Analysis of Factors Affecting Concentrations and Concentration-To-Dose Ratios of Trazodone.

BACKGROUND: Trazodone is prescribed for several clinical conditions. Multiple factors may affect trazodone to reach its therapeutic reference range. The concentration-to-dose (C/D) ratio can be used to facilitate the therapeutic drug monitoring of trazodone. The study aimed to investigate factors on the concentrations and C/D ratio of trazodone. METHODS: This study analyzed the therapeutic drug monitoring electronic case information of inpatients in the First Hospital of Hebei Medical University from October 2021 to July 2023. Factors that could affect the concentrations and C/D ratio of trazodone were analyzed, including body mass index, sex, age, smoking, drinking, drug manufacturers, and concomitant drugs. RESULTS: A total of 255 patients were analyzed. The mean age was 52.44 years, and 142 (55.69%) were women. The mean dose of trazodone was 115.29 mg. The mean concentration of trazodone was 748.28 ng/mL, which was in the therapeutic reference range (700-1000 ng/mL). 50.20% of patients reached the reference range, and some patients (36.86%) had concentrations below the reference range. The mean C/D ratio of trazodone was 6.76 (ng/mL)/(mg/d). A significant positive correlation was found between daily dose and trazodone concentrations (r 2 = 0.2885, P < 0.001). Trazodone concentrations were significantly affected by dosage, sex, smoking, drinking, and concomitant drugs of duloxetine or fluoxetine. After dosage emendation, besides the above factors, it was influenced by age ( P < 0.05, P < 0.01, or P < 0.001). CONCLUSIONS: This study identified factors affecting trazodone concentrations and C/D ratio. The results can help clinicians closely monitor patients on trazodone therapy and maintain concentrations within the reference range.

Association between early-life factors and pubertal timing in girls / 中国当代儿科杂志

OBJECTIVES@#To study the association between early-life factors (including birth weight, method of birth, gestational age, and history of gestational metabolic disorders) and pubertal timing in girls.@*METHODS@#The stratified cluster sampling method was used to select the girls in grades 2-3 and 7-8 from three primary schools and three middle schools in Guangzhou, China from March to December, 2019, and breast development was examined for all girls. A questionnaire survey was performed to collect the information on early-life factors. The multivariate logistic regression model was used to evaluate the association of gestational metabolic disorders, birth weight, method of birth, and gestational age with pubertal timing in girls. The Bootstrap method was used to assess the mediation effect of body mass index (BMI) (Z score) between high birth weight (≥4 000 g) and pubertal timing.@*RESULTS@#A total of 1 665 girls were enrolled, among whom 280 (16.82%) were judged to have early pubertal timing. The multivariate logistic regression analysis showed that high birth weight was associated with the increased risk of early pubertal timing (OR=2.12, 95%CI: 1.19-3.66, P=0.008). Nevertheless, no significant association was observed between other early-life factors and pubertal timing (P>0.05). The OR for the mediation effect of BMI (Z score) between high birth weight and early pubertal timing was 1.25 (95%CI: 1.09-1.47), accounting for 29.33% of the total effect of high birth weight on early pubertal timing.@*CONCLUSIONS@#High birth weight is associated with the increased risk of early pubertal timing in girls, and overweight/obesity may play a partial mediating role in the association between high birth weight and early pubertal timing in girls.

