Preliminary clinical analysis of direct renin inhibitor aliskiren in the treatment of severe coronavirus disease 2019 patients with hypertension / 中华内科杂志

Objective:To explore the feasibility of direct renin inhibitor aliskiren for the treatment of severe or critical coronavirus disease 2019 (COVID-19) patients with hypertension.Methods:The antihypertensive effects and safety of aliskiren was retrospectively analyzed in three severe and one critical COVID-19 patients with hypertension.Results:Four patients, two males and two females, with an average age of 78 years (66-87 years), were referred to hospital mainly because of respiratory symptoms. Three were diagnosed by positive novel coronavirus 2019 (2019-nCoV) nucleic acid or antibody, and the critical patient with cardiac insufficiency was clinically determined. Two patients were treated with calcium channel antagonist (CCB), one with angiotensin converting enzyme inhibitor (ACEI), and one with angiotensin Ⅱ receptor antagonist (ARB). After admission, ACEI and ARB were discontinued, one patient with heart failure was treated by aliskiren combined with diuretic.Three patients were treated with aliskiren combined with CCB among whom two withdrew CCB due to low blood pressure after 1 to 2 weeks. Based on comprehensive treatment including antiviral and oxygenation treatment, blood pressure was satisfactorily controlled by aliskiren after three to four weeks without serious adverse events. All patients were finally discharged.Conclusion:Our preliminary clinical data shows that antihypertensive effect of aliskiren is satisfactory and safe for severe COVID-19 patients complicated with hypertension.

Comparison of efficacy and safety of laparoscopic surgery for gallstones and common bile duct stones / 中国基层医药

Objective@#To evaluate the efficacy and safety of laparoscopic surgery in the treatment of gallstones and common bile duct stones.@*Methods@#Eighty-seven patients with gallstones complicated with common bile duct stones who underwent concurrent laparoscopic surgery at Zhoushan Hospital from December 2015 to December 2017 were enrolled.The patients were divided into A group and B group according to the digital table.A group(38 cases) underwent laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE), and B group(49 cases) underwent endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy (LC). The curative effect of the two groups was observed.The operation time, the success rate of the operation and the rate of laparotomy were recorded in the two groups.The corresponding hospitalization time and cost were compared.The safety of the two different procedures was compared after surgery, and the complications of the two groups were recorded.@*Results@#In A group, the average diameter of common bile duct stones was (1.02±0.25)cm, the average diameter of common bile duct diameter was (1.15±0.25)cm.In B group, the mean diameter of common bile duct stones was (0.99±0.26)cm, and the average diameter of common bile duct was (1.13±0.26) cm.The differences between the two groups were not statistically significant (t=0.513, 0.437, 0.367, P=2.083, 1.533, 1.095). The successful operation rate of A group was 92.11%(35/38), which in B group was 91.84%(45/49), the difference was not statistically significant between the two groups(χ2=0.006, P=0.974). The incidence rate of complications in B group was 20.41%, which was significantly higher than that in A group, the difference was statistically significant(χ2=3.654, P=0.019). The hospitalization time, hospitalization expenses in A group were (10.6±2.6)d, (26 649.8±3 478.6)CNY, respectively, which were significantly better than those in B group (t=21.971, 17.168, all P<0.05).@*Conclusion@#The efficacy of LC combined with LCBDE for patients with gallstones complicated with common bile duct stones is better than ERCP/EST combined with LC surgery, and the safety of the former is higher than the latter.

Comparison of efficacy and safety of laparoscopic surgery for gallstones and common bile duct stones / 中国基层医药

Objective To evaluate the efficacy and safety of laparoscopic surgery in the treatment of gallstones and common bile duct stones.Methods Eighty-seven patients with gallstones complicated with common bile duct stones who underwent concurrent laparoscopic surgery at Zhoushan Hospital from December 2015 to December 2017 were enrolled.The patients were divided into A group and B group according to the digital table.A group (38 cases) underwent laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE),and B group (49 cases) underwent endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy (LC).The curative effect of the two groups was observed.The operation time,the success rate of the operation and the rate of laparotomy were recorded in the two groups.The corresponding hospitalization time and cost were compared.The safety of the two different procedures was compared after surgery,and the complications of the two groups were recorded.Results In A group,the average diameter of common bile duct stones was (1.02 ± 0.25) cm,the average diameter of common bile duct diameter was (1.15 ± 0.25) cm.In B group,the mean diameter of common bile duct stones was (0.99 ± 0.26) cm,and the average diameter of common bile duct was (1.13 ± 0.26) cm.The differences between the two groups were not statistically significant (t =0.513,0.437,0.367,P =2.083,1.533,1.095).The successful operation rate of A group was 92.11％ (35/38),which in B group was 91.84％ (45/49),the difference was not statistically significant between the two groups (x2 =0.006,P =0.974).The incidence rate of complications in B group was 20.41％,which was significantly higher than that in A group,the difference was statistically significant(x2 =3.654,P =0.019).The hospitalization time,hospitalization expenses in A group were (10.6 ± 2.6) d,(26 649.8 ± 3 478.6) CNY,respectively,which were significantly better than those in B group (t =21.971,17.168,all P ＜ 0.05).Conclusion The efficacy of LC combined with LCBDE for patients with gallstones complicated with common bile duct stones is better than ERCP/EST combined with LC surgery,and the safety of the former is higher than the latter.

