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Investigation on the distribution of the components of metabolic syndrome in 500 cases of stroke

Jianguo ZHAO ; Xiangyu ZANG ; Bozhen NIU ; Boying TONG ; Xiaoyan DONG ; Shanshan WANG

Clinical Medicine of China.2011;27(1):32-34. doi:10.3760/cma.j.issn.1008-6315.2011.01.010

Objective To explore the relation of stroke and metabolic syndrome (MS), and provide theoretical evidence for prevention of stroke and MS. Methods Five hundred stroke patients accompanied with MS were enrolled, and divided into different types according to the distribution of the components of metabolic syndrome and abnormal metabolic condition. The systolic blood pressure(SBP) ,diastolic blood pressure( DBP),fasting glycemia ( FPG ), triglycerides ( TG ), total cholesterol ( TC ), low density density lipoprotern-cholesterol (LDL-C), high density density lipoprotern-cholesterol (HDL-C)of each patient were detected and recorded. Results Among these stroke patients with MS, most patients were 60 - 69 years old ( 39.60% ), and there was no significant difference between two gender( P = 0. 545 ). Among each component of MS, hypertension was most related to MS;patients complicated with hypertension + hyperlipidemia + hyperglycemia were the most major proportion of stroke patients with MS(48. 00% ). Conclusion MS and its components are all risk factors for stroke,and the more complication the patients had,the more patients suffered from stroke with MS. Targeted interventions of different type of abnormal condition has important prevention effect on MS and stroke.

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Changes and correlation between platelet activation and inflammatory response in patients with essential hypertension

Yanzhou GAO ; Xun LI

Clinical Medicine of China.2011;27(1):26-28. doi:10.3760/cma.j.issn.1008-6315.2011.01.008

Objective To investigate the changes and correlation between platelet activation and inflammatory response in patients with essential hypertension(EH). Methods Sixty-one patients with essential hypertension and sixty-four patients with paroxysmal supraventricular tachycardia as control group were enrolled in the study. The levels of high sensitivity C reactive protein ( hs-CRP ) and mean platelet volume ( MPV ) were measured and compared between the control group and the essential hypertension group. Results Compared with the control group,the levels of hs-CRP and MPV in the EH group were significantly higher( [3.51 ± 1.95]mg/L vs [ 1.15 ± 0. 77 ] mg/L, P ＜ 0. 05 ). The MPV in the EH group was significantly higher than that in the control group ( [ 11.29 ± 2. 18 ] flvs [ 9. 20 ± 2. 31 ] fl, P ＜ 0. 05 ). The level of hs-CRP positively correlated to the level of M PV (r = 0. 452, P = 0. 003 ). Conlusions There were inflammatory response and platelet activation in patients with EH and the serum levels of hs-CRP and MPV is correlated with the development of essential hypertension.

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Application of pressure-protective brace in the rehabilitation training for the elder patients after surgical operation of femoral intertrochanteric fracture

Qi WANG ; Xuexi DUAN ; Jiangtao YAN ; Huiping SONG ; Teishi ZHAO ; Zhiqiang WANG ; Shenghua ZHANG ; Liquan CHEN

Clinical Medicine of China.2011;27(1):19-22. doi:10.3760/cma.j.issn.1008-6315.2011.01.006

