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Effect of calcitriol on secondary hyperparathyroidism

Hui XU ; Jin ZHANG ; Xiaomiao CHENG ; Qiaoling ZHOU

Journal of Central South University(Medical Sciences).2013;38(9):920-924. doi:10.3969/j.issn.1672-7347.2013.09.009

Objective:To investigate the calcium-phosphate metabolic condition in maintenance hemodialysis patients with chronic kidney disease (CKD), and to observe the effect of large dose calcitriol on secondary hyperparathyroidism (SHPT).
Methods:We tested and compared the serum levels of calcium, phosphate, intact parathyroid hormone (iPTH), and alkaline phosphatase (AKP) in hemodialysis patients at different hemodialysis time (Group A with hemodialysis period≤3 years and Group B with hemodialysis period>3 years). We also detected those indexes before and after treating SHPT with large dose calcitriol. Twenty SHPT patients were divided into Group I (enlargement of parathyroid gland or nodule detected by color Doppler ultrasound) and Group II (normal parathyroid gland detected by color Doppler ultrasound).
Results:In the maintenance hemodialysis patients, the serum phosphate was (2.11±0.38) mmol/L and iPTH was (581.11±487.75) pg/mL. The serum level of iPTH in Group B was higher than that in Group A [(828.13±690.39) pg/mL vs (477.94±324.73) pg/mL, P<0.001]. In Group I, the serum level of iPTH [before vs after:(2471.7±898.3) pg/mL vs (2510.4±825.7) pg/mL] and AKP [before vs after:(524.2±18.8)U/L vs (511.3±19.3)U/L] did not change after the treatment of large dose calcitriol (P>0.05). In Group II, the serum level of iPTH [before vs after:(1358.5±302.8) pg/mL vs (369.3±43.4) pg/mL, P<0.001] and AKP [before vs after:(565.9±23.9)U/L vs (234.8±21.1)U/L, P<0.001] decreased signiifcantly after the treatment of large dose calcitriol.
Conclusion:Patients with longer time of hemodialysis have a higher level of iPTH. Large dose calcitriol can improve the clinical syndrome of SHPT, and decrease the level of iPTH and AKP in SHPT patients with normal parathyroid gland.

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Social support and negative emotion in parents of children with congenital heart disease before operation

Lu DENG ; Huiping WANG ; Jindong CHEN ; Lezhi LI

Journal of Central South University(Medical Sciences).2013;38(9):915-919. doi:10.3969/j.issn.1672-7347.2013.09.008

Objective:To explore the relationship between social support and negative emotion in parents of children with congenital heart disease before the operation.
Methods:Social support rating scale (SSRS), self-rating anxiety scale (SAS), and Center for epidemiological survey-depression scale (CES-D) were used to assess the association between social support and anxiety and depression in 226 parents.
Results:The mean SSRS score was signiifcantly lower than the normal. There was signiifcant difference in social support of parents in monthly family earning and knowledge about surgery. Parents with monthly family income≤1000 yuan had lower scores than the other groups. Parents who knew nothing about the surgery approach had lower scores. Social support was significantly correlated to negative emotion (anxiety and depression). Social support could predict anxiety and depression.
Conclusion:Social support is widely and significantly correlated to negative emotion in parents of children with congenital heart disease before the surgery.

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Effect of angiotensin II and aldosterone on the proliferation of cardiac ifbroblasts in rats

Yongjin XIE ; Meisheng YAN ; Luyue GAI

Journal of Central South University(Medical Sciences).2013;38(9):902-908. doi:10.3969/j.issn.1672-7347.2013.09.006

