The impact of preoperative glycated hemoglobin (HbA1c) on postoperative complications after elective major abdominal surgery: a meta-analysis / 대한마취과학회지

Background@# Diabetes is a risk factor for postoperative complications. Previous meta-analyses have shown that elevated glycated hemoglobin (HbA1c) levels are associated with postoperative complications in various surgical populations. However, this is the first meta-analysis to investigate the association between preoperative HbA1c levels and postoperative complications in patients undergoing elective major abdominal surgery. @*Methods@# PRISMA guidelines were adhered to for this study. Six databases were searched up to April 1, 2020. Primary studies investigating the effect of HbA1c levels on postoperative complications after elective major abdominal surgery were included. Risk of bias and quality of evidence assessments were performed. Data were pooled using a random effects model. Meta-regression was performed to evaluate different HbA1c cut-off values. @*Results@# Twelve observational studies (25,036 patients) were included. Most studies received a ‘good’ and ‘moderate quality’ score using the NOS and GRADE, respectively. Patients with a high HbA1c had a greater risk of anastomotic leaks (odds ratio [OR]: 2.80, 95% CI [1.63, 4.83], P 7% may be putting pre-optimized patients at risk. Future randomized controlled trials are needed to explore causation before policy changes are made.

Effect of laparoscopic surgery on postoperative rehabilitation and stress response of patients with colorectal cancer / 中国基层医药

Objective:To explore the effect of laparoscopic surgery on postoperative rehabilitation and stress response of patients with colorectal cancer.Methods:From January 2018 to September 2019, 94 patients with colorectal cancer were selected in the General Hospital of Marine Police of the Chinese People's Armed Police Force.They were divided into observation group (47 cases) and control group (47 cases) according to the random digital table method.The observation group was treated with laparoscopic surgery, while the control group was treated with open surgery.The changes of perioperative indicators, postoperative rehabilitation indicators, postoperative complications and 24-hour stress response indicators were compared between the two groups.Results:The time of lymph node dissection and operation had no statistically significant differences between the two groups (all P>0.05). The amount of bleeding of the observation group [(153.61±27.58)mL] was less than that of the control group [(271.32±23.25)mL] ( t=22.371, P<0.05). In the observation group, the exhaust time [(43.27±6.18)h] and the recovery time of bowel sounds [(20.31±3.28)h] were faster than those in the control group [(67.38±9.91)h and (34.54±5.17)h] ( t=14.153, 15.934, all P<0.05). The incidence of postoperative complications in the observation group (4.26%) was lower than that in the control group (21.28%) (χ 2=6.114, P<0.05). The serum levels of norepinephrine (NE) [(92.13±10.45)μg/L], C-reactive protein (CRP) [(17.38±3.01)mg/L] and Cor [(137.87±23.15)μg/L] in the observation group were lower than those in the control group [(136.27±15.42)μg/L, (26.73±2.34)mg/L and (185.42±27.39)μg/L] ( t=16.245, 16.813, 9.090, all P<0.05). Conclusion:Laparoscopic radical resection of colorectal cancer has good effect on patients with colorectal cancer.It can speed up postoperative rehabilitation and reduce stress response.It is worthy of popularizing.

Susceptibility weighted imaging in evaluation of the fetal vertebra and vertebral anomalies / 中华放射学杂志

