Tartrate-resistant acid phosphatase 5b is a potential biomarker for rheumatoid arthritis: a pilot study in Han Chinese

Background Bone damage around the joints is one of the major pathophysiological mechanisms that leads to rheumatoid arthritis （RA） chronic disability.Serum tartrate-resistant acid phosphatase 5b （TRACP-5b） is secreted by osteoclasts,its activity can be used as a clinically relevant bone resorption marker.The aim of this study was to test whether the measurement of serum levels of TRACP-5b in patients with RA would correlate with measures of disease activity and with responses to therapy.Methods Fifty-six patients were randomly assigned to receive recombinant human cytotoxic tlymphocyte-associated antigen-4 immunoglobulin （RhCTLA4-lg）,infliximab or methotrexate （MTX）.The clinical and serologic indicators of RA activity were evaluated at baseline and at 24 weeks.Serum TRACP-5b was measured by Enzyme-linked Immunosorbent Assay （ELISA） at 0,12 and 24 weeks.Hand X-rays were obtained at baseline.Results At baseline,the levels of TRACP-5b correlated with the severity of X-ray damage,disease duration （r=0.332,P=0.012）,and tender joint count （r=0.408,P=0.002）.The 24 weeks values of TRACP-5b for RhCTLA4-lg group and infliximab group differed significantly from the baseline values in each group （P 〈0.05; P 〈0.05）,whereas only the value for RhCTLA4-lg group differed significantly from the 24 weeks value for the MTX group （P 〈0.01）.Considering the two biologics-treated groups together,the TRACP-5b levels at 24 weeks differed significantly from the baseline values only in those patients who reached an ACR70 level （P 〈0.05）.Conclusions Measurement of serum TRACP-5b in RA patients reflects clinical and radiological measures of disease activity,treatment with certain biologics,and degree of response to therapy.TRACP-5b should be investigated further as a potential biomarker to predict response to therapy,including slowing of radiographic progression.     

Pioglitazone inhibits the expression of nicotinamide adenine dinucleotide phosphate oxidase and p38 mitogen-activated protein kinase in rat mesangial cells

Background Oxidative Stress and p38 mitogen-activated protein kinase （p38MAPK） play a vital role in renal fibrosis. Pioglitazone can protect kidney but the underlying mechanisms are less clear. The purpose of this study was to investigate the effect of pioglitazone on oxidative stress and whether the severity of oxidative stress was associated with the phosphorylation level of p38MAPK.     

Effect and mechanism of tacrolimus on melanogenesis on A375 human melanoma cells

Background Topical tacrolimus has been used for vitiligo as a common treatment option for more than ten years while the underlying mechanism is still uncertain.The aim of this study was to investigate the direct effects of tacrolimus on the melanogenesis and migration on human A375 melanoma cells.The expression of c-KIT mRNA and protein of human A375 cells were also investigated.Methods The cultured A375 human melanoma cells were randomly assigned to control and tacrolimus treatment groups （10,102,103and 104 nmol/L）.The cell proliferation was measured with Cell Counting Kit-8 assays.Melanin content was measured with NaOH method.Transwell migration assay was used to measure cell migration.The expression of c-KIT mRNA and protein were measured with real-time fluorescence quantitative polymerase chain reaction and immunohistochemistry respectively.Results The cell proliferation of the 103 and 104 nmol/L tacrolimus groups were significantly lower （0.666±0.062 and 0.496±0.038） as compared with the control （0.841±0.110,P 〈0.05）.The mean melanin content in all groups treated with different concentration of tacrolimus （10,102,103,104 nmol/L） increased compared with the control group （P 〈0.05）.Dosedependent increase in cell migration were seen in all tacrolimus-treated groups （P 〈0.01）.The expression of c-KIT mRNA level in A375 cells exposed to tacrolimus （103and 104 nmol/L） had significantly increased by 3.03-fold and 3.19-fold respectively compared with the control （P 〈0.05）.Conclusions Although tacrolimus had no effects on cell proliferation on A375 human melanoma cells,it could increase the melanin content and cell migration.The expression of c-KIT mRNA and protein increased dose-dependently in tacrolimus-treated groups as compared with the control.Our study demonstrated that tacrolimus could enhance the melanogenesis and cell migration on A375 cells.     

