[Analysis of influence of MR signs on Harris score in ARCO stages 2-4 femoral head necrosis].

OBJECTIVE: To analysis and determine MR signs of Harris score ARCO stages 2-4 in osteonecrosis of femoral head (ONFH). METHODS: Thirty-four patients with ONFH of ARCO stages 2 to 4 who underwent routine MR, T2 mapping, 3D-SPACE sequence examination and Harris score were retrospectively collected from January 2019 to June 2020, and 3 patients were excluded, and 31 patients were finally included, including 23 males and 8 females, aged from 18 to 62 years old with an average of(40.0±10.8) years old. Among them 21 patients with bilateral femoral head necrosis, totally 52 cases, including 17 with ARCO stage 2 patients, 24 ARCO stage 3, and 11 ARCO stage 4. MR imaging signs (femoral head collapse depth, ONFH index, bone marrow edema, hyperplasia, grade and T2 value of cartilage injury, and joint effusion) were scored and measured on the picture archiving and communication system (PACS) workstation, and the cartilage quantitative parameter T2 value was calculated and measured on Siemens postprocessing workstation. Pearson correlation analysis was used to evaluate the correlation between various MR signs and Harris score, and then multiple linear regression analysis was used to examine impact of MR signs on Harris hip score. RESULTS: Femoral head collapse depth(r=-0.563, P=0.000), grade of cartilage injury(r=-0.500, P=0.000), and joint effusion (r=-0.535, P=0.000) were negatively correlated with Harris score by Pearson correlation analysis. Multiple linear regression analysis showed that joint effusion(ß=-6.198, P=0.001) and femoral head collapse depth(ß=-4.085, P=0.014) had a significant negative impact on Harris hip score. CONCLUSION: Femoral head collapse depth and joint effusion both had significant negative relationship with Harris hip score. It is recommended to routinely evaluate femoral head collapse depth and joint effusion quantitatively and gradedly, so as to efficiently and accurately assist clinical diagnosis and treatment.

Zeolitic imidazolate framework-8 for selective extraction of a highly active anti-oxidant flavonoid from Caragana Jubata.

The medicinal compositions or active components in medicinal plants are the major sources to find new drugs or lead compounds. Exploring novel sorbents with good selectivity for extraction and separation of medicinal compositions or active components from complex medicinal plants are interesting and challenging. Metal-organic frameworks (MOFs) show great potential in adsorption and extraction recently. Herein, we report our primary attempt of zeolitic imidazolate framework-8 (ZIF-8) as a model MOF for selective extraction of a flavonoid named 3,4-dihydroxy-8,9-methylenedioxypterocarpan (compound 1) from a traditional medicinal plant Caragana Jubata. The enrichment factor of ZIF-8 for compound 1 is 57.7. The recoveries of compound 1 at three spiked levels (50, 100, 150 mg L-1) in Caragana Jubata dichloromethane extract are 62.1%, 66.4%, and 75.4%, respectively, with the relative standard deviations of less than 2.9%. The compound 1 also gave good linearity (R2 of 0.999) in the concentration range of 5-1000 mg L-1. The obtained compound 1 gave highly antioxidant activity (DPPH radical scavenging rate of 79.03%, inhibitory rate on lipid peroxidation of 75.30%, which were higher than the positive controls Vitamin C and BHT) and low IC50 values (5.438 ±â€¯0.068, 20.970 ±â€¯0.083 µg mL-1 for DPPH radical scavenging activities and inhibitory effects on lipid peroxidation, respectively). These results demonstrated the feasibility of MOFs in selective extraction of medicinal compositions or active components from complex medicinal plants. The current work may open a new way of MOFs in selective extraction of pharmacological active components from medicinal plants.

[Lignan glycosides and sucrose esters from roots of Securidaca inappendiculata].

