Facilitation of spinal α-motoneuron excitability by histamine and the underlying ionic mechanisms / 生理学报

Spinal α-motoneurons directly innervate skeletal muscles and function as the final common path for movement and behavior. The processes that determine the excitability of motoneurons are critical for the execution of motor behavior. In fact, it has been noted that spinal motoneurons receive various neuromodulatory inputs, especially monoaminergic one. However, the roles of histamine and hypothalamic histaminergic innervation on spinal motoneurons and the underlying ionic mechanisms are still largely unknown. In the present study, by using the method of intracellular recording on rat spinal slices, we found that activation of either H or H receptor potentiated repetitive firing behavior and increased the excitability of spinal α-motoneurons. Both of blockage of K channels and activation of Na-Ca exchangers were involved in the H receptor-mediated excitation on spinal motoneurons, whereas the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels were responsible for the H receptor-mediated excitation. The results suggest that, through switching functional status of ion channels and exchangers coupled to histamine receptors, histamine effectively biases the excitability of the spinal α-motoneurons. In this way, the hypothalamospinal histaminergic innervation may directly modulate final motor outputs and actively regulate spinal motor reflexes and motor execution.

The serum homocysteine level in patients with acute ischemic stroke (AIS) after thrombolysis and its relationship with clinical outcomes

SUMMARY OBJECTIVE The present study aims to investigate whether hyperhomocysteinemia (HHcy) affects the outcomes of the thrombolytic treatment for patients with AIS. METHODS A sample of 120 AIS patients were recruited and grouped according to their serum homocysteine (Hcy) levels. The National Institute of Health Stroke Scale (NIHSS) was obtained before treatment and 7 days after it to evaluate neurological outcomes; modified Rankin Scale (mRS) was obtained 12 weeks later to assess functional outcomes. Receiver operating characteristic curve (ROC) was used to demonstrate the relationship between serum Hcy level and the outcomes after tPA treatment. RESULTS The serum Hcy level of 120 patients was of 27.57±20.17μmol/L. The NIHSS scores of the patients in the low Hcy level group were remarkably lower compared to those in the high-level group (p<0.05), after 7 days of treatment. In addition, the mRS scores of the patients in the low Hcy level group, after 12 weeks, were remarkably lower compared to those in the high-level group (p<0.01). ROC demonstrated that the serum Hcy level is related to the clinical outcomes of thrombolytic treatment with moderate specificity (80.3%) and sensitivity (58.2%). CONCLUSION In conclusion, higher serum Hcy levels can indicate poorer clinical outcomes of thrombolytic treatment in patients with AIS.

RESUMO OBJETIVO O presente estudo tem por objetivo investigar se a hiperhomocisteinemia (HHcy) afeta os resultados do tratamento trombolítico em pacientes com AVCI agudo. METODOLOGIA Uma amostra de 120 pacientes AVCI agudo foi recrutada e agrupada de acordo com os níveis séricos de homocisteína (Hcy). Uma avaliação nos padrões do National Institute of Health Stroke Scale (NIHSS) foi obtida antes do tratamento e 7 dias após ele para avaliar desfechos neurológicos e a escala de Rankin modificada foi utilizada 12 semanas depois para avaliar os desfechos funcionais. A curva ROC (Receiver Operating Caracteristic) foi utilizada para demonstrar a relação entre os níveis séricos de Hcy e os desfechos após tratamento com t-PA. RESULTADOS Os níveis séricos de Hcy de 120 pacientes foi de 27,57±20,17μmol/L. Os escores NIHSS dos pacientes no grupo de baixo nível de Hcy foram notavelmente mais baixos em comparação àqueles do grupo de nível mais alto (p<0,05), após 7 dias de tratamento. Além disso, os escores mRS dos pacientes no grupo de baixo nível de Hcy, após 12 semanas, foram consideravelmente mais baixos em comparação com os do grupo de alto nível (p<0,01). A curva ROC demonstrou que o nível sérico de Hcy tem relação com os desfechos clínicos do tratamento trombolítico com especificidade moderada (80,3%) e sensibilidade (58,2%). CONCLUSÃO Podemos concluir então que níveis séricos mais altos de Hcy podem prever desfechos clínicos piores para o tratamento trombolítico em pacientes com AVCI agudo.

