Correlation of Bridging Septa Thickening in the Perinephric Space and Split Renal Function in Acute Unilateral Upper Urinary Tract Obstruction / 中山大学学报(医学科学版)

[Objective]To study the relationship between bridging septa thickening in the perinephric space and split renal function in acute unilateral upper urinary tract obstruction.[Methods]50 patients with acute unilateral upper urinary tract obstruction by calculus were analyzed retrospectively. According to the images of multi-slice spiral CT (MSCT)scanning,all cases were divided into thickened bridging septa group(n=25)and normal bridging septa group (n=25),The CT values of renal cortical in the plain(CTp)and renal cortical enhancing(CTe)phase were measured, the difference of increasement value(CTe-CTp)and the CT value ratio of the ipsilateral and opposite in renal cortical phase was analyzed by independent sample T test.[Results]The CT increasement value of bridging septa thickening and normal group were(103±30)HU and(128±24)HU respectively,the difference between the two groups was statistically significant(P<0.01);and CTac/CTuc were 0.81±0.13 and 0.96±0.06 respectively(P<0.01).[Conclusion]Thickening of bridging septa in the perinephric space with acute unilateral upper urinary tract obstruction will weaken the enhancement of renal cortical,and increased the likelihood of split renal function impairing.

Preparation and micro/nano structure analysis of human vaginal wall acellular matrix / 上海交通大学学报（医学版）

Objective · To investigate the micro/ nano structure of human vaginal wall acellular matrix, and provide parameters for bionic vagina.Methods · A total of 35 vaginal specimens were obtained from 35 postmenopausal patients who underwent cystocele repair and/or rectocele repair.Cells in specimens were entirely removed, and the extracellular matrix was maintained. Then the acellular matrix was observed by general observation,H-E staining, Masson staining, scanning electron microscope and Micro-CT. The external and internal structure properties were measured and analyzed.Results · All cells in 35 vaginal specimens were totally removed. The vaginal wall acellular matrix was a double-layer fibrous reticular structure composed of interlaced collagen fibers, which were further arranged into bundles. Pores were distributed among fiber bundles. Epithelial side structure of vaginal wall acellular matrix was dense and subepithelial tissue was loose. There was no significant difference in fiber diameter [(82.4±9.3) nm vs (87.5±10.2)nm, P=0.432] and fiber bundle thickness [(67.6±9.3) μm vs (65.3±5.2) μm, P=0.634] between the dense and loose layers. Fiber bundle separation [(180.1±24.5) μm vs (118.2±23.0) μm, P=0.003] and total porosity [(77.1±4.2)% vs (66.6±2.8)%, P=0.002] were higher in loose layer. There was no significant difference in the micro/nano structure parameters of the acellular matrix between the anterior vaginal wall and the posterior vaginal wall.Conclusion · There was no significant difference in the fiber diameter and the fiber bundle thickness between the dense layer and the loose layer of vaginal wall acellular matrix, but the porosity of the dense layer fiber bundle was smaller than that of the loose layer.

Preparation and micro/nano structure analysis of human vaginal wall acellular matrix / 上海交通大学学报（医学版）

Objective · To investigate the micro/ nano structure of human vaginal wall acellular matrix, and provide parameters for bionic vagina.Methods · A total of 35 vaginal specimens were obtained from 35 postmenopausal patients who underwent cystocele repair and/or rectocele repair.Cells in specimens were entirely removed, and the extracellular matrix was maintained. Then the acellular matrix was observed by general observation,H-E staining, Masson staining, scanning electron microscope and Micro-CT. The external and internal structure properties were measured and analyzed.Results · All cells in 35 vaginal specimens were totally removed. The vaginal wall acellular matrix was a double-layer fibrous reticular structure composed of interlaced collagen fibers, which were further arranged into bundles. Pores were distributed among fiber bundles. Epithelial side structure of vaginal wall acellular matrix was dense and subepithelial tissue was loose. There was no significant difference in fiber diameter [(82.4±9.3) nm vs (87.5±10.2)nm, P=0.432] and fiber bundle thickness [(67.6±9.3) μm vs (65.3±5.2) μm, P=0.634] between the dense and loose layers. Fiber bundle separation [(180.1±24.5) μm vs (118.2±23.0) μm, P=0.003] and total porosity [(77.1±4.2)% vs (66.6±2.8)%, P=0.002] were higher in loose layer. There was no significant difference in the micro/nano structure parameters of the acellular matrix between the anterior vaginal wall and the posterior vaginal wall.Conclusion · There was no significant difference in the fiber diameter and the fiber bundle thickness between the dense layer and the loose layer of vaginal wall acellular matrix, but the porosity of the dense layer fiber bundle was smaller than that of the loose layer.