Nine compounds, including five lignan glycosides (1-5), three sucrose esters (6-8), and one organic acid ester (9), were isolated from the ethanol extract of the roots of Securidaca inappendiculata by various chromatographic methods including silica gel, MPLC and preparative HPLC. Their structures were elucidated as acernikol-4″-O-ß-D-glucopyranoside (1), (7R, 8S)-dihydrodehydrodiconiferyl alcohol 9-O-ß-D-glucopyranoside (2), (7R, 8S)-dihydrodehydrodiconiferyl alcohol 4-O-ß-D-glucopyranoside (3), (7R, 8S)-dihydrodehydrodiconiferyl alcohol 9'-O-ß-D-glucopyranoside (4), (7R, 8S)-5-methoxydihydrodehy-drodiconiferyl alcohol 4-O-ß-D-glucopyranoside (5), 3, 6'-O-diferuloylsucrose (6), 3-O-feruloyl-6'-O-sinapoylsucrose (7), sibricose A5 (8), and mehyl ferulate (9) on the basis of 1H-, 13C-NMR and MS experiments. Compounds 1-5, 8, and 9 were isolated from the Securidaca genus for the first time. Compounds 2, 3, and 7 exhibited weak cytotoxic activities against Hela and MCF-7 cell lines.

SpinachDB: A Well-Characterized Genomic Database for Gene Family Classification and SNP Information of Spinach.

Spinach (Spinacia oleracea L.), which originated in central and western Asia, belongs to the family Amaranthaceae. Spinach is one of most important leafy vegetables with a high nutritional value as well as being a perfect research material for plant sex chromosome models. As the completion of genome assembly and gene prediction of spinach, we developed SpinachDB (http://222.73.98.124/spinachdb) to store, annotate, mine and analyze genomics and genetics datasets efficiently. In this study, all of 21702 spinach genes were annotated. A total of 15741 spinach genes were catalogued into 4351 families, including identification of a substantial number of transcription factors. To construct a high-density genetic map, a total of 131592 SSRs and 1125743 potential SNPs located in 548801 loci of spinach genome were identified in 11 cultivated and wild spinach cultivars. The expression profiles were also performed with RNA-seq data using the FPKM method, which could be used to compare the genes. Paralogs in spinach and the orthologous genes in Arabidopsis, grape, sugar beet and rice were identified for comparative genome analysis. Finally, the SpinachDB website contains seven main sections, including the homepage; the GBrowse map that integrates genome, genes, SSR and SNP marker information; the Blast alignment service; the gene family classification search tool; the orthologous and paralogous gene pairs search tool; and the download and useful contact information. SpinachDB will be continually expanded to include newly generated robust genomics and genetics data sets along with the associated data mining and analysis tools.

[Chemical Constituents from Caragana changduensis].

Objective: To study the chemical constituents of the red heartwood of the stems and roots of Caragana changduensis. Methods: The chemical constituents were isolated and purified by means of several column chromatographic techniques,and their structures were determined by spectroscopic methods. Results: Ten compounds were isolated and identified as kushenin( 1),( 6aR,11aR)-3-hydroxy-4,9-dimethoxy-pterocarpan( 2),(-)-4-methoxymaackiain( 3),(-)-homopterocarpin( 4),2,4-dimethoxybenzoic acid( 5),2-methoxy-4-ethoxybenzoic acid( 6),3-acetyl-oleanolic acid( 7),7-hydroxy-2,3-dimethylchromone( 8),liquiritigenin( 9),and ß-sitosterol( 10). Conclusion: Compounds 1,3,5,7,and 8 are obtained from this genus for the first time. All the compounds are obtained from this plant for the first time.

[Screening of active fractions with antithrombotic effect from Caragana jubata].

The antithrombotic effect of Caragana jubata (Pall.)Poir.ethanolic extract (TE)was evaluated by inferior vena cava thrombosis in rats and acute pulmonary thrombosis in mice. To search for the bioactive fractions of TE, comparison on acute pulmonary thrombosis was made between the two main fractions of TE (TE-1 and TE-2). Besides, pharmacological effects of TE, TE-1 and TE-2 on bleeding time and clotting time were also studied. Reference substances combined with UPLC/DAD-q-TOF-MS were applied to identify the main six compounds and other chemical constituents of the TE. The results showed that TE could significantly reduce the rat thrombosis weight in all doses (P<0.01) and improve the protective rate to mice in medium and high doses (P<0.05). TE-2 showed a stronger effect on protecting the mice from paralysis or death and prolonging the bleeding time and clotting time than TE-1. Chemical constituents in TE mainly include isoflavones, pterocarpans and stilbenoids. Constituents in TE-2 were mainly isoflavones and pterocarpans, while those in TE-1 were mainly stilbenoids, which could be inferred that all of these three kinds of constituents may be responsible for the antithrombotic effects of Caragana jubata.