Research Progress in Mechanism of Functional Dyspepsia by Acupuncture / 中国中医药信息杂志

Acupuncture is effective in the treatment of functional dyspepsia, and its mechanism may be related to abnormal gastric motility, central nervous system dysfunction, brain intestinal peptide secretion disorder, plasma molecular metabolite content changes and abnormal gene expression. This article summarized the mechanism of acupuncture treatment for functional dyspepsia in recent years from the aspects of electrophysiology, imaging, molecular biology, metabolism and genomics, and provided basis for clinical treatment of functional dyspepsia.

10-year Trend of Lifestyle Changing Instruction for Acute Myocardial Infarction Patients at Discharge in China / 中国循环杂志

Objective: To assess the trend of lifestyle changing instruction for acute myocardial infarction (AMI) patients at discharge in China from 2001-2011. Methods: Based on national representative data of China PEACE retrospective AMI study and the number of instructions AMI patients received at discharge, our research was classified into 3 groups: no instruction group, (1-2) instructions group and (3-5) instructions group. We described the instruction rates in different groups with 10-year trend and no instruction status in 5 regions of eastern urban, central/western urban, eastern rural, central rural, and western rural. In addition, we reported the instruction rates of diet consulting, exercise consulting, blood lipid evaluation, smoking cessation, and weight control with 10-year trend. Results: A total of 16100 medical records of AMI from 162 hospitals were enrolled. No instruction rates at discharge were 76.6%, 65.7% and 54.4% in 2001, 2006 and 2011, respectively, Ptrend<0.001. The proportion for receiving (1-2) instruction(s) at discharge increased from 23.2% in 2001 to 42.9% in 2011, Ptrend<0.001; the rate for receiving (3-5) instructions was 2.7% in 2011.No instruction rates in 5 regions were from 47.1% to 69.5%; no instruction rates in central and western rural regions had little changes during the 10-year period, Ptrend=0.11 and Ptrend=0.10, respectively; no instruction rates in the rest 3 regions showed decreasing trend, all Ptrend<0.001. Most of the single instruction rates for lifestyle changing increased from 2001 to 2011, diet consulting were 16.6%, 27.8%, and 38.3% respectively, Ptrend<0.001; exercise consulting were 9.2%, 10.9% and 14.3% respectively, Ptrend<0.001; from 2001 to 2011, blood lipids evaluation was increased from 0.9% to 11.9%; smoking cessation increased from 2.2% to 8.8%, both Ptrend<0.001; however the weight control rate was 1.3% in 2011, which was had little change within 10 years, Ptrend=0.32.

Research on the Development Path of Beijing-Tianjin-Hebei Healthcare Industry from the Perspective of Cross-boundary Integration / 中国卫生经济

Under the strategic background of the "Healthy China" and the "coordinated development of Beijing-Tianjin-Hebei",based on the perspective of cross-boundary integration,taking the Beijing-Tianjin-Hebei health industry as the study case,it analyzed the basic condition of the health industry cross-boundary integration of the Beijing-Tianjin-Hebei region and considered that the Beijing-Tianjin-Hebei healthcare industry marketplace was immerse,which had good industrial foundation conditions and a certain degree of dislocation,provided with foundation for cross-border integration development.Therefore,it put forward further development path of the horizontal industry crossover and vertical industry chain integration in Beijing-Tianjin-Hebei healthcare industry,building and perfecting industrial chain,extending industrial development space,and promoting the cultivation and development of healthcare industry in three places.

