KCNJ2/HIF1α positive-feedback loop promotes the metastasis of osteosarcoma.

BACKGROUND: Early metastasis is a hallmark of osteosarcoma (OS), a highly common type of malignant tumor. Members of the potassium inwardly rectifying channel family exert oncogenic effects in various cancers. However, the role of the potassium inwardly rectifying channel subfamily J member 2 (KCNJ2) in OS is unclear. METHODS: The expression of KCNJ2 in OS tissues and cell lines was measured using bioinformatic analysis, immunohistochemistry, and western blotting. Wound-healing assays, Transwell assays, and lung metastasis models were used to analyze the effects of KCNJ2 on mobility of OS cells. The molecular mechanisms linking KCNJ2 and HIF1α in OS were explored by mass spectrometry analysis, immunoprecipitation, ubiquitination detection, and chromatin-immunoprecipitation quantitative real-time polymerase chain reaction. RESULTS: KCNJ2 was found to be overexpressed in advanced-stage OS tissues, as well as in cells with high metastatic potential. High expression of KCNJ2 was associated with a shorter survival rate of OS patients. KCNJ2-inhibition repressed the metastasis of OS cells, whereas KCNJ2-elevation induced the opposite effects. Mechanistically, KCNJ2 binds to HIF1α and inhibits its ubiquitination, thus increasing the expression of HIF1α. Interestingly, HIF1α binds directly to the KCNJ2 promoter and increases its transcription under hypoxic conditions. CONCLUSION: Taken together, our results indicated that a KCNJ2/HIF1α positive feedback loop exists in OS tissues, which significantly promotes OS cell metastasis. This evidence may contribute to the diagnosis and treatment of OS. Video Abstract.

[Research Advances on the Relationship between Overt Hyperthyroidism and Risk of Erectile Dysfunction].

Studies have demonstrated the detrimental effects of overt hyperthyroidism on sexual functioning.Here,we comprehensively reviewed the studies that focused on the association between overt hyperthyroidism and erectile dysfunction (ED).After the systematic searching for relevant studies,we find that overt hyperthyroidism is significantly associated with the high risk of ED.The prevalence of ED in patients with hyperthyroidism ranges from 3.05% to 85%,while that in general population is 2.16% to 33.8%.A study reported that the erectile functioning of the hyperthyroidism patients was improved (International Index of Erectile Function:22.1±6.9 vs. 25.2±5.1) after the achievement of euthyroidism.The underlying mechanism of the increase in the risk of ED by overt hyperthyroidism might be correlated to the dysfunction of hypothalamus-pituitary-thyroid axis,dysregulation of sex hormones,abnormal expression of thyroid hormone receptors,and psychiatric or psychological disturbances (e.g.,depression,anxiety,and irritability).Since limited clinical trials have been conducted,additional well-designed cohorts with sizable samples are warranted to elucidate the evidence and mechanism of hyperthyroidism predisposing to ED.The present review indicates that overt hyperthyroidism and the risk of ED are associated,which reminds the clinicians should assess the thyroid stimulating hormone in hyperthyroidism patients presenting with ED,especially in those without positive conventional laboratory findings for causing ED.

Use of Streptococcus thermophilus for the in situ production of γ-aminobutyric acid-enriched fermented milk.

γ-Aminobutyric acid (GABA) is a potentially bioactive ingredient with health-promoting properties that is added to functional foods. Streptococcus thermophilus was selected to produce naturally GABA-enriched fermented milk. This strain can yield a GABA concentration of 2.8 g/L after a 48-h fermentation. In the presence of 1 g/L food-grade casein hydrolysate as a nitrogen source, S. thermophilus yielded GABA concentrations as high as 5.4 g/L or even 8.3 g/L when cocultured with Lactobacillus rhamnosus. In other words, both of these added conditions promoted GABA enrichment. The GABA dose achieved with fermented milk was comparable to the doses of commercially available GABA supplements. Additionally, the in situ use of S. thermophilus to produce GABA-enriched fermented milk was cost effective. The complete genomic sequence of S. thermophilus GABA has been published and will be highly useful to other researchers studying the regulation of genes related to GABA accumulation. In conclusion, the S. thermophilus GABA-producing strain reported herein represents a natural method for the production of fermented milk containing high GABA concentrations.

