Objective To compare the effect of inhibiting neointimal hyperplasia between domestic sirolimus eluting stent(Firebird TM stent)and the TaxusTM stent by IVUS.Methods From May 2003 to June 2007,168 patients with 236 native lesions underwent DES implantation,of which,108 patients(147 lesions)were implanted with the FirebirdTM stents and the other 60 patients(89 lesions)were implanted with the TaxusTM stent.Quantitative angiography(QCA)and intravascular ultrasound(IVUS)analysis were performed at one-year follow-up.Results The baseline clinical and angiographic characteristics between the two groups were similar.There were less in-stent late loss(0.17?0.29 mm vs 0.43?0.51 mm,P0.05).But the Absolute and relative measwements of intimal hyperplasia including manifested as intimal hyperplasia area(0.35?0.58 mm2 vs 1.29?1.26 mm2),percentage of intimal hyperplasia area(5.45%?9.26% vs 17.38%?13.75%),percentage of maximal intimal hyperplasia area(9.41%?14.15% vs 31.56%?20.99%),intimal hyperplasia volume(2.09?5.46 mm3 vs 13.43?18.59 mm3)and percentage of intimal hyperplasia volume(1.68%?5.84% vs 8.62%?9.90%)were lower in the Firebird stent group than those in the Taxus stent group(all P

Objective To evaluate the diagnostic value of localization and nature by ultrasonography in adrenal gland malignant tumors. Methods Adrenal gland malignant tumors were diagnosed by ultrasonography in 27 patients. Among them, 6 Cushing syndrome adenomas, 9 adrenogenital syndrome adrenocortical adenocarcinomas, 12 metastases were confirmed by surgery and pathology. Results There were differences in ultrasonographic appearances of 27 patients in adrenal gland malignant tumors with different pathology. Correctly diagnose was made in 26 patients for the localization by ultrasonography, and the accuracy was 96.3 %, while 25 patients were correctly diagnosed in nature and the accuracy was 92.6 %. Conclusions Ultrasonographic appearances of adrenal gland malignant tumors have some features, and ultrasonography is of great value in the localizing and qualitative diagnosing.

Combined with method of ketoconazole resistance screening, a 7alpha,15alpha-diOH-DHEA high-producing mutant Colletotrichum lini ST-1 was obtained by compound mutation of NTG and low energy N+ ion beam implantation. With the substrate concentration of 10 g/L DHEA, the molar yield of 7alpha,15alpha-diOH-DHEA reached 34.2%, increased by 46.2% than that of the original strain. Then we optimized the medium. First, Plackett-Burman design was used to evaluate the effects of medium components on molar yield of the product. Results show that glucose, yeast extract and MgSO4 x 7H2O were the important parameters for the biotransformation process. Subsequently, the path of steepest ascent was used to approach the optimal levels. To obtain the optimal levels, central composite design and response surface analysis were carried out. The optimal medium was as follows (g/L): glucose 26.34, yeast extract 12.15, corn flour 3.00, FeSO4 x 7H2O 0.015, MgSO4 x 7H2O 0.14, KH2PO4 0.90. Under the optimal conditions, the molar yield of 7alpha,15alpha-diOH-DHEA reached 49.3%, which was 44.2% higher than that of using the medium before optimization.
Biotransformation ; Colletotrichum ; metabolism ; Dehydroepiandrosterone ; chemistry ; Fermentation ; Hydroxylation ; Industrial Microbiology ; Mutation

Objective To investigate the influence of diabetes mellitus (DM) on left ventricular(LV) remodeling in patients with acute ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI) within 12 hours of symptom onset. Methods Four hundred and fifty-one consecutive patients with acute STEMI treated by primary PCI were prospectively enrolled in the current study. Baseline, angiographic and PCI features and prevalence of LV remodeling at one-week during hospitalization and 6-month clinical follow-up by two-dimensional echocardiography were compared between 93 diabetic and 358 non-diabetic patients. Results Despite similar baseline clinical and angiographic characteristics, symptom-to-door time was longer (399±106 min vs. 321±116 min, P=0.006) and prevalence of multivessel disease was higher (65.6%vs. 51.7%, P=0.02) in diabetic patients. More patients in diabetic group had LV remodeling at 6-month clinical follow-up (29.0%vs. 17.3%, P=0.01), and DM was an independent predictor of LV remodeling (RR 2.1, 95%CI 1.31-4.79, P=0.02). The rate of rehospitalization due to heart failure did not differ between diabetic and non-diabetic patients (12.9%vs. 8.1%, P=0.15), however, more adverse events occurred in patients with LV remodeling comparing to those without LV remodeling (25.8% vs. 6.6%, P < 0.001). Conclusions Diabetic patients with STEMI often have an increased risk of LV remodeling after treated by primary PCI. Thus, comprehensive therapeutic strategy for diabetic patients presented with STEMI is required considering the poor prognosis of these patients with LV remodeling.

