Child ; China ; Congresses as Topic ; Humans ; Syncope ; diagnosis ; therapy ; Tilt-Table Test

Objective To observe the effects of mizoribine(MZR)on renal tubular epithelial?mesenchymal transition(EMT)of mice which have been performed unilateral ureteral obstruction(UUO),and study the mechanism of its anti?fibrosis of renal interstitial. Methods A total of 24 CD1 mice were randomly divided into sham group,UUO model group and MZR treatment group,with 8 mice in each group. The day before op?eration,mice of MZR treatment group had been given MZR 10 mg/kg/d lavage,those of sham group and UUO model group had been given equal saline lavage. Fourteen days after the operation ,blood was collected and serum creatinine and blood urea nitrogen were measured;the obstruction kidneys were harvested for section,HE staining and Masson staining were employed to observe the changes of kidney pathological;the expression ofα?SMA and E?Cad in kidney with detected by immunohistochemical and Western blot method. Results Compared with sham group,serum creatinine and blood urea nitrogen of mice in UUO model group and MZR treatment group were significantly elevated ,kidney pathological chang?es and the expression ofα?SMA in renal tissue were increased and that of E?Cad was reduced ,the differences were all statistically significant(P<0.05);compared with UUO model group,mice in MZR treatment group had different degree of improvements in serum creatinine,blood urea ni?trogen and kidney pathological changes ,the expression ofα?SMA in renal tissue was inhibited and that of E?Cad was increases ,and the differences were statistically significant(P<0.05). Conclusion MZR may inhibit the development of renal tubular EMT in UUO mice ,thereby reduce the level of renal tubule interstitial fibrosis and improve renal function.

OBJECTIVE:To establish a HPLC method for the simultaneous determination of blood drug concentration of acetaminophen and phenacetin.METHODS:Diamonil C 18 was used as the chromatographic column,the mobile phase was methanol-water(45∶55),theophyllinum was used as internal standard,the detection wavelength was254nm and the column temperature was set at the room temperature.RESULTS:The minimum determination concentration of acetaminophen and phenacetin was5?g/ml,the calibration curve was linear in a range from5～25?g/ml;The recovery rate of both acetaminophen and phenacetin in this method was more than95%;both the intraday RSD and the interday RSD were less than4.0%.CONCLUSION:The method is rapid and accurate,which can satisfy the needs of the clinic blood drug concentration deter-mination of paracetamol and phenacetin.

Accidents, Occupational ; prevention & control ; Humans ; Occupational Diseases ; diagnosis ; Occupational Health Services ; organization & administration

Objective To establish a RP-HPLC method for determination of the concentrations of dextromethorphan and its metabolites dextrorphan in human urine.Methods Phenacetine was used as internal standard,and the urine sample was hydrolyzed by enzyme,alkalified and extracted with hexane-butanol(91).The separation was carried out on DiamonsilTM C18 column(250 mm?4.6 mm,5 ?m) with mobile phase of acetonitrile-1% triethylamine buffer solution(pH adjusted to 2.2 with H3PO4).Gradient elution was done for 0-15 min(20%-35% A).The flow rate was 1.0 ml/min.The detection wavelength was set at 280 nm and the column temperature was 40℃.Results The linear ranges of dextromethorphan and dextrorphan were 0.05-2.0 ?g/ml(r=0.999 9,n=5) and 0.5-20.0 ?g/ml(r=0.999 9,n=5),respectively,and their lowest detecting concentrations were 0.04 ?g/ml and 0.4 ?g/ml,respectively.The intra-day and inter-day precision were both less than 10%.The low,middle and high extraction recoveries were between 94%-108%.Conclusion Our method is accurate and sensitive,and is suitable for the CYP2D6 phenotype analysis and pharmacokinetic studies of dextromethorphan and its metabolites in human.

Objective To evaluate the predictive value of diffusion weighted imaging ( DWI) for progres-sion free survival(PFS)in patients with cervix cancer after neoadjuvant chemotherapy (NACT).Methods Thirty two consecutive patients with pathologically confirmed cervical cancer underwent MRI including DWI before and after NACT.Pathologic results and MR images were reviewed .Univariate analysis was applied by Kaplan -Meier method.The Cox proportional hazard model was used to evaluate prognostic variables for multivariate analysis .Re-ceiver operating characteristic ( ROC) curves were used to find optimal cutoff values of independent prognostic fac -tors for disease progression.Results Of 32 patients,10 had disease progression during follow -up period.In uni-variate analysis,FIGO stage,tumor size,the depth of tumor invasion,lymph node metastasis and ADC changes be-tween before and after neoadjuvant chemotherapy (ΔADC) were significantly associated with the disease progres-sion.In multivariate analysis , FIGO stage and ΔADC were the independent prognostic factors for PFS .Optimal cutoff values that determined by ROC curves analyses were FIGO stage ⅡandΔADC 0.31.Area under the ROC curve(AUC)of FIGO stage and ΔADC were 0.841(sensitivity 90.0%,specificity 68.2%)and 0.864(sensitivity 80.0%,specificity 81.8%),respectively.Conclusion In patients with cervix cancer after NACT ,FIGO stage andΔADC are significant predictive values for PFS .