Role of atmosphere-ocean interactions in supermodeling the tropical Pacific climate.

The supermodel strategy interactively combines several models to outperform the individual models comprising it. A key advantage of the approach is that nonlinear improvements can be achieved, in contrast to the linear weighted combination of individual unconnected models. This property is found in a climate supermodel constructed by coupling two versions of an atmospheric model differing only in their convection scheme to a single ocean model. The ocean model receives a weighted combination of the momentum and heat fluxes. Optimal weights can produce a supermodel with a basic state similar to observations: a single Intertropical Convergence zone (ITCZ), with a western Pacific warm pool and an equatorial cold tongue. This is in stark contrast to the erroneous double ITCZ pattern simulated by both of the two stand-alone coupled models. By varying weights, we develop a conceptual scheme to explain how combining the momentum fluxes of the two different atmospheric models affects equatorial upwelling and surface wind feedback so as to give a realistic basic state in the tropical Pacific. In particular, we propose a mechanism based on the competing influences of equatorial zonal wind and off-equatorial wind stress curl in driving equatorial upwelling in the coupled models. Our results show how nonlinear ocean-atmosphere interaction is essential in combining these two effects to build different sea surface temperature structures, some of which are realistic. They also provide some insight into observed and modelled tropical Pacific climate.

[Prospective comparative study of unilateral biportal endoscopic transforaminal lumbar interbody fusion and endoscopic transforaminal lumbar interbody fusion for treatment of single-segment degenerative lumbar spinal stenosis with lumbar spondylolisthesis].

Objective: To compare the effectiveness of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) and endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) in the treatment of single-segment degenerative lumbar spinal stenosis with lumbar spondylolisthesis. Methods: Between November 2019 and May 2023, a total of 81 patients with single-segment degenerative lumbar spinal stenosis with lumbar spondylolisthesis who met the selection criteria were enrolled. They were randomly divided into UBE-TLIF group (39 cases) and Endo-TLIF group (42 cases). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, body mass index, surgical segment, and preoperative visual analogue scale (VAS) scores for low back and leg pain, Oswestry Disability Index (ODI), and serum markers including creatine kinase (CK) and C reactive protein (CRP). Total blood loss (TBL), intraoperative blood loss, hidden blood loss (HBL), postoperative drainage volume, and operation time were recorded and compared between the two groups. Serum markers (CK, CRP) levels were compared between the two groups at 1 day before operation and 1, 3, and 5 days after operation. Furthermore, the VAS scores for low back and leg pain, and ODI at 1 day before operation and 1 day, 3 months, 6 months, and 12 months after operation, and intervertebral fusion rate at 12 months after operation were compared between the two groups. Results: All surgeries were completed successfully without occurrence of incision infection, vascular or nerve injury, epidural hematoma, dural tear, or postoperative paraplegia. The operation time in UBE-TLIF group was significantly shorter than that in Endo-TLIF group, but the intraoperative blood loss, TBL, and HBL in UBE-TLIF group were significantly more than those in Endo-TLIF group ( P<0.05). There was no significant difference in postoperative drainage volume between the two groups ( P>0.05). The levels of CK at 1 day and 3 days after operation and CRP at 1, 3, and 5 days after operation in UBE-TLIF group were slightly higher than those in the Endo-TLIF group ( P<0.05), while there was no significant difference in the levels of CK and CPR between the two groups at other time points ( P>0.05). All patients were followed up 12 months. VAS score of low back and leg pain and ODI at each time point after operation significantly improved when compared with those before operation in the two groups ( P<0.05); there was no significant difference in VAS score of low back and leg pain and ODI between the two groups at each time point after operation ( P>0.05). There was no significant difference in the intervertebral fusion rate between the two groups at 12 months after operation ( P>0.05). Conclusion: UBE-TLIF and Endo-TLIF are both effective methods for treating degenerative lumbar spinal stenosis with lumbar spondylolisthesis. However, compared to Endo-TLIF, UBE-TLIF requires further improvement in minimally invasive techniques to reduce tissue trauma and blood loss.