Objective To investigate the possible inhibition effect of a domestic novel drug-eluting balloon(DEB), such as controlling the vascular stenosis and reducing the intimal hyperplasia, on obstructive peripheral arterial disease (PAD) of lower extremity. Methods Male New Zealand rabbits (weighted 2.5-3.0 kg) were used for this study. Mustang bare metal stents (BMS) were separately implanted at both the proximal and distal site of abdominal aorta to establish the PAD models in rabbits. Bare balloon (PTA group) or drug-eluting balloon (DEB group) was separately used to dilate the stent segment of the aorta. The animals were sacrificed 28 days after the treatment. The aorta stent specimens were collected and sent for pathologic examination. Using Masson staining method the degree of intimal hyperplasia was estimated and the expression level of paclitaxel-targeted β-tubulin was determined with immunohistochemical method. The results were compared between the two groups. Results Morphologically, both the degree of intimal hyperplasia and the vascular stenosis rate in DEB group were significantly lower than those in PTA group. Meanwhile, immunohistochemical examination of paclitaxel-targeted β-tubulin indicated that its expression level in DEB group was obviously higher than that in PTA group. Conclusion This experimental study indicates that the domestic novel DEB has potential inhibition effect in respect of controlling the loss of lumen as well as reducing the intimal hyperplasia. This novel DEB carries excellent property, suggesting the possibility to use DEB in clinical treatment of PAD.

Objective By using optical coherence tomography (OCT) to evaluate the vascular neointimal hyperplasia and the stent strut coverage degree in patients with acute myocardial infarction (AMI) and in patients with stable angina (SA) one year after receiving drug-eluting stent (DES) implantation, and to compare the clinical results between the two groups. Methods A total of 39 patients, who received DES implantation due to coronary heart disease, including AMI (n=16, AMI group) and SA (n=23, SA group), during the period from March 2011 to July 2012, were enrolled in this study. One year after DES implantation, coronary angiography and OCT reexaminations were performed in all patients. The neointimal hyperplasia (NIH) thickness, NIH area, NIH volume, strut coverage and apposition rate were determined with OCT. The results were compared between the two groups. Results OCT measuring results showed that the mean NIH thickness of AMI group and SA group was ( 66 . 8 ± 20 . 7 ) mm and ( 121 . 6 ± 135 . 7 ) mm respectively (P=0.022); the NIH volume ratio were 5.66%±3.18% and 11.88%±8.22% respectively (P=0.005); the percentage of cross-section with NIH thickness over 100 μm was 22.56%±23.99% and 40.14%± 30.01% respectively (P=0.034); and the percentage of overall stent strut coverage was 89.27%±6.40% and 93.42%±7.03% respectively (P=0.007). All the above mentioned data of AMI group were obviously lower than those of SA group. Conclusion After DES implantation, the intimal repair, intimal hyperplasia and stent strut coverage in AMI patients are poorer.

Objective To explore the value of virtual touch tissue quantification(VTQ) on the early diagnosis of gouty nephropathy.Methods 180 healthy controls and 109 gout patients including 57 cases with normal renal function,and 52 cases with gouty nephropathy were measured by VTQ in this study.The shear wave velocity (SWV) of renal cortex,renal medulla and renal sinus were measured using virtual touch tissue quantification(VTQ).The recorded SWV value was compared.Results In all groups,the SWV of renal cortex was the highest with significant difference (P ＜0.01).The SWV of renal cortex in gouty nephropathy group was higher than those in control group (t =0.342,P =0.026).The SWV of renal medulla and sinus in gout with normal renal function group and gouty nephropathy group were higher than those in control group,respectively (gout with normal renal function group:t =-0.311,-0.628; P =0.012,0.000;gouty nephropathy group:t =-0.369,-0.701 ; P =0.000,0.000).The SWV of renal cortex,medulla and sinus had no significant difference between gout patients with normal renal function and gouty nephropathy patients(t =0.117,-0.059,-0.073; P =0.232,0.575,0.523).Conclusions The VTQ technology could quantitatively evaluate tissue elasticity of the gout patients and provide evidence for the early diagnosis of gouty nephropathy.