Roles of Long-chain Acyl Coenzyme A Synthetase in Absorption and Transport of Fatty Acid / 中国医学科学杂志(英文版)

Long-chain acyl coenzyme A synthetase (ACSL) is a member of the synthetase family encoded by a multigene family; it plays an important role in the absorption and transport of fatty acid. Here we review the roles of ACSL in the regulating absorption and transport of fatty acid, as well as the connection between ACSL and some metabolic diseases.

Relation Between Cellular Senescence and Liver Diseases / 中国医学科学杂志(英文版)

Cellular senescence refers to a process that cellular proliferation and differentiation modulated by the multiple stimulating factors gradually decline. Aging cells present the irreversible stop of proliferation and differentiation and change in secretory function because the cell cycle of aging cells is steadily blocked at some point. It has have been shown that cellular senescence plays an important role in the occurrence and development of liver diseases. In this paper, we review the advances in relations between cellular senescence and liver diseases.

Role of mast cells in estrogen-mediated experimental endometriosis in rats / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the role of mast cells in the pathogenesis of estrogen-mediated experimental endometriosis in rats.</p><p><b>METHODS</b>Endometriosis model was established by transplanting autologous fragments of uterus to the inner surface of the abdominal wall in 24 un-pregnant female Sprague Dawley rats. The rats were divided randomly into three groups (n=8 in each group), and were injected with different doses of estrogen: high-dose group (200 μg·kg⁻¹·d⁻¹), low-dose group (100 μg·kg⁻¹·d⁻¹) and the control group (0 μg·kg⁻¹·d⁻¹). The ovaries were surgically removed in high-dose and low-dose groups. Four rats were sacrificed in each group at 2 and 4 weeks after surgery. Their serum estradiol levels, size of lesions, total number of mast cells and degranulations, serum TNF-α levels, expression of tryptase and NGF in tissues were analyzed and compared among groups.</p><p><b>RESULTS</b>The mean levels of serum estradiol 2 weeks and 4 weeks after model established and serum TNF-α at 4 weeks in estrogen-treated groups were significantly higher than those in control group (all P<0.05). The mean size of endometriotic lesions in the estrogen-treated groups was also significantly larger than that in the control group 2 weeks and 4 weeks after model established (all P<0.05). Meanwhile, both at week 2 and week 4, the mean ratio of degranulation/total number of mast cells by toluidine blue staining in low-dose estrogen group was significantly higher than that in the control group (P<0.05). The expression of NGF in high-dose estrogen group was significantly higher than that in the control group at week 4(P<0.05).</p><p><b>CONCLUSION</b>Estrogen can promote the growth of endometriotic lesions and may mediate the pathogenesis of endometriosis by activating mast cells, which may be associated with increasing TNF-α and NGF levels.</p>

Sodium cromoglycate attenuates experimental endometriosis in rats by regulating mast cells / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of sodium cromoglycate on experimental endometriosis in rats.</p><p><b>METHODS</b>Endometriosis model was established in 36 unpregnant female SD rats by transplanting autologous fragments of endometrium to the inner surface of the abdominal wall. The endometriotic lesions were measured by a second laparotomy 2 weeks after surgery. Then the rats were randomly divided into four groups (n=8 in each group) to receive intraperitoneal injection of different doses of sodium cromoglycate for 2 weeks: high-dose group (20 mg·kg⁻¹·d⁻¹); low-dose group (10 mg·kg⁻¹·d⁻¹); the negative control group and the blank control group. The animals were sacrificed and the size of the lesions were measured. The endometriosis model of SD rats was identified by HE staining and immunohistochemical staining of keratin and vimentin. The total number of mast cells and their degranulation were measured by Toluidine blue staining; the concentrations of TNF-α in serum were measured by enzyme linked immunosorbent assay; the concentrations of estradiol in serum were measured by enzyme immunoassay; the expression of tryptase and nerve growth factor (NGF) were measured by immunohistochemical staining.</p><p><b>RESULTS</b>The number of activated mast cells (MC) by Toluidine blue staining in high-dose group was significantly lower than that in negative control group (P<0.05), and its ratio of degranulation/total number of MC was significantly lower than that in negative control group or blank control group (P<0.05). The serum TNF-α levels and tryptase expression in tissues in high-dose group were significantly lower than those in negative control group or blank control group (P<0.05). However, no significant difference in the size of endometriotic lesions and expression of NGF was found among groups (P>0.05).</p><p><b>CONCLUSION</b>Sodium cromoglycate can stabilize mast cells from degranulation, which may relieve the clinical symptoms of endometriosis by reducing TNF-α and tryptase levels.</p>

Roles of the lipid metabolism in hepatic stellate cells activation △ / 中国医学科学杂志(英文版)

