Objective To observe the efficacy and safety of arginine vasopressin receptor antagonist tolvaptan for treating hyponatremia caused by syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Methods Six patients diagnosed with SIADH were enrolled in this study.Four cases were allocated to tolvaptan group (oral tolvaptan 15-60 mg/d,the dosage was adjusted based on the level of serum sodium).Two cases were allocated to regular treatment group (liquid was limited 1 000 ml/d,intravenous drip was less than 3％ sodium chloride and/or oral salt capsule 10-15 g/d several times was adjusted based on the level of serum sodium).Data of the level of serum sodium at 4,7 d,baseline value of serum sodium,serum sodium at the first normal time,24 h urine and weight change were collected.Safety assessment was given before and after treatment,including medical history,physical examination,electrocardiogram,laboratory tests,and incidence of adverse events.Results The level of serum sodium in tolvaptan group increased from the first day of the treatment.During the period of treatment,serum sodium at 4 d increased 22,16,14,11 mmol/L compared with the baseline value respectively.No obvious change of sodium was observed in regular treatment group compared with the baseline value.For 7 d treatment,serum sodium level increased 14,13,14,13 mmol/L in tolvaptan group compared with the baseline level respectively.Only 2 cases in regular treatment group increased 4 mmol/L,and sodium level in regular treatment group did not reach the lower limit of normal level of serum sodium.In tolvaptan group,all patients urine output increased after 1 d treatment and began to stabilize in 3 d.24 h urine putouts were much more than 1 500 ml during treatment.Urine putouts 780-1 400 ml were observed in regular treatment group.There was no difference before and after treatment.Although weight dropped after treatment in the two groups,weight in tolvaptan group fell obviously.In the two groups,there was no difference in blood pressure and heart rate before and after treatment.There were no serious complications and adverse events.Conclusions Compare with regular treatment,arginine vasopressin receptor antagonist is more effective therapy because it can correct the SIADH in patients with hyponatremia and reduce water retention.It also has a good security.

Objective To establish the magnetic activated cell sorting system(MACS)for isolation and incubation of human ovarian carcinoma-derived microvascular endothelial cells(ODMECs) and to observe their ability to form tubule-like structure(TLS) in vitro.Methods MACS was used to purify ODMECs with antiCD31 antibody and ODMECs were identified according to their morphological,biochemical and phenotypic characteristics.The ability of ODMECs to intake acetylated-low-density lipoprotein(DIL-acLDL) and Ulex europeaus agglutinin-1(UEA-Ⅰ) was assayed to observe the formation of TLS in vitro.Results Flow cytometry showed that the purity of ODMECs was up to 99.6%.The ODMECs were characterized by cobble stones,contact inhibition,expressed CD31,CD105 and FⅧ-Rag,and exhibited the ability to bind to UEA-1,intake DIL-acLDL and form TLS during incubation.Conclusion The MACS we established can be used to isolate and incubate human ODMECs and study the formation characteristics of TLS.

OBJECTIVETo exacted analysis each time interval in isovolumic relaxation time (IVRT) of normal subjects through observin the changes of cardiac structure and hemodynamics during the IVRT. Then to provide the evidence of cardiac resynchronization therapy.

METHODSQuantitative analysis was performed for 60 subjects. The dual-channel echocardiography(DCE), pulse wave doppler (PW) and tissue wave dapper (TDI) examination of all the subjects were recorded, and IVRT was divided into two intervals, isovolumic relaxation time of early intervals (IVRTe) and isovolumic relaxation time of late interval (IVRT1). Then measured the time of each interval. Indicators were used including: (1) IVRT; (2) IVRTe; (3) IVRTI; (4) IVRTI/IVRT; calculating the data after heart rate corrected; (5) cIVRT; (6) clVRTe; (7) clVRTI; (8) clVRTI/clVRT; (9) measuring the time difference in mitral blood and tissue (TE-é) of DCE group.