[Stenting of subtotal conclusion of internal carotid artery and comparing the cerebral embolic load of proximal balloon protection device with distal filter protection device].

OBJECTIVE: To study the safety, efficacy and perioperative complications of endovascular therapy in the treatment of subtotal conclusion of internal carotid artery(ICA) in patients. To compare the cerebral embolic load of proximal balloon protection device versus distal filter protection device during the operation. METHODS: Review all the operations of stenting for subtotal conclusion of ICA in Xuanwu hospital. New cerebral infarction after stenting was assessed by diffusion-weighted magnetic resonance imaging. Count the number of new ischemic lesions of every patient. RESULTS: 35 patients with subtotal conclusion of ICA received endovascular stenting. Proximal protective device was used for 21 patients. Distal protective device was used for 14 patients. All procedures succeeded. 32 patients received the cerebral MRI 1 week before and within 48 hours after the operation. Compared with filter protection(n = 14), proximal balloon device(n = 18) resulted in a significant reduction in the incidence of new cerebral infarction (6/18 vs 10/14, P = 0.03). The number of new cerebral ischemic lesions were significant reduced by proximal balloon device (1/18 vs 4/14, P = 0.0006) . There were no serious cardiovascular events in 35 patients during the operation and the following up 3 months. 3 patients had restenosis which was demonstrated by ultrasound of ICA at 3 months after stenting. CONCLUSIONS: Endovascular stenting may be a safe and valid method for the treatment of subtotal occlusion of ICA. For the stenting of subtotal occlusion of ICA, proximal balloon protection device as compared with filter protection may reduce the embolic load to the brain more effectively. The stenting of subtotal occlusion of ICA still needs the randomized trails to confirm the safety and validity.

[Research progress of different minimally invasive spinal decompression in lumbar spinal stenosis].

Objective: To review the application and progress of different minimally invasive spinal decompression in the treatment of lumbar spinal stenosis (LSS). Methods: The domestic and foreign literature on the application of different minimally invasive spinal decompression in the treatment of LSS was extensively reviewed, and the advantages, disadvantages, and complications of different surgical methods were summarized. Results: At present, minimally invasive spinal decompression mainly includes microscopic bilateral decompression, microendoscopic decompression, percutaneous endoscopic lumbar decompression, unilateral biportal endoscopy, and so on. Compared with traditional open surgery, different minimally invasive spinal decompression techniques can reduce the operation time, intraoperative blood loss, and postoperative pain of patients, thereby reducing hospital stay and saving treatment costs. Conclusion: The indications of different minimally invasive spinal decompression are different, but there are certain advantages and disadvantages. When patients have clear surgical indications, individualized treatment plans should be formulated according to the symptoms and signs of patients, combined with imaging manifestations.

Metal-organic framework-derived nitrogen-doped carbon-confined CoSe2 anchored on multiwalled carbon nanotube networks as an anode for high-rate sodium-ion batteries.

