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Pregnancy in renal transplant recipient: A case report and review

Journal of Peking University(Health Sciences).2009;41(6):710-711. doi:10.3969/j.issn.1671-167X.2009.06.020

SUMMARY In recent years, successful pregnancies in renal transplant women have been reported worldwide. However, pregnancy in renal trasplant recipient is relatively rare in China. This paper reported a case of pregnancy 2 years post renal transplant. At the end of 28 weeks' gestation she had abnormal liver and renal function complicated with severe preeclampsia. Literatures were reviewed on considerations about pregnancy in renal transplant women. Maternal and neonatal outcomes can be improved by intensive care during pregnancy, proper immunosupression and timely termination of pregnancy.

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Application of covered stent in the treatment of radiation-induced common carotid artery bleeding to a patient with nasoparyngeal carcinoma: A case report

Bin LIU ; Xiaoming ZHANG ; Qingle LI

Journal of Peking University(Health Sciences).2009;41(6):707-709. doi:10.3969/j.issn.1671-167X.2009.06.019

SUMMARY Bleeding is a rare but fatal complication after radiotherapy for nasoparyngeal carcinoma ( NPC ) . In this article , we report an NPC case treated with radiotherapy complicated with bleeding of the common carotid artery (CCA) . A 44-year-old man with NPC was treated with external radiotherapy 19 years ago, and a second course of treatment to the same field was administrated because of local nasoparyngeal recurrence 4 years ago. The patient was admitted to our hospital for massive bleeding. Conservative therapy including routine medication, blood transfusion and local compression showed almost no effect. Emergency carotid angiography revealed bleeding from the left CCA, and a self-expanding covered stent was deployed through percutaneous transluminal femoral approach. After the placement of the covered stent , angiography showed the bleeding was successfully controlled. So self-expanding covered stenting may be a safe, effective and minimal-invasive option for bleeding of the carotid artery . Longterm follow-up is required for further evaluation.

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Increasing specificity of real time PCR to detect microRNA through primer design and annealing temperature increase

Xiangjun HE ; Qi ZHANG ; Yujing LIU ; Xiuying PAN

Journal of Peking University(Health Sciences).2009;41(6):691-698. doi:10.3969/j.issn.1671-167X.2009.06.016

Objective: To investigate the non-specific and inaccurate amplification in cases of highly similar sequences among family members and the length heterogeneity of mature microRNA ( miRNA) ,and find a condition that discriminates maximally among similar miRNA family members and detects the accurate expression level of miRNAs. Methods: Primers with their mismatches and/or 3' end at different positions were designed. Amplification efficiencies were compared using matched and various mismatched primers by RNA-tailing and primer-extension RT-PCR at different annealing temperatures. Expression levels of several miRNAs in mouse brain were compared using miRNA specific primers with different termini. Results: Raising annealing temperatures 12℃-14℃above the T_m of the primers maximally increased amplification specificity without sacrificing sensitivity. Primers designed with their termini on or near variant positions could efficiently discriminate between miRNA isoforms. Using primers that terminated before the end of the mature miRNA did not miss the detection of shorter mature miRNA and provided accurate expression levels. Conclusion: Careful primer design and higher annealing temperature can increase specificity and accuracy of real time PCR miRNA detection.

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Comparison and clinical significance of different imageological methods in the detection of transitional carcinoma of upper urinary tract:Analysis of 234 cases

Qian ZHANG ; Bingdong WANG ; Jieping WANG ; Yayuan ZHAO ; Xiaowei SUN ; Jinrui HAO ; Zhisong HE

Journal of Peking University(Health Sciences).2009;41(6):687-690. doi:10.3969/j.issn.1671-167X.2009.06.015