The characteristics and outcome of Stenotrophomonas maltophilia bacteremia in patients with neutropenia / 天津医药

@#Objective To investigate the characteristics and outcome of Stenotrophomonas maltophilia bacteremia in patients with neutropenia. Methods The clinical data of Stenotrophomonas maltophilia bacteremia in patients with neutropenia from January 2006 to December 2016 were respectively analyzed. Results In 32 patients with neutropenia, there were 20 cases with acute leukemia, 7 cases with severe aplastic anemian (SAA), and 5 cases of non-hodgkin lymphoma. All patients had long time to use broad-spectrum antibiotic history. Twenty-one patients had central venous catheters and eleven had peripheral venous catheters in situ. Twenty-five patients were found neutropenia due to chemotherapy, and seven cases with bone failure attributed to SAA. Seventeen patients were dead, and fifteen recovered. Drug susceptibility tests showed multiple drug resistance. Stenotrophomonas maltophilia were partially susceptive to tigercycline, trimethoprim - sulfamethoxazole, levofloxacin, cefoperazone-sulbactam. ceftazidime, minocycline and piperacillin-tazobactam. The severe neutropemia, thrombocytopenia, long duration of granulocyte reduction and polymicrobial infection were the adverse prognostic factors. Conclusion Stenotrophomonas maltophilia bacteremia in patients with neutropenia has a high mortality rate, which needs to timely diagnose and treatment with effective antibiotics.

Effects of Optimized Formulas of Radix Astragali and Radix Angelicae Sinensis Extracts on Survival Status of Idiopathic Pulmonary Fibrosis Mice and on Expression of Cytogenesis-related Factors in Lung Tissues / 广州中医药大学学报

Objective To observe the effect of the optimized formulas of extracts of Radix Astragali and Radix Angelicae Sinensis on the survival status of the idiopathic pulmonary fibrosis (IPF) mice,and on the expression levels of transforming growth factor-β (TGF-β) and vascular endothelial growth factor(VEGF),so as to optimize the therapeutic regimen and to explore the therapeutic mechanism.Methods One hundred and five SPF ICR male mice were randomly divided into normal group,model group and 5 Chinese medicine treatment groups (group 1,2,3,4,5 of the optimized formula of Radix Astragali and Radix Angelicae Sinensis extracts).The mice in the model group and the 5 treatment groups were intratracheally injected with bleomycin (5 mg/kg) to induce the pulmonary fibrosis model.On day 21,the lung tissues were taken out for the test.Hydroxyproline content was detected by alkaline hydrolysis method,and morphological changes of lung tissues were observed by hematoxylineosin (HE) staining and Mallory's staining methods.The expression levels of TGF-β and VEGF were detected by polymerase chain reaction (PCR).Results The HE staining and Mallory's staining results showed that the pulmonary fibrosis in the 5 treatment groups was relieved as compared with that in the model group,especially in the group 1,and the alveolar structure recovered better.The 21-day overall death rate in the treatment groups were lower than those in the model group,and group 1 and group 5 had the lowest rates,the difference being statistically significant (P＜ 0.05).Compared with the model group,the content of hydroxyproline in the lung tissues of the treatment groups were decreased to some degrees,and there was significant difference (P ＜ 0.05 or P ＜ 0.01).The expression levels of TGF-β and VEGF in model group were higher than those in normal group,but were deceased in the treatment groups to some degrees,except TGF-β expression in group 5,and the difference was significant(P ＜ 0.05 or P ＜ 0.01).Conclusion When the contents of Radix Astragali water-extract and Radix Angelicae Sinensis alcohol-extract were predominated,the extract formula exerts certain effects on decreasing hydroxyproline content in the lung tissues,inhibiting the expression levels of TGF-β and VEGF,and relieving the degree of pulmonary fibrosis in IPF mice.

A study on application of BacT/ALERT 3D liquid culture technology on tuberculosis drug resistance detection / 预防医学

Objective To evaluate the BacT/ALERT 3D liquid culture technology on the detection of drug resistance of Mycobacterium tuberculosis(MTB)and to compare the difference between this technology and Lowenstein -Jensen (L -J) proportion method.Methods BacT/ALERT 3D liquid culture technology and L -J proportion technology were applied to detect the drug resistance of tuberculosis from the positive cultures of 219 solid culture samples.Results The average detection time of BacT/ALERT 3D method was 8.02 ±3.85 d,which was about 20 days shorter than that of L -J proportion method.60 drug resistance strains were found using BacT/ALERT 3D technology,While 79 drug resistance strains were found using L -J proportion technology.There showed no significant difference (P >0.05).The compliance rate of BacT/ALERT 3D method and L -J proportion method on the anti -tuberculosis drugs INH,RFP,EMB and SMwas 95.43%,92.69%,95.43% and 92.24% respectively.Conclusion BacT/ALERT 3D liquid culture technology could detect drug resistant TB strains rapidly with high concordance with the results of L -J proportion method on anti -tuberculosis drugs.