Metal selenides, as potential alternative candidates for sodium storage, have promising applicability due to their high theoretical specific capacity. However, their huge volume change and sluggish electrode kinetics during sodium ion uptake and release processes can result in insufficient cycling life and inferior rate performance, hindering their practical application. Herein, nitrogen (N)-doped carbon-confined cobalt selenide anchored on multiwalled carbon nanotube networks (denoted as CoSe2@NC/MWCNTs) was designed and successfully built through a selenization process with ZIF-67 MOF as the template. The existence of the interconnected MWCNT network plays a crucial role in not only enhancing the electronic conductivity and ion/electron-transfer efficiency but also ensuring structural stability. Consequently, the optimized CoSe2@NC/MWCNTs composite delivers a high reversible capacity of 479.6 mA h g-1 at a current rate of 0.2 A g-1, accompanied by a 92.0% capacity retention over 100 cycles and a predominant rate performance of 227.4 mA h g-1 even under 20 A g-1 when examined as the anode in Na-ion batteries. Moreover, the kinetic behaviors were confirmed using CV profiles at various rates, as well as the galvanostatic intermittent titration technique (GITT) and electrochemical impedance spectroscopy (EIS). Besides, the HRTEM images clearly reveal the sodium-ion storage mechanism of the CoSe2 hybrid. These results make CoSe2@NC/MWCNTs a prospective anode material in advanced sodium-ion batteries.

In vivo evaluation of additively manufactured multi-layered scaffold for the repair of large osteochondral defects.

The repair of osteochondral defects is one of the major clinical challenges in orthopaedics. Well-established osteochondral tissue engineering methods have shown promising results for the early treatment of small defects. However, less success has been achieved for the regeneration of large defects, which is mainly due to the mechanical environment of the joint and the heterogeneous nature of the tissue. In this study, we developed a multi-layered osteochondral scaffold to match the heterogeneous nature of osteochondral tissue by harnessing additive manufacturing technologies and combining the established art laser sintering and material extrusion techniques. The developed scaffold is based on a titanium and polylactic acid matrix-reinforced collagen "sandwich" composite system. The microstructure and mechanical properties of the scaffold were examined, and its safety and efficacy in the repair of large osteochondral defects were tested in an ovine condyle model. The 12-week in vivo evaluation period revealed extensive and significantly higher bone in-growth in the multi-layered scaffold compared with the collagen-HAp scaffold, and the achieved stable mechanical fixation provided strong support to the healing of the overlying cartilage, as demonstrated by hyaline-like cartilage formation. The histological examination showed that the regenerated cartilage in the multi-layer scaffold group was superior to that formed in the control group. Chondrogenic genes such as aggrecan and collagen-II were upregulated in the scaffold and were higher than those in the control group. The findings showed the safety and efficacy of the cell-free "translation-ready" osteochondral scaffold, which has the potential to be used in a one-step surgical procedure for the treatment of large osteochondral defects. Supplementary Information: The online version contains supplementary material available at 10.1007/s42242-021-00177-w.

NiCo-LDH nanoflake arrays-supported Au nanoparticles on copper foam as a highly sensitive electrochemical non-enzymatic glucose sensor.

The detection of glucose in human blood is of great importance in the diagnosis and prevention of diabetes. In this work, we fabricated a novel electrochemical non-enzymatic glucose sensor, NiCo-LDH nanoflake arrays-supported Au nanoparticles on copper foam (NiCo-LDH@ Au/Cu) by galvanic replacement and electrodeposition methods. Owing to the synergistic effect of three-dimensional (3D) architecture of Cu foam, high electrocatalytic activity of Au nanoparticles and NiCo-LDH nanoflake arrays, the NiCo-LDH@Au/Cu electrode exhibits excellent electrocatalytic ability for glucose oxidation in NaOH solution. Under optimized conditions, the NiCo-LDH@Au/Cu electrode shows excellent activity with a linear range from 0.5 to 3000 µM at the potential of 0.50 V (vs. Ag/AgCl), a low detection limit of 0.23 µM (S/N = 3), an ultra-prompt response time of 0.5 s, and a high sensitivity of 23100 µA mM-1 cm-2, as well as good selectivity and stability. Furthermore, the as-fabricated non-enzymatic glucose sensor was successfully applied to the glucose detection in human serum as a promising candidate in the development of electrochemical non-enzymatic glucose sensor.

Three-dimensional microspheres constructed with MoS2 nanosheets supported on multiwalled carbon nanotubes for optimized sodium storage.