Significance of early lymphocyte-platelets ratio on the prognosis of patients with extensive burns / 中华烧伤杂志

Objective: To analyze the changing trend and characteristics of lymphocyte-platelets ratio (LPR) of early stage in patients with extensive burns, and to explore the prognostic significance of LPR. Methods: A retrospective case series study was conducted. From January 2008 to December 2018, 244 patients with extensive burns were admitted to the First Affiliated Hospital of Naval Medical University, including 181 males and 63 females, aged (44±16) years. The total burned area of patients was 60.0% (42.0%, 85.0%) total body surface area. Platelet and lymphocyte test results of patients were collected on the 1st, 2nd and 3rd day after admission, and LPR of patients was calculated to analyze the changing trend of the three days after admission. Univariate and multivariate logistic regression analysis were conducted to investigate the risk factors or independent risk factors for death of patients, including age, sex, total burn area, area of full-thickness burns and above, inhalation injury, and LPR. According to the 1st day's LPR after admission of patients, the receiver operating characteristic (ROC) curve predicting death of patients was drawn to find the optimal value of LPR. Patients were divided into high LPR group (n=136) and low LPR group (n=108) based on the optimal value of LPR, and the clinical data of total burn area, area of full-thickness burns and above, inhalation injury, tracheotomy, offline time of patients within 28 days, and mortality in the 2 groups were compared. The surviving curve of patients was drawn by Kaplan-Meier method to predict the difference of the 90-day survival rate between the two groups of patients. Data were statistically analyzed with Student's t test, Mann-Whitney U test, and chi-square test. Results: Within 3 days of admission, the LPR of patients showed a time-dependent upward trend. LPR of patients on the 2nd and 3rd day after admission was 8.6 (5.3, 14.4) and 8.6 (4.9, 13.7), respectively, which were significantly higher than the 1st day's 6.3 (4.2, 9.8), with Z values of -4.25 and -3.43, respectively, P<0.01. Univariate logistic regression analysis showed that age, total burn area, area of full-thickness burns and above, inhalation injury, and LPR were all risk factors for death of patients (with odds ratios of 1.03, 1.73, 1.31, 4.74, and 3.11, respectively, 95% confidence intervals of 1.01-1.06, 1.40-2.13, 1.21-1.42, 1.62-13.86, and 1.41-6.88, respectively, P<0.01). Multivariate logistic regression analysis showed that age, area of full-thickness burns and above, and LPR were independent risk factors for death of patients (with odds ratios of 1.06, 1.36, and 2.85, respectively, 95% confidence intervals of 1.03-1.09, 1.19-1.55, 1.02-7.97, P<0.05 or P<0.01). The area under ROC curve of the 1st day's LPR, predicting death of patients, was 0.61 (with 95% confidence interval of 0.51-0.71, P<0.05), and the optimal predicted value was 5.8 with corresponding sensitivity of 77% and specificity of 52% respectively. The total burn area, area of full-thickness burns and above, rates of incidence of inhalation injury, tracheotomy, and mortality of patients in high LPR group were significantly higher than those in low LPR group (with Z values of -3.06 and -3.19, χ2 values of 5.42, 11.64, and 8.45, respectively, P<0.05 or P<0.01). The offline time of patients within 28 days in high LPR group was significantly shorter than that in low LPR group (Z=-2.98, P<0.01). Kaplan-Meier survival analysis showed that the 90-day survival rate of admission of patients in low LPR group was significantly higher than that of patients in high LPR group (χ2=8.24, P<0.01). Conclusions: The early LPR of patients with extensive burns showed a time-dependent upward trend. The LPR on the first day after admission that is closely correlated with total burn area, area of full-thickness and deeper burns, inhalation injury, tracheotomy, and mortality of patients, is an independent risk factor for the prognosis of patients with extensive burns. The first day's LPR after admission is significantly correlated with the 90-day survival rate of patients, which can be used as an evaluation index for the severity of extensive burns.

Research progress on the relationship between liver cirrhosis and thyroid hormones / 中华肝脏病杂志

There exists a complex relationship between liver and thyroid hormones. Liver plays an important role in the activation, inactivation, transportation, and metabolism of thyroid hormones. At the same time, thyroid hormones also affect hepatocytes activity and liver metabolism, such as lipid and bilirubin metabolism. Importantly, thyroid hormone levels often change abnormally in patients with liver cirrhosis. Therefore, studying the change of thyroid hormone levels in patients with liver cirrhosis has a certain clinical value for assessing the severity, prognosis, diagnosis and treatment. This paper reviews the research progress on the relationship between liver cirrhosis and thyroid hormone.

