ABSTRACT
Objective To investigate the role of histone H4 in the polarization of alveolar macrophages (AM) in lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) in mice. Methods i) The specific pathogen free male C57BL/6 mice were randomly divided into control group and 2, 4, 6 and 8 mg/kg LPS groups, with six mice in each group. The mice in the LPS groups were intratracheally administered LPS according to their respective doses, while the mice in the control group received an equivalent volume of 0.9% saline. After 12 hours, the arterial blood gas was analyzed, and the pulmonary edema and histopathological changes in lung tissues of mice in each group were observed. The level of histone H4 in bronchoalveolar lavage fluid (BALF) of mice was detected using enzyme-linked immunosorbent assay , and mice AMs of the five group were isolated using adherent method. ii) AMs from normal mice were isolated using adherent method and randomly divided into control group, histone H4 injury group, BALF injury group and anti-histone H4 antibody (anti-H4) intervention group. In the histone H4 injury group, AMs were treated with histone H4 at a final concentration of 20 mg/L. In the BALF injury group and anti-H4 intervention group, AMs were treated with 200 μL BALF supernatant from mice intratracheally administered 6 mg/kg body weight LPS, with the latter group treated with 25 mg/L anti-H4 antibody. The control group AMs were treated with phosphate-buffered saline. iii) After 12 hours of stimulation, the cells were collected, and the relative expression of tumor necrosis factor-α (Tnfa), interleukin-1β (Il1b), differentiation antigen 206 (Cd206) and arginase 1 (Arg1) in AMs was detected using real-time quantitative polymerase chain reaction. Results i) Compared with the control group, mice in all four LPS groups exhibited rapid breathing, inflammatory reaction and lung edema in lung tissues, which were aggravated in a dose-dependent manner. The ratio of partial pressure of arterial oxygen to fraction of inspired oxygen in mice decreased with the increase of LPS dose (P<0.05). The wet/dry weight ratio of lung, the level of histone H4 in BALF and the relative expression of Tnfa and Il1b mRNA in AMs increased with the increase of LPS dose (all P<0.05). The mice in the 6 and 8 mg/kg LPS groups developed ARDS. The level of histone H4 in BALF and the relative expression of Tnfa and Il1b mRNA in AMs of mice in 6 and 8 mg/kg LPS groups were higher than those in the other three groups (all P<0.05). ii) The relative expression of Tnfa and Il1b mRNA increased (both P<0.05), and the relative expression of Cd206 and Arg1 mRNA decreased (both P<0.05) in AMs of histone H4 injury group and BALF injury group compared with the control group. Compared with BALF injury group, the relative mRNA expression of Tnfa and Il1b in AMs of anti-H4 intervention group decreased (both P<0.05), while the relative expression of Arg1 mRNA increased (P<0.05). Conclusion LPS can induce a dose-dependent increase in histone H4 levels in BALF in mice. Histone H4 drives the development of ARDS by activating AMs to M1 polarization. Antagonizing histone H4 to interfere with AM polarization to M1 could be a target for the treatment of ARDS.
ABSTRACT
Objective: To analyze the existing problems in the construction of pneumoconiosis rehabilitation station in Beijing under the framework of ecosystem theory, and put forward countermeasures. Methods: A total of four managers directly involved in the construction of three pneumoconiosis rehabilitation stations in Beijing and 12 rehabilitation doctors working in rehabilitation stations were selected as the interviewees using the judgment sampling method. Based on the perspective of ecosystem theory, an interview outline was designed to conduct a semi-structured interview with the interview subjects. In combination with literature data, the current situation, existing problems and solutions of pneumoconiosis rehabilitation station construction were analyzed. Results: There were still deficiencies in the construction of pneumoconiosis rehabilitation stations in Beijing. At the microscale level, pneumoconiosis patients could not make full use of family resources for active and effective pulmonary rehabilitation treatment, and family members lack of effective rehabilitation guidance and assistance for patients. At the medium-scale level, the resources of primary rehabilitation institutions were insufficient, the medical support for pneumoconiosis rehabilitation was insufficient, and the pneumoconiosis rehabilitation stations lacked a unified information management and technology platform. At the macroscale level, it has not established clear and specific requirements for the construction management and evaluation of pneumoconiosis rehabilitation stations, and there was social discrimination and prejudice against pneumoconiosis patients. Conclusion: It is necessary to improve the recognition of rehabilitation in primary medical and health institutions, strengthen education on the awareness of the disease and rehabilitation skills guidance for patients and their families, strengthen the responsibilities of technical support institutions in rehabilitation stations, promote the construction of primary rehabilitation stations and personnel training, make full use of information technology, promote information exchange and knowledge sharing, and ensure the quality of rehabilitation of pneumoconiosis.