Influence of PD-1 inhibitor pembrolizumab on T lymphocyte subsets and NK cells in patients with late stage non-small cell lung cancer / 国际肿瘤学杂志

Objective To observe the changes of T lymphocyte subsets and natural killer (NK) cells in patients with late stage non-small cell lung cancer (NSCLC) before and after treatment with PD-1 inhibitor and its clinical effect.Methods Totally 23 patients with NSCLC in Guangzhou Modern Hospital from January 2015 to January 2016 were collected.All patients were given 6 cycles of PD-1 inhibitor treatment after chemotherapy or targeted drug treatment failure.Peripheral venous blood was collected before and after treatment to detect the percentage of CD3 +,CD4 +,CD8 + and NK cells in peripheral blood lymphocytes.The curative effects were evaluated by chest CT after treatment of 2,4,6 cycles.Results Compared with before treatment,the proportions of CD3+ (69.56％ ±7.81％ vs.63.91％ ±6.43％,t =2.679,P =0.005),CD4+ (39.01％ ±4.98％ vs.36.09％ ±4.77％,t =2.031,P =0.024) and CD4+/CD8+ (1.82 ±0.48 vs.1.49 ± 0.32,t =2.743,P =0.004) were increased after treatment,with significant differences.While compared with before treatment,the proportions of CD8 + (24.08％ ± 5.13％ vs.26.04％ ± 6.44％,t =1.142,P =0.130) and NK cells (22.68 ％ ± 9.56％ vs.21.45 ％ ± 10.01％,t =0.426,P =0.337) had little changes,with no significant differences.There were 3 patients with complete remission,10 patients with partial remission,8 patients with stable disease and 2 patients with progressive disease when completing 6 cycles of PD-1 inhibitor treatment.Ten patients showed untoward effects such as mild sleepiness,thirst,tussis,pruritus and rash,and they were well tolerable.Conclusion PD-1 inhibitor can improve the patient's cellular immune function,and can achieve a more satisfactory short-term efficacy and acceptable adverse reactions,which maybe bring new hopes for patients with NSCLC.

Effects of embolic agents with different particle sizes on interventional treatment of uterine fibroids

Objective: To compare the effects of embolic agents with different particle sizes on interventional treatment of uterine fibroids [UFs]

Methods: One-hundred and thirty patients with UFs were divided into a treatment group and a control group [n=65] by random draw. All patients were treated by uterine artery embolization, with the treatment group using 200 Micro m polyvinyl alcohol [PVA] particles and the control group using 500 Micro m PVA particles

Results: The success rate of embolization was 100%. After intervention, the treatment group was significantly less prone to complications such as lower abdominal pain, fever, nausea, vomiting and bleeding than the control group [P<0.05]. The follicle-stimulating hormone levels of both groups were similar before and after intervention, and there were also no significant inter-group differences. The uterine and UF volumes of both groups significantly decreased six months after intervention [P<0.05], and those of the treatment group were significantly lower [P<0.05]. The two groups had similar physical function, role-physical, bodily pain and general health scores before intervention, but the treatment group scored significantly higher than the control group did six months after intervention [P<0.05]

Conclusion: Interventional embolization can well treat UFs, without apparently affecting ovarian functions. Small-sized PVA particles can improve the quality of life by shrinking the uterus and UFs as well as by reducing the risks of complications

Association between polymorphism of leptin receptor gene and serum leptin in asthma / 中国综合临床

