Clinical management of primary hypomagnesemia with secondary hypocalcemia / 中华内分泌代谢杂志

Primary hypomagnesemia with secondary hypocalcemia(HSH) is a rare cause of hypoparathyroidism. This article presents a case of a 26-year-old male with recurrent generalized weakness and tetany, and a literature review of diagnosis and treatment of primary HSH. The biochemical tests revealed the patient had severe hypomagnesemia, mild hypocalcemia, hypokalemia, and hypoparathyroidism. Transient receptor potential melastatin-6(TRPM6) gene mutation were detected by gene test, which confirmed the diagnosis of primary HSH. The patient had been treated with long term oral magnesium supplementation, who remained asymptomatic during the follow-up. Primary HSH is a rare autosomal-recessive disorder caused by mutations in the TRPM6 gene which encoding a magnesium permeable channel expressed in the intestine and the kidney. The primary defect is impaired intestinal absorption of magnesium with secondary renal excretion, leading to a series of clinical symptoms. The treatment is mainly through lifelong magnesium supplementation.

Approach to the patient with syndrome of pituitary resistance to thyroid hormone / 中华内分泌代谢杂志

Syndrome of resistance to thyroid hormone(RTH)is a rare hereditary thyroid disease with various clinical manifestations and laboratory findings. RTH could be misdiagnosed and mistreated, resulting in aggravation of the disease. We reviewed the medical records of a patient with RTH over the past six years. In addition, we provided a summary of latest progress for RTH to help the clinicians to improve the understanding of the disease.

Effect of ultrasound-guided vacuum-assisted excision verus open surgery for benign phyllodes tumors of breast on postoperative local recurrence / 中华外科杂志

Objectives@#To examine the effect of VAE and open surgery on the postoperativelocal recurrence of benign phyllodes tumors of breast and to investigate the clinical efficacy of VAE in the treatment of benign phyllodes tumors.@*Methods@#The clinical data of 128 patients with benign phyllodes tumors of breast admitted to the Guangdong Women and Children Hospital from January 2013 to January 2018 were retrospectively analyzed. All patients were female, aged (37.7±9.1) years (range: 16 to 56 years). Eighty patients underwent ultrasound-guided VAE (minimally invasive group) and 48 patients underwent open surgery (open group). The t-test, χ2 test or Fisher exact probability method were used to compare the clinical characteristics of the two groups of patients. Logistic regression was used to analyze the prognostic factors of postoperative local recurrence.@*Results@#The maximum diameter of tumor in the minimally invasive group was smaller than that in the open group ((20.6±7.4) mm vs. (42.0±2.0) mm, t=-7.173, P=0.000). The follow-up time was (36.4±1.8) months (range: 12 to 71 months). There were 7 cases of local recurrences during the follow-up period. The local recurrence rates in the minimally invasive and open groups were 5.0% (4/80) and 6.3% (3/48). The results of multivariate analysis showed that the maximum tumor diameter of 25 mm was an independent prognosis factor for postoperativelocal recurrence (OR=0.122, 95%CI: 0.016 to 0.901, P=0.039). While surgical procedure, age, menopausal status and history of fibroadenomas in the ipsilateral breast is not an independent prognostic factor for postoperative local recurrence. In the minimally invasive surgery group, the local recurrence rates were 2.9% (2/69) and 2/11 in patients with tumor maximum diameters<25 mm and ≥25 mm, respectively.@*Conclusions@#Local recurrence of breast benign phyllodes tumors is closely related to the tumor size. For patients with tumor diameter<25 mm, the postoperative local recurrence rate of VAE is low, which can be used in clinical practice. Intraoperative complete resection to achieve a negative surgical margin should be guaranteed to avoid local recurrence.

