of each voriconazole group had no significant difference compared with those of control group (F=0.220,0.106;P＞0.05).On 7 days after the injection,b-wave amplitudes decreased significantly at doses of 200 μg and 400 μg (P＜0.05).On 14 days after the injection,there was no significant difference between the the amplitude of 200 μg group and that of control group (P＞ 0.05).However,the amplitude of the 400 μg group decreased continuously and there was still significant difference (P＜0.05).Light microscopy did not reveal any corneal abnormality in both control group and voriconazole groups.The retinas were normal except that of the 400 μg group,which had a thinner and degenerated inner nuclear layer and disordered photoreceptor layer.Under transmission electron microscope,there were no ultrastructure damages of corneas in both control group and voriconazole groups,either.The rabbit retinas of the 50 μg and 200 μg group have normal inner nuclear layer and photoreceptor layer,but degrees of changes in both layers were observed in the eyes of 200 μg and 400 μg group.Conclusions There is no obvious effects on rabbit corneas and retinas after single intravitreal injection of voriconazole at he dose less than or equal 100 μg.There are no obvious effects on rabbit corneas at the dose of 200 μg and 400 μg,while there are damages to the retinas in both functions and histological structures.

Objective To explore the roles of reactive oxygen species(ROS) and TGF-?1 in aldosterone-induced PAI-1 production.Methods Quiescent rat mesangial cells (MCs) were treated by aldosterone.The level of ROS in MCs induced by aldosterone was measured by confecal laser scanning microscopy and the TGF-?1 activity in the supematant of culture was measured by mink lung epithelial cell (Mvllu) proliferation inhibition MTT assay.Then,before the addition of aldosterone,MCs were pretreated with NAC or TGF-?1 neutralizing antibody to decrease cellular ROS or inhibit activity of TGF-?1 induced by aldosterone respectively.PAI-1 mRNA was examined by semi-quantification RT-PCR and PAI-1 protein by Western blotting.Results The intracellular ROS induced by aldosterone increased by 5-fold compared to that of control group,and the activity of TGF-?1 stimulated by aldosterone increased markedly.TGF-?1 neutralizing antibody and NAC effectively decreased aldosterone-induced PAI-1 mRNA expression by 30% and 32%,and PAI-1 protein expression by 21% and 11%,respectively.However,neither TGF-?1 neutralizing antibody nor NAC alone could regulate aldosterone-induced PAI-1 mRNA and protein expression to normal level in 24 hours.Conclusions ROS and TGF-?1 play important roles in up-regulation of aldosterone- induced PAI-1 in MCs.ROS and TGF-?1 are not the exclusive pathway of PAI-1 expression induced by aldosterone in MCs.