Effect of Huangkui extract powder on the expression of nephrin and podocin in podocyte induced by high glucose / 中国基层医药

Objective To investigate the effect of Huangkui extract powder (HK) on the expression of nephrin and podocin proteins in mouse podocytes induced by high glucose,which is involved in the treatment of diabetic nephropathy (DN).Methods Cultured mouse podocytes (MPC5) were incubated in high glucose and HK at 5.6 mmol/L NG,5.6 mmol/L NG + 0.45 g/L HK,25 mmol/L HG,25 mmol/L HG + 0.45 g/L HK,respectively.The 5.6 mmol/L NG group was used as normal control.After 24 hours of intervention,we detected podocyte apoptosis by Annexin-V FITC/PI double staining,measured the mRNA and protein expression of nephrin and podocin by qRT-PCR and Western blot.Results Compared with the control group (5.6 mmol/L,NG),the apoptosis rate of podocytes in the high glucose concentration group (25 mmol/L,HG) was significantly higher [(20.39 ± 0.03) ％ vs.(17.70 ± 0.91) ％,t =2.947,P ＜ 0.05)].The apoptosis rate of podocytes in the 25 mmol/L HG + 0.45 g/L HK group was significantly lower than that in the 25 mmol/L HG group [(11.96 ± 1.11) ％ vs.(20.39 ± 0.03) ％,t =7.586,P ＜ 0.01].The results of qRT-PCR and Western blot showed that the expression of nephrin and podocin was significantly inhibited by high glucose concentration compared with the control group[(0.489 ±0.040) vs.(0.721 ±0.022),t =4.992,P ＜0.01;(0.387 ±0.014) vs.(0.778 ±0.036),t =10.050,P ＜0.01],and the expression of podocin and nephrin was increased by appropriate concentration of H K [(0.603 ± 0.013) vs.(0.489 ± 0.040),t =2.653,P＜0.05;(0.640±0.024) vs.(0.387 ±0.014),t=8.946,P＜0.01].Conclusion Podocyte apoptosis can be induced by prolonged high glucose treatment,but a certain concentration of HK can inhibit podocyte death induced by high glucose.The possible mechanism is that HK may inhibit the apoptosis of podocytes by regulating the expression of podocin and nephrin in podocytes at high glucose concentration,thus plays a protective role on podocytes.

Paclitaxel coated balloon versus plain balloon angioplasty in treating popliteal arteriosclerosis occlusive disease / 中华普通外科杂志

Objective To compare the short-term clinical results of paclitaxel coated balloon angioplasty (PCBA) and plain balloon angioplasty (POBA) in remedying popliteal arteriosclerosis occlusive disease.Methods From July 2013 to July 2016,56 patients of severe intermittent claudication or critical limb ischemia (CLI) due to stenosis or occlusion of popliteal artery were treated by PCBA in 30 patients (30 limbs),and by POBA in 26 patients (26 limbs).We compared clinical data of both groups at 1,3 and 6 months.Results The mean(± SD)length of treated segment in PCBA and POBA group respectively was (8.6 ± 3.3) cm and (6.9 ± 3.7) cm (t =1.817,P ＞ 0.05).According to peak systolic velocity rate (PSVR ＞ 2.4 as restenosis),l-month,3-month and 6-month restenosis rates were 0 (0 patients)in PCBA group vs.11.5％ (3 patients)in POBA group(x2 =1.74,P ＞0.05),0(0 patients)vs.24.0％ (6 patients) (x2 =5.59,P ＜ 0.05),3.6％ (1 patients)vs.65.2％ (15 patients) (x2 =22.29,P ＜ 0.01),respectively.6-month target lesion revascularization(TLR) was 3.6％ (1 patient) in PCBA group vs.60.9％ (in 14 patients) in POBA group(x2 =19.97,P ＜0.01),limb salvage rate at 6 months was 100％ (28 patients)vs.65.2％ (15 patients) (x2 =11.55,P ＜ 0.01).Conclusion In the short term,paclitaxel coated balloon angioplasty was superior to POBA for anti-restenosis of popliteal arteriosclerosis occlusive disease.

