Objective:To compare influence of valsartan (Val) combined amlodipine (Am) or hydrochlorothiazide (Hyd) on blood pressure variability and quality of life in aged patients with hypertension .Methods:A total of 127 aged patients with hypertension stage 2 and 3 were randomly divided into Val + Am group (n=64) and Val + Hyd group (n=63) .Circadian rhythm and variability of blood pressure and quality of life were observed in both groups before and after treatment .Results:(1) After treatment ,the 24hSBP ,DBP ,SBPV , DBPV and daytime SBP , DBP ,SBPV ,DBPV ,and nighttime ,morning surge of SBP and DBP all significantly reduced in both groups;(2) Compared with Val+ Hyd group ,there were significant reductions in 24hSBP [(120.6 ± 10.2) mmHg vs . (110.9 ± 11.3) mmHg] ,daytime SBP [(120.6 ± 11.3) mmHg vs .(111.6 ± 11.37) mmHg] ,nighttime SBP [(118.5 ± 11.6) mmHg vs .(108.6 ± 11.9) mmHg] ,morning surge of SBP [ (26.2 ± 13.7) mmHg vs .(23.0 ± 10.4) mmHg] (P<0.05 or <0.01);24hSBPV [ (10.7 ± 2.2) mmHg vs .(8.2 ± 2.0) mmHg] ,daytime SBPV [ (10.4 ± 1.9) mmHg vs .(8.1 ± 2.1) mmHg] (P<0.01 all);significant rise in improved percentages of physical health ,mental health and total function in quality of life (P<0.05 or <0.01) in Val + Am group .Conclusion:Valsartan combined am-lodipine or hydrochlorothiazide can both effectively improve blood pressure variability and quality of life in aged pa-tients with hypertension ,and the effect of the former is even better .

Objective To establish the normal data of the fetal thorax,and to evaluate its values in the diagnosis of fetal thorax malformation.Methods Totally 398 normal singleton fetuses at 16 to 36 gestational weeks(GW) were enrolled,2D-US and 3D-US VOCAL technique were used to measure the 2D data and 3D volumes on the transverse section at the level of the four-chamber view,and the correlation among all measurements with GW was analyzed.Thirty fetuses collected randomly were examined to analyze the reliability.Nine fetuses with congenital thoracic dysplasia (CTD) and 10 fetuses with congenital diaphragmatic hernia (CDH) were assessed and compared with the normal fetuses.Results ① In healthy controls,the fetal thoracic 2D measurements and 3D volumes increased along with the growth of the GW.The regression equations were listed as follows:thoracic transverse diameter (cm) =-0.002 GW2 + 0.301 GW-1.510;thoracic anteroposterior diameter (cm) =0.003GW2 + 0.046GW + 0.666;thoracic area (cm2) =0.071GW2-1.466 GW + 14.728;thoracic circumference (cm) =0.01GW2 + 0.313GW + 3.341;thoracic volume (cm3) =0.285 GW2-7.797GW + 66.592;lung volume (cm3) =0.178 GW2-5.317GW + 45.539;the ratio of lung volume to thoracic volume =0.005GW + 0.396.② The reliabilities of the data obtained by the same/two different operators were good.③ CTD group was obviously lower than the healthy controls in all thoracic measurements (all P ＜0.01).There was no statistical difference in the 2D data between the CDH group and healthy controls (P ＞0.05),while the 3D volumes and the ratio of lung volume to thoracic volume were obviously lower than those in the healthy controls (P ＜0.01).Conclusions 2D-US can evaluate the fetal thoracic development and malformation preliminarily,but 3D-US VOCAL technology plays an important role in distinguishing different types of thoracic malformations.

