Objective To observe the earlier changes of left heart structure and function in patients with Grade 1 hypertension.Methods 65 patients with Grade 1 hypertension were measured on the left atrial diameter(LAD),left ventricular diameter,thickness of ventricular,mass index and evaluate the left ventricular systolic and diastolic function by UCG.Results Compaired to 50 normal controls,the LAD and left ventricular diastolic function of the patients(38.06?3.68 mm,0.72?0.11) was significantly different with those of 50 normal controls(29.86?3.08 mm,1.18?0.08)(P

Child ; Humans ; Infant ; Spasms, Infantile ; genetics ; Syndrome

· AIM: To explore the relationship between the expression of Fas/FasL and the apoptosis in retinal ischemia/reperfusion injury of rats, as well as the therapeutic effects of basic fibroblast growth factor (bFGF)on the ischemic retina.injury were made by transiently elevating introcular pressure. A total of 28 rats were divided into Normal Group and Operative Group. The latter were subdivided into 1, 6, 12, 24, 48 and 72h after reperfusion, in which the left eyes of the rats were in the ischemia/reperfusion groups and the right ones were in the treatment groups (bFGF intracameral injection). Apoptosis was assessed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling (TUNEL) method, and theexpression of Fas/FasL ligand was studied by strept avidin-biotin complex (SABC) immunohistochemistry.mai rats' retinae, but there were a significant number of TUNEL positive cells in 6-24h after transient ischemia followed by a decrease at 48h. The number of TUNEL positive cells reached a maximum at 24h after ischemia.The expression of Fas gradually increased as early as at 6h, reached a peak at 24h, then decreased at 48h. Similarly, the expression of Fas ligand was at peak in 24-48h in GCL and INL of retina. bFGF ministered before reperfusion inhibited apoptotsis and ameliorated the tissue damage. It also diminished Fas and FasL expression in ischemic/reperfused retina.siently elevated IOP induced apoptosis of cells in the retina. Fas/FasL may have an important role in the early events of the apoptotic pathways. bFGF can rescue RGCs from retinal ischemia/reperfusion injury through down-regulation of Fas and Fas ligand expression and may represent an important mechanism for therapeutic neuroprotection.

OBJECTIVE: To investigate the effects of episodic hypoxia(EHYP) on liver CYP3A2 and CYP2E1. METHODS: Healthy masculinity rats were divided randomly into five groups: control group, 3 -day EHYP group, 7 -day EHYP group, 14 -day EHYP group, and 28 -day EHYP group. 24 h after the management of EHYP, the rats were anesthetized by intraperitoneal injection, and the eyeball blood 2ml was drawn to prepare serum. The activities of ALT and AST in the serum were determined by enzymatic methods. The activities of liver microsomal erythromycin demethylase(ERD) and aniline hydroxylase(ANH) were detected by spectrophotography. The levels of mRNA expression of CYP3A2,CYP2E1 were assayed with RT-PCR. RESULTS: The serum activities of ALT,AST showed no remarkable change. However, after 7 days of hypoxia, ERD and ANH activities were remarkably elevated, and at 28 days induction rates reached up to155.5% and 42.2%, respectively. Meanwhile, the levels of mRNA expression of CYP3A2,CYP2E1 also increased by 220.5% and 102.8%, respectively. CONCLUSION: Chronic EHYP can remarkably increase the activities of ERD and ANH, whose mechanism is probably related to up-regulating of CYP3A2 and CYP2E1 expression at the transcriptive level.

Background:Myopathy due to smooth muscle cells( SMC)abnormalities is involved in the pathogenesis of diabetic gastroparesis(DGP),however,the relationship between myopathy and advanced glycation end products(AGEs)is not fully clarified. Aims:To investigate the ultrastructural changes of gastric SMC in patients with diabetes mellitus( DM)and the relationship between expressions of contractile proteins and AGEs. Methods:Full-thickness gastric specimens from 30 gastric neoplasm patients undergoing gastrectomy from July 2012 to December 2012 at the First Affiliated Hospital with Nanjing Medical University were collected. Of them 15 patients had DM( DM group)and the other 15 patients without ( control group). Ultrastructure of SMC was observed by transmission electron microscopy. Expressions of three contractile proteins[ myosin heavy chains( MHC),α-actin and calponin]and Nε-carboxymethyllysine( CML),the key component of AGEs in gastric muscular layer were determined by Western blotting,and expressions of MHC,α-actin and calponin mRNA were determined by real-time PCR. Correlations of mRNA expressions of three contractile proteins with protein expression of CML were analyzed by Pearson correlation coefficient. Results:In DM group,significant ultrastructural changes were found in gastric SMC,including disruption of gap junction,swelling of mitochondria,occurring of lipofuscin in cytoplasm,increase in cell membrane alveolae,and thickening of basal lamina. Protein and mRNA expressions of muscular MHC,α-actin and calponin were significantly lower in DM group than in control group(P all ﹤0. 01),while protein expression of CML was significantly higher in DM group(P ﹤0. 01). In gastric muscular layer of DM group, negative correlations were found between expressions of MHC,calponin mRNA and CML protein(r= -0. 59,P=0. 02;r= -0. 63,P=0. 01),but no correlation was seen between α-actin mRNA and CML protein(r= -0. 49,P=0. 06). Conclusions:Disruption of SMC ultrastructure,decrease in contractile proteins and increase in AGEs are existed in gastric muscular layer of DM patients,and there is a negative correlation between contractile proteins and AGEs. These changes may cause impaired contractility of SMC,and subsequently lead to gastric motility disorders in diabetic patients.