Agricultural Workers' Diseases ; Humans ; Musculoskeletal Diseases

BACKGROUND: The key point in the treatment of acute cerebral infarction lies in inproving the blood supply of brain effectively as soon as possible as well as rescue ischemic and half diazonal nerve cells, so as to contract the local of infarction as great as possible.OBJECTIVE: To observe the effect of traditional treatment of cerebral piamatral microcirculation in gerbil with cerebral ischemic reperfusion injury by supplementing qi and activating blood circulation.DESIGN: Contrast animal experiment at random.SETTING: Zhabei Branch of Shanghai Changzheng Hospital.MATERIALS: The experiment was performed in the Institute of Naval Medicine (key laboratory of the whole army). Twenty-two healthy Monglian gerbils of clean grade (six months old) were selected and randomly divided into medicine group and control group with 11 gerbils in each group.METHODS: Animals were routinely anaesthetized and fixed in prone position to open the cranium window in median line and expose the pia mater. The cranium window was protected by being covered with a cotton ball containing artificial cerebrospinal fluid (ACSF) after operation. Gerbils were fixed in dorsal position with an median incision made in the lateral cervical nucleus to isolate and expose bilateral common carotid artery (CCA). The bilateral CCA were occluded by atraumatic micro-bulldog clamp, and the occluded blood flow in the distal end was observed under the microscope. Thirty minutes after occlusion of bilateral CCA, the vascular clamp was unclamped to recover the cerebral blood reperfusion. Gerbils in the medicine group were abdominally injected with 0.4 mL of Huangqi injection (containing 0.8 g of crude drug), 0.3 mL of compound Danggui injection (containing Danggui, Chuanqiong and Honghua, 0.09 g for each)and 0.3 mL of Danshen injection (containing 0.45 g of Shengyao). Animals in the control group were abdominally injected with same-volume of normal saline. The changes of pial microcirculation were quantitatively observed in two groups through cranium window respectively before blockage, at the reperfusion after blockage as well as in 120 minutes after injection by laser microcirculation microscope and the TV video system.MAIN OUTCOME MEASURES: The changes of piamatral microcirculation as well as comparison in venous blood flow velocity in gerbils of each group before and after ischemic reperfusion.RESULTS: All gerbils were involved in the analysis of results with no animal died in the experiment.①When the CCA of animals in the two groups were blocked, obvious contraction of piamatral microcirculation was seen and partial blood vessels were blocked up. Platelet and red blood cells etc.adhered to the arteriolae of grade Ⅰ and veinules below grade Ⅲ with microthrombus formed and large ischemic area appeared. The blood flow rate was obviously slowed down. Moderate and severe aggregations were found in red blood cells, and the white blood cells were significantly increased.There was obvious exudation in the periphery of microvessels. After CCA reperfusion, the arteriolae and veinule were in different thickness, and the thrombus in veinule of grade Ⅰ and Ⅱ formed in the cerebral ischemia were difficult to be removed by blood flow. Red blood cell moderately aggregated, and the number of white blood cells greatly increased. White small thrombus could be seen sometimes, while the exsudation in the periphery of microvessel was not significantly ameliorated. Great changes were found in gerbils of the medicine group after abnormal injection of supplementing qi and activating blood circulation medicine: almost all arteriolae and venulae were opened, and the rate of blood flow was accelerated with the blood flow rate remarkably increased. Deposit in the venulae began to decreased, and the thrombus was gradually dissolved. Red blood cells were moderately aggregated or normal. Blood flow in ischemic spot was improved significantly than that after reperfusion. The exudation in the periphery of microvessels was gradually lessened even dissolved. However,no obvious change was found in gerbils of the control group. ②The blood flow rate of arteriole in the medicine group was 1.04-1.50 mm, which was obviously higher than that in the control group with significant differences (P ＜ 0.5-0.01).③The blood flow rate of veinule in the medicine group was 0.96-1.12 mm/s, which was remarkably higher than that in the control group with marked differences (P ＜ 0.05-0.01).CONCLUSION: The effect on piamatral microcirculation of gerbil with cerebral ischemic reperfusion by supplementing qi and activating blood is exact, which is directly related with accelerated blood flow rate, expanded veinule and arteriolae as well as ameliorated blood-supply of brain.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

Objective To detect the serum prohibitin protein(PHB)level in children with renal interstitial damage and analyze the correlation between PHB and renal interstitial fibrosis(RIF). Methods Serum PHB protein levels were determined by Western blot analysis in 36 children with kidney diseases,and 30 healthy children were studied as control. Levels of BUN,Scr,and urinary microprotein series(including ALBU/Cr,NAGU/Cr,IgG U/Cr,α1-MU/Cr)were studied by automatic biochemical analyzer. Renal interstitial damage was semiquantitatively graded according to Katafuchi's method. The correlation between serum levels of serum PHB protein and those of BUN,Scr as well as urine microprotein were analyzed. Results Serum PHB protein was positive in children with diverse kidney diseases however it was negative in the normal controls(P ＜ 0.05). Serum PHB levels were significantly higher in children with proliferative glomerulonephritis than those with non-proliferative glomerulonephritis(P ＜ 0.05). Statistical analysis indicated that serum PHB levels positively correlated with the degree of tubulointerstitial lesions(r ＝ 0.868,P ＜ 0.001)as well as the glomerular injuries(r ＝ 0.753,P ＜ 0.001). And,serum PHB levels were also positively correlated with urinary microprotein including NAG(r ＝ 0.586,P ＜ 0.001)and IgG(r ＝ 0.341,P ＜ 0.001). Conclusions Serum PHB levels were significantly increased in children with kidney diseases and were positively correlated with the degrees of renal interstitial damage,suggesting that PHB might be a potential clinical marker for detecting tubulointerstitial lesions.