Primary effectiveness of the GORE (R) Viabahn endoprosthesis in stenosed or obliterated superficial femoral artery / 中华普通外科杂志

Objective To observe the primary clinical results of Gore （R） Viabahn endoprosthesis for atherosclerotic stenosis or occlusion in superficial femoral artery (SFA).Methods From March 2013 to November 2013,45 consecutive patients (54 limbs) who had ischemic symptom due to stenosis or occlusion of superficial femoral artery were treated by endovascular deployment of Gore （R） Viabahn endoprosthesis.We observed patency rate,improvement of Rutherford classification and ankle-brachial index,limb salvage rate and survival rate after 1,3 and 6 months.Results 43 patients (52 limbs)were followed-up,among which 32 patients(38 limbs)belonged to TASC Ⅱ type C or type D lesion.The mean (± SD) length of treated segment in 52 limbs was(19 ±4)cm.The rate of postoperative patency on duplex ultrasonography:one month,3 months and 6 months were 96.15％ (50 limbs),92.31％ (48 limbs)and 90.38％ (47 limbs) ; Ankle-brachial index increased from(0.32 ±0.20)to(0.68 ±0.18) (t =3.180,P ＜ 0.005) after 6 months ; at 6 months limb salvage rate was 96.08 percent (49 limbs),and survival rate was 97.67％ (42 patients).Conclusions Implantation of Gore （R） Viabahn endoprosthesis in atherosclerotic stenotic or occluded superficial femoral artery safely achieves a definite primary clinical effectiveness.

Mid and long term results of endovascular procedures for diabetic below-the-knee lesions / 中华普通外科杂志

Objective To analyze the mid and long term results of endovascular procedures for diabetic below-the-knee lesions.Methods We retrospectively analyzed data of 762 patients (797 limbs in Wagner Grade 1 to 4) who suffered ischemic symptoms of diabetic below-the-knee lesions,admitted for endovascular procedures from Aug 2005 to May 2012.Technical success rate and complications,anklebrachial index,wound healing,limb salvage and survival were evaluated.Results 762 patients (797 limbs) underwent 857 endovascular procedures with immediate technical success in 805 times (success rate 93.93％).30 day complications included 33 cases (4.33％) of hematoma or pseudoaneurysm related to access site,20 cases (2.62％) of vasovagal reflex,38 cases (4.99％) of belowthe-knee arteriorrhexis,75 cases (9.84％) of inflow-limited dissection,23 cases (3.02％) of arterial embolism,4 cases (0.52％) of blue-toe sign.Postoperative mean ABI was improved significantly,from 0.33 ± 0.20 to 0.68 ± 0.17,P ＜ 0.005.722 patients (751 limbs) were followed up for more than 12 months (35 ± 23 months),wound healing rate within 3 months was 72.28％,limb salvage rate after 12 months was 85.62％,survival rate was 95.01％.Conclusions Immediate technical success rate of endovascular procedures for diabetic below-the-knee lesions is high,complications rate is low,medium and long term efficacy is satisfactory.

The use of 5-hydroxytryptamine (5HT) receptor antagonist after percutaneous transluminal angioplasty in infrapopliteal arteriosclerotic occlusive disease / 中华普通外科杂志

Objective To evaluate a 5HT receptor antagonist sarpogrelate hydrochloride after percutaneous transluminal angioplasty (PTA) in infrapopliteal arteriosclerotic occlusive disease.Methods From June 2010 to June 2012,105 (116 limbs) patients of infrapopliteal arteriosclerosis obliterans treated by PTA were divided randomly into two groups:treatment group (58 cases,64 limbs)and control group(47 cases,52 limbs).All patients were treated with aspirin and clopidogrel for 3 months.Patients in treatment group were treated with additional sarpogrelate hydrochloride.Intermittent claudication,rest pain,amputation rate,ABI,vascular prosthesis obstructing degree were assessed.Results 95 patients were followed up for 6 months,the intermittent claudication rate in treatment group and control group were 3.8％ and 16.3％ (P ＜ 0.05); while there was not different on 1,3 months,in the intermittent claudication rate and 1,3,6 months,in rest pain rate,amputation rate,target artery patency rate and ABI between the two groups (P ＞ 0.05).There was one bleeding event in treatment group (1.7％).Conclusions 5HT receptor antagonist (sarpogrelate hydrochloride) significantly improves intermittent claudication after PTA in infrapopliteal arteriosclerotic occlusive disease,and its use is safe with aspirin and clopidogrel.

Primary experience on double access technique to treat chronic total occlusion in lower extremity artery / 中华放射学杂志

Objective To estimate the security and effectiveness of double access technique to treat chronic total occlusion in lower extremity artery. Method Fifty four patients,who had lower limb arteriosclerosis and accepted failed endovascular treatment because of unable to reenter true lumen through antegrade access,were treated immediately in double access style to recanalize occluded artery (including 27 patients of dorsalis pedis artery puncture,17 patients of posterior tibial artery punctrue,5 patients of proximal anterior tibial artery puncture and 5 patients of distal superficial femoral artery puncture). Evaluate the revascularization rate,complication rate and 6-month limb salvage rate of double access technique,t test was used to compare the ABI.Results Revascularization rate was 98.2％ (53/54),average puncture frequency of every case was 6 ( the first access was 2 in every patient,the second access was 4 in every patient ),average treatment time was 167 minutes,complication rate was 5.6％ (3/54),2 patients were occlusion in puncture segment of the second access,1 patient was hematoma in the second access point. 6-month ABI after intervention increased from 0.44 ±0.13 to 0.69 ±0.15,6-month limb salvage rate was 100％. Conclusion For chronic total occlusion,double access is a feasible technique to deal with unable to reenter true lumen throughantegrade access,the complication rate is low,the primary limb salvage rate is relatively high.