Association of Preadmission Statin Use and Mortality in Critically Ill Patients: A Meta-Analysis of Cohort Studies.

Background: A large number of studies have been conducted to determine whether there is an association between preadmission statin use and improvement in outcomes following critical illness, but the conclusions are quite inconsistent. Therefore, this meta-analysis aims to include the present relevant PSM researches to examine the association of preadmission use of statins with the mortality of critically ill patients. Methods: The PubMed, Web of Science, Embase electronic databases, and printed resources were searched for English articles published before March 6, 2020 on the association between preadmission statin use and mortality in critically ill patients. The included articles were analyzed in RevMan 5.3. The Newcastle-Ottawa Scale (NOS) was used to conduct quality evaluation, and random/fixed effects modeling was used to calculate the pooled ORs and 95% CIs. We also conducted subgroup analysis by outcome indicators (30-, 90-day, hospital mortality). Results: All six PSM observational studies were assessed as having a low risk of bias according to the NOS. For primary outcome-overall mortality, the pooled OR (preadmission statins use vs. no use) across the six included studies was 0.86 (95% CI, 0.76-0.97; P = 0.02). For secondary outcome-use of mechanical ventilation, the pooled OR was 0.94 (95% CI, 0.91-0.97; P = 0.0005). The corresponding pooled ORs were 0.67 (95% CI, 0.43-1.05; P = 0.08), 0.91 (95% CI, 0.83-1.01; P = 0.07), and 0.86 (95% CI, 0.83-0.89; P < 0.00001) for 30-, 90-day, and hospital mortality, respectively. Conclusions: Preadmission statin use is associated with beneficial outcomes in critical ill patients, indicating a lower short-term mortality, less use of mechanical ventilation, and an improvement in hospital survival. Further high-quality original studies or more scientific methods are needed to draw a definitive conclusion.

Assessment of the long-term leaching characteristics of cement-slag stabilized/solidified contaminated sediment.

The use of stabilized/solidified (S/S) soils and sediments as sustainable construction materials is a global concern due to the potential risk of contaminant leaching including potentially toxic elements. The long-term leachability of four metals (Zn, Pb, Cd and As) in sediments mixed with OPC (Ordinary Portland Cement) and OPC/GGBS (Ground Granulated Blast Furnace Slag) binders were investigated through a combination of tank leaching tests and kinetic leaching models, with varying ranges of curing ages and ambient pH. The leaching data revealed that both binder compositions offer an excellent immobilization capacity for the four metals, while their releases are strongly pH-dependent and are a complex function of curing time. The partial replacement of OPC by GGBS is more effective for fixing Zn and As at pH of 1, Pb at pH of 7, Zn and Pb at pH of 10. Controlling leaching mechanisms and leachability indices were determined using nonlinear regression analysis and kinetic leaching models. The first-order diffusion model (FRDM) was the most applicable model for describing the leaching characteristics of these metals under the investigated cases, the leaching rate is controlled by surface wash-off initially and then by diffusion. The leachability indices indicate that the cement-slag S/S sediment can be regarded as an environmentally sustainable material with potential beneficial uses in construction.

Association analysis between extracurricular physical activity and dyslipidemia among primary, middle and high school students in Guangzhou / 中华心血管病杂志