RESULTSThe i-wave within IVRT in PW images was found in 45 subjects, and the i-wave was about 1/2 of IVRT (49.17 +/- 5.37) ms. IVRT was divided into IVRTe and IVRTI by a turning point at descending branch of i-wave as t-point. The j-wave was observed in 84% TDI images, and the j-wave was about 1/2 of IVRT (43.13 +/- 4.83) ms. IVRT was divided into IVRTe and IVRTI by a turning point of the onset of j-wave as t-point. A significant difference was found between PW and TDI with measurement of IVRT, IVRTe, IVRTI (P < 0.05). There were no significant differences between the common group and DCE group (P > 0.05). After heart rate corrected, the data showed no significant difference using pairwise comparisons among the three groups (P > 0.05). The mean and standard deviation of IVRTI/IVRT, cIVRTI/clVRT were (0.50 +/- 0.12) ms. There were little difference of time intervals and good consistenc using DCE measured IVRT with multiple tests confinmed.

CONCLUSIONThe study found that IVRT might be divided into IVRTe and IVRT1 phases. There were i-wave in IVRTe and j-wave in IVRT1. The t-point was nearly midpoint inisovolumic relaxation time.

Adult ; Diastole ; physiology ; Echocardiography ; Female ; Healthy Volunteers ; Humans ; Male ; Middle Aged ; Ventricular Function, Left ; physiology

Objective To obtain scientific data for control of iodine deficiency disorders(IDD) by reviewing the surveillance information of school children intelligence quotient(IQ) after the implementation of universal salt iodization. Methods One thousand five hundred and eighty children were selected from 11 primary school in Dalian city of Liaoning province during 2006 to 2009. IQ was measured by Combined Raven Test-C2(CRT-C2) in China. Groups of IQ were classified as outstanding(≥ 130), excellent (120- 129), above average (110- 119), average (90 - 109), below average(80 - 89), margin(70 - 79), low(≤69). Urinary samples of children were collected randomly. Urinary iodine were determined by As-Ce catalytic spectrophotometry. The growth characteristics of IQ were analyzed according to surveillance year and born year. Results The average IQ of children aged 8-10 were 110.4 ± 14.0,112.5 ± 12.4,117.2 ± 11.4,116.2 ± 12.6, respectively, increased year by year from 2006 to 2009. Its average annual increase from 2007 to 2009 were 2.1,3.4,1,9 compared with the IQ in 2006 respectively. The medians of urinary iodine were 224.7,266.7,222.1 μg/L from the year 2007 to 2009, respectively, which were all between 200 - 300 μg/L and can be classified as more than adequate level. The average IQ of children born during the year of 1994 to 2000 were 106.7 ± 13.0,108.1 ± 13.9,108.5 ± 13.4,111.3 ± 14.3,113.6 ± 12.5,115.3 ± 12.3,119.8 ± 11.2, respectively. Its average annual increase from 1995 - 2000 were 1.4,0.9,1.5,1.7,1.7,2.2 compared with the IQ born in 1994 respectively. The ratio of IQ in margin group and low group were all below 2% ; the ratio was increasing in excellent group and outstanding group and decreasing in average group and below average group significantly year after year(x2 = 52.471,34.329,66.483,11.148, all P<0.01). Conclusions Universal salt iodization improves IQ scores. IQ index should be brought into the surveillance project and put in use in IDD control.