Purpose To investigate the expression of gelsolin-like actin-capping protein (CapG) in gastric cancer and adjacent normal gastric tissues and its relationship with clinicopathological features and prognosis.Methods The immunohistochemical (IHC) assay was performed to detect the expression of CapG protein in 125 specimens of gastric cancer (study group) and 30 specimens of matched adjacent normal gastric tissues (control group).No patients had received chemotherapy or radiotherapy before surgery.Immunostaining was scored semiquantitatively by two independent observers who were blinded to the patients' outcome and other clinicopathological parameters.The correlation of the expression of CapG with clinicopathological characteristics and prognosis was analyzed.Results Cytoplasmic and nuclear CapG protein staining was detected in all gastric cancer tissues.CapG protein expression was absent or low in matched adjacent normal gastric tissues but significantly higher in gastric cancer tissues.Expression of CapG in the tumor was not significantly associated with gender,age,tumor size,tumor location (P ＞ 0.05).However,elevated CapG expression was strongly correlated with the depth of invasion (P =0.044),lymph node metastasis (P =0.026),distant metastasis (P =0.001),and AJCC stage (P =0.012).Significant poorer overall survival was observed in the high CapG expression group compared with that of the low CapG expression group (P ＜0.001).Multivariate analysis showed overall survival correlated with the patients' tumor location,lymph node metastasis,distant metastasis,AJCC stage and the expression of CapG protein.Conclusion CapG is highly expressed in gastric cancer.Tumors with CapG up-regulation tend to have poorer prognosis,suggesting overexpression of CapG may contribute to the prediction of poorer prognosis and may be a potential therapeutic target for gastric cancer.

Objective To establish normative data for the fetal cisterna magna septa (CMS) at various gestational age,and to evaluate its clinical significance.Methods A total of consecutive fetal between 14 and 40 gestational week(GW) were included in this prospective study.The length and width of CMS were measured by two-dimensional ultrasonography.Regression analysis was used to study the relationship between the width and length of the fetal cisterna magna septa and gestational age.Twenty-five case of fetuses with the absence of CMS and 12 case of fetuses with the enlargement of CMS were retrospectively analyzed in the past six years in our hospital.Results ①The fetal CMS length and width increased gradually between 14 and 22 GW,then plateaued between 23 GW and 36 GW,and decreased after 37 GW.This ultrasonographic pattern was in agreement with normal development of rhombencephalon.②The absence of CMS in the fetuses were common in Dandy-Walker syndrome,holoprosencephaly,severe hydrocephalus,neural tube defects,rhombencephalon synapsis and Arnold-Chiari malformation.The enlargement of CMS in the fetuses may be shown in physiologic enlargement of posterior fossa.ConclusionsCMS is a potential new marker for normal development of rhombencephalon.The enlargement and absence of CMS are related to various malformations of central neural system,especially in the abnormalities of posterior fossa.

Objective To evaluate the differences among five representative and useful Doppler parameters in the diagnosis of the three common types of renal artery stenosis (RAS). Methods Five Doppler parameters including renal peak systolic velocity (RPSV), renal-aortic ratio (RAR), renal-interlobar ratio (RIR),acceleration time (AT),and resistant index (RI) were measured in 221 patients before renal arteriography. Differences between the groups of patients with various clinical causes of RAS were analyzed by Chi-Squared test. One-way ANOVA or t test were used to compare the means between different groups.The optimal cutoff value was determined with the maximum sum of sensitivity and specificity. Results Of the 442 renal arteries (main and accessory renal arteries) demonstrated at arteriography,214 were normal or stenosed less than 50 %, 204 stenoses 50% - 99 %, and 24 occlusions. RIR, RAR and RI were significantly different between the atherosclerotic and non-atherosclerotic RAS groups (P ＜0.05), while RPSV and AT were not. The optimal cutoff values of RAR,RIR and RI for detecting RAS between the atherosclerotic and non-atherosclerotic groups were much different (2.5 versus 1.9, 5. 1 versus 6.5, 0.57 versus 0.50,respectively) ,but those of RPSV and AT were similar or the same (170 cm/s versus 200 cm/s,51 ms versus 51 ms,respectively). Conclusions In the case of RAS (diameter reduction≥50%),it is advised to establish separate cutoff values of RAR, RIR and RI according to atherosclerotic and non-atherosclerotic RAS, but the same cutoff value of RPSV and AT can be applied. RIR is a good Doppler parameter in the diagnosis of RAS,especially atherosclerotic and fibromuscular dysplasia RAS.