Study of RET proto-oncogene mutations in two pedigrees affected with multiple endocrine neoplasia type 2A / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the pattern of RET proto-oncogene mutations in two pedigrees affected with multiple endocrine neoplasia type 2A (MEN2A).</p><p><b>METHODS</b>Peripheral blood samples were collected from members of the two pedigrees, with total genomic DNA extracted for polymerase chain reaction (PCR). PCR products of 7 exons of the RET proto-oncogene (including exons 8, 10, 11, 13, 14, 15, 16) which have higher mutation rates were purified and subjected to direct sequencing. Suspected mutations in the 2 probands were verified in other members of the pedigrees. To exclude other mutations, PCR products of remaining 14 exons were sequenced in the proband from pedigree 1.</p><p><b>RESULTS</b>A novel heterozygous mutation, 1893-1895delCGA, was detected in exon 11 of the RET proto-oncogene among 3 patients and 2 unaffected members from pedigree 1, while a heterozygous mutation, Cys634Arg, was detected in exon 11 among 2 patients and 1 unaffected family member from pedigree 2.</p><p><b>CONCLUSION</b>The heterozygous 1893-1895delCGA and Cys634Arg mutations of the RET proto-oncogene probably underlie the disease in the two pedigrees. Above discovery has enriched the human gene mutation database.</p>

A comparison of clinical characteristics between 2 pedigrees of multiple endocrine neoplasia type 2A with different RET mutations / 中华内科杂志

Multiple endocrine neoplasia type 2A (MEN2A) is a hereditary syndrome. Here, two different RET proto-oncogen mutation were identified from family members of two MEN2A pedigrees by genetic screening. One RET mutations were found at codons 1893 and 1895 in exon 11 (1893-1895delCGA) from pedigree 1, which is a novel mutation, the other occurs at codon 634 (Cys634Arg) in exon 11 from pedigree 2. However, the clinical characteristics were similar in the patients of the two pedigrees. All the patients were in middle-age at onset. Most of them were firstly diagnosed with bilateral adrenal pheochromocytoma with different degrees of thyroid abnormalities (elevated serum calcitonin with or without thyroid mass, or had been diagnosed with medullary thyroid carcinoma). Some family members were with elevated serum parathyroid hormone but with no other evidences for hyperparathyroidism.

Approach to the patient with aldosterone-producing adrenocortical carcinoma / 中华内分泌代谢杂志

Aldosterone-producing adrenocortical carcinoma (ACC) is a rare endocrine malignancy. Only a few cases are reported in China. This systematic review investigated the diagnosis and treatment strategy of aldosterone-producing ACC through a recent case of the disease. A case of a 49-year-old female who diagnosed with aldosterone-producing ACC by hormonal assays, medical imaging and pathology. Her condition has been alleviated after surgery. Aldosterone-producing ACC is a rare malignancy with limited treatment options and surgery is the primary treatment strategy.

Application of domestically made endoscopic stapling instrument for laparoscopic assisted rectal cancer resection / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the safety and feasibility of domestically made endoscopic stapling instrument in laparoscopic assisted rectal cancer resection (Dixon).</p><p><b>METHODS</b>Sixty-four patients with rectal cancer were randomly divided into the research group (35 cases) to receive laparoscopic assisted rectal cancer resection using ENDO RLC general endoscopic linear cutter and single-use loading unit and circular staplers with staples (from REACH medical equipment co.LTD) and the control group (29 cases) to receive surgery with the corresponding products widely used (fom Johnson and Johnson Medical Euipment C.Ltd). The clinical data of the two groups were compared.</p><p><b>RESULTS</b>Satisfactory therapeutic effects were obtained in all the cases. The two groups showed no significant differences in the operative time, intraoperative anastomosis success rate, or postoperative complications (anastomotic bleeding, leakage, or stricture) between the two groups (P>0.05), but the average cost of endoscopic stapling instrument was significantly lower in the research group (6604.31 ± 699.95 vs 7822.28 ± 576.98 RMB Yuan, P<0.05).</p><p><b>CONCLUSION</b>The domestic endoscopic stapling instrument is safe, effective and less costly for laparoscopic assisted rectal cancer resection.</p>

X-linked adrenoleukodystrophy: a retrospective analysis of 11 cases with review of literature / 中国医师杂志

