Objective To explore the protective effect and mechanism of modified Buyang Huanwu Decoction and Shenqi Dihuang Decoction on diabetic kidney disease(DKD)mice based on the regulation of VEGF-C/VEGFR3 pathway inhibiting lymphangiogenesis.Methods Twenty-four male db/db mice were randomly divided into model group,Chinese medicine group(modified Buyang Huanwu Decoction combined with Shenqi Dihuang Decoction,crude drug 24.44 g·kg-1)and western medicine group(Irbesartan,13.5 mg·kg-1),with eight mice in each group.Eight db/m mice were selected as control group.Intragastric administration was given once a day for 12 consecutive weeks.Fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),urinary albumin/creatinine ratio(ACR)and kidney index were measured.The pathological changes of renal tissue were observed by HE and Masson staining.The expressions of fibronectin(FN),type I collagen(Col I),Vimentin,α-smooth muscle actin(α-SMA),transforming growth factor-β1(TGF-β1),vascular endothelial growth factor receptor 3(VEGFR3),vascular endothelial growth factor-C(VEGF-C),lymphatic endothelial hyaluronic acid receptor 1(LYVE-1),podoplanin(PDPN),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in renal tissue were detected by immunohistochemistry.The protein expressions of Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,VEGF-C,LYVE-1,TNF-α and IL-1β in renal tissue were detected by Western Blot.The mRNA expressions of FN,Col I,TGF-β1,VEGF-C,VEGFR3,TNF-α and IL-1β in renal tissue were detected by Real-time PCR.Results Compared with the control group,the levels of serum FBG,TG,TC,ACR and kidney index in the model group were significantly increased(P＜0.05).Glomerular hypertrophy,mesangial matrix increased,basement membrane thickening,cystic cavity narrowing,renal tubular epithelial cell degeneration and necrosis,interstitial infiltration of a large number of inflammatory cells,renal tubular atrophy;the level of renal fibrosis was significantly increased(P＜0.05).The protein expressions of FN,Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,LYVE-1,TNF-α,IL-1β in renal interstitium,the expression of VEGF-C protein in cytoplasm and the expression of VEGFR3 and PDPN protein around renal tubular capillaries were significantly up-regulated(P＜0.05).The protein expressions of Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,VEGF-C,LYVE-1,TNF-α and IL-1β in renal tissue were significantly up-regulated(P＜0.05).The mRNA expression levels of FN,Col I,TGF-β1,VEGF-C,VEGFR3,TNF-α and IL-1β in renal tissue were significantly increased(P＜0.05).Compared with the model group,the levels of serum TG,TC and ACR in the Chinese medicine group were significantly decreased(P＜0.05).Renal tissue injury was improved to varying degrees,renal inflammatory cell infiltration was reduced to a certain extent,and renal tissue fibrosis was significantly reduced(P＜0.05).The protein expressions of FN,Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,LYVE-1,TNF-α,IL-1β in renal interstitium,the protein expression of VEGF-C in cytoplasm and the protein expressions of VEGFR3 and PDPN around renal tubular capillaries were significantly down-regulated(P＜0.05).The protein expressions of Col I,Vimentin,α-SMA,TGF-β1,VEGFR3,VEGF-C,LYVE-1,TNF-α and IL-1β in renal tissue were significantly down-regulated(P＜0.05).The mRNA expression levels of FN,Col I,TGF-β1,VEGF-C,VEGFR3,TNF-α and IL-1β in renal tissue were significantly decreased(P＜0.05).Conclusion Modified Buyang Huanwu Decoction combined with Shenqi Dihuang Decoction can reduce the level of inflammation and fibrosis in renal tissue of DKD mice,and its mechanism may be related to the regulation of VEGF-C/VEGFR3 pathway to inhibit lymphangiogenesis.