Objective To investigate the relation between intrauterine growth and the development of carotid atherosclerosis in later life. Methods The intima-media thickness of carotid was measured with ultrasonography in 2036 people aged above fifty who had complete birth records, and divided into normal and abnormal group. They were asked to fill in the cardio-cerebrovascular questionnaire, and venous blood samples were taken and analysed for various biochemical parameters. The relation between carotid atherosclerosis and various parameters at birth and in adult life was assessed. Results The birthweight and head circumference in abnormal group were less than those in normal. The prevalence of carotid atherosclerosis was greatest in those weighed 2500g or less, whose risk of carotid atherosclerosis was greater than those weighed between 3000g and 3500g, after adjustment for cardiovascular risk factors. Conclusions Increased atherogenesis may be one independent mechanism mediating the epidemiological link between impaired fetal growth and vascular disease.

[Summary] A total of 128 individuals with type 2 diabetes underwent continuous glucose monitoring for 3 consecutive days.The dawn phenomenon was defined by three different parameters according to the previous research:(1)the absolute increase of glucose level from nocturnal nadir to prebreakfast value(?G) above 20 mg/dl;(2)?G above 10 mg/dl;( 3 ) insulin requirement increased at least 20%.The participants were secondarily separated by presence/absence of a dawn phenomenon based on the definitions above.The impact on blood glucose fluctuation of different groups was assessed according to the standard deviation of blood glucose( SDBG) , the area under curve above 10 mmol/L ( AUC ) , and the mean amplitude of glycemic excursions ( MAGE ) , etc.The frequencies of dawn phenomenon were 64.8%(?G≥20mg/dl), 85.2%(?G≥10 mg/dl), and 59.4%(rise in insulin requirement≥20%)respectively.The impacts on SDBG, AUC, MAGE, and MODD were without statistical difference(P>0.05) between the presence and absence of the dawn phenomenon patients when?G≥10 mg/dl.However, the differences reached statistical significance(P<0.05) when ?G≥20 mg/dl and the increase in insulin requirement≥20%. Besides, the incidence of dawn phenomenon was positively correlated with HOMA-IR, HbA1C , and free C-peptide.Dawn phenomenon is a very frequent event in type 2 diabetes and not only impacts the overall glycemic control but also exaggerates glucose fluctuation.To be clinically relevant, ?G≥20mg/dl should be taken as the quantitative criterion of the dawn phenomenon.

Objective To evaluate early skeletal muscle myopathy with contrast‐enhanced ultrasound ( CEUS) in diabetic rabbits . Methods Alloxan ( 100 mg/kg ) was given intravenously to 11 New Zealand w hite rabbits . Another 5 age‐matched normal rabbits were used as controls .CEUS was performed at baseline and 1 ,2 ,3 months after the establishment of diabetes ,respectively . T hen ,skeletal muscle samples were obtained for pathological observation . Additionally ,the diabetic rabbits were divided into 3 groups according to their pathologic findings : mild , moderate , and severe myopathy group . M icro‐perfusion parameters ,including artery‐to‐vein transit time ( A‐VT T ) ,muscle tissue mean transit time ( M‐M T T ) and muscle tissue peak intensity ( M‐PI) were calculated . Results T he diabetic rabbits exhibited a lower body weight increase and a decrease of muscle thickness .Plasma levels of triglyceride ,cholesterol and creatinine were significantly higher in diabetic group than those in control group ( P ＜0 .05) . T he A‐V T T and M‐M T T values of the diabetic rabbits significantly increased over time ( all P ＜ 0 .05 ) ,whereas M‐PI value significantly decreased compared with that in control group ( P ＝ 0 .013 ) . Besides ,the A‐V T T value was significantly higher in severe myopathy group than that in mild group ( P ＝0 .001) . T he M‐M T T values in both moderate and severe groups were significantly higher w hen compared to that in mild group ( all P ＜0 .05) . T he A‐VT T and M‐M T T values were correlated with the severity of diabetic myopathy( e＝0 .898 , P ＜0 .001 ;e＝ 0 .527 , P ＝ 0 .01 ) . Conclusions Diabetic rabbits have defective skeletal muscle micro‐ perfusion in the early stage . CEUS can quantify impaire muscle microcirculation ,and is a valuable tool for assessment of diabetic myopathy .