Objective X-linked adrenoleukodystrophy (X-ALD) is a genetically determined disorder that is characterized by demyelination of central nervous system,and impaired adrenal cortex and abnormal accumulation of very long chain fatty acids in body fluid and tissue.The clinical manifestation,biochemical change,and magnetic resonance imaging were analyzed.Methods Clinical data of 11 cases with X-ALD were summarized and analyzed,including symptoms,signs,and inspection result.Relevant literature was reviewed.Results All cases were males,whose average onset age was (7.2 ± 4.7) year-old.It was (2.4 ± 1.9) years that the mean interval appears from onset to diagnosis.Six cases were with onset of adrenal insufficiency (AI),remaining 5 onset neural symptoms,where plasma very-long-chain fatty acids (VLCFA) was tested in 6 patients,all with abnormally high levels and brain magnetic resonance imaging(MRI) showed demyelination of cerebral white matter in 9 ones.Conclusions ALD is a X-linked genetically determined disorder that mainly affects the nervous system and adrenal gland.Plasma VLCFA test,ALD gene test,and cerebral MRI are reliable diagnostic methods.Early diagnosis and appropriate therapy would improve survival and neurological outcomes.

Application and evaluation of invasive prenatal diagnostic techniques and analysis of chromosomal karyotype / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the safety, effectiveness and complications of serial invasive prenatal diagnostic techniques, and to investigate the prenatal diagnosis indication as well as to analyze the abnormal chromosomal karyotype.@*METHODS@#We retrospectively studied all patients from March 2005 to May 2012 who received amniocentesis and cordocentesis in the prenatal diagnosis center of Second Xiangya Hospital. The indication of the procedure, successful rate and complications were evaluated, and 25 abnormal chromosome nuclear types were analyzed.@*RESULTS@#A total of 669 patients received invasive prenatal diagnosis from March 2005 to May 2012 in Second Xiangya Hospital: 598 received amniocentesis and 71 cordocentesis carried out. Compared with the cordocentesis group, the amniocentesis group had higher achievement ratio (91.54% vs 100%, P<0.05), lower spontaneous abortion rate (1.41% vs 0.33%, P<0.05), fewer abnormal karyotypes (11.27% vs 2.84%, P<0.05) and lower expenditure (880 yuan vs 800 yuan, P<0.05). Positive screening, advanced maternal age, and ultrasonography abnormality were the top 3 indications of amniocentesis and cordocentesis. We found 25 abnormal karyotypes, including 6 cases of trisomy 21, 4 sex chromosomal abnormalities, 7 autosomal balanced translocations, 1 marker chromosome, and 7 mosaics.@*CONCLUSION@#As a widely used invasive prenatal diagnosis, amniocentesis is safe and effective. The complications of cordocentesis are much higher than those of amniocentesis, which is not a proper routine procedure for prenatal diagnosis of abnormal karyotype. The analysis of karyotype not only can identify fetal chromosome abnormality, but also provide the scientific basis for pregnancy continuation, thus reducing the ratio of birth defect.

Prenatal anxiety and cesarean section with non-medical indication / 中南大学学报(医学版)

Objective: To explore the relationship between prenatal anxiety and cesarean section (c-section) with non-medical indication. Methods: Nested case-control study was used to analyze the risk factors for c-section with no medical needs: 433 pregnant women with gestational age longer than 24 weeks were enroled in this study. According to the mode of delivery, we divided them into a vaginal delivery group, a c-section group without medical need and a c-section group with medical need. Results: The c-section rate was 62.1%, 55.8% of which was c-section without medical need at family request. The score of state anxiety (S-AI) and trait anxiety (T-AI) was 42.53±11.04 and 44.40±10.23 respectively, much higher than that of normal population. After the adjustment of maternal social economic status and other prenatal statuses for this pregnancy, the prenatal anxiety was still associated with c-section with non-medical indication. The adjusted odd ratio for prenatal anxiety state, prenatal trait anxiety state and c-section with non-medical indication was 1.41 (95%CI: 1.06-1.87) and 1.23 (95% CI: 1.08-1.40), respectively. Conclusion: Prenatal anxiety state is a risk factor for c-section with non-medical indication.

