AIMTo study the diagnostic accuracy of transient elastography (TE) for detecting clinically significant portal hypertension (CSPH) in Indian patients with cirrhotic portal hypertension.METHODSThis retrospective study ...AIMTo study the diagnostic accuracy of transient elastography (TE) for detecting clinically significant portal hypertension (CSPH) in Indian patients with cirrhotic portal hypertension.METHODSThis retrospective study was conducted at the Institute of Liver, Gastroenterology, and Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, on consecutive patients with cirrhosis greater than 15 years of age who underwent hepatic venous pressure gradient (HVPG) and TE from July 2011 to May 2016. Correlation between HVPG and TE was analyzed using the Spearman’s correlation test. Receiver operating characteristic (ROC) curves were prepared for determining the utility of TE in predicting various stages of portal hypertension. The best cut-off value of TE for the diagnosis of CSPH was obtained using the Youden index.RESULTSThe study included 326 patients [median age 52 (range 16-90) years; 81% males]. The most common etiology of cirrhosis was cryptogenic (45%) followed by alcohol (34%). The median HVPG was 16.0 (range 1.5 to 30.5) mmHg. Eighty-five percent of patients had CSPH. A significant positive correlation was noted between TE and HVPG (rho 0.361, P < 0.001). The area under ROC curve for TE in predicting CSPH was 0.740 (95%CI: 0.662-0.818) (P < 0.01). A cut-off value of TE of 21.6 kPa best predicted CSPH with a positive predictive value (PPV) of 93%.CONCLUSIONTE has a fair positive correlation with HVPG; thus, TE can be used as a non-invasive modality to assess the degree of portal hypertension. A cut-off TE value of 21.6 kPa identifies CSPH with a PPV of 93%.展开更多
Regional portal hypertension is a rare cause of upper gastrointestinal bleeding.We reported an extremely rare case in which regional portal hypertension was associated with both the splenic arteriovenous fistula and c...Regional portal hypertension is a rare cause of upper gastrointestinal bleeding.We reported an extremely rare case in which regional portal hypertension was associated with both the splenic arteriovenous fistula and chronic pancreatitis.In June 2010,our patient,a 41-year-old man,was admitted to a local hospital due to a sudden melena and dizziness without haematemesis and jaundice.The splenic arteriovenous fistula in this patient was successfully occluded through transcatheter arterial embolization.At the 12-mo follow-up,our patient was in good condition.展开更多
AIM:Adrenomedullin (ADM) is a potent vasodilator peptide. ADM and nitric oxide (NO) are produced in vascular endothelial cells.Increased ADM level has been linked to hyperdynamic circulation and arterial vasodilatatio...AIM:Adrenomedullin (ADM) is a potent vasodilator peptide. ADM and nitric oxide (NO) are produced in vascular endothelial cells.Increased ADM level has been linked to hyperdynamic circulation and arterial vasodilatation in cirrhotic portal hypertension (CPH).The role of ADM in non-cirrhotic portal hypertension (NCPH) is unknown,plasma ADM levels were studied in patients with NCPH,compensated and decompensated cirrhosis in order to determine its contribution to portal hypertension (PH) in these groups. METHODS:There were 4 groups of subjects.Group 1 consisted of 27 patients (F/M:12/15) with NCPH due to portal and/or splenic vein thrombosis (mean age:41±12 years),group 2 consisted of 14 patients (F/M:6/8) with compensated (Child-Pugh A) cirrhosis (mean age:46±4), group 3 consisted of 16 patients (F/M:6/10) with decompensated (Child-Pugh C) cirrhosis (mean age:47±12). Fourteen healthy subjects (F/M:6/8) (mean age:44±8) were used as controls in Group 4.ADM level was measured by ELISA.NO was determined as nitrite/nitrate level by chemoluminescence. RESULTS:ADM level in Group 1 (236±61.4 pg/mL) was significantly higher than that in group 2 (108.4±28.3 pg/mL) and group 4 (84.1±31.5 