Objective To analyze the etiologies,clinical characteristics and prognostic factors of patients with acute renal failure(ARF)admitted to the hospital at high altitude.Method This retrospective study included clinical data of patients with acute renal failure in the General Hospital of Tibet Military Command from May 2001 to April,2006.Results There were 85 male patients and 63 female patients with mean age(42.4?18.1)years old.Among 148 patients with acquired ARF,52.7% was iatrogenic or nosoeomal origin, demonstrating a trend of increasing.The ARF included pre-renal(n=48,32.4%),renal parenchymal(n= 90,60.8%)and post-renal(n=10,6.8%)in origin.Acute high altitude sickness(n=20)was the major causes of pre-renal ARF.Renal parenchymal ARF could be classified into glomerular vascular lesions(n=24), acute tubular necrosis(n=53),acute interstitial nephritides(n=12),and contusion of unitesticle(n=1).of 90 cases of renal parenchymal ARF,39 patients(43.3%)were induced by medicines.Lithiasis was the major causes of post-renal ARF.The mortality of ARF in our study was 42.6%.The mortality of patients contracted ARF in hospital was much higher than that of patients community ARF in community(55.1 vs 23.6%;P=0.01). There was no significant differences of the mortality between the patients with and without dialysis treatment. Univariate analysis showed that prognosis was correlated with age,the presence of hematuria and oliguria or anuria Hb,and the number of organ system failures.The logistic regression showed that age,Hb and the number of organ system dysfunction were the predictors of mortality.Conlusions The major causes of ARF at high altitude were acute high altitude sickness and the use of medicines with nephrotoxicity.The morbility and mortality of nosocomisl ARF increased significantly.Prevention of MODS is a key management to decrease mortality in severe ARF.

BACKGROUND:Recently,researches have found that insulin-like growth factor-1(IGF-1)can induce the differentiation of bone marrow-derived mesenchymal stem cells(BMSCs)into chondrocytes,but there are no reports concerning the differentiation of adipose-derived mesenchymal stem cells(ADMSCs)into chondrocytes induced by IGF-1,as well as interaction with transforming growth factor-β1(TGF-β1)during this process.OBJECTIVE:To explore the possibility of inducing ADMSCs chondrogenic differentiation by using IGF-1 and the interaction with TGF-β1 in induction.METHODS:ADMSCs were obtained,and seeded at 2×10~5 cells/cm~2 in culture flask.Insulin-free chondrogenic media containing IGF-1 or(and)TGF-β1 were used to induce ADMSCs.2 weeks later,cells were harvested and stained by using toluidine blue and collagen Ⅱ antibody immunohistochemistry.Intracellular sulfated proteoglycan and collagen Ⅱ coloring were observed.Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the expression of collagen Ⅱ,aggrecan and Sox9 mRNA.RESULTS AND CONCLUSION:After induced,toluidine blue stain exhibited that the cells in the three induction groups were polygonal,with cytoplasm and cell membrane of blue different dyeing.Immunohistochemistry for type Ⅱ collagen demonstrated that cytoplasm and cell membrane were stained brown in three induction groups.RT-PCR revealed that the expression of collagen Ⅱ,aggrecan,Sox9 mRNA of IGF + TGF group were significantly greater than the IGF and TGF groups,and IGF and TGF groups were significantly stronger than the control group.No significant difference was determined between the IGF and TGF groups.These results indicated that IGF-1 can induce chondrogenic differentiation from ADMSCs,expressing chondrocyte specific cell phenotype.There is synergism of IGF-1 and TGF-01 to induce the differentiation of ADMSCs into chondrocytes.

