Recognition of Iron Overload Cardiomyopathy / 罕见病研究

Iron overload cardiomyopathy (IOC) is a type of cardiac dysfunction caused by several factors resulting in iron overload in the myocardium. Two major causes of IOC include hereditary hemochromatosis and transfusion-dependent anemia. IOC significantly reduces long-term survival of patients. Since IOC is a rare disease in Asian populations that also lacks etiology-specific manifestations, early diagnoses in clinical practice are challenging. Two groups of patients with high risk of IOC should be further investigated: those who present heart failure of unknown origin will be screened for iron overload followed by confirmation of IOC; and those who have high risk of iron overload or an established diagnosis will be monitored for the development of IOC. Serum ferritin is recommended as the first-line screening test for iron overload, while cardiac magnetic resonance T2* should be used to confirm iron overload in the myocardium. Phlebotomy and iron chelating agents can effectively remove the extra iron from the body, preventing IOC, as well as reverse the disease at an early stage and slow down its progession. Timely diagnosis and treatment is critical in improving the prognosis of patients with IOC. Therefore, this review aims to help clinicians to understand IOC in multiple dimensions including pathogenesis, clinical manifestations, diagnostic methods and treatment choices.

Diagnostic Value of the Electroencephalogram and Cerebrospinal Fluid in Viral Encephalitis.

BACKGROUND: Electroencephalogram (EEG) and cerebrospinal fluid (CSF) are widely used in the clinical diagnosis of viral encephalitis (VE), but their value in the diagnosis of VE and the detection rate of abnormal indicators need to be further supported by more clinical data. METHODS: In this study, routine laboratory testing, biochemical examinations of cerebrospinal fluid (CSF) and EEG characteristics were performed in patients with VE to guide the diagnosis and treatment of VE in clinical settings. A total of 330 patients with VE were enrolled in the Department of Neurology of the Third Affiliated Hospital of Zunyi Medical University from January 1, 2015 to January 30, 2020. EEG, routine testing and assessment of biochemical indicators of CSF were performed within 10 days after admission, and the results were analyzed by paired χ 2 test to compare the diagnostic value of EEG and CSF for VE. RESULTS: In 330 cases of VE, 283 cases (85.76%) had abnormal EEG, and 189 cases (57.27%) had abnormal CSF indicators. The incidence of EEG abnormalities was higher than that of CSF indicators, and the difference was statistically significant ( P <0.05). CONCLUSIONS: Both the EEG and CSF analysis are valuable indicators in the diagnosis of VE patients. Compared with the CSF examination, the EEG examination had a better diagnostic efficacy for the diagnosis of VE. In addition, a normal EEG or a normal CSF level cannot exclude VE, and it is still necessary to develop new diagnostic indicators to cover all viral encephalitides.

Aberrant TDP-43 phosphorylation: a key wind gap from TDP-43 to TDP-43 proteinopathy.

TDP-43 proteinopathy is a kind of neurodegenerative diseases related to the TAR DNA-binding protein of 43-kDa molecular weight (TDP-43). The typical neurodegenerative diseases include amyotrophic lateral sclerosis (ALS), frontotemporal lobar degeneration (FTLD), Alzheimer's disease (AD), Parkinson's disease (PD) and so on. As the disease process cannot be blocked or slowed down, these patients have poor quality of life and poor prognosis, and bring a huge burden to the family and society. So far, the specific pathogenesis of TDP-43 proteinopathy is not clear, and there is no effective preventive measure and treatment program for this kind of disease. TDP-43 plays an important role in triggering or promoting the occurrence and progression of TDP-43 proteinopathy. The hyperphosphorylation of TDP-43 is undoubtedly an important factor in triggering or promoting the process of TDP-43 proteinopathy. Hyperphosphorylation of TDP-43 can inhibit the degradation of TDP-43, aggravate the aggregation of TDP-43 protein, increase the wrong localization of TDP-43 in cells, and enhance the cytotoxicity of TDP-43. More and more evidences show that the hyperphosphorylation of TDP-43 plays an important role in the pathogenesis of TDP-43 proteinopathy. Inhibition of TDP-43 hyperphosphorylation may be one of the important strategies for the treatment of TDP-43 proteinopathy. Therefore, this article reviews the role of TDP-43 phosphorylation in TDP-43 proteinopathy and the related mechanisms.