ABSTRACT
Objective:To analyze the expression and role of activated transcription factor 3 (ATF3) in breast cancer.Methods:The Cancer Genome Atlas\Gene Expression Omnibus (TCGA\GEO) database information was queried, the expression level of ATF3 in breast cancer was analyzed by bioinformatics method and the survival curve was drawn. the parallel function and pathway enrichment analysis of ATF3 gene interaction network were constructed.Results:The level of ATF3 mRNA in breast cancer was significantly lower than that in normal breast tissue, but the expression level of ATF3 was significantly increased after chemotherapy. Survival analysis found that after systematic treatment, the survival period of breast cancer patients in the ATF3 high expression group was significantly prolonged, and the difference was statistically significant ( P<0.05). Enrichment analysis revealed that breast cancer-related pathways concentrate in Estrogens signaling pathway, mitogen-activated protein kinase kinases (MAPK) signaling pathway, phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) signaling pathway, Wnt signaling pathway, Breast cancer signaling pathway, and Cell cycle signaling pathway. Conclusions:ATF3 is involved in regulating the proliferation of breast cancer cells. After systematic treatment, the high expression of ATF3 indicates a better outcome.
ABSTRACT
Objective:To investigate the clinical value and safety of ultrasound guided percutaneous transhepatic gallbladder puncture and drainage (PTGBD) in the treatment of pregnancy combined with acute biliary pancreatitis (ABP).Methods:The clinical data of 47 pregnant combined with ABP from 2010 to 2019 in Shengjing Hospital of China Medical University were retrospectively analyzed. Among them, 19 patients received regular medication (conservative group), and the other 28 patients received PTGBD (PTGBD group). Clinical indexes of two groups including acute physiology and chronic health evaluation acute physiology and chronic health evaluationⅡ(APACHEⅡ), serum amylase, white blood cell and total bilirubin were respectively recorded before and 3 days after treatment.Results:There were no statistical difference in the indexes before treatment between 2 groups ( P>0.05). The APACHE Ⅱ, serum amylase, white blood cell and total bilirubin after treatment were significantly lower compared with those before treatment, conservative group: (5.9 ± 1.9) scores vs. (7.2 ± 1.3) scores, (736.8 ± 64.2) U/L vs. (969.2 ± 124.3) U/L, (10.3 ± 1.4) × 10 9/L vs. (14.7 ± 2.1) × 10 9/L and (55.3 ± 9.5) mmol/L vs. (67.1 ± 10.2) mmol/L; PTGBD group: (4.1 ± 1.7) scores vs. (7.0 ± 1.2) scores, (465.5 ± 77.9) U/L vs. (1 001.8 ± 112.5) U/L, (8.4 ± 2.2) × 10 9/L vs. (13.5 ± 2.6) × 10 9/L and (38.4 ± 10.6) mmol/L vs. (73.7 ± 12.5) mmol/L, and the indexes in PTGBD group were statistically lower than those in conservative group, and there were statistical differences ( P<0.05). In conservative group, 5 cases died (both mother and infant) after deterioration of the condition and 1 infant died after birth. In PTGBD group, 3 cases died (both mother and infant) after deterioration of the condition and 1 infant died after birth. The maternal cure rate and fetal survival rate in PTGBD group were statistically higher than those in conservative group PTGBD: 89.3% (25/28) vs. 14/19 and 85.7% (24/28) vs. 13/19, and there were statistical differences ( P<0.05). Conclusions:Among patients with pregnancy combined with ABP, early PTGBD is more effective than conservative medication, and quickly relieves symptoms and reduces complications.
