Sodium thiosulfate and pamidronate for treatment of calciphylaxis: case report / Tiosulfato de sodio y pamidronato para el tratamiento de calcifilaxis: reporte de caso

Abstract Introduction: Calciphylaxis is an infrequent disease that almost exclusively affects patients with chronic kidney disease, although cases have been observed in patients without renal function impairment. The diagnosis is mainly made by clinical manifestations and subsequently confirmed by radiological and histological study. The optimal treatment is not known, although there is a consensus that a multifactorial approach is required. Clinical Case: A 68-year-old woman on hemodialysis for 2 years, who presented a painful nodular lesion in the left thigh, a skin biopsy was performed resulting in a diagnosis of calciphylaxis. Treatment and Outcome: Treatment was started with intravenous sodium thiosulfate. Pamidronate is added intravenously, three months later, due to an unfavorable evolution. After 6 months of treatment, improvement in nodular lesions and healing of the ulcerated lesion was observed to be generally well tolerated treatment. Conclusion: The combined treatment of sodium thiosulfate, pamidronate and calcitomimetics has been effectiveand safe for the treatment of calciphylaxis, inducing complete remission.

Resumen: Introducción: La calcifilaxis es una enfermedad infrecuente que afecta casi exclusivamente a pacientes con insuficiencia renal, aunque se han observado casos en pacientes sin deterioro de la función renal. El diagnóstico es clínico confirmándose con estudio radiológico e histológico. No se conoce con exactitud el tratamiento óptimo, aunque hay consenso en que se requiere un abordaje multifactorial. Caso Clínico: Mujer de 68 años en hemodiálisis desde hace 2 años, que presenta una lesión nodular dolorosa en muslo izquierdo, resultando un diagnostico compatible con calcifilaxis, tras biopsia cutánea. Tratamiento y resultado: Inicia tratamiento con tiosulfato de sodio vía venosa. Tres meses más tarde y ante la evolución desfavorable, se añade al tratamiento pamidronato vía intravenosa. Tras 6 meses de tratamiento se observa mejoría de las lesiones nodulares y cicatrización de la lesión ulcerada, habiéndose experimentado buena tolerancia. Conclusión: El tratamiento combinado de tiosulfato de sodio, pamidronato y calcimiméticos ha resultado efectivo y seguro para el tratamiento de la calcifilaxis, induciendo su remisión completa.

Exercise Training Attenuates Sympathetic Activity and Improves Morphometry of Splenic Arterioles in Spontaneously Hipertensive Rats / Treinamento Físico Atenua a Atividade Simpática e Melhora a Morfometria das Arteríolas Esplênicas em Ratos Espontaneamente Hipertensos

Abstract Background: Alterations in the structure of resistance vessels contribute to elevated systemic vascular resistance in hypertension and are linked to sympathetic hyperactivity and related lesions in target organs. Objective: To assess the effects of exercise training on hemodynamic and autonomic parameters, as well as splenic arteriolar damages in male Wistar Kyoto (WKY) and Spontaneously Hypertensive Rats (SHR). Methods: Normotensive sedentary (WKYS) and trained (WKYT) rats, and hypertensive sedentary (SHRS) and trained (SHRT) rats were included in this study. After 9 weeks of experimental protocol (swimming training or sedentary control), arterial pressure (AP) and heart rate (HR) were recorded in freely moving rats. We assessed the autonomic control of the heart by sympathetic and vagal autonomic blockade. Morphometric analyses of arterioles were performed in spleen tissues. The statistical significance level was set at p < 0.05. Results: Resting bradycardia was observed in both trained groups (WKYT: 328.0 ± 7.3 bpm; SHRT: 337.0 ± 5.2 bpm) compared with their respective sedentary groups (WKYS: 353.2 ± 8.5 bpm; SHRS: 412.1 ± 10.4 bpm; p < 0.001). Exercise training attenuated mean AP only in SHRT (125.9 ± 6.2 mmHg) vs. SHRS (182.5 ± 4.2 mmHg, p < 0.001). The WKYT showed a higher vagal effect (∆HR: 79.0 ± 2.3 bpm) compared with WKYS (∆HR: 67.4 ± 1.7 bpm; p < 0.05). Chronic exercise decreased sympathetic effects on SHRT (∆HR: -62.8 ± 2.8 bpm) in comparison with SHRS (∆HR: -99.8 ± 9.2 bpm; p = 0.005). The wall thickness of splenic arterioles in SHR was reduced by training (332.1 ± 16.0 µm2 in SHRT vs. 502.7 ± 36.3 µm2 in SHRS; p < 0.05). Conclusions: Exercise training attenuates sympathetic activity and AP in SHR, which may be contributing to the morphological improvement of the splenic arterioles.