Protective Effect of Huangqi Guizhi Wuwutang Combined with Shengmaiyin on Cardiac Function of Diabetic Cardiomyopathy / 中国实验方剂学杂志

Objective:To observe the protective effect of Huangqi Guizhi Wuwutang combined with Shengmaiyin on the heart function in patients with diabetic cardiomyopathy and explore its anti-myocardial fibrosis and anti-inflammatory effects. Method:The 96 patients were randomly divided into observation group （48 cases） and control group （48 cases）. Both groups were given comprehensive measures to control blood sugar， blood lipids， blood pressure and heart failure. Patients in control group took Tongmai Jiangtang capsule， 3 granules/time， 3 times/day. Patients in observation group took Huangqi Guizhi Wuwutang combined with modified Shengmaiyin， 1 dose/day. The treatment courses were three months in both groups. Left ventricular ejection fraction （LVEF）， early diastolic peak velocity E peak/late diastolic peak velocity A peak （E/A）， left ventricular end diastolic diameter （LVEDd） and cardiac output per stroke （SV） through echocardiography were recorded before and after therapy. Cardiac troponin-I （cTn I）， troponin T （cTn-T）， creatine kinase isoenzyme -MB （CK-MB）， lactate dehydrogenase （LDH）， transforming growth factor-<italic>β</italic>₁ （TGF-<italic>β</italic>₁） before and after treatment ， matrix metalloproteinase-2 （MMP-2）， insulin-like growth factor-1 （IGF-1）， interleukin-6 （IL-6）， IL-1， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， soluble ST2 （sST2） and galectin-3 （Gal-3） levels were detected. Symptom of cardiac insufficiency and traditional Chinese medicine （TCM） syndrome score were evaluated before and after treatment. Result:The LVEF and E/A data in observation group were higher than those in control group （<italic>P</italic><0.01）. The levels of cTn-I， cTn-T， LDH and CK-MB in the observation group were lower than those in the control group （<italic>P</italic><0.01）. After treatment， the levels of TGF-<italic>β</italic>₁， MMP-2， IGF-1， IL-6， IL-1， TNF-<italic>α</italic>， NT-proBNP， sST2 and Gal-3 in the observation group decreased and were lower than those in the control group （<italic>P</italic><0.01）. The clinical efficacy of the observation group was better than that of the control group （<italic>Z</italic>=1.974，<italic>P</italic><0.05）. Conclusion:On the basis of conventional intervention of western medicine， Huangqi Guizhi Wuwutang combined with modified Shengmaiyin has anti-inflammatory and anti-myocardial fibrosis effects， with inhibitory effect on myocardial remodeling， and can reduce myocardial tissue damage to improve ventricular diastolic function and protect heart function. With such high clinical efficacy， it is worthy of clinical use.

Icaritin Improves Memory and Learning Ability by Decreasing BACE-1 Expression and the Bax/Bcl-2 Ratio in Senescence-Accelerated Mouse Prone 8 (SAMP8) Mice.