Using plasma renin concentration to screen primary aldosteronism in hypertensive patients and to observe the effect of posture / 中华内分泌代谢杂志

Objective Plasma renin concentration (PRC) offers advantages in processing and standardization as compared with plasma renin activity (PRA). The aim of the study is to compare the sensitivity and specificity of plasma aldosterone concentration ( PAC)/PRA (ARR) and PAC/PRC (AARR) in screening primary aldosteronism ( PA ) in hypertensive patients and to observe the influence of different postures on PRC and AARR. Method ( 1 ) PAC and PRC in the supine position and after 1-hour and 2-hour upright posture were determined in 28 patients with PA and 51 patients with essential hypertension. The diagnostic efficacies during different postures were compared according to the ROC curve analysis. (2) 31 patients with PA, 242 patients with essential hypertension, and 145 normotensitive subjects were recruited in the study. The diagnostic efficacy of AARR in screening PA from hypertensive patients was evaluate. PAC, PRA, and PRC were measured by radioimmunoassay. Results ( 1 ) The AUC of AARR in the supine position, 1-hour and 2-hour upright posture were0.950 (95% CI0.906-0.994, P<0. 01), 0.979 (95% CI0.956-1.000, P<0.01) and 0.917 (95% CI 0. 856-0. 979, P<0. 01 ) respectively. AARR of 1 -hour upright yielded the highest screening efficiency. ( 2 ) The correlation coefficient index of Log-PRA and Log-PRC was 0. 705 ( P< 0. 01, n = 418 ), whereas the correlation coefficient index of Log-ARR and Log-AARR was 0.705 (P<0.01, n=418). The AUC of ARR and AARR were 0.998 (95% CI0. 981-1. 000, P<0.01 ) and 0.957 (95% CI0. 929-0.985, P<0.01 ) respectively according to the ROC curve. The optimal cutoff of AARR during upright 1 hour was 42.36 ng · dl-1/ng ·dl-1 ( sensitivity 87.10%, specificity 93.75% ). Conclusion The screening efficacy of AARR in screening PA in hypertensive patients was comparable with ARR. AARR measured after keeping upright 1 hour yielded the highest screening efficiency. The optimal cutoff of AARR was 42.36 ng · dl-1/ng ·dl-1.

Relationship between adiponectin and cardiac damage induced by aldosterone in SD rats / 中华内分泌代谢杂志

Objective To investigate relationship between adiponectin and cardiac damage induced by aldosterone in SD rats. Methods Male SD rats were treated with aldosterone infusion for 4 weeks, systolic blood pressure (SBP) was measured every week. At the end of experiment, the myocardial structure was observed, the levels of adiponectin in plasma and adiponectin mRNA expression of adipose tissue in epididymal fat pad were measured. 3T3-L1 adipocytes treated with 10-8 and 10-6 moL/L aldosterone for 24 and 48 h, adiponectin mRNA expressions and adiponectin concentrations in culture medium were measured. Results Aldosterone induced only a slight increase in the SBP of SD rats[(123±7)mm Hg, P<0.05]. However, aldosterone significantly induced cardiac ultrastructure changes, such as mitochondrial swelling and disordered internal structures. Furthermore, the level of plasma adiponectin decreased 22.8% after aldosterone treatment for 4 weeks ( P<0. 05 ). When 3T3-L1 adipocytes were treated with 10-8 and 10-6 mol/L aldosterone for 24 h, adiponectin concentrations in culture medium decreased 21.8% and 27. 2%, respectively (P < 0. 05); for 48 h, adiponctin mRNA expressions decreased 22.1% and 37.4%, respectively ( P<0. 05 ). The effect of aldosterone was reversed by spironolactone,which was partly independent of SBP. Conclusions Low level of adiponectin may be involved in cardiac damage induced by aldosterone in SD rats.

Relationship between low- and high-dose dexamethasone suppression test in patients with Cushing syndrome / 中华内分泌代谢杂志