Resumo Fundamento: Alterações na estrutura dos vasos de resistência contribuem para elevar a resistência vascular sistêmica na hipertensão, estando ligadas à hiperatividade simpática e lesões em órgãos-alvo. Objetivo: Avaliar os efeitos do treinamento físico nos parâmetros hemodinâmicos e autônomos, assim como as lesões arteriolares esplênica em ratos machos Wistar Kyoto (WKY) e espontaneamente hipertensos (SHR). Métodos: Ratos normotensos sedentários (WKYS) e treinados (WKYT), e ratos hipertensos sedentários (SHRS) e treinados (SHRT) foram incluídos neste estudo. Após nove semanas de aplicação do protocolo experimental (treinamento de natação ou controle sedentário), registraram-se a pressão arterial (PA) e a frequência cardíaca (FC) dos ratos em movimento livre. Avaliamos o controle autônomo do coração através de bloqueio autônomo simpático e vagal. Análises morfométricas das arteríolas esplênicas foram realizadas. Adotou-se o nível de significado estatístico de p < 0,05. Resultados: Observou-se bradicardia de repouso nos dois grupos treinados (WKYT: 328,0 ± 7,3 bpm; SHRT: 337,0 ± 5,2 bpm) em comparação aos seus respectivos grupos sedentários (WKYS: 353,2 ± 8,5 bpm; SHRS: 412,1 ± 10,4 bpm; p < 0,001). O treinamento físico atenuou a PA média apenas no grupo SHRT (125,9 ± 6,2 mmHg vs. 182,5 ± 4,2 mmHg no SHRS; p < 0,001). O grupo WKYT mostrou maior efeito vagal (∆FC: 79,0 ± 2,3 bpm) em comparação ao grupo WKYS (∆FC: 67,4 ± 1,7 bpm; p < 0,05). Exercício crônico diminuiu os efeitos simpáticos em SHRT (∆FC: -62.8 ± 2.8 bpm) em comparação a SHRS (∆FC: -99,8 ± 9,2 bpm; p = 0,005). A espessura da parede das arteríolas esplênicas nos SHR foi reduzida pelo treinamento (332,1 ± 16,0 µm2 nos SHRT vs. 502,7 ± 36,3 µm2 nos SHRS; p < 0,05). Conclusões: O treinamento físico atenua a atividade simpática e a PA em SHR, o que pode contribuir para melhorar a morfologia das arteríolas esplênicas.

13,14-EpDPE dilates coronary arterioles in rats by activating BK channels / 医学研究生学报

Objective The mechanisms of docosahexaenoic acid (DHA) protecting the cardiovascular system have not yet been clarified. This study was to investigate the vasorelaxative effect of 13,14-epoxy docosapentaenoic acid (13,14-EpDPE) on coronary arterioles in normal rats and its action mechanisms.Methods We isolated coronary artery smooth muscle cells (CASMCs) from normal rats by enzyme digestion, examined the open probabilities of the large conductance calcium-activated potassium (BK) channels in inside-out single channel configuration in the presence of different concentrations (0, 1, 10 and 100 pmol/L) of 13,14-EpDPE, and recorded the BK currents with the patch clamp in whole cell configuration. Then we assessed the coronary arterial relaxation by measuring dilatory responses to 13,14-EpDPE in pre-contracted tissues with or without pre-treatment with iberiotoxin.Results In the presence of 0, 1, 10 and 100 pmol/L of 13,14-EpDPE, the open probabilities of the BK channels were 0.25±0.03, 0.34±0.03, 0.44±0.06 and 0.85±0.16 (n=6), respectively, significantly increased at 100 pmol/L as compared with 0, 1 and 10 pmol/L (P<0.05). The BK channels were activated by 13,14-EpDP in a concentration-dependent manner and its half-effect concentration was (15.94±1.21) pmol/L. The current density was increased from (58.27±16.35) to (95.94±23.00) pA/pF (P=0.002) after 10 pmol/L 13,14-EpDP perfusion when the stimulation voltage was 100 mV. 13,14-EpDPE dilated the isolated coronary arterioles in a dose-dependent manner, and its effects were abolished after pre-treatment with iberiotoxin (100 nM).Conclusion 13,14-EpDPE can dilate coronary arterioles by activating BK channels in CASMCs, which might be one of the mechanisms underlying its protective effect on the cardiovascular system.