Objective To explore the effect of a subcutaneous microintroducer tunnelling technique on placement of tunnelled peripherally inserted central catheter(TPICC).Methods A total of 521 patients undergoing chemotherapy with peripherally inserted central catheters in our hospital from January 2021 to February 2023 were enrolled in this study.A total of 313 patients who received the subcutaneous microintroducer tunnelling were assigned to a tunnelling group and 208 who did not have the subcutaneous tunnelling were assigned to the non-tunnelling group.The two groups were compared in terms of the incidence of catheter displacement,blood leakage,seepage,subcutaneous congestion,catheter associated infection,catheter blockage,catheter-associated thrombosis,nerve injury,lymphorrhagia,unplanned withdraw of catheter,difficulty in catheter withdraw,and catheter damage.Results The subcutaneous microintroducer tunnelling group exhibited a significantly lower incidence of catheter displacement,blood leakage,and catheter associated infections compared to those in the non-tunnelling group(all P<0.05).However,there was no significant difference between the two groups in the incidence of nerve injury,seepage subcutaneous congestion,lymphorrhagia,difficulty in catheter withdraw,catheter damage,incidence of catheter blockage,catheter-associated thrombosis,and unplanned withdraw of catheter(all P>0.05).Conclusion The subcutaneous microintroducer tunnelling is a safe and effective technique.It effectively reduces the rates of post-placement complications in TPICC.

Objective To explore the effect of a subcutaneous microintroducer tunnelling technique on placement of tunnelled peripherally inserted central catheter(TPICC).Methods A total of 521 patients undergoing chemotherapy with peripherally inserted central catheters in our hospital from January 2021 to February 2023 were enrolled in this study.A total of 313 patients who received the subcutaneous microintroducer tunnelling were assigned to a tunnelling group and 208 who did not have the subcutaneous tunnelling were assigned to the non-tunnelling group.The two groups were compared in terms of the incidence of catheter displacement,blood leakage,seepage,subcutaneous congestion,catheter associated infection,catheter blockage,catheter-associated thrombosis,nerve injury,lymphorrhagia,unplanned withdraw of catheter,difficulty in catheter withdraw,and catheter damage.Results The subcutaneous microintroducer tunnelling group exhibited a significantly lower incidence of catheter displacement,blood leakage,and catheter associated infections compared to those in the non-tunnelling group(all P<0.05).However,there was no significant difference between the two groups in the incidence of nerve injury,seepage subcutaneous congestion,lymphorrhagia,difficulty in catheter withdraw,catheter damage,incidence of catheter blockage,catheter-associated thrombosis,and unplanned withdraw of catheter(all P>0.05).Conclusion The subcutaneous microintroducer tunnelling is a safe and effective technique.It effectively reduces the rates of post-placement complications in TPICC.

ObjectiveTo investigate the protective effect of Shentong Zhuyutang-containing serum against oxidative stress and apoptosis in chondrocytes of rats with knee osteoarthritis （KOA）. MethodFifty male rats were orally administered with normal saline， low-， medium-， and high-dose Shentong Zhuyutang （1.73， 3.46， 6.92 g·kg^-1）， and glucosamine sulfate （0.3 g·kg^-1） for two weeks. Serum samples were collected after the treatment period. The KOA model was established， and chondrocytes were isolated and randomly divided into normal group， model group， low-， medium-， and high-dose Shentong Zhuyutang-containing serum groups， and glucosamine sulfate group. During the chondrocyte culture， adenosine monophosphate （AMP）-activated protein kinase （AMPK） inhibitor Compound C （10 μmol·L^-1） was added， and the cells were divided into normal group， model group， Shentong Zhuyutang-containing serum group， and Compound C + Shentong Zhuyutang-containing serum group. Cell proliferation was detected using 5-ethynyl-2'-deoxyuridine （EdU） staining. Apoptosis was determined using terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL）. Reactive oxygen species （ROS） levels were measured using DCFH-DA probe. Glutathione （GSH） and malondialdehyde （MDA） levels were determined using the colorimetric method. Real-time polymerase chain reaction （PCR） was used to measure the mRNA expression levels of matrix metalloproteinase-3 （MMP-3）， MMP-13， type Ⅱ collagen （Col Ⅱ）， and Aggrecan. Western blot was performed to measure the protein expression of phosphorylated （p）-AMPK and silent information regulator factor 1 （Sirt1）. ResultCompared with the normal group， the model group showed a significant decrease in chondrocyte proliferation rate， GSH activity， Col Ⅱ and Aggrecan mRNA expression， p-AMPK and Sirt1 protein levels （P<0.01）， and increased ROS levels， MDA content， TUNEL-positive cell rate， and MMP-3 and MMP-13 mRNA expression （P<0.01）. Compared with the model group， Shentong Zhuyutang-containing serum increased the number of EdU-positive cells， GSH activity， Col Ⅱ and Aggrecan mRNA expression， p-AMPK and Sirt1 protein levels in KOA rat chondrocytes （P<0.05， P<0.01）， and decreased the TUNEL-positive cell rate， ROS levels， MDA content， MMP-3 and MMP-13 mRNA expression （P<0.05， P<0.01）. Compared with the Shentong Zhuyutang-containing serum group， the Compound C + Shentong Zhuyutang-containing serum group showed significantly reduced p-AMPK and Sirt1 protein expression， GSH activity， Col Ⅱ and Aggrecan mRNA levels （P<0.01）， and increased TUNEL-positive cell rate， ROS levels， MDA content， MMP-3 and MMP-13 mRNA levels （P<0.01）. ConclusionShentong Zhuyutang-containing serum attenuates oxidative damage and reduces apoptosis in chondrocytes of rats with KOA， and its protective effect may be associated with the activation of the AMPK/Sirt1 signaling pathway.