Objective: To investigate the prevalence of dyslipidemia, and to explore the association between extracurricular physical activity and dyslipidemia among primary, middle and high school students in Guangzhou. Methods: This cross-sectional study selected primary and middle school students in Guangzhou by the stratified cluster sampling method from March to December 2019. Physical examination and blood lipid test were performed. Information about students' basic characteristics and extracurricular physical activity was collected by questionnaire. Multivariate logistic regression analysis was used to determine the association between extracurricular physical activity and dyslipidemia in this cohort. Results: A total of 7 797 participants (mean aged (12.2±2.9) years) were included (4 194 (53.79%) boys and 3 603 (46.21%) girls]. The detection rates of high total cholesterol, high triglycerides, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol and dyslipidemia were 12.49% (974/7 797), 6.44% (502/7 797), 6.62% (516/7 797), 11.31% (882/7 797) and 23.83% (1 858/7 797), respectively. Dyslipidemia rate was lower in the junior school students (21.39% (675/3 156)) than in primary school students (25.96% (896/3 451)) and high-school students (24.12% (287/1 190)) (P<0.001). The dyslipidemia rates of boys and girls were similar (23.15% (971/4 194) vs. 24.62% (887/3 603), P>0.05). Dyslipidemia rate was lower in students with extracurricular physical activity than in students without extracurricular physical activity (22.50% (923/4 102) vs. 25.30% (935/3 695), P<0.05). Multivariate logistic regression analysis showed that extracurricular physical activity was associated with lower risk of dyslipidemia (OR=0.88, 95%CI=0.79-0.99, P=0.033). Among all types of extracurricular physical activities, participating in extracurricular large ball game was associated with 28% lower risk among junior school students (OR=0.72, 95%CI=0.57-0.91, P=0.006). Conclusion: The prevalence of dyslipidemia is high among primary, middle and high school students in Guangzhou. Extracurricular physical activity is associated with reduced risk of dyslipidemia in this cohort.

Analysis for body composition status and development pattern of children and adolescents aged 6-17 years in Guangzhou / 中华实用儿科临床杂志

Objective:To analyze the current status of body composition and development patterns of children and adolescents aged 6-17 years in Guangzhou.Methods:This was a cross-sectional study involving 8 169 school students from 3 elementary schools and 3 middle schools in Guangzhou from March to December 2019.The fat-free mass (FFM) and fat mass (FM) were measured by the bioelectrical impedance analysis.The fat-free mass index (FFMI) and fat mass index (FMI) were calculated via the height standardization. T test was used to compare quantitative variables between groups.The growth pattern of body composition was described using the Hattori chart. Results:A total of 4 431 boys (54.24%) and 3 738 girls (45.76%) were involved in this study.FFM and FM both increased with age between boys and girls.Except for boys aged 11 years, FFM in boys were significantly higher than that in girls with the same age (all P<0.05). In the age of 7-10 years, FM in boys were significantly higher than that in girls with the same age, while it was significantly higher in girls aged 12 years and older than that of boys at the same age (all P<0.05). The Hattori chart showed that the difference in body composition between genders occurred after 11 years old.In contrast to girls, increases in the weight and body mass index (BMI) in boys were mainly attributed to the FFM development. Conclusions:The development of FFM and FM in children and adolescents varies with age, accompanied with the gender-specific features.FFM in boys is higher than that of girls at the same age.The weight gain in boys is mainly attributed to the development of fat-free tissues, and thus the utility of BMI may lead to the overestimation of obesity.

Dredged marine sediments stabilized/solidified with cement and GGBS: Factors affecting mechanical behaviour and leachability.

