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Adrenocortical crisis (AC) is a kind of endocrine emergency, often occurs in infection, shock, trauma, or postoperative, if the processing is not handling timely, can endanger patient's life.But as the disease is not common and the clinical symptoms are not typical,so it is easy to be misdiagnosis and missed diagnosis.This case was a "lumbar spinal canal decompression surgery" patient, who appeared postoperative confusion, oxygenation decline,and could not seperated from breathing machine, clinical manifestations were atypical.
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Objective To explore the relationship between plasma adiponectin, visfatin, leptin, and resistin levels, and the onset of colonic polyps in prediabetes subjects. Methods A total of 468 prediabetes subjects, who received colonoscopy examination, were enrolled in this study, including 248 cases of colon polyps (polyps group with prediabetes) and 220 cases without colonic mucosal lesions ( polyps-free group with prediabetes). According to the clinical characteristics of colonic polyps, colonic polyps patients with prediabetes were subdivided into single polyp group, multiple polyps group, low-risk polyps group, and high-risk polyps group, respectively. In addition, 108 subjects with normal glucose tolerance, who were matched with prediabetes subjects on gender and age, were selected as control group, and 46 cases of them were refered to polyps group with normal glucose tolerance and 62 cases were refered to polyps-free group with normal glucose. Plasma adiponectin, visfatin, leptin, and resistin levels were measured in all subjects, and related risk factors of colonic polyps in prediabetes patients were analyzed. Results Not only in normal glucose tolerance subjects, but also in prediabetes subjects, plasma visfatin levels in polyps group were significantly higher than those in polyps-free group (P＜0.05), and plasma adiponectin levels were significantly lower than those in polyps-free group [normal glucose tolerance (9.8±4.8 vs 13.3±3.9)mg/L, P＜0.05; prediabetes (5.6 ± 3.7 vs 9.2 ± 4.4)mg/L, P＜0.01], respectively. However, no significant difference in the plasma leptin and resistin levels were observed between polyps-free group and polyps group ( both P＞0. 05), respectively. In addition, in prediabetes subjects, plasma visfatin levels increased (P＜0.05) and adiponectin levels decreased significantly [(4.3 ± 2.6 vs 6.7 ± 3.9) mg/L, P＜0.05] in multiple polyps group than in single polyp group. Nevertheless, there were no significant differences in plasma leptin and resistin levels between two groups (both P＞0.05). Moreover, plasma adiponectin levels decreased significantly in high-risk polyps group with prediabetes than in low-risk polyps group with prediabetes[(3.7±2.9vs7.4±3.5)mg/L,P＜0.05].Meanwhile,noneofplasmavisfatin,leptin,andresistinlevels had shown significant difference between two groups (all P＞0.05). The multivariate logistic regression analysis found that adiponectin was an independent protective factor for colon polyps, multiple colon polyps and high-risk colon polyps. Conclusion The changes of plasma adiponectin levels might be associated with onset of colonic polyps in prediabetes.
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Objective To investigate the efficacy and safety of non-blocking renal artery laparoscopic partial nephrectomy in the treat-ment of renal cell carcinoma of stage T 1~T2.Methods From January 2012 to May 2016,the 140 patients with renal cell carcinoma of stage T1~T2 were selected ,and their clinical data were retrospectively analyzed .All the patients were equally divided into the observation group and the control group with 70 patients in each group according to the different treatment methods .Patients of the observation group were trea-ted with non-blocking renal artery laparoscopic partial nephrectomy ,while patients of the control group were treated with blocking renal artery laparoscopic partial nephrectomy .Recorded the postoperative complications ,postoperative recovery condition and renal function changes of the two groups.Results All the patients completed the surgery sucessfully and there was no conversion to laparotomy .The perative time,amount of bleeding ,gastrointestinal recovery time and postoperative hospital stay in the observation group were less than those of the control group (P0.05).One week after the operation , the incidence of secondary bleeding ,urinary leakage ,pulmonary infection ,incision infection ,renal infection and other complications in the observation group was 2.9%,which was significantly lower than 15.7%in the control group(P<0.05).The postoperative serum SCr values in the observation group and the control group were respectively (89.24 ±11.92)μmol/L and (137.24 ±11.49)μmol/L, which were significantly higher than (67.24 ±12.49)μmol/L and (68.14 ±13.11)μmol/L before the operation(P<0.05).In the mean time,the postoperative serum SCr values of the observation group was significantly lower than that of the control group (P<0.05).All the pa-tients were followed up to now , and the median survival time of the observation group and the control group were (25.32 ±3.14) months and (19.39 ±4.10) months respectively.That is to say,the median survival time of the observation group was significantly longer than that of the control group(t=4.209,P<0.05).Conclusion Non-blocking renal artery laparoscopic partial nephrectomy for treatment of renal cell car -cinoma of stage T1~T2 can avoid warm ischemia ,reduce postoperative complications ,protect renal function ,promote the patient ’ s recovery , and prolong the survival time ,which is a safe and effective method .
