Two-year changes of biochemical profiles and bone mineral density after percutaneous ultrasound-guided microwave ablation for primary hyperparathyroidism.

PURPOSE: To investigate the changes of the serum parathyroid hormone (PTH) and calcium level, as well as bone mineral density (BMD), after percutaneous ultrasound-guided microwave ablation (MWA) for primary hyperparathyroidism (pHPT) caused by single hyperfunctional nodule. METHODS: The study enrolled 20 patients with a total of 20 nodules of MWA treatment to pHPT in one session. The normalization rate of the serum PTH and calcium was evaluated at every 6 months during 2-year follow-up after MWA. The bone mineral density (BMD) at lumbar spine and femoral neck were also compared before and after the procedure. RESULTS: The normalization rate of both PTH and serum calcium at 6-, 12-, 24-month follow-up was 66.6%, 80.0%, and 62.5%, respectively. Though the normalization rate of serum calcium level at 6-, 12-, and 24-month visit after MWA was 100%. The BMD increased 12, 24 months after MWA at lumbar spine (1.022 ± 0.155, 1.057 ± 0.151 vs 0.965 ± 0.145 g/cm2, p < 0.01) and femoral neck at 2-year assessment (0.819 ± 0.094 vs 0.771 ± 0.102 g/cm2, p = 0.015). Seven nodules disappeared in 20 nodules (35.0%), average ablation time was 122.29 ± 107.54 s (34-460 s). Six patients encountered voice change during the procedure, one participant was confirmed recurrent laryngeal injuries but recovered within 2 months. CONCLUSIONS: Percutaneous ultrasound-guided microwave ablation results in improvement of biochemical profiles and bone mineral density in subjects with single hyperfunctional parathyroid nodule. However, the long-term efficacy of the MWA remains to be verified.

The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis.

The aim of the present study was to investigate the correlation of neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW) with diabetic nephropathy (DN) and diabetic retinopathy (DR). We searched for eligible studies from PubMed, Embase, Web of Science, and CNKI up to 1 December 2017. Standardized mean difference (SMD) was calculated with a confidence interval (CI) of 95%. A total of 48 studies were included in our meta-analysis. Compared with patients with type Ⅱ diabetes mellitus (T2DM) and without DR, NLR, MPV, and PDW were higher in patients with DR (SMD = 0.77; 95% CI: 0.49-1.05; P<0.001; SMD = 0.68; 95% CI: 0.36-0.99; P<0.001; SMD = 0.52; 95% CI: 0.28-0.76; P<0.01). Compared with patients with T2DM and without DN, NLR, MPV, and PDW were higher in patients with DN (SMD = 0.63; 95% CI: 0.43-0.83; P<0.001; SMD = 0.81; 95% CI: 0.36-1.25; P<0.001; SMD = 0.70; 95% CI: 0.50-0.90; P<0.001). We also found that MPV was strongly associated with the severity of DR, and NLR was closely related to the degree of DN. Our findings indicated that NLR, MPV, and PDW could be recommended as inexpensive diagnostic biomarkers for DN and DR. However, considering several limitations in the present study, further high-quality clinical studies should be performed to investigate the relationship of NLR, MPV, and PDW to DN and DR.

Angiotensin II receptor blocker valsartan ameliorates cardiac fibrosis partly by inhibiting miR-21 expression in diabetic nephropathy mice.

Cardiac fibrosis with diabetic nephropathy (DN) is one of major diabetic complications. miR-21 and MMP-9 were closely associated with fibrosis diseases. Angiotensin II receptor blockers (ARB) have cardioprotective effects. However, it remains unclear whether miR-21 was involved in the mechanism of cardiac fibrosis with DN by target MMP-9 and ARB ameliorates cardiac fibrosis partly by inhibiting miR-21 expression. In this study, In Situ Hybridization(ISH), RT-PCR, cell transfection, western blotting and laser confocal telescope were used, respectively. ISH showed that miR-21, concentrated in cytoplasmic foci in the proximity of the nucleus, was mainly localized in cardiac fibroblasts and at relatively low levels in cardiomyocytes within cardiac tissue with DN. RT-PCR showed that miR-21 expression was significantly enhanced in cardiac tissue with DN, accompanied by the increase of col-IV, FN, CVF, PVCA, LVMI, HWI and NT-pro-BNP (p < 0.05). Bioinformatics analysis and Luciferase reporter gene assays showed that MMP-9 was a validated target of miR-21. Furthermore, cell transfection experiments showed that miR-21 overexpression directly decreased MMP-9 expression. Interestingly, miR-21 levels in cardiac tissue was positively correlated with ACR (r = -0.870, P = 0.003), whereas, uncorrelated with SBP, HbA1C and T-Cho (p > 0.05). More importantly, ARB can significantly decrease miR-21 expression in cardiac tissue, cardiac fibroblasts and serum. Overall, our results suggested that miR-21 may contribute to the pathogenesis of cardiac fibrosis with DN by target MMP-9, and that miR-21 may be a new possible therapeutic target for ARB in cardiac fibrosis with DN.