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Objective:To investigate the clinical efficacy and prognosis of transjugular intrahepatic portosystemic shunt (TIPS) and drug combined with endoscopic treatment in patients with liver cirrhosis and esophagogastric variceal bleeding (EGVB).Methods:From January 2012 to December 2013, at the First Affiliated Hospital of Xi′an Jiaotong University, the data of 147 patients with liver cirrhosis and EGVB undergoing TIPS or drug combined with endoscopic treatment were retrospectively collected, with 87 cases in TIPS treatment group and 60 in drug combined with endoscopic treatment group.The 5 years follow-up data were analyzed, and the overall survival rates, rebleeding-free survival rates and hepatic encephalopathy-free survival rates at 6 weeks, 1 year, 2 years and 5 years after treatment of two groups were compared. Independent sample t test, Mann-Whitney U test, chi-square test, Fisher exact test, Z test, log-rank test and trend test were used for statistical analysis. Results:There were no significant differences in age, gender, etiology, Child-Pugh classification, initial liver function, coagulation function, liver ascites, previous history of hepatic encephalopathy, blood pressure and preoperative blood transfusion history between the TIPS treatment group and combination of drugs and endoscopy treatment group (all P>0.05). Forty-one patients died within 5 years, of which 20 (48.8%) died of rebleeding and 6 (14.6%) died of hepatic encephalopathy. There were no significant differences in 6-week, 1-year and 2-year overall survival rates between the TIPS group and drug combined with endoscopic treatment group (all P>0.05), however the 5-year overall survival rate of the TIPS treatment group was higher than that of the drug combined with endoscopic treatment group (78.4% vs. 63.2%), and the difference was statistically significant ( Z=2.06, P=0.048). The 6-week, 1-year, 2-year, 5-year rebleeding-free survival rates of the TIPS group were 97.7%, 96.5%, 88.9% and 70.9%, respectively, which were all higher than those of the drug combined with endoscopic treatment group (86.7%, 53.3%, 43.3% and 27.1%), and the differences were statistically significant ( Z=2.35, 6.39, 6.26 and 4.80, all P<0.05). There were no significant differences in hepatic encephalopathy-free survival rates at 6 weeks, 1 year and 2 years after treatment between the TIPS group and drug combined with endoscopic treatment group (all P>0.05), however the 5-year hepatic encephalopathy-free survival rate of the TIPS treatment group was lower than that of the drug combined with endoscopic treatment group (67.7% vs. 86.7%), and the difference was statistically significant ( Z=2.28, P=0.030). The lower the Child-Pugh classification, the higher the cumulative 5-year survival rate ( χ2=6.75, P<0.01). There was no statistically significant difference in the 5-year overall survival rate in patients with the same Child-Pugh classification between the TIPS group and the drug combined with endoscopic treatment group (all P>0.05). Conclusions:The efficacy of TIPS is better than that of the drug combined with endoscopic treatment in treating EGVB. Even the long-term risk of hepatic encephalopathy of TIPS is higher, the short-term, middle-term and long-term rebleeding rate are decreased. Patients with Child-Pugh grade C do not need to avoid TIPS when choosing the treatment, the earlier the TIPS used, the better survival benefit will be obtained.
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Objective To observe the expression of aquaporin-7 (AQP-7)during the development of renal tubules of mice,and investigate the relationships between AQP-7 and renal tubule development.Methods Kidneys were selected from mice at embryonic days(E)12,14,17,and 18 and postnatal days(P)1,3,7,14,24,40 and 70.The expression of AQP-7 was observed by immunohistochemical(IHC)method in renal tubules.The surface area density values of AQP-7 positive expression were measured by stereological method while the content variation of AQP-7 in the renal tissue of mice was examined by Western blot.Results IHC analysis showed that AQP-7 was expressed in developing renal tubules at the proximal tubule at E14 day,localized along the brush border of the proximal straight tubules (S3 segment)where the cortex and outer medullalie after P14 d,but AQP-7 was not observed in the nephrogenic zone or inner medulla.The results of stereology discovered that the surface area density values of AQR-7 had increased gradually in the apical of renal tubule and reached the maximum at P24 d and then remained stable with the growth of mice.Western blot indicated that AQP-7 expression in kidneys had reached the peak at P24 d and remained stable.Conclusion The expressions of AQP-7 in the developing renal tubules of mice show a chronological and spatial sequence,which plays an important role in water and glycerol balance of mouse kidneys at the late stage of development.