ABSTRACT
OBJECTIVE: To study the literature characteristics and research status of occupational hand-arm vibration disease in China. METHODS: Literature information on occupational hand-arm vibration disease published before 2018 in China were searched and collected through the China National Knowledge Infrastructure(CNKI) and Wanfang Database. The bibliometrics was used to analyze the publication time, type, journal sources, authors and their institutions, citation situation, funds and high-frequency key words. RESULTS: From 1975 to 2018, a total of 349 papers on occupational hand-arm vibration disease were published. The main article type was monograph, with a total of 179 articles(accounting for 51.3%). The articles were distributed in 79 kinds of journals, among them, 10 journals including China Occupational Medicine and Industrial Health and Occupational Diseases were the main carriers to publish related articles(237 papers, accounting for 67.9%). The main research institutions of the literature were Jining Medical College and Guangdong Province Hospital for Occupational Disease Prevention and Treatment, with 134 papers(accounting for 38.4%) published. Among the 5 core authors of the literature, 4 were from the above 2 research institutions. A total of 121 articles(accounting for 34.7%) were cited, and 77 articles(accounting for 22.1%) were supported by research fund. The top 3 high-frequency key words used were arm vibration disease, hand-transmitted vibration/local vibration and occupational disease. CONCLUSION: Occupational hand-arm vibration disease has attracted the attention of Chinese researchers, however, follow-up research, literature quality and funding support still need to be improved.
ABSTRACT
Objective@#Primary liver cancer is a kind of gastrointestinal malignant tumor with high morbidity and mortality. Early diagnosis is difficult, with postoperative high recurrence rate and high metastasis rate, poor prognosis, so it is particularly important to better understand the occurrence and development of liver cancer from the gene level, so as to provide theoretical basis for gene therapy or targeted drug therapy in the future.@*Methods@#TCGA database for liver cancer gene transcriptome data information and clinical phenotype information was downloaded, and R language edgeR package was used to standardize the transcriptome data. The log FC > 1, FDR < 0.01 gene was set to be expressing differences gene, and then the weighted correlation network analysis (WGCNA) methods was used to analyze the relationship between liver cancer stage (stage) and the differentially expressed genes to look for hub genes.@*Results@#Four hub genes related to tumor staging were identified (TPX2, HJURP, KIAA1524, SGO2). Kaplan-meier survival curve was drawn and it was found that their expression level was significantly correlated with patient survival time, and high expression level was an independent prognostic factor.@*Conclusions@#WGCNA method is used to mine the TCGA database information and find the hub genes related to tumor staging. The relationship between TPX2, HJURP, KIAA1524 and liver cancer has been reported in the literature, except SGO2. This study will provide important theoretical basis for the follow-up study of liver cancer.