Management strategies for the safe disposal of contaminated dredged marine sediment constitute a global-scale environmental issue. The stabilization/solidification method was investigated as a sustainable approach to the recycling of the sediment as a construction material. A systematic study of the factors affecting the mechanical performance and contaminant release was performed. The physico-chemical variables selected to assess the potential re-use of the sediment treated with Ordinary Portland cement (OPC) and Ground Granulated Blast Furnace Slag (GGBS) in an aquatic environment were: curing duration (7, 28, 56 and 98 days), curing temperature (5, 20 and 40 °C) and ambient (leachate) pH (1, 4, 7 and 10). Unconfined compressive strength (UCS) tests were conducted and extended-duration tank leaching tests were used to characterize the long-term leaching of Al, Cr, Mn, Fe, Ni, Cu, Zn, As, Cd, Ba, Pb. The results showed that S/S methods provide excellent immobilization of metals in marine sediment at a pH range of 4 to 10. Immobilization efficiencies of >99.9% for Mn, Fe, Zn, As, Ba, Pb and >97.8% for Al, Cu and Zn are reported over 100 days. GGBS replacement is an effective way to further improve sediment properties by enhancing strength, mitigating sediment alkalization and offering a better immobilization capacity for Fe, Ni and Zn. The release of metals (Al, Mn, Cu, As, Ba and Pb) was strongly associated with a coupling effect of the physico-chemical factors, with metal-specific responses to curing temperature, curing duration and pH. Mn mobility showed a dramatic sensitivity to ambient pH while Ba was less pH-dependent. Al release is related to strength and leached out by dissolution in all situations considered. Considering that dredged marine sediments may contain multiple metal contaminants which exhibit individual responses to remediation, treatment with GGBS may be considered a potentially suitable management option.

Liver Resection for Hepatocellular Carcinoma in Non-alcoholic Fatty Liver Disease: a Multicenter Propensity Matching Analysis with HBV-HCC.

BACKGROUND: The incidence of hepatocellular carcinoma (HCC) in non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. Higher perioperative risks may be anticipated due to underlying steatohepatitis, while long-term outcomes after liver resection are unknown. We sought to investigate outcomes after liver resection for NAFLD-HCC versus hepatitis B virus (HBV)-HCC using propensity score matching (PSM). METHODS: Consecutive patients who underwent liver resection for HCC between 2003 and 2014 were identified from a multicenter database. Patients with NAFLD-HCC were matched one-to-one to patients with HBV-HCC. RESULTS: Among 1483 patients identified, 96 (6.5%) had NAFLD-HCC and 1387 (93.5%) had HBV-HCC. Patients with NAFLD-HCC were older (median age 57 vs. 50 years), more often overweight (50.0% vs. 37.5%), less often to have cirrhosis (30.2% vs. 72.5%) and liver dysfunction (Child-Pugh B: 4.2% vs. 10.7%), had larger tumor size (median 7.2 vs. 6.2 cm) yet had better tumor differentiation (27.1% vs. 17.6%) compared with patients with HBV-HCC (all P < 0.05). Perioperative mortality and morbidity were comparable between the two groups (1.0% vs. 1.4% and 20.8% vs. 23.2%, both P > 0.05). No differences were noted in median OS and RFS among patient with NAFLD-HCC versus HBV-HCC before or after PSM. CONCLUSION: While patients with NAFLD-HCC had different clinical characteristics than patients with HBV-HCC, liver resection resulted in similar perioperative outcomes and comparable OS and RFS among patients with NAFLD-HCC and HBV-HCC.

Comparison of antithrombotic effects between salvianolic acid A and aspirin / 药学学报

This study was designed to compare the antithrombotic effects of salvianolic acid A and aspirin. The anti-platelet aggregation and anticoagulant effects of salvianolic acid A and aspirin in vitro and in vivo were investigated in normal rats. The anti-cerebral ischemia and anti-platelet aggregation effects of salvianolic acid A and aspirin were also investigated in rats with thrombotic cerebral ischemia. All animal care and experimental procedures were reviewed and approved by the Animal Ethics Committee of Chinese Academy of Medical Sciences. The results of antiplatelet aggregation in vitro and in vivo showed that salvianolic acid A could mildly inhibit adenosine diphosphate (ADP), arachidonic acid (AA) and thrombin (THR)-induced antiplatelet aggregation in a dose-dependent manner, while aspirin played a strong inhibitory effect on AA-induced platelet aggregation in vivo. The effects of salvianolic acid A and aspirin on the coagulation system were similar. At the same time, the results of maximum platelet aggregation rate (MAR) in the rat cerebral ischemia model [MARADP= (41.67±4.55)%, MARAA= (53.22±2.83)%, MARTHR= (73.33±5.04)%] indicated that salvianolic acid A could mildly inhibit ADP and AA-induced antiplatelet aggregation [MARADP= (26.13±4.60)%, MARAA= (35.53±13.73)%, P<0.01], while aspirin played a strong inhibitory effect on AA-induced platelet aggregation [MARAA= (8.13±2.99)%]. Salvianolic acid A (10 mg·kg-1) significantly improved the neurological function, cerebral infarction volume [(10.77±7.80)%] and brain edema [(79.72±0.83)%] compared with the model group [(43.50±12.69)%, (82.25±0.89)%] (P<0.01), while the effect of aspirin (100 mg·kg-1) was not obvious. The above results suggest that compared with aspirin, salvianolic acid A provided a mild inhibitory effect on platelet aggregation and protected against cerebral ischemia induced by thrombus. Therefore, salvianolic acid A has a good application prospect in the prevention and treatment of thrombotic diseases.

