Abstract:Objective To prepare a microRNA (miRNA) delivery system using the branched polyethyleneimine (BPEI), linear polyethylenimine (LPEI) and polyamidoamine dendrimers (PAMAM) loaded with miRNA-15a and miRNA-16-1, which can inhibit prostate cancer PC3 cell proliferation, and to examine the zeta potential, intracellular uptake, and the inhibition effect on PC3 cells of the three constructed nano-complexes. Methods Particle size analyzer was used to determine the size and potential of the three kinds of nano-complexes, and the miRNA affinity capability of them was determined by agarose gel electrophoresis retardation assay. The uptake efficiency of the nano-complexes by PC3 cells was examined by NC-miRNA labeled with FAM. CCK8 method was used to determine the inhibitory effect of the nano-complexes loaded with miRNA-15a and miRNA-16-1 against PC3 cells, and PCR was used to analyze their inhibitory effect on expression of Bcl-2, Cylin D₁ and Wnt3a gene in PC3 cells. Results BPEI, LPEI and PAMAM loaded with miRNA could form stable nano-complexes. When N/P=5, the intracellular uptake of BPEI/miRNA-FAM by PC3 cells was significantly higher than that of LPEI/miRNA-FAM and PAMAM/miRNA-FAM (P<0.05). BPEI, LPEI and PAMAM could all carry miRNA-15a and miRNA-16-1 into PC3 cells and block Bcl-2, Cylin D₁ and Wnt3a expression in PC3 cells. Conclusion BPEI, LPEI and PAMAM loaded with miRNA-15a and miRNA-16-1 can suppress proliferation of prostate cancer PC3 cells and block Bcl-2, Cylin D₁ and Wnt3a expression.

Abstract:Objective To observe the expression and activity changes of vascular adhesion protein-1 (VAP-1) in the small intestine and serum of rats during severe hemorrhagic shock and resuscitation, and to study its influence on shock prognosis. Methods Fifty rats were evenly randomized into sham group, hemorrhagic shock group, shock resuscitation group, control recovery group and the experimental recovery group. Rat models of severe hemorrhagic shock and resuscitation were established. Before shock, 1 hour after shock and 1 hour after resuscitation, the expressions of VAP-1 protein and mRNA in the intestinal tissues of rats were examined by Western blotting analysis and real-time RT-PCR, respectively; and the serum levels of VAP-1 and its activities were determined by ELISA kit. Rats in the experimental recovery group was resuscitated by injection of 20 mg/kg 2-bromoethylamine and those in the control recovery group were given 1 mL/kg normal saline, and then the blood pressure, intestinal mucosa injury (Chiu's score), small intestinal epithelial cell apoptosis (TUNEL detection) and 24-hour survival rates were compared between the two recovery groups. Results The intestinal VAP-1 protein and mRNA expressions and the serum VAP-1 and its activities in the severe hemorrhagic shock group were significantly higher than those in the sham shock group (P<0.05). Compared with the shock group, the above parameters were decreased in the recovery group, but were still higher than those in the sham group. Compared with the saline control group, 20 mg/kg 2-bromoethylamine significantly increased the blood pressure of animals 1 h and 24 h after recovery (P=0.010, 0.039), significantly improved the Chiu's score and apoptosis index of small intestinal epithelial cells (P=0.022, P=0.002), and improved the 24-hour survival rates of rats(90% to 60%). Conclusion The levels of VAP-1 and its activities are increased in severe hemorrhagic shock rats, and fluid resuscitation can inhibit this increase. Inhibition of VAP-1 activities can improve the low blood pressure, intestinal mucosa injury and apoptosis of small intestinal mucosa cells after the severe hemorrhagic shock and resuscitation, improving the 24-hour survival rates of rats.