Endothelin-1 expression in pulmonary hypertensive chickens by hypoxia / Expresión de Endotelina-1 en pollos con hipertensión arterial pulmonar por hipoxia hipobárica

ABSTRACT Objective. To determine the effect of hypobaric hypoxia exposition in pulmonary arterioles expression of endothelin-1 (ET-1). Materials and methods. Two groups of commercial broiler chickens were used: one of them were raised at 2638 (hypobaric hypoxia) and the other one at 300 m (relative normoxia) above sea level. Incidence of pulmonary hypertension (PH) was evaluated by calculating the cardiac mass index values and ET-1 protein expression was established in pulmonary arterioles by immunohistochemistry and morphometry. Results . ET-1 expression was higher in arterioles of animals exposed to hypoxia as compared to the low altitude exposed broilers (p<0.01). Arterioles from pulmonary hypertensive chickens (PHC) showed ET-1 higher expression than arterioles from healthy chickens (non-hypertensive, NHC) at low altitude, those exposed to hypobaric hypoxia (p<0.01). 53% of chickens subjected to altitude conditions developed pulmonary hypertension. Under normoxia, no chickens developed that pathology. Conclusions. Quantitative characteristics and sites of ET-1 expression in the lungs are important in the understanding of PH pathogenesis in broilers and the adapting mechanisms to hypobaric hypoxia, as to design new pharmacological approaches. This is a first approach which accounts for the abovementioned features in broilers subjected to natural conditions of normoxia and hypobaric hypoxia.

RESUMEN Objetivo. Determinar el efecto de la exposición a hipoxia hipobárica sobre la expresión de Endotelina-1 en arteriolash pulmonares. Material y métodos. Se utilizaron 2 grupos de pollos de engorde de una estirpe comercial: uno de ellos criados a 2638 y el otro, a 300 m de altitud. La incidencia de HAP se evaluó según los valores del índice de masa cardiaca y se compararon los niveles de expresión de la proteína ET-1 en arteriolas pulmonares de pollos de engorde sanos y enfermos por HAP mediante inmunohistoquímica y morfometría. Resultados. La expresión de la proteína ET-1 fue mayor en las arteriolas de los pollos expuestos a hipoxia hipobárica que en los criados bajo condiciones de normoxia relativa (p<0.01). Los animales enfermos por HAP presentaron mayor expresión de la proteína ET-1 en las arteriolas pulmonares que los animales sanos ubicados en las dos altitudes (p<0.01). 53% de los animales desarrollaron hipertensión pulmonar y ninguno de los mantenidos en normoxia lo hicieron. Conclusiones. El conocimiento de las características cuantitativas y lo sitios de expresión de la ET-1 son elementos importantes para entender aún más la patogenia de la HAP y el diseño de fármacos para su control. Este estudio constituye la primera aproximación cuantitativa relacionada con la expresión de ET-1 en pollos de engorde con HAP de origen hipóxico no inducida.

The histological analysis of the glenohumeral "critical zone" / Análisis histológico de la "zona crítica" glenohumeral

The arterial integrity of the "critical zone" of the rotator cuff has led to much uncertainty regarding rotator cuff tendinopathy. As the region of the supraspinatus tendon is the most common area affected by impingement, its central aspect is situated approximately 10 mm from the insertion at the greater humeral tubercle. Although many studies have investigated the vascularity of the "critical zone", there still appears to be lack of consensus regarding its extent. Through the employment of gross dissection and standard histology analysis of twenty-five adult bilateral cadaveric scapulo-humeral regions (n = 50), this study aimed to quantify the degree of vascularity, or lack thereof, within the "critical zone" by evaluating its relative morphometric features. The demographic representation of the sample was also considered. Results: i) Mean diameter of arteriole lumen: 91.6±75.2 µm; ii) Mean diameter of entire arteriole: 119.8±87.1 µm; iii) Mean arteriole wall thickness: 15.1±9.5 µm; iv) Mean area occupied by an arteriole: 20644.4±3358.0 µm2; v) Mean number of arterioles within "critical zone": 14.6±8.7. All tissue samples displayed a scarce distribution of arterioles along the musculo-tendinous junction relative to the "critical zone". A directly proportional relationship between the morphometric parameters was indicated by positive strong correlations and accompanying statistically significant P values. As 66 % of the number of arterioles within the "critical zone" were distributed between the minimum value and the upper quartile, it was postulated to be hypovascular, therefore confirming the findings of previous studies.