ObjectiveTo investigate the effect of supplemented Buyang Huanwutang on kidney tissue， nuclear factor-κB （NF-κB） pathway， and fibrosis factors in diabetic kidney disease （DKD） mice. MethodA total of 24 db/db mice （11-12 weeks old） were randomized into the model group （equivalent volume of distilled water， once/day， 8 weeks）， supplemented Buyang Huanwutang group （16.0 g·kg^-1， once/day， 8 weeks）， and irbesartan group （13.5 mg·kg^-1， once/day， 8 weeks） after adaptive feeding for 1 week and positive urinary protein monitoring， with 8 in each group. Another 8 db/m mice （11-12 weeks old） were included in the normal group （equivalent volume of distilled water， once/day， 8 weeks）. Then samples were collected， and the levels of fasting blood glucose （FBG）， total cholesterol （TC）， triglyceride （TG）， blood urea nitrogen （BUN）， serum creatinine （SCr）， and urinary microalbumin （mALB） were detected. The mRNA expression of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and monocyte chemoattractant protein-1 （MCP-1） was determined by real-time polymerase chain reaction （Real-time PCR）. The expression of nuclear factor-κB （NF-κB）， NF-κB inhibitor α （IκBα）， phosphorylated IκBα （p-IκBα）， transforming growth factor-β₁ （TGF-β₁）， α-smooth muscle actin （α-SMA）， and fibronectin （FN） in kidney tissue was measured by Western blot. The expression of NF-κB in renal tissue was detected by immunofluorescence. The pathological changes of kidney were observed under light microscope. ResultCompared with the normal group， the model group showed glomerular hypertrophy， increase in extracellular matrix， thickening of basement membrane， small cystic lumen， interstitial inflammatory cell infiltration， and some interstitial fibrosis （P<0.01）. Moreover， the model group had higher content of FBG， mALB， TC， TG， BUN， and SCr （P<0.01）， higher expression of inflammatory factors TNF-α， IL-1β， and MCP-1， and fibrosis-related proteins TGF-β₁， α-SMA， and FN （P<0.01）， and stronger activation of NF-κB pathway in renal tissue （P<0.01） than the normal group. Compared with the model group， supplemented Buyang Huanwutang alleviated the pathological injury in kidney （P<0.01）， decreased the content of mALB， TC， and TG， the content of BUN and SCr （P<0.01）， and the content of TNF-α， IL-1β， and MCP-1 （P<0.05， P<0.01）， and inhibited the activation of NF-κB pathway and the expression of fibrosis factors in renal tissue （P<0.05， P<0.01）， but had no significant effect on blood glucose level. ConclusionBy inhibiting NF-κB pathway and the expression of fibrosis factors in renal tissue， supplemented Buyang Huanwutang can exert anti-inflammatory and anti-fibrosis effect and alleviate the pathological damage in kidney tissue， thereby protecting the kidney.