pg/mL) (both P<0.0001) but was lower than that in Group3 (324±93.7 pg/mL) (P=0.002).NO level in group 1 (27±1.4 μmol/L) was significantly higher than that in group 2 (19.8±2.8 μmol/L) and group 4 (16.9±1.6 μmol/L) but was lower than that in Group 3 (39±3.6 μmol/L) (for all three P<0.0001).A strong correlation was observed between ADM and NO levels (r=0.827,P<0.0001). CONCLUSION:Adrenomedullin and NO levels were high in both non-cirrhotic and cirrhotic portal hypertension and were closely correlated,Adrenomedullin and NO levels increased proportionally with the severity of cirrhosis,and were significantly higher than those in patients with NCPH. Portal hypertension plays an important role in the increase of ADM and NO.Parenchymal damage in cirrhosis may contribute to the increase in these parameters.展开更多
In bilateral pbeochromocytoma, localization of the dominant adrenal is challenging but highly important since the removal of dominant side can markedly improve cardiovascular outcomes. To demonstrate the usefulness of...In bilateral pbeochromocytoma, localization of the dominant adrenal is challenging but highly important since the removal of dominant side can markedly improve cardiovascular outcomes. To demonstrate the usefulness of glucagon-stimulated BAVS (bilateral adrenal venous sampling) in determining the dominant adrenal to be removed, the authors reviewed records of patients who underwent BAVS with glucagon stimulation from 1997-2010. Nineteen out of 44 patients were diagnosed with bilateral pheochromocytoma. Mean age at diagnosis was 33 ± 14 years. Duration of hypertension was 5 ± 6 years with highest systolic BP (blood pressure) of 186 ±30 mmHg and diastolic BP of 113 ±18 mmHg. Headache (68%) is the most common symptom followed by paroxysmal hypertension (58%). Majority were taking 〉 3 anti-hypertensive drugs. On glucagon-stimulated BAVS, 63% had right adrenal dominance. Three patients, who were hypertensive for 1, 6 and 12 years, underwent removal of the dominant adrenal. On follow-up (mean period = 36 months), there was marked improvement in BP control [pre-op vs. post-op: (systolic) 160-240 mmHg vs. 120-150 mmHg; (diastolic) 90-110 mmHg vs. 70-90 mmHg] and reduction in number of anti-hypertensive medications (from 3-5 to 2 classes of drugs). BAVS with glucagon stimulation is a valuable tool in the identification of the dominant adrenal to be removed in patients with bilateral pheochromocytoma to alleviate chronic hypertension.展开更多
Objective The aims of the present study were to investigate the associations of 46 A〉G, 79 C〉G, 491 C〉T and 659 C〉G genetic variants of the human beta 2-adrenergic receptor (β2-AR), ADRB2, gene with essential h...Objective The aims of the present study were to investigate the associations of 46 A〉G, 79 C〉G, 491 C〉T and 659 C〉G genetic variants of the human beta 2-adrenergic receptor (β2-AR), ADRB2, gene with essential hypertension (EH) in Xinjiang Kazakans population.Methods A gender-matched case-control (271 hypertensive cases and 267 normotensive controls) study was used to investigate the associations of the four variations in the coding region of ADRB2 with EH. The genotypes of the variants were identified by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) methods. Results 46 A〉G, 79 C〉G and 659 C〉G polymorphisms were common in the Kazakan population, but 491 C〉T was a mutation (frequency ofT allele was only 0.003) and only found in EH group. The fxequency distributions of genotypes and alleles for 659 C〉G between the EH and control groups was significantly different (P〈0.05), while those for 46 A〉G and 79 C〉G polymorphisms were not statistically different. Logistic regression analysis suggested that the G allele of 659 C〉G polymorphism was a risk factor for hypertension (minor allele vs common homo; odds ratio, 13.240, 95% CI, 4.052-43.274; P〈0.05). Covariance analysis showed that systolic and diastolic blood pressure levels in GG+CG group of 659 C〉G were significantly higher than those in the CC group, but no significant difference of blood pressure were found between common homo and minor allele for 46 A〉G and 79C〉G polymorphisms. Haplotype analysis showed that two hyplotypes, HI: 46A-79C-491C-523C(48%)and H5:46A-79C-491C-659G, were associated with EH.Conelusion ADRB2 genetic variants may play independent roles in the molecular genetic mechanism of EH in Xinjiang Kazakans population (d Geriatr Cardio12010; 7:52-57).展开更多