Objective To explore the advantages of susceptibility weighted imaging (SWI) in depiction of normal fetal vertebra and vertebral anomalies.Methods This prospective study was approved by our institutional review board, and written informed consent was obtained from every participant, Fifty-eight pregnant women (gestation age 22 to 39 weeks, average 29 ± 3 weeks) who were suspected of carrying babies with vertebral anomalies by ultrasound screening underwent 1.5 T fetal spine MRI[including half-fourier acquisition single-shot turbo spin-echo(HASTE),true fast imaging with steady-state(True FISP) and SWI sequences]. MR images were reviewed for their quality by two radiologists independently. The image scores in HASTE, True FISP and SWI were compared by using Kruskal-Wallis test and Mann-Whitney U test. Three segments (cervical, thoracic and lumbosacral segments, respectively) of 15 fetuses were, at random, collected to compare among HASTE,True FISP and SWI and then evaluated by ANOVA analysis.The diagnostic accuracy of the three sequences among 32 cases with follow-up results was calculated respectively and compared by using Chi-square test. Results There was statistical differences among three sequences(χ2=50.685,P<0.05).The scores of SWI was higher than that of True FISP, and the scores of True FISP was higher than that of HASTE in the evaluation of the fetal vertebra(P all<0.05).The differences among cervical,thoracic and lumbosacral segments on True FISP and HASTE showed significant difference statistically (P all<0.05), also the image quality of cervical segment could not meet the requirement of clinical diagnosis. The image quality of SWI was favorable clinically and no statistical difference among three segments was found(P>0.05).A total of 32 fetal vertebral anomalies were identified by follow-up after birth including hemivertebra (n=14), fusion of vertebrae (n=1), butterfly vertebra (n=1), multiple vertebral malformations(n=9),spinal bifida(n=5),caudal regression syndrome(n=2).The diagnostic accuracy of SWI, True FISP and HASTE was 93.75% (30/32), 56.25% (18/32) and 37.50% (12/32) respectively.The diagnostic accuracy of SWI was the best compared to that of True-FISP and HASTE(χ2=10.083,20.017;P<0.01). Conclusion SWI proved to be the optimal technique in depiction of fetal vertebra and vertebral anomalies than True FISP and HASTE,especially in depiction of cervical vertebra.

Role of immunoproteasome subunit β2i in DOCA/salt-induced vascular inflammation in mice / 中国病理生理杂志

AIM:To investigate the role of immunoproteasome subunit β2i in deoxycorticosterone acetate (DOCA)/salt-induced vascular inflammation in mice.METHODS:Wild-type and β2i knockout male mice were used.The right kidney was removed and DOCA pellet was subcutaneously implanted in the mice.The mice were then received 1% NaCl as drinking water for 3 weeks.The total RNA and protein were isolated from thoracic aorta 3 weeks later.The aortic tissues were fixed in formalin, embedded in paraffin and sectioned.Western blot, real-time PCR and immunohistochemistry were performed to detect the expression of β2i, macrophage marker Mac-2, NF-κB, and proinflammatory cytokines IL-1β, IL-6 and TNF-α in thoracic aorta.RESULTS:Compared with sham group, DOCA/salt treatment significantly increased the expression of β2i at mRNA and protein levels, increased the infiltration of macrophages and expression of Mac-2, and upregulated the expression of NF-κB and proinflammatory cytokines including IL-1β, IL-6 and TNF-α in wild-type group, whereas theses effects were markedly attenuated in β2i knockout mice.CONCLUSION:Immuneproteasome subunit β2i is involved in DOCA/salt-induced vascular inflammation through activation of NF-κB signaling in the mice.

Relationship between subclinical hypothyroidism and diabetic nephropathy in type 2 diabetic patients / 中华老年医学杂志

Objective To investigate the relationship between subclinical hypothyroidism and diabetic nephropathy in type 2 diabetic patients (T2DM).Methods We retrospectively analyzed the clinical data of 218 patients with T2DM treated at the Department of Endocrinology,Shanghai Tongren Hospital from January 2015 to December 2016.Based on the level of thyroid stimulating hormone (TSH),patients were divided into a hypothyroidism group (TSH＞4.20 mU/L) and a control group (TSH 0.35-4.20 mU/L),and the relationship between subclinical hypothyroidism and diabetic nephropathy was evaluated.Results There were 46 cases in the subclinical hypothyroidism group and 172 cases in the control group.The incidences of diabetic nephropathy were significantly different between the two groups (P ＜0.05).Furthermore,the incidence of diabetic nephropathy was significantly higher in patients with high levels of TSH (≥10.0 mU/L) than in those with low levels of TSH (＜10.0 mU/L) (P＜0.05).Conclusions Diabetic patients with subclinical hypothyroidism are prone to diabetic nephropathy,so it is necessary to screen thyroid function.