Objective To summarize our experience in surgical intervention of patients with mediastinal hemangioma.Methods From January 1994 to August 2017,18 patients underwent surgical treatment were diagnosed with mediastinal hemangioma in our department.There were 9 females and 9 males,with the average age of(50.9 ± 14.0) years.Seven patients were seen with signs and symptoms related to the tumor,and the other 11 patients had no symptom.Three cases were located in the anterior mediastinum,1 case in the middle mediastinum and 14 cases in the posterior mediastinum.All of the cases experienced chest computed tomography(unenhanced or contrast-enhanced CT scan).Most mediastinal hemangiomas manifested as well-marginated masses at CT.Seven hemangiomas showed heterogeneous enhancement at contrast-enhanced CT.Calcifications were demonstrated in 2 patients.Preoperative diagnosis was not confirmed in all patients.Two cases were suspected to be hemangioma preoperatively,other cases were suspected to be thymoma,neurofibroma or malignancy.Eight cases were treated by video-assisted thoracic surgery approach,3 of those converted to thoracotomy due to high risk of hemorrhage.Ten cases experienced traditional thoracotomy.Results Seventeen patients had total excision,but one experienced biopsy because of hemorrhage.There were no operative death and major complications.The average operation time was(105.0 ± 49.6) minutes,and the average blood loss was(111.7 ± 138.9) ml.The postoperative hospital stay was (4.7 ± 3.5) days on average.Follow-up time ranged from 1 to 18 months(median,9.6 months).No recurrence was found in the patients with total excision at the time of follow-up.The patient undergoing biopsy showed no progression of the disease for 12 months.Conclusion Mediastinal hemangiomas were rare tumors,without relatively specific clinical manifestation.Calcification and phleboliths on CT scan were helpful in suggesting the vascular nature of the mass.Preoperative diagnosis of mediastinal hemangioma was usually very difficult.Mediastinal hemangiomas were mainly treated by surgical approach and had good prognosis.

Objective To assess the efficacy and safety of using a novel channel dilator (the Corsair microcatheter) accompanied with special occlusion guide wires for coronary chronic total occlusion (CTO) recanalization. Methods From 2011 December to 2013 August,we performed 89 cases (the study group) using channel dilator and the new special occlusion guide wires for CTO recanalization. Another 89 CTO lesions treated before using the corsair microcatheter were compared as the control group.We recorded clinical characteristic, outcome of PCI,radiation exposure time, contrast utilization and the procedure time. The MACE rate was monitored during follow up. Results The intracoronary channel dilator accompanied with special occlusion guide wires were inserted into 33 left anterior descending arteries, 17 left circumlfex arteries and 38 right coronary arteries. The success rates of procedure were signiifcantly higher in the study group than in the control group (91% vs. 67.7%, P < 0.05). Procedure and lfuoroscopy time tended to be lower in the study group than in the control group. There were no serious complications related to the catheter and no death case recorded. Conclusions The channel dilator accompanied with special occlusion guide wires may facilitate the conventional approach with a higher success rate in PCI.

Aged ; Aortic Rupture ; diagnostic imaging ; therapy ; Catheter Ablation ; methods ; Female ; Humans ; Radiography

No abstract available.
Hemophilia A* ; Hemorrhage* ; Humans

Aim To study the mechanisms of inotropic responses to doxazosin enantiomers in the isolated rat atrium.Methods We analyzed the positive inotropic response to (-)doxazosin and the negative inotropic response to (+)doxazosin in the left atrium of rat u-sing receptor-pharmacological technique.Results In the preparation treated with verapamil,the positive in-otropic responses to 3 μmol·L-1 (-)doxazosin were significantly inhibited from the control level (245.7 1 ± 44.29)mg to (172.50 ±43.34)mg,(P<0.05).In the preparation treated with methylene blue,the posi-tive inotropic responses to 3 μmol·L-1 (-)doxazosin were significantly potentiated from the control level (245.7 1 ±44.29 )mg to (303.33 ±45 .90 )mg,(P<0.05 ).In the preparation treated with H-89 ,the positive inotropic responses to 3,10 and 30 μmol · L-1 (-)doxazosin were (338.57 ±96.86 ) mg, (471.43 ±107.61)mg and (520.00 ±103.44)mg, which were significantly (P<0.05 ~0.01)larger than the control levels of (245.71 ±44.29)mg,(314.29 ±90.34)mg and (357.14 ±68.49 )mg.Treatment with phenoxybenzamine,atropine,propranolol or indo-methacin did not significantly affect the responses to doxazosin enantiomers.Conclusion The positive ino-tropic responses to (-)doxazosin in the isolated left a-trium of rat are partially involved in L-type Ca2+chan-nels and intracellular cGMP level.However,α-adre-noceptors,muscarinic receptors,β-adrenoceptors and cyclooxygenases are not related to the responses to doxazosin enantiomers.