Objective To observe the effect of pressure-protective brace with pressure-sensitive device in the early stage rehabilitation training enhance bone healing, shorten the treatment course and reduce complications,a kind of independently developed pressure-protective brace with pressure-sensitive device was utilized with quantified discontinuous longitudinal stress stimulation under doctors' regulation according to procedure. Methods The pressure-protective brace with pressure sensitive device for rehabilitation training was developed in May 2008 ,and was applied in clinics during January 2009 to June 2010. Forty elder patients,with complete clinical data, underwent Dynamic Hip Screw (DHS) internal fixation of femoral intertrochanteric fracture were were enrolled into this study. These cases were assigned into experimental group and control group with 20 patients respectively. The patients of experimental group performed lower extremity rehabilitation training wearing the pressure-protective brace. The load training of lower extremities with double crutches was modulated by doctors through regulating the threshold value of pressure in different time and different condition after operation according to the prearranged rehabilitative plan of individuation. The controls were instructed to performed lower extremity rehabilitation training in traditional way. Both the clinical healing and bone union time in all cases were evaluated according to the uniform standard. Results Total 40 patients were followed up for 13.0 - 24. 0 weeks ( average, 17.6 weeks ). Clinical healing time was 7.0 - 12. 0 weeks ( average,9. 1 weeks ) and bone healing time was 12. 0 - 16.0 weeks(average,13. 7 weeks)in experimental group. While in control group,the clinic healing time and bone union time was 9. 0 - 13.0 weeks( average, 11.3 weeks) and 14. 0 -20. 0 weeks (average, 16. 6 weeks)respectively. The Independent T-test results showed that whether clinic healing time or bone healing time presented significant differences between experimental group and the controls( P＜0. 01 ). All of the fractures in these two groups were healed at the end time of follow up without adverse complications,including fracture displacement, implant break, implant loose and failure. Conclusion The pressure-protective brace with pressure sensitive device used for quantifying rehabilitation training can enhance bone union, shorten the treatment course and reduce complications. This method further proves that discontinuous compressive stress in a certain range can stimulate fracture healing.

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Expression of insulin-like growth factor Ⅱ mRNA-binding protein 3 in transitional cell carcinoma of bladder and its clinical significance

Xuejun HE ; Wengang LIU ; Shaoyi SHE ; Shangjin HE ; Qiancheng QIU ; Wenqiang LIU

Clinical Medicine of China.2011;27(1):82-85. doi:10.3760/cma.j.issn.1008-6315.2011.01.027

Objective To investigate the expression of insulin-like growth factor Ⅱ mRNA-binding protein 3( IMP3 ) in transitional cell carcinoma of bladder( TCCB ) and its clinical significance. Methods The IMP3 expressions in 6 normal bladder tissues and 48 TCCB tissues were determined by immunohistochemistry staining, and the relationships between IMP3 expression and gender, age, pathological grading and staging were analyzed statistically. Results The positive expression rate of IMP3 was 62.5% ( 30/48 ) in bladder cancer,which were significantly higher than that in normal control ( 0/6 ) ( P ＜ 0. 05 ). The positive rate of IMP3 expression were significantly lower in superficial TCCB ( 46. 15%, 12/22 ) or early TCCB [ Grade Ⅰ 12. 5%(1/8) ,Grade Ⅱ 60. 0% (12/20) ] than that in invasive TCCB [T2 or above,81.8% (18/22) ] or advanced TCCB [ Grade Ⅲ ,85% ( 17/20 ) ] ( Ps ＜ 0. 05 ). Conclusion IMP3 is a promising biomarker for eraly detection and assessment of the malignancy degree in TCCB.

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Diagnosis value of urinary type Ⅳ collagen, NAG and serum CysC,β2-MG for diabetic nephropathy

Yuquan LIANG ; Yuanqing ZHOU ; Ruilian LIANG ; Jianmin XIE ; Yuchan CHEN ; Jianwei LUO ; Jianhui LIU

Clinical Medicine of China.2011;27(1):65-68. doi:10.3760/cma.j.issn.1008-6315.2011.01.021