Objective To investigate the relationship between leptin receptor(LEPR) gene Gln223Arg in polymorphism and serum leptin level of patients with asthma.Methods A case-control study was conducted.One hundred and ninety-two asthma patients were recruited from asthma gene library,among them 100 patients only with asthma(asthma group) and 92 patients with both asthma and metabolic syndrome(asthma complicated with metabolic syndrome group).And 108 normal people were selected as control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphism of LEPR gene Gln223Arg locus.Serum leptin levels were measured by enzyme-linked immuno sorbent assay,its relationship with asthma was analyze.Results The frequencies of genotype GG,GA,AA in asthma group,asthma complicated with metabolic syndrome group and normal control group were (83.00％ (83/100) vs.83.70％ (77/92) vs.70.37％ (76/108),15.00％ (15/100) vs.15.22％ (14/92) vs.27.78％ (30/108),and2.00％ (2/100) vs.1.08％ (1/92) vs.1.85％ (2/108) respectively).G and A alleles in asthma group,asthma complicated with metabolic syndrome group and normal control group were 90.50％ vs.91.30％vs.84.26％,9.50％ vs.8.70％ vs.15.74％ respectively.Compared with the control group,GG genotype and GA + AA genotype were different between in asthma group and asthma complicated with metabolic syndrome group.The patients with GG genotype showed 2.056 (x2 =4.599,P =0.032,OR =2.056,95％ CI =1.057-3.999) and 2.161 folds (x2 =4.907,P =0.027,OR =2.161,95 ％ CI =1.084-4.311) risk in asthma group and asthma complicated with metabolic syndrome group than that with GA + AA genotype.In terms of leptin levels,in asthma group,female were significant higher than that of control group (P =0.037,P =2.93),while in asthma complicated with metabolic syndrome group,male and female were significantly higher than control group (P =0.001,0.000 ; P =4.530,4.690).Conclusion The polymorphisms of LEPR gene locus Gln223 Arg are related with asthma.Genotype GG carrier is susceptible for the disease.In female,serum leptin is positive relationship with asthma group,especially in asthma complicated with metabolic syndrome.

Inhibition of cytohesin-1 by siRNA leads to reduced IGFR signaling in prostate cancer

To explore how cytohesin-1 (CYTH-1) small interfering RNA (siRNA) influences the insulin-like growth factor receptor (IGFR)-associated signal transduction in prostate cancer, we transfected human prostate cancer PC-3 cell lines with liposome-encapsulatedCYTH-1 siRNA in serum-free medium and exposed the cells to 100 nM IGF-1. The mRNA and protein levels of the signal molecules involved in the IGFR signaling pathways were determined by real-time PCR and detected by Western blotting. The relative mRNA levels of CYTH-1, c-Myc, cyclinD1 and IGF-1R (CYTH-1 siRNA group vs scrambled siRNA group) were 0.26 vs 0.97, 0.34 vs 1.06, 0.10 vs 0.95, and 0.27 vs 0.41 (P < 0.05 for all), respectively. The relative protein levels of CYTH-1, pIGF-1R, pIRS1, pAkt1, pErk1, c-Myc, and cyclinD1 (CYTH-1 siRNA group vsscrambled siRNA group) were 0.10 vs 1.00 (30 min), 0.10 vs 0.98 (30 min), 0.04 vs 0.50 (30 min), 0.10 vs 1.00 (30 min), 0.10 vs 1.00 (30 min), 0.13 vs 0.85 (5 h), and 0.08 vs 0.80 (7 h), respectively. The tyrosine kinase activity of IGF-1R was associated with CYTH-1. The proliferative activity of PC-3 cells transfected with CYTH-1 siRNA was significantly lower than that of cells transfected with scrambled siRNA at 48 h (40.5 vs87.6 percent, P < 0.05) and at 72 h (34.5 vs 93.5 percent, P < 0.05). In conclusion, the interference of siRNA with cytohesin-1 leads to reduced IGFR signaling in prostate cancer; therefore, CYTH-1 might serve as a new molecular target for the treatment of prostate cancer.

Curative effect of transplantation of brachial triceps long head branch from radial nerve in restoration of anterior branch of axillary nerve: Functional analysis in 13 cases / 中国组织工程研究