Objective To investigate the relationship between the degree of serum cortisol suppression by low-dose dexamethasone (1 mg) and full serum cortisol suppression (suppression rate > 50% ) by high-dose dexamethasone (8 mg) in patients with Cushing syndrome, and to evaluate these tests in Cushing disease. Methods Ninty-one patients with Cushing syndrome were studied retrospectively. The relationship of 20%, 30%, 40%, and 50% cortisol suppression by overnight 1mg dexamethasone with full serum cortisol suppression by overnight 8 mg dexamethasone was analyzed, and the sensitivity and specificity in the diagnosis of Cushing disease were evaluated. Results The degree of cortisel suppression during overnight 1 mg dexamethasone suppression test was correlated with that during overnight 8 mg dexamethasone suppression test (r=0. 649,P<0. 001 ). 30, 22, 13, and 9 patients had greater than 20%, 30%, 40%, and 50% serum cortisol suppression respectively during overnight 1 mg dexamethasone suppression test. Among them, 23 ( 76. 7% ), 20 (90. 9% ), 12 (92.3%), and 9 ( 100.0% )patients had full serum cortisol suppression during overnight 8 mg dexamethasone suppression test. The sensitivity of the cutoff of greater than 20%, 30%, 40%, and 50% serum cortisol suppression for the diagnosis of Cushing disease was 52.8%, 32.7%, 22.6%, and 15.7%, and the specificity was 94.7%, 94.7%, 97.4%, and 97.4% respectively. Conclusions In patients with Cushing syndrome, greater than 20% serum cortisol suppression during overnight 1 mg dexamethasone suppression test is usually associated with full serum cortisol suppression during overnight 8 mg dexamethasone suppression test, and most of them are finally diagnosed as Cushing disease.

Role of osteoblasts in the sense of glucose / 中国组织工程研究

BACKGROUND: Recent study showed that osteocalcin may elevate Insulin secretion and sensitivity, prevent the fat accumulation, play a role in the metablism of glucose and lipid. Undercarboxylated osteocalcin works as the main role. OBJECTIVE: To investigate the effect of different concentrations of glucose on osteoblast undercarboxylated osteocalcin. METHODS: The rib trabeculae were resected and broken, trypsinizated and washed completely by PBS. Bone surface and non-adhesive floating cells in cleaning fluid were observed with inverted microscope. Rib trabeculae was washed by DMEM culture medium once, and cultured in culture bottle. The culture liquid was replaced by new one once a week. The osteoblast was moved from the scledte a week later. The cells were fused monolayer and could be subcultured 4 to 6 weeks later. The active second or third generation cells were inoculated to 6-pore plate forming 5 groups. Osteoblast were stimulated by 5.6 mmol/L., 7.6 mmol/L, 9.6 mmol/L, 12.6 mmol/L, 20.6 mmol/L glucose medium respectively after the 80% cells were fused, the vitamin K_2 was added into the culture liquid until the concentration of it to be 10~(-5) mol/L. Supernatant was collected after half hour culturing, the undercarboxylated osteocalcin level were detected with RIA test kit, and corrected it as the total the undercarboxylated osteccalcin, calculated the carboxylated incomplete osteocalcin rate. RESULTS AND CONCLUSION: The rate of ostecblast carboxylated incomplete osteocalcin was different under different concentration glucose. The rate of 7.6 mmol/L, 9.6 mmol/L, 20.6 mmol/L concentration glucose groups were higher than that of 5.6 mmol/L glucose group [(0.27±0.02)%, (0.29±0.04)%, (0.12±0.02)%, P < 0.05]. It is indicated that osteoblast could sense the change of glucose concentration by regulating the secretion of the undercarboxylated osteocalcin between the concentration of 5.6mmol/L to 9.6mmol/L, while the carboxylated incomplete osteocalcin decreased as the concentration of glucose increased.

Influential factors on the ratio of plasma aldosterone concentration to plasma renin activity in screening primary aldosteronism / 中华内分泌代谢杂志

The ratio of plasma aldosterone concentration to plasma renin activity (ARR) is a practical parameter in screening for primary aldosteronism (PA).However,variations of the cutoff value of ARR in different studies have been reported due to plenty of influential factors that may affect the secretions of renin and aldosterone. Lack of standardization of assays for ARR also makes direct comparisons among different studies difficult.The associated influential factors on ARR were introduced in this review.

A novel RET proto-oncogene mutation in a pedigree of multiple endocrine neoplasia type 2A / 中华内分泌代谢杂志

Objective To observe the clinical manifestation and the mode of RET proto-oncogene mutation in a pedigree of mutiple endocrine neoplasia type 2A (MEN2A). Methods Genomic DNA was extracted from the peripheral blood lymphocytes in 18 family members including 3 patients, then PCR was performed to amplify seven exons of the RET proto-oncogene, i. e. exon 8,10,11,13-16. The PCR products were directly sequenced to identify the RET mutation and then sequenced after subcloning to identify their heterozygosity. Results The male proband suffered from pheochromocytoma and medullary thyroid carcinoma since the age of 30; while his sibling sister was ill with pheochromocytoma, and his brother with medullary thyroid carcinoma. A novel heterozygous mutation, 1893-1895delCGA, was detected in exon 11 of the RET proto-oncogene in the 3 patients and the other 2 family members. Conclusion A novel heterozygous mutation of RET proto-oncogene, 1893-1895delCGA, seems to be the disease-causing mutation in the studied MEN2A family.