Research ideas on Tongmai Yangxin Prescription in treatment of coronary artery disease based on network pharmacology / 中草药

Coronary artery disease (CAD) is a complex, multifactorial, chronic disease and one of the most dangerous diseases to human health due to its high mortality. The single target drug therapy is widely used in the treatment of CAD, but it could not meet the demand of today's treatment of complex disease. However, traditional Chinese medicine (TCM) has a good effect in treating complex disease. Tongmai Yangxin Prescription, based on "Zhigancao Decoction", is used to cure cardiovascular disease. The formulae is developed by Professor Ruan Shi-yi who won the title of "Guo Yi Da Shi (master of national medicine)". The studies on the single herb which consists in Tongmai Yangxin Prescription, such as Rehmanniae Radix and Glycyrrhizae Radix, have been made considerable progress. But systematic research of Tongmai Yangxin Prescription is still unavailable. There is a certain risk when we use Tongmai Yangxin Prescription in clinic, as the molecular basis of the formulae is unclear. The approach of network pharmacology is to set up a model of the compound action of Tongmai Yangxin Prescription. Meanwhile the model is based on the experimental data from single herb or active ingredients. Then, drug-target network, CAD-pathway network, and CAD-symptom network could be built to explain the functional mechanism through the method of literature mining and data mining, combining the theory of TCM.

An improved method of electrode placement for ECG monitoring in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>This study examines the impacts of an improved electrode placement on the electrocardiogram (ECG) results in order to determine a better electrode placement for ECG monitoring in children.</p><p><b>METHODS</b>ECG was recorded using the traditional electrode placement and the modified electrode placement (with shortened electrode distance) respectively in 50 pediatric patients. The amplitudes of P wave and QRS wave on ECG by the two measurements were compared. Furthermore, the impacts of different body positions on the amplitudes of P wave and QRS wave were studied after applying the modified electrode placement.</p><p><b>RESULTS</b>There were no significant differences in the amplitudes of P wave and QRS wave on ECG by the traditional electrode placement and the modified electrode placement (P>0.05). When modified electrode placement was utilized, the body position change did not lead to significant changes in the amplitudes of P wave and QRS wave (P>0.05).</p><p><b>CONCLUSIONS</b>A satisfactory ECG can be obtained with the modified electrode placement independent of patient's body position, suggesting that the modified electrode placement can be used instead of the traditional placement in children.</p>

Meta analysis of XRCC3 Thr241Met polymorphism and lung cancer susceptibility of populations in East Asia

OBJECTIVE@#To assess the relation between XRCC3 Thr241Met polymorphism and lung cancer susceptibility of populations in East Asia.@*METHODS@#Related studies of XRCC3 Thr241Met polymorphism and lung cancer susceptibility of populations in East Asia were collected through searching the Pubmed, Embase Library, SPRINGER, CNKI and CSSCI.@*RESULTS@#According to the entry criteria, there were 8 case-control studies in the assessing system and there were 6 321 study cases, including 3 215 patients with lung cancer and 3 106 cases without cancers. Meta analysis results showed the combined OR value of the ratio of genotype Thr/Met+Met/Met and Thr/Thr was 1.03 (95%CI: 0.89-1.20) (P>0.05).@*CONCLUSIONS@#XRCC3 Thr241Met polymorphism may not related to lung cancer susceptibility of populations in East Asia. Allele 241Met did not increase the risk of lung cancer.