Icaritin (ICT) is the main component in the traditional Chinese herb Epimedium, and it has been shown to have anti-Alzheimer's disease (AD) effects, but its neuroprotective effects and the pharmacological mechanisms are unclear. In the present study, senescence-accelerated mouse prone 8 (SAMP8) mice were randomly divided into a model group and an ICT-treated group. Learning and memory abilities were detected by the Morris water maze assay, and the expression of amyloid beta protein (Aß) and ß-site APP cleavage enzyme 1 (BACE1) was determined by Western blotting and polymerase chain reaction (PCR). Histological changes in CA1 and CA3 were detected by hematoxylin-eosin staining (H&E staining), and the immunohistochemical analysis was used to detect the expression and localization of Bax and Bcl-2. The results showed that compared with the SAMP8 mice, the ICT-treated SAMP8 mice showed improvements in spatial learning and memory retention. In addition, the number of necrotic cells and the morphological changes in CA1 and CA3 areas were significantly alleviated in the group of ICT-treated SAMP8 mice, and the expression of BACE1, Aß 1-42 levels, and the Bax/Bcl-2 ratio in the hippocampus was obviously decreased in the ICT-treated group compared with the control group. The results demonstrated that ICT reduced BACE-1 levels, the contents of Aß 1-42, and the Bax/Bcl-2 ratio, suggesting that ICT might have potential therapeutic benefits by delaying or modifying the progression of AD.

Icariin improves cognitive deficits by reducing the deposition of ß-amyloid peptide and inhibition of neurons apoptosis in SAMP8 mice.

Effective therapeutic drugs for prevent or reverse the pathobiology of Alzheimer's disease (AD) have not been developed. Icariin (ICA), a prenylated flavonol glycoside derived from the traditional Chinese herb Epimedium sagittatum, exerts a variety of pharmacological activities and shows promise in the treatment and prevention of AD. This study investigated the neuroprotective effects of ICA in SAMP8 mice model of aspects of early AD and explored potential underlying mechanisms. Our results showed that intragastric administration of ICA could reverse the learning and memory impairment of SAMP8 mice in the Morris water maze. Western blot of hippocampal specimens revealed that ICA down-regulated the expression of BACE1 to reduce the expression of cytotoxic Aß1-42. Furthermore, ICA siginificantly increase the Bcl-2/Bax ratio by increasing the expression of anti-apoptotic protein Bcl-2, and decreasing the expression of pro-apoptotic protein Bax, and thus inhibit neurons apoptosis. These findings indicate that ICA could improve cognitive deficits by reducing the deposition of ß1-42 and inhibition of neurons apoptosis and provide further evidence for the clinical efficacy of ICA in the treatment of AD.

Therapeutic effect of Atricure bipolar radiofrequency ablation on patients with rheumatic heart disease complicated atrial fibrillation／ / 心血管康复医学杂志

Objective :To explore therapeutic effect of Atricure bipolar radiofrequency ablation on patients with rheu‐matic heart disease (RHD) complicated atrial fibrillation (AF) and its safety .Methods :A total of 90 RHD+AF pa‐tients ,who were treated in our hospital from Apr 2015 to Apr 2016 ,were selected .All patients received valve re‐placement ;according to radiofrequency ablation (RFA) mode ,patients were divided into bipolar RFA group (n＝45 ,received Atricure bipolar RFA ) and unipolar RFA group (n＝45).Aortic occlusion time during surgery ,bypass time ,incidence of surgery‐related complications ,AF conversion rates and changes of cardiac function after surgery were observed and compared between two groups .Results :Compared with unipolar RFA group ,there were signifi‐cant reductions in aortic occlusion time [ (78.12 ± 23.42) min vs.(65.03 ± 21.37) min] and bypass time [ (164. 59 ± 50. 74) min vs.(115. 37 ± 36.45) min] in bipolar RFA group ( P＝0.007 ,0.001).No surgery‐related complica‐tion occurred in bipolar RFA group ,while there were four cases who needed permanent pacemaker implantation in unipolar RFA group .AF conversion rate on one ,three and six months after surgery in bipolar RFA group were sig‐nificantly higher than those of unipolar RFA group (86. 67% vs.68. 89%, 91. 11% vs.71.11%, 93. 33% vs 77. 78%) , P＜0.05 all.Compared with unipolar RFA group on six months after surgery ,there was significant rise in LVEF [ (53.29 ± 6.91)% vs.(56. 47 ± 7. 84)%] in bipolar RFA group ( P＝0.044).Compared with unipolar RFA group on one year after surgery ,there were significant rise in AF conversion rate (71.11% vs.88. 89%) and LVEF [ (54. 27 ± 6. 32)% vs.(59.03 ± 7.02)%] , P＝0.035 , 0. 001 ,and significant reduction in LVEDd [ (51. 38 ± 9.16) mm vs.(47. 42 ± 8.31) mm] in bipolar RFA group ( P＝0.034) . Conclusion :Atricure bipolar radiofre‐quency ablation possesses significant short‐term therapeutic effect and higher safety in patients with rheumatic heart disease complicated atrial fibrillation .