ABSTRACT
Objective@#To observe the changes of extracellular histones and pulmonary microvascular endothelial cells, and study the activating role of extracellular histones to pulmonary microvascular endothelial cells in the pathogenesis of acute respiratory distress syndrome (ARDS) .@*Methods@#The correlation of the severity of acute lung injury with extracellular histones and pulmonary endothelial damage was studied through mice model, and acute lung injury was produced by aspiration of different concentrations of hydrochloric acid (0.01、0.1、0.3 and 0.5 mol/L, 2 ml/kg). Tumor necrosis factor-α (TNF-α), soluble thrombomodulin (sTM) and lung pathological change were measured. The pro-inflammatory role of extracellular histones was tested by injecting calf thymus histones (CTH) or specific anti-H4 antibody through tail vein. The direct activating role of extracellular histones to pulmonary microvascular endothelial cells was studied through pulmonary endothelial model.@*Results@#The extracellular histones in plasma were increased obviously 6h after aspiration of different concentrations of hydrochloric acid in mice. A positive correlation was seen between extracellular histones and concentrations of aspirated hydrochloric acid (r=0.9180, P<0.05). The sTM in plasma also showed a positive correlation with concentrations of aspirated hydrochloric acid (r=0.8701, P<0.05). Merely administering CTH could not only increase TNF-α and sTM in plasma but also cause obvious lung injury, while specific anti-H4 antibody could relieve the inflammation and lung damage caused by CTH. Extracellular histones could directly damage pulmonary endothelial cells to release sTM in pulmonary endothelial model in vitro, while anti-H4 antibody could protect the endothelial cells.@*Conclusion@#Extracellular histones are the key endogenic inflammatory mediators during the pathogenesis of ARDS caused by aspiration of hydrochloric acid, which could promote inflammation by directly activating pulmonary endothelial cells.
ABSTRACT
Objective To investigate the effect of laparoscopic total extraperitoneal tension-free hernia repair (TEP) in the treatment of inguinal hernia with absorbable biological mesh.Methods A retrospective analysis of the clinical data of 19 patients with inguinal hernia with biological mesh was performed from September 2015 to September 2016 in Shengjing Hospital of China Medical University.The average operative time,average incision pain time,average postoperative venting time,average hospital stay,average operative cost,and long-term chronic pain,postoperative complications,and recurrence rate were observed.Results All the 19 patients were successfully operated.The average operation time was (35.0 ± 4.0) min,the average incision pain time was (1.5 ± 0.6) d,and the average postoperative venting time was (1.5 ± 1.2) d.The average hospital stay was (4.5 ±0.9) d,the average surgery cost was (23 534.6 ± 1 259.9) yuan.Two patients developed swelling of the scrotum after surgery,and one patient developed postoperative fat liquefaction.All patients were followed up for 1 year by telephone,with no recurrence,no serious complications,and chronic pain discomfort.Conclusions The application of absorbable biopsy TEP is a good and reliable way to treat inguinal hernia.Postoperative patients have mild pain and low complication rate.There is no recurrence in recent follow-up,and the short-term effect is satisfactory.It is a reliable method for the treatment of inguinal hernia.The cost is high,and can be selected according to age and individual needs.
ABSTRACT
Objective@#In order to explore the role of heparan sulfate (HS) during the pathogenesis of acute respiratory distress syndrome (ARDS) , the protective effect of HS and its fragments against extracellular histones was compared.@*Methods@#Calf thymus histones (CTH) were injected via femoral vein to induce ARDS in rats. HS, HS fragments or saline was intraperitoneally injected (10mg/kg, Q6h, 24h) to test the protective effect against CTH. The ratio of wet/dry lung weight, protein content in bronchoalveolar lavage fluid (BALF) , total leukocyte and neutrophil count in BALF were measured.@*Results@#After CTH injection, the ratio of wet/dry lung weight (5.7±0.95) was much higher than the saline control group (3.1±0.15). The protein content (0.47±0.086mg/ml) , total leukocyte[ (97.4±15.6l) ×104/ml] and neutrophil (18±3.4/LPF) in BALF were obviously increased compared with the saline control group. The intervention of HS evidently decreased ratio of wet/dry lung weight (4.2±0.41) , protein content[ (0.26±0.019) mg/ml], leukocyte[ (61.3±5.74) ×104/ml] and neutrophil (12±1.8/LPF) in BALF. HS fragments also decreased ratio of wet/dry lung weight, protein content, leukocyte and neutrophil count in BALF though the strength was much less than HS.@*Conclusion@#HS and its fragments could provide protection against extracellular histones during the pathogenesis of ARDS. For the protective effect full length HS was much better than HS fragments.