Objective To compare the efficacy of urinary type Ⅳ collagen( Ⅳ C), N-acetyl-β-D-glucosaminidase( NAG ), serum cystatin C ( CysC ), β2 microglobulin ( β2-MG ) in early diagnosis of diabetic nephropathy(DN) ,and to develop a multiple regression equation using above mentioned indices. Methods One hundred and eight cases of DM patients were enrolled in the study. All those DM patients were divided into two groups according to 24 hr urinary albumin excretion(UAE): non-DN group( UAE ＜30 mg/24 h)and DN group (UAE ≥30 mg/24 h). Receiver operating characteristics (ROC)curve was developed using urinary IVC, NAG,serum CysC and β2-MG,and the efficiency of the four indices for early diagnosis of diabetic nephropathy were assessed by area under the curve ROC (AUCROC). Furthermore, the regression equation of four indicators was developed. All statistical analyses were performed using SPSS 13.0. Results The levels of urine Ⅳ C, NAG,CysC,β2-MG,were(3.91±1.93)ng/ml, ( 12.20 ±3.46)U/L, ( 1.18 ±0.41 )mg/L , (2. 50 ±0. 74)mg/ml in the non-DN group, respectively; and ( 14.14 ± 11.17 ) ng/ml, ( 23.12 ± 13.57 ) U/L, ( 2.69 ± 1.69 ) mg/L and(5.21 ± 2.78)mg/ml in the DN group, respectively. There were significant differences in the comparison of the four indicators between the two groups ( Ps ＜ 0.01 ). AUCROC of Ⅳ C, NAG, CysC and β2-MG were 0. 747,0.732,0.764 and 0.823 respectively;which meant the diagnostic efficacy for DN decended from β2-MG, CysC,Ⅳ C, to NAG in order. All these indices showed significant efficiency in assisting diagnosis of early DN ( Ps ＜0.01 ). The regression equation of UAE and the four indices was: UAE = - 242.624 + 6.362IVC + 8.662NAG + 64. 622CysC + 29.488β2-MG, and the equation had statisticl significance( P ＜ 0.O1 ). Conclusion Urine Ⅳ C, NAG,serum CysC, and β2-MG showed significant value in assisting diagosis of early DN, and could be sensitive indices for DN.

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Changes of expression of signaling pathway of NF-κB/IκB in rat lung tissue with diabetes

Hualei LIU ; Lina WANG ; Yaxin SHEN ; Weixin MU ; Mian WANG ; Zhiqiang GENG

Clinical Medicine of China.2011;27(1):12-15. doi:10.3760/cma.j.issn.1008-6315.2011.01.004

Objective To investigate the effect of activation of NF-κB signaling pathway on pathogenesis of lung in diabetes mellitus(DM) rat. Methods The experimental type 2 diabetic rats were built by injecting streptozotocin (STZ) and feeding with high fat and glucose food. At the 12nd and 24th week, we observed the alteration of morphology in the lung of rats in the control group(20 rats) ,the DM group(30 rats)using spectroscopic analysis. The collagen accumulation of lung was observed by masson trihrome staining, and alteration of NF-κB P65, IκBα, and PKC in lung was observed by immunohistochemistry. Results The tissue structure of lung in the DM rats distributed deranged in the light microscope, alveolar wall were thicken, extracellular matrixes increased and pulmonary fibrosis appeared. With the development of pathogenic condition, the expression increased obviously. The staining optical density value of NF-κB P65 in tissue of lung in the 12 w and 24 w DM group were 0. 20 ± 0. 01 and 0. 35 ± 0. 06 respectively, which was significantly higher than those of the control group at the corresponding time point ( 0. 12 ± 0. 02 and 0. 17 ± 0. 03, respectively, Ps ＜ 0. 0l ). The staining optical density value of IκB in tissue of lung in the 12 w and 24 w DM group were 0. 29 ±0. 02 and 0. 36 ± 0. 03, respectively, which were significantly higher than those of the control at the corresponding time point (0. 08 ± 0. 02 and 0. 22 ± 0. 08, respectively, Ps ＜ 0. 01 ). Conclusion The signaling pathway of NF-κB/IκB participate in the occurrence and development in the pathogenesis of lung in DM, and may be one of the mechanisms of lung injury.