The implantation of an intravascular stent has become a widely used minimally invasive treatment for coronary heart diseases due to its minimal invasiveness and high efficiency.But the long-term outcomes are often compromised by in-stent restenosis (ISR),which severely restricts its practical effectiveness.In this paper,the formation mechanism of ISR was discussed,and the effects of mechanical environment on ISR were analyzed from the view of solid mechanics.The research progress of stent expansion in vessels with 4 different shapes,including straight vessel,tapered vessel,bifurcation vessel and curved vessel was reviewed.Moreover,the correlations between vessel stress and vessel shape change caused by stent expansion and ISR were reviewed.Finally,based on the influence of different vessel shapes on stent expansion,a multi-objective optimization design method was proposed to improve the stent expansion performance and reduce the occurrence of ISR.

OBJECTIVETo study the E-CD and Snail expressions in colorectal cancer and their relationship with colorectal cancer invasion, metastasis and prognosis.

METHODSImmunohistochemical staining (EnVision) was used to detect the E-CD and Snail expressions in 30 normal colorectal mucosa, 30 colorectal adenoma and 142 colorectal cancer tissues.

RESULTSE-CD in the normal colorectal mucosa was strongly positive expressed (90.0%), significantly higher than that in colorectal adenomas (63.3%) and colorectal cancer tissues (41.5%). E-CD expression was significantly related to tumor differentiation, invasion depth, vascular invasion, lymph node metastasis and Dukes' stage (P < 0.05), but not to the patients' age, gender, tumor size and tumor histological type (P > 0.05). The 1-, 3- and 5-year survival rates of the E-CD positive patients with colorectal cancer were significantly higher than that in E-CD negative patients. The positive expression rate of Snail in colorectal cancer tissues (52.1%) was significantly higher than that in normal colorectal mucosa (6.7%) and colorectal adenomas (26.7%, P < 0.05). The snail expression was significantly correlated to tumor histological type, differentiation, invasion depth, vascular invasion, lymph node metastasis and Duke's stage (P < 0.05), but not to patients' age, sex and tumor size (P > 0.05). The 1-, 3- and 5-year survival rates of Snail negative patients with colorectal cancer was significantly higher than that in patients with positive expression (P < 0.05). The expressions of E-CD and Snail in colorectal cancer tissues were inversely correlated (P < 0.05). Cox multivariate analysis showed that E-CD and Snail can be used as independent prognostic indicators (P < 0.05).

CONCLUSIONE-CD and Snail expressions in colorectal cancer are related to the tumor invasion, metastasis and prognosis. Low expression of E-CD and high expression of Snail are related to the advanced stage, and poor prognosis in colorectal cancer patients. E-CD and Snail can be used as independent prognostic indicators.

Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; Adenocarcinoma, Papillary ; metabolism ; pathology ; Adenoma ; metabolism ; Adolescent ; Adult ; Aged ; Cadherins ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Intestinal Mucosa ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Snail Family Transcription Factors ; Survival Rate ; Transcription Factors ; metabolism ; Young Adult

A high resolution Micro-CT system for small animal imaging is introduced in this paper. Micro-focus X-ray tube with focal diameter of 100 microm and flat panel detector with imaging area of 13cm x 13cm are adopted in this system. The data acquired in rotation scanning is reconstructed with cone beam algorithm. The resolving power of the detector is measured to be 31 lp/cm at 10% of the MTF. The resolution of the Micro-CT system could achieve 185 m when the magnification factor is 1.94. Thighbone of a rabbit is used as sample imaging with the system. The trabecular bone could be imaged clearly. And the ability of small animal imaging of the system has been demonstrated.
Animals ; Equipment Design ; Rabbits ; X-Ray Microtomography ; instrumentation

OBJECTIVETo investigate the effect of low intensity and very high frequency (VHF) electromagnetic radiation (170 MHz) on nervous system function and serum enzymes and immune function in human subjects with occupational exposure to VHF.

METHODSTo measure the intensity of VHF and other environmental factors on the spot, to hold the questionnaire about chief complaints, to examine the rheoencephalography and the neurobehavior function, to analyze ALT, AST, ALP and LDH, and IgA, IgM and IgG in experimental group and control group.