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<p><b>OBJECTIVE</b>This research project aimed to evaluate whether a simplified method for identifying high-risk individuals for cardiovascular diseases proposed by the China Rural Health Initiative (CRHI) was feasible in the rural areas in China.</p><p><b>METHODS</b>2 036 adults, aged 20 years or older were stratified-randomly sampled from 12 villages in Luquan county and Anguo county (Hebei province) respectively, to receive physical examination and filling in administered questionnaires. "Gold Standard" was used on high risk in Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults to evaluate the CRHI standards:people with a history of coronary heart disease or stroke, or elderly as men ≥50 years or women ≥60 years with diabetes, or elderly with systolic blood pressure ≥160 mmHg. Sensitivity, specificity, positive and negative predictive values related to the identification of high-risk individuals for cardiovascular diseases were assessed.</p><p><b>RESULTS</b>The concordance rate between the CRHI standard and the gold standard was 92.9% , with sensitivity as 77.2%, specificity as 98.5%, Youden's Index as 0.76, positive predictive value as 94.7% and negative predictive value as 92.5%. Under CRHI standard, 21.3% of the adults were identified as high risk. The rate was increasing with age (P < 0.001), reaching 44% among those who were over 60 years old.</p><p><b>CONCLUSION</b>The CRHI standard seemed simple and easy and was suitable for identifying high-risk individuals for cardiovascular diseases in the resource-constrained rural areas.</p>
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ObjectiveTo investigate the role of the anti-podocyte antibody in the pathogenesis of membranous nephropathy(MN).Methods Thirty-six frozen section slice from biopsies of normal kidney were randomly divided into 3 groups:A,B and C groups(n=12,respectively),then,serum of MN and IgA nephropothy patients,and normal saline were added by drops to frozen section respectively,then the changes were observed by fluorescence microscope.Twenty-one male New Zealand white rabbits were feed with standard diet for 1 week,then were randomly divided into 3 groups:D,E,F groups (n=7,respectively),and injected with the serum of MN and IgA nephropathy,and normal saline respectively through ear-border vein.24-h urinary protein, serumalbumin, serumcreatinineweredetected. Atweek8afterinjection, the histopathological changes in kidney tissue of rabbits were observed by light microscope,electron microscope and immunofluorescence staining. Results Immunofluorescenee staining displayed IgG deposition in glomerular podocytes in group A,and there was no positive expression in other two groups.The quantitative measurement of 24-h urinary protein increased significantly after injection of MN serum (P＜0.01),meanwhile the serum albumin markedly decreased (P＜0.01).The inmnunofluorescence staining showed that IgG deposited in the glomerulus capillaries wall,which presented spherical particles.Light microscope revealed the thickening of GBM without nailing process formation.Electron microscope showed the podocyte foot processes,subepithelial dense deposits.Such pathological changes were not found in E group and F group.Conclusion There is anti-podocyte antibody in blood of MN patients,which may play a role in the pathogenesis of MN.
