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Objective To assess the efficacy and safety of ultrasound-guided percutaneous transluminal angioplasty (PTA) for treatment of stenosis of autogenous arteriovenous fistulas in maintenance hemdialysis patients. Methods From September 2016 to August 2017, thirty patients with autologous arteriovenous fistula (AVF) stenosis diagnosed in Guangzhou First People′s Hospital underwent PTA under the guidance of ultrasound for the first time. The vascular diameter of AVF stenosis and the blood flow of AVF before and after operation were evaluated. During the follow-up period,the patency time and complications were recorded. Results In 93. 3%( 28/30) patients, primary ultrasound-guided PTA procedures were successfully performed. The internal diameter of the stenosis increased from (1. 62±0. 30) mm preoperatively to (3. 61±0. 66) mm postoperatively (t＝18. 205,P＜0. 001),and the natural blood flow increased from (270. 0±36. 5) ml/min preoperatively to (611. 4±46. 6) ml/min postoperatively (t＝50. 221,P＜0. 001). The post-intervention primary patency rates at 90 and 180 d were 96. 4%(27/28) and 85. 7%(24/28), respectively. There was no rupture of the vein,or other severe complication during the PTA procedure. One patient had perilesional swelling,and one patient had extravasation after the PTA procedure. Conclusion Ultrasound-guided PTA is a safe and effective method for treatment of stenosis of autogenous arteriovenous fistulas in maintenance hemdialysis patients.
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Objective To investigate the role of miR-155 in diabetic nephropathy(DN)and its mecha-nism. Methods MiR-155 expression level in kidney was detected by real-time PCR and in situ hybridization. The target gene of miR-155 was predicted by bioinformatics and verified by Western Blot and double luciferase reporter activity. Western Blot was used to detect the related marker proteins of mesangial cells proliferation and mesangial matrix. Results (1)The expression of miR-155 increased in DN renal tissue and high glucose-stimulated renal cells.(2)MiR-155 was related to the regulation of Smad5 gene expression.(3)MiR-155 promoted the mesangial cells proliferation and increased extracellular matrix by down-regulating Smad5 expression. Conclusions MiR-155 can promote the mesangial cells proliferation and renal fibrosis by regulating Smad5 gene,providing a basis for further understanding the pathogenesis of DN.
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Objective To investigate the role of miR-155 in diabetic nephropathy(DN)and its mecha-nism. Methods MiR-155 expression level in kidney was detected by real-time PCR and in situ hybridization. The target gene of miR-155 was predicted by bioinformatics and verified by Western Blot and double luciferase reporter activity. Western Blot was used to detect the related marker proteins of mesangial cells proliferation and mesangial matrix. Results (1)The expression of miR-155 increased in DN renal tissue and high glucose-stimulated renal cells.(2)MiR-155 was related to the regulation of Smad5 gene expression.(3)MiR-155 promoted the mesangial cells proliferation and increased extracellular matrix by down-regulating Smad5 expression. Conclusions MiR-155 can promote the mesangial cells proliferation and renal fibrosis by regulating Smad5 gene,providing a basis for further understanding the pathogenesis of DN.