Vincristine (VCR) is mainly used to treat acute lymphocytic leukemia, Hodgkin and non-Hodgkin lymphoma in clinic with definite therapeutic effect. But the obvious neurotoxicity and local stimulation of which limit its clinic use. In order to increase the lymph targeting to enhance the curative effect and to lower the adverse reaction of VCR, the VCR loaded transfersomes (VCR-T) were prepared with dry-film and ultrasonic dispersing methods, and the corresponding pharmaceutical properties, pharmacokinetical characteristics and the targeting ability were studied. The average particle size of VCR-T prepared was 63 nm with an entrapment ratio of 59%. The in vitro transdermal research with modified Franz cell showed that VCR-T permeated through the skin in accordance with polynomial equation, and with an accumulation permeation percentage of 67.4% up to 12 h. An HPLC method was utilized to determine the pharmacokinetics and tissue distribution of VCR. Compared with the iv injection of VCR solution, the retention time of VCR in blood was extended by 12 times with VCR-T, and the targeting index in rat lymph was increased by 2.75 times. As a result, transfersomes could penetrate the skin and enter into the systemic circulation carrying VCR with good lymph targeting ability, which makes it probably a new lymphtic targeting drug delivery system.
Administration, Cutaneous ; Animals ; Antineoplastic Agents, Phytogenic ; administration & dosage ; blood ; pharmacokinetics ; Area Under Curve ; Drug Delivery Systems ; Liposomes ; chemistry ; Lymph Nodes ; metabolism ; Male ; Particle Size ; Rats ; Rats, Sprague-Dawley ; Skin Absorption ; Spleen ; metabolism ; Surface-Active Agents ; chemistry ; Tissue Distribution ; Vincristine ; administration & dosage ; blood ; pharmacokinetics

Objective To study the effect of comprehensive Chinese medicine therapy,including Chinese herbal medicine fumigation,massage,and quadriceps exercise,on adipokines of visfatin and chemerin content in joint fluid of patients with knee osteoarthritis (KOA),and to explore its possible therapeutic mechanism for KOA.Methods A total of 60 cases of KOA patients were randomly divided into treatment group and control group,30 cases in each group.The treatment group was treated with comprehensive Chinese medicine therapy,and the control group was treated with Chinese medicine fumigation alone.After treatment for 2 weeks,the clinical efficacy of both groups was evaluated,and the changes in the scores of the Western Ontario and McMaster Universities Arthritis Index (WOMAC)were observed.Moreover,the contents of visfatin and chemerin in jointfluid were examined.Results (1) The total effective rate of the treatment group was 96.7％ and that of the control group was 83.3％,the difference being significant (P ＜ 0.01).(2) After treatment,WOMAC scores of both groups were obviously decreased(P ＜ 0.01 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group (P ＜ 0.01).(3) The contents of visfatin and chemerint in joint synovial fluid of both groups were decreased (P ＜ 0.01 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group(P ＜ 0.05).Conclusion The comprehensive Chinese medicine therapy of Chinese herbal medicine fumigation,massage and quadriceps exercise is effective for the treatment of KOA,and can decrease the contents of visfatin and chemerin in joint fluid of KOA patients,which may be one of its therapeutic mechanisms.