ABSTRACT
Objective To explore the experience and efficacy of laparoscopic diagnosis and treatment of internal gallbladder fistula (IGF). Methods The clinical data of 24 cases of IGF treated by laparoscopic exploration/surgery were retrospectively analyzed in Shengjing Hospital of China Medical University from January 2012 to January 2018. Results All the 24 patients had underwent laparoscopic exploration and were confirmed as IGF. Among these patients, 16 cases had cholecystoduodenal fistula, 3 cases had cholecystocolic fistula, 3 cases had cholecystogastric fistula, and 2 cases had cholecystocholedo fistula (Mirizzi syndrome). All patients underwent cholecystectomy, and patients with common bile duct stones underwent common bile duct exploration and T tube drainage. Treatment of internal fistula including:duodenal fistula repair (16 cases), colon fistula repair (3 cases), gastric fistula repair (3 cases), duodenal fistula repair and gastrectomy (1 case), and Roux-en-Y cholangiojejunostomy (1 case). Eleven cases were performed laparoscopically (45.8％);13 cases were converted to open surgery (54.2％). Postoperatively, 2 patients experienced mild bile leakage and healed after active drainage for 2 months, and the rest recovered well. After 6 months of follow- up, no complications such as gastrointestinal fistula, obstruction, or stenosis occurred. Conclusions The clinical manifestations of gallbladder fistula generally lack specificity, so that preoperative diagnosis is difficult. IGF is hardly to self- heal, and surgical treatment is still the mainstay for treatment. For appropriate situation, experienced surgeons with the developed laparoscopic techniques are reliable treatment for IGF.
ABSTRACT
Objective@#To investigate the effect of baicalin on the changes in hemorheology and its mechanism during the development of Acute Respiratory Distress Syndrome(ARDS) induced by oleic acid (OA) in rats.@*Methods@#Rats were randomized into 3 groups: control, ARDS (OA induction, 0.12 mg/kg) and ba-icalin-treated group (300 mg/kg). The blood samples were collected at 30 min, 1, 2, 3, 6, 12 and 6 h after OA injection. The whole blood viscosity, plasma viscosity, Maximum erythrocyte deformability index (DImax) were detected. Meanwhile, blood gas analysis and Routine blood test were also performed.@*Results@#The level of arte-rial oxygen partial pressure and oxygenation index decreased (P<0.01 vs. control) and oxygenation index (178 mm Hg, 1 mm Hg=0.133 kPa) reached the diagnostic standard of ARDS at 2 h in ARDS group. In baicalin-treated group, the level of arterial oxygen partial pressure and oxygenation index increased versus the ARDS group. The platelet count (PLT) decreased in baicalin-treated and ARDS groups. Compared with the ARDS group, the level of PLT increased significantly in baicalin-treated group at 30min, 1, 2, and 3 h. Hematocrit (HCT) increased in baicalin-treated and ARDS groups. Compared with the ARDS group, the level of HCT de-creased significantly in baicalin-treated group at 2, 3, 6 and 12 h. Meanwhile, all the index of hemorheology improved in baicalin-treated group.@*Conclusion@#Baicalin may improve hypoxemia of ARDS induced by OA in rats. It may be due to the Improvement of microcirculation of lung.
ABSTRACT
Objective@#To explore the role of lysophosphatidic acid, vascular endothelial growth facor and endothelin in the pathogenesis of pulmonary fibrosis in coal workers’pneumoconiosis patients, the relationship of lysophosphatidic acid, VEGF and ET in serum was studied.@*Methods@#Sixty two pneumoconiosis patients were selected as cases group, which included 23 cases of stage Ⅰ, 25 cases of stageⅡand 14 cases of stageⅢ. Twenty workers were selected as dust exposure group who exposed to coal dust for more than 2 years and had not been diagnosed as pneumoconiosis. Ten healthy people who had no occupational dust exposure were simultaneously selected as the control group. The serum levels of LPA, VEGF and ET were measured by ELISA.@*Results@#The serum levels of VEGF and ET in coal dust exposed group and pneumoconiosis group were much higher than in the control group. The differences were statistically significant among the three groups (P<0.01) . The serum levels of LPA increased in the dust exposed group, stage Ⅰand stage Ⅱgroup. The serum levels of LPA correlated positively with the levels of VEGF and ET (P<0.05) .@*Conclusions@#The serum levels of LPA, VEGF and ET had evident correlation with the pulmonary fibrosis caused by coal dust, which indicate that LPA, VEGF and ET may play a pivotal role in the process of pulmonary fibrosis. The study will throw light on both pathogenesis and early intervention for pneumoconiosis.