Comparison of low-dose sequences of dual-source CT and echocardiography for preoperative evaluation of aortic valve disease

Background Accurate evaluation of coronary artery,aortic valve annulus diameter （AVAD）,and cardiac function in patients with aortic valve disease is of great significance for surgical strategy.In this study,we explored the preoperative evaluation of low-dose sequence （MinDose sequence） scan of dual-source CT （DSCT） for those patients.Methods Forty patients suspected for aortic valve disease （the experimental group） underwent MinDose sequence of DSCT to observe coronary artery,AVAD,and left ventricular ejection fraction （LVEF）.Another 33 subjects suspected for coronary artery disease （the control group） underwent conventional retrospective electrocardiographically-gated sequence of DSCT.Two-dimensional transthoracic echocardiography （2D-TTE） and four-dimensional transthoracic echocardiography （4D-TTE） were applied in the experimental group to measure AVAD and LVEF and compared with MinDose-DSCT.Results There was a strong correlation between LVEFs measured by 2D-TTE and MinDose-DSCT （r=0.87,P ＜0.01）,as well as between 4D-TTE and MinDose-DSCT （r=0.90,P ＜0.01）.AVAD measured by MinDose-DSCT was in good agreement with corresponding measurements by 2D-TTE （r=0.90,P ＜0.01）.The effective dose in the experimental group was 63.54％ lower than that in the control group.Conclusions MinDose sequence of DSCT with a low radiation dose serving as a one-stop preoperative evaluation makes effective assessment of the coronary artery,AVAD,and LVEF for patients with aortic valve disease.     

Effects of plasma ghrelin, obestatin, and ghrelin/obestatin ratio on blood pressure circadian rhythms in patients with obstructive sleep apnea syndrome

Background Obstructive sleep apnea syndrome （OSAS） is strongly associated with obesity and with cardiovascular disease.Ghrelin and obestatin are two peptides from the same source but have opposite roles.Both of them can affect feeding and regulate vascular tune.The aim of this study was to investigate the relationship between plasma ghrelin,obestatin,the ratio of ghrelin and obestatin （G/O） and sleep parameters and blood pressure circadian rhythms in patients with OSAS.Methods This study enrolled 95 newly diagnosed over-weight OSAS patients （OSAS group）,30 body mass index （BMI）-match non-OSAS adults （over-weight group） and 30 non-OSAS normal weight adults （control group）.Polysomnography （PSG） was performed in the OSAS group and over-weight group.Blood pressure of all subjects was monitored by means of 24-hour ambulatory blood pressure monitoring.The concentration of plasma ghrelin and obestatin was detected by enzyme-linked immunosorbent assay （ELISA）.Results Plasma ghrelin levels in the OSAS group and over-weight group were significantly lower than that of the control group （P ＜0.05）.Plasma obestatin levels were lower in the over-weight group and OSAS group,but there was no significant difference among the three groups.The blood pressure in OSAS patients was higher,and there was a significant difference in all blood pressure parameters compared to the control group,and in the daytime average diastolic blood pressure （DBP）,nocturnal average systolic blood pressure （SBP） and DBP,DBP variability values as compared to over-weight subjects.Furthermore,there were significantly more non-dipper patterns of blood pressure （including hypertension and normotension） in the OSAS group than in the other two groups （P ＜0.01）.Correlation analysis showed that ghrelin levels had a significant correlation with BMI and nocturnal average DBP but not with PSG parameters.In contrast,the G/O ratio had a negative correlation with apnea-hypopnea index （AHI） （P ＜0.05）,as well as a strong positive correlation with the blood pressure variability values （P ＜0.01）.In multivariate analyses,AHI （P ＜0.05） and G/O （P ＜0.05）were independently related to SBP variability changes,while AHI （P ＜0.05）,G/O （P ＜0.01） and BMI （P ＜0.05） were independently related to DBP variability changes.Conclusions Our data show plasma ghrelin and obestatin levels were related to obesity in OSAS.Sleep apnea in OSAS patients could have led to an imbalance in G/O in the basis of obesity.Moreover,the imbalance may promote nighttime blood pressure elevation and affect blood pressure circadian disorder.     