Objective:To investigate the effect of angiotensin II (ang II), aldosterone (ald) and their receptor antagonists losartan (los) and spironolactone (spi) on the proliferation and collagen production of cardiac ifbroblasts (CFs) in rats.
Methods:CFs were isolated from neonatal SD rats by collagenase II method and puriifed with differential attachment and detachment method. The 3 or 4 passages of the CFs were divided into the following groups:angiotensin II, angiotensin II+aldosterone, aldosterone, angiotensin II+losartan, and aldosterone+spironolactone. The cell viability of the CFs was assessed by Cell Counting Kit-8 (CCK-8) after the drug administration. The mRNA and protein expression levels of COL1A1, COL3A1, MMP1 and TIMP1 were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot respectively.
Results:Ang II and Ald facilitated the proliferation rate of the CFs independently compared with that in the control group (38.5%vs 28.5%;P<0.05), and the proliferation rate in the ang II+ald group was higher than that in the ang II group and ald group alone (54.4%, P<0.05). Los and spi inhibited the effect induced by ang II and ald respectively (P<0.05). Compared with the control group, ang II and ald signiifcantly enhanced COL1A1, COL3A1 and MMP1 expression both at the mRNA and protein levels (P<0.05), but the TIMP1 expression was inhibited (P<0.05), which could be abolished by corresponding receptor antagonists los and spi (P<0.05).
Conclusion:Ang II and ald can promote the proliferation of CFs, and the COL1A1 and COL3A1 expression is enhanced both at mRNA and protein levels. Ang II and ald have synergistic effect when they are used together, while los and spi may restrain the effect. The mechanism is probably linked with the balance of MMPs/TIMPs.

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Diagnosis and treatment of ketamine-associated cystitis：A report of 3 cases and literature review

Liang HUANG ; Dongjie LI ; Zhengyan TANG ; Guilin WANG ; Jian DING ; Kuan LUO ; Ke HUANG ; Jie ZHOU ; Yonglin LI

Journal of Central South University(Medical Sciences).2013;38(9):966-970. doi:10.3969/j.issn.1672-7347.2013.09.017

Objective:To determine the diagnosis, treatment, and pathogenesis of ketamine-associated cystitis.
Methods:Clinical data from 3 patients with ketamine-associated cystitis were analyzed retrospectively and discussed in light of relevant literature.
Results:In the 3 cases, 2 presented severe lower urinary tract symptoms, including frequency, urgency, dysuria, urge incontinence, and painful haematuria. Urinalysis and urine culture were negative. Imaging examination demonstrated thickening of the bladder wall and a small capacity. Inflammatory changes in the bladder mucosa were observed by cystoscopy and biopsies. After cessation of ketamine use, with the addition of steroids or hydrodistension, the symptoms in the 3 patients improved. The symptoms recurred in 2 patients, as 1 was exposed to ketamine again and 1 had severe bladder contraction after for 3-4 month follow-up.
Conclusion:Ketamine-associated cystitis is a new urinary system inlfammatory damage. Its etiology and treatment methods are not clear. early abstinence from ketamine use and early treatment are crucial for patients with ketamine-associated cystitis to avoid irreversible damage.

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BMPs and cancer

Wei XIONG ; Li WANG ; Fenglei YU

Journal of Central South University(Medical Sciences).2013;38(9):959-965. doi:10.3969/j.issn.1672-7347.2013.09.016

Bone morphogenetic proteins (BMPs) were first studied as growth factors or morphogens of the transforming growth factor-beta super family. These growth molecules, originally associated with bone and cartilage development, are now known to play important roles in morphogenesis and homeostasis in many other tissues. Recently, signiifcant contributions of BMPs, their receptors, and interacting molecules have been linked to carcinogenesis and tumor progression. BMPs can sometimes play a role as a tumor suppressor. This article explains the composition and biological characteristics of BMPs, and investigates their new roles in the pathogenesis of cancer.

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Development of green hospitals home and abroad

Yiju YANG ; Na ZENG ; Minxue SHEN ; Zhenqiu SUN

Journal of Central South University(Medical Sciences).2013;38(9):949-953. doi:10.3969/j.issn.1672-7347.2013.09.014

Green hospital construction is a new challenge for medical industry after global sustainable development strategy was put forward. The core connotation of green hospital includes green building, green healthcare, patient safety, and doctor-patient harmony. Many countries have established green building evaluation system to deal with energy crisis. Leadership in Energy and Environmental Design (LEED), Green Guide for Health Care (GGHC) in the U.S., and Evaluation System for Green Hospital Building (CSUS/GBC 2-2011) in China have guiding signiifcance for the development of green hospitals in China. The evaluation system of green hospitals home and abroad still focuses on green building, and establishment of suitable synthesis evaluation system of green hospitals in China needs further research.