ABSTRACT
Objective To explore the effect of EZH2 on Hcy-induced cholesterol accumulation of foam cells. Methods THP-1 foam cells were divided into control group ,100 μmol/L Hcy group and folic acid group. Lipid droplet in foam cells was tested by Oil red O. TC and TG contents in cells were determined by enzymic meth od. H3K27me3 level and EZH2 protein expression were detected by Western-blot. EZH2 mRNA expression was assayed by q-PCR. H3K27me3 level and TC and TG contents were examined followed by overexpression or knock- down of EZH2. Results After administration of Hcy,TC and TG contents in foam cells were increased (P <0.05). H3K27me3 level and EZH2 expression were also increased(P<0.05). Overexpression of EZH2 caused the expansion of H3K27me3 level,and the TC and TC contents were also increased(P<0.05). Conclusion Regula-tion of H3K27me3 by EZH2 might be involved in Hcy-induced accumulation of cholesterol in foam cells.
ABSTRACT
Objective To explore the effect of EZH2 on Hcy-induced cholesterol accumulation of foam cells. Methods THP-1 foam cells were divided into control group ,100 μmol/L Hcy group and folic acid group. Lipid droplet in foam cells was tested by Oil red O. TC and TG contents in cells were determined by enzymic meth od. H3K27me3 level and EZH2 protein expression were detected by Western-blot. EZH2 mRNA expression was assayed by q-PCR. H3K27me3 level and TC and TG contents were examined followed by overexpression or knock- down of EZH2. Results After administration of Hcy,TC and TG contents in foam cells were increased (P <0.05). H3K27me3 level and EZH2 expression were also increased(P<0.05). Overexpression of EZH2 caused the expansion of H3K27me3 level,and the TC and TC contents were also increased(P<0.05). Conclusion Regula-tion of H3K27me3 by EZH2 might be involved in Hcy-induced accumulation of cholesterol in foam cells.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the plasma level of extracellular histones in patients with silicosis, and to explore the role of extracellular histones in the pathogenesis of pulmonary fibrosis in silicosis.</p><p><b>METHODS</b>Sixty-two patients with silicosis were enrolled as the silicosis group, consisting of 23 patients with stage I silicosis, 25 with stage II silicosis, and 14 with stage III silicosis; sixty workers who had a history of occupational exposure to silica dust for more than 2 years and had not been diagnosed with silicosis were enrolled as the silica dust exposure group; sixty-five healthy workers without a history of occupational exposure to dust were enrolled as healthy controls. Enzyme-linked immunosorbent assay was applied to measure the plasma levels of plasma extracellular histone (H4) and transforming growth factor-β(TGF-β).</p><p><b>RESULTS</b>Compared with healthy controls [(0.82±0.67) μg/ml], the silica dust exposure group[(4.14±2.85) μg/ml] and silicosis group[(9.50±5.04) μg/ml] had significant increases in plasma level of H4 (P<0.01). The plasma level of H4 was significantly correlated with the stage of silicosis(r=0.8955, P=0.0388). The silicosis group had a significantly higher plasma level of TGF-β than the silica dust exposure group and healthy controls(P <0.05). In the patients with silicosis, the plasma level of H4 was significantly correlated with that of TGF-β(r=0.5375, P<0.01).</p><p><b>CONCLUSION</b>The plasma level of extracellular histones increases significantly in the pathogenesis of silicosis, and extracellular histones may play an important role in the progression of fibrosis in silicosis.</p>
Subject(s)