Molybdenum disulfide (MoS2) has been regarded as a promising anode material in the field of sodium-ion batteries (SIBs), with the advantages of high theoretical capacity and large interlayer spacings. Unfortunately, its intrinsic poor electrical conductivity and large volume changes during the sodiation/desodiation reactions still limit its practical application. To deal with this shortcoming, we built MoS2 nanosheet/multiwalled carbon nanotube (denoted as MoS2-MSs/MWCNTs) composites with a three-dimensional (3D) micro-spherical structure, assembled in situ from MoS2 nanosheets. These nanosheets are connected to each other by the MWCNTs network, which provides a highly conductive pathway for electrons/ions through interparticle and intraparticle interfaces, accelerating charge transfer and ion diffusion capabilities. More importantly, the carbon network can boost electrical conductivity and relieve structural strain. Consequently, the as-prepared MoS2-MSs/MWCNTs composite presents a high reversible specific capacity of 519 mA h g-1 at 0.1 A g-1 after 100 cycles with a capacity retention of 94.4% and excellent rate performance (227 mA h g-1 at 10 A g-1). Outstanding cycling stability was also achieved (327.1 mA h g-1 over 1000 cycles at 2 A g-1) and was characterized by scanning electron microscopy (SEM) analysis. Our findings provide a simple and effective strategy to explore anode materials with advanced sodium storage properties.

Clinical Efficacy of Polycaprolactone ß-Calcium Triphosphate Composite for Osteoconduction in Rabbit Bone Defect Model.

The combination of ß-tricalcium phosphate (ß-TCP) with polycaprolactone (PCL) has been considered a promising strategy for designing scaffolds for bone grafting. This study incorporated PCL with commercially available ß-TCP (OsteoceraTM) to fabricate an injectable bone substitute and evaluate the effect of PCL on compressive strength and setting time of the hydraulic cement. The mechanical testing was compliant with the ASTM D695 and ASTM C191-13 standards. Results showed that PCL-TCP composite presented a well-defined architecture with uniform pore distribution and a significant increase in compressive strength compared with ß-TCP alone. Eighteen rabbits, each with two surgically created bone defects, were treated using the PCL-TCP composites. The composite materials were resorbed and replaced by newly formed bone tissue. Both PCL-TCP and ß-TCP demonstrated equivalent clinical effects on osteoconduction property in terms of the percentage of newly formed bone area measured by histomorphometric analysis. PCL-TCP was proven to be as effective as the commercially available ß-TCP scaffold (OsteoceraTM).

Determination of an Initial Stage of the Bone Tissue Ingrowth Into Titanium Matrix by Cell Adhesion Model.

For achieving early intervention treatment to help patients delay or avoid joint replacement surgery, a personalized scaffold should be designed coupling the effects of mechanical, fluid mechanical, chemical, and biological factors on tissue regeneration, which results in time- and cost-consuming trial-and-error analyses to investigate the in vivo test and related experimental tests. To optimize the fluid mechanical and material properties to predict osteogenesis and cartilage regeneration for the in vivo and clinical trial, a simulation approach is developed for scaffold design, which is composed of a volume of a fluid model for simulating the bone marrow filling process of the bone marrow and air, as well as a discrete phase model and a cell impingement model for tracking cell movement during bone marrow fillings. The bone marrow is treated as a non-Newtonian fluid, rather than a Newtonian fluid, because of its viscoelastic property. The simulation results indicated that the biofunctional bionic scaffold with a dense layer to prevent the bone marrow flow to the cartilage layer and synovia to flow into the trabecular bone area guarantee good osteogenesis and cartilage regeneration, which leads to high-accuracy in vivo tests in sheep . This approach not only predicts the final bioperformance of the scaffold but also could optimize the scaffold structure and materials by their biochemical, biological, and biomechanical properties.

Exploiting Polythiophenyl-Triazine-Based Conjugated Microporous Polymer with Superior Lithium-Storage Performance.