The effect evaluation on the application of BacT/ALERT 3 D technique for the fast cultivation of mycobacterium tuberculosis / 预防医学

Objective To evaluate the BacT/ALERT 3D liquid rapid culture system for the rapid detection of mycobacterium tuberculosis(MTB)and early diagnosis of pulmonary tuberculosis.Methods BacT/ALERT 3D liquid culture mediums and lowenstein-jensen(L-J)solid culture mediums were applied to detect Mycobacterium tuberculosis sputum specimens respectively.Analysis of detection results and detection time were also performed.Results Average positive days of BacT/ALERT 3D liquid culture medium was(13 ±2.05)days,which was shorter than that of L-J solid culture mediums(34.7 ±4.76 )d (P<0.05 ).Compared to the L -J solid culture mediums,BacT/ALERT 3D liquid culture medium had higher positive rate for 59 patients whose sputum smear test was positive,and the positive rate were 71.18%(42/59)and 67.80%(40/59)respectively(P<0.05).BacT/ALERT 3D liquid culture medium had higher positive rate than L-J solid culture mediums for 106 patients whose sputum smear test was negative,and the positive rate were 39.62%(42/106)and 26.42%(28/106)respectively(P<0.05).Conclusion Compared to the traditional L-J solid culture system,BacT/ALERT 3D liquid culture system can shorten detection time and improve the positive detection rate of MTB in specimens with low concentration.

Management of Kasabach-Merritt syndrome by drug therapy and surgery / 中华整形外科杂志

<p><b>OBJECTIVE</b>To summarize the characters of Kasabach-Merritt syndrome (KMS) and to evaluate the therapeutic effect of drug therapy combined with surgery.</p><p><b>METHODS</b>From 2004 to 2010, 59 cases with KMS, who underwent drug therapy and surgery, were retrospectively studied. The average age of the patients, including 33 male and 26 female (male/female, 1.269/1), was 2.9 months (range, 7 days-2.5 years). 28 cases with maxillofacial lesions were treated with the ligation of external carotid artery and injection of carbonyldiamide and methylprednisolone. 31 cases with lesions at trunks and extremities were treated by excision of lesions. All the patients were followed up for 2.8 years (range, 6.5 months -7.3 years). Therapeutic outcomes were assessed by evaluating platelet counts,size of lesion, function of trunk and limb.</p><p><b>RESULTS</b>58 cases were cured except for one dead case. Emergency operation was given in 4 cases, and selective operation was performed in other cases (55 cases). The thrombocyte count, hemoglobin and blood coagulation function returned to normal within 1-2 weeks. The mental condition, appetite, body weight,sleeping were greatly improved one week after treatment. The size of the lesions decreased gradually after the management of ligation of external carotid artery including 18 cases within 6-12 months and 10 cases within 13-24 months. Long term follow-up studies indicated that there was no recurrent case, and the weight, height, immunity of the patients with good function activities were in keeping with the normal counterparts.</p><p><b>CONCLUSIONS</b>The drug combined with surgery therapy is a very reliable management with high curative rate, short disease period and minimum side-effect.</p>