[Saponins from roots of Securidaca inappendiculata with cytotoxic activities].

Seven acylated triterpene saponins were isolated from the roots of Securidaca inappendiculata by means of various chromatographic techniques such as silica gel, MPLC, preparative HPLC, and semi-preparative HPLC. Their chemical structures were identified as securioside A(1), securioside B(2), 3-O-ß-D-glucopyranosyl presenegenin 28-O-ß-D-xylopyranosyl-(1-->4)-α-L-rhamnopyranosyl-(1-->2)-[ß-D-glucopyranosyl-(1-->3)]-4-O-[(E)-3,4-dimethoxycinnamoyl]-ß-D-fucopyranosyl ester(3), 3-O-ß-D-glucopyranosyl presenegenin 28-O-ß-D-xylopyranosyl-(1-->4)-α-L-rhamnopyranosyl-(1-->2)-[ß-D-glucopyranosyl-(1-->3) ] -4-O-[(E/Z)-3, 4-dimethoxycinnamoyl]-ß-D-fucopyranosyl ester(3/4), 3-O-ß-D-glucopyranosyl presenegenin 28-O-α-L-arabinopyranosyl-(1-->3)-ß-D-xylopyranosyl-(1-->4)-α-L-rhamnopyranosyl-(1-->2)-4-O-[(E)-3,4-dimethoxycinnamoyl]-ß-D-fucopyranosyl ester(5), polygalasa- ponin XLV(6), and polygalasaponin XLVI (7) on the basis of spectroscopic data analysis and physicochemical properties. Among them, compounds 5-7 were isolated from the plants in genus Securidaca for the first time and compounds 3, 3/4 were isolated from the species for the first time. The cytotoxicity assay showed that compounds 2, 3/4, 5 have moderate cytotoxic activities against Lewis lung carcinoma LLC cells with IC50 values of 41.10, 38.17, and 48.92 µmol · L(-1), respectively; compound 2 exhibited moderate cytotoxic activities against human breast cancer MCF-7 cells with an IC50 value of 47.93 µmol · L(-1).

Investigation of phase effects of coherent beam combining for large-aperture ultrashort ultrahigh intensity laser systems.

Large-aperture ultrashort ultrahigh intensity laser systems are able to achieve unprecedented super-high peak power. However, output power from a single laser channel is not high enough for some important applications and it is difficult to improve output power from a single laser channel significantly in the near future. Coherent beam combining is a promising method which combines many laser channels to obtain much higher peak power than a single channel. In this work, phase effects of coherent beam combining for large-aperture ultrashort laser systems are investigated theoretically. A series of numerical simulations are presented to obtain the requirements of spatial phase for specific goals and the changing trends of requirements for different pulse durations and number of channels. The influence of wavefront distortion on coherent beam combining is also discussed. Some advice is proposed for improving the performance of combining. In total, this work could help to design a practical large-aperture ultrashort ultrahigh intensity laser system in the future.

[Isoflavonoids from Caragana changduensis and their nitric oxideinhibitory activities].

Ten isoflavonoids were isolated from the heartwoods of Caragana changduensis Lion f. by means of various column chromatographic techniques. Based on the detailed spectral data analysis (MS and NMR), as well as comparison with the literatures, their chemical structures were determined as 7,2'-dihydroxy-8,4'-dimethoxyisoflavone (1), 4'-hydroxy-7,3'-dimethoxyisoflavone (2), 5, 7, 4'-trihydroxy-2',5'-dimethoxyisoflavone (3), prunetin (4), afrormosin (5), odoratin (6), genistein (7), texasin (8), pratensein (9), and 6,7,3'-trihydroxy-4'-methoxyisoflavone (10). Among them, compounds 1-3 and 9-10 were isolated from the Caragana genus for the first time. All the compounds were obtained from this species for the first time. In the preliminary assays, compounds 1, 2, 6, and 7 possessed significant inhibitory effects on NO production, with IC50 values of 48.12, 25.32, 62.71, 43.59 µmol x L(-1), respectively.