Effect of Bortezomib on Angiotensin Ⅱ-induced Abdominal Aortic Aneurysm in ApoEMice / 中国医学科学院学报

Objective To investigate the role of proteasome inhibitor bortezomib (BTZ) in inflammatory response in abdominal aortic aneurysm (AAA) formation induced by angiotensin Ⅱ (Ang Ⅱ). Methods Ang Ⅱ-induced ApoEmice AAA models were established. Forty male ApoEmice (8-10-week-old) were randomly and equally divided into four groups:Sham group,BTZ group,Ang Ⅱ group,and Ang Ⅱ+BTZ group.HE staining,immunohistochemical staining,and flow cytometry were used to analyze the inflammatory response. Real-time quantitative polymerase chain reaction (qPCR) was used to analyze the mRNA expression of intercellular cell adhesion molecule-1 (ICAM-1). Western blotting was used to analyze the activation of nuclear factor κB signaling (NF-κB). Results The mean maximum suprarenal aortic diameter (Dmax) of Sham group,BTZ group,Ang Ⅱ group,and Ang Ⅱ+BTZ group were (1.00±0.01),(0.99±0.01),(1.50±0.13),and (1.20±0.04)mm,respectively (F=8.959,P=0.000). The Dmax of Ang Ⅱ group was significantly larger than those of Sham group (P=0.000) and Ang Ⅱ+BTZ group (P=0.015). The incidence of AAA in Ang Ⅱ group,Ang Ⅱ+BTZ group,and Sham group were 60%,17%,and 0,respectively. HE staining revealed that the abdominal aortic wall thickening was more severe in Ang Ⅱ group than in Sham group and Ang Ⅱ+BTZ group,similar with the infiltration of inflammatory cells. Immunohistochemical staining demonstrated that the CD3T lymphocyte count was significantly higher in Ang Ⅱ group than in Sham group (107.9±15.9 vs. 0,P=0.000) and Ang Ⅱ+BTZ group (107.9±15.9 vs. 0.8±0.5,P=0.000). Flow cytometry also demonstrated that the proportion of the CD3T lymphocytes of the Ang Ⅱ group [(13.50±0.69)%] was significantly higher than that in the Ang Ⅱ+BTZ group [(10.40±0.78)%] at week 1 (t=3.009,P=0.040),and the proportion of the CD3T lymphocytes of the Ang Ⅱ group [(22.70±0.93)%] was significantly higher than that in the Ang Ⅱ+BTZ group [(15.10±0.97)%] at week 4 (t=5.654,P=0.005). The qPCR analysis showed that the mRNA expression of ICAM-1 was significantly up-regulated in Ang Ⅱ group than in Sham group (1.93±0.54 vs. 1.00±0.15,P=0.011) and Ang Ⅱ+BTZ group (1.93±0.54 vs. 0.83±0.08,P=0.009). Western blot analysis showed a lower phosphorylation level of inhibitor of NF-κB in the Ang Ⅱ group compared with the Sham group or Ang Ⅱ+BTZ group,accompanied with an increased phosphorylation level of p65. Conclusion Proteasome inhibitor BTZ can attenuate AAA formation partially by regulating T lymphocytes infiltration through regulating the mRNA expression of ICAM-1 regulated by the activation of NF-κB signaling pathway.

Change of Serum Angiopoietin-like Protein 2 and Its Significance in Patients with Arteriosclerotic Occlusion / 中国医学科学院学报