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Expression and signiifcance of thrombonspondin-1 in oxygen-induced retinopathy in mice

Guoguo YI ; Qian TAN ; Peng WANG ; Jian JIANG ; Dan LIU

Journal of Central South University(Medical Sciences).2013;38(9):944-948. doi:10.3969/j.issn.1672-7347.2013.09.013

Objective:To examine the expression and function of thrombonspondin-1 (TSP-1) in oxygen-induced retinopathy in new-born mice, and to investigate its role in retinal neovascularization. Methods:A total of 40 C57BL/6J newborn mice were divided equally into a model group (n=20)andanormalcontrolgroup(n=20).Miceinthemodelgroupwereexposedto75%oxygentoestablish the oxygen-induced retinopathy (OIR) model. On the 7th, 9th, and 11th day after the birth of mice, 5 mice were randomly selected each time from the 2 groups to examine the expression of TSP-1 mRNA with reverse transcription polymerase chain reaction (RT-PCR). After that, 5 mice were selected on the 11th day to observe the retinal neovascularization by fluorescein angiography retinal flatmount. Results:On the 11th day, fluorescein angiography retinal flatmount showed that the retinal blood vessels presented mean network distribution in the normal control group, while in the model group, a lot of dilatated areas in the retinal main vessels surrounded the optic disc. Meanwhile lots of new blood vessels were found surrounding the optic disc with irregular distribution but well distributed peripherial retinal small vessels, which was typical of early stage OIR. There was no signiifcant difference in the retinal TSP-1 mRNA level between the model group and the normal control group in the postnatal 7-day mice (P>0.05). Compared with the normal control group, the expression of TSP-1 mRNA in the model group was signiifcantly lower in postnatal 9-day and 11-day mice (P<0.05, P<0.01) , and the expression of TSP-1 mRNA in postnatal 9-day mice was lower than that in the postnatal 11-day mice(P<0.05).
Conclusion:In the early stage of OIR model (retinal vascular growth and development stage), the expression of TSP-1 mRNA in the retinal tissue is gradually decreased, implying that TSP-1 (as a negative regulatory factor) may be involved in the formation of retinal neovascularization in the early stage.

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Measurement of proximal femoral morphology and analysis of 500 cases in Hunan Province

Yigang PI ; Yaochao ZHAO ; Wanchun WANG ; Zhong HE ; Xinzhan MAO

Journal of Central South University(Medical Sciences).2013;38(9):925-930. doi:10.3969/j.issn.1672-7347.2013.09.010