Association between improved trunk stability and walking capacity using ankle-foot orthosis in hemiparetic patients with stroke: evidence from three-dimensional gait analysis

Background Restoration of both normal movement of the pelvis and centre of mass is a primary goal of walking rehabilitation in post-stroke patients because these movements are essential components of effective gait. The aim of this study is to quantitatively analyze the effect of ankle-foot orthosis on walking ability, and to investigate the correlation between improvements in trunk motion and walking capacity.     

Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy

Background Preoperative incisional local anaesthesia with ropivacaine is a common method of providing postlaparoscopy pain relief.The pulmonary recruitment manoeuvre also provides pain relief,but the combined effect of these two methods on pain following laparoscopic procedures has not been reported.We investigated the efficacy of combining local anaesthetic infiltration of ropivacaine with pulmonary recruitment manoeuvre on postoperative pain following diagnostic hysteroscopy and laparoscopy.Methods This prospective,randomized,controlled study involved 60 patients divided into two groups （n=30,each）.Group 1 received 20 ml of 0.5％ ropivacaine injected peri-incisionally preoperatively,with intra-abdominal carbon dioxide removed by passive deflation.Group 2 received 20 ml of 0.5％ ropivacaine injected peri-incisionally with five manual inflations of the lungs with a positive-pressure ventilation of 40 cmH2O at the end of surgery.The last inflation was held for 5 seconds.The intensity of postoperative incisional and shoulder pain was evaluated using a numerical rating scale at 0,2,4,8,12,24 and 48 hours postoperatively by an independent blinded anaesthesiologist.Tramadol was given postoperatively for analgesia.Results Compared with group 1,incisional ropivacaine infiltration combined with pulmonary recruitment manoeuvre significantly reduced dynamic pain at 0 hour,4 hours,and 24 hours postoperatively （4.1 ± 2.2 vs.2.1 ± 1.9,P=0.002;2.7 ± 2.7 vs.1.2 ± 1.3,P=0.035; and 3.5 ± 2.1 vs.2.1 ± 1.8,P=0.03,respectively）.Static incisional pain was significantly relieved at 0 hour,2 hours,and 24 hours postoperatively （3.1 ± 1.7 vs.1.6 ± 1.3,P=0.001; 1.4 ± 1.3 vs.0.5 ± 0.8,P=0.012;and 2.3 ± 1.9 vs.1.0 ± 1.5,P=0.038,respectively）.Group 2 had more patients without shoulder pain （P＜0.05） and fewer requiring tramadol （P＜0.05）.Conclusion Ropivacaine with pulmonary recruitment manoeuvre provided simple and effective pain relief after diagnostic hysteroscopy and laparoscopy.     

Intense exercise can cause excessive apoptosis and synapse plasticity damage in rat hippocampus through Ca2+ overload and endoplasmic reticulum stress-induced apoptosis pathway

Background Intense exercise can cause injury and apoptosis, but few studies have reported its effect on the central nervous system （CNS）. The initial reason for hippocampus injury is the excitotoxicity of glutamate and calcium overload. Intracellular free Ca2＋ （[Ca2＋]i） overload may trigger the apoptosis pathway and neuron damage. The aim of this study was to investigate whether intense exercise could cause hippocampus apoptosis and neuron damage and then to determine which pathway was activated by this apoptosis. Methods We used one bout of swimming exhaustion rats as models. Intracellular [Ca2~]i was measured to estimate the calcium overload by Fura-2/AM immediately after exhaustion; glial fibrillary acidic protein （GFAP） and synaptophysin （SYP） immunofluorescence were performed for estimating astrocyte activation and synapse plasticity 24 hours after exhaustion. Apoptosis cells were displayed using dUTP nick end labelling （TUNEL） stain; endoplasmic reticulum （ER） stress-induced apoptosis pathway and mitochondrial apoptosis pathway were synchronously detected by Western blotting. Results An increasing level of intracellular [Ca2＋]i （P 〈0.01） was found in the hippocampus immediately after exhaustion. GFAP and SYP immunofluorescence showed that the astrocytes are activated, and the synapse plasticity collapsed significantly 24 hours after exhaustion. TUNEL stain showed that the number of apoptosis cells were notably raised （P 〈0.01）; Western blotting of the apoptosis pathway showed increasing levels of caspase-3 cleavage （P 〈0.01）, Bax （P 〈0.01）, caspase-12 cleavage （P 〈0.01）, C/EBP-homologous protein （CHOP） （P 〈0.01）, and phospho-Junamino- terminal kinases （p-JNK; P 〈0.01） and decreasing level of Bcl-2 （P 〈0.01）. Our results proved that exhaustion can induce hippocampus injury and apoptosis by [Ca2＋]i overload, with collapsed synaptic plasticity as the injury pattern and ER stress-induced apoptosis as the activated pathway. Concl     

Distinct properties and metabolic mechanisms of postresuscitation myocardial injuries in ventricular fibrillation cardiac arrest versus asphyxiation cardiac arrest in a porcine model

Background The two most prevalent causes of sudden cardiac death are ventricular fibrillation cardiac arrest （VFCA） and asphyxiation cardiac arrest （ACA）. Profound postresuscitation myocardial dysfunction has been demonstrated in both VFCA and ACA animal models. Our study aimed to characterize the two porcine models of cardiac arrest and postresuscitation myocardial metabolism dysfunction. Methods Thirty-two pigs were randomized into two groups. The VFCA group （n=16） were subject to programmed electrical stimulation and the ACA group （n=16） underwent endotracheal tube clamping to induce cardiac arrest （CA）. Once induced, CA remained untreated for a period of 8 minutes. Two minutes following initiation of cardiopulmonary resuscitation （CPR）, defibrillation was attempted until return of spontaneous circulation （ROSC） was achieved or animals died. To assess myocardial metabolism, 18F-FluoroDeoxyGlucose Positron Emission Tomography was performed at baseline and 4 hours after ROSC. Results ROSC was 100% successful in VFCA and 50% successful in ACA. VFCA had better mean arterial pressure and cardiac output after ROSC than ACA. Arterial blood gas analysis indicated more detrimental metabolic disturbances in ACA compared with VFCA after ROSC （ROSC 0.5 hours, pH： 7.01±0.06 vs. 7.21±0.03, P〈0.01; HCO3： （15.83±2.31 vs. 20.11±1.83） mmol/L, P〈0.01; lactate： （16.22±1.76 vs. 5.84±1.44） mmol/L, P〈0.01）. Myocardial metabolism imaging using Positron Emission Tomography demonstrated that myocardial injuries after ACA were more severe and widespread than after VFCA at 4 hours after ROSC （the maximum standardized uptake value of the whole left ventricular： 1.00±0.17 vs. 1.93±0.27, P〈0.01）. Lower contents of myocardial energy metabolism enzymes （Na＊-K＊-ATPase enzyme activity, Ca2＊- ATPase enzyme activity, superoxide dismutase and phosphodiesterase） were found in ACA relative to VFCA. Conclusions Compared with VFCA, ACA causes more severe myocardium injury an     

血清巨噬细胞移动抑制因子、肿瘤坏死因子-α与糖尿病肾病的相关性研究

目的探讨血清巨噬细胞移动抑制因子(macrophage migration inhibitory factor,MIF)、肿瘤坏死因子-α(tumor necrosisfactor alpha,TNF-α)浓度在2型糖尿病(type 2 diabetes mellitus,T2DM)正常尿蛋白组及糖尿病合并肾病(diabetic nephropathy,DN)患者中的变化及其临床意义。方法将97例T2DM患者根据尿蛋白排泄率(urinary albumin excretion rate,UAER)分为正常尿蛋白组(A组,31例)、微量尿蛋白组(B组,35例)、大量尿蛋白组(C组,31例),取30例健康体检者作为对照组(D组),ELLSA方法检测各组血清MIF、TNF-α浓度,同时检测患者空腹血糖(fasting plasma glucose,FBG)、糖化血红蛋白(glycosylatedhemoglobin,HbA1c)、三酰甘油(triglycerides,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白(high-density lipoprotein,HDL-C)、低密度脂蛋白(low-density lipoprotein,LDL-C)、尿素氮(blood urea nitrogen,BUN)肌酐(serum creatinine,Cr)。结果正常尿蛋白组(A组,31例)及糖尿病肾病(B、C)组血清MIF浓度高于正常对照组(P<0.05);糖尿病正常尿蛋白组(A组)与微量尿蛋白组(B组)、大量尿蛋白组(C组)血清MIF浓度差异无统计学意义。糖尿病肾病(B、C)组血清TNF-α高于正常对照组(P<0.05);糖尿病肾病(B、C)组血清TNF-α高于糖尿病正常尿蛋白组(A组)。采用Spearman相关分析,血清MIF与DM病程(r=0.435,P<0.01)、HbA1c(r=0.459,P<0.01)、FBG(r=0.520,P<0.01)、TG(r=0.256,P<0.05)呈正相关,与HDL-C(r=-0.244,P<0.05)浓度呈负相关;血清TNF-α与尿A/C(r=0.254,P<0.01)、DM病程(r=0.182,P<0.05)呈正相关。Logistic回归分析结果表明,在校正年龄、糖尿病病程、BMI、HbA1c、HDL、Cr等因素后,血清TNF-α与蛋白尿的OR=1.069(95%CI:1.005～1.137,P=0.035),血清MIF浓度与蛋白尿无相关关系。结论 2型糖尿病患者血清TNF-α浓度的变化在糖尿病肾病病程中更敏感,临床上可参考血清TNF-α浓度或同时检测血清MIF与TNF-α浓度,来判断糖尿病肾脏的损伤程度。     

Clinical manifestation of the SRSF2 gene mutation in Chinese patients with chronic myelomonocytic leukemia

BackgroundSpliceosome mutations have been recently identified and associated with hematological malignancies. SRSF2, one of components of the splicing machinery, has a high mutation frequency during chronic myelomonocytic leukemia, according to previous reports. However, the relevance of this finding in Chinese populations remains unknown.

MethodsWe recruited 50 Chinese patients with chronic myelomonocytic leukemia to analyze the state of SRSF2 and to assess the corresponding clinical features by polymerase chain reaction followed by direct sequencing.

ResultsTen of 50 patients (20%) harbored SRSF2 mutations, including five P95R, two 95H, and three P95L point mutations. The patient group was older than the wild type group (P <0.01). No significant statistical differences were observed with regard to the other clinical characteristics (sex, peripheral blood count, serum lactate dehydrogenase, karyotype, World Health Organization classification, etc.) between these two groups. Two of the patients showed an early evolution to acute myeloid leukemia.

ConclusionsSRSF2 mutations are frequent in chronic myelomonocytic leukemia patients, but show a relatively lower incidence in Chinese patients. Moreover, the mutation can be related to old age and an unfavorable prognosis. Our results provide valuable insights for the development of a diagnostic marker, or for the identification of a therapeutic target for chronic myelomonocytic leukemia.

     

A recommended technique of renal vein anastomosis in rat kidney transplantation for trainee

Background Various rat kidney transplantation models have been introduced over the decades and the study on the models seems to lack novelty and necessity.However,vascular anastomosis,especially renal vein,is still very difficult for trainees.The aim of this study was to provide the modified renal venous anastomosis of rat kidney transplantation to substitute the currant method for trainees.Methods Male Wistar rats were used as donors and recipients,respectively.Left orthotopic transplantation was performed with a modified technique of renal vein anastomosis,combining the end-to-end sutures with epidural catheter.Meanwhile,the survival rate,warm ischemia time,renal venous anastomosis time,and complications were recorded to evaluate the merits of the modified technique compared with the current recommended technique of rat renal vein.Two trainees took part in the learning of the models in two methods for performing 30 operations,respectively.Results The difference in warm ischemia time （from （57.25±7.30） minutes in the first 10 operations to （30.05±1.85）minutes in the third 10 operations） and renal vein anastomosis time （from （32.80±3.80） minutes in the first 10 operations to （19.30±0.98） minutes in the third 10 operations） was significantly short （P＜0.01） and the survival rate was statistically high （from （25±7）％ in the first 10 operations to 70％ in the third 10 operations） in equal number of operations （P＜0.01） by comparing with the current recommended method （（47.60±7.19） minutes to （22.8±1.85） minutes,（22.40±3.10） minutes to （9.95±1.50） minutes,45％±7％ to 80％±0,respectively）.The intraoperative complications and postoperative complications of renal venous anastomosis were also significantly decreased （P＜0.01）.Conclusions The technique with epidural catheter can shorten the learning curve of the trainee learning rat kidney transplantation.It may replace the currently recommended technique of rat renal vein for trainees.     

Comparison of clinical curative effect between open surgery and endovascular repair of abdominal aortic aneurysm in China

Objective   To compare clinical curative effects of open surgery (OS) or endovascular repair (EVAR) for patients with abdominal aortic aneurysm (AAA) in China.

Data sources  We performed a comprehensive search of both English and Chinese literatures involving case studies on retrograde OS or EVAR of AAA in China from January 1976 to December 2010.

Study selection  According to the inclusion criteria, 76 articles were finally analyzed to compare patient characteristics, clinical success, complications, and prognosis.

Results  We analyzed a total of 2862 patients with 1757 undergoing OS (OS group) and 1105 undergoing EVAR (EVAR group). There was no significant difference in the success rate of the procedures. Operative time, length of ICU stay, fasting time, duration of total postoperative stay, blood loss, and blood transfusion requirements during the procedure were significantly lower in the EVAR group. A 30-day follow up revealed more cardiac, renal, pulmonary, and visceral complications in the OS group (P <0.01). Low-limb ischemia, however, was more common in the EVAR group (P <0.05). The 30-day mortality rate, including aorta-related and non-aorta related mortality, was significantly lower in the EVAR group (P <0.01). In the follow-up period, there were more patients with occlusions of artificial vessel and late endoleak in the EVAR group (P <0.01). The overall late mortality rate was higher in the OS group (P <0.01), especially non-aorta-related late mortality and mortality during the fourth to the sixth year (P <0.01).

Conclusions  EVAR was safer and less invasive for AAA patients. Patients suffered fewer complications and recovered sooner. However, complications such as artificial vessel occlusion, low-limb ischemia, and endoleak were common in EVAR. Clinicians should carry out further research to solve these complications and improve the efficacy of EVAR.

     

Effect of catheter radiofrequency ablation on C-reactive protein, brain natriuretic peptide and echocardiograph in patients with persistent and permanent atrial fibrillation

Background Radiofrequency catheter ablation （RFCA） for atrial fibrillation （AF） has developed rapidly,and is a commonly performed ablation in many major hospitals throughout the world,due to its satisfactory results.The aim of this study was to detect the effect of RFCA on C-reactive protein （CRP）,brain natriuretic peptide （BNP）,and echocardiograph in patients with persistent and permanent AF.Methods A total of 120 patients （71 males,mean age （50.8＆#177;12.0） years） with persistent and permanent AF undergoing RFCA under guidance of the Carto merge technique were studied.Left atrial diameter （LAD）,right atrial diameter （RAD）,left ventricular ejection fraction （LVEF）,CRP,and BNP were observed 3,6 and 12 months after RFCA and compared with results before RFCA.The recurrence of atrial arrhythmias was observed 3 and 12 months after the procedure.Results Compared with that before RFCA,LAD and RAD decreased and LVEF increased significantly after RFCA.Meanwhile,the levels of CRP and BNP were reduced significantly at 3,6,and 12 months after RFCA （P〈0.05）.In the non-recurrent patients,LVEF was increased significantly compared with the recurrent patients at 3,6,and 12 months after RFCA （P〈0.05）.CRP and BNP levels were decreased significantly in the non-recurrent patients compared with the recurrent patients at 3,6,and 12 months after RFCA （P〈0.05）.After one or two applications of RFCA,during a follow-up of 12 months,12 patients （10.0%） had AF,10 patients （8.3%） had atrial flutter,and 5 patients had atrial tachycardia （4.2%）.Conclusions Conversion of AF to sinus rhythm by RFCA,has been shown to reduce LA size and improve LVEF.It can also significantly decrease the levels of CRP and BNP in patients with persistent and permanent AF and reduce the risk of inflammation and developing heart failure.     

Hydrogen sulfide defends against the cardiovascular risk of Nw-nitro-L-argininemethyl ester-induced hypertension in rats via the nitric oxide/endothelial nitric oxide synthase pathway

Background Dyslipidemia caused by liver injury is a significant risk factor for cardiovascular complications.Previous studies have shown that hydrogen sulfide （H2S） protects against multiple cardiovascular disease states in a similar manner as nitric oxide （NO）,and NO/endothelial nitric oxide synthase （eNOS） pathway is the key route of NO production.The purpose of this study was to investigate whether H2S can ameliorate the high blood pressure and plasma lipid profile in Nw-nitro-L-argininemethyl ester （L-NAME）-induced hypertensive rats by NO/eNOS pathway.Methods Thirty-six 4-week old Sprague-Dawley （SD） male rats were randomly assigned to 6 groups （n=6）：control group,L-NAME group,control ＋ glibenclamide group,control ＋ NaHS group,L-NAME ＋ NaHS group,and L-NAME ＋ NaHS ＋ glibenclamide group.Measurements were made of plasma triglycerides （TG）,low-density lipoprotein （LDL）,high-density lipoprotein （HDL）,total cholesterol （CHO）,glutamic-pyruvic transaminase （ALT） levels after 5 weeks.Then measurements of NO level and proteins expression of eNOS,P-eNOS,AKT,P-AKT were made in liver tissue.Results After 5 weeks of L-NAME treatment,the blood pressure,plasma TG （（1.22±0.12） mmol/L in L-NAME group vs.（0.68±0.09） mmol/L in control group; P ＜0.05） and LDL （（0.54±0.04） mmol/L in L-NAME group vs.（0.28±0.02） mmol/L in control group; P ＜0.05） concentration were significantly increased,and the plasma HDL （（0.26±0.02） mmol/L in L-NAME group vs.（0.69±0.07） mmol/L in control group; P ＜0.05） concentration significantly decreased.Meanwhile the rats treated with L-NAME exhibit dysfunctional eNOS,diminished NO levels （（1.36±0.09） mmol/g protein in L-NAME group vs.（2.34±0.06） mmol/g protein in control group; P ＜0.05） and pathological changes of the liver.H2S therapy can markedly decrease the blood pressure （（37.25±4.46） mmHg at the fifth week; P ＜0.05）,and ameliorate the plasma TG （（0.59±0.06） mmHg）,     

Evaluation of pelvic visceral functions after modified nerve-sparing radical hysterectomy

Background Nerve-sparing radical hysterectomy （NSRH） was developed in an attempt to minimize complications after radical hysterectomy.Since 2008,a modified NSRH-nerve plane-sparing radical hysterectomy （NPSRH） has been developed at the Cancer Hospital,Chinese Academy of Medical Sciences.The aim of this study was to investigate the role of NPSRH in improving postoperative pelvic visceral dysfunctions.Methods Eighty-three patients with International Federation of Gynecology and Obstetrics （FIGO） stage IB1-IIA2 cervical cancer received NPSRH （the study group） from January 2008 to October 2012.One hundred and sixty-six patients who underwent conventional radical hysterectomy （CRH） were randomly selected as the control group.Age,pathological type and stage were matched between the two groups.The safety of surgery was assessed by duration of operation and blood transfusion rate.Postoperative short-term bladder function was analyzed by duration of catheterization.Long-term bladder,anorectal and sexual function were evaluated with questionnaires.Results Seventy-eight patients （94.0%） in the NPSRH group and one hundred and sixty patients （96.4%） in the CRH group completed the study.Median follow-up time was 31.9 months and 31.0 months respectively （P=0.708）.There was no significant difference between the two groups in terms of age,body mass index,FIGO stage,pathologic type,preoperative and postoperative therapy （P 〉0.05）.The blood transfusion rate shared no difference between two groups （P=0.364）.The operation time in the NPSRH group was significantly longer than CRH group （P 〈0.01）.But the duration of catheterization and hospitalization in the NPSRH group was significantly reduced compared with CRH group （P 〈0.01）.In addition,the incidence of long-term urinary frequency,urinary incontinence,urinary retention,straining to void,constipation and diarrhea was significantly lower in the NPSRH group （P 〈0.05）.However,there was no significant difference regarding sexual function （P 〉0.05）.Conclusions The current evidence indicated that NPSRH improved long-term bladder function compared to CRH.Moreover,it may improve long-term anorectal function as well.