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Objective:To investigate the efficacy of lanthanum carbonate versus calcium acetate in the treatment of hyperphosphatemia in patients receiving maintenance hemodialysis. Methods:A total of 202 patients with chronic renal failure who received maintenance hemodialysis in Department of Nephrology, Yiwu Central Hospital from March 2016 to January 2017 were included in this study. These patients were on dialysis for ≥ 6 months with blood phosphorus level > 1.78 mmol/L before dialysis. They were randomly divided into the lanthanum carbonate ( n = 100) and calcium acetate ( n =102) groups. Two patients in the lanthanum carbonate group withdrew from the study due to intolerance of vomiting. All patients were treated for 9 months. During the study period, low calcium dialysate was rationally used, and strict dietary phosphate restriction was applied. The changes in serum phosphorus, calcium and parathyroid hormone contents before and after treatment were compared between the two groups, and they were compared between before and after treatment in each group. Results:During the treatment, the average dose of phosphate binder was 1 500 mg/d in the lanthanum carbonate group and 3 335 mg/d in the calcium acetate group. There were no significant differences in general demographic data and biochemical indexes between the two groups (both P > 0.05). No significant differences in dietary phosphorus content and dialysate calcium concentration were observed between the two groups (both P > 0.05). In the calcium acetate group, blood phosphorus content decreased from (2.12 ± 0.35) mmol/L before treatment to (1.55 ± 0.24) mmol/L after treatment ( t = 13.43, P < 0.01). In the lanthanum carbonate group, blood phosphorus content decreased from (2.14 ± 0.3) mmol/L before treatment to (1.45 ± 0.17) mmol/L after treatment ( t = 20.01, P < 0.01). In the lanthanum carbonate group, the difference in blood phosphorus content between before and after treatment was (0.69 ± 0.29) mmol/L, which was significantly higher than that in the calcium acetate group [(0.57 ± 0.37) mmol/L, t = 2.553, P < 0.01]. Hypercalcemia did not occur in both groups, and there were no significant differences in carotid intima thickening and presence of calcified plaque between the two groups (both P > 0.05). Conclusion:Under the premise of effectively implementing rational low calcium dialysate use and strict dietary phosphate restriction, both calcium acetate and lanthanum carbonate can effectively reduce the blood phosphorus level in patients undergoing maintenance hemodialysis. Lanthanum carbonate has better effect in reducing serum phosphorus level than calcium acetate, but it is likely to produce gastrointestinal reactions. Neither treatment method bears the risk of hypercalcemia.
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Objective To assess the 64-slice spiral CT differential diagnosis of the effect on the gastrointesti-nal tract intraepithelial neoplasia and early cancer.Methods A retrospective study of patients with gastric cancer clinical data of 28 patients who underwent surgery and CT scans.CT scans of the tumor in all patients,the stomach wall thickness,tumor extension,N1 and N2 lymph node involvement,liver,peritoneum,lung metastasis.Comparison of spiral CT differential diagnosis of pathological findings and results.Results spiral CT staging was correct in 20 (71.4%).Preoperative CT scan to identify early gastric sensitivity 96.1%,specificity of 100% and an accuracy of 96.4%.Assessment of pathological lymph node involvement sensitivity,specificity,and accuracy were 73.1%, 50.0% and 84.2%.12 patients (42.9%)of the stomach wall thickness 2cm and all patients (100.0%)were serosal involvement.CT detec-tion of T1 and T2 tumors sensitivity and specificity were 57.1% and 90.5%;89.5% and 77.8%.CT assessment of pancreatic invasion of sensitivity,specificity,and accuracy were 100.0%,73.9% and 78.6%.Spiral CT assessment of serosal involvement with/without adjacent organ invasion of sensitivity,specificity and accuracy of 96.4% and reached 96.2%,100.0%.Conclusion Spiral CT in the diagnosis and evaluation of preoperative staging of gastric useful means of early gastric cancer.
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Objective To investigate the relationship between the neuroprotective effect of epigallocatechin gallate ( EGCG ) for PC12 cells induced by 1-methyl-4-phenyl-pyridinium ( MPP+ ) and activating nuclear factor-related factor 2 ( NRF2 ).Methods Well differentiated PC12 cells treated with MPP+ were used as the in vitro cell models,and PC12 cells were pretreated with different concentrations of EGCG.MTT assay was used to investigate the cell viability.Western blot was used to observe the expression of NRF2 in cells and distribution in the nucleus and the cytoplasm.Real-time PCR was used to observe the antioxidant enzymes,HO-1 and NQO1 mRNA expression.Results Pretreatment of PC12 cells with different concentrations of EG CG for an hour could restore cell viability.Western blot showed that expression of NRF2 in cells treated with MPP+ for 24 hours was increased 148％ +5％ compared with the control group (t =6.102,P ＜0.01 ).The level of NRF2 in EGCG pretreated group was 188％ + 6％ compared with the control group(t =11.172,P ＜0.01 ).Moreover the NRF2 protein level in the nuclear was also increased.Western blot showed that the NRF2 protein level in the nuclear was 258％ +2％ compared with the control group (t =21.995,P ＜ 0.01 ).Further research found U 120,an inhibitor of ERK,could inhibit the effect of EGCG.The levels of NRF2 in both samples were 148％ ± 15％ and 158％ ± 1％ compared with their respective control groups(t =6.118,8.058,both P ＜0.01 ).In accordance with the NRF2 data,real-time PCR indicated that the levels of HO-1 and NQO1 mRNA expression increased obviously in the group pretreated with EGCG.Likewise,U120 could also inhibit HO-1 and NQO1 mRNA expression induced by EGCG.Conclusions EGCG can repair oxidative damage to PC12 cells induced by MPP+.The protective effect may be related through the ways to activate ERK-NRF2 and induce downstream of antioxidant enzyme expression,such as HO-1 and NQO1.