Gastroesophageal reflux disease( GERD)is caused by dysfunction of lower esophageal sphincter( LES), which allows the contents of stomach and duodenum to reflux into esophagus. Currently,medical and surgical therapies are the main treatment for GERD,but patients need to take life-long acid suppression and the surgical treatment has the risks of potential side effects. Endolumenal therapy as a minimally invasive approach to GERD can safely and effectively relieve the symptoms of GERD,especially Stretta radiofrequency procedure,transoral noninvasive fundoplication( TIF ) and LinX reflux management system. This article reviewed the advances in study on endolumenal therapy for GERD.

Abstract?AIM: To analyze the clinical effects of partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis.?METHODS:The conditions of 22 patients (25 eyes) who underwent partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis were retrospectively reviewed. The following data were analyzed:1 ) the angle of deviation of primary position; 2 ) the presence of diploma in the primary position;3) the presence of compensatory head posture;4) the motility of the affected eye.All of the patients attended 6mo postoperative follow-up examinations.?RESULTS: According to the results of examinations before and during operation, different operations were performed:2 eyes were treated with partial rectus muscle transportation, 20 eyes were treated with recession of antagonistic muscle of paralytic rectus muscle combined with partial rectus muscle transportation, 3 eyes were treated with recession of antagonistic muscle, partial rectus muscle transportation and recession of yoke muscle.Twenty patients were orthotropia in the primary position, the diploma and abnormal head posture were eliminated. Two patients with binocular lateral rectus muscles paralysis were in mild undercorrection which were resolved by wearing 8△and 10△prisms respectively. The procedure improved strabismus of 25 eyes from 100.23△ ± 42.61△ preoperatively to 0.82△ ± 2.67△postoperatively ( t=10.797,P<0.001).Ocular movement was improved from -4.52 ±0.51 preoperatively to -2.68 ± 0.63 postoperatively (t=-19.468, P<0.001).? CONCLUSION: Partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis can effectively correct the primary position in paralytic strabismus, eliminate the presence of diploma in primary position and abnormal head posture, and improve the ocular motility, which provides content clinical effects.

Objective To study the effect on Henoch-Schnlein purpura nephritis with cyclophosphamide (CTX) intravenous pulse therapy.Methods Fourty cases of Henoch-Schonlein purpura nephritis were divided into observation group and control group.The observation group:8～10 mg/(kg?time) of CTX was added into 100 mL of saline which was dropped intravenously,2 days was a period of treatment, intermission of 30 d, and the total duration was 4-6 months. The control group only applied prednisone and dipyridamole.Results After CTX pulse therapy 24 h proteinuria determination and hematuria decreased obviously. The effect before and after therapy had significant difference (P

Objective To study the effect of glucocorticoid receptor(GCR) on the treatment of patients with nephrotic syndrome(NS) and to observe the accommodation effect of herbal gynostemmae,acanthopanax senticosus harns on GCR levels.Methods The patients were divided into 3 groups: the healthy control group,treatment group Ⅰ(GC only) and treatment group Ⅱ(combination with herbal gynostemmae,acanthopanax senticosus harns and GC),radioligand binding assay was used to measure the GCR levels of each group.At the same time,the urine protein ratio within 24 hours was observed in each group.Results Compared with healthy control group,the GCR levels of treatment group Ⅰ and Ⅱ were both reduced,but after 4 weeks of treatment in the treatment group Ⅱ,not only GCR level recovered but also the urine protein were decreased faster than treatment group Ⅰ.Conclusions Herbal gynostemmae,acanthopanax senticosus harns can accommodate the GCR levels of children with NS.They can also eliminate urine protein and cure NS ideally.

Objective To investigate the pathological diagnosis of high-grade intraepithelial neoplasia in gastric biopsy.MethodsOne hundred and forty-three cases diagnosed by gastric biopsy as high-grade intraepithelial neoplasia were analyzed by light microscopy,and were compared with the pathological findings of surgical specimens in 60 cases and a second biopsy in 13 cases.Results Among the sixty cases treated surgically following the gastric biopsies,no carcinoma was found in 6,while the other 54 were diagnosed as gastric adenocarcinoma,27 in advanced stage and 27 in early stage,respectively.Fifteen cases were well-differentiated,24 moderately-differentiated,12 poorly-differentiated and 3 were of mucinous type.Four of the 13 cases with a second biopsy were diagnosed as well-differentiated adenocarcinoma,8 low-grade intraepithelial neoplasia and 1 chronic inflammation.The colorectal adenomas-like changes were morphologically found in 6 surgically-treated cases without carcinoma,5 of whom mucous muscles were not found by biopsy.Fibroblastic reactions were found in 9 cases,all of which were diagnosed as adenocarcinoma in surgical specimens.Conclusion Ninety percent of the cases who are diagnosed as high-grade intraepithelial neoplasia by biopsy may have already been complicated with adenocarcinoma.The location and depth of the specimen in gastric biopsy have a considerable influence on pathological diagnosis.The fibroblastic reaction may be considered as an important marker for gastric adenocarcinoma in pathological diagnosis of gastric biopsy.