RESULTSThe intensity of VHF (direction of antenna: 0 degrees, 10 m and 135 degrees, 20 m) was higher than that of national standard on-the-spot. The incidences of symptoms such as headache, insomnia and amnesia etc. was significantly higher in experimental group (P < 0.01). Rheoencephalography indicated that the raising time of both left [(0.155 3 +/- 0.057 9) s] and right [(0.154 1 +/- 0.059 2) s] in the experimental group after exposure were significantly longer than before exposure [(0.104 4 +/- 0.030 2) s, (0.103 2 +/- 0.030 4) s respectively] or in the control [(0.118 5 +/- 0.056 8) s, (0.117 7 +/- 0.057 5) s respectively, (P < 0.01)]. Neurobehavior function test showed that digital symbol, digital span and pursuit aiming test were decreased after exposure in the experimental group (P < 0.01). Serum enzyme analysis showed that AST, ALP and LDH were significantly increased after exposure in the experimental group (P < 0.01). No marked change was found in IgA level, while the levels of IgM and IgG after exposure in the experimental group especially the latter were significantly increased (P < 0.01).

CONCLUSIONSLow-intensity VHF radiation can decrease the nervous system function in occupationally exposed personnel and induce increase in some kinds of enzymes and immunoglobulins.

Adolescent ; Adult ; Electroencephalography ; radiation effects ; Electromagnetic Fields ; adverse effects ; Higher Nervous Activity ; drug effects ; Humans ; Immunoglobulin G ; blood ; radiation effects ; Immunoglobulin M ; blood ; radiation effects ; Male ; Occupational Exposure ; Radiation Dosage ; Radio Waves ; adverse effects ; T-Lymphocyte Subsets ; immunology ; radiation effects

A patient referred to our hospital, diagnosed with left idiopathic chronic orchialgia, was evaluated with a thorough medical and psychiatric history, physical examination, scrotal ultrasound and magnetic resonance imaging. Conservative management failed. The patient had temporary pain relief after undergoing outpatient cord block three times. Microsurgical denervation of the left spermatic cord was operated in March, 2011. A pain questionnaire was used to determine efficacy before and after operation, and complete pain relief was noted at one week after operation. The follow up period was 12 months, at the end of which the pain score was still zero. No complications, including testicular atrophy and hydrocele, occurred. Microsurgical denervation of the spermatic cord can be a minimally invasive, safe and effective management option for treatment of idiopathic chronic orchialgia.
Denervation ; methods ; Humans ; Male ; Middle Aged ; Spermatic Cord ; surgery ; Testicular Diseases ; surgery

OBJECTIVEInterventional treatment for childhood combined congenital heart disease (CHD) has developed very quickly and more new types of occluders have emerged in recent years. The aim of this study is to investigate the efficiency and safety of interventional treatment for combined CHD in children.

METHODSEight children with combined CHD (4 boys and 4 girls), aged 6.1+/-2.9 years, underwent simultaneous transcatheter therapy. Of the 8 children with CHD, 1 case had atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA), 1 case had ASD, PDA and pulmonary stenosis (PS), 1 case had ASD and PDA, 1 case had patent foramen ovale (PFO) and PS, and 4 cases had ASD and PS. The methods of transcatheter intervention for these patients were as follows: in patients with ASD,VSD and PDA, the occlusion of VSD was performed first, followed by PDA and ASD occlusions; in patients with ASD, PDA and PS, the occlusion of percutaneous balloon pulmonary valvuloplasty (PBPV) was performed first, followed by PDA and ASD occlusions; in patients with PFO and PS, the occlusion of PBPV was performed first, and PFO occlusion followed; in patients with ASD and PS, the occlusion of PBPV was performed first, and ASD occlusion followed.