The lipids present in hepatic stellate cells (HSCs) lipid droplets include retinyl ester, triglyceride, cholesteryl ester, cholesterol, phospholipids and free fatty acids. Activation of HSCs is crucial to the development of fibrosis in liver disease. During activation, HSCs transform into myofibroblasts with concomitant loss of their lipid droplets and production of excessive extracellular matrix. Release of lipid droplets containing retinyl esters and triglyceride is a defining feature of activated HSCs. Accumulating evidence supports the proposal that recovering the accumulation of lipids would inhibit the activation of HSCs. In healthy liver, quiescent HSCs store 80% of total liver retinols and release them depending on the extracellular retinol status. However, in injured liver activated HSCs lose their retinols and produce a considerable amount of extracellular matrix, subsequently leading to liver fibrosis. Further findings prove that lipid metabolism of HSCs is closely associated with its activation, yet relationship between activated HSCs and the lipid metabolism has remained mysterious.

Effects of simvastatin on expression of CTGF and α-SMA in renal tubulointerstitium of rats with diabetic nephropathy / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of low-dose simvastatin on the expression of connective tissue growth factor (CTGF) and α-smooth muscle actin (α-SMA) in the renal tubulointerstitium of rats with diabetic nephropathy.</p><p><b>METHODS</b>Sixty male SD rats were randomly divided into three groups: Group C (control group), Group D, in which diabetes was induced by stroptozotocin (STZ) and Group DS, in which STZ-induced diabetic rats were treated with low-dose (no cholesterol-lowering effect) simvastatin. The following parameters were measured after 6 weeks and 12 weeks in each groups, respectively: body weight and kidney weight, 24-h urinary albumin excretion (UAE), biochemical indexes including blood glucose (GLU), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG) and serum creatinine (SCr). The expression of CTGF and α-SMA in renal tubulointerstitium was assessed by immunohistochemical method.</p><p><b>RESULT</b>After 6 and 12 weeks, there were no significant differences in SCr, LDL, HDL and TG levels among all three groups. The expression levels of CTGF and α-SMA in the tubulointerstitium of Group DS were significantly decreased compared with those of Group D at week 6 (P<0.05); there were no significant differences compared with Group C (P>0.05). After 12 weeks, CTGF and α-SMA expressions in Group DS were also lower than those in Group D (P<0.05); while higher than those in Group C (P<0.05).</p><p><b>CONCLUSION</b>Simvastatin with a under cholesterol-lowering dose, can decrease the expression levels of CTGF and α-SMA in renal tubulointerstitium of rats with diabetic nephropathy, by which the progression of the tubulointerstitial fibrosis would be delayed.</p>

Expression of soluble Toll-like receptors in pleural effusions / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The Toll-like receptors (TLRs) represent a group of single-pass transmembrane receptors expressed on sentinel cells that are central to innate immune responses.The aim of this study was to investigate the presence of soluble TLRs in pleural effusions, and the diagnostic values of TLRs for pleural effusion with various etiologies.</p><p><b>METHODS</b>Pleural effusion and serum samples were collected from 102 patients (36 with malignant pleural effusion, 36 with tuberculous pleural effusion, 18 with bacterial pleural effusion, and 12 with transudative pleural effusion). The concentrations of TLR1 to TLR10 were determined in effusion and serum samples by enzyme linked immunosorbent assay. Four classical parameters (protein, lactate dehydrogenase, glucose and C-reactive protein (CRP)) in the pleural fluid were also assessed. Receiver-operating characteristic curves were used to assess the sensitivity and specificity of pleural fluid TLRs and biochemical parameters for differentiating bacterial pleural effusion.</p><p><b>RESULTS</b>The concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 in bacterial pleural effusion were significantly higher than those in malignant, tuberculous, and transudative groups, respectively. Analysis of receiver operating characteristic curves revealed that the area under the curves of TLR1, TLR3, TLR4, TLR7 and TLR9 were 0.831, 0.843, 0.842, 0.883 and 0.786, respectively, suggesting that these TLRs play a role in the diagnosis of bacterial pleural effusion. Also, the diagnostic value of TLRs for bacterial pleural effusions was much better than that of biochemical parameters (protein, lactate dehydrogenase, glucose and CRP).</p><p><b>CONCLUSIONS</b>The concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 appeared to be increased in bacterial pleural effusion compared to non-bacterial pleural effusions. Determination of these pleural TLRs may improve the ability of clinicians to differentiate pleural effusion patients of bacterial origin from those with other etiologies.</p>