A Novel Method for Assaying Enzymatic Activity of Ribosome-inactivating Protein Using Plasmid DNA as Substrate / 生物化学与生物物理进展

A novel method for assaying the enzymatic activity of ribosome-inactivating proteins(RIPs) has been developed.The principle of the method is based on that RIP can remove some adenine bases from double-stranded supercoiled DNA molecules,subsequently,the deadenylated DNA was cleaved into nicked and linear form.After treatment with acidic aniline,the deadenylated DNA was degraded into many small fragments,and run out of the gel.The enzymatic activities of two RIPs(trichosanthin and cinnamomin) were tested using this method,the limit of sensitivity is about 50 ng(trichosanthin) and 5 ng(reduced cinnamomin) .It should be emphasized that the merit of this method is to avoid the preparation of ribosome.

Association between activity of nuclear factor-kappa B and angiotensin system in renal tissues of diabetic rats / 中国组织工程研究

BACKGROUND: Nowadays, angiotensin Ⅱ plays an important role in onset of diabetic nephropathy. Therefore, the nuclear factor-κB may have adjustive effects on angiotonin system of kidney tissue of diabetic rats. OBJECTIVE: To observe the relationship of activity of inhibitive nuclear factor-κB with angiotensin Ⅱ and its type 1 receptor mRNA expression of renal tissue of diabetic rats. DESIGN: Completely randomized group design, control experiment. MATERIALS: The experiment was conducted at the Experimental Animal Center, Sun Yat-sen University of Medical Sciences between March and April 2000. Fifty-one pure breed clean grade male Wistar rats were select ed. METHODS: ①Models were established in 39 rats. Streptozotocin dissolv ing in citric acid buffer (0.1 mmol/L,pH=4.5) were given to establish dia betic models with 60 mg/kg intraperitoneal injection. If the fasting blood glucose maintained above 13.9 mmol/L, the establishment of models was successful. The thirty-nine rats were randomly assigned into 3 groups: model group (n=17, without other interventional measure, feeding normally) and pyrrolidine dithiocar2. Bamate (PDTC) (active inhibitor of nuclear fac tor-κB) interventional group [n=22, PDTC at the dose of 20 mg/kg were given with intraperitoneal injection, twice a day]. Other 12 rats were as normal control group, did not make into diabetic models with normal breeding. ②After feeding for 18 weeks kidneys were got in every group. The activity of nuclear factor-κB was detected with electrophoretic mobility shift assay. The expression of type 1 receptor mRNA of angiotensin Ⅱ was measured with reverse transcription polymerase chain reaction (RT-PCR). Contents of angiotonin Ⅰ and angiotensin Ⅱ were tested with Radio Im munoassay (RIA). Activity of rennin was referred to that the result of the level of angiotonin Ⅰ at 37 ℃ water bath subduced to that at 4 ℃. ③Dif ference of measurement data was compared with single factor analysis of variance. After normal transformation, the non-normal distribution data were conducted with statistical disposal. MAIN OUTCOME MEASURES: Comparison of contents of angiotensin Ⅰ and Ⅱ, activities of rennin and nuclear factor-κB and expression of type 1 receptor mRNA of angiotensin Ⅱ in renal tissues of rats of each group. RESULTS: In the normal control group, model group and PDTC interven tional group 1, 6 and 13 rats were dropped out, respectively, so 11, 11 and 9 rats in each group were involved in the result analysis. ①Activity of nu clear factor-κB: It was higher significantly in the model group than that in the normal control group and PDTC interventional group (P ＜ 0.01 ). It was similar between the normal control group and the PDTC interventional group. ②Activity of rennin of renal tissue: It was similar among the 3 groups. ③Content of angiotonin Ⅰ of renal tissue: It was higher obviously in the model group that that in the normal control group and the PDTC interventional group (P ＜ 0.01 ). ④Content of angiotensin Ⅱ in renal tissue: It was similar between the model group and the normal control group. It was lower markedly in the PDTC interventional group than that in the model group and the normal control group (P ＜ 0.01 ). Expression of type 1 receptor mRNA of angiotensin Ⅱ: It was lower remarkably in the model group than that in the normal control group (P ＜ 0.01 ). It was lower dis tinctly in the PDTC interventional group than that in the model group and the normal control group (P ＜ 0.01 ). CONCLUSION: The increase of activity of nuclear factor-κB in renal tissue of diabetic rats can inhibit the activity of nuclear factor-κB, which will induce the reduction of the level of angiotensin Ⅱ and expression of type 1 receptor mRNA of angiotensin Ⅱ in renal tissue of diabetic rats.