G-protein Coupled Estrogen Receptor 1 Expression in Primary Breast Cancers and Its Correlation with Clinicopathological Variables / 한국유방암학회지

PURPOSE: G-protein coupled estrogen receptor 1 (GPER) probably play important roles in the progression of breast cancer including endocrine therapeutic resistance. We evaluated GPER in primary breast cancers. METHODS: Immunohistochemistry was used to detect GPER in paraffin-embedded tissues of primary breast cancers from 423 patients and GPER expression was correlated with clinicopathological factors. RESULTS: GPER was expressed in 63.8% of specimens, coexpressed with estrogen receptor alpha (ERalpha) in 36.6% of tumors and was positive in 62.5% of the ERalpha-negative tumors. The expression of GPER had no relationship with the status of ERalpha, progesterone receptor and HER2. Although the expression of GPER was significantly inversely related with nodal status (p=0.045), no correlation between GPER expression and other clinicopathological variables (age, menstruation status, tumor size, stage, histologic grade, Nottingham Prognostic Index or pathological type) was found. CONCLUSION: GPER and ERalpha exhibited independent expression pattern of distribution in primary breast cancers. A long-term follow-up and a more definite molecular phenotype for ER are necessary in confirming studies.

Protective effects of metformin on low-density lipoprotein-induced endothelial dysfunction in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the protective effect of metformin on the endothelial function and the mechanisms in rats with low-density lipoprotein (LDL) injection.</p><p><b>METHODS</b>A single dose (4 mg/kg) of natural LDL was injected through the sublingual vein of rats to induce vascular endothelial dysfunction. Blood samples were then collected from the rats to detect the concentrations of malondialdehyde (MDA) and nitric oxide (NO), activity of superoxide dismutase (SOD) and serum lipid levels. The thoracic aorta of rats was obtained to assay acetylcholine (ACh)-induced endothelium-dependent relaxation (EDR) and sodium nitroprusside (SNP)-induced endothelium-independent relaxation. The effects of metformin pretreatment on the endothelial functions in the rats were investigated.</p><p><b>RESULTS</b>A single-dose LDL significantly inhibited ACh-induced EDR without affecting SNP-induced endothelial-independent relaxation. The injection decreased serum NO and elevated serum MDA level, but had no effect on serum lipid level. Metformin markedly attenuated LDL-induced inhibition of EDR, serum MDA elevation, and serum NO reduction without affecting the serum lipid levels.</p><p><b>CONCLUSION</b>Metformin provides protection against vascular endothelial dysfunction induced by LDL in rats, the mechanism of which is probably associated with protection of endothelium-dependent relaxation factor and inhibition of the oxidative stress.</p>

Transthoracic echocardiography in transcatheter closure of atrial septal aneurysm combined with secoundum-type atrial septal defect / 中南大学学报(医学版)

OBJECTIVE@#To explore the value of transthoracic echocardiography (TTE) in transcatheter closure of atrial septal aneurysm (ASA) combined with secoundum-type atrial septal defect (ASD).@*METHODS@#Fourteen patients (3 males and 11 females) who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography. The ASA projected to the right atrium in all patients. The width of basilar part was 13 approximately 24 (18.5+/-3.9) mm, and the vertical extent was 7 approximately 11(9.7+/-1.8) mm. Ten patients combined with single hole ASD and 4 patients with multiple hole ASD. Blood shifting from the left atrium to the right atrium was displayed in color Doppler in all patients. All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE, and examined with TTE during the follow-up.@*RESULTS@#Transcatheter closure was successfully performed by 14 occluders in all patients. No residual shunt was detected immediately by TTE after the procedure in all patients. During the 6 approximately 12 month follow-up, no residual shunt or occluder shifting was found, the dimensions of the heart became normal in 11 patients (79%) and were significantly decreased in 4.@*CONCLUSION@#Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD, and extra attention must be paid to the specialty. TTE is very important in case selection before transcatheter closure, and it may be used to monitor and guide the procedure during transcatheter closure.