Humans , Case-Control Studies , Disease Progression , Dust , Histones , Blood , Occupational Exposure , Silicon Dioxide , Silicosis , Blood , Pathology , Transforming Growth Factor beta , BloodABSTRACT
Objective To investigate the clinical characteristics of tuberous sclerosis-associated huge renal angiomyolipoma,and to summarize the experiences of diagnosis and treatment.Methods The clinical data of 9 patients with tuberous sclerosis-associated huge renal angiomyolipoma treated in Peking Union Medical College Hospital from January 2009 to June 2014 was analyzed retrospectively,including 4 males and 5 females.The age at onset and diagnosis of tuberous sclerosis was 0 to 7 years (mean 2.3 years) and 2 to 30 years (mean 19.6 years),respectively,and the diagnosis age of renal angiomyolipoma was 14 to 35 years (mean 25.2 years).In the 9 patients,8 cases had facial angiofibromas,7 cases had hypomelanotic macules,6 cases had ungual fibromas and epilepsy,and 5 cases had family history.All the patients underwent abdominal ultrasound examination,CT scan and serum creatinine testing,and 3 cases received renal dynamic imaging to assess renal lesions and functional status.Results Imaging examinations showed typical renal angiomyolipomas,which were bilateral and multiple lesions with the maximum diameter greater than 10 cm in every patient,and with 2 patients had a history of acute retroperitoneal hemorrhage.The levels of serum creatinine were normal in all patients,and 3 patients had unilateral glomerular filtration rate of 44.4-99.1 ml/min (mean 62.9 ml/min).One patient underwent unilateral partial nephrectomy,2 patients underwent selective renal artery embolization,1 received blood transfusion due to acute bleeding,1 received rapamycin treatment,and 4 patients underwent close follow-up.Conclusions Tuberous sclerosis-associated renal angiomyolipomas are often bilateral and multiple.Increase of the lesion diameter may only enhance the risk of bleeding with small effect on renal function.Therapeutically,close follow-up and mTOR inhibitor are the preferred treatment options,surgery or selective renal arterial embolization is used only for the possible malignancy,acute bleeding or patients with high risk of bleeding.
ABSTRACT
Objective To investigate the curative effects of the traditional surgical method of posterior pedicle Schanz screw fixa-tion with partially stripping injured paravertebral muscle in treating thoracolumbar fracture .Methods 52 cases with thoracolumbar fracture underwent posterior pedicle Schanz screw fixation to partially strip injured paravertebral muscle from January ,2010 to Jan-uary ,2012 .The patients were divided into partially stripping injured paravertebral muscle group (32 cases) and traditionally strip-ping injured paravertebral muscle group(20 cases) .The blood loss ,postoperative drainage ,kyphosis postoperative 3 d VAS scores , vertebral height correction rate ,Cobb angle correction ,Oswestry dysfunction indexes were copmared .Results Comparing with tra-ditionally stripping injured paravertebral muscle group ,the partially stripping injured paravertebral muscle group has better effect in transperative blood loss ,postoperative drainage and postoperative 3 d VAS scores ,the differences were statistically significant .But there was no statistical significance between the two groups in vertebral height correction rate ,kyphosis Cobb angle correction ,Os-westry dysfunction indexes .Conclusion Partially strip injured paravertebral muscle has less painful than traditional surgery does , being safe and effective with small invasion and easy to recover .