Comparison of two different renorrhaphy techniques in retroperitoneal laparoscopic partial nephrectomy for complex tumor / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Partial nephrectomy is currently the standard treatment for clinical T1 renal neoplasms, as it can provide oncologic outcomes equivalent to radical nephrectomy. The aim was to evaluate the efficacy of self-retaining suture (SRS) in renorrhaphy technique in retroperitoneal laparoscopic partial nephrectomy (LPN) for a single renal mass of moderate or high complexity by assessing peri-operative outcomes.</p><p><b>METHODS</b>A retrospective analysis was done of 64 patients between 2010 and 2012 for complex renal mass (RENAL score ≥ 7) in whom retroperitoneal LPN was performed with two layers using continuous knotless barbed suture (Quill PDO SRS group; n = 34) and absorbable vicryl (non-SRS group; n = 30), respectively. Cases were matched for RENAL score. All the surgical procedures were performed by the same surgeon with experience of more than 500 cases of LPN. Comparisons were made in patients and preoperative outcomes and peri-operative complications between SRS group and non-SRS group.</p><p><b>RESULTS</b>Mean warm ischemia time (WIT) in SRS group was less than non-SRS group (18.0 vs. 24.8 minutes, P = 0.021). Renorrhaphy suture cost in SRS group was lower than non-SRS group ($269.6 vs. $335.8, P = 0.001). There were no significant differences between the two groups for postoperative changes in creatinine and estimated glomerular filtration rate and the rate of peri-operative complications.</p><p><b>CONCLUSION</b>SRS was safe for complex renal tumor with two layers, continuous and unknot suture, during LPN and would reduce the WIT and renorrhaphy suture cost significantly.</p>

The situation of stomatological basic research supported by National Natural Science Foundation of China in the past decade / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To review the situation of stomatological research projects supported by National Natural Science Foundation of China (NSFC) and to analyze the status of stomatological research and obtained achievements in the past decade.</p><p><b>METHODS</b>The internet-based science information system of NSFC together with Yearbook of Chinese Stomatology was served as the basis of data collection. All of the data were arranged and analyzed by Excel.</p><p><b>RESULTS</b>A total of 866 projects and 234.4054 billion Yuan were supported by NSFC during the past decade, and they were increasing continuously. The average supportive strength of each single project was also enhanced. The percentage of projects supported by the NSFC for young scientists accounted for the biggest proportion. The approved projects of stomatology were covering an increasingly wide area of the subjects. The projects number of different areas kept growing, and further investigations were done in these projects. The areas number were from 10 increasing to 26.</p><p><b>CONCLUSIONS</b>With the support of NSFC, great progress has been made in stomatology, and the interdisciplinary research between stomatology and other disciplines is more active.</p>

Retroperitoneal laparoscopic living donor nephrectomy: report of 58 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To review a single-institution experience with retroperitoneal laparoscopic living donor nephrectomy (RLDN).</p><p><b>METHODS</b>Fifty-eight donors underwent RLDN at our institution (including 32 male and 26 female donors aged 20-61 years, mean 42 years). Left nephrectomy was performed in 56 cases. The first 35 patients underwent total RLDN, and the latter 23 received modified RLDN.</p><p><b>RESULTS</b>RLDN was performed successfully in all the patients without conversion to open surgery. The mean surgical time was 93 min (range 70-130 min), and the mean blood loss was 20 ml (range 10-50 ml), with a mean warm ischemia time of 2.8 min (1.3-6 min). Retroperitoneal hematoma occurred postoperatively in one case. The mean hospital stay of the donors was 6.4 days (5-10 days). Two recipients showed delayed graft function, and one graft was lost because of acute rejection. The other recipients had normal renal function in two weeks except for 3 having normal renal function in 4 weeks.</p><p><b>CONCLUSION</b>RLDN is a safe procedure with minimal invasiveness, and the modified RLDN lowers the learning curve of the surgery.</p>

Effects and mechanisms of L-glutamate microinjected into nucleus ambiguus on gastric motility in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>L-glutamate (L-GLU) is a major neurotransmitter in the nucleus ambiguus (NA), which can modulate respiration, arterial pressure, heart rate, etc. This study investigated the effects and mechanisms of L-GLU microinjected into NA on gastric motility in rats.</p><p><b>METHODS</b>A latex balloon connected with a pressure transducer was inserted into the pylorus through the forestomach for continuous recording of the gastric motility. The total amplitude, total duration, and motility index of gastric contraction waves within 5 minutes before microinjection and after microinjection were measured.</p><p><b>RESULTS</b>L-GLU (5 nmol, 10 nmol and 20 nmol in 50 nl normal saline (PS) respectively) microinjected into the right NA significantly inhibited gastric motility, while microinjection of physiological saline at the same position and the same volume did not change the gastric motility. The inhibitory effect was blocked by D-2-amino-5-phophonovalerate (D-AP5, 5 nmol, in 50 nl PS), the specific N-methyl-D-aspartic acid (NMDA) receptor antagonist, but was not influenced by 6-cyaon-7-nitroquinoxaline-2,3-(1H,4H)-dione (CNQX) (5 nmol, in 50 nl PS), the non-NMDA ionotropic receptor antagonist. Bilateral subdiaphragmatic vagotomy abolished the inhibitory effect by microinjection of L-GLU into NA.</p><p><b>CONCLUSIONS</b>Microinjection of L-GLU into NA inhibits the gastric motility through specific NMDA receptor activity, not non-NMDA receptor activity, and the efferent pathway is the vagal nerves.</p>