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Study of expression and clinical significance of Livin and VEGF protein in bladder urothelial carcinoma

Weixing GAO ; Chaoyong LIU ; Xiaohai GUAN ; Shaosan KANG ; Jian LIU ; Lei WANG ; Fenghong CAO ; Xiaoqiang LI

Clinical Medicine of China.2011;27(1):8-11. doi:10.3760/cma.j.issn.1008-6315.2011.01.003

Objective To investigate the expressions of Livin protein and VEGF protein in bladder urothelial carcinoma(BUC) ,and theirs relationships with the clinicopathologic parameters of bladder urothelial carcinoma. Methods The expression of Livin and VEGF protein in 69 samples of BUC tissue and 10 samples of normal bladder epithelium tissue were detected by immunohistochemical SP method. Their relationships with clinicopathologic data were statistically analyzed. Results The positive expression rate of Livin and VEGF in BUC tissues were 65.2% (45/69) and 46.4% ( 32/69), but negative in normal bladder epithelium tissues, which showed significant differences in the comparison (Ps ＜ 0. 05 ). We found significant difference in the comparison of Livin positive rate between groups with or without recurrence ( 78. 8 % vs 48. 1%, χ2 = 6. 13, P ＜ 0. 05 ); but no differences in pathological grade,TNM stage and tumor number( Gl 55.6% ,G2 64. 3% ,G3 73.9% ;Ta ～ T1 61.9% ,T2 ～ T4 70. 4%; Single-tumor 59. 6%, multi-tumor 77.3%; χ2 = 1.52,0. 52,2.07, Ps ＞ 0. 05 ). For BUC,the expression of VEGF was correlated with the pathological grade,TNM stage( Gl 16. 7% ,G2 53.6% ,G3 60. 9%, χ2 = 8. 91; Ta ～ T1 33.3%, T2 ～ T4 66. 7%; χ2 = 7. 34; Ps ＜ 0. 05 ), but not the tumor number and recurrence( Single-tumor 57.4% , multi-tumor 59. 1%, χ2 = 0. 01; with recurrence 51.5% , without recurrence 40. 7% ,χ2= 0. 69; Ps ＞ 0. 05 ). We found no relationship between the expression of Livin and VEGF (r =0. 056,P ＞ 0. 05 ). Conclusion The overexpressions of Livin and VEGF protein may play an important role in the occurrence and development of BUC. Combind detection of these two protein can be used in the diagnosis and prognosis of BUC.

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Effects of statins and ACEI/ARB treatment on Heme Oxidase-1 expression

Yun ZHANG ; Duanmin XU ; Songming CHEN

Clinical Medicine of China.2011;27(1):86-88. doi:10.3760/cma.j.issn.1008-6315.2011.01.028

Objective To observe the effects of statins, angiotensin-converting enzyme inhibitor/adrenergic receptor binder ( ACEI/ARB ) treatment on Heme Oxidase-1 ( HO-1 ) expression in patients with coronary artery disease. Methods HO-1 expression in periphery white blood cells was detected using Western blot before and after 3 months treatment of the above antioxidants in 60 patients who were diagnosed as coronary artery disease by coronary angiography. Results HO-1 expression measured by gray scale peak by western blot was significantly higher after 3 months antioxidant treatment than that before antioxidant treatment( 168. 9 t6. 8vs 112.7 ± 6.3, P = 0.008 ). Conclusion Effects of statins and ACEI/ARB in treating coronary artery disease may be due to its promoting expression of HO-1.

