Sequential CoreValve implantation for a mal‐positioned prosthesis during transcatheter aortic valve implantation

Transcatheter aortic‐valve implantation is rapidly emerging as an effective, safe, and sustainable alternative for a specific subset of high‐surgical risk and/or inoperable patients with severe aortic stenosis. However, technical challenges remain for this relatively new procedure, not the least mal‐positioning of the transcatheter prosthesis resulting in acute aortic regurgitation. We report a case of deep implantation of a CoreValve prosthesis that was inadvertently pulled out of the aortic annulus during repositioning. The patient received a second sequential CoreValve successfully.© 2010 Wiley‐Liss, Inc.     

HMG-CoA Reductase Inhibitors (Statins) Activate Expression of PPARα/PPARγ and ABCA1 in Cultured Gallbladder Epithelial Cells

In gallbladder epithelial cells (GBEC), PPARα and PPARγ ligands modulate inflammation by suppression of TNFα production and prevent excessive accumulation of cholesterol by ABCA1 activation. Recently, HMG-CoA reductase inhibitors (statins) were shown to activate PPARα and PPARγ in various cells but no studies of their effects in GBEC have been conducted. The objective of this study was, therefore, to determine the effects of statins on PPAR and ABCA1 expression and the anti-inflammatory effect of statins in GBEC. Canine GBEC were cultured on Petri dishes. Expression of the proteins PPARα, PPARγ, and ABCA1 was measured by western blotting analysis after treatment with simvastatin, pravastatin, NO-pravastatin, PPARα ligand, or PPARγ ligand in the culture media. Expression of ABCA1 and LXRα mRNAs was estimated by RT-PCR. Expression of TNFα mRNA was measured by RT-PCR after 24 h pre-treatment with the statins, preceding 1 h of lipopolysaccharide (LPS) loading. Simvastatin, pravastatin, and NO-pravastatin increased expression of the proteins PPARα, PPARγ, and ABCA1, and expression of the mRNA of ABCA1 and LXRα in GBEC. Pre-treatment with simvastatin, pravastatin, and NO-pravastatin suppressed the production of TNFα mRNA induced by LPS. In conclusion, statins probably contribute to the preservation of GBEC function by activation of PPARα and PPARγ, which have anti-inflammatory effects by suppression of pro-inflammatory cytokines, and ABCA1 activation mediated by LXRα, which prevents the accumulation of cholesterol in GBEC.     

The effect of orlistat-induced weight loss,without concomitant hypocaloric diet,on cardiovascular risk factors and insulin sensitivity in young obese Chinese subjects with or without type 2 diabetes

BACKGROUND: We examined the weight-losing effect of orlistat treatment on insulin sensitivity and cardiovascular risk factors in a group of severely obese young Chinese patients with or without type 2 diabetes mellitus. METHODS: Obese patients with diabetes (n = 33) and obese nondiabetic patients (n = 27) were given orlistat, 120 mg 3 times daily, without a concomitant hypocaloric diet for 6 months (body mass index [calculated as weight in kilograms divided by the square of height in meter; kg/m2] range, 27.8-47.4). The efficacy measures were (1) insulin sensitivity indices derived from the homeostasis model assessment and a composite measure of whole-body insulin sensitivity index; (2) glycemic control; (3) cardiovascular risk factors, including anthropometry, blood pressure, lipid profiles, and albuminuria; and (4) body composition determined by dual-energy x-ray absorptiometry. RESULTS: At baseline, patients with diabetes had lower body mass index and percentage of body fat but higher waist-hip ratios and were more insulin resistant. Orlistat therapy reduced body weight, waist and hip circumferences, percentage of total body fat, blood pressure, fasting plasma glucose and lipid levels, albuminuria, and insulin sensitivity indices in both groups (all, P<.05). Despite less weight reduction, we found a greater percentage of reduction from baseline in glycosylated hemoglobin level (-11.6% vs -3.6%; P<.001), fasting plasma glucose level (-18.2% vs -5.0%; P<.001), and systolic blood pressure (-7.1% vs -3.1%; P =.02) in patients with diabetes. Obese subjects without diabetes had greater improvements in triglyceride levels, albuminuria, and the homeostasis model assessment (all, P<.01). CONCLUSION: Short-term orlistat treatment without the use of a hypocaloric diet significantly improved insulin sensitivity and cardiovascular risk profiles in severely obese Chinese patients with or without type 2 diabetes.     

脉冲电磁场对周围神经再生的作用

目的探索脉冲电磁场对周围神经再生的影响及其作用机制。方法用PEM-1电磁脉冲发生器进行动物和临床试验。动物试验应用SD雄性大鼠24只,在距梨状肌下约1cm处切断坐骨神经后原位吻合,随机分成0.5、1、2月3组,每组分成对照组和实验组,实验组用微电脑电磁脉冲发生器进行治疗,两组均在不同时间,通过肉眼观察,肌电图检测及取材组织学检测。临床选用离断手指再植病例23例,用脉冲电磁场治疗仪进行治疗,12例进行对照。检测参数为皮温、触觉、疼觉、振动觉、温觉、出汗试验。结果实验组较对照组Wallerian变性明显加速,血管增生明显,纤维组织增生轻,神经再生及传导速度加快。治疗组再植手指皮肤触、疼觉、振动觉、温觉、出汗试验等方面均较对照组佳,治疗后局部皮温明显上升,特别出汗试验明显佳于对照组。结论脉冲电磁场治疗能促进周围神经再生。     

The role of linked color imaging in endoscopic diagnosis of Helicobacter pylori associated gastritis

Abstract

Objective

Linked color imaging (LCI), a novel image-enhanced endoscopy, can make it easy to recognize differences in mucosal color. It may be helpful for diagnosing H. pylori associated gastritis and H. pylori infection status. We investigated whether LCI could improve the diagnostic accuracy of H. pylori associated gastritis.     

糖尿病患者的主观幸福感调查及影响因素分析

目的研究糖尿病患者的主观幸福感及其影响因素。方法用纽芬兰纪念大学幸福度量表(MUNSH)、社会支持评定量表(SSRS)、生活事件评价问卷、Zung氏焦虑与抑郁自评量表(SAS和SDS)分别对35例门诊糖尿病患者和33例健康对照组的主观幸福感、生活事件评价、社会支持、情绪状态进行评价,并对患者的躯体状况(疾病严重程度、疾病持续时间、有无并发症等)进行评分。结果与正常对照组相比,糖尿病患者的主观幸福感明显降低(对照组为10±8,糖尿病患者为5±6),且患者的主观幸福感与生活事件评价、焦虑抑郁程度呈负相关(相关系数分别为0.25,0.23,0.13);与总社会支持呈正相关(相关系数为0.28)。结论糖尿病患者的主观幸福感与多种因素有关,其中生活事件评价是重要影响因素之一。