Objective To investigated the changes of angiopoietin-like protein 2(Angptl2) in patients with arteriosclerotic occlusion (ASO). Methods A total of 140 subjects including 75 ASO patients (ASO group) and 65 healthy subjects (control group) were enrolled in this study. Angptl2 and adiponectin were evaluated by using enzyme-linked immunosorbent assay. Biochemical data and high sensitive C reactive protein were measured and recorded as well. Results Compared to the control group,the ASO group presented with significantly higher level of plasma Angptl2 [(13.55±9.17) μg/L vs. (9.04±4.79) μg/L,P=0.010]. Plasma Angptl2 level of critical limb ischemia subjects was significantly higher than that of intermittent claudication subjects [(17.01±10.20)μg/L vs. (10.53±6.97) μg/L,P=0.003]. The best diagnostic cutoff value of Angptl2 was 13.67 μg/L,with a sensitivity of 60.34% and a specificity of 81.25%. In addition,type 2 diabetes mellitus patients with ASO exhibited significantly higher serum Angptl2 levels [(18.67±9.84)μg/L] than those without ASO [(13.01±3.47) μg/L] (P=0.021). In ASO group,serum Angptl2 levels were negatively correlated with ankle brachial index (r=-0.244,P=0.035). Conclusion The plasma level of Angptl2 increases in ASO patients. Its level is remarkably increased when the disease progressions to critical limb ischemia. Angptl2 can be a potential biological marker of disease progression.

Expression and clinical significance of clusterin in acute cerebral infarction / 重庆医学

Objective To investigate the expression and clinical significance of clusterin (CLU ) in acute cerebral infarction (ACI) .Methods A total of 154 inpatients with ACI within 48 h of the first onset in the First Affiliated Hospital of Nanchang Uni‐versity from May to December 2013 served as the ACI group and divided into subgroups according to the neural function defection degree and whether having plaque .Contemporaneous 45 individuals undergoing the healthy physical examination were selected as the control group .The serum CLU and complement C3 levels were detected .The National Institutes of Health Stroke Scale (NIH‐SS) and Barthel index scores were conducted ,the rehabilitation course and outcome until 90 d after onset were followed up ,and the comparative analysis on serum CLU level was performed .Results The serum CLU and complement C3 levels in the ACI group were significantly higher than those in the control group ,the differences were statistically significant (P0 .05) ,the serum CLU level had statistically significant differences among other prognosis types of the patients groups (P<0 .01 or P<0 .05) .The lower the serum CLU level ,the rehabilitation the better .Conclusion CLU play a role by regulating the complement system after cerebral infarction occurrence ,serum CLU level is correlated with carotid arterial plaque ,neurological function defection degree and prognosis in ACI patients ,which can serve as one of biochemical indicators for evaluating the disease condition and guiding prognosis in ACI patients .

Application of health education path in health education on patients with diabetes / 现代临床护理

Objective To study the effect of the health education path on health education in patients with diabetes.Methods According to random number table method,100 type 2 diabetes mellitus(T2DM)patients were divided into control group and health education path group.Health education path group received health education through the health education path and the control group by traditional methods.The rate of diabetes-related knowledge mastery and the control of blood glucose in two groups were compared. Result The rate of diabetes-related knowledge mastery and the control of blood glucose in the health education path group were significantly better than those of the control group(P<0.05,for both).Conclusion Health education according to health education path to the patients with diabetes can increase the degree of knowledge and the control effect of blood sugar.

Assessment of the American Joint Committee on Cancer 7th edition staging for localised prostate cancer in Asia treated with external beam radiotherapy

<p><b>INTRODUCTION</b>Most international clinical practice guidelines for prostate cancer (PCa) are driven by data derived in a Western setting. However, tumour biology and clinical disease progression are likely to differ in the Asian population. We compare the performance of the revised American Joint Committee on Cancer (AJCC) prognostic groups with the commonly used D'Amico Risk Classification and conventional predictors for PCa, in a large cohort of Asian patients.</p><p><b>MATERIALS AND METHODS</b>We retrospectively reviewed data for 404 consecutive Singaporean patients receiving definitive radiotherapy at our centre between December 1996 and October 2006. The primary outcome was biochemical relapse-free survival (BRFS), defined using the Phoenix definition. The secondary outcome was overall survival (OS). Prognostic risk groups were defined using AJCC 7th edition (AJCC7) and 6th edition (AJCC6). Univariate analysis (UVA) and multivariate analysis (MVA) were performed for the following putative risk factors: age, Gleason score, prognostic grouping, tumour classification, radiation delivery technique, radiotherapy dose, hormonal therapy and initial PSA value.</p><p><b>RESULTS</b>For the cohort, median age was 69 years. Median follow-up was 66.3 months. Five-year BRFS rate was 84.3% with 71 biochemical relapses and 5-year OS rate was 89.1% with 54 deaths. The concordance-indices for BRFS prediction were 0.588, 0.550 and 0.567 for AJCC7, AJCC6 and D'Amico respectively. Initial PSA, T-stage and AJCC7 were prognostic for BRFS on UVA. Comparison of AJCC7 vs. D'Amico showed no statistical additional value of either classification system although D'Amico was superior when compared to AJCC6 in predicting BRFS. T-stage ≥3 and D'Amico were significant prognostic factors for BRFS on MVA.</p><p><b>CONCLUSION</b>In our local, predominantly Chinese population, neither AJCC6 nor AJCC7 demonstrated a high predictive accuracy for BRFS although AJCC7 has a slightly better predictive ability than AJCC6.</p>