Abstract:Objective To study the regulatory effects of long non-coding RNA HIF1A-AS1 on the myocardial ischemia reperfusion (I/R) injury and the related mechanism. Methods Myocardial I/R injury model was established with SD rats, and hypoxia reoxygenation (H/R) model was established with rat cardiac myocytes. si-HIF1A-AS1 was used to inhibit HIF1A-AS1 expression in the cardiac myoctyes. Then the mRNA expression of HIF1A-AS1 was detected by real-time PCR, the growth vitality of cardiac myocytes was investigated by MTT assay, the concentration of lactate dehydrogenase (LDH) in the culture media was detected by ELISA, and the autophagy-associated protein Beclin-1 expression was observed by Western blotting analysis. Results HIF1A-AS1 expression was increased in cardiac muscle of rat I/R model and rat cardiac myocytes of H/R model. Inhibition of HIF1A-AS1 by siRNA protected the cardiomyocytes against H/R injuries, reversing the decreased growth vitality of cardiac myoctyes, increased LDH level in the culture media, and increased expression of autophagy-related protein Beclin-1 induced by H/R stimulation. Conclusion Inhibition of long non-coding RNA HIF1A-AS1 might play a protective role in I/R injury of cardiac myoctyes by inhibiting the excessive autophagy of cardiomyocytes.

Abstract:Objective To explore the role of Vav3 gene in multidrug resistance (MDR) of gastric cancer and the related mechanism. Methods QRT-PCR was used to examine the expressions of Vav3 gene in gastric cancer tissues, tumor-adjacent tissues, human gastric cancer cell line SGC7901, and gastric epithelial cell line GES-1. Then Vav3-siRNA was synthesized and tansfected into SGC7901 cells. MTT assay was then used to determine the inhibition rates of tumor cells exposed to chemotherapeutic agents (5-FU, L-OHP) before and after Vav3-siRNA transfection. Real-time RT-PCR and Western blotting analysis were used to observe the expressions of inhibitor of apoptosis proteins (IAPs): xIAP, Survivin, and Livin; meanwhile, the expression and activity of Caspase-3 and Caspase-8 were also determined. Results Vav3 was over-expressed in gastric cancer tissues and gastric cell line compared with those in tumor-adjacent tissues and gastric epithelial cell line GES-1(P<0.05). Expression of Vav3 was significantly inhibited by Vav3-siRNA (P<0.01). Inhibition rates of tumor cells exposed to 5-FU and L-OHP were significantly increased 48 h after Vav3-siRNA tansfection (P<0.05). The expressions of xIAP and Survivin were significantly decreased in cancer cells after Vav3-siRNA tansfection (both P<0.05), and no notable change was found for Livin expression; also the expression and activity of Caspase-3 and Caspase-8 protein were significantly increased after Vav3-siRNA tansfection in SGC7901 cells (all P<0.05). Conclusion Vav3 can participate in MDR of gastric cancer by regulating apoptotic pathways, and inhibition of Vav3 can help reverse MDR of gastric cancer cells by regulating some IAPs.

Abstract:Objective To investigate the effect of aspirin (Asp) on cognitive function and the insulin-like growth factor-1 receptor/phosphorylated insulin-like growth factor-1 receptor (IGF-1R/p-IGF-1R) expression in the hippocampus of rats with diabetic encephalopathy, so as to analyze the protective mechanism of aspirin on brain. Methods Diabetes mellitus (DM) was induced by intraperitoneal injection of streptozotocin (STZ, 60 mg/kg body mass). Rats were randomly assigned to four groups (n=10 animals per group), i.e. control, control + Asp, DM, and DM + Asp groups. One week after the injection of STZ, the animals in Con+Asp and DM+Asp groups were gavaged with aspirin (10 mg/ [kg·d]) for 14 weeks. Meanwhile, the control group received the same dose of noromal saline for 14 weeks, and then the cognitive function was observed by Morris water maze (MWM) test in all rats. The expressions of IGF-1R and p-IGF-1R proteins in the hippocampus of rats were examined by Western blotting analysis. Results The cognitive function of diabetic rats was improved after treated with aspirin: the escape latency of MWM test in DM + Asp group was significantly shorter than that in DM group (P< 0.01); the number of platform crossing and time spent in the target quadrant in the MWM test were significantly more in DM + Asp group compared with those in DM group (P<0.01 or P<0.05). H-E result showed that the neurons in DM + Asp group were increased compared with that in DM group. The hippocampal expression of p-IGF-1R protein in DM group was significantly lower than that in the control group (P<0.01) and aspirin treatment significantly increased p-IGF-1R expression (P<0.01). However, the IGF-1R protein levels in the hippocampus showed no significant difference between different groups. Conclusion Aspirin may protect the brain of rats with diabetic encephalopathy by regulating the IGF-1R signaling pathway.