Objective To evaluate the significance of color Doppler ultrasound examination of renal blood flow combined with the detection of bone morphogenetic protein-7(BMP-7)in early diagnosis of type 2 diabetic nephropathy.Methods Blood BMP-7 level was tested in 90 patients with type 2 diabetic nephropathy and 30 controls,and parameters of renal blood flow were measured by color Doppler ultrasound examination.Blood BMP-7 level as well as resistant index(RI)of segmental renal artery(SRA)and interlobar renal artery(IRA),were compared between these two groups.Results Compared with controls,blood BMP-7 level gradually decreased with the aggravation of diabetic kidney damage(P＜0.01).The peak systolic velocity(Vmax)and the end diastolic velocity(Vmin)of SRA and TRA were slowed gradually,while RI increased(P＜0.01).Blood BMP-7 level was negatively correlated with IRA's and SRA's RI of IRA and SRA(r =-0.603,P＜0.01;r =-0.652,P＜0.01).Conclusions Color Doppler ultrasound examination of renal blood flow combined with detection of BMP-7 might play an important role in early diagnosis of type 2 diabetic nephropathy.

Objective To investigate the types,incidence rate and related factors of adverse drug reactions(ADRs)in pa-tients with concomitant multi-drug resistant pulmonary tuberculosis(MDR-TB)and diabetes mellitus(DM)and those with only MDR-TB in an attempt to improve the surveillance of patients with both MDR-TB and DM.Methods A total of 359 MDR-TB patients who were diagnosed in the first batch of the 5th round of China Global Fund project in Wuhan city from December 1, 2006 to June 30,2014 and enrolled in the whole supervision process were retrospectively analyzed.They fell into MDR-TB(DM+)group(n=74;20.6%,74/359)and MDR-TB(DM -)group(n=285;79.4%,285/359).The incidence and the occurrence time of ADRs were compared between the two groups.The patients with MDR-TB(DM +)group were divided into two sub-groups in terms of the occurrence of ADRs.The treatment success rate and the effects of age,body mass index,plasma albumin level before treatment,fasting blood glucose level,smoking,alcohol consumption and other diseases on ADRs were investiga-ted.Results ①The incidence of ADRs in MDR-TB(DM+)group(39 cases,52.7%)was not significantly different from that in MDR-TB(DM -)group(141 cases,49.5%)(c2=0.245,P>0.05). ② The incidence of hypothyroidism(c2=6.08,P<0.05), hypokalemia(c2=12.37,P<0.05)and QT interval prolongation(c2=4.32,P<0.05)was significantly higher in MDR-TB(DM+)group than in MDR-TB(DM -)group during the treatment. ③ The lower body mass index(F=6.289,P<0.05),the de-creased level of plasma albumin(F=9.743,P<0.05),concomitant chronic liver disease(c2=6.000,P<0.05)and other chronic diseases(c2= 4.125,P<0.05)were associated with ADRs in patients with both MDR-TB and DM.No associations of sex,age, mean fasting blood glucose level,smoking,alcohol consumption,duration of diabetes,initial treatment and retreatment,number of resistant drugs was found with ADRs. ④There were 17 cases(43.6%,17/39)cured in ADRs group and 25 cases(71.4%,25/35)cured in non-ADRs group,with significant difference found(c2=5.825,P<0.05).Conclusion The patients with concomi-tant MDR-TB and DM are more likely to develop hypothyroidism,hypokalemia,and QT interval prolongation during the treat-ment,and need periodic monitoring and adjustment of medication.Those with the worse nutritional status(lower BMI and plas-ma albumin level)and other concomitant diseases(such as chronic liver disease,etc.)are more likely to have ADRs.Those with ADRs tend to have lower success rate of cure,and they are more likely to suffer treatment failure,loss to follow-up,interruption of treatment and so on.

OBJECTIVES:To evaluate the efficacy of rapamycin(RPM)oral liquid plus cyclosporine(CsA)on the preven?tion of early acute rejection after renal allograft.METHODS:20patients undergoing primary renal allografting were randomly divided into RPM trial group and Azathioprine(Aza)control group,10cases in each group,who were respectively assigned to receive CsA and adrenocortial hormones-based immunosuppression for6months,indexes including survival rates of recipients/kidneys,incidences of acute rejection and adverse reactions between2groups were compared.RESULTS:For the17patients who had finished6-month treatment,the survival rates(recipients/kidneys)were100%.Only2episodes of acute rejection occurred in one case in Aza group.Both groups had2cases of severe adverse episodes.CONCLUSIONS:The combined therapy pf RPM plus CsA is effective in the prevention of acute renal allograft rejection,and it can maintain renal function at a good level.Nevertheless,it may increase the hepatotoxicity of CsA.