Diabetes mellitus and Alzheimer's disease: GSK-3ß as a potential link.

It is well known that Alzheimer's disease (AD) is closely related to diabetes mellitus (DM), and AD is also regarded as Type 3 diabetes (T3D). However, the exact link between AD and DM is still unclear. Recently, more and more evidence has shown that glycogen synthase kinase-3ß (GSK-3ß) may be the potential link between DM and AD. In DM, GSK-3ß is the crucial enzyme of glycogen synthesis, which plays a key role in regulating blood glucose. More importantly, GSK-3ß is one of the key factors leading to insulin deficiency and insulin resistance, and insulin resistance is an important hallmark of the occurrence and development of DM. In AD, GSK-3ß plays an important role in hyperphosphorylation of microtubule-associated protein tau (tau), which is one of the pathological features in AD. GSK-3ß is one of the important kinases of tau phosphorylation and is involved in the insulin/phosphoinositide 3-kinase/protein kinase B (insulin/PI3K/Akt) signaling pathway. Dysfunction of the insulin/PI3K/Akt signaling pathway, which regulates glucose metabolism in the brain, can lead to tau hyperphosphorylation in the brain of AD patents. Additionally, insulin resistance in DM may cause ß-amyloid (Aß) deposition, which will be cleared by tau, but excessive phosphorylation of tau will further aggravate the neurotoxicity; then damage the brain and affect the cognitive function. GSK-3ß is considered as a common kinase in insulin signaling transduction and tau protein phosphorylation, so we have reasons to believe that GSK-3ß is a potential link between DM and AD.

Research Progress of Resveratrol Inhibiting Microglial Activation in Neuroinflammation / 中国药学杂志

Many neurodegenerative diseases are closely linked with neuroinflammation, microglia is one of the important participants, which plays an important role in physiological and pathological states. Therefore, inhibiting the excessive activation of microglia will be the potential drug targets of control neuroinflammation. Recent studies have found resveratrol in the central nervous system have a neuroprotective effect, which related to the inhibition of microglia activation and control of neuroinflammation. In this study, its possible mechanisms will be reviewed.

Relationship between procalcitonin level and spontaneous recanalization of infarct related artery in patients with myocardial infarction / 心血管康复医学杂志

Objective :To explore relationship between procalcitonin (PCT) level and spontaneous recanalization (SR) of infarct related artery in patients with myocardial infarction (MI).Methods :The 109 MI patients from our coro-nary care unit (CCU) were divided into SR group (n＝45 ,TIMI blood flow grade 2～3) and no SR group (n＝64 , TIMI blood flow grade 0 －1) according to TIMI blood flow grade .General data ,biochemical indexes were com-pared between two groups ,influencing factors of infarct related artery SR were analyzed ,and ROC curve of PCT level predicting infarct related artery SR was drawn .Results :Compared with no SR group ,there were significant reductions in levels of LDL-C [ (2.57 ± 0. 61 ) mmol/L vs.(2.13 ± 0.62 ) mmol/L ] , lipoprotein a (Lp (a )) [ (234.16 ± 72.67) mg/L vs.(182.62 ± 69.35) mg/L] ,PCT [ (0.12 ± 0.05) μg/L vs .(0.07 ± 0.04) μg/L] , hsCRP [ (6.05 ± 3.68) mg/L vs.(3.12 ± 2.53) mg/L] and creatine kinase isoenzyme MB (CK-MB) [ (85.56 ± 23.67) U/L vs.(74.36 ± 22.65) U/L] in SR group , P＜0.05 or ＜0.01. Logistic multi-factor regression analysis indicated that PCT level was independent predictive factor for coronary SR (OR＝0.661 , P＝0.001).Area under ROC curve was 0.760 for PCT predicting coronary SR , P＝0.001 ,95% CI 0.645－0.874 ,optimal cutoff point was 0.085μg/L ,and sensitivity and specificity was 84.4% and 65.4% respectively .Conclusion :PCT is independent predictive factor for infarct related ar-tery SR in MI patients.When PCT level ＜0.085μg/L ,artery SR rate tends to increase .