The role of angiogenesis in myocardial injury in septic mice / 中华急诊医学杂志

Objective To investigate the angiogenesis,apoptosis and their mechanisms in septic mice with myocardial injury.Methods Forty male C57BL/6 mice aged 8 weeks were randomly ( random number) divided into two groups:the sepsis group and the control group.The mice of sepsis group were treated with lipopolysaccharide (LPS) ( 10 mg/kg Intraperitoneal injection) while the mice of control group were treated with saline solution instead (10 mg/kg Intraperitoneal injection).Cardiac function of mice (n =40) was evaluated with ultrasound 6 hours after LPS administration.Subsequently,the tissues of heart,lung and kidney of mice (n =6) were taken and treated with Haematoxylin -Eosin staining (H&E) in order to observe the pathological changes and verify the successfulness of modeling.Immunohistochemistry staining with PECAM - 1 and α - SMA was used to identify the angiogenesis in the heart ( n =3 ),while the TUNEL apoptosis assay was applied for detecting the myocardial cell apoptosis ( n =3 ).The mRNA was extracted from heart tissue (n =6) to observe the expression of HIF-1 ot which was proved to be an angiogenesis factor.All the results were analyzed by independent sample t - test.Results Compared to the control group,mice in the sepsis group showed increased in thickness of left ventricular diastolic anterior wall ( t =- 4.60,P ＜ 0.05 ) and thickness of left ventricular systolic anterior wall (t =-3.24,P ＜0.05 ) along with decrease in left ventricular end diastolic diameter ( t =3.57,P ＜ 0.01 ) and stroke volume ( t =5.51,P ＜ 0.01 ).Immunohistochemistry staining with alpha - SAM antibody revealed increase in cardiac angiogenesis in the sepsis group (t =- 11.00,P ＜ 0.01 ).TUNEL apoptosis assay demonstrated apoptosis of the cardiomyocytes [ sepsis group versus control group:( 191.31 ±5.41 ) vs ( 52.24 ±4.32) ] and RT - PCR showed an increase in the expression of HIF - 1 alpha in the mice of the sepsis group ( t =- 8.12,P ＜0.05) Conclusions There were apparent myocardial angiogenesis,apoptosis and cardiac dysfunction in septic animal models.HIF-1α might play a role in the angiogenesis pathway.

Inhibition effect of anti-epidermal growth factor receptor antibody mediated by recombinant adeno-associated virus vector on pancreatic cancer cell lines / 中华消化外科杂志