OBJECTIVE To investigate in vitro activities of 12 antimicrobial agents including cefmetazole against extended-spectrum beta-lactamases-producing Escherichia coli(528 strains),Klebsiella pneumoniae(311 strains) and Proteus mirabilis(15 strains).METHODS They all collected from 15 teaching hospitals in China during 2005 and 2006 and included in the study.The levels of minimal inhibitory concentration(MIC) of 12 antimicrobial agents were determined by agar dilution method.WHONET 5.4 Software was used to analyze the data.RESULTS Against ESBLs-producing E.coli and ESBLs-producing K.pneumoniae,carbapenems were the most active antimicrobial agents(all 100.0% susceptible),followed by cephamycins(80.1-97.3%).Piperacillin/tazobactam(78.5-95.1%)showed a higher activity than cefoperazone/sulbactam(44.1-56.2%).The susceptible rate to ceftazidime against ESBLs-producing E.coli was remarkably higher than the other three cephalosporins,however the differences did not happen to ESBL-producing K.pneumoniae obviously.The susceptible rate to cefuroxime was below 1.6%.ESBLs-producing K.pneumoniae showed high sensitivity to carbapenems,cephamycins and ?-lactam/lactamase inhibitor combinations(all 100% susceptible),however the susceptible rates to cephalosporins were relatively lower.CONCLUSIONS Carbapenems and cephamycins remain the relatively high activity against ESBLs-producing Enterobacteriaceae.

Human NUDT16 (hNUDT16) is a decapping enzyme initially identified as the human homolog to the Xenopus laevis X29. As a metalloenzyme, hNUDT16 relies on divalent cations for its cap-hydrolysis activity to remove m⁷GDP and m²²⁷GDP from RNAs. Metal also determines substrate specificity of the enzyme. So far, only U8 small nucleolar RNA (snoRNA) has been identified as the substrate of hNUDT16 in the presence of Mg²(+). Here we demonstrate that besides U8, hNUDT16 can also actively cleave the m⁷GDP cap from mRNAs in the presence of Mg²(+) or Mn²(+). We further show that hNUDT16 does not preferentially recognize U8 or mRNA substrates by our cross-inhibition and quantitative decapping assays. In addition, our mutagenesis analysis identifies several key residues involved in hydrolysis and confirms the key role of the REXXEE motif in catalysis. Finally an investigation into the subcellular localization of hNUDT16 revealed its abundance in both cytoplasm and nucleus. These findings extend the substrate spectrum of hNUDT16 beyond snoRNAs to also include mRNA, demonstrating the pleiotropic decapping activity of hNUDT16.
Amino Acid Motifs ; Biocatalysis ; Cell Nucleus ; enzymology ; Consensus Sequence ; Cytoplasm ; enzymology ; metabolism ; Guanosine Diphosphate ; metabolism ; Histidine ; metabolism ; Humans ; Hydrolysis ; Luciferases ; genetics ; Magnesium ; metabolism ; Manganese ; metabolism ; Mutagenesis ; Mutation ; Pyrophosphatases ; antagonists & inhibitors ; chemistry ; genetics ; metabolism ; RNA Caps ; chemistry ; metabolism ; pharmacology ; RNA, Small Nucleolar ; chemistry ; metabolism ; pharmacology