Therapeutic effect of simultaneous CABG and HVR on CHD patients with heart valve disease and its in-fluence on prognosis / 心血管康复医学杂志

Objective:To explore influence of simultaneous coronary artery bypass grafting (CABG) and heart valve replacement (HVR) therapy on ICU stay time,cardiac function and long-term prognosis in patients with coronary heart disease (CHD) complicated heart valve disease (HVD).Methods:A total of 94 CHD + HVD patients were selected from our hospital.They were randomly and equally divided into non-simultaneous treatment group (NST group) and simultaneous treatment group (ST group),according received CABG and HVR simultaneously.Postop-erative cardiac function,related indexes during and after operation,survival rate within five years and incidence rate of adverse reactions were compared between two groups.Results:Compared with NST group after operation,there were significant rise in LVEF [ (44.23 ± 11.03)% vs.(49.58 ± 11.39)%],left ventricular early diastolic peak flow velocity/late diastolic peak flow velocity (E/A) [ (0.87 ± 0.09) vs.(0.94 ± 0.12)] and percentage of NYHA classⅡ(46.81% vs.70.21%),and significant reductions in left atrial diameter (LAD) [ (39.47 ± 10.16) mm vs.(34.46 ± 8.72) mm],left ventricular end-diastolic dimension (LVEDd) [ (58.49 ± 10.65) mm vs.(53.17 ± 9.13) mm],left ventricular end-systolic dimension (LVESd) [ (48.69 ± 8.73) mm vs.(42.07 ± 8.36) mm],cardiotho-racic ratio (CTR) [ (0.66 ± 0.14) vs.(0.54 ± 0.09)],percentage of NYHA class Ⅲ(34.04% vs.12.77%),as-cending aorta block time,extracorporeal circulation time,ventilator assist time,ICU stay and hospitalization time in ST group,P＜0.05 or ＜0.01.Compared with NST group after five-year follow-up,there was significant reduction in incidence rate of major adverse cardiovascular events (40.43% vs.19.15%),and significant rise in five-year sur-vival rate (44.68% vs.68.08%) in ST group,P＜0.05 both.Conclusion:Simultaneous CABG and HVR can signifi-cantly shorten ICU stay time etc.postoperative observation index,improve cardiac function and long-term survival rate,reduce incidence rate of adverse reactions in CHD + HVD patients.

Relationship between CCL2 CCR2 and platelet aggregation rate in patients with acute myocardial in-farction / 心血管康复医学杂志