Objective To investigate the effects of anxiety and depression on the quality of life (QOL) in patients with irritable bowel syndrome with diarrhea (IBS‐D) and the difference in gender .Methods IBS‐D patients met the Rome Ⅲ diagnostic and subtyping criteria were consecutively enrolled .The intestinal symptoms , psychological status , and QOL of patients were evaluated using IBS‐specific symptom questionnaires , the Hamilton anxiety scale (HAMA) ,the Hamilton depression scale (HAMD) ,and the Chinese Version of IBS‐QOL instrument .The data were analyzed by chi‐square test variance analysis ,t test or Spearman rank correlation analysis .Results A total of 155 IBS‐D patients were enrolled .Among them ,115 were complicated with anxiety and/or depression .The number of male and female with comorbid psychological disorders was 69 cases(71 .13% ) and 46 cases(79 .31% ) ,respectively ,and the difference was not statistically significant (χ2 = 1 .267 ,P= 0 .26) . Compared with 40 patients without anxiety or depression ,there was no statistically significant difference (F=1 .143 ,P> 0 .05) in the scores of intestinal symptoms in 59 patients with comorbid anxiety alone and 56 patients with anxiety and/or depression (20 .85 ± 5 .84 vs .21 .71 ± 7 .47 vs .22 .87 ± 6 .09) .The total IBS‐QOL score of the 155 patients was 71 .61 ± 19 .22 .There was negative correlation between IBS‐QOL score and HAMA , HAMD scores(r= -0 .262 and -0 .268 ,both P= 0 .001) .The total IBS‐QOL score of patients with comorbid anxiety and depression or depression were lower than that of patients without anxiety or depression (66 .05 ± 22 .88 vs 77 .22 ± 15 .35 , F = 4 .412 , P = 0 .005) .Except health worrying and sexual ,the scores in six dimensions(including dysphoria ,interference with activity ,body image ,food avoidance and social reaction) were all significantly decreased (F= 3 .309 ,3 .279 ,4 .177 ,3 .765 ,6 .041 and 3 .830 , P= 0 .013 ,0 .012 ,0 .013 , 0 .007 ,0 .001 and 0 .010) .In male patients ,the total score of IBS‐QOL and the scores of dysphoria ,body image and social reaction of patients with anxiety and depression or depression were lower than those of patients without anxiety and depression (t = 2 .143 ,2 .110 ,2 .279 ,3 .061 ; P = 0 .036 ,0 .039 ,0 .027 ,0 .003) .In female patients ,the score of food avoidance domain significantly decreased (t= 2 .812 ,P= 0 .008) .The scores of IBS‐QOL and six dimensions (including dysphoria ,interference with activity ,body image ,food avoidance and social reaction) of patients with history of severe mental disorders and being abused were even lower than those patients without such histories (t= 3 .241 ,3 .433 ,2 .499 ,2 .296 ,2 .514 ,3 .413 and 2 .601 ;P= 0 .001 ,0 .001 ,0 .014 , 0 .023 ,0 .013 ,0 .001 and 0 .010) .Conclusions The QOL of patients with IBS‐D was significantly affected by psychological factors with gender differences .The approaches to improve the psychological status of IBS patients were helpful to enhance the efficacy of comprehensive therapy .

Objective To evaluate the two-stage repair in hypospadias cripples.Methods 35 patients with hypospadias cripples underwent two-stage repair.At the first stage,a full-thickness graft of skin or buccal mucosa was used for urethral plate reconstruction after the release of chordee.The second stage was performed 6 months after completion of the first stage.Tubularization of the replaced urethral plate was the preferred technique.Results There was no urethra stricture or “preplaced urethral plate ” atrophy.Fistula developed in 2 of 35 cases.Conclusion The twostaged technique was a useful strategy to deal with the myriad abnormalities encountered in crippled hypospadias.This technique could not only create a neourethra successfully,but also give the penis a near-normal shape and appearance.

Adult ; Cell Adhesion Molecules ; genetics ; Genetic Predisposition to Disease ; Genotype ; HIV Infections ; etiology ; genetics ; Humans ; Lectins, C-Type ; genetics ; Middle Aged ; Receptors, Cell Surface ; genetics

OBJECTIVE: To investigate the rules of lymphatic metastasis of rectal carcinoma, and to help clinical diagnosis and treatment. METHODS: A retrospective analysis was performed in the 979 patients with rectal carcinoma who underwent surgical resection from 1995 to 2004. The associations between lymphatic metastasis and clinicopathologic variables were evaluated by Chi-squared test and logistic regression. RESULTS: The rate of lymph node metstasis was 71.4% for patients younger than 30 years old, 40.7% in the patients with tumor diameters over 6 centimeters, 82.5% in the patients with extraneous tumor invasion, 71.6% for patients of poor-differentiated adenocarcinoma, 70.4% for patients with mucoid adenocarcinoma, 100% for patients with signet-ring cell carcinoma and 46.4% for patients with more than half intestinal circumference invasion. Logistic regression analysis showed that the degree of lymphatic metastasis was related to the differentiating degrees, depths of tumor invasion and intestinal circumference invasion, and the differentiating degree was the major factor. CONCLUSION The lymphatic metastasis of rectal carcinoma is related to age, tumor size, intestinal circumference invasion, depth of tumor invasion and the differentiating degree of the tumor; the differentiating degree is the major factor.
Adenocarcinoma ; pathology ; Adult ; Age Factors ; Carcinoma, Signet Ring Cell ; pathology ; Female ; Humans ; Logistic Models ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Rectal Neoplasms ; pathology ; Retrospective Studies