Abstract:Objective To investigate the effect of glucose transporter-1(GLUT1) suppression on microvasculature pathological changes in diabetic mice. Methods Thirty-six 8-week-old C57BL/6 mice were randomly divided into normal control, diabetic control and GLUT1siRNA treatment groups. Diabetic model was established by intraperitoneal injection of streptozotocin. GLUT1siRNA treatment group received intravitreal injection of siRNA-mediated GLUT1, and the other two groups received equal amount of non-specific siRNA. Twenty-one weeks after diabetic induction, immunoblotting was conducted to examine the expression of GLUT1 and two inflammation factors: ICAM-1 and TNF-α. We also calculated the retinal glucose concentration. Leukostasis assay and vascular leakage assay were utilized to compare the microvasculature pathological changes between the two groups. Results The expression of GLUT1 was significantly down-regulated in GLUT1siRNA treatment group compared with the other two groups (P<0.01), decreased by 77.00% compared with the normal control group and only being 8.07% of the diabetic control group. Though retinal glucose concentration of diabetic control and GLUT1siRNA treatment groups were higher than that of normal control, that in GLUT1siRNA treatment group was only 50.05% that of the diabetic control group (P<0.01). The expressions of ICAM-1 and TNF-α in GLUT1siRNA treatment and diabetic control were significantly higher than that in the normal control group, and their expressions in GLUT1siRNA treatment group were 66.14% (P<0.05)and 54.76% (P<0.01)those of the diabetic control group, respectively. Moreover, compared with GLUT1siRNA treatment group, diabetic control group had more adherent leukocytes in the retinal microvasculature and larger areas of leaked FITC-labeled albumin retina. Conclusion GLUT1siRNA can limit glucose transport into the retina by inhibiting GLUT1 expression, thus decrease retinal glucose concentration and alleviate microvasculature changes of diabetic retinopathy.

Abstract:Objective To observe Th9 cells and IL-9 level in adult patients with primary immune thrombocytopenia(ITP), and to discuss their potential roles in the pathogenesis of ITP. Methods A total of 25 newly diagnosed ITP patients and 25 sex- and age-matched healthy controls were enrolled in the present study. The percentage of Th9 cells in the peripheral blood samples of the two groups were detected by flow cytometry, expressions of IL-9, TGF-β, PU.1 and IRF4 mRNA were analyzed by real time-RCR, and IL-9 protein level was examined by ELISA. The platelet count was recorded by sysmex XE-2100. Results Compared with the healthy controls, the ratio of Th9 cells was significantly increased in ITP patients(P<0.05); and the ratio of Th9 cells in patients with PLT≤30×10⁹/L was significantly higher than that in patients with PLT>30×10⁹/L(P<0.05). IL-9 mRNA and protein expressions in ITP patients were significantly higher than those in the healthy controls, and those in patients with PLT≤30×10⁹/L were also significantly higher than those with PLT>30×10⁹/L(P<0.05). Compared with healthy controls, the mRNA expressions of IL-9, TGF-β, PU.1 and IRF4 were raised significantly in ITP patients(P<0.05). The ratio of Th9 cells and IL-9 protein level were negatively correlated with PLT in ITP patients(r=-0.428 1, P=0.032 8; r=-0.537 5, P=0.005 6, respectively). Furthermore, follow-up study of 11 ITP patients found that both Th9 cells and IL-9 protein levels took a declining tendency after effective treatment(P<0.05). Conclusion Abnormal activation of Th9/IL-9 may participate in the occurrence and development of ITP disease, which provides new clues for further understanding of ITP pathogenesis and selecting potential therapeutic targets in immune therapy of ITP.