Objective:To explore relationship among expressions of CC type chemokine ligand 2 (CCL2) and its re-ceptor (CCR2) and platelet aggregation rate in patients with acute myocardial infarction (AMI).Methods:A total of 60 AMI patients treated in our coronary care unit were regarded as AMI group,another 60 healthy subjects un-dergoing physical examination were enrolled as normal control group.Plasma CCL2 level,expressions and location of platelet CCL2 and CCR2 in coronary thrombus tissue were measured in two groups.Changes of activated glyco-protein Ⅱb/Ⅲa compound (PAC-1) and CD62p levels,and influence of different CCL2 level on platelet aggregation rate (PAR) were compared in normal control group before and after CCL2 stimulus.Results:Compared with nor-mal control group,there were significant rise in plasma CCL2 level [ (159.63 ± 54.32) pg/ml vs.(218.79 ± 76.34) pg/ml],expressions of platelet CCL2 [ (0.86 ± 0.38) vs.(2.05 ± 0.59)] and CCR2 protein [ (0.93 ± 0.42) vs.(2.67 ± 0.51)] in AMI group (P＝0.001 all),co-location expression relationship existed between CCL 2/CCR2 and CD62p in AMI patients.Compared with before CCL2 stimulus,there were significant rise in expressions of PAC-1 [ (9.83 ± 3.14)% vs.(18.96 ± 4.25)%] and CD62p [ (5.08 ± 1.16)% vs.(8.33 ± 1.89)%] in normal control group after CCL2 stimulus,P＝0.001 both.When CCL2 ≥100ng/ml,maximum PAR was significantly higher than that of CCL2＝0ng/ml level,P＝0.001 all.Conclusion:Expression of CCL2/CCR2 is closely associated with plate-let aggregation rate in AMI patients.CCL2/CCR2 may be involved in disease progress via affecting platelet aggrega-tion rate.

TLR4 is a link between diabetes and Alzheimer's disease.

Recently, more and more studies have shown that there is an essential link between diabetes mellitus (DM) and Alzheimer's disease (AD). In addition, innate immunity plays an important role in the occurrence and development of DM and AD, which increase the risk of developing type 2 diabetes (T2D) and AD. Although the pathogenesis of those diseases is still a matter of debate, the important role of Toll-like receptor 4 (TLR4) in the two diseases has been receiving much attention at present. TLR4 and insulin resistance do have close ties, and chronic TLR4 activation may contribute to the insulin resistance. Aside from this, TLR4-mediated chronic inflammation also causes many DM complications such as diabetic nephropathy, diabetic retinopathy and diabetic neuropathy and has a profound impact on the internal environment of the body and brain's microenvironment. In parallel, TLR4 is widely distributed in the brain and also has an important role in the central nervous system (CNS) via regulation of neuroinflammation. The cerebrum under the circumstances of insulin resistance may lead to mitochondrial dysfunction in neurons. Interestingly, in the initial stage, the activation of TLR4 has a useful scavenging effect on amyloid beta (Aß), but chronic long-term activation leads to Aß deposition in the brain. Therefore we speculate that the TLR4 signaling pathway may be a potential link between DM and AD.

Diagnostic efficiency and result of prostate biopsy for patients with t-PSA between 4.0 and 10 ng/ml / 军事医学

Objective To investigate the diagnostic efficiency and result of prostate biopsy for patients with t -PSA between 4.0 and 10 ng/ml.Methods This analysis was based on 20 qualified research papers from such lectronic databases as PubMed, MEDLINE, EMBASE and Cochrane from January 2010 until September 2017.Data extracted was analyzed using classic Meta-analysis with R software .The random or fixed effect model analysis was used to estimate the rate.Heterogeneity was analyzed using I 2 statistic.Results Totally 5481 patients were included in the 20 research papers. The positive rate of prostate biopsy was 20.6％, with t-PSA between 4.0 and 10 ng/ml, which was higher than the rate in the data from CUA Guide(2014).The difference was statistically significant .Conclusion Patients should be subjected to prostate biopsy if their t-PSA ranges 4.0 from 10 ng/ml regardless of the rate of f/t-PSA.The Gleason grade is relatively low when PSA is in the gray area , and the risk is also low.

Malignant transformation in monostotic fibrous dysplasia:clinical and imaging features / 实用放射学杂志

Objective To investigate clinical and imaging features of malignant transformation in monostotic fibrous dysplasia (FD).Methods Radiography (n=12),computed tomography (CT)(n=7)and magnetic resonance imaging (MRI)(n=5)data of 12 monostotic FD cases proved by surgery and pathology were retrospectively reviewed.Results Among 12 cases,6 cases underwent surgery.Their images showed osteolytic lesions in the operative area with direct signs of aggressiveness (poorly defined margin,cor-tical destruction and soft tissue mass).For the 6 cases without surgery,radiography and CT showed poorly margin,osteolytic le-sions within or near the area of ground-glass opacity.MRI showed lesions with heterogeneous signal intensity and pronounced con-trast-enhancement.Histopathologically,9 cases were osteosarcomas,2 cases were fibrosarcomas,and 1 case was malignant fibrous histiocytoma (MFH).Conclusion The imaging information of malignant transformation of FD can provide evidence of possible ma-lignancy.

