Pathogenesis of chronic heart failure in rats based on ferroptosis-mediated oxidative stress and intervention effect of Shenfu Injection / 中国中药杂志

This study aims to investigate the pathogenesis of chronic heart failure based on ferroptosis-mediated oxidative stress and predict the targets of Shenfu Injection in treating chronic heart failure. A rat model of chronic heart failure was established by the isoproterenol induction method. According to the random number table method, the modeled rats were assigned into three groups: a model group, a Shenfu Injection group, and a ferrostatin-1(ferroptosis inhibitor) group. In addition, a normal group was designed. After 15 days of intervention, the cardiac mass index and left ventricular mass index were determined. Echocardiography was employed to eva-luate the cardiac function. Hematoxylin-eosin staining and Masson staining were employed to reveal the pathological changes and fibrosis of the heart, and Prussian blue staining to detect the aggregation of iron ions in the myocardial tissue. Transmission electron microscopy was employed to observe the mitochondrion ultrastructure in the myocardial tissue. Colorimetry was adopted to measure the levels of iron metabolism, lipid peroxidation, and antioxidant indicators. Flow cytometry was employed to measure the content of lipid-reactive oxygen species(ROS) and the fluorescence intensity of ROS. Western blot and RT-qPCR were employed to determine the protein and mRNA levels, respectively, of ferroptosis-related factors in the myocardial tissue. The results showed that the rats in the model group had reduced cardiac function, elevated levels of total iron and Fe~(2+), lowered level of glutathione(GSH), increased malondialdehyde(MDA), decreased superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px), and rising levels of ROS and lipid-ROS. In addition, the model group showed fibrous tissue hyperplasia with inflammatory cell infiltration and myocardial fibrosis, iron ion aggregation, and characteristic mitochondrial changes specific for iron death. Moreover, the model group showcased upregulated protein and mRNA levels of p53 and COX2 and downregulated protein and mRNA levels of GPX4, FTH1, SLC7A11, and Nrf2 in the myocardial tissue. The intervention with Shenfu Injection significantly improved the cardiac function, recovered the iron metabolism, lipid peroxidation, and antioxidant indicators, decreased iron deposition, improved mitochondrial structure and function, and alleviated inflammatory cell infiltration and fibrosis. Furthermore, Shenfu Injection downregulated the mRNA and protein levels of p53 and COX2 and upregulated the mRNA and protein levels of GPX4, FTH1, SLC7A11, and Nrf2 in the myocardial tissue. Shenfu Injection can improve the cardiac function by regulating iron metabolism, inhibiting ferroptosis, and reducing oxidative stress injury.

Etiological factor distribution in elderly outpatients with vertigo/dizziness / 中华老年医学杂志

Objective To clarify the distribution of etiological factors in elderly versus non-elderly outpatients with vertigo/dizziness for optimizing the diagnosis and therapy. Methods We retrospectively analyzed data of outpatients with vertigo/dizziness in Shaanxi Provincial People's Hospital from April 2015 to April 2017 and conducted diagnoses in accordance with the currently wide-accepted diagnostic criteria. Results A total of 3 356 patients with chief complains of vertigo/dizziness were recruited ,and their top seven etiological factors were benign paroxysmal positional vertigo (n＝ 1 320 ,39.3%) ,chronic subjective dizziness(n＝680 ,20.3%) ,vestibular migraine(n＝386 ,11.5%) ,posterior circulation ischemia (n＝213 ,6.4%) ,Meniere's disease (n ＝ 138 ,4.1%) ,vestibular neuritis (n＝ 121 ,3.6%) ,and vestibular paroxysmia(n＝76 ,2.3%). The top four etiological factors for the elderly patients (n＝1 255)were benign paroxysmal positional vertigo (n＝ 498 ,39.7%) ,chronic subjective dizziness (n＝ 279 ,22.2%) ,posterior circulation ischemia(n＝161 ,12.8%) ,and vestibular migraine(n＝73 ,5.8%) ;while the top four etiological factors for non-elderly patients (n＝ 2 101)were benign paroxysmal positional vertigo (n＝ 822 ,39.1%) , chronic subjective dizziness(n＝401 ,19.1%) ,vestibular migraine(n＝313 ,14.9%) ,and vestibular neuritis(n＝105 ,5.0%). The detection rate in elderly patients versus non-elderly patients was significantly higher in chronic subjective dizziness (22.2% vs.19.1%,P＝ 0.032 )and in posterior circulation ischemia (12.8%vs.2.5%,P＝0.000) ,and was significantly lower in vestibular neuritis (1.3% vs.5.0%,P＝ 0.000 ) ,in vestibular migraine(5.8% vs.19.4%,P ＝ 0.000)and in other causes (1.0% vs.2.7%,P ＝ 0.002) . Conclusions The ratio of posterior circulation ischemia is markedly higher in elderly outpatients than in non-elderly outpatients ,whereas the ratios of vestibular migraine and vestibular neuritis in elderly patients are lower than in non-elderly outpatients.