Objective:To determine the diagnostic value of multislice CT urography (MSCTU) in patients with transitional cell carcinoma ( TCG) of upper urinary tract by comparing other imageology methods used. Methods: Two hundred and thirty four cases of transitional cell carcinoma of upper urinary tract, in which 82 cases were diagnosed pathologically with pelvic carcinoma and 152 cases with ureteral carcinoma, between June 2004 and September 2006 in our institute were enrolled in a retrospective study. Most of them underwent urological ultrasound, intravenous urogram (IVU) , retrograde pyelography and MSCTU. We compared the positive rate (PR) and diagnostic rate (DR) of these methods used by chi-square test. Results: Among the 234 cases, 215 patients underwent urologic ultrasound, in which 152 cases were detected to be abnormal, with the PR of 70.1% ;Meanwhile, 58 cased were diagnosed by this examination, with the DR of 27. 0%. IVU was performed in 193 patients and 132 cases were found to be abnormal, and the PR was 68. 4% , 65 cases were diagnosed by IVU and the DR was 33.7%. And 132 patients underwent retrograde pyelography, by which 115 cases of lesion were detected, with the PR of 87. 1% ; In the meantime, 93 cases were diagnosed, with the DR of 70. 5%.MSCTU was performed in 226 cases and 220 cases were found to be abnormal, and the PR was 97.3% ;214 cases were diagnosed by MSCTU, with the DR of 94. 7%. The DR of detecting TCC of retrograde pyelography had statistically significant difference with that of ultrasound and IVU(P＜0.001). As compared with retrograde pyelography, MSCTU had statistically significant superiority (P＜0.001). Conclusion: To shorten the diagnosis time and mitigate the sufferings, patients with hematuria supposed to be TCC of upper urinary tract should be recommended to undergo MSCTU first.

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Optimization of riboflavin sodium phosphate loading to calcium alginate floating microspheres by response surface methodology

Anyang ZHANG ; Tianyuan FAN

Journal of Peking University(Health Sciences).2009;41(6):682-686. doi:10.3969/j.issn.1671-167X.2009.06.014

Objective:To investigate the preparation, optimization and in vitro properties of riboflavin sodium phosphate floating microspheres. Methods: The floating microspheres composed of riboflavin sodium phosphate and calcium alginate were prepared using ion gelatin-oven drying method. Results: The properties of the microspheres were investigated, including the buoyancy, release, appearance and entrapment efficiency. The formulation was optimized by response surface methodology (RSM). Conclusion: The optimized microspheres were round. The entrapment efficiency was 57.49%. All the microspheres could float on the artificial gastric juice over 8 hours. The release of the drug from the microspheres complied with Fick' s diffusion.

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Clinical features of hypokalemic periodic paralysis

Wei WANG ; Chunyun ZHAO ; Yanming GAO

Journal of Peking University(Health Sciences).2009;41(6):678-681. doi:10.3969/j.issn.1671-167X.2009.06.013

Objective: To explore the clinical features of hypokalemic periodic paralysis, and compare clinical features of primary group with those of thyrotoxicosis secondary group. Methods: Clinical data of 44 patients with hypokalemic periodic paralysis in Peking University First Hospital from 1996 December to 2008 December were retrospectively analyzed. Results: There were 22 patients in primary group, and 22 in thyrotoxicosis group. Identical clinical features of both the groups; (1 ) It had a predilection in young men. (2)Main symptoms were limb movement disorder and fatigue, and paralysis recurrent attacked in most patients. (3) 40. 9% to 68. 2% patients had obvious incentives, and the common ones were a heavy meal, sweet drinks, or strenuous'exercise. (4) Serum potassium levels of the two groups were obviously lower than the normal range. (5) In 20% patients of primary group and 25% patients of thyrotoxicosis secondary group, CK levels were higher than normal, while LDH and HBDH levels were normal.(6) The doses of potassium replishment were not correlated to serum potassium levels at the onset. Different clinical features of the two groups; (1) Patients of thyrotoxicosis group had hypermetabolism symptoms and thyroid dysfunction. Patients of primary group had no hypermetabolism symptoms, and all of them were euthyroid. (2) Serum potassium levels of thyrotoxicosis secondary group were lower than those of primary group significantly [(2.25±.67) vs (2.78±.49) mmol/L, P=0;007]. (3) Hyperkalemia is easier than primary group to rebound in thyrotoxicosis secondary group, after replenishment of potassium. Conclusion: Hypokalemic periodic paralysis has its clinical features, and patients with early diagnosis and replenishment of potassium in time have good prognosis. The doses of potassium replenishment are not determined by serum potassium levels at the onset. Hyperkalemia is easier to rebound in thyrotoxicosis secondary group after replenishment of potassium, serum potassium levels should be monitored closely, and hyperthyrosis radically cured.