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Fifty four patients with chronic sinusitis (without nasal polyps) were randomly divided into two groups. Thirty patients in experimental group were treated with dirithromycin and 24 patients in control group were treated with clarithromycin. The doses was both 250 mg q. d. and the duration of treatment was 3to 6 months. The VAS scores of subjective symptoms (nasal obstruction, purulent nasal discharge,headache, smell worse ) and Lund-Mackay scores of objective signs (sinus CT ) in both groups were improved significantly compared with the baseline(P ＜0.05), and there were no statistical significances between two groups ( P ＞ 0. 05 ). The curative effect was positively correlated with the duration of treatment.The total effective rates were 73% and 67% and adverse reaction rates 7% and 21% in two groups,respectively (P ＞ 0. 05 ); but the adverse reactions in control group were more serious than those in experimental group. During the six-month follow-up, no recurrence and aggravation were observed. The results suggest that low-dose dirithromycin may be more suitable for long-term treatment of chronic sinusitis.
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Sixty four patients undergoing endoscopic sinus surgery were randomly divided into two groups.In nimesulide group (n=32) patients were given nimesulide capsule 100 mg after surgery and 32 patients in control group were given 100 mg vitamin C as placebo.The visual analogue scale (VAS) was used to evaluate the degree of pain during withdrawing nasal packing.The VAS value of the nimesulide group was 2.8±1.1 3 h after surgery and 2.7±1.2 during with drawing nasal packing,that of control group was 6.7±0.6 and 8.3±0.6,respectively (both P<0.01).The results revealed that nimesulide had a siguificant analgesic effect in endoscopic sinus surgery.
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This study was designed to disclose the specific changes of distortion product otoacoustic emission (DPOAE), including DP-gram and I/O-gram in guinea pigs treated with GM for 10 and 17 days. Forty guinea pigs were divided into four groups:group I (treated with GM for 10 days), group II (treated with normal saline for 10 days), group III (treated with GM for 17 days), group IV (treated with normal saline for 17 days). DPOAE including DP-gram and DP-I/O was recorded by use of CELESTA 503 Cochlear Emission Analysis and the out hair cell loss was numerated. (1) The amplitude in group I showed significant reduction at frequencies of 4, 6, 8 kHz. There were significant differences, compared to group II (t=2.52, 1.92, 2.10, P<0.05). The amplitude in group III also decreased at frequencies of 3, 4, 6, 8 kHz. There were also significant differences compared to group IV (t=3.27, 2.81, 2.92, 3.13, P<0.01). The amplitude of DP-I/O in group I and group III at different frequencies and stimulus levels showed reduction. (2) At the level L1 <60 dB SPL, the stimulus levels to elicit a 0 dB response in group I and group III were higher than those in corresponding control groups, respectively. (3) The mean of threshold shift was 5.0+/-3.8 dB in group I and 25.0+/-6 dB in group III at 8 kHz frequency. (4) The out hair cell loss was 22.16% in group I and 48.36% in group III, both showed significant difference as compared to controls, respectively (P<0.01). The employment of DPOAE can be a useful tool in monitoring ototoxicity of GM for its sensitivity and specificity in guinea pigs treated with GM. The changes in DPOAE were consistent with those in histology.
Subject(s)
Animals , Female , Male , Acoustic Stimulation , Methods , Cochlea , Gentamicins , Guinea Pigs , Hair Cells, Auditory, Outer , Pathology , Otoacoustic Emissions, Spontaneous , Physiology , Perceptual Distortion , Physiology , Random AllocationABSTRACT
In order to observe the DPOAE of guinea pigs under awake and anesthetic conditions, we invesitigated the amplitude of distortion product emission and I/O function curves and made a comparative analysis of their changes under different conditions. It was found that the amplitude of DPOAE and I/O curves did not show difference in the guinea pigs under awake and anesthetics conditions. We deem it credible and simple to measure DPOAE in the guinea pigs under awake condition, which is similar to measuring DPOAE in the guinea pigs under physiological condition.