Clinical analysis of the PADUA and the RENAL scoring systems for renal neoplasms: a retrospective study of 245 patients undergoing laparoscopic partial nephrectomy.

OBJECTIVE: To investigate the clinical significance of preoperative aspects and dimensions used for anatomic (PADUA) and radius exophytic/endophytic nearness anterior/posterior location (RENAL) scoring systems for renal neoplasms in patients undergoing laparoscopic partial nephrectomy. METHODS: A retrospective analysis was carried out on clinical data of 245 Chinese patients with renal neoplasms undergoing laparoscopic partial nephrectomy from June 2008 to June 2012. The perioperative complications and variables, as well as PADUA and RENAL score, were compared. RESULTS: The PADUA and RENAL scoring systems were significantly associated with percent change in estimated glomerular filtration rate (P = 0.032 and P = 0.026 respectively), whereas the RENAL scoring system was also significantly associated with warm ischemia time (P = 0.032). On multivariate analysis, both scores were able to predict percent change in estimated glomerular filtration rate (PADUA, P = 0.011; RENAL, P = 0.028). There were no significant associations between the two scoring systems assessed and the occurrence of complications or tumor stage. The correlation between PADUA classification and RENAL nephrometry score was significant (P < 0.0001). Fleiss' generalized kappa was 0.69-0.89 for the various components of the PADUA score and 0.67-0.89 for the RENAL nephrometry components. CONCLUSIONS: The PADUA classification and RENAL nephrometry score are comprehensive assessment tools for delineating renal tumor anatomy. The reproducibility of the PADUA and RENAL scores is substantial, but further research is required to evaluate its performance in more accurately predicting operative and patient-related outcomes.

[Analysis of risk factors of cardiogenic shock secondary to acute myocardial infarction].

OBJECTIVE: To explore risk factors for cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) patients arising from comorbidities so as to identify high risk patients earlier. METHODS: A retrospective study was conducted on 5523 patients who were hospitalized with AMI in PLA General Hospital from January 1993 to December 2009. The patients were divided into two groups based on presence or absence of CS. Logistic regression analysis was used from comorbidities to evaluate the independent risk factors for CS. RESULTS: Among 5523 hospitalized AMI patients, 197 (3.57%) developed CS. The 30-day in hospital mortality rate of CS group was significantly higher than that of non-CS group [55.33% (109/197) vs. 7.49% (399/5326), P<0.001]. On the basis of logistic regression analysis, advanced age [odds ratio (OR)=1.03, 95% confidence interval (95%CI) 1.02 - 1.05, P<0.001], previous attack of myocardial infarction (OR=1.57, 95%CI 1.13 - 2.19, P=0.007), history of stroke (OR=1.98, 95%CI 1.20 - 3.27, P=0.008), chronic renal failure (OR=1.76, 95%CI 1.23 - 2.51, P=0.002) and pneumonia (OR=1.72, 95%CI 1.17 - 2.52, P=0.006) were independent risk factors for CS. Using receiver operator characteristic curve (ROC curve) analysis, the model was shown a good quality to judge the outcome of CS patients as the area under curve equals 0.81 (95%CI 0.75 - 0.85, P<0.001). CONCLUSIONS: Advanced age and comorbidities including previous myocardial infarction, previous stroke, chronic renal failure and pneumonia were independent risk factors for CS.

[Optimization of supercritical fluid extraction of bioactive components in Ligusticum chuanxiong by orthogonal array design].

