Distinct Uric Acid Trajectories Are Associated With Different Risks of Incident Hypertension in Middle-Aged Adults

Objectives

To identify common uric acid (UA) trajectories in middle-aged adults and to examine their association with the risk of hypertension.

Identifying patients without favourable long-term outcome among those with medically stabilized unstable angina and a negative dipyridamole stress echocardiogram

Aims: Patients with medically stabilized unstable angina anda negative stress echocardiogram have a favourable outcome asa whole. This study sought to identify which subsets of patientsare associated with serious events at long-term within thispopulation. Methods and results: We studied and followed-up 128 patients(mean 2.2 ± 1.3 years) with medically stabilized unstableangina and a negative dipyridamole stress echocardiogram. Cumulativesurvival rates were 98.2±1.3%, 96.0±2.2% and 93.2±3.2%,at 1, 2 and 4 years, respectively. Freedom from events (death,myocardial infarction, and revascularization) were 98.2±1.3%,96.0±2.2% and 86.3±6.0%, at 1, 2, and 4 years,respectively. Cumulative mortality rate was higher in men (3.6±2.5%,8.5±4.1%, and 12.2±5.4% at 1, 2, and 4 years,vs. 0% at the end of the follow-up in women; p = 0.034), andin those with previous myocardial infarction (4.3±4.3%,9.1±6.2%, and 18.2±2.3% at 1, 2 and 4 years, vs.1.1±1.1%, 2.9±2.1%, and 2.9±2.1% in thosewithout previous myocardial infarction, respectively; p = 0.047). Conclusion: Among patients with medically stabilized unstableangina and a negative dipyridamole stress echocardiogram, malegender and previous myocardial infarction are associated witha non-favourable outcome.     

Combined Transradial and Transpedal Approach for Femoral Artery Interventions

Objectives

The purpose of this prospective study was to evaluate the acute success and complication rates of combined transradial and transpedal access for femoral artery intervention.

Assessing the potential of angiotensin II type 1 receptor and donor specific anti-endothelial cell antibodies to predict long-term kidney graft outcome

Endothelial cell antigens have been reported as potential targets for antibodies in the context of organ transplantation, leading to increased risk for graft failure. Serum samples from 142 consecutive living donor kidney recipients were tested for the presence of antibodies to angiotensin II – type 1 receptor (AT1R), donor endothelial cells, and donor HLA. Graft survival was monitored for five years post-transplant, and secondary outcomes, including biopsy-proven rejection, proteinuria, biopsy-proven vasculopathy, and renal function based on serum creatinine were also assessed for the first two to three years. AT1R antibody levels were positive (>17 U/mL) in 11.3%, 18.8% and 8.1% of patients pre-transplant, post-transplant and at time of indication biopsy, respectively. XM-ONE assay was positive in 17.6% of patients pre-transplant (7 IgG+; 15 IgM+; 3 IgG+/IgM+). Overall, 4 patients experienced antibody-mediated rejection (AMR), 31 borderline cellular rejection (BCR), 19 cellular rejection (CR) and 3 mixed AMR and CR within the first 24 months. While pre-existing and de novo donor-specific HLA antibodies were associated with graft failure and many secondary outcomes, no statistical association was found for either anti-endothelial or anti-AT1R antibodies, indicating that these tests may not be the best predictors of graft outcome in living donor renal transplantation.     

唾液肌酐、尿素和尿酸水平对慢性肾脏病的诊断价值

目的：探讨检测唾液尿素(Urea)、肌酐(Cr)和尿酸(UA)水平对慢性肾脏病（CKD）的诊断价值。方法选择2010年1月至2013年12月88例CKD患者为研究对象(观察组)。将88例患者按照肌酐清除率(CCr)分为CKD晚期26例(A组),CCr<30 ml/(min·1.73 m2);CKD中期32例(B组),30 ml/(min·1.73 m2)≤CCr≤60 ml/( min·1.73 m2);CKD早期30例(C组),CCr＞60 ml/(min·1.73 m2)。另选择健康人群92例为对照组。统计受试者血清和唾液中Cr、Urea、UA含量,并对各指标与年龄、CKD分期、吸烟状况、BMI的关系进行相关性分析。结果随着肌酐清除率的降低,血清和唾液Cr、Urea、UA水平呈升高趋势(P<0.01),但C组和对照组间血清和唾液Cr、Urea、UA水平比较差异均无统计学意义(P>0.05);CKD患者血清Cr、UA水平明显高于唾液,差异有显著统计学意义(P<0.01);血清和唾液Urea水平比较差异均无统计学意义(P>0.05）;A组、B组、C组和对照组各组间,血清Cr、UA水平明显高于唾液,差异均有统计学意义(P<0.05),而血清和唾液Urea水平比较差异则无统计学意义(P>0.05);血清Cr、Urea、UA水平与唾液Cr、Urea、UA水平分别呈正相关(P<0.05);血清和唾液Cr、Urea、UA水平与CKD分期均呈正相关(P<0.05),与年龄、吸烟状况、BMI等因素无明显相关性(P>0.05)。结论唾液Cr、Urea、UA水平可反映血清Cr、Urea、UA含量,与CKD病情进展密切相关,随着CKD病情的进展呈现上升趋势,检测唾液Cr、Urea、UA含量可用于中晚期CKD的监测。     

2型糖尿病患者血清瘦素与颈动脉内膜中层厚度的相关性研究

目的探讨2型糖尿病（T2DM）患者血清瘦素水平与颈动脉内膜中层厚度（IMT）的关系。方法选择35例2型糖尿病患者、16例正常对照者,分别测定其血清瘦素、空腹血糖、糖化血红蛋白Alc（HbAlc）、C肽、血脂、血压、体重指数（BMI）及腰围,同时使用高分辨率超声检测双侧颈动脉IMT。结果T2DM患者血清瘦素浓度与颈动脉IMT呈显著正相关。结论血清瘦素浓度与颈动脉IMT的增厚有关,提示瘦素可能是导致T2DM患者动脉粥样硬化中的一项危险因素。     

Topical treatment with Tong-Luo-San-Jie gel alleviates bone cancer pain in rats

Ethnopharmacological relevance

The herbal analgesic gel Tong-Luo-San-Jie (TLSJ) and its modifications are used in traditional Chinese medicine to manage cancer pain. However, its mechanisms are still unknown.

Aim of the study

To investigate the effects and mechanisms of TLSJ gel on bone cancer pain in a rat model.

Materials and methods

A bone cancer pain rat model was established by inoculating Walker 256 rat carcinoma cells directly into the right tibial medullary cavity of Sprague–Dawley rats (150–170 g); Phosphate buffered saline (PBS) tibial inoculation was used as control. Cancer-bearing rats were treated twice a day with external TLSJ gel (0.5 g/cm²/day) or inert gel control for 21 day (n=10/group). Behavioral tests such as mechanical threshold and paw withdrawal latency (PWL) were carried out. Osteoclastic activities were determined and carboxyterminal pyridinoline cross-linked type I collagen telopeptides (ICTP) and bone-specific alkaline phosphatase (BAP) concentrations were detected with ELISA after treatment. Adverse effects were monitored, and biochemical and histological tests were performed in naïve rats treated with local TLSJ gel for six weeks.

Results

TLSJ treatment significantly restored bone cancer-induced decrease of PWL and mechanical threshold compared to inert gel. It also decreased the level of blood serum ICTP and BAP and inhibited osteoclast activities. No adverse effects or abnormal biochemical and histological changes were detected after TLSJ treatment.

Conclusion

The present study shows that TLSJ significantly inhibits bone cancer-induced thermal and mechanical sensitization. It suggests that the gel may be useful in managing cancer pain and that it may act by inhibiting osteoclastic activity.     

益心舒胶囊对老年人尿酸、肌酐、尿素氮的影响

目的：探讨益心舒胶囊对长期服用小剂量阿司匹林（50mg·d-1）的老年人尿酸、肌酐、尿素氮的影响。方法：将60例老年人随机分为益心舒胶囊治疗组和常规治疗组,每组30例,另外选取30例不服用阿司匹林的老年人为对照组;在入组前、治疗第1月、3月及6月时,测定其相应指标。结果：治疗6个月后,益心舒胶囊治疗组血尿酸（UA）明显低于常规治疗组（P〈0.05）;与常规治疗组相比,益心舒胶囊治疗组血肌酐（Cr）和尿素氮（BUN）无显著性差异（P〉0.05）。结论：益心舒胶囊可改善老年人长期服用阿司匹林所致的高尿酸血症     

不稳定性心绞痛毒损心络说

不稳定性心绞痛(UA)除具有冠心病(CHD)气虚血瘀的病机共性之外,还具有毒邪致病的特点。提出毒损心络为UA的重要病机,解毒为其重要治法。