La integridad arterial de la "zona crítica" del manguito rotador ha dado lugar a una gran incertidumbre con respecto a la tendinitis del mismo. A medida que la región del tendón del músculo supraespinoso sea el área más común afectada por el impacto, su aspecto central estará situado aproximadamente a 10 mm desde la inserción en el tubérculo mayor del húmero. Aunque muchos estudios han investigado la vascularización de la "zona crítica", aún parece existir falta de consenso en cuanto a su extensión. A través de la disección macroscópica y análisis de la histología normal de ambas regiones escápulo-humerales, se realizó en 25 cadáveres adultos (n = 50), este estudio que tuvo como objetivo cuantificar el grado de vascularización, o su ausencia, dentro de la "zona crítica" mediante la evaluación de su características morfométricas. También se consideró la representación demográfica de la muestra. Resultados: i) La media de diámetro de lumen de las arteriolas: 91,6 ± 75.2 µm; ii) El diámetro medio de la totalidad de las arteriolas: 119,8 ± 87.1 µm; iii) la media del espesor de la pared de las arteriolas: 15,1 ± 9.5µm; iv) La media de la zona ocupada por una arteriola: 20.644,4 ± 3358.0 µm2; v) La media de las arteriolas dentro de la "zona crítica": 14,6 ± 8,7. Todas las muestras de tejidos tenían una escasa distribución de las arteriolas a lo largo de la unión músculo-tendinosa con relación a la "zona crítica". Una relación directamente proporcional entre los parámetros morfométricos indica fuertes correlaciones positivas y junto a valores de P estadísticamente significativos. Como el 66 % de las arteriolas dentro de la "zona crítica" se distribuyeron entre el valor de cuartil mínimo y superior, se postuló como hipovascular, por lo tanto confirma los resultados de estudios anteriores.

Propofol relaxes mesenteric arteriole via gap junction / 临床麻醉学杂志

Objective To investigate the effects of propofol on mesenteric artery in SD rats and to observe whether the effect of propofol on the mesenteric artery relaxation is related to the gap. Methods Pressure myograph was used to examine the effect of 18β-GA and 2-APB on the relaxation induced by propofol 1×10 -7 ,3×10 -7 ,1×10 -6 ,3×10 -6 ,1 ×10 -5 ,3 ×10 -5 ,1 ×10 -4 and 3 ×10 -4 mol/L in acutely separated mesenteric arterioles of SD rat.Results The diameter of mesenteric arteri-oles were increased from (208.6±13.4)to (213.5±13.6),(21 9.7±13.2),(226.4±12.5),(234.9 ±12.3),(245.5±13.0),(267.4±1 5.2),(336.2±18.3)and (385.9 ±14.2)μm after application of 1×10 -7 ,3×10 -7 ,1 × 10 -6 ,3 × 10 -6 ,1 × 10 -5 ,3 × 10 -5 ,1 × 10 -4 and 3 × 10 -4 mol/L propofol,re-spectively.Propofol induced dilation of the rat mesenteric arterioles in a concentration-dependent man-ner (P < 0.01 ).After pretreatment with 18β-GA and 2-APB,1 × 10 -4 mol/L propofol induced dilation was absolutely decreased (P <0.01).Conclusion These results suggest that propofol relaxes mesenteric arterioles via gap junction.

Effect of large conductance Ca2+-activated K+ channel current and cytosolic calcium concentrations in retinal artery smooth muscle cells on diabetic retinal artery tension / 中华实验眼科杂志

Background Diabetic retinopathy (DR) is a common microvascular complications of the retina,retinal vascular smooth muscle cells of large conductance calcium-activated potassium channels (BK) is a major factor in regulating vasomotor and hemodynamic.Currently,functional changes of BK channel in retinal artery smooth muscle cells (RASMCs) and its role in DR were rarely reported.Objective This study was to investigate the early vascular damage mechanisms in DR by detecting the changes of BK channels current,calcium concentration and open probability (NP0) of BK channel with different calcium concentration in RASMCs of normal and diabetic rats.Method Fifty SPF SD 8-12 weeks old rats were randomly divided into normal control group and diabetic model group.Forty diabetic rats was intraperitoneally injected with 60 mg/kg streptozotocin to form type 1 diabetic model,10 rats (the normal control group) were injected sodium citrate solution with the same manner.Fluorescent probe was applied to detect calcium concentration in rat RASMCs;RASMCs were isolated by using enzyme digestion,and BK-channel electric currents and calcium concentrations in the RASMCs were measured by whole-cell patch clamp technique and fluorescence assay,respectively.The NP0 of BK channel was measured by single patch clamp technique.Results Diabetic models were successfully established in 36 rats with the success rate 90％.When stimulation voltage is greater than 60 mV,the current density of BK channel in RASMCs of diabetic model group decreased;when stimulating voltage was 100 mV,the BK channel currents of RASMCs in the normal control group and diabetic model group were (100±23) PA/PF and (50 ± 7) PA/PF,the difference was statistically significant (t =19.80,P ＜ 0.05).After adding specific BK channel blocker African scorpion toxin 100 nmol,the BK channel current in the normal control group significantly reduced,and that in the diabetes model group was not significantly changed;the calcium ion concentrations in RASMCs were (123±11)nmol/L and (255± 10)nmol/L in the normal control group and diabetic model group,the difference was statistically significant (t =32.50,P＜0.05).When stimulation voltage was 60 mV,with increasing calcium ion concentration,the NP0 of BK channel increased (F =15.28,P＜0.05).Conclusions The electric current and NP0 of BK-channel are obviously reduced and the calcium concentration is evidently elevated in RASMCs of diabetic rats,suggesting that the abnormal of BK-channel is probably one of the important causes of retinal artery abnormal contraction in diabetic rats.