Micropuncture versus traditional puncture technique in the treatment complications of lower extremity arteriosclerosis occlusion / 中华普通外科杂志

Objective To compare the clinical results of micropuncture technique and traditional puncture technique in the treatment of lower extremity arteriosclerosis occlusion.Methods From January 2007 to February 2012,862 patients of lower extremity arteriosclerosis occlusion were treated by endovascular technology,385 patients ( 463 limbs ) by 21-G micropuncture technique and 477 patients ( 586 limbs ) by traditional 18-G puncture technique.Access sites were managed with manual pressure hemostasis or a vascular closure device.Primary endpoints included groin hematoma ( ≥ 2 cm),pseudoaneurysm,iatrogenic arteriovenous tistula,retroperitoneal hematoma,vascular perforation requiring repair and blood flow limited dissection.Results Patients assigning to undergo micropuncture technique were at higher risk,there was a significant shorter puncture time required for micropuncture technique vs.traditional puncture technique,(3.2 ± 2.3 vs.5.1 ± 3.2,P ＜ 0.05 ),the overall access site complications rate was lower in micropuncture group ( 6.2％ vs.6.7％,x2 =7.91,P ＜ 0.005 ).Conclusions In lower extremity arteriosclerosis occlusion treatment,arterial access can be completed by micropuncture which was safer and more effective than traditional puncture technique.

Primary implantation of a self-expanding nitinol stent versus percutaneous transluminal angioplasty for arteriosclerosis obliterans of superficial femoral artery / 中华普通外科杂志

Objective To compare the mid-term clinical results of primary implantation of a selfexpanding nitinol stent and primary percutaneous transluminal angioplasty (PTA) for long range arteriosclerosis obliterans of the superficial femoral artery. Methods From December 2005 to February 2007,109 patients who had moderate-severe claudication or chronic limb ischemia (CLI)due to stenosis or occlusion of the superficial femoral artery were treated by endovascular technology. 53 patients (73 limbs) were treated by primary stenting and 56 patients (76 limbs)by PTA. We compared the clinical data of stenting group and PTA group at 6,12 and 24 months. Results The mean length of the treated segment was (16± 8)cm in the stenting group and(15±7)cm in the PTA group. At 6 months, the rate of restenosis on duplex ultrasonography was 13.7% in stenting group and 30.2% in PTA group (X2=4.09, P<0.05);at 12 months the restenosis rates were 25.5% in stenting group and 46.9% in PTA group(X2=4.75, P<0.05);at 24 months the restenosis rates on duplex ultrasonography were 38.1% in stenting group and 65.9% in PTA group(X2=6.66, P<0.01). Rutherford stages in stenting group were significantly better than those in PTA group. Conclusion In the mid-term, primary implantation of a self-expanding nitinol stent yielded results that were superior to those with PTA for arteriosclerosis obliterans or long range stenosis of the superficial femoral artery.

Human biochemical genetics: an insight into inborn errors of metabolism / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Inborn errors of metabolism (IEM) include a broad spectrum of defects of various gene products that affect intermediary metabolism in the body. Studying the molecular and biochemical mechanisms of those inherited disorder, systematically summarizing the disease phenotype and natural history, providing diagnostic rationale and methodology and treatment strategy comprise the context of human biochemical genetics. This session focused on: (1) manifestations of representative metabolic disorders; (2) the emergent technology and application of newborn screening of metabolic disorders using tandem mass spectrometry; (3) principles of managing IEM; (4) the concept of carrier testing aiming prevention. Early detection of patients with IEM allows early intervention and more options for treatment.

Newborn screening of inherited metabolic diseases by tandem mass spectrometry / 北京大学学报(医学版)

Application of TMS technology in newborn screening has resulted in major expansion of disorder panel for metabolic diseases in recent years. This automated, multiplex testing methodology detects multiple analytes from single analysis of one blood spot, which leads to detection of 30-35 disorders of amino acids, organic acids, and fatty acids metabolism. The early identification of persons affected with inborn errors of metabolism has led to unexpected discoveries related to the natural history of the disorder or options for therapy. This article summarized (1) the basic principles of this technology and methodology. (2) Current status of application of this methodology in the United States, European countries and in China. (3) The positive impacts on the public health and advances in medical genetics. Finally (4) Challenges, issues and possible solutions. The purpose of this article aimed at introducing new technology and exploring the possibilities of implementing into developing countries where medical genetics is not developed and foreseeing the possible problems and obstacles.