BACKGROUND: Injury of axillary nerve leads to the inability of abduction in the upper limb which needs surgery treatment. However, which way of operative approach is more preferable is still uncertain. Whether one-stage posterior operation of nerve transfer can achieve better effects remains unclear, the choice of approach method is an argument.OBJECTIVE: To explore the therapeutic effect of the transposition operation of the branch to long head of triceps branchii to recover the anterior branch of axillary nerve that can restore the function of deltoid muscle and refrain from the deprivation of function to extend elbow.METHODS: A total of 13 cases with axillary nerve injury without any recovery sign admitted at the Department of Hand Surgery, China-Japan Union Hospital of Jilin University were selected, including 11 males and 2 females, aged 18-55 years, mean aged 28.4 years; Under 10-times operating microscope, the anterior branch of axillary nerve was chosen to coincide the branch to long head of triceps branchii in use of 11 -0 atraumatic nylon in posterior approach. The standard issued by the Hand Surgery Society of Chinese Medical Association was adopted to assess the upper limb function postoperatively.RESULTS AND CONCLUSION: All patients were followed-up for 6-53 months with an average of 21 months. All incisions after surgery gain primary healing. The function of shoulder abduction had recovered in some degree. Among of total, 7 cases had deltoid strength of M4 or even more; 4 cases had deltoid strength of M3; one had M2 and one had M1. The effective rate was 92%, and excellent rate was 85%. There was no impact on the extension of elbow in all cases. It was a reliable and convenient technique to recover shoulder abduction with the branch to long head of triceps brachii from radial nerve in restoration of the function of deltoid muscle. It was beneficial to the restoration of axillary nerve with partially injured brachial plexus, and severe quadril.

Tumor necrosis factor -α, interleukin-6 and C reactive protein are involved in the function of islet β-cell in asthma / 中国医师杂志

Objective To explore the association between inflammatory cytokines and islet β-cell function in chronic persistent asthma patients. Methods 112 adults with persistent asthma and 60 healthy volunteers were enrolled in this study. According to the severity of disease, all subjects were divided into persistent-mild group and persistent-moderate group. Plasma tumor necrosis factor-α(TNF-α), interleukin6(IL-6) and C-reactive protein (CRP) were determined. Oral glucose tolerance and insulin releasing test were performed. The ratio of the area under the curve of insulin to area under the curve of glucose ( AUC1/AUCG ), homeostasis model assessment for insulin resistance ( HOMA-IR), insulin sensitivity index( ISI),homeostasis model assessment for β-cell function (HBCI) and early insulin secretion index(△I30/△G30)were calculated. The values of forced expiratory volume in l second ( FEV1 ), forced vital capacity(FVC)and FEV1/FVC were recorded. Results In patient groups, the values for plasma TNF-α, IL-6, CRP,AUC1, AUC1/AUCG, HOMA-IR, HBCI significantly increased compared with those in control group, while ISI declined ( t =2. 02～13.62, P ＜0. 05). Multiple step regression analysis showed that HOMA-IR was positively correlated with CRP, LDL-C, BMI, AUC1, TNF-α( P ＜0. 01 orP ＜0. 05), but negatively correlated with FEV1 ( P ＜ 0. 05 ). Conclusion The results indicated that inflammatory cytokines ( TNF-α,IL-6,CRP) might result in insulin resistance in asthma patients who had hyperinsulinism at the same time.

Correlation of Different Indexes of Arterial Elastic Function / 中华高血压杂志

Objective To study the correlation of three different indexes of arterial elastic function(PWV, C_ 1 and C_ 2 , AI). Methods 1306 out-patients with hypertension were recruited. Two or three arterial elastic function were measured at the same time. Large and small arterial elastic indexes(C_ 1 and C_ 2 );pulse wave velocity(PWV)and augmentation index (AI) in 428 cases , C_ 1 , C_ 2 and PWV(n=208), C_ 1 , C_ 2 , PWV and AI(n=60). Results C_ 1 was negatively related to PWV and positively related with C_ 2 . No correlation between AI and PWV, AI and C_ 1 and C_ 2 was found. Conclusion PWV, C_ 1 and C_ 2 are consistent for the arterial elastic function measurement. However, little relevance between AI and PWV, AI and C_ 1 and C_ 2 was shown.

The relation between overload and variability of blood pressure and overweight or obesity in patients with essential hypertension / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between blood pressure variability, overweight or obesity in patients with essential hypertensive.</p><p><b>METHODS</b>A hundred ninety-one patients with essential hypertension were divided into three groups: normal, overweight and obese according to body mass index (BMI). The characteristics of the variability of 24-hour ambulatory blood pressure monitoring (ABPM) in three groups were compared.</p><p><b>RESULTS</b>Blood pressure overload and variability increased parallel with the increase of BMI. In overweight group, the variabilities of systolic blood pressure at night (nSBPSD) increased 14.10%, the variabilities of diastolic blood pressure at night (nDBPSD) increased 13.15% and the variabilities of mean arterial pressure at night (nMAPSD) increased 15.92% respectively. In the obese group, the above three variabilities increased more significantly (compared to normal group P < 0.05-0.01). However, increases of the three blood pressure variabilities were observed only in the male patients.</p><p><b>CONCLUSIONS</b>The overweight or obesity increased the blood pressure overload and variabilities in patients with essential hypertension. The increases of blood pressure variabilities were observed only in male patients and at night.</p>