Abstract:Objective To observe the effect of electro-acupuncture on reproductive endocrine and renal contents of superoxide dismutase (SOD) and malondialdehyde (MDA) in aging male (PADAM) rats with partial androgen deficiency. Methods Forty male rats were randomly divided into normal control group (n=10) and model group (n=30). Rats in the model group were injected with cyclophosphamide 20 mg/(kg·d) into the abdominal cavities to establish PADAM model. The 24 successful model rats were further randomized into electro-acupuncture, androlin treatment and blank groups; rats received corresponding treatment for 8 weeks. The general conditions of the animals were observed before and 1 day after modeling and at the end of treatment. Tail suspension experiments and exhaustion swimming tests were performed; and the serum total testosterone (TT) and free testosterone (FT) levels were determined. The contents of SOD and MDA in renal tissues were examined at the end of the experiments by hydroxylamine method. Results After treatment with cyclophosphamide, the serum levels of TT and FT in rats were significantly decreased (P<0.01), being lower than the 99% confidence interval of the normal control group, and the animals developed behaviors similar to those of PADAM, indicating successful modeling. The serum TT and FT levels in electro-acupuncture group and androlin group were significantly higher than those in the pre-therapy and blank control groups (P<0.01); the duration of immobility and exhaustion swimming were also significantly improved in the two treatment groups (P<0.01); and SOD activities in the kidney were significantly increased (P<0.01) and MDA contents were significantly decreased (P<0.01) in electro-acupuncture group and androlin group; while no significant differences were found between electro-acupuncture group and androlin group (P>0.05). Conclusion Electro-acupuncture can increase serum TT and FT levels in PADAM rats, improve the depression state, myodynamia and energy in the aging rats, with its effect being equivalent to that of testosterone propionate. Electro-acupuncture can increase SOD level and decease MDA level in PADAM rats, indicating that electro-acupuncture may function by improving the free radicals system of PADAM rats.

Abstract:Objective To investigate the intratumoral expression of the metastasis-associated in colon cancer 1 (MACC1) and to discuss the clinical relevance associated with hepatocellular carcinoma (HCC). Methods Immunohistochemistry staining was performed to assess the expressions of MACC1 protein in 108 HCC liver tissues and matched adjacent non-tumor liver tissues. Quantilative real-time PCR (qPCR) was employed to examine MACC1 mRNA expression in 30 HCC tissues and the corresponding adjacent non-tumor tissue, and 20 normal liver tissues. The association of MACC1 expression in HCC tissues with the clinicopathological and prognosis was analyzed. Results Immunohistochemistry results showed that the positive rate of MACC1 in HCC tissues was significantly higher than that in the para-carcinoma tissue (49.1% vs 34.2%, P=0.011). qPCR revealed that MACC1 mRNA expression in HCC tissues was significantly higher than that in the noncancerous liver tissues and normal liver tissues(P<0.001). One-factor analysis of variance indicated that MACC1 expression in human HCC tissue was significantly related to tumor size, presence of capsule and pathological types(P<0.05). Survival analysis disclosed that the 1-year, 3-year and 5-year survival rates were 0.650, 0.492, and 0.280 for MACC1 positive patients and 0.799, 0.684, and 0.566 for MACC1 negative patients, respectively, with significant differences found between the two groups(P=0.006). Conclusion Expression of MACC1 in HCC tissues is associated with malignancy evolution and clinical outcome of HCC patients; MACC1 may serve as an important molecule for predicting prognosis patients with hepatic cancer and a new target for gene therapy of liver cancer.

Abstract:Objective To study the validity of psychological test items for selecting the crew members for the 2014 World Tank Championship. Methods Totally 36 candidates (21-33 years old) were assessed with items in Uchida-Kraepelin test, EPQ, EP707A Fingers Flexibility Instrument, EP706 Attention Distribution Instrument and Situational Judgement test. Results The comprehensive rankings of psychological test results well fit with their rankings in the military competence, with kappa value higher than 0.75. Conclusion The five tests in this study can well predict the performance of the subjects, indicating that the involved items have satisfactory validity.

Abstract:Objective To evaluate the feasibility and safety of reconstructive treatment with multiple stents and coiling for un-ruptured vertebral artery dissection aneurysms (UVADAs). Methods A retrospective review was conducted for all the patients who underwent reconstructive treatment with multiple stents (2 or 3) and coiling for UVADAs in our department between June 2009 and April 2014; the clinical outcomes and follow-up data were analyzed to assess the feasibility and safety of reconstructive treatment with multiple stents and coiling for UVADAs. Results All patients were treated with multi-stents and coiling and the successful release rate of stents was 100%. Immediate occlusion outcome after operation was as follows: total obliteration was achieved in 8 cases, subtotal obliteration in 7 cases, partial obliteration in 23 cases; there were no intra-operative thrombosis. Angiographic followed-up outcome was as follows: one case (2.6%, 1/38) had ischemic event; 8 cases with total obliteration and 7 with subtotal obliteration had imaging cure; among the 23 cases with partial obliteration, 7 had imaging cure, 7 had improved imaging, and 8 had stable imaging. All the patients had satisfactory outcomes during a follow-up of 19-month (4-126 months), with mRS score being 0-1. Conclusion Our preliminary experience suggests that reconstructive treatment with multiple stents and coiling is feasible and safe for UVADAs, but the conclusion needs to be further verified by large sample studies.