ABSTRACT
Objective To analyze the characteristics of adrenal metastasis from renal cell carcinoma (RCC),and explore the principles to deal with the ipsilateral adrenal gland during radical nepbrectomy.Methods The data of adrenal metastasis in 19 patients with RCC from January 2003 to December 2012 was retrospectively analyzed,including 8 cases with ipsilateral adrenal metastasis,5 with contralateral adrenal metastasis,and 6 with bilateral adrenal metastasis,respectively.The relationship between RCC location,diameter,TNM stage and adrenal metastases was evaluated,and the clinical features of adrenal metastasis were summarized.Results Diameters of RCC ranged from 1.6 cm to 12.6 cm in the 19 cases,and the average diameter was 6.3 cm.The mean diameter of primary RCC,metastasized to the ipsilateral,contralateral and bilateral adrenal gland,was 5.6,6.5 and 7.1 cm,respectively.Among the 9 patients whose primary RCC located in the upper pole,the number of patients with bilateral,ipsilateral and contralateral adrenal metastasis was 3,3,3,respectively.Of the 7 patients with RCC located in the middle and lower pole,the number of patients with bilateral,ipsilateral and contralateral adrenal metastasis was 3,2,2,respectively.Three patients with diffused RCC in the whole kidney occurred ipsilateral adrenal metastases.RCC and adrenal metastasis were simultaneously found in 9 patients,with the average diameter of the primary RCC of 7.4 cm and the clinical stage of T2b-4N0-1 M1.Adrenal metastasis were found in 10 patients during the postoperative follow-up,with the average diameter of the primary RCC of 5.3 cm and the clinical stage of T1a-4N0M0.Nine patients underwent surgery,8 received non-surgical treatment,and 2 had no treatment.Fourteen patients had an average follow-up of 31.9 months,with 1,3 and 5-year survival rates of 84.2％,26.3％ and 15.8％,respectively.Conclusions Adrenal metastasis from RCC may be associated with the diameter and TNM of the primary tumor,regardless of the location.For the patients with normal adrenal gland observed in pre-operative imaging,ipsilateral adrenalectomy is not recommended.
ABSTRACT
<p><b>BACKGROUND</b>Blood pressure variability (BPV) is a reliable prognostic factor for cardiovascular events. Currently there is a worldwide lack of large sample size studies in visit-to-visit BPV. Based on the Kailuan Study, we analyzed the visit-to-visit BPV of patients to investigate the range and influencing factors of BPV.</p><p><b>METHODS</b>In 11 hospitals in the Kailuan Company, 4 441 patients received routine health checkups. Physical examination measured blood pressure (BP), body height, body weight, and waist circumference, and body mass index was calculated. Blood samples were analyzed for plasma total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), and high-sensitivity c-reactive protein (hs-CRP).</p><p><b>RESULTS</b>The effect of gender on systolic BPV was investigated. The average systolic BPV was 10.35 mmHg (1 mmHg = 0.133 kPa) overall, 10.54 mmHg in males and 10.06 mmHg in females. Multivariate Logistic regression analysis revealed that the age (RR = 1.022), systolic BP (SBP, RR = 1.007), LDL-C (RR = 1.098), and history of hypertension (RR = 1.273) were significant risk factors for higher systolic BPV. We found that aging (RR = 1.022), increased SBP (RR = 1.007), and a history of hypertension (RR = 1.394) were determinants of systolic BPV in males. The risk factors for systolic BPV of females were aging (RR = 1.017), increased SBP (RR = 1.009), increased LDL (RR = 1.136), and increased TG (RR = 1.157).</p><p><b>CONCLUSION</b>Our findings indicated that the systolic BPV is closely associated with age, SBP and history of hypertension.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Blood Pressure , Physiology , C-Reactive Protein , Metabolism , China , Cities , Hypertension , Lipoproteins, HDL , Blood , Lipoproteins, LDL , Blood , Logistic Models , Triglycerides , Blood , Waist Circumference , PhysiologyABSTRACT
The pathogenesis of chronic obstructive pulmonary disease is the dysfunction of qi-blood-body fluid.By the analysis of the pathogenesis of different stages of COPD,qi deficiency,phlegm,blood stasis is the key to COPD.According to the pathogenesis of syndrome differentiation,a good curative effect can be achieved by the selection of different treatment methods like tonifying qi,eliminating phlegm and removing blood stasis.