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Objective To compare the immune effects of Coxsackievirus B3 (CVB3) capsid protein VP1 expressed bacterially, recombinant adenovirus rAd/VP1 and recombinant plasmid pcDNA3/VP1which express VP1 protein in mice. Methods After expressed in prokaryotic cells, VP1 protein was purified. Recombinant adenovirus rAd/VP1 and recombinant plasmid pcDNA3/VP1 were amplified and extracted. Six to 8-week-old, male BALB/c mice were divided into four groups randomly. Each group contained 18 mice. The mice of pcDNA3/VP1 group or VP1 protein group were immunized intramuscularly with three injections at three weeks apart, of recombinant plasmid pcDNA3/VP1 at a dose of 100 μg/mouse or recombinant protein VP1 at a dose of 50 μg/mouse. The mice of rAd/VP1 group were immunized intramuscularly twice at two weeks interval with rAd/VP1 at a dose of 1.2 × 107 PFU. The control group was mock-immunized with 100 μl of PBS intramuscularly. Mice were bled from the retroorbital sinus plexus every two weeks after each immunization. ELISA and micro-neutralization test were used to detect levels of CVB3-specific IgG antibody and neutralizing antibody titers in the sera of immunized mice. Three weeks after the last immunization, the cytotoxic T lymphocyte(CTL) killing activity of spleen lymphocytes was detected with CCK-8 assay. Subsequently, virus titers in the sera of immunized mice were determined by the 50% cell culture infective dose( CCID50 ) assay on HeLa cell monolayers and percentage of animals surviving were observed after lethal CVB3 attack over a period of 21 days. Results The titers of specific IgG antibody and neutralizing antibody in sera of VP1 protein immunized mice were higher than other groups( P ＜0.05 ). While CTL killing activity of spleen lymphocytes of VP1 protein immunized mice was lower than mice in rAd/VP1 group( P ＜0. 05). Virus titers in sera of VP1 protein immunized mice were lower than the mice in pcDNA3/VP1 or rAd/VP1 groups ( P ＜ 0.05 ), while survival rate was significantly higher than these two groups ( P ＜ 0.05 ).Conclusion VP1 protein induced higher level of humoral immune response and acquired obvious immune protection effects in mice. The immunizing potency of VP1 protein vaccine surpassed plasmid pcDNA3/VP1or recombinant adenovirus rAd/VP1. It appeared to be a promising candidate among the three different vaccines.
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Objective To construct recombinant adenovirus Ad/MDC-VP1 and investigate its im-muno-boosting effect of the mice primed with the experimental DNA vaccine against Coxsackievirus infection. Methods The recombinant adenovirus Ad/MDC-VP1 was constructed and packaged. The Western blot analysis was used to verify the target protein. BALB/c mice were divided into four groups: Ad/MDC-VP1 group, pcDNA3/MDC-VP1 group, pcDNA3/MDC-VP1 prime-Ad/MDC-VP1 boost group and PBS group. The mice in each group were immunized intramuscularly. The titers of serum IgG and neutralizing antibody were tested by ELISA and trace neutralization assay, respectively. The lymphocytes proliferation activity and specific CTL cytotoxic activity were tested by CCK-8 assay. The mice in each group were challenged with le-thal dose of Coxsackievirus, and the assay of the serum virus titers and the observation of protection efficacy against Coxsackievirus infection were carried out. Results The recombinant adenovirus Ad/MDC-VP1 was successfully constructed and the target protein was expressed. It was observed that the titers of CVB3 VP1 specific antibody, lymphocyte stimulation index, CTL cytotoxicity activities and protection rate of the pcDNA3/MDC-VP1 prime-Ad/MDC-VP1 boost group were much higher than those of the rest groups( P < 0.05), and the titer of serum virus was lower after CVB3 challenged ( P < 0.05 ). Conclusion Both the cellular and humoral immune responses in mice could been significantly enhanced by the pcDNA3/MDC-VP1 prime-Ad/MDC-VP1 boost strategy.
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Objective To analyse the development of mouse kidney. Method Sterological methods were used in this study.Results The nephrogenic zone appeared in 14th day's kidney of the fetus development, medulla could be found in the late stage of fetus development kidney and developed after birth. Inner medulla were observed on 21st day after birth, nephrogenic zone disappeared on 7th day after birth. Morphometric analysis proves that medulla developed mainly after birth, cortex volume also developed rapidly after birth, especially after 21st day postnatally, the development of corpuscle number was finished before 7th day postnatally. Conclusion The development of mouse kidney begins on 14th day of embryo and stops on 21st day after birth, the period of the medulla development is between E 18 days and 21 days after birth.