Advantage in Bright-blood and Black-blood Magnetic Resonance Imaging with High-resolution for Analysis of Carotid Atherosclerotic Plaques / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>About 50% of the cerebral ischemia events are induced by intracranial and extracranial atherosclerosis. This study aimed to evaluate the feasibility and accuracy for displaying atherosclerotic plaques in carotid arteries and analyzing their ingredients by using high-resolution new magnetic resonance imaging (MRI) techniques.</p><p><b>METHODS</b>Totally, 49 patients suspected of extracranial carotid artery stenosis were subjected to cranial MRI scan and magnetic resonance angiography (MRA) examination on carotid arteries, and high-resolution bright-blood and black-blood MRI analysis was carried out within 1 week. Digital subtraction angiography (DSA) examination was carried out for 16 patients within 1 month.</p><p><b>RESULTS</b>Totally, 103 plaques were detected in the 49 patients, which were characterized by localized or diffusive thickening of the vessel wall, with the intrusion of crescent-shaped abnormal signal into lumens. Fibrous cap was displayed as isointensity in T1-weighted image (T1WI) and hyperintensities in proton density weighted image (PDWI) and T2-weighted image (T2WI), lipid core was displayed as isointensity or slight hyperintensities in T1WI, isointensity, hyperintensities or hypointensity in PDWI, and hypointensity in T2WI. Calcification in plaques was detected in 11 patients. Eight patients were detected with irregular plaque surface or ulcerative plaques, which were characterized by irregular intravascular space surface in the black-blood sequences, black hypointensity band was not detected in three-dimensional time-of-flight, or the hypointensity band was not continuous, and intrusion of hyperintensities into plaques can be detected. Bright-blood and black-blood techniques were highly correlated with the diagnosis of contrast-enhanced MRA in angiostenosis degree, Rs = 0.97, P < 0.001. In comparison to DSA, the sensitivity, specificity, and accuracy of MRI diagnosis of stenosis for ≥50% were 88.9%, 100%, and 97.9%, respectively.</p><p><b>CONCLUSIONS</b>High-resolution bright-blood and black-blood sequential MRI analysis can accurately analyze ingredients in atherosclerotic plaques. Determined by DSA, MRI diagnosis of stenosis can correctly evaluate the serious degree of arteriostenosis.</p>

The clinical significance of Sentinel lymph node biopsy in N0 penile cancer / 中国癌症杂志

10.3969/j.issn.1007-3969.2013.05.006

The recent clinical efficacy study of photoselective vaporization of prostate (120 W) for treatment of large gland benign prostatic hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the recent clinical safety and efficacy of photoselective vaporization of prostate (120 W) for the treatment of large gland benign prostatic hyperplasia.</p><p><b>METHODS</b>The clinical data of 112 cases who accepted photoselective vaporization of prostate (120 W) for the treatment of severe benign prostatic hyperplasia (the weight of prostate > 75 g) from July 2010 to January 2012 was statistical analyzed. Relief symptoms and complications were observed around surgery, and the recent clinical efficacy was analyzed.</p><p><b>RESULTS</b>All the operations were smooth. There were not transurethral resection syndrome. No cases need transfusion intraoperative and postoperative. The operation average time was (52.6 ± 12.1) minutes, and the average amount of bleeding was (27.4 ± 18.5) ml. The postoperative bladder irrigating time was (19.4 ± 7.3) hours, the mean postoperative indwelling catheter time was (3.2 ± 0.6) days, and the mean postoperative hospital stay was (4.8 ± 1.3) days. Postoperative international prostate symptom score (t = 52.24 - 59.10), quality of life (t = 48.42 - 53.63), maximum flow rate (t = -31.01 - -24.23) and residual urine volume (t = 9.85 - 12.53) compared with preoperative are significantly improved (P < 0.01).</p><p><b>CONCLUSIONS</b>With the safe operation of photoselective vaporization of prostate (120 W) for the treatment of large gland benign prostatic hyperplasia, it is less bleeding, recent efficacy is significant, and it is especially appropriate to elderly patients at high risk of large gland.</p>