Correlation of enlarged perivascular space and post-stroke depression in patients with ischemic stroke / 国际脑血管病杂志

Objective To investigate the correlation between enlarged perivascular space (EPVS) and post-stroke depression (PSD) in patients with ischemic stroke. Methods Consecutive patients with acute cerebral infarction admitted to hospital from March 2010 to March 2014 were enroled prospectively. The patients completed head MRI examination after admission and performed EPVS grading. At 3 months after symptom onset, they performed PSD assessment according to Hamilton Depression Scale (HAMD) and Classification and Diagnostic Criteria of Mental Disorders in China, 3rd edition (CCMD-3). The relationship between EPVS and PSD was analyzed. Results A total of 249 patients were enroled; including 62 patients (4. 9% ) experienced PSD at 3 months. There were significant differences in the proportions of the EPVS classification patients of the baseline National Institutes of Health Stroke Scale score ( the median [interquartile range]; 4 [3 - 6] vs. 3 [2 - 5]; Z = - 2. 950, P = 0. 003), centrum semiovale (χ2 = 14. 370, P = 0. 001), and periventricular (χ2 = 11. 590, P = 0. 003)between the PSD group and the non-PSD group. Multivariable logistic regression analysis showed that centrum semiovale EPVS grade 2 (odds ratio [OR] 3. 89, 95% confidence interval [ CI] 1. 59 - 9. 56) and grade 3 (OR 3. 28, 95% CI 1. 04 - 10. 33) were significantly correlated with PSD; periventricular EPVS grade 2 (OR 0. 72, 95% CI 0. 27 - 1. 91) and grade 3 (OR 2. 24, 95% CI 0. 68 - 7. 37) were not correlated with PSD. Conclusions Centrum semiovale EPVS is independently associated with PSD, and periventricular EPVS is not.

Evaluation methods for small vascular network distribution and counting around the knee joint in rats / 中国组织工程研究

BACKGROUND:With the deepening of bone tissue engineering research and bone metabolism understanding, it is a hotspot to analyze the blood supply and nutritional status of tissue-engineered bone. OBJECTIVE:To compare different methods for evaluating smal vascular network distribution around the knee joint in rats in order to provide a guideline for the study of microvascular network in tissue-engineered bone. METHODS:Eighteen Sprague-Dawley rats were randomly divided into three groups, with six rats in each group. Three commonly methods were used to evaluate the smal vascular network around the knee joint in rats:immunohistochemistry analysis, angiography analysis, and CT scans and reconstruction analysis. RESULTS AND CONCLUSION:The microstructure of vascular network could be observed by immunohistochemistry, but the spatial distribution of vessels could not be evaluated. The spatial distribution of vessels could be showed by angiography and CT scans. However, some of micro vessels were showed unclearly by CT scans. The number of blood vessels detected by immunohistochemistry was (26.50±3.02) vessels, significantly higher than those detected by angiography and CT scans that were (14.12±1.47) and (9.00±1.79) vessels, respectively. Combination of immunohistochemistry and angiography can evaluate the microvascular network at microscopic and macroscopic levels, which can provide the whole information of the vascular network.

Effect of acute hypoxia on contractile function of isolated small pulmonary arteries in patients with moderate chronic obstructive pulmonary disease / 中华麻醉学杂志

Objective To evaluate the effect of acute hypoxia on the contractile function of isolated small pulmonary arteries in patients with moderate chronic obstructive pulmonary disease (COPD).Methods Seven patients with lung cancer,of both sexes,scheduled for elective pulmonary lobectomy,with no pulmonary hypertension and with normal pulmonary function after examination,were included in the study.Six cases were diagnosed as having moderate COPD.Lung tissues 5 cm away from the tumor tissues were taken during operation and the small pulmonary arteries were isolated and divided into 2 groups:control group (n =7) and COPD group (n =6).The contractile amplitude of small pulmonary arteries was detected using vasomotor tone meter under the state of acute hypoxia.Results Contractile amplitude of small pulmonary arteries in response to hypoxic stimulus was significantly decreased in COPD group compared with control group (P ＜ 0.01).Conclusion Acute hypoxia can further reduce the contractile function of isolated small pulmonary arteries in patients with moderate COPD.