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BACKGROUND:Structural and functional changes of endothelial cels are the common pathological basis of cardiovascular disease. Severe structural and functional damage of endothelial cels are found in patients with hypertension or coronary heart diseases. OBJECTIVE:To explore a new treatment method for hypertension from the perspective of vascular endothelial progenitor cels. METHODS: PubMed and Wanfang databases were retrieved using the keywords “hypertension, EPCs” and approximately relevant 200 English and 100 Chinese literatures were obtained. Forty-nine eligible literatures were screened finaly. RESULTS AND CONCLUSION:Endothelial progenitor cels have strong differentiation and proliferation capacities. This review may provide a new insight into potential sources of cels for diagnosis and treatment of hypertension.
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Objective:To clarify whether IL-10 enhanced the M2 phenotype induced by IL-4.Methods:M-CSF induced bone marrow-derived macrophages ( BMDMs) were generated from C57BL/6J mice bone marrow cells.The RNA transcriptional profile was e-valuated using the Mouse Whole Genome.We performed in vitro eosinophil migration assay and in vivo macrophage transfer.Results:The results showed that IL-10 enhanced gene expression of M2a markers induced by IL-4 in M-CSF-induced BMDMs.Moreover,IL-4 and IL-10 synergistically induced CCL24 ( Eotaxin-2) production.Enhanced CCL24 expression was also observed in GM-CSF-induced BMDMs and zymosan-elicited,thioglycolate-elicited and naive peritoneal macrophages.CCL24 was a CCR3 agonist and an eosinophil chemoattractant.In vitro,IL-4+IL-10-stimulated macrophages produced a large amount of CCL24 and increased eosinophil migration, which was inhibited by anti-CCL24 antibody.IL-4+IL-10-stimulated ( but not IL-4 or IL-10 alone) macrophages transferred into the peritoneumof C57BL/6J mice increased eosinophil infiltration into the peritoneal cavity.Conclusion:These results demonstrate that IL-4+IL-10-simulated macrophages have enhanced M2a macrophage-related gene expression,CCL24 production and eosinophil infiltration-inducing activity,thereby suggesting theircontribution to eosinophil-related diseases.
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OBJECTIVE@#To evaluate the osteogenetic character and repairing maxillary sinus superior wall fractures capability of calcium phosphate cement (CPC) before and after combined with recombinant human bone morphogenetie protein-7(rhBMP-7).@*METHOD@#A 10 mmX5 mm bone defect in the maxillary sinus superior wall was induced by surgery in all 24 New Zealand white rabbits. These 24 rabbits were randomly divided into two groups. The defects were repaired with CPC group (n = 12) and CPC/rhBMP-7 group (n = 12). The osteogenesis of bone defect was monitored by gro'ss observation, histological examination, observation under scanning electron microscope and measurement of ALP activity at 6 and 12 weeks after the implantation.@*RESULT@#In group CPC,new bone was found to form slowly and little by little. In group CPC/rhBMP-7, however, new bone was observed to form early and massively. The ALP activity in group CPC showed significant statistical difference with that of group CPC/rhBMP-7 (P < 0.05).@*CONCLUSION@#The CPC/rhBMP-7 composite has osteoconductibility and osteoinductibility, comparing the use of CPC/rhBMP-7 with CPC for the repair of orbital fracture, the former show obvious advantage repairing ability in maxillary sinus superior wall defect.