With the yields of ferulic acid, coniferylferulate, Z-ligustilide, senkyunolide A, butylidenephthalide, butylphthalide, senkyunolide I, senkyunolide H, riligustilide, levistolide A, and total pharmacologically active ingredient as evaluation indexes, the extraction of Ligusticum chuanxiong by supercritical fluid technology was investigated through an orthogonal experiment L9 (3(4)). Four factors, namely temperature, pressure, flow rate of carbon dioxide, co-solvent concentration of the supercritical fluid, were investigated and optimized. Under the optimized conditions, namely 65 degrees C of temperature, 35 MPa of pressure, 1 L x min(-1) of CO2 flow rate, 8% of co-solvent concetration, supercritical fluid extraction could achieve a better yield than the conventional reflux extraction using methanol. And the supercritical fluid extraction process was validated to be stable and reliable.

[Clinical analysis of the application of R.E.N.A.L. nephrometry score for the nephron sparing surgery].

OBJECTIVE: To investigate the clinical significance of R.E.N.A.L. nephrometry score for renal neoplasms in patients undergoing nephron sparing surgery. METHODS: A retrospective analysis was conducted of clinical data of 110 patients with renal neoplasms undergoing nephron sparing surgery, who were admitted to Peking University First Hospital from January 2010 to January 2012. The operation approaches, perioperative variables and perioperative complications as well as R.E.N.A.L. scores were compared. RESULTS: The R.E.N.A.L. nephrometry score was significantly associated with the operation approach (P<0.001), while there was no significant association between the scoring system and the occurrence of complications (P<0.611). Meanwhile, it was associated with ischemia time (P<0.023) and percentage change in the creatinine level (P<0.025). Low complexity tumors had significantly shorter ischemia time and low percentage change in the creatinine level than high complexity tumors (P<0.008, P<0.010). Fleiss' generalized kappa was 0.52 to 0.89 for the R.E.N.A.L. nephrometry components. CONCLUSION: The R.E.N.A.L. nephrometry score is a comprehensive assessment tool for delineating renal tumor anatomy. The reproducibility of R.E.N.A.L. nephrometry scores is substantial, but further research is required to evaluate its performance in predicting operative outcomes more accurately.

[Rapid identification of micro-constituents in monoammonium glycyrrhizinate raw materials by high-pressure solid phase extraction-high performance liquid chromatography-mass spectrometry].

OBJECTIVE: To establish a method for rapid identification of micro-constituents in monoammonium glycyrrhizinate by high-pressure solid phase extraction-high performance liquid chromatography-mass spectrometry. METHOD: HPLC preparative chromatograph was adopted for determining the optimal method for high-pressure solid phase extraction under optimal conditions. 5C18-MS-II column (20.0 mm x 20.0 mm) was used as the extraction column, with 35% acetonitrile-acetic acid solution (pH 2. 20) as eluent at the speed of 16 mL x min(-1). The sample size was 0.5 mL, and the extraction cycle was 4.5 min. Then, extract liquid was analyzed by high performance liquid chromatography-mass spectrometry (HPLC-MS) after being concentrated by 100 times. RESULT: Under the optimal condition of high-pressure solid phase extraction-high performance liquid chromatography-mass spectrometry, 10 components were rapidly identified from monoammonium glycyrrhizinate raw materials. Among them, the chemical structures of six micro-constituents were identified as 3-O-[beta-D-glucuronopyranosyl-beta-D-glucuronopyranosyl]-30-0-beta-D-apiopyranosylglycyrrhetic/3-O- [P-D-glucuronopyranosyl-beta-D-glucuronopyranosyl]-30-O-beta-D-arabinopyranosylglycyrrhetic, glycyrrhizic saponin F3, 22-hydroxyglycyrrhizin/18alpha-glycyrrhizic saponin G2, 3-O-[beta-D-rhamnopyranosyl]-24-hydroxyglycyrrhizin, glycyrrhizic saponin J2, and glycyrrhizic saponin B2 by MS(n) spectra analysis and reference to literatures. Four main chemical components were identified as glycyrrhizic saponin G2, 18beta-glycyrrhizic acid, uralglycyrrhizic saponin B and 18alpha-glycyrrhizic acid by liquid chromatography, MS(n) and ultraviolet spectra information and comparison with reference substances. CONCLUSION: The method can be used to identify chemical constituents in monoammonium glycyrrhizinate quickly and effectively, without any reference substance, which provides basis for quality control and safe application of monoammonium glycyrrhizinate-related products.