Diagnosis and treatment of complicated interstitial pregnancy / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To review the diagnosis and treatment of interstitial pregnancy.</p><p><b>METHODS</b>Four cases with complicated interstitial pregnancy were diagnosed and treated from January, 2004 to June, 2007 at the Affiliated Obstetrics and Gynecology Hospital, College of Medicine, Zhejiang University. The clinical data and follow-up records were analyzed retrospectively.</p><p><b>RESULTS</b>All 4 nulliparous patients were misdiagnosed before operation. The median age was 30 years (25-34 years), and the median duration of amenorrhea was 48 days (37-58 days). The median concentrations of serum beta-hCG were 3245.5 IU/L (282-30729 IU/L). Two patients with interstitial pregnancy had high levels of beta-hCG, and were diagnosed and treated under laparoscopy. Among them one patient was underwent transcervical curettage under laparoscopic guidance,and another underwent laparoscopic salpingotomy. The remained two patients had low levels of beta-hCG, and were diagnosed and treated under hysteroscopy, 50 mg methorexate(MTX)was injected into the implanted sites under hysteroscopic guidance. The levels of serum beta-hCG in 4 patients dropped down quickly, reaching undetected levels at a mean duration of 13 days after operation. Three months postoperatively, ultrasonic examination revealed the normal contour of uterus.</p><p><b>CONCLUSIONS</b>Endoscopic examination is helpful to make a correct diagnosis, and transcervical curettage (or transcatheter chemotherapy) under laparoscopic guidance (or under hysteroscopic guidance) may be a promising approach for young or nulliparous women with interstitial pregnancy who want to maintain future fertility.</p>

Status and drug resistance surveillance of enterococcus infection in patients with severe hepatitis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To analyze the infection status and the drug resistance of enterococci in patients with severe hepatitis to guide future treatment.</p><p><b>METHODS</b>All bacteria from infected patients with severe hepatitis were cultured with BacT/Alert120 automation instrument (Aksu) and identified with Vitek-AMS60 (Biomerieux). Drug sensitivities of the isolated enterococci were tested with 11 antibacterial agents.</p><p><b>RESULTS</b>Among the 112 isolated enterococci, Enterococcus faecalis was the most preponderant bacterium, and the second was E. faecium. Their isolation rates were 79.5% and 14.3%, respectively. 57.1% of all the enterococci were found in the ascetic fluid of patients with severe hepatitis. Fifty-eight (51.8%) isolated enterococci were found to be high level aminoglycoside resistant (HLAR), 19 (17.0%) enterococci were ampicillin-resistant enterococcus (ARE) and 7 (6.3%) were both HLAR and ARE. The susceptive rates of the enterococci to vancomycin and teicoplanin were very high, namely 96.4% and 100%, respectively. No vancomycin or teicoplanin resistant enterococci were found, but 4 enterococci were mildly sensitive to vancomycin.</p><p><b>CONCLUSION</b>Enterococcus faecalis is the most prevalent species isolated in severe hepatitis patients infected with enterococcal infection. From our study, vancomycin and teicoplanin are the drugs of first choice to treat those infections.</p>

Study on association of CTLA4 gene polymorphism with Grave's disease in Guangxi Zhuang nationality population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the polymorphic (AT)n repeats in 3ountranslated region of exon 4 of CTLA4 gene [CTLA4(AT)n] and Graveso disease (GD) in Zhuang nationality population of Guangxi province.</p><p><b>METHODS</b>The studied groups comprised 48 patients with GD and 44 normal controls. Amplification of target DNA was carried out by polymerase chain reaction (PCR). The amplified products were run by 8% polyacrylamide gel electrophoresis, and then followed by 0.1% silver staining. Some of amplified products were sequenced directly.</p><p><b>RESULTS</b>Nineteen alleles of CTLA4 gene microsatellite polymorphism were found in Guangxi Zhuang nationality individuals. The 106 bp long allele was apparently increased in patients with GD of Zhuang nationality but not in healthy controls (P< 0.05).</p><p><b>CONCLUSION</b>CTLA4 gene microsatellite polymorphism is strongly associated with Graveso disease in Zhuang nationality population of Guangxi province. CTLA4(AT)n 106 bp may be the susceptible gene in GD patients of Zhuang nationality in Guangxi; 19 alleles of CTLA4 gene microsatellite polymorphism were found in Guangxi Zhuang nationality individuals.</p>

Pericardial sinuses and recesses effusion of 16-slice helical CT imaging and anatomic correlation / 中华放射学杂志

Objective To evaluate the CT features and implications of the pericardial sinuses and recesses effusion by combining the sectional cadavers and 16 mttlti-slice CT(MSCT)reformation.Methods The anatomy and communication of the pericardial sinuses and recesses on the axial,coronal and saggital sectional cadavers(respectively 1 case),and the morphologic features on MSCT reformatted images in 104 patients were observed,The detection rate of effusion was analyzed.Results The sectional cadavers and CT images showed that the pericardia] sinuses and recesses were formed by the reflections of the pericardium on the root of the great vessels.The detection rate of the sinuses and recesses was lower in small effusion than in moderate and large effusion(P