Conjugated microporous polymers (CMPs) have been heralded as promising energy-storage materials with advantages such as chemical flexibility, porous structure, and environmentally friendliness. Herein, a novel conjugated microporous polymer was synthesized by integrating triazine, thiophene, and benzothiadiazole into a polymer skeleton, and the Li+ -storage performance for the as-synthesized polymer anode in Li-ion batteries (LIBs) was investigated. Benefiting from the inherent large surface area, plentiful redox-active units, and hierarchical porous structure, the polymer anode delivered a high Li+ storage capacity up to 1599 mAh g-1 at a current rate of 50 mA g-1 with an excellent rate behavior (363 mAh g-1 at 5 A g-1 ) and a long-term cyclability of 326 mAh g-1 over 1500 cycles at 5 A g-1 , implying that the newly developed polymer anode offers a great prospect for next-generation LIBs.

Surgical Management and Factors Affecting the Prognosis for Patients with Thyroid Cancer Spinal Metastases: A Retrospective Analysis of 52 Consecutive Patients from a Single Center.

BACKGROUND: Thyroid cancer, one of the most common endocrine malignancies in developed areas and China, is associated with favorable prognosis. However, the presence of spinal metastases will remarkably reduce the life expectancy for patients with thyroid cancer. In addition, limited information is available about such disease. METHODS: Various potential clinical factors were submitted to univariate and multivariate analyses to identify the independent variables that predicted the prognosis for patients. In addition, the survival rate was estimated according to the Kaplan-Meier method, and statistic differences were calculated by the log-rank test. Moreover, factors with a P value of ≤0.1 were performed multivariate analysis using a multivariate Cox proportional hazards model, and factors with a P value of <0.05 were considered as statistically significant. RESULTS: Seven potential independent prognostic factors had been identified through univariate analysis, which were then subjected to multivariate analysis. Our results suggested that age of ≤50 years, single segment involved, and follicular thyroid cancer were the independent favorable prognostic factors. CONCLUSIONS: Findings in this study indicate that age of ≤50 years, single segment involved, and follicular thyroid cancer are favorable prognostic factors for patients with thyroid cancer spinal metastases.

[Distribution and risk factors of steno-occlusive lesions in patients with ischemic cerebrovascular disease].

OBJECTIVE: To investigate the distribution of atherosclerotic steno-occlusive lesions in Chinese patients with ischemic cerebrovascular disease and the risk factors for occlusive lesions of intracranial and extracranial arteries. METHODS: 583 consecutive patients with ischemic cerebrovascular disease, 449 males and 134 females, aged 18-86, 415 with cerebral infarction and 168 with transient ischemic attack (TIA), underwent angiography. The angiographic findings and relevant clinical; data were analyzed. RESULTS: Fifty of the 583 patients had normal findings in angiography and 527 had occlusive lesions of different degrees, among which 24.3% had only extracranial artery disease (EAD), 36.8% had only intracranial disease (IAD), and 38.9% had both EAD and IAD. In total the incidence of IAD was 75.6%, higher than that of EAD (63.2%). In the carotid TIA patients the percentage of IAD was significantly higher than that of the EAD (P = 0.005), and in the cerebral infarction patients the percentage of IAD was higher than that of the EAD, but now significantly. In the patients with TIA of vertebrobasilar artery the incidence of IAD was significantly higher than that of the EAD (P < 0.01). The proportion of pure IAD alone was high in patients aged < or =40 was 75.5% with the middle cerebral artery as the most frequently involved site, while the proportion of coexistence of IAD and EAD was high in the middle-aged and old-aged groups (39.4% and 48.0% respectively, P < 0.001) with the origin of internal carotid artery as the commonest site of lesions. Multivariable Logistic regression identified age, diabetes, hyperlipidemia, and coronary artery disease as the independent risk factors for EAD, and hypertension, diabetes, and hyperlipidemia for IAD. The patients with EAD were significantly elder and had an increased frequency of coronary artery disease compared with those with IAD. CONCLUSION: In general, the morbidity of IAD was higher that that of EAD in the Chinese patients with ischemic cerebrovascular disease, and presents symptoms of both extracranial and intracranial arteries; however, pure EAD is not uncommon. The distribution pattern of occlusive disease differs among different groups of patients. The patients with EAD are often elder and have an increased frequency of coronary artery disease.