Objective To construct a recombinant adeno-associated virus(rAAV)vector containing a human anti-epidermal growth factor receptor(anti-EGFR)single-chain variable fragment antibody gene,and observe its inhibitory effects on pancreatic cancer cell lines.Methods Human anti-EGFR single-chain variable fragment antibody gene was inserted into the Kpn I and Bgl Ⅱ sites to construct a rAAV-anti EGFR vector,and then rAAV1-EGFP group and rAAV1-anti EGFR group were established.The expression of anti-EGFR antibody was observed.Antibody expression was detected by Western blot,and the inhibition and apoptosis rates of human pancreatic cancer cell lines(PCT-3,SW1990,Capan-1,ASPC-1,MiaPaCa-2 and PANC-1 cells)were detected by CCK-8 assay and flow cytometry,respectively.All data were analyzed using the t test.Results The results of Western blot assay demonstrated that anti-EGFR antibody was expressed in 6 pancreatic cancer cell lines.The inhibition rates of rAAV1-EGFP and rAAVl-anti EGFR on pancreatic ASPC-1 cells were 1.1%± 2.4% and 15.1%±3.5%,respectively,with a significant difference between the 2 groups(t =6.598,P ＜0.05).The apoptosis rates of PANC-1 cells were 7.0% ± 3.0% in the rAAV1-EGFP group and 1 1.4% ± 2.5% in the rAAV1-anti EGFR group,with no significant difference between the 2 grouvs(t = 1.952,P ＞0.05).The apoptosis rates of SW1990,ASPC-1,Capan-1,PCT-3,MiaPaCa-2 cells were 1.1% ± 0.8%,1.5% ± 0.7%,1.7% ± 1.2%,1.1%±0.7% and 2.2% ± 1.1% in the rAAV1-EGFP group,and 17.6% ± 2.2%,46.9% ± 3.9%,20.0% ±2.8%,12.1% ± 1.6% and 31.1% ±2.5% in the rAAV1-anti EGFR group,respectively,with significant differences between the 2 groups(t = 12.208,19.846,10.405,10.909,18.327,P ＜0.05).Conclusions A rAAV-anti EGFR vector with human anti-EGFR single-chain variable fragment antibody gene was constructed.Anti-EGFR antibody has obvious inhibition effects on pancreatic cancer cell lines.

Study on glucose, creatinine, urea nitrogen and serum ET-1 of patients with acute cerebral infarction / 中华急诊医学杂志

Objective To study glucose,creatinine,urea nitrogen and serum ET-1 of patients with acute cerebral infarction,and to explore the relationship between neurologic impairment and ET-1 levels.Methods The glucose,creatinine,urea nitrogen and serum ET-1 were retrospectively analyzed in 50 patients with acute cerebral infarction ( ＜ 24 h) and 50 patients with non-neurological diseases.ET-1 determined by 125I radioimmunoassay.Results There were no significant differences in glucose,creatinine and urea nitrogen of acute cerebral infarction ( P ＞ 0.05 ) ; Compared to the control groups,ET-1 levels was significantly higher ( P ＜ 0.01 ),and levels of serum ET-1 in acute cerebral infarction were significantly correlated with their neurological deficits ( P ＜ 0.01 ).Conclusions Levels of serum ET-1 can severd as diagnostic and prognostic indicator of acute cerebral infarction.

MRI findings of fetal cleft lip and palate / 中华放射学杂志

Objective To investigate the MR findings of fetal cleft lip (CL) and evaluate the advantages and limitations of MRI in the diagnosis. Methods Twelve pregnant women suspicious of fetal CL/cleft palate(CP) on ultrasonography were enrolled in the study. The findings of ultrasonography, MRI and following-up were compared. Results MRI and ultrasonography detected 12 fetuses with CL/CP. The following-up results showed 1 case with incomplete cleft lip and the other 11 cases with complete cleft lips and cleft palates. MRI and unltrasonography were consistent with the follow-up in CL detection, showing completed or uncompleted soft tissue interruption of the fetal lips with amniotic fluid filling which is high signal on T_2WI. On MRI, CP showed discontinuous of the soft tissue which were interrupted by long T_2 signal and communicating with oral cavity and nasal cavity. MRI missed 1 case and excluded 1 case of CP. Ultrasonography predicted 5 case of CL, excluded 1 CP but missed 6 cases. The accuracy, sensitivity and specificity in detection CL/CP was 91.7% (11/12), 90.9% (10/11), 100% (1/1) for MRI and 50.0% (6/12),45.5% (5/11), 100% (1/1) for ultrasonography, respectively. Conclusion MR imaging had advantage over ultrasonography in detecting CP, MRI is an essential when CP is suspicious on ultrasonography.