Acute heat stress increases HSP70 expression in the testis, epididymis and vas deferens of adult male mice / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects of acute heat stress on the expression patterns of heat shock protein 70 (HSP70) in the testis, epididymis and vas deferens of adult male mice.</p><p><b>METHODS</b>Thirty-two 8-week-old male mice were randomly divided into a control and 3 heat stress groups. After a week of pretreatment, the latter 3 groups were exposed to heat stress at (39 +/- 0.5) degrees C for 0.5, 1 and 3 hours, respectively, followed immediately by collection of the blood and determination of glutamic oxaloacetic transaminase (GOT) concentration. Sperm suspension was made from one epididymis for the detection of sperm concentration and abnormal acrosome rate, while the testis, epididymis and vas deferens on the other side were harvested for immunohistochemical analysis.</p><p><b>RESULTS</b>Heat stress induced different degrees of decrease in epididymis indexes and sperm concentration and a dramatic increase in GOT concentration (P < 0.01), but caused no significant changes in the body weight, testis indexes and abnormal acrosome rate in the mice (P > 0.05). There was a tendency of gradual descent in sperm concentration and ascent in abnormal acrosome rate with the increasing time of heat stress. The most decrease in body weight, testis indexes and epididymis indexes was observed in the 0.5 h group. Immunohistochemical results showed that HSP70 was expressed in the testis, epididymis and vas deferens, mildly in the Leydig cells of the testis and distributed in the nuclei of the Leydig cells, spermatoblasts and spermatocytes. In the epididymis, HSP70 was expressed mainly in the cytoplasm of principal and ciliated cells, but not in the basal and clear cells, while in the vas deferens, it was observed mainly in the cytoplasm of the basal cells, but not in the principal cells. With the increase of heating time, the HSP70 expression was markedly elevated in the testis and epididymis, but not so obviously in the vas deferens.</p><p><b>CONCLUSION</b>Acute heat stress was harmful to the reproductive system of adult male mice. The region- and cell-specific patterns of HSP70 expressions in the testis, epididymis and vas deferens suggested that HSP70 might play an important role in spermatogenesis and sperm maturation. The dramatic increase of HSP70 expression after heat stress might be responsible for the prevention of cells from high temperature.</p>

Prostate androgen-regulated gene: a novel potential target for androgen-independent prostate cancer therapy / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate the involvement of the prostate androgen-regulated (PAR) gene in the androgen receptor (AR) signaling pathway and the malignant phenotype of androgen-independent prostate cancer (PCa) cells.</p><p><b>METHODS</b>The difference in PAR expression between LNCaP and PC3 cells was detected by reverse transcription-polymerase chain reaction (RT-PCR). Androgen and anti-androgen effects on PAR expression were evaluated by RT-PCR in LNCaP, PC3 cells and PC3 cells stably transfected with vector containing wild-type AR. To determine the importance of PAR in the malignant proliferation of androgen-independent PCa cells, we used small interfering RNA (siRNA) transfection to knock down the expression of the gene in PC3 cells. The changes in the malignant phenotype of PCa cells after transfection were analyzed by cell count, colony formation in soft agar and flow cytometry.</p><p><b>RESULTS</b>PAR expression was 3-fold higher in PC3 cells than that in LNCaP cells. Dihydrotestosterone (DHT) regulated PAR mRNA expression in LNCaP cells and the effect was inhibited by the AR antagonist, flutamide. By contrast, DHT did not affect PAR expression in PC3 cells. The reintroduction of AR into PC3 cells by stable transfection restored the androgen effect on PAR upregulation. After the knockdown of the PAR gene by siRNA, PC3 cells exhibited a reversal of the malignant phenotype.</p><p><b>CONCLUSION</b>Because of the possibility that PAR is downstream from the AR, and because of its contribution to malignant proliferation in androgen-independent PCa cells, the gene could be a potential therapeutic target for androgen-independent PCa with AR signaling pathway alteration.</p>