RESULTSThe intervention operation was successfully performed in all of the 8 patients. No serious adverse events occurred during the operation. No residual shunt was found and all the occlusion devices were in the suitable sites shown by transthoracic echocardiography (TTE) and X-ray right after the operation. In the 6 patients with PS, the systolic pressure across the pulmonary valve decreased from 75.3+/-15.6 mmHg (before operation) to 14.0+/-5.6 mmHg after operation (P<0.05).A 3.4+/-1.2 years follow-up demonstrated that no residual shunt occurred and gradients across valve or coarctation sites were within the limit of satisfactory results. No complications were observed during the follow-up.

CONCLUSIONSTranscatheter interventional therapy for childhood combined CHD can obtain satisfactory results by proper procedures.

Cardiac Catheterization ; adverse effects ; methods ; Child ; Child, Preschool ; Ductus Arteriosus, Patent ; surgery ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; surgery ; Heart Septal Defects, Atrial ; surgery ; Heart Septal Defects, Ventricular ; surgery ; Humans ; Male ; Pulmonary Valve Stenosis ; surgery

OBJECTIVETo evaluate the value of reoperation for local recurrence of rectal carcinoma.

METHODSThe data of 62 cases with post-operative local recurrence of rectal carcinoma were analyzed retrospectively.

RESULTSAll the 62 patients received reoperation. Thirty two of those patients were treated with radical resection (16 patients combined multiple organ resection), 6 palliative resection, 11 colostomy, and 13 laparatomy only. The 1-, 3- and 5-year survival rates in the patients accepted radical resection were 90.6%, 59.4% and 18.8% respectively. But in patients undergone palliative resection and combined therapy, survival time was 6-24 months with median survival time of 16 months. The patients, accepted laparatomy and intra-abdominal chemotherapy, all died within 2-14 months postoperatively. For patients with postoperative recurrence time >5 years, <2 years and 2-5 years, the reoperation resection rates were 100%(11/11), 62.9%(22/35), and 31.3%(5/16) respectively, and there were significant differences among 3 groups (P<0.01). The rate of reoperation resection of pure local recurrence was 80.0%(32/40). The rate of reoperation resection of local recurrence, associated with near organ invasion, was 27.3%(6/22). The difference was significant(P<0.01). The reoperation resection rate of first operation with Dixon or Miles was 61.9%(26/42) and 30.0%(6/20), and the difference was significant as well(P<0.05).

CONCLUSIONSThe recurrence of rectal carcinoma still needs positive operation in order to prolong the survival time and improve the quality of life of the patient. First operative procedure, post-operative recurrence time and recurrence type are important factors of reoperative resection.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; surgery ; Postoperative Period ; Rectal Neoplasms ; pathology ; surgery ; Reoperation ; Retrospective Studies ; Survival Rate ; Young Adult

OBJECTIVETo investigate the potential cell sources of neointimal cells in autologous vein graft in rat model.

METHODSVein graft neointimal cell origins were investigated using a model of vein-to-artery interposition modal. Slides were stained with hematoxylin and eosin, immunohistochemical staining was also performed with primary antibodies alpha-smooth actin or CD34.

RESULTSNeointimal thickening was greater at the proximal ends (65.2 +/- 4.6) microm and, to a lesser extent, distal ends (64.7 +/- 5.3) microm, in comparison to the middle of the graft (63.5 +/- 5.6) microm. Vein-originating cells survived and make a contribution to neointimal formation within the vein graft, mostly adjacent to the lumen, suggesting an intimate association with endothelial cells, donor arterial smooth muscle cells or circulating progenitor cells.

CONCLUSIONSVein graft neointimal cells arise predominantly from vein-derived endothelial cells, donor arteria smooth muscle cells or circulating progenitor cells. It suggests clinical relevance of stenosis-inhibiting therapies directed at the vein graft or early system pharmacologic administration.

Anastomosis, Surgical ; Animals ; Carotid Artery, Common ; surgery ; Hyperplasia ; Jugular Veins ; pathology ; transplantation ; Male ; Models, Animal ; Rats ; Rats, Sprague-Dawley ; Transplantation, Autologous ; Tunica Intima ; pathology