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BACKGROUND:In osteoarthritis cartilage degeneration, connective tissue growth factors as the important effector molecules play an important role in chondrocyte proliferation and differentiation. Clinical application of diacerein for the treatment of osteoarthritis has achieved good effect, but the exact mechanism of the treatment is unclear. OBJECTIVE:To observe the effect of different concentrations of diacerein on the expression of connective tissue growth factor in the articular cartilage induced with interleukin-1βin vitro. METHODS: Chondrocytes of Sprague Dawley rats were culturedin vitro, and then the chondrocytes were induced with recombinant human interleukin-1β to prepare the osteoarthritis model. Rats in the normal control group received no treatment; rats in the model group were treated with recombinant human interleukin-1β; rats in the experimental group were treated with different concentrations of diacerein+10 μg/L recombinant human interleukin-1β. The proliferation of chondrocytes was observed withMTT assay, and Western blot was used to detect the expression of connective tissue growth factor. The experiments above were repeated for three times. RESULTS AND CONCLUSION:The MTT assay results showed that compared with the normal control group, the diacerein could promote the proliferation activity of chondrocytes, and more significant in the concentration of 10-5 mol/L (P < 0.01); the proliferation capacity of chondrocytes in the experimental group was decreased after induced with interleukin-1β (P < 0.05), but when compared with the normal control group, the diacerein with the concentrations of 10-4 mol/L and 10-5 mol/L could promote the MTT proliferation capacity of chondrocytes with or without interleukin-1β (P < 0.05). Western blot results showed that interleukin-1β could reduce the expression of connective tissue growth factor (P< 0.01), and 10-5 mol/L diacerein could significantly promote the expression of connective tissue growth factor induced with interleukin-1β, and the effect was significantly higher than that in the model group (P < 0.01). Diacerein can promote expression of connective tissue growth factor induced with interleukin-1β, it may be one the mechanism of diacerein for promoting chondrocytes differentiation and proliferation and the treatment of osteoarthritis.
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BACKGROUND:The safety and efficacy of simultaneous bilateral total knee replacement or selective unilateral total knee arthroplasty in patients with severe osteoarthritis of the knees are stil controversial. OBJECTIVE:To compare safety and clinical efficacy of patients with osteoarthritis knees after simultaneous bilateral total knee replacement or selective unilateral total knee replacement. METHODS:Total y 60 cases with severe osteoarthritis of the knees (90 knees) undergoing total knee replacement were divided into unilateral total knee replacement group (n=30, 30 knees), and the simultaneous bilateral total knee replacement group (n=30, 60 knees). RESULTS AND CONCLUSION:There was no significant difference in the incidence of other complications such as infection, mortality, pulmonary embolism in patients of both groups (P>0.05). The incidence of cardiovascular complications, postoperative blood loss and blood transfusion were higher in the bilateral knee group than in the unilateral knee group (P0.05). However, Visual Analogue Scale scores were significantly lower in the bilateral knee group than in the unilateral group (P<0.05). These data indicated that the risk of cardiovascular complications was high in patients receiving bilateral total knee replacement. Patients with severe cardiovascular disease should avoid simultaneous bilateral total knee arthroplasty.
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[Objective]To examine the effect and safety of the combination of rifampin plus levofloxacin given orally for treating chronic orthopedic implant-related infections. [Methods]From March 2006 to December 2007,13 patients with chronic orthopedic implant-related infections were treated orally with rifampin ,600 mg/day,plus levofloxacin,600mg/day.The study group included 6 males and 7 females, with average age of 51.6 years (range, 17~75 years).During treatment,clinical follow-up was performed, including blood and differential counts ,erythrocyte sedimentation rate , and hepatic enzyme levels,C-reactive protein levels,and radiological data.Cure was defined as the absence of clinical signs and symptoms of infection (fever,local pain,redness,warmth,sinus tract infection ),ESR50 mg/l) without microbiological documentation of infection.[Results]Among 13 patients included in the study and evaluable for safety, one patient had gastrointestinal side effects and was not evaluable for treatment effectiveness. Twelve patients with chronic orthopedic implant-related infections , antibiotics were administrated orally for a total of 6 months . Two patients, on whom pseudoarthrosis presented, were treated with autologous bone graft and internal fixation subsequently. Ten of 12 patients with chronic orthopedic implant-related infections had successful outcomes . Those rates were determined after a post-treatment follow-up of 6 to 27 months (average, 24 months ).The overall success rate was 83.3% among 12 patients.Ten cases had been followed up,and no case had infection recurrence.[Conclusion]With nutrition support, the combination of rifampin plus levofloxacin given orally for treating chronic orthopedic implant-related infections are effective methods.