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Clinical characteristics of rheumatoid arthritis with interstitial pulmonary fibrosis

Ru LI ; Xia LI ; Xiaoping ZHANG ; Xiaohong XIANG ; Zhanguo LI

Journal of Peking University(Health Sciences).2009;41(6):674-677. doi:10.3969/j.issn.1671-167X.2009.06.012

Objective:To analyze the clinical characteristics of interstitial pulmonary fibrosis (IPF) in patients with Rheumatoid arthritis (RA). Methods: We retrospectively analyzed 198 RA patients with or without IPF. Characteristics of RA-IPF in clinical and lab data were analyzed. Age, duration of disease,clinical and laboratory parameters, history of smoking and medicine were compared between the patients with and without IPF. Results: (1) Among the 198 RA patients, 15.2% (30/198) were found with IPF. 100% RA-IPF patients had HRCT findings. However, 63.3% (19/30) had positive findings in chest X-ray, and only 46. 7% ( 14/30) had the complaints of cough and short breath. Velcro rales were found in 50.0% (15/30) patients with IPF and no acropachy occurred. Only one patient suffered from hypoxemia. IPF presented after the joint symptoms in most patients. (2 ) RA-IPF patients were older than those without IPF [(65.50±9.71) vs (55.22±12.98) years, P＜0.01]; Higher positivity of anti-keratin antibodies ( AKA) were found in RA-IPF compared to patients without IPF (61. 5% vs 35.9% , P =0.014). Furthermore, the levels of anti-cyclic citrullinated peptide (CCP) antibody were significantly higher in RA-IPF [(4.38±2.08) vs (3.20±2. 12) , P =0.01]. No differentiation of duration of disease, history of smoking and medicine, IgM rheumatoid factor, IgG rheumatoid factor, anti-nuclear antibody, anti-SSA antibody and levels of immunoglobins and complements were found between the two groups of RA patients with and without IPF. Conclusion: The clinical symptoms of IPF in RA patients are mild and more common in older patients. AKA and anti-CCP antibody might be important antibodies associated with RA-IPF.

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Effect of icariin on the mRNA expressions of Cbfαl, BMP2, BMP4 in rat osteoblasts

Wei HE ; Zili LI ; Yuanlu CUI ; Biao YI ; Cheng LIANG ; Xiaoxia WANG ; Yang LI ; Xing WANG

Journal of Peking University(Health Sciences).2009;41(6):669-673. doi:10.3969/j.issn.1671-167X.2009.06.011

Objective: To investigate the effect of icariin on the proliferation, differentiation, and the mRNA expressions of Cbfαl, BMP2, BMP4 of rat osteoblasts. Methods: Primary rat osteoblastic cells were obtained by sequentia collagenase/trypsin enzyme digestion from calvarial bones of new born ( within 24 h) SD rats and were identified by Alkaline phosphatase and alizarin red staining. The passage 3-5cells were treated with icariin at the concentration of 0 mol/L, 10~(-8)mol/L, 10~(-7)mol/L, 10~(-6)mol/L,10~(-5)mol/L, 10~(-4)mol/L for 24 h, 48 h, 72 h, and the proliferation of the cells was measured by CCK-8assay. The proliferation index was detected by Flow Cytometry and the activity of alkaline phosphatase was determined by p-Nitrophenyl phosphate (pNPP) method after being treated with icariin at the concentration mentioned above for 48 h. The total cellular RNA was extracted 48 h after being treated with icariin at the concentration of 10~(-6)mol/L, and the expressions of Cbfα1, BMP2, BMP4 mRNA were examined by real-time PCR. Results: Icariin showed no effect on the proliferation of osteoblasts, but improved ALP activity. The Cbfα1, BMP2, BMP4 mRNA were significantly upregulated after icariin treatment. Conclusion: Icariin could promote the differentiation ability of rat osteoblasts through upregulating the Cbfα1, BMP2, BMP4 mRNA expressions.