Abstract:Objective To evaluate the feasibility and safety of superselective renal artery clamping technique in laparoscopic partial nephrectomy and to assess its short-term effect on postoperative renal function. Methods Totally 23 patients, who were diagnosed as having renal malignant tumor and treated with transperitoneal laparoscopic partial nephrectomy by the same doctor at department of urology, Changhai Hospital from June 2013 to May 2014, were included in the present study. Superselective technique and traditional renal artery clamping technique were employed in group A (10 cases) and group B (13 cases), respectively. The operation time, intraoperative blood loss, postoperative renal function and other clinical parameters were compared between the two groups. Results Compared with group B, group A had significantly increased operation time ([257.60 ± 22.03] min vs [199.08 ± 36.70] min, P<0.05), intraoperative blood loss ([220 ± 57.01] mL vs [71.54 ± 30.51] mL, P<0.05) and postoperative incision drainage ([113.33 ± 24.82] mL vs [68.08 ± 28.88] mL, P<0.05), and there were no Grade Ⅲ-Ⅳ complications such as massive bleeding or urinary leakage in the two groups. But patients in group A had slighter renal function damage postoperatively in the early stage compared with group B, as demonstrated by slighter eGFR decrease ([3.14 ± 7.22]% vs [15.26 ± 9.53]%, P<0.05) for a similar ischemic time ([28.60±8.17]) min vs ([27.85±6.16] min). Conclusion Superselective renal artery clamping does less harm to the kidney than traditional main renal artery clamping in laparoscopic partial nephrectomy, and it is worth further research for its benefit in early-stage renal function recovery postoperatively.

Abstract:Ebola virus is a highly virulent pathogen which can cause severe viral hemorrhagic fever in humans and non-human primates, with the case fatality rates being as high as 90%. Currently, there is neither a specific treatment nor a vaccine licensed for use in humans. The challenge brought by the Ebola epidemic has promoted the following research focuses: specific and sensitive detection techniques, safe and effective vaccines and drugs. Here, we summarized the epidemiology, biology and pathogenesis of ebola virus, as well as the recent advances in diagnosis and vaccines for prevention of Ebola hemorrhagic fever.

Abstract:Hydrogen sulfide (H₂S) is the third endogenous gaseous mediator following nitric oxide and carbon monoxide. It has been demonstrated that H₂S plays important regulatory roles in modulating the physiological and pathophysiological processes of the nervous system, respiratory system, digestive system, and cardiovascular system. Recently, regulatory roles of H₂S in cardiovascular system are widely focused and seem to be complex. Here we sum up the roles of H₂S in mediating the cardiovascular regulation and illustrate its underlying mechanisms and perspectives.

Abstract:Intervertebral disc degeneration (IVDD) is characterized by the excessive degradation of extracellular matrix (ECM), which underlies many spine-related disorders. Matrix metalloproteinases (MMPs) and a disintegrin metalloproteinases with thrombospondin motifs (ADAMTSs) are believed to be the major proteolytic enzymes responsible for ECM degradation. This review summarizes the current literatures on gene expression and regulation of MMPs, ADAMTSs, and tissue inhibitors of metalloproteinases (TIMPs) in IVDD. Reports have showen that specific MMPs (MMP-1, -2, -3, -7, -8, -10, and -13) and ADAMTS (ADAMTS-1, -4, and -15) are upregulated in human degenerated intervertebral discs. Tissue inhibitor of metalloproteinase-3 is downregulated and TIMP-1 is upregulated in human degenerated intervertebral discs relative to nondegenerated intervertebral discs. Regulation of the MMP and ADAMTS expression is affected by many factors including mechanical, inflammatory, oxidative stress, and so on. Genetic predisposition also plays an important role in expression of MMP-1, -2, -3, and -9. Upregulation of MMP and ADAMTS expression is implicated in ECM destruction, which can lead to the development of IVDD. Future IVDD therapeutics may target specific MMPs and ADAMTSs which is essential in the pathological proteolysis of ECM.