Heritability of serum leptin levels: a twin study / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the contribution of genetic factors to the variance of serum leptin concentration in healthy, normotensive twins.</p><p><b>METHODS</b>A total of 57 pairs of twins were investigated: 28 female and 19 male pairs of monozygotic(MZ) twins, and 6 female and 4 male pairs of dizygotic(DZ) twins. The zygosity of twins was determined by comparing the concordance of the genotype of nine fluorescence-labeled microsatellite markers. The genetic analysis was performed using the variance-based method. Serum leptin levels were determined in duplicate by a radioimmunoassay Kit (Linco Research, Inc., St. Charles, Missouri) as previously described.</p><p><b>RESULTS</b>The test of genetic variance revealed a significantly larger within-pair variance of serum leptin in the DZ twins, in comparison with the MZ twins. The corresponding heritability for serum leptin was 8%. Adjusted for BMI, gender, and uric acid (UA), the heritability for serum leptin was 0.18%. Log leptin correlated significantly with blood pressure (SBp r=0.355 P<0.001; DBp r=0.339 P<0.001). Stepwise multiple linear regression analysis revealed that only BMI, gender and UA were linked independently to serum leptin levels(R(2)=0.788, P<0.001).</p><p><b>CONCLUSION</b>The above data indicate that environmental factors other than genetic factors are important determinants of leptinemia in normal subjects.</p>

Effect of Cilazapril and Metoprolol on Brachial Artery in Patients with Essential Hypertension / 中华高血压杂志

Aim:To compare the effect of cilazapril and metoprolol on the compliance o f brachial artery in essential hypertension(EH). Methods:Compliance of brachial artery was determined by Pulsed Doppl er techniques. Brachial artery diameter(Dd),flow velocity(Vm),volumic blood flow (Q) and the distensibility(Dis) increased markedly,the resistance(R) used as the indexes of compliance of brachial artery. Results:Sixty seven EH were divided into two groups(A,B) random ly. Group A were treated with Cilazaril,Group B with Metoprolol. Aft er 6 months treatment, BP in all the patients decreased. In Group A,the Dd,Vm,Q and Dis increased markedly,but R of brachial artery decreased obviously. In group B,no obvious changes of branchial artery were found. Conclusion:Cilazapril may improve the compliance of brachial artery partially.

Hereditary instability of BRCA1 gene at locus D17S855 in hepatocellular carcinoma in Chinese / 解放军医学杂志

Objective To investigate the microsatellite instability(MSI) and loss of heterozygosity(LOH) of BRCA1 gene at locus D17S855 in sporadic liver cancer in chinese,and their influence on the expression of corresponding genes of liver cancer,in order to provide laboratory basis for clinical treatment and prognosis analysis of liver cancer.Methods The following techniques were used in the study: extraction of DNA from paraffin-embedded tissues,polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP),ordinary silver stain,Envision immunohistochemistry and Leica-Qwin computer imaging techniques.MSI and LOH of BRCA1 gene at locus D17S855 were detected and BRCA1 proteins were identified.Results MSI at locus D17S855 was positive in 14 of 74 samples of liver cancer(18.9%).MSI positive rate in TNM I+II(31.6%) was much higher than that in TNM III+IV(5.6%,P

Phacoemulsification and intraocular lens implantation with topical anesthesia in out-patient department / 眼科新进展

Objective　To evaluate the effect of phacoemulsification and intraocular lens implantation with topical anesthesia in out-patients department.Methods　Phacoemulsification and intraocular lens implantation were performed successively in 132 patients(157 eyes) with topical anesthesia.Results　Phacoemulsification and intraocular lens implantation were successfully performed in 152 eyes(96.8%)with topical anesthesia and 5 eyes(3.2%)need retrobulbar anesthesia additionally.The visual acuity and complications after operation in the topical anesthesia were the same as that performed previously under retrobular anesthesia.Conclusions　Phacoemulsification and intraocular lens implantation may be performed with topical anesthesia through scleral tunnel incision.It is convenient for us to perform the operations on the out-patient patients with cataract.

EXPERIMENTAL PATHOLOGICAL STUDY OF STRESS CARDIOMYOPATHY / 中国法医学杂志

The purpose of this study is to. investigate the pathologic changes of stress cardiomyopathy in ex-perimental rats. The results revealed some changes including myocardial fibers band necrosis by HE stain, early myocardium ischaemic changes by HBFP stain, Ca++overload of myocardial cells by GBHA stain. These methods are important for diagnosis of stress cardiomyopathy and early myocardial ischaemia.