[Tortuosity and kinking of cervical segment of internal carotid artery: an analysis of 7 cases].

OBJECTIVE: To outline the clinical manifestations and compare the different radiological methods of detecting malformation of cervical segment of internal carotid artery. METHODS: A retrospective analysis of 7 cases with malformation of cervical segment of internal carotid artery between May, 2004 and April, 2011. CT angiography (CTA) and magnetic resonance angiography (MRA) were used to detect the morphology of cervical segment of internal carotid artery. RESULTS: This disease entity provided no obvious symptoms in five cases, and such complains as pharyngeal foreign body sensation in one and odynophagia in another. Physical examination showed a bulge with pulsation on pharyngeal wall in four cases, and apparent normal pharynges in other three patients, all of which were covered with intact pharyngeal mucosa. Twelve carotid arteries were observed in seven cases, five of which were showed tortuosity and seven kinking. All of the five patients with recorded radiological materials had identified malformations of internal carotid artery, two of which were tortuosity bilaterally and two kinking bilaterally and one tortuosity and kinking respectively. CTA and MRA revealed tortuosity of cervical segment of internal carotid arteries. CONCLUSIONS: No typical clinical symptoms were shown in the malformation of cervical segment of internal carotid artery. Pharyngeal bulge with pulsation could be encountered. CTA and MRA showed excellent ability to depict the malformation of cervical segment of internal carotid artery and its relationship with surrounding structures, which could protect carotid artery from unintended damage.

Blood oxygen level-dependent MRI for the monitoring of neoadjuvant chemotherapy in breast carcinoma: initial experience.

PURPOSE: To determine the feasibility of using R2* map MRI for pretreatment diagnosis and monitoring of tumor response to neoadjuvant chemotherapy (NAC) in patients with breast cancer. MATERIAL AND METHODS: Twenty-eight women with breast cancer, as evidenced by pathology, underwent MR imaging prior to and after chemotherapy. All patients were examined by conventional MRI and R2* map imaging. Subjects were divided into major histological response (MHR) and non-major histological response (NMHR) groups. Mean R2* values of cancerous and normal glandular tissues were measured before and following NAC. Differences in R2* and ΔR2*% values between these two groups were compared with paired or independent t tests. The relationship between ΔR2*% and histological response was examined using Spearman's correlation test. RESULTS: Before NAC, the average R2* values in carcinoma were lower than in normal glandular tissue (P<.05). After two to four cycles of NAC, the R2* values in carcinoma were increased (P<.05 ), but this change was not significant in normal glandular tissue. After NAC, ΔR2*% was significantly higher in MHR as compared to NMHR (P<.05). The ΔR2*% correlated with the histological response (r=0.581, P<.01). CONCLUSION: In women undergoing NAC for breast cancer treatment, R2* and ΔR2*% appear to provide predictive information of tumor response which is probably associated with changes in tumor angiogenesis and tissue oxygenation. R2* map imaging of breasts may therefore be useful in monitoring tumor response to NAC.

Medical comorbidities at admission is predictive for 30-day in-hospital mortality in patients with acute myocardial infarction: analysis of 5161 cases.