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Association of blood pressure variability and cerebral infarction in elderly men with atherosclerosis

Genqiang FANG ; Yi GU ; Changning HAO ; Li HAN ; Zhenhao HUANG ; Yiqin SHI ; Linlin ZHANG ; Yanchao HUANG ; Junli DUAN

Clinical Medicine of China.2011;27(1):29-32. doi:10.3760/cma.j.issn.1008-6315.2011.01.009

Objective , To investigate the influence of blood pressure variability on cerebral infarction in older men. Methods Ambulatory blood pressure was measured in 1527 elderly men ( older than 65 yrs) with atherosclerosis. All cases were divided into 2 groups: Six hundred and seven patients with cerebral infarction ( group A)and 920 patients without cerebral infarction ( group B). Smooth curve method was used to analyze each patient's ambulatory blood pressure data and the trend of each patient's blood pressure curve was portrayed. The differences between the actual blood pressure and the blood pressure on the curve was defined as blood pressure variability,and the blood pressure variability between the 2 groups was compared. Results The systolic blood pressure variability in 24 hours in group A was significantly higher than that in group B( [8.4'±2. 2]mm Hg vs [ 8.0 ± 2. 0 ] mm Hg, P ＜ 0. 01 ), especially for the systolic blood pressure variability in daytime( [ 8. 2 ± 2. 2 ] mm Hg vs [ 7. 8 ± 2. 1 ] mm Hg, P ＜ 0. 01 ). However, the systolic blood pressure variability at night was not significantly different between the 2 groups( [ 8.9 ± 3. 9 ] mm Hg vs [ 8. 7 ± 3.7 ] mm Hg,P ＞ 0. 05 ). There were no significant difference between the diastolic blood pressure of 24 hours( [5. 5 ± 3.8 ] mm Hg vs [5.5 ± 1.5 ]mm Hg,P ＞0. 05),during daytime([5.4 ± 1.5]mm Hg vs [5.3 ± 1.4] mm Hg,P ＞0.05)and nighttime ( [ 6. 1 ± 2.7 ] mm Hg vs [ 6. 1 ± 2. 6 ] mm Hg, P ＞ 0. 05 ). Conclusion In elderly men with atherosclerosis,cerebral infarction was closely related to systolic blood pressure variability,but independent of nighttime systolic blood pressure and diastolic blood pressure variability.

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Expression and significance of NF-κB and P-glycoprotein in cervical cancer tissue before and after neoadjuvant chemotherapy

Yan ZHANG ; Ning LI ; Aixia MENG

Clinical Medicine of China.2011;27(1):23-26. doi:10.3760/cma.j.issn.1008-6315.2011.01.007

Objective To investigate the relationship between the expression of NF-κB and Pglycoprotein(P-gp) in cervical cancer tissue before and after neoadjuvant chemotherapy(NACT). Methods The mRNA and the protein expression levels of NF-κB and P-gp were determined by Real time-PCR and immunohistochemical assay respectively in cancer specimens from 40 cevical cancer patients, which were collected before and after NACT. Results The mRNA expression levels of NF-κB were 50. 340 ± 0. 780 and 67. 595 ± 0. 914 before and after NACT respectively, which showed significant difference statistically ( t = -73. 384 ,P ＜ 0. 01 ). We also found significant difference in the comparison between MDR1 mRNA expression before and after NACT(45. 800 ±0. 636 vs 62. 381 ±0. 743 ,t = -66. 582,P ＜0. 01 ). The positive rate of NF-κB protein expression before and after NACT were 50% ( 20/40 ), 80% ( 32/40 ) respectively, which showed significant difference statistically( χ2 = 7. 912, P = 0. 005 ). The positive rate of P-gp protein expression after NACT was significantly higher than that before NACT [ 40% ( 16/40 ) vs 70% ( 28/40 ), χ2 = 7. 273, P = 0. 007 ]The mRNA and protein expressions of NF-κB were positively correlated with those of P-gp before and after NACT( r = 0. 408,r = 0. 327 respectively, Ps ＜ 0. 05 ). Conclusion NF-κB and P-gp may play an important role in multi-drug resistance of cervical carcinoma. Chemotherapy drugs in our NACT strategy may induce the activation of NF-κB and multi-drug resistance. Activation of NF-κB may correlate with multi-drug resistance mediated by P-gp.

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