Neuron-specific enolase, S-100B protein and cerebra infarction / 国际脑血管病杂志

Previous studies have agreed that the levels of neuron-specific enolase (NSE)and S100B protein have an important value for the severity of cerebral infarction and prognosis estimation. This article reviews the relationship between the serological changes of NSE and S100B and cerebral infarction, infarct volume, severity of neurological deficits, infarct location,and prognosis, as well as the advances in research on the evaluation of therapeutic drugs.

Ubiquitin-proteasome system and cardiovascular diseases / 基础医学与临床

The ubiquitin-proteasome system(UPS) containing ubiquitin-activating enzyme(E1),ubuquitin-conjugating enzyme(E2s),ubiquitin-ligase(E3s) and 26S proteasome,is involved in the degradation of most intracellular proteins.One major function of UPS is to prevent accumulation of non-functional and potentially toxic proteins.Moreover,it has become clear that the UPS fulfills an important function in most aspects of eukaryotic biology,such as inflammation,cell proliferation,intracellular signaling,transcriptional control,and apoptosis.Recent studies demonstrated that the UPS regulates the initiation and progression of atherosclerosis,ischemia-reperfusion injury,familial cardiomyopathies,hypertrophic and heart failure.This review briefly summarizes current knowledge about structure,function,regulation of UPS and its pathophysiological role in cardiovascular diseases.

Research of myocardin and its relation to cardiovascular diseases / 基础医学与临床

Myocardin is a remarkably potent transcriptional coactivator which specifically expresses in cardiovascular system and directly binds to serum response factor.It activates transcription of a subset of SRF-regulated genes encoding cardiomyocytes and smooth muscle cells contractile proteins.Abnormal expression of myocardin is associated with cardiovascular diseases including atherosclerosis,myocardial hypertrophy and hypertension.Here,recent developments in the structure,expression and regulation of myocardin and its relation with cardiovascular diseases are reviewed.

Study of clinical value and influencing factors of ~1H-MR spectroscopy in mammary tumors / 中华放射学杂志

Objective To investigate the diagnostic value of 1H magnetic resonance spectroscopy (1H-MRS) in mammary tumors and to discuss the technique factors which influence the detection rate.Methods The 1H-MRS features of 47 mammary tumors, of which 24 malignant tumors and 23 benign tumors confirmed by pathology were analyzed. All of the tumors were detected before Gd-DTPA enhancement. Results Eleven of 24 malignant tumors showed increased choline resonance peak at 3.24 ppm while 4 of 23 benign ones at 3.24 ppm .The positive value were 45.8% and 17.4% respectively. The sensitivity and specificity were 45.8% and 82.6% respectively by using 1H-MRS to discriminate benign from malignant tumors. The main factors influencing the detection rate were low suppressed lipid, low suppressed water and low single-noise rate.Conclusion Choline is not special features of malignant tumors. Choline can be obtained despite the nature of tumor if they grow rapidly. The low sensitivity of choline to be detected mainly dues to technique factors.

Balloon dilation of ureter through ureteroscopy for ureter stenosis / 中华泌尿外科杂志

ObjectiveTo assess the effect of balloon o f ureter through ureteroscopy for management of ureter stenosis.Met hods42 cases ureter stenosis underwent balloon dilation of ureter,2 2 being male,20 being female.The average age was 46 years.There was 5 ureteropel vic junction stenosis,8 upper ureter stenosis,5 middle part stenosis,24 lower pa rt stenosis.The length of stenosis was from 0.5 cm to 2.0 cm.Result sThe balloon dilating catheter was passed over the ureter stenosis area and was put in proper position in 39 cases.3 cases were failed(7.2%). 37 ca ses successfully underwent balloon dilation of the ureter on one session.All pat ients were followed up for 6 to 24 months(mean 14 months).The degree of hydronep hrosis decreased with no recurrence in 37 cases(88.1%).2 casese failed to gain the effect after the double-J stent was removed(4.7%). There are no serious co mplication found in all patients.ConclusionsBalloon di lation of ureter offers many advantages,such as:good result,repeatable and reduc ing the cost and hospital stay.