BACKGROUND: The present study investigated the prognostic value of medical comorbidities at admission for 30-day in-hospital mortality in patients with acute myocardial infarction (AMI). METHODS: A total of 5161 patients with AMI were admitted in Chinese PLA General Hospital between January 1, 1993 and December 31, 2007. Medical comorbidities including hypertension, diabetes mellitus, previous myocardial infarction, valvular heart disease, chronic obstructive pulmonary disease (COPD), renal insufficiency, previous stroke, atrial fibrillation and anemia, were identified at admission. The patients were divided into 4 groups based on the number of medical comorbidities at admission (0, 1, 2, and ≥ 3). Cox regression analysis was used to calculate relative risk (RR) and 95% confidence intervals (CI), with adjustment for age, sex, heart failure and percutaneous coronary intervention (PCI). RESULTS: The mean age of the studied population was 63.9 ± 13.6 years, and 80.1% of the patients were male. In 74.6% of the patients at least one comorbidity were identified. Hypertension (50.7%), diabetes mellitus (24.0%) and previous myocardial infarction (12%) were the leading common comorbidities at admission. The 30-day in-hospital mortality in patients with 0, 1, 2, and ≥ 3 comorbidities at admission (7.2%) was 4.9%, 7.2%, 11.1%, and 20.3%, respectively. The presence of 2 or more comorbidities was associated with higher 30-day in-hospital mortality compared with patients without comorbidity (RR: 1.41, 95% CI: 1.13-1.77, P = 0.003, and RR: 1.95, 95% CI: 1.59-2.39, P = 0.000, respectively). CONCLUSIONS: Medical comorbidities were frequently found in patients with AMI. AMI patients with more comorbidities had a higher 30-day in-hospital mortality might be predictive of early poor outcome in patients with AMI.

[Differential changes of intrarenal oxygenation in rat models of acute tubular necrosis caused by aristolochic acid and gentamicin].

OBJECTIVES: To investigate the characteristics of renal oxygenation status in aristolochic acids I (AA-I) induced ATN rat model by method of blood oxygenation level-dependent MRI (BOLD-MRI) and compare it with ATN model caused by gentamicin. METHODS: 28 male Wistar rats were randomly divided into control, AAN and GM groups, which were subcutaneously injected with normal saline, AA-I (25 mg x kg(-1)x d(-1)) or GM (200 mg x kg(-1)x d(-1)) respectively for 4 days. Intrarenal oxygenation was measured by BOLD-MRI at 4(th) day and 7(th) day. Renal histopathological changes and renal function were also observed at day 7. RESULTS: Serum level of creatinine and urinary NAG were obviously elevated at day 7 in AAN and gentamicin group. Diffuse tubular necrosis confined to the margin of renal cortex and medulla without edema or infiltration of inflammation cells was the main pathological finding in AAN group. BOLD-MRI revealed that renal medullar R2(*) was elevated significantly at both day 4 [(50.6 +/- 15.6)/s vs (35.6 +/- 4.3)/s, P < 0.01] and day 7 [(58.4 +/- 14.8)/s vs (37.8 +/- 3.6)/s, P < 0.01] in AAN group when compared to control, showing opposite changes to GM group whose R2(*) was decreased at the same time. In addition, the renal cortical R2(*) in AAN group was also higher than that of control [(40.3 +/- 14.7)/s vs (28.7 +/- 3.2)/s, P < 0.05] at day 7, showing opposite changes to GM group. CONCLUSION: Intrarenal hypoxia exists in acute AAN rats, which initiates in the medulla following an involvement in renal cortex. The phenomenon of persistent low level of intrarenal oxygenation is different from change of GM-induced ATN, which may contribute to the progression of renal interstitial fibrosis in AAN.

Encephalic large arteries narrowness and peripheral neuropathy in a patient with adult-onset Still's disease.

Adult-onset Still's disease (AOSD) is a rare, systemic inflammatory disorder, characterized by spiking high fever, fever-associated evanescent rash, arthritis, myalgia, serositis and hepatosplenomegaly. White blood cell count, neutrophilic cell count, and serum ferritin level are markedly elevated in the active stage of the disease. Neurological complications of AOSD commonly were cranial nerve palsies, seizures, aseptic meningoencephalitis, peripheral neuropathy and Miller-Fisher syndrome. We report a previously healthy 60-year-old Chinese man who fulfilled the criteria for AOSD and had a combination of focal and peripheral neurological symptoms. Magnetic resonance angiography (MRA) and transcranial Doppler ultrasonography (TCD) showed narrowness of cerebral blood vessel. Peripheral neuropathy was confirmed by electromyography and sural nerve biopsy. His generalized neuropathy and other symptoms were rapidly improved by receiving glucocorticoid therapy. We do a literature review about neurological manifestations observed in AOSD patients.