Abstract:Objective To discuss the clinical value of diluted contrast enhanced Dyna CT in evaluating direct carotid-cavernous fistula(DCCF). Methods The clinical data of 16 patients with traumatic and solo fistulous DCCF were retrospectively studied. The images by 3D rotatory digital subtraction angiography (3D-DSA) and diluted contrast enhanced Dyna CT were used for comparison and analysis of their values for diagnosis of DCCF. The comparison items included information on the orificium fistulae, the retrograde leptomeningeal venous drainage (RLVD), the draining veins and the compartment of the cavernous sinus. Results Compared with 3D rotatory DSA, Dyna CT demonstrated 21 more findings in 15 patients (93.75%), including the detection of the orificium fistulae (n=8), the RLVD (n=2), the draining veins (n=2), and compartment of the cavernous sinus (n=9), with significant difference found between Dyna CT and 3D-DSA in revealing the orificium fistulae and compartment of the cavernous sinus (P<0.05), while not in revealing RLVD and the draining veins. Conclusion Compared with 3D-DSA, Dyna CT can more effectively demonstrate the orificium fistulae and compartment of the cavernous sinus of DCCF, which may benefit the clinical diagnosis and treatment of DCCF.

Abstract:Objective To evaluate the efficacy and safety of the robotic-assistant laparoscopic pyeloplasty(RALP) combined with flexible ureteroscopy(f-URS) for treatment of ureteropelvic junction obstruction(UPJO) with renal stones. Methods We retrospectively reviewed the records of 5 patients who underwent RALP and f-URS for UPJO combined with renal stones from May 2012 to August 2013.Three cases had solitary stones located at the lower calyx, and the other two had multiple stones. Results The operation was successful in all the 5 patients with no severe complications. The average total operation time was (132.4±24.8) min and the average f-URS time was (25.4±11.9) min. f-URS had full views of the collecting system with no blind area in all cases. Post-operative KUB and CT scan showed no residual stone fragments. The symptoms were greatly relieved in all patients after a 6-month follow-up postoperatively, with one patient still having 2 cm hydronephrosis; and the UPJO outcomes were satisfactory in the others. Conclusion Hybrid RALP combined with f-URS is safe and feasible for treatment of UPJO complicated with renal stones.

Abstract:Objective To evaluate the clinicopathological features and prognosis of patients with bladder neoplasm aged between 20 and 30 years old. Methods The clinical data of the patients with bladder tumors aged 20-30 years old, who were treated from Jan. 2009 to March 2014, were retrospectively analyzed. The general information, clinical manifestations, diagnostic essentials, pathological outcomes, treatment strategies and prognoses were analyzed. Results A total of 20 patients were included in this study, which accounted for 1.22%(20/1 645) of all the bladder neoplasm cases in our hospital during the same period. The mean age of the 20 patients was (25.8±3.1) years old, including 13 males and 7 females. Gross hematuria as the main clinical symptoms were found in 10 patients, 6 patients were detected accidently due to non-hematuria symptoms, and 4 patients were diagnosed during the health checkup. There were 2 multifocal and 18 solitary tumors, with the total number of tumors being 24, including 15 in the lateral bladder wall, 3 in the posterior wall, 1 in the anterior wall, 3 in the trigone and 2 in the bladder neck. Two tumors in patients with hematuria were missed by ultrasound. The maximum diameters of tumors measured by ultrasound ranged from 0.4 cm to 2.7 cm (mean [1.1±0.7] cm). The detection rate of cystoscopy for tumors was 100%. The pathological results found 1 paraganglioma and 19 urothelial neoplasms, including 2 urothelial flat lesions and 17 papillary urothelial neoplasms. Of the 20 patients, 19 received transurethral resection of bladder tumor, 1 underwent exploratory laparotomy after four-cycles of neoadjuvant chemotherapy with gemcitabine and cisplatin. Sixteen patients were followed-up for 3 months to 5 years (mean [28±16] months). Three patients had recurrence, with one progressed to muscle invasive carcinoma. Conclusion Bladder neoplasms in patients aged 20-30 years old are usually solitary, of low grade and low stage; meanwhile, there is a possibility of highly aggressive disease. It is noteworthy that a good few of patients are asymptomatic. The long-term follow-up is crucial for all these patients.