Objective:To evaluate the effect of age and gender on the femoral morphology to guide prosthesis selection in operation and design.
Methods:A total of 500 females and males were collected from the departments of orthopedics and medical radiology, Second Xiangya Hospital, Central South University. Informed consent was obtained from all subjects. All patients underwent anteroposterior position scan of the left or right hip joint using Philips Digital Diagnost DR system. The shooting range included the hip joint and at least 2/3 of the proximal femur. The images were measured with Onis 2.3 software. We measured 13 parametersfromthepatients,includingtheexternalparamtersofthefemur,radius-lengthparameters of femoral medullary cavity, and morphological parameters of the femoral medullary cavity. Results:Compared with Westeners, the offset was smaller, while the neck shaft angle was signiifcantly larger in Chinese population (P<0.05). Most parameters of the proximal femoral medul ary cavity diameter were significantly smal er in Chinese population than those in Westerners (P<0.05). The canal lfare index in Chinese population was signiifcantly larger than that in the Westerners (P<0.01). According to the Noble classification, in Chinese population, the proportion of champagne lfute type was signiifcantly larger, while the proportion of standard type was significantly smaller than that in Westerners. There was significant difference in the proximal femur between Chinese population and Westerners. The largest difference of the proximal morphology was presented between males and females in the 31-50 years old people (P<0.05), while the smallest was in the over 70 years old population (P>0.05). The main differences between 31 and 70 years old were the diameter of femoral head, the offset of isthmus, the medullary cavity diameter and extracortical width at isthmus level and the medullary cavity diameter at the level of the lesser trochanter (P<0.05). The modullary transverse diameter at 20 mm below the lesser trochanter and isthmus and extracortical width of isthmus in the male and female group was positively correlated with age (P<0.01), while the parameters of the proximal femoral canal morphology in the female group were negatively correlated with age. The female canal parameters had a stronger correlation. Conclusion:Chinese proximal femoral parameters are signiifcantly different from Westerners. When people, especially females, get older, the medullary cavity diameter of the isthmus and proximal femur becomes wider and the morphology of the femur becomes straight. The difference in the femoral morphology between the male and female decline with the age. There is almost no difference for the over 70 years old. For the 31-70 years old, The male femoral cavity diameter is larger and the position of isthmus is lower than in the females.

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Effect of acute exposure to high altitude on the pharmacokinetics of propranolol

Wenbin LI ; Zhengping JIA ; Hua XIE ; Juanhong ZHANG ; Yanling WANG ; Ying HAO ; Rong WANG

Journal of Central South University(Medical Sciences).2013;38(9):909-914. doi:10.3969/j.issn.1672-7347.2013.09.007

Objective:To study the pharmacokinetics of propranolol in Wistar rats after acute exposure to high altitude.
Methods:Fourteen male Wistar rats (200±20) g were selected. After administration of propranolol tablets (0.05 g/kg, i.g.), blood samples (3 mL) were collected at 0, 20, 40 min,1, 1.5, 2, 4, 6, 8, 12 and 24 h, respectively. The pharmacokinetic parameters were determined by LC-MS/MS and DAS 2.0 software.
Results:The main pharmacokinetic area under concentration-time curve (AUC), mean retention time (MRT), half-life (t1/2) and peak plasma concentration (Cmax) of propranolol were increased by 442.61%, 47.45%, 73.13%and 352.97%, respectively, whereas Tmax and clearance (CL) were decreased by 80.87%and 68.94%, respectively.
Conclusion:This study displays significant changes in the pharmacokinetics of propranolol under high altitude, which may provide evidence for clinical rational application of propranolol at high altitude.

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Two cases of pulmonary thromboembolism associated with protein C and protein S deifciency and literature review

Fang LIU ; Lanyan ZHU ; Ping CHEN ; Zhihui SHI ; Shaokun LIU

Journal of Central South University(Medical Sciences).2013;38(9):971-976. doi:10.3969/j.issn.1672-7347.2013.09.018

To explore the clinical manifestations, diagnosis and treatment of pulmonary thromboembolism associated with protein C (PC)/protein S (PS) deifciency. Two male patients 29 and 26 years old diagnosed with PC deifciency and/or PS deifciency were retrospectively analyzed and related literatures were reviewed. The most common symptoms were pain in the lower limbs with chest pain or decreased vision. Color dopper lfow imaging (CDFI) showed lower deep venous phlebothrombosis. Multislice CT angiography (CTA) revealed pulmonary embolism. The level of serum homocysteine (HCY) increased and the level of plasma PC/PS content decreased to PC 57.4%, and PS 28.9%in patient 1, while PS 33.4%in patient 2. Poor routine anticoagulant response was observed. After the diagnosis of PC/PS deficiency, vitiamin B6 and B12 anticoagulant therapy was added, and the symptoms in the patients improved significantly. Congenital thrombophilia should be taken into consideration for young patients with lower deep venous thrombosis and pulmonary embolism which occur recurrently without obvious predisposing causes before 40. Plasma PC/PS concentrations or activity help a lot in the diagnosis and treatment.

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