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Association of SNPs in N-formylpeptide receptor gene with susceptibility of aggressive periodontitis

Xiaoling ZHU ; Huanxin MENG ; Li ZHANG ; Li XU ; Zhibin CHEN ; Dong SHI ; Xianghui FENG

Journal of Peking University(Health Sciences).2009;41(6):664-668. doi:10.3969/j.issn.1671-167X.2009.06.010

Objective: To explore the association of the single nucleotide polymorphisms (SNPs) in N-formylpeptide receptor (FPR) gene with the susceptibility of aggressive periodontitis (AgP). Methods: A total of 94 AgP patients and 73 healthy controls were entered into the study. Peripheral blood sample was obtained from each subject by venepuncture. Genomic DNA was isolated from each sample.The target fragment of FPR gene was amplified by PCR. The SNPs in FPR gene were detected by denature high performance liquid chromatography ( DHPLC) combined with DNA sequencing. Results: There were two non-synonymous SNPs in the 370 bp FPR gene fragment;289C/A and 301G/C. The 289C/Awas a novel SNP. No variation in nucleotides 329 and 378 was detected. There were no statistically significant differences in distributions of the genotypes and alleles for FPR289 and FPR301 between AgP patients and healthy controls. Using multivariate logistic regression (adjusted for age and gender) , it was showed that the adjusted Ors of AgP for the C~+ genotype and allele C of FPR301 combined with smoking were 5.74 and 5.20 respectively. Conclusion: The presence of the C~+ genotype/allele C of FPR301 together with smoking conferred a higher risk for AgP. The result suggests that the SNPs in FPR gene may not be associated with the susceptibility of AgP in Chinese.

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Expression and function of cyclooxygenase-2 in endometrial carcinoma

Junya CHEN ; Qinping LIAO

Journal of Peking University(Health Sciences).2009;41(6):657-663. doi:10.3969/j.issn.1671-167X.2009.07.009

Objective: To evaluate the cyclooxygenase-2 ( COX-2) expression at mRNA and protein levels , as well as its clinical significance, and to study the correlation of COX-2 with angiogenesis, apoptosis and estrogen or progestron receptors. Methods: Forty-one samples of normal endoraetrium tissues and 52 ones of endometrial carcinomas( EC) were collected,together with their corresponding clinical information. RT-PCR was adopted to determine the expression of COX-2 mRNA. Immunohistochemical staining was engaged to evaluate the protein expression of COX-2, VEGF, Bcl-2 and the MVD marked by CD105. And TUNEL was used to count the apoptosis cells. Results: (1) Significantly higher mRNA and protein levels of COX-2 were found in endometrial carcinomas than in normal endometrial tissues ( P＜0.001) . (2) At protein level ,COX-2 expression was related to the grade(P =0.020) , but had nothing to do with the stage, pathological type, depth of myometrium invasion and lymph node metastasis. Neither did the level of COX-2 mRNA with all the factors above. (3)The level of COX-2 mRAN had nothing to do with that of protein(P =0. 125, r =0. 222). (4) The higher the expression of COX-2 protein was, the higher that of VEGF,MVD or Bcl-2 was,and the lower the count of apoptosis cells was P＜0.05. (6)The upregulation of COX-2 protein had no correlation with ER-α and ER-β . But it had positive correlation with PRA and PRB,P was 0.031 and 0.007 .respectively. Conclusion: (1)The expression of COX-2 is significantly higher in EC than in normal endometrium tissue, not only at the mRNA level, but also at protein level. ( 2 ) At protein level, COX-2 expression is related to the grade, but has nothing to do with the stage, pathological type, depth of myometrium invasion and lymph node metastasis. Neither does the level of COX-2 mRNA with all the factors above. (3)The upregulation of COX-2 protein in EC correlates with the increase of VEGF protein and MVD. (4) The upregulation of COX-2 protein in EC correlates with the increase of Bcl-2 protein and the decrease of apoptosis cells. (5)The upregulation of COX-2 protein in EC has no significant correlation with ER expression, but has something to do with the increase of PRA and PRB.

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