Abstract:Objective To investigate the prevalence of thyroid nodules in elderly patients (age≥80 years) with type 2 diabetes mellitus (T2DM), and to analyze the correlation between thyroid nodules and type 2 diabetes mellitus. Methods The study included two groups: one group included 103 patients with T2DM (diabetic group) and the other group included 103 patients without T2DM (control group). Information including clinical history, fasting plasma glucose(FPG), thyroid hormone, and ultrasonic finding of thyroid glands was collected for both groups. The clinical features of thyroid nodules were compared between the two groups and their relationship with other indices was analyzed. Results (1)The prevalence rate of thyroid nodules in diabetic group was greatly higher than that of the control group (84.47% vs 70.59%). The proportion of patients with multiple nodules was as high as 80.46% in the diabetic group. Presence of thyroid nodule was significantly associated with patient ages (χ²=7.060, P<0.05), but not with gender, body mass index (BMI), or serum glucose level. (2) The positive rate of thyroid dysfunction in the diabetic group was significantly higher than that in the control group (15.53% vs 6.80%, P<0.05). The prevalence rates of sub-clinical hypothyroidism were similar between the two groups. T₃ and T₄ levels of thyroid function in the diabetic group were significantly lower than those in the control group (P<0.05), and the thyroid stimulating hormone (TSH) levels were similar between the two groups. Conclusion Elderly patients (age≥80 years) have a higher liability for thyroid disease, which may affect the control and prognosis of diabetes. It is recommended for those patients to receive regular check-up for thyroid function and morphology changes.

Abstract:Objective To investigate the prevalence of metabolic syndrome (MS) in permanent residents aged 55 or above in a community in Yangpu District, Shanghai, and to analyze its association with smoking, alcohol consumption, and outdoor activities. Methods By cluster random sampling, the residents were selected from one community in Yangpu district between January and December 2013 to answer questionnaire and receive physical examination and relevant laboratory assessment. The factors of MS were also analyzed. Results A total of 1 002 participants finally answered the questionnaire and finished other tests. According to the diagnostic criteria in T2DM Prevention & Treatment Chinese Guideline 2010, the prevalence of MS was 18.66% in this study, with the prevalence being 17.70%(120/678) in female and 20.68%(67/324) in male. Univariate analysis and multivariate analysis suggested that overweight, hypertension, diabetes history, increased LDL-C and smoking history were the associated risk factors of MS (P<0.05). Conclusion The middle and old aged residents have high prevalence of MS in the community population of this study. Overweight, hypertension, diabetes history, high LDL-C and smoking history are the risk factors for MS morbidity, suggesting that weight control and smoking cessation may be early intervention for preventing MS.

Abstract:Objective To discuss the timing of surgery, operation strategy and technique of upgrading chronically right ventricle-paced heart failure patients to cardiac resynchronization therapy. Methods Six chronically right ventricle-paced heart failure patients underwent surgery of upgrading to CRT in our department between March 2009 to February 2014. The clinical characteristics, surgical techniques and follow-up data were retrospectively analyzed. Results Six patients, including single-chamber pacemaker (VVI) 2 cases, dual-chamber pacemaker (DDD) 4 cases, were successfully complete the upgrade operation, no complications. In two cases which original pacemaker pockets were on the left, the left ventricular electrodes were implanted through the left subclavian vein, without subcutaneous tunnel. In 4 cases which original pacemaker pockets were on the right, the left ventricular electrodes implanted through the right internal jugular vein in 2 patients, running in the subcutaneous tunnel from right internal jugular vein to the right chest, while in other 2 cases, the left ventricular electrodes implanted through Left subclavian vein, running in the subcutaneous tunnel from the right chest to the left chest. There were a total of 10 primary electrode wires, the two wires were removed, the eight were continued to use. Follow-up data showed that in the postoperative 3 days, compared with admission, CRT significantly reduced the mean ORS duration(P＜0.05)and BNP(P＜0.05),while left ventricular end-diastolic diameter, ejection fraction and NYHA class no significant changes. In the postoperative 3 months, CRT significantly reduced the mean ORS duration and BNP, and increased the LV ejection fraction, left ventricular end-diastolic diameter were reduced significantly, the patients cardiac function was improved by an average of one grade of NYHA functional class. Conclusion Correct preoperative operation strategy and intraoperative operation skills is the key of upgrading chronically right ventricle-paced to cardiac resynchronization therapy,Upgrade surgery can significantly improve the synchronization of left and right ventricular contraction, improve heart function and quality of life.