Clinical outcome of patients with left anterior descending artery ostial lesions treated with percutaneous coronary intervention: case-matched comparison with bypass surgery / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the immediate and late clinical outcome of left anterior descending artery ostial lesions treated with percutaneous coronary intervention.</p><p><b>METHODS</b>Seventeen patients (6 females and 11 males) treated with percutaneous coronary intervention for ostial left anterior descending artery stenoses have had clinical follow-ups over 12 months. Clinical events were defined as an occurrence of death, myocardial infarction, recurrent angina, and requiring repeat revascularization (either by angioplasty or by surgery). A matched population treated with coronary bypass surgery was selected based on the similarities in age, left ventricular ejection fraction and the number of diseased vessels. Kaplan-Meier event-free survival curves were generated and the matched comparison was done using the Chi-square test (Mc Neimar method).</p><p><b>RESULTS</b>In the catheter-based angioplasty group, the patients' mean age was 63 +/- 8 years. One patient was treated with directional atherectomy plus balloon, 6 with rotational atherectomy plus balloon, 7 with stent and 3 with rotational atherectomy plus stent. Glycoprotein IIb/IIIa antagonist was used in 4 cases. Initial procedural success without major complications was achieved in all cases. The mean reference diameter was 2.90 +/- 0.48 mm. The minimum lumen diameter increased from 1.05 +/- 0.30 mm to 2.40 +/- 0.45 mm, and the diameter stenosis decreased from 64% +/- 7% to 8% +/- 13%. During the follow-up period, adverse events requiring repeat revascularization occurred in 8 patients. The event-free probability was 0.42 +/- 0.14 in a two-year period. In a matched population treated with bypass surgery (single mammary graft), only one event occurred, and the difference in event-free survival in two-year period between the two patient groups was significant.</p><p><b>CONCLUSIONS</b>Percutaneous coronary intervention for left coronary descending artery ostial lesion is technically feasible and safe, leading to an optimal early success rate, but has a higher risk of late restenosis and greater need for repeat revascularization than coronary bypass surgery.</p>

Visfatin gene expression and secretion are regulated by aldosterone in 3T3-L1 preadipocytes and adipocytes / 中国病理生理杂志

AIM:To explore the effect of aldosterone on visfatin gene expression and secretion in 3T3-L1 preadipocytes or adipocytes.METHODS:Aldosterone at concentration of 10-8 or 10-6 mol/L with or without 10-6 mol/L spironolactone was added to cultured 3T3-L1 preadipocytes or adipocytes for 24 h or 48 h.The mRNA levels of visfatin and mineralocorticoid receptor were measured using real time PCR.The concentration of visfatin in the culture medium was determined by ELISA.RESULTS:In 3T3-L1 preadipocytes treated with aldosterone,the mRNA expression of visfatin reduced and the mRNA expression of mineralocorticoid receptor(MR) increased,but the concentration of visfatin in culture medium was not regulated significantly by aldosterone.In adipocytes with aldosterone treatment,the mRNA expression of visfatin and visfatin concentration in culture medium reduced,and mRNA expression of MR increased.The effect of aldosterone was blocked by spironolactone to some extent.CONCLUSION:Aldosterone inhibits the gene expression and protein secretion of visfatin in 3T3-L1 adipocytes.