Discrepancy of blood pressure between the brachial artery and radial artery / 世界急诊医学杂志（英文）

@#BACKGROUND: In this study, we attempted to find the relations between blood pressure (BP) measured on the brachial artery (bBP) and BP assessed on the radial artery (rBP) in the right arm. METHODS: Three hundred and fifteen patients were enrolled in this study. Those who had peripheral vascular disease, wounds of arm skin or subcutaneous tissue infection were excluded. After a 15-minute equilibration and stabilization period after inducation of anesthesia, three bBP and rBP records were obtained sequentially using an oscillometric device with an adult cuff and infant cuff, respectively. Order for each BP was randomized. RESULTS: The bBP was significantly lower than the rBP (P<0.05). The difference between the two values varied from 13 to 18 mmHg in systolic BP (SBP), diastolic BP (DBP) and mean blood pressure (MAP) respectively. And the rBP was positively correlated with the bBP (r=0.872, 0.754, 0.765; P<0.001, <0.001, <0.001; SBP, DBP, MAP, respectively). CONCLUSION: The bBP value can be evaluated by the noninvasive measurements of rBP using an appropriate cuff in clinical practice.

Bile duct perforation in children: is it truly spontaneous?

<p><b>INTRODUCTION</b>Bile duct perforation (BDP) with resultant biliary ascites in children is a rare clinical condition. The aetiopathogenesis is still an enigma, with increasing evidence suggesting anomalous union of pancreaticobiliary ductal (AUPBD) system as the prime causative factor.</p><p><b>CLINICAL PICTURE</b>We report 2 cases of spontaneous perforation of the bile duct confirmed on histopathological examination as choledochal cyst, in a 6-month-old female child and a 4-year-old boy who presented with subtle clinical symptoms.</p><p><b>TREATMENT AND OUTCOME</b>Both patients were successfully managed by excision of the gall bladder and common bile duct and Roux-en- Y hepaticojejunostomy. This procedure was performed following initial cholecystostomy drainage in the second case.</p><p><b>CONCLUSIONS</b>From the available literature and experience with our patients, BDP is not merely spontaneous but may be related to AUPBD and choledochal cyst.</p>

Clinical evaluation of two tooth preparation methods of metal-porcelain restoration / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical performance of the two configurations of gingival margin preparation of tooth.</p><p><b>METHODS</b>The cases in this study were divided into two groups according to different tooth defects. Each group consisted of 40 cases. One group's gingival margin configuration was 90 degree shoulder, the other was under-gingival non-shoulder. The clinical performance of these restorations was followed up for 1 year and 2 years. The evaluators examined the restorations for plaque index, gingival index, marginal discolor and marginal fit.</p><p><b>RESULTS</b>There was no significant difference in the evaluators between the two groups.</p><p><b>CONCLUSION</b>The under-gingival non-shoulder margin configuration of porcelain fused to metal should be used for clinical application compared with the 90 degree shoulder one in certain circumstance.</p>

Use of Gastrointestinal Segment in Urinary Diversion / 대한비뇨기과학회지

We have studied general patient characteristics, the early and late postoperative complications associated with each procedure and the results of urodynamic studies in 29 patients who had received various kinds of urinary diversion at the Dept. of Urology, Dong-A University Hospital from May 1990 to May l994. The results are as follows. 1. Of 29 urinary diversions, ileal conduit was performed in 18 patients, appendicoureterocutaneostomy in 2, Indiana pouch in 8 and rectal pouch in l. The surgical indications were bladder tumor in 28 and pelvic actinomycosis in 1 2. Sex ratio between male and female was 22:7. Average age according to each procedure was 67,4 years old in ileal conduit group, 62.5 years old in appendicoureterocutaneostomy, 54.3 years old in lndiana pouch, and 33.0 years old in rectal pouch. Average operative time ranged from 275.5 to 647.5 minutes. with lndiana pouch group taking maximum time and appendicoureterocutaneostomy group taking the least time. 3. There was no change in postoperative renal function and serum electrolytes. Concerning the period of hospital stay, ileal conduit in 21.3 days, Indiana pouch group was 28.7 and appendicoureterocutaneostomy in 20.5 days being the shortest of all. 4. Wound infection was most common early postoperative complication occurring in 5 out of 29 patients. Anastomotic leakage was seen in 2 out of 18 ileal conduits, 2 paralytic ileus in ilea1 conduit and lndiana pouch each. 5. Six months postoperative cystometric studies show the average volume and average reservoir pressure of 533.3ml and 22.7cmH2O in lndiana pouch and 38.0cmH2O in rectal pouch which is greater than the maximum intraluminal pressure. In conclusion, the author believes that the urologic surgeon should be familiar with several procedures, because these procedures should be tailored to the patient's anatomy, prior surgery, renal function and preference.