Objective: To explore the direct and/or the enhancing antihypertensive effects of wind-dispelling herbs involvingFangfeng (Saposhnikoviae Radix) and Baizhi (Angelicae dahuricae Radix) using liver-yang hyperactivi...Objective: To explore the direct and/or the enhancing antihypertensive effects of wind-dispelling herbs involvingFangfeng (Saposhnikoviae Radix) and Baizhi (Angelicae dahuricae Radix) using liver-yang hyperactivity renalhypertension rat. Methods: Model rats with hyperactivity of liver-yang hyperactivity were prepared using male SD rats.Once successful, the rats were randomly divided into groups and given medicine by gavage for 4 weeks. Blood wascollected from the abdominal aorta to prepare serum. Serum nitric oxide (NO) concentration was determined bychemical colorimetry. The contents of ET, TXB2 and 6-K-PGF1a were determined by enzyme linked immunosorbentassay (ELISA). Results: Compared with the control model group, the blood pressure, serum ET and TXB2 of rats in thewind dispelling medicine group was not significantly reduced, while those of rats in captopril group, Tianma GoutengDecoction I group (TGD group) decreased significantly (P 〈0.05 for both). Interestingly, the blood pressure, serum ETand TXB2 of rats in the combination group (wind dispelling medicine & TGD) decreased significantly compared withboth wind dispelling medicine group and TGD group. Meanwhile, the levels of serum NO and 6- K-PGF1a in thecombination group was much higher than those in the wind dispelling medicine group or TGD group (P 〈0.05 for both).However, the levels of serum NO and 6- K-PGF1a in the wind dispelling medicine group was not significantly increasedcompared with the model group. Conclusion: There is no direct pressure lowering effects of wind dispelling medicinealone, while wind dispelling medicine could potentiates the antihypertensive effects of Tianma Gouteng Decoction I.Besides, the synergistic effects may be related to decreased ET and TXB2 levels and the increased NO and 6- K-PGF1alevels.展开更多
Diesel spray is injected at high pressure. So, upper stream region of spray is high Weber number condition. However, even if the fuel is injected at high pressure, the downstream region of spray is corresponding to re...Diesel spray is injected at high pressure. So, upper stream region of spray is high Weber number condition. However, even if the fuel is injected at high pressure, the downstream region of spray is corresponding to relatively low Weber number condition. Thus, KH (Kelvin-Helmholtz) model modeled for high Weber number conditions and MTAB (modified Taylor analogy breakup) model are used for primary and secondary breakup processes respectively. This study is focused on the development of new hybrid breakup model The calculations are performed by LES (large eddy simulation) incorporated into KIVA code. LES of non-evaporating diesel spray are performed using KH & RT (Rayleigh-Taylor) model, MTAB model and KH-MTAB model. Then, LES with these models were compared with experimental results. As the result, the availability of KH-MTAB model is showed. It is found that KH-MTAB is good agreement with experimental results of penetration and SMD (Sauter mean diameter) in relatively low density conditions.展开更多
OBJECTIVE: To investigate the role of adrenomedullin (AM) in the development of hypoxic pulmonary hypertension (HPH), and to assess the expression of AM and adrenomedullin receptor (AMR) in the lungs of rats with HPH....OBJECTIVE: To investigate the role of adrenomedullin (AM) in the development of hