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Objective: To understand the detection rate, epidemic pattern of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory tract infection (ALRTI) in China. Methods: From June 2017 to March 2020, a prospective multi-center study on the viral aetiology among hospitalized children with ALRTI was conducted in six pediatrics hospital of North China, Northeast, Northwest, South China, Southeast, and Southwest China. A total of 2 839 hospitalized children with ALRTI were enrolled, and the respiratory specimens were collected from these cases. A multiplex real-time RT-PCR assay were employed to screen the respiratory viruses, and the molecular epidemiological and clinical characteristics of children infected with RSV were analyzed. Results: The positve rate of RSV was 18.6% (528/2 839), and the positive rate of RSV in different regions ranged from 5.5% to 44.3%. The positive rate of RSV in male was higher than that in female (20.2% vs 16.3%), and there was a significant statistically difference between two groups (χ2=6.74, P=0.009). The positive rate of RSV among children under 5 years old was higher than that among children older than 5 years old (22.3% vs 4.5%), and there was a significant statistically difference between two groups (χ2=97.98,P<0.001). The positive rate of RSV among the <6 months age group was higher than that of other age groups (all P<0.05). During January 2018 and December 2019, RSV was detected in almost all through the year, and showed peaks in winter and spring. RSV-positive cases accounted for 17.0% (46/270) among children with severe pneumonia, including 36 cases infected with RSV alone. Conclusion: RSV is an important viral pathogen in children under 5 years old with ALRTI in China. The virus can be detected almost all through the year and reached the peak in winter and spring. RSV could lead to severe pneumonia in children and caused huge threaten to children's health.

The clinical data of 22 patients with giant renal hamartoma in Zhejiang Provincial People's Hospital who underwent robot-assisted laparoscopic nephron-sparing surgery from October 2014 to January 2020 were retrospectively analyzed. All the patients successfully completed the operation. The operation time and renal artery occlusion time was (179±34) min and (19.8±2.5) min, respectively. The intraoperative blood loss was (117±62) ml, and the postoperative hospital stay was (9.0±1.5) d. All cases were confirmed as renal angiomyolipoma by postoperative pathology. No urine leakage, postoperative bleeding and other complications occurred. Postoperative telephone follow-up was performed for 6 to 52 months, and no tumor recurrence on the surgical side was reported.

Objective: To evaluate the efficacy and safety of low dose sublingual nifedipine dripping pills (5 mg) in treating moderate and severe hypertension in comparison with normal dose (10 mg) of sublingual nifedipine dripping pills. Methods: This study was designed as a randomized, double-blind, positive drug parallel controlled, multi-center, non-inferiority clinical trial. Patients with moderate and severe hypertension were enrolled by 14 clinical trial centers, randomly divided into the trial group (sublingual 5 mg nifedipine dripping pills) and the control group (sublingual 10 mg nifedipine dripping pills). The changes in blood pressure were monitored continuously within 2 hours after the initial administration, repeated the dose in 20 minutes interval after the initial administration for up to additional 3 doses (maximum 4 doses) if the antihypertensive efficacy was not satisfactory. The efficacy of antihypertensive therapy between the two groups was evaluated by repeated administration rates and blood pressure changes at 60 minutes post the initial administration, and the safety of treatment was evaluated by recording adverse event rate of the two groups. Results: The anti-hypertensive effective rates at 60 minutes after sublingual administration were 83.5% (202/242) and 86.7% (208/240) respectively between the trial group and control group (χ(2)=1.307, P= 0.253) . On the aspect of antihypertensive effectiveness at 60 minutes after single dose of sublingual administration, the anti-hypertension effective rates of the trial group and the control group were 85.6% (154/180) and 87.2% (164/188) respectively (χ(2)=0.221, P= 0.639). Prevalence of the repeated administration was also similar between the two groups (25.6%(62/242) in the trial group and 21.7% (52/240) in the control group, χ(2)=1.043, P= 0.307). On the safety aspect, there was no adverse events/reactions in the trial group, but there were 15 cases of adverse events/reactions occurred in control group (6.25%, χ(2)=15.611, P< 0.001). Conclusions: In the treatment of moderate to severe hypertension, the antihypertensive efficacy of low dose nifedipine dripping pills is similar to that of conventional dosage, and the safety profile of low dose nifedipine dripping pills is better than that of the conventional dose.

Objective: To explore the effect of implanting short stent in root of aorta for the treatment of Stanford type A aortic dissection. Methods: Clinical data of 39 patients with Stanford type A aortic dissection who underwent surgical procedure at the Department of Cardiovascular Surgery of Luoyang Central Hospital Affiliated to Zhengzhou University, between January 2013 and December 2015 were retrospectively analyzed. There were 31 males and 8 females aged 27 to 75 (49.3±10.3) years. All patients received short stent implanting in aortic root, total arch replacement and stented elephant trunk implantation were performed at the same time. Results: All the operations were successfully performed. Two patients died during hospitalization. Four patients underwent reexploration for postoperative bleeding. Postoperative mortality was 5.1%(2/39). Follow-up duration was 3 to 24 months, with a median time of 14 months. One patient died of lung infection, gastrointestinal bleeding and renal faliure during follow-up. Conclusion: Patients with aortic intimal tear located at higher root of aorta may be suitable for short stent implanting, and the procedure has satisfactory clinical outcomes.

Objective: To investigate glucose metabolism status and its relationship with blood pressure, obesity, renal function and cardio-cerebral vascular events in Chinese essential hypertensive patients., Methods: Essential hypertensive patients without diabetic history were enrolled in this cross-sectional survey. All patients filled in questionnaires and received physical examination and laboratory tests. Oral glucose tolerance test (OGTT, fasting and 2 hours glucose level after drinking the 75 g glucose solution) was performed in patients who signed the informed consent., Results: (1) The control rate of systolic BP was lower in patients with dysglycemia than in patients without dysglycemia (41.0% vs. 46.4%, P = 0.000). (2) The albuminuria detection rate and the abnormal rate of estimated glumerular filtration rate (eGFR) increased significantly with the deterioration of glucose metabolism. (3) Multifactor-analysis showed that abnormal waist circumference, decreased eGFR and presence of albuminuria were independent risk factors for abnormal glucose metabolism. Cardiovascular events was significantly higher in patients with abnormal glucose metabolism than patients with normal glucose metabolism., Conclusion: Abnormal glucose metabolism is common in Chinese essential hypertensive patients. When complicated with abnormal glucose metabolism, essential hypertensive patients had poor blood pressure control rate and were related to higher cardiovascular risk.

Objective: To determine whether circulating level of catestatin (CST) could provide prognostic information independently of conventional risk markers for the development of in-hospital heart failure in patients with ST-segment elevation myocardial infarction (STEMI)., Methods: The data of 120 STEMI patients (mean age: 61 years, 73% male) were collected from the Second Hospital of Shanxi Medical University and Taiyuan Central Hospital between November 2010 and September 2011.The patients were categorized into 4 groups according to CST (ng/L) quartile: ≤ 74.72, 74.73-79.67, 79.68 - 84.21 and ≥ 84.22 ng/L. Clinical features, therapeutic approaches were compared among groups. The patients were also grouped according to Killip class: Killip level I (n = 68), Killip level II (n = 23), Killip level III (n = 18), Killip level IV (n = 11). CST, NE and NT-proBNP were compared among groups. The Spearma rank correlation and multivariate logistic regression analysis were applied to determine the association between risk factors and in-hospital heart failure. Receiver-operator characteristic (ROC) curve was performed to evaluate the power of CST and NT-proBNP on predicting in-hospital heart failure., Results: Gender, hospital days, past history of smoking, hypertension, myocardial infarction, CK-MB peak level, TnI peak level, heart rate, blood pressure, blood glucose, blood lipid levels on admission and early reperfusion therapy were similar among groups. Patients with higher CST values were more likely to be older, to have lower body mass index, to have higher white blood cell count, CysC, hs-CRP, NE, NT-proBNP, past history of angina, diabetes mellitus, being diuretic users, and to have a lower ejection fraction (all P < 0.05). Higher CST levels were also associated with increased risk of heart failure (P < 0.05). In proportion with the deterioration of the cardiac function, CST, NE, NT-proBNP concentration gradually increased (all P < 0.05). Spearman rank correlation analysis showed that the CST was negatively correlated with LVEF (r(s) = -0.923, P < 0.001) and positively correlated with NT-proBNP (r(s) = 0.884, P < 0.001). After multivariate adjustment, CST remained to be an independent risk factor for the development of in-hospital heart failure (OR = 1.125, 95%CI: 1.056 - 1.198;P < 0.001). The area under the ROC curve of CST and NT-proBNP was 0.777 and 0.874. Using CST = 77.29 ng/L as a cut-off value, the sensitivity was 92.8% and specificity was 70.6% for predicting the development of in-hospital heart failure., Conclusion: The plasma CST level is an independent predictor for the development of in-hospital heart failure in patients with STEMI.

Objective: To explore the associations between fasting serum lipids and high-sensitivity C-reactive protein (hsCRP)., Methods: Serum triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and hsCRP were measured in residents of Chengdu, China. Subjects with potential factors which might influence lipids and hsCRP were excluded, 580 subjects [mean age (62.3 ± 6.6) years; male: 58.7%] were finally recruited by random sampling methods., Results: There was a weak positive relationship between TG and hsCRP (r = 0.108, P = 0.01) and a weak negative relationship between HDL-C and hsCRP (r = -0.197, P < 0.001), this was also true in the sub-group with BMI < 24 kg/m(2) (r = 0.236, -0.140 respectively, all P < 0.001). In subjects with BMI < 24 kg/m(2), the hsCRP concentration was significantly higher in subjects with higher TG or lower HDL-C (all P < 0.05). hsCRP increased in proportion with the degree of dyslipidemia. After adjusting for gender, age, TC, LDL-C, fasting blood glucose, systolic blood pressure, diastolic blood pressure, history of hypertension and diabetes, smoking and alcohol drinking, logistic regression analysis showed that the odds ratio for increased hsCRP was 1.970 in subjects with either increased TG or lower HDL-C (P = 0.105) and 9.098 in subjects with both higher TG or lower HDL-C levels (P = 0.031). However, the observed relationship between TG, HDL-C and hsCRP in subjects with BMI < 24 kg/m(2) could not be observed in subjects with subjects with BMI > 24 kg/m(2) despite significant more cardiovascular risk factors in these subjects., Conclusions: A weak positive correlation between TG and hsCRP as well as a weak negative correlation between HDL-C and hsCRP was evidenced in the whole cohort suggesting dyslipidemia might be related to enhanced inflammatory status. However, this relationship is not observed in subjects with BMI > 24 kg/m(2) despite existence of more cardiovascular risk factors in these subjects.

Objective: To observe the histopathological features of posttransplant complications for hepatic allografts and evaluate their biopsy values., Methods: From January 1999 to May 2011, a total of 268 percutaneous hepatic allograft biopsies were conducted in 207 recipients and the diagnostic procedures for staining, classification and staging performed according to the Banff schema and Chinese Schema on hepatic allograft rejection., Results: Among them, there were ischemia/reperfusion injury (n = 26, 9.7%), acute T cell-mediated rejection (n = 83, 31.0%), acute antibody-mediated rejection (n = 12, 4.5%), chronic posttransplantation rejection (n = 31, 11.6%), immunosuppressive-induced liver injury (n = 70, 26.1%) and recurrent diseases (n = 18, 6.7%). Acute T cell-mediated rejection and drug-induced liver injury were two most common causes of allograft dysfunctions., Conclusion: Percutaneous hepatic allograft biopsy is valuable for the diagnosis and evaluation of various posttransplantation complications.

Objective: To observe the association between preprocedural high sensitivity C-reactive protein (hs-CRP) level and incidence of contrast induced acute kidney injury (CI-AKI) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and the impact of atorvastatin pretreatment on CI-AKI., Methods: According to the level of preprocedural hs-CRP, 270 ACS patients were divided into three groups: high hs-CRP group (hs-CRP ≥ 3 mg/L, n = 176), moderate hs-CRP group (hs-CRP 1-3 mg/L, n = 60) and normal hs-CRP group (hs-CRP < 1 mg/L, n = 34). According to the dosage of preprocedural atorvastatin, the high hs-CRP group was further divided into 10 mg group (n = 49), 20 mg group (n = 66) and 40 mg group (n = 61). Serum creatinine (Scr), blood urea nitrogen (BUN), cystatin C (Cys C), hs-CRP were measured at before and 24 hours, 48 hours after PCI. CCr and GFR were calculated according to Scr and Cys C. Risk factors for CI-AKI were determined by multivariate logistic regression analysis., Results: (1) Cys C was significantly increased and GFR after PCI significantly reduced in high and moderate hs-CRP groups compared with normal hs-CRP group (P < 0.05). (2) Incidence of CI-AKI was 43.18%, 38.33%, 20.59% in high, moderate and normal hs-CRP groups, respectively (P < 0.05). (3) In high hs-CRP group, postprocedural GFR was significantly higher while postprocedural Cys C and hs-CRP were significantly lower in 40 mg statin subgroup than 10 mg and 20 mg statin subgroups (P < 0.05), similar trends were documented when comparing 20 mg statin subgroup with 10 mg statin subgroup (P < 0.05). (4) Multivariate logistic regression analysis showed that pretreatment with high dose atorvastatin was a protective factor for post CI-AKI (20 mg atorvastatin: OR = 0.15, 95%CI 0.06 - 0.33, P = 0.001; 40 mg atorvastatin: OR = 0.10, 95%CI 0.04 - 0.23, P = 0.001), while high levels of preprocedural hs-CRP (OR = 2.06, 95%CI 1.01 - 4.23, P = 0.048), diabetes mellitus (OR = 10.71, 95%CI 5.29 - 21.70, P = 0.001), advanced age (OR = 2.64, 95%CI 1.05 - 6.63, P = 0.038) and renal failure (OR = 5.14, 95%CI 1.13 - 23.39, P = 0.034) were independent risk factors of CI-AKI., Conclusion: High hs-CRP level is linked with the development of CI-AKI in ACS patients undergoing PCI and pretreatment with 40 mg atorvastatin is associated with lower incidence CI-AKI, possibly by reducing the postprocedural inflammation responses.

Objective: To summarize the histopathological features of posttransplant complications for renal allografts and evaluate the biopsy values., Methods: Between January 1997 and May 2010, a total of 1712 percutaneous renal allograft biopsies were performed in 1500 kidney transplants and diagnostic procedures for staining, classification and staging had been performed according to the Banff 1997 and 2005 Schema., Results: There were 213 (14.2%) cases of acute T cell-mediated rejection post transplantation in 1500 kidney transplants. Meanwhile there were 36 (2.4%) cases of acute antibody-mediated rejection. Chronic T cell-mediated rejection and chronic antibody-mediated rejection were 251 (16.7%) cases and 45 (3.0%) cases, respectively. Acute CNI-nephrotoxicity and chronic CNI-nephrotoxicity were 106 (7.1%)cases and 251 (16.7%) cases, respectively. Relapsed or new nephropathy were 6 (0.4%) cases. Chronic CNI-nephrotoxicity is the most common cause of allograft dysfunction in the long survival recipients., Conclusion: Percutaneous renal allograft biopsy is valuable for the diagnosis of various posttransplantation complications.

Objective: To investigate the association between serum uric acid (UA) and early kidney damage and the prevalence of early kidney damage [89 >or= GFR >or= 60 ml * min(-1) * (1.73m(2))(-1)] in the middle-aged and elders with normal serum creatinine., Methods: A survey of cardiovascular risk factors, including serum UA and estimated glomerular filtration rate (eGFR) [according to MDRD (modification of diet in renal disease) equation], was carried out in a local general population of Chengdu. A total of 1023 subjects with normal serum creatinine [mean age: (63 +/- 6) years; male: female = 52.7%: 47.3%] were recruited by random sampling method. The subjects were divided into 4 groups (A, B, C, D) according to the quartiles of serum UA levels (A: UA < 282 micromol/L, B: 282 micromol/L or= 379 micromol/L)., Results: In the group, the prevalence of early kidney damage was 28.1% (men: 35.8% > women: 19.5%, P < 0.01). In men and women, serum UA and mild kidney dysfunction were negatively correlated, and the prevalence of early kidney damage significantly increased with the elevated level of serum UA. The prevalence of early kidney damage was higher in men than women (P < 0.01). According to the logistic regression analysis adjusting for age, gender, waist, body mass index, triglyceride, HDL-C, total cholesterol, history of hypertension and diabetes type 2, the odds ratio of the prevalence of early kidney damage were 1.0 [B: 1.740 (P = 0.151), C: 3.599 (P = 0.01) and D: 5.488 (P < 0.01) respectively]., Conclusion: In the middle-aged and elders with normal serum creatinine, serum UA and eGFR are negatively correlated. And serum UA level is independently associated with early kidney damage.

Objective: To investigate nerve growth factor (beta-NGF) and its receptors expression in human pancreatic ductal adenocarcinoma., Methods: Expression and distribution of beta-NGF, tyrosine kinase A (TrKA) and P75(NGFR) were detected in operation tissue specimens of pancreatic ductal adenocarcinoma with immunohistochemistry and real-time PCR. Relations of beta-NGF and its receptors with clinical pathological characters, especially nerve invasion were analyzed., Results: beta-NGF and TrKA expression are higher in pancreatic adenocarcinoma than normal pancreas, and the differences are significant (P < 0.01). beta-NGF and TrKA expression are associated with the differentiation grades (DG), lymphatic node metastasis, nerve invasion and surgical pathological stages. Poorer of DG and later stages, more expression of beta-NGF and TrKA. beta-NGF and TrKA expression have positive correlations. beta-NGF, TrKA and P75(NGFR) mRNA expression have significantly increased 3.84, 4.23 and 2.41 times than normal tissues by real-time PCR, respectively., Conclusions: beta-NGF and TrKA might play potential roles in carcinogenesis for pancreatic cancer, have affinity with clinicopathological characters of pancreatic cancer. beta-NGF and TrKA may have mutual effect in signal transduction leading to perineural invasion of pancreatic carcinoma.

Objective: To study the relationship between microalbuminuria and cognitive impairment in primary hypertensive patients., Methods: A total of 200 hypertensive patients were included in this study. Blood pressure, body height and weight, total cholesterol, triglyceride, fasting plasma glucose, 2 hour-postprandial blood sugar, insulin level and urine protein were measured. Microalbuminuria and urine creatinine were determined in patients without proteinuria. The risk stratification of hypertension was evaluated. The cognitive function and calculate scores were tested by the Mini Mental State Examination (MMSE) and patients were divided into two groups: > 24-scores were classified as normal cognition group, < or = 24-scores as impaired cognition group., Results: Among the 200 hypertensive patients, proteinuria was detected in 25 patients. There was no significant difference in the cognitive function between patients with and without proteinuria (P > 0.05). There were significant differences on age, educational level, occupation, smoking, history of coronary heart disease, history of cerebrovascular disease, the risk stratification of hypertension, microalbuminuria/creatinine ratio, postprandial insulin level, cholesterol and diastolic blood pressure between normal cognition function group and impaired cognition function group (all P < 0.05). Multivariate logistic regression analysis showed that microalbuminuria, educational level and the risk stratification of hypertension were significantly correlated to cognition impairment (all P < 0.05)., Conclusions: Educational level, the risk stratification of hypertension and microalbuminuria are associated with cognitive impairment in this patient cohort.

Objective: To investigate the effects of lipiodol-hydroxyapatite nanoparticle (lipi-nHAP) on the growth, necrosis, apoptosis, proliferation, and angiogenesis of hepatic tumor., Methods: Ultrasound-emulsification was used to make lipi-nHAP Eighty New Zealand white rabbits underwent implantation of carcinoma cells of the line VX2 into the left lobe of liver. Two weeks later the rabbits underwent catheterization into the gastroduodenal artery so that, and then the rabbits were randomly divided into four equal groups to receive infusion via the hepatic artery of different drugs: physiological saline (Group A), lipiodol (Group B), adriamycin + lipiodol (Group C), and lipi-nHAP (Group D). Seven and 14 days after the treatment the size of tumor was observed by spiral CT scan, and the volume and growth rate of tumor were calculated. Two weeks after the treatment 8 rabbits from each group were killed and their liver tumors were taken out and the survival rates of remaining rabbits were observed. The necrosis rate of the liver tumor was assessed by measuring the area of the tumor and the necrosis. The apoptotic rate was examined by TUNEL method. Mcrovessel density (MVD) was examined by immunohistochemistry anti-CD31 antibody. Anti-proliferating cell nuclear antigen (PCNA) monoclonal antibody was used to detect the expression of PCNA so as to calculate the proliferation index of the cells., Results: The tumor volume and growth rate of Group D 7 and 14 days after treatment were both significantly lower than those of other groups (all P < 0.05) and the necrosis rate and apoptotic index of Group D were both significantly higher than those of other groups (all P < 0.05). The values of MVD were higher in Groups C and D compared with those of Group A. Compared with those in other groups, the values of MVD and expression level of PCNA were significantly lower in group D (all P < 0.05). The survival time of Group D was longer than those of other groups (all P < 0.05)., Conclusion: lipi-nHAP can suppress the growth of tumor, increase the tumor's necrosis rate and apoptotic index, inhibit the development of neovascularization, decrease the expression level of PCNA of residual tumor, and prolong the surviving time of the animals with hepatic tumor. It may become an effective embolization material to treat liver cancer.

Objective: The waist circumference (WC) cut-off point for abdominal obesity is gender and ethnic-group specific. The aim of the study was to explore the best WC cut-point for identifying cardiovascular risk factors clustering among Chinese adults., Method: The data from 15,628 Chinese adults aged > or = 25 years in 1994 National Diabetes Mellitus Survey were reanalyzed. Odds ratios for different WC categories (stratified in units of 5 cm) were calculated with the first stratum (WC < 70 cm) as reference category. Receiver Operator Characteristic curve (ROC) analysis was employed to determine the optimal WC cut-point for detecting multiple cardiovascular disease risk factors., Results: The prevalences of insulin resistance, dyslipidemia, hypertension and hyperglycemia were higher among higher WC categories for both men and women. Odds ratios for metabolic syndrome significantly increased from the WC category of > or = 85 cm in man (OR = 2.08, 95% CI: 1.80 - 2.39) and > or = 80 cm in women (OR = 1.66, 95% CI: 1.41 - 1.97). The ROC analysis showed that the optimal WC cut-point was 85 cm in men with the sensitivity of 60.79% and specificity of 69.66%, and 80 cm in women with sensitivity of 59.88% and specificity of 65.35%., Conclusion: The best WC cut-point is 85 cm in men and 80 cm in women for identifying Chinese adults at high risk of cardiovascular disease.

Objective: To investigate the relationship between the expression of phosphoenolpyruvate carboxykinase (PEPCK) gene and insulin resistance induced by high-fat diet and the effect of rosiglitazone, a thiazolidinedione drug., Methods: Sixty-three normal 8-week-old male SD rats were randomly divided into 2 groups: short-term group, n = 33, to be fed for 8 weeks and re-divide into 3 equal subgroups: standard chow diet subgroup (NC subgroup fed with standard chow diet), high-fat diet subgroup (HF subgroup, to be fed with lard), and high-fat diet with rosiglitazone subgroup (HF + rosiglitazone subgroup); and long-term group, n = 30, to be fed for 28 weeks, and re-divided into 3 corresponding 3 subgroups: By the end of experiment, serum samples were collected to examine the blood glucose (BG), triglyceride (TG) and free fatty acid (FFA). At the end of the experiment the rats were killed and the visceral adipose tissue was taken out to be weighed, and the liver, muscle, and epididymis were isolated. Glucose infusion rate (GIR) methods and tissue uptake of (3)H-2-deoxyglucose were used to short-and long-term groups evaluate the insulin sensitivity. PEPCK gene expression was investigated to detect the expression of PEPCK mRNA by using semi-quantitative RT-PCR method., Results: In the short-term group, the serum FFA and TG of the HF + rosiglitazone subgroup were lower by 24.5% and 54.0% respectively compared with those the HF subgroup (both P < 0.01). In the long-term group, the serum TG of the HF subgroup was higher by 32.4% in comparison with that of the NC subgroup (P < 0.05), and the serum FFA and TG of the HF + rosiglitazone subgroup were lower by 49.5% and 23.0% respectively compared with those of the HF subgroup (both P < 0.0). In the short-term group the GIR of the HF subgroup was lower by 51.25% in comparison with that of the NC subgroup (P < 0.01). And the GIR of the HF + rosiglitazone subgroup was higher by 149.6% than that of the HF group (P < 0.01). In the long-term group, the rate of uptake of (3)H-2-deoxyglucose in liver, muscle and adipose tissue of the HF subgroup were lower by 42.0%, 36.7%, and 48.1% respectively than those of the HF subgroup (all P < 0.01), and the rate of uptake of 3H-2-deoxyglucose in liver, muscle and adipose tissue of the HF + rosiglitazone subgroup were higher by 39.6%, 66.3%, and 66.7% respectively than those of the HF subgroup (all P < 0.01). In the short-term group the adipose PEPCK mRNA expression of the HF subgroup was 89% +/- 13% that of the NC subgroup; and the adipose PEPCK mRNA expression of the HF + rosiglitazone subgroup was 154% +/- 28% that of the NC subgroup, and was higher by 65.4% than that the HF subgroup (P < 0.05). In the long-term group, the adipose PEPCK mRNA expression of the HF + rosiglitazone subgroup was 144% +/- 17% that of the NC subgroup (P < 0.05), and was higher by 43.3% than that of the HF subgroup (P < 0.05)., Conclusion: Thiazolidinedione drug increases the re-esterification of fatty acids and reduces circulating FFA, and induces the expression of adipose PEPCK which is accompanied by reduction of FFA, thus improving insulin resistance.

Objective: To review the results of the valve-sparing operation (David procedure) in patients with aortic root disease., Methods: Twenty-nine patients with aortic root disease, 20 males and 9 females, aged 39 +/- 17 (10-64), 10 being of heart functional class I, 15 of class II, and 4 of class III, and 15 with gentle, 9 with moderate, and 5 with severe aortic insufficiency underwent David procedure, one undergoing the aortic valve-sparing reimplantation (David I), 25 undergoing aortic valve-sparing remodeling (David II), and 3 undergoing a new modified aortic valve-sparing operation. After the operation the patients were followed up for 29 +/- 15 months (5-74 months)., Results: No intra-operative death was found. The mean extracorporeal circulation time was 126 min +/- 25 min, and the aortic crossclamp time was 87 min +/- 22 min. All patients recovered to heart functional class I. Post-operatively 11 patients showed no normal, eight gently and two moderate aortic regurgitation., Conclusion: The valve-sparing operation is an ideal operation to the aortic root aneurysm with more or less normal aortic leaflets and valvular ring normal.

Objective: To observe the effects of rosiglitazone and metformin in rats on insulin resistance induced by high-fat diet., Methods: Normal 8-week old male SD rats were divided into four groups. They were normal chow group (NC, n = 11), high-fat diet (HF, n = 11), metformin-treated (HF + Met, n = 11) and rosiglitazone-treated group (HF + Ros, n = 11). Rosiglitazone 3 mg x kg(-1) x d(-1) and metformin 300 mg x kg(-1) x d(-1) were given orally to HF + Ros and HF + Met group, respectively. After feeding for 8 weeks, serum insulin, adiponectin, glucose (BG), triglyceride (TG) and free fatty acid (FFA) were measured in all the rats. Insulin sensitivity was measured with glucose infusion rate (GIR) and determined by using euglycemic-hyperinsulinemic clamp method., Results: High-fat diet induced obesity in SD rats after feeding for 8 weeks. High-fat diet decreased adiponectin level by 43.7% (P < 0.01) and GIR by 51.3% (P < 0.01) as compared with the NC group. Metformin decreased body weight by 8.4% (P < 0.01) and TG level by 40.5% (P < 0.01). Metformin significantly increased GIR by 58.9% (P < 0.01) when compared with the HF group. Rosiglitazone caused an apparent reduction of FFA (-25.3%, P < 0.05) and TG level (-54.0%, P < 0.01). At the same time, rosiglitazone increased adiponectin by 60% (P < 0.01), and improved insulin sensitivity by 149.6% (P < 0.01) as compared with the HF group., Conclusions: (1) High-fat diet induces insulin resistance in SD rats; this was associated with an increase in visceral fat and a decrease in the level of adiponectin; (2) Metformin treatment improved insulin sensitivity accompanied by a decrease in body weight and TG level; (3) Rosiglitazone treatment ameliorates IR in a greater extent and is accompanied by a reduction of FFA, TG and an increase of adiponectin levels.

Objective: To investigate the effect of promoter region polymorphism of osteoprotegerin (OPG) gene on bone mineral density (BMD) and markers of bone turnover in postmenopausal women., Methods: The OPG genotype were determined by PCR-RFLP in 259 postmenopausal women of Han race in Shanghai area, and BMD at lumbar-spine, femoral neck, trochanter and Ward's triangle etc., were measured by dual-energy X-ray absorptiometry (DEXA). Some markers of bone turnover were also detected., Results: Hardy-Weinberg equilibrium was evident for OPG polymorphism. The frequency of the genotype is as following: TT59%, TC28%, CC13%. Postmenopausal women were divided into two groups. Women aged less than 65 years old were in group I, and aged 65 years old and over were in group II. In group I the BMD at femur neck area was 0.64 g/cm(2) +/- 0.11 g/cm(2), 0.67 g/cm(2) +/- 0.11 g/cm(2), 0.68 g/cm(2) +/- 0.14 g/cm(2) of TT, TC, CC genotypes respectively, among which a significant difference was observed (P < 0.05 by ANOVA), and the significant difference also presented after adjusted by age and BMI, but not found the significant difference in other markers. In group II, significant link was not observed between OPG polymorphism and BMD with markers of bone turnover., Conclusion: OPG polymorphism may have an effect on the BMD of postmenopausal women aged less than 65. It is possibly that the role of OPG gene mainly on the obtaining of peak BMD in women.

Objective: To determine the effect of raloxifene hydrochloride (RLX) on the lumbar spine and total hip bone mineral density (BMD), bone metabolism and serum lipids in Chinese postmenopausal women with osteoporosis., Methods: 204 Chinese postmenopausal women with osteoporosis from 3 hospitals in Beijing and Shanghai were randomly divided into 2 groups of 102 women: RLX group (RLX of the dosage of 60 mg/day was given for 12 months) and placebo group. In addition, 500 mg of elemental calcium and 200 units of vitamin D were given daily to all women. BMD, serum bone markers and lipids were measured before and after drug administration. The BMD of lumber spine and hip was measured by dual-energy X-ray absorptiometry (DEXA). Serum bone gamma-carboxyglutamic acid-containing protein (BGP) and C-teloppeptide were analyzed by one-step ELISA. Serum lipids were measured by enzymatic method., Results: By the end of the 12-month study period, the lumbar spine BMD was increased by 3.3% +/- 4.8% in the RLX group and 1.0% +/- 4.9% in the placebo group (P < 0.001); the hip BMD was increased by 1.4% +/- 4.8%in the RLX group and decreased by 0.9% +/- 5.0% in the placebo group (P < 0.01). New vertebral fracture occurred in none of the subjects in the RLX group and in 5 subjects of the placebo group (P = 0.059). The serum BGP and CTX decreased by 41.7% and 61.5% respectively in the RLX group, both significantly more than those in the placebo group (10.6% and 35.6% respectively, both P < 0.001). Both the total cholesterol and low-density lipoprotein cholesterol were significantly lower in the RLX group than in the placebo group (both P < 0.001), however, there were no significant differences in high-density lipoprotein cholesterol and triglycerides between these two groups. One subject in the RLX group and 5 subjects in the placebo group discontinued the study due to adverse events. There were no differences in the number of subjects with hot flushes (3 in the RLX group and 1 in the placebo group) and the number of subjects with leg cramps (9 in the RLX group and 4 in the placebo group). No venous thromboembolic event was reported., Conclusion: RLX of the dosage of 60 mg/day for 12 months significantly increases the lumbar spine and total hip bone BMD, significantly decreases bone turnover and has favorable effects on serum lipids in Chinese postmenopausal women with osteoporosis.

We evaluated the effect of vasoactive intestinal peptide (VIP) receptor, a brain-gut peptide receptor, which is capable of exciting central neurons, on the pathogenesis of hepatic encephalopathy (HE). By means of radioligand binding assay, VIP receptors in crude synaptosomal membrane of rat brains were investigated in a rat model of HE induced by partial hepatectomy following carbon tetrachloride intoxication and in controls. A dissociation constant (Kd) was found 0.28 +/- 0.01 nmol/L and a maximal binding capacity (Bmax) 9.56 +/- 0.29 fmol/mg of protein in HE rats. Only decreased Bmax values were observed (P < 0.002) and the Kd values were statistically unchanged (P > 0.20) in HE rats as compared with in controls. The results suggest that the changes of VIP receptors in brains play a significant role in the pathogenesis of HE. The mechanism of HE induced by the alterations of VIP receptors in the brains was described.