Retroperitoneal laparoscopic management of primary aldosteronism with report of 130 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate retroperitoneal laparoscopic partial or total adrenalectomy for primary aldosteronism.</p><p><b>METHODS</b>From February 2000 to September 2003, 130 patients (76 women and 54 men) with a confirmed diagnosis of primary aldosteronism underwent retroperitoneal laparoscopic operation. Of the 130 cases, there were 119 cases with Aldosterone-producing Adenoma and 11 cases with Idiopathic Adrenal Hyperplasia (unilateral of 2 cases). Eleven cases with Idiopathic Adrenal Hyperplasia underwent unilateral adrenalectomy. Of the 119 cases with Aldosterone-producing Adenoma, 61 cases underwent total adrenalectomy, and 58 cases underwent partial adrenalectomy. All cases were with preoperatively high plasma aldosterone, low plasma rennin and hypokalemia and arterial hypertension.</p><p><b>RESULTS</b>Operations were successfully performed in all cases. The operative time ranged from 15 to 225 min (mean 52 +/- 40 min, Md = 43 min) and the operative bleeding ranged from 0 to 200 ml (mean 23 +/- 34 ml, Md = 20 ml, zero bleeding means that less than 5 ml) without blood transfusion. The hospital length of stay was ranged from 3 to 9 d (mean 5.1 +/- 1.3 d). No major complication occurred. Kalemia was normalized within one month and aldosterone/PRA ratio was decreased obviously in all cases. Postoperatively blood pressure was normalized within 2 month in 88 cases without using any drug.</p><p><b>CONCLUSION</b>It is safe and practical to perform retroperitoneal laparoscopic partial on total adrenalectomy on the patients with primary aldosteronism.</p>

Production in Pichia pastoris and characterization of genetic engineered chimeric HBV/HEV virus-like particles / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the presentation of a neutralization epitope-containing peptide antigen of hepatitis E virus (HEV) on chimeric virus-like particles (VLPs) of hepatitis B surface antigen (HBsAg).</p><p><b>METHODS</b>The gene fragment corresponding to amino acids (aa) 551-607 (HEnAg) of HEV capsid protein, which contains the only neutralization epitope identified to date, was fused via a synthetic glycine linker in frame with the gene of HBsAg. The resulted fusion gene was then integrated through transformation into the genome of Pichia pastoris under the control of a methanol-induced alcohol oxidase 1 (AOX1) promoter and expressed intracellularly. The expression products in the soluble cell extracts were characterized by Western blot, ELISA, CsCl density gradient analysis, and electron microscopic visualization.</p><p><b>RESULTS</b>The novel fusion protein incorporating HBsAg and the neutralization epitope-containing HEnAg was expressed successfully in Pichia pastoris with an expected molecular weight of approximately 32 kD. It was found to possess the ability to assemble into chimeric HBV/HEV VLPs with immunological physical and morphological characteristics akin to HBsAg particles. Not only did the chimeric VLPs show high activity levels in a HBsAg particle-specific ELISA but they were also strongly immunoreactive with hepatitis E (HE) positive human serum in a HEV specific ELISA, indicating that HEnAg peptide fragments were exposed on VLP surfaces and would be expected to be readily accessible by cells and molecules of the immune system. Similarity between chimeric VLPs to highly immunogenic HBsAg particles may confer good immunogenicity on surface-displayed HEnAg.</p><p><b>CONCLUSION</b>The chimeric HBV/HEV VLPs produced in this study may have potential to be a recombinant HBV/HEV bivalent vaccine candidate.</p>