Analysis of operative complications of photoselective vaporization of prostate (120 W) for treatment of benign prostatic hyperplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To explore operative complications of photoselective vaporization of prostate (120 W) for treatment of benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>The clinical data of 186 cases who underwent photoselective vaporization of prostate (120 W) for the treatment of BPH from May 2010 to April 2012, was statistically analyzed.</p><p><b>RESULTS</b>The operative time ranged from 7 to 147 minutes, and the average time was (37.7 ± 21.5) minutes. No patient accepted intraoperative blood transfusion, and occurred transurethral resection syndrome or capsular perforation. The time of postoperative indwelling catheter ranged from 1 to 11 days, and average time was (4.3 ± 2.2) days. Surgical outcome was satisfactory. Early postoperative complications included bladder spasm (3 cases), transient dysuria (19 cases), urinary tractirritation (94 cases), secondary hemorrhage (26 cases), transient urge incontinence (19 cases), all cases were relieved after treatment. Long-term complications, including recurrence (1 case), bladder neck stenosis (2 cases) and urethral stricture (2 cases), who had required reoperation. Postoperative patients with international prostate symptom score (29.4 ± 3.4), maximum urinary flow rate ((6.0 ± 1.6) ml/s) and residual urine ((167 ± 150) ml) had improved (t = -76.0 - 61.4, P < 0.01).</p><p><b>CONCLUSIONS</b>With less invasive, less bleeding and rapid postoperative recovery, photoselective vaporization of prostate (120 W) is a safe and effective minimally invasive treatment techniques for BPH. But there is still some complications after surgery and proper handling is required.</p>

Coronary microembolization induced myocardial contractile dysfunction and tumor necrosis factor-α mRNA expression partly inhibited by SB203580 through a p38 mitogen-activated protein kinase pathway / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The microemboli produced during spontaneous plaque rupture and ulceration and during coronary intervention will reduce coronary reserve and cause cardiac dysfunction. It is though that inflammation caused by the microinfarction induced by the microembolization may play an essential role. It is known that the activation of p38 mitogen-activated protein kinases (MAPK) in both infected and non-infected inflammation in myocardium may cause a contractile dysfunction. But the relation between the activation of p38 MAPK and microembolization is still unknown.</p><p><b>METHODS</b>Sprague-Dawley rats were randomly divided into three groups: Sham group, coronary microembolization (CME) group and SB203580 group (n = 10 per group). CME rats were produced by injection of 42 µm microspheres into the left ventricle with occlusion of the ascending aorta. SB203580, a p38 MAPK inhibitor, was injected into the femoral vein after the injection of microspheres to make the SB203580 group. Left ventricular ejection fraction (LVEF) was determined by echocardiography. The protein concentration of P38 MAPK in the myocardium was assessed by Western blotting. The relative expression of mRNA for tumor necrosis factor (TNF)-α was assessed by the technique of semi-quantitative polymerase chain reaction amplification.</p><p><b>RESULTS</b>LVEF was depressed at three hours up to 12 hours in the CME group. Increased p38 MAPK activity and TNF-α mRNA expression were observed in the CME group. The administration of SB203580 partly inhibited p38 MAPK activity, but did not fully depress the TNF-α expression, and partly preserved cardiac contractile function.</p><p><b>CONCLUSIONS</b>p38 MAPK is significantly activated by CME and the inhibition of p38 MAPK can partly depress the TNF-α expression and preserve cardiac contractile function.</p>