[Correlative study of carotid transient ischemic attacks and intracranial or extracranial angiostenosis].

OBJECTIVE: To investigate the relationship between the clinical features of carotid transient ischemic attacks (TIA) and the intracranial or extracranial angiostenosis. METHODS: Location and degree of stenosis of involved arteries were examined by the digital subtraction angiography in 52 patients with carotid TIA. RESULTS: Intracranial or extracranial vascular lesions of different degrees were revealed in 45 patients (86.5%), and 29 out of 45 (64.4%) had more than one site. Severe stenosis and occlusion occurred more frequently in TIA patients with short duration (less than 1 hour) and multiple attacks (more than twice). CONCLUSION: Most patients with TIA of carotid systems have stenosis in intracranial or extracranial arteries. TIA with short duration and multiple attacks always accompany with severe stenosis or occlusion in intracranial or extracranial arteries. Digital subtraction angiography helps to identify the vascular etiology of TIA and provides the instruction of therapeutic regimen.

Evaluation of imaging studies for vesicoureteral reflux in infants with first urinary tract infection.

BACKGROUND: Routine imaging studies following first urinary tract infection(UTI) in infancy are clinically used to identify who has vesicoureteral reflux (VUR) and acute pyelonephritis or renal scars. The potential value of these images in avoiding children acquiring renal complication and whether the children benefited from these examinations were not well justified. METHODS: Analysis was undertaken of 114 infants (228 renal units) at the time of first documented UTI. All underwent renal ultrasound, voiding cystourethrography (VCUG) and dimercaptosuccinic acid (DMSA) renal scan on admission and repeated follow-up VCUG, DMSA or both after 4-6 months if initial examinations showed abnormal at first time. The VUR on VCUG when UTI and its statistical correlations with both acute and follow-up DMSA renal scan revealing renal scar were calculated. RESULTS: Seventeen children (14.9%) had VUR detected by VCUG. Forty-six patients (40.4%) had abnormal findings on acute DMSA renal scans (acute pyelonephritis or renal scars). The sensitivity, specificity, positive prediction rate and negative prediction rates of DMSA for VUR were 63%, 82.6%, 32.7% and 94.3%, respectively. The initial identified VUR versus renal scarring on follow-up DMSA showed little correlation. CONCLUSIONS: There is limited effectiveness of routine investigation by VCUG in infants with first confirmed UTI. VCUG may be withheld in a child who presents with first UTI before the age of one year if there has been no demonstrable abnormal DMSA scan.

[The relationship between coronary atherosclerotic stenosis and cerebral atherosclerotic stenosis].

OBJECTIVE: To observe the relationship between coronary and carotid/cerebral atherosclerotic stenosis. METHODS: Carotid/aortocranial angiography and coronary angiography were performed in 34 CAD patients complicated with symptomatic cerebral ischemia. Patients were divided into 3 subgroups according to the extent of arterial stenosis determined by angiography. There were 5 light, 4 moderate and 25 severe stenosis determined by coronary angiography and there were 6 light, 6 moderate and 24 severe stenosis determined by carotid/aortocranial angiography. RESULTS: The extent of coronary artery stenosis was parallel to the carotid artery or vertebral artery stenosis. Twenty-four patients out of 25 patients with severe coronary stenosis had severe cerebrovascular stenosis (P = 0.873). The coincident rate was as high as 92% for patients with moderate or severe cerebrovascular stenosis whose Califf risk scores of coronary artery were more than or equal to 2. The follow-up study showed the incidence of cardiovascular event and cerebrovascular event increased significantly in the patients with moderate to severe coronary and cerebral arteries stenosis and 3 patients with severe stenosis found in both coronary and cerebral arteries died during follow up. CONCLUSION: The incidence and severity of coronary artery stenosis is parallel with carotid artery or vertebral artery stenosis.