Association of CALCA genetic polymorphism with essential hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Calcitonin gene-related peptide (CGRP) is the predominant neurotransmitter in capsaicin-sensitive sensory nerves. Participation of CGRP in hypertension is one of the most extensively studied topics in the field. There is growing evidence to the effect that CGRP is associated with essential hypertension (EH). The aims of this study were to pinpoint whether single nucleotide polymorphisms (SNPs) in the genes coding for CALCA were associated with EH susceptibility in a Hunan Han population.</p><p><b>METHODS</b>A total of 293 subjects with EH and 208 controls were enrolled in the study. Genomic DNA was extracted from peripheral blood leucocytes by a phenol-chloroform method. The CALCA T-692C was genotyped using a restriction fragment length polymorphism method.</p><p><b>RESULTS</b>A statistically significant difference in CALCA T-692C genotypic distribution was observed between cases and controls (P=0.001). Moreover, the frequencies of the C allele were 14.85% in the EH group and 7.45% in the control group, prevalence of C alleles in EH subjects and controls was significantly incomparable (P<0.001). Furthermore, the results of Logistic regression analysis showed that the carriers of C allele (TC+CC genotypes) were associated with increased EH risk (OR=2.093, 95% CI: 1.317-3.326, P<0.01).</p><p><b>CONCLUSIONS</b>CALCA genetic polymorphism is associated with EH susceptibility. Carriers of at least one C allele at the polymorphic site CALCA T-692C showed increased risk for EH.</p>

The effect of cyclooxygenase-2 on lymphangiogenesis in breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To study the effect of cyclooxygenase-2 (COX-2) on lymphangiogenesis in breast cancer.</p><p><b>METHODS</b>By the means of immunohistochemistry, COX-2, vascular endothelial growth factor-C (VEGF-C) and D2-40 were examined in the tissue samples of primary tumors from 94 patients underwent surgical resections for breast cancer from November 1998 to March 2002. Eighty-three patients were followed-up. The expressions of VEGF-C mRNA and protein were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot in MDA-MB-231 cell lines by the treatment of selective COX-2 inhibitor Nimesulide at different doses. The expressions of VEGF-C protein were evaluated in MDA-MB-231 cells treated by PGE2 (1 microg/ml) and Trastuzumab (1 microg/ml), respectively.</p><p><b>RESULTS</b>COX-2 over-expression was observed in 46.8% of surgical specimens (44/94), while VEGF-C overexpression occurred in 51.1% of tumor samples (48/94). COX-2 was strongly correlated with VEGF-C expression (P < 0.01), micro-lymphatic vessels (P = 0.032) and metastatic lymph nodes (P = 0. 035). Patients with COX-2 positive tumors had a significant shorter survival time than those with negative tumors did, including disease-free survival (P = 0.010) and overall survival (P = 0.040). Nimesulide could down-regulate the expressions of VEGF-C mRNA and protein in a does-dependent manner, while PGE2 could up-regulate the expressions. The expression of VEGF-C protein up-regulated by PGE2 treatment was decreased by Trastuzumab.</p><p><b>CONCLUSIONS</b>COX-2 over-expression can up-regulate the expression of VEGF-C. VEGF-C might promote lymph node metastasis by a lymph-angiogenic pathway, then affect the prognosis of the patients with breast cancer.</p>