Effect of gender on training-induced vascular remodeling in SHR

There is accumulating evidence that physical inactivity, associated with the modern sedentary lifestyle, is a major determinant of hypertension. It represents the most important modifiable risk factor for cardiovascular diseases, which are the leading cause of morbidity and mortality for both men and women. In addition to involving sympathetic overactivity that alters hemodynamic parameters, hypertension is accompanied by several abnormalities in the skeletal muscle circulation including vessel rarefaction and increased arteriole wall-to-lumen ratio, which contribute to increased total peripheral resistance. Low-intensity aerobic training is a promising tool for the prevention, treatment and control of high blood pressure, but its efficacy may differ between men and women and between male and female animals. This review focuses on peripheral training-induced adaptations that contribute to a blood pressure-lowering effect, with special attention to differential responses in male and female spontaneously hypertensive rats (SHR). Heart, diaphragm and skeletal muscle arterioles (but not kidney arterioles) undergo eutrophic outward remodeling in trained male SHR, which contributed to a reduction of peripheral resistance and to a pressure fall. In contrast, trained female SHR showed no change in arteriole wall-to-lumen ratio and no pressure fall. On the other hand, training-induced adaptive changes in capillaries and venules (increased density) were similar in male and female SHR, supporting a similar hyperemic response to exercise.

An in vitro experimental study and clinical applications of MR angiography with low-dose contrast agent of lower limb arteries at 3.0 T / 中华放射学杂志

Objective To evaluate the feasibility and diagnostic accuracy of CE-MRA with low dose contrast agent by comparison with DSA in diabetic patients with peripheral arterial diseases. Methods ( 1 )Study in vitro: test tubes containing Gd-DTPA of different concentrations were scanned, and the relationship between signal intensities and concentrations of GD-DTPA was analyzed. DSA and CE-MRA with selected concentrations of Gd-DTPA were performed on stenotic vascular models to estimate the proper low dose of GD-DTPA for clinical applications. (2) Clinical applications: 78 diabetic patients with peripheral arterial diseases were scanned from the abdomen and pelvis station to the calf-foot station in a 3 T MR system with standard bolus chase 3D CE-MRA sequence after injection of 13 ml GD-DTPA . The image quality,diagnostic rate of stenosis of arteries in calf and degree of venous contamination were evaluated with Fisher's exact test. DSA images of 220 vascular segments in 22 patients ( 10 segments per patient) were acquired as the gold standard and compared with CE-MRA by using Kappa test. Results The MR signal intensities were proportional to the concentrations of contrast agent in present study, and all stenotic segments of vascular model were displayed by CE-MRA with GD-DTPA at lower concentration of 1.5 mmol/L. As for MRA images of 78 diabetic patients with low dose Gd-DTPA, about 97.4% (76/78) showed diagnostic image quality for pelvic and thigh stations. But the MRA images of lower extremities were interfered by the venous contamination significantly (P ＜ 0.01 ). Compared with DSA for 22 patients, the diagnostic sensitivity, specificity and agreement coefficient (Kappa value) of MRA were 96. 0% ( 168/175), 73.3%(33/45), and 0.72 (P＜0.01), respectively. Conclusion Using 3.0 T MR scanner, high quality CE-MRA of lower limb arteries can be obtained for clinical applications with contrast agent dose as low as 13 ml,which has comparable diagnostic sensitivity and specificity with DSA. But the limitation of venous contamination in MRA image should be resolved in further studies.

Correlation between the ratio of intima/media thickness and inflammatory factors in renal small artery of diabetic nephropathy rats / 中华肾脏病杂志

Objective To observe the change of intima/media thickness ratio and expression of inflammatory factors in renal small artery of diabetic rats, and to explore the correlations of intim/media ratio with inflammatory factors and vascular lesions of diabetic nephropathy (DN) rats. Methods Seventy healthy SD rats were randomly divided into diabetic nephropathy group (DN, n=40) and normal control group (N, n=30). DN rat model was induced by intraperitoneal injection of streptozotocin (STZ). Thirty-five DN rats were successfully established. N group received same dose of citrate buffer. Rats were sacrificed after 4, 12, 24 weeks respectively.The intima/media thickness ratio in renal small artery was detected by immunofluorescence. The monocyte chemoattractant protein-1 (MCP-1) protein and mRNA expression of renal small artery were detected by immunohistochemistry and in-situ hybridization at each time point. Results Blood glucose and urine protein excretion (24 h) at different time points in DN group were significantly higher than those of N group (P＜0.05). From the 12th week, Scr, BUN, serum phosphorus were significantly higher than those of N group (P＜0.05). At the 4th week, renal small artery had the expression of MCP-1 protein and mRNA. The expression increased gradually with time, reached the highest at the 24th week, and was significantly higher than that of N group at each time point (P＜0.05). Immunofluorescence results showed that as compared to N group, in the first 4 weeks, intima/media thickness ratio in DN group was not different, at the 12th week the ratio was higher but without significant difference, at the 24th week the ratio was significantly higher (P＜0.05). Small artery intima/media thickness ratio of DN group was positively correlated with MCP-1, cholesterol, triglyceride, serum phosphate (r=0.742, P＜0.01; r=0.740, P＜0.01; r=0.829, P＜0.01; r=0.580, P＜0.01). Conclusions The arterioles intima/media thickness ratio of early DN is significantly correlated with MCP-1, lipids and phosphorus. MCP-1 may be involved in the DN vascular disease.

Efeito da poluição atmosférica urbana da cidade de São Paulo nas células sangüíneas e no sistema cardiopulmonar: estudo morfo-funcional em camundongos in vivo / Effect of urbain air pollution of Sao Paulo city in the blood and cardiopulmonary system: a morpho-functional study in mice in vivo

Objetivo: checar se poluentes do ar urbano de São Paulo induzem alterações sangüíneas e cardiopulmonares. MM: camundongos Balb/c foram expostos por 7, 14, 21, 30 e 45 dias em 3 câmaras: Limpa (controle), Intermediária (seletiva ao PM) e Suja (ar externo). Após exposição, os animais foram ventilados (FlexiVent) e coletados dados de mecânica pulmonar, sangue, coração e pulmão. Foram registrados PM, CO, SO2 e NO2 diários. Resultados: aos 21 e 45 dias coincidentes com picos de poluição houve aumento da resistência de via aérea (45d p=0,012), leucocitose (21d p < 0,001 e 45d p=0,039) e vasoconstricção pulmonar (21d p=0,034) nos animais da Câmara Suja, sem alteração de coronárias. Nenhum poluente excedeu limites de qualidade de ar.

Objective: verify if air pollution of São Paulo city induces alterations in blood and cardiopulmonary systems. MM: Balb/c mice were exposed during 7, 14, 21, 30 and 45 days to 3 chambers: Clean (control), Intermediate (PM only) and Dirty (external air). After exposure, animals were ventilated (FlexiVent) and collected lung mechanics data and blood, heart and lung. PM, CO, SO2 e NO2 were measured daily. Results: on day 21 and 45, coincidently to peak of pollutions, there was proximal airway resistance increase (45d p=0.012), leukocytosis (21d p < 0.001 and 45d p=0.039) and vasoconstriction of peribronchiolar arterioles (21d p=0.034) in animals of Dirty Chamber with no alterations of coronaries. Neither pollutants exceeded the standard limits.

E-Flow imaging on detection of the fingertip's microvascular changes of hemodynamics in patients with essential hypertension / 中华超声影像学杂志

objective To assess relationship between microvascular changes of hemodynamics of the fingertip and evolution of hypertension in patients with essential hypertension(EH)by enhanced power Doppler imaging(E-Flow).Methods The right ring fingertip'S blood flow peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI)of finger ventral arteriole and nail bed arteriole in thirty-nine patients with EH were separately observed and were made contrast with 35 age-matched healthy subjects by E-Flow imaging.Results Compared with traditional colour Doppler flow imaging and power Doppler imaging,E-Flow imaging was clearer to demonstrate the distribution and movement of the fingertip'S microvascular.It was shown that the PSV and EDV in the ring finger ventral arteriole and nail bed arteriole of EH were decreased(P＜0.05),but the RI increased(P＜0.05),along with the evolution of EH.Conclusions Fingertip'S microvascular changes of hemodynamics could be a criterion to detect obstruction alternations of essential hypertension.E-Flow imaging iS superior to traditional color Doppler flow imaging and power Doppler imaging in differentiating microvascular and could provide a new method in assessing microvacular changes of patients with EH for clinic.

The cause of impairment of gallbladder emptyingin patients with gallstone and diabetes mellitus / 重庆医科大学学报

Objective:To investigate the abnormity of arterioles in gallbladder and its relation with gallbladder hypomotility in patients with gallstone and diabetes mellitus.Methods:30 patients with simple gallstone and 30 patients with gallstone accompanied with diabetes mellitus were analyzed.Their gallbladder emptying function was measured with B ultrasound before operation.After operation,the arterioles of gallbladder rinsed with PAS reagent in photos were analyzed in tubular area and stereo system with BEIHANG CM-2000B biological and medical photo system.Results:The gallbladder volumes of fasting(V 0),two hours after eating(V 2) increased (59.3?0.6 vs 37.9?5.4,44.7?6.6 vs 14.3?4.9 respectively),whilethe ejective volume of bile(EV) and the ejective rate of gallbladder two hours after eating[GBEF 2 (%)] decreased in patients with diabetes mellitus(14.5?7.1 vs 23.4?9.3,24.9?12.7 vs 61.5?8.5,respectively).In patients with gallstone and diabetes mellitus,the area ratio of arterioles wall to whole arterioles in cross section was significantly higher than in the patients with simple gallstone(0.81 ?0.09 vs 0.58?0.15, P 0.05).Conclusion:The emptying function is significantly impaired in patients with gallstone and diabetes mellitus.The sedimentation of PAS positive material in the wall of arterioles lead to the stenosis of arterioles,and it is probably the cause for gallbladder hypomotility.

Experimental study on etiology and pathogenesis of the small intracranial aneurysm in rabbit / 中华神经科杂志

Objective To invectigate the etiology and pathogenesis of intracranial aneurysm. Methods Four experimental animal models of intracranial aneurysm were established with normal horse serum injected into veins or the neck regions, or into both common carotid arteries which were narrowed, by using silk ligature or noradrenalin injection into the neck regions. Results Ten intracranial aneurysms were found in the experimental animal model.Conclusion The immunological response,arteryischemia and continuous vasospasm may be considered the direct pathogenic factors of the intracranial aneurysm.

The Effects of Choto-San (Diao-Teng-San) on Blood Pressure and Narrowing of the Retinal Arterioles in SHR and SHRSP / 日本東洋医学雑誌

It has been reported that Choto-san (diao teng san) is effective for the treatment of patients suffering from hypertension. Narrowing of the retinal arterioles is one of the important findings in hypertension.<br>The authors examined the pharmacological effects of Choto-san on the blood pressure and narrowing of the retinal arterioles in spontaneously hypertensive rats (SHR) and strokeprone SHR (SHRSP).<br>SHR and SHRSP rats (nine treatment cases and five control cases) were used. 200mg/kg/day of Choto-san was administered orally to the SHR and SHRSP for 12 weeks. After the 12 weeks of administration, the blood pressure was measured by the tailcuff method. Narrowing of the retinal arterioles was measured by the percentage ratio of the artery to vein caliber.<br>After three months of administration of Choto-san, the blood pressure of the SHR and SHRSP was shown to be significantly lower than that of the control. The percentage ratio of the artery to vein caliber in the treatment group was shown to be significantly higher than that of the control group SHR and SHRSP.<br>These findings suggest that Choto-san may lower the blood pressure and inhibit narrowing of the retinal arterioles in SHR and SHRSP.

Effects of Hypoxia on Calmodulin Levels of Lung Tissue and Intrapulmonary Arteriolar Wall in Young Pigs / 第三军医大学学报

The effects of chronic hypoxia on calmodulin levels of lung tissue and intrapulmonary arteriolar wall in young pigs were studied .The specimens of hypoxic animals were taken under hypoxic condition from the hypoxic animals. It was observed that (1) the swine exposed to chronic intermittent hypobaric hypoxia showed significant pulmonary prcssor response at 4000m simulated high altitude , (2) the calmodulin level of lung was higher in hypoxic group than in sea level one , while that of intrapulmonary arteriolar wall exhibited no significant difference between hypoxic and control groups . The latter finding suggests that hypoxic pulmonary arteriolar constriction may not be associated with an obvious change of calmodulin level in vascular smooth muscle .

Vasodilating characteristics of iptakalim hydrochloride / 解放军医学杂志

Objective To observe the pharmacological characteristics of a novel antihypertensive drug iptakalim hydrochloride (Ipt) by dilating large and small arteries. Methods The vasodilating action of Ipt was studied using isolated rat tail artery helical strips and aortic rings. Results The vasodilating action of Ipt at 10 7-10 3mol/L was observed in rat tail artery strips precontracted with potassium chloride (KCl) in a concentration and endothelium dependent manner, but no significant vasodilating effect was seen on rat aortic rings. Ipt-induced relaxation in tail artery was significantly greater in spontaneous hypertensive rats than that in normotensive rats. The vasodilating actions of Ipt in small arteries could be markedly antagonized by glibenclamide, an inhibitor of ATP-sensitive potassium channels. Conclusion The results suggest that iptakalim hydrochloride has a selective vasodilating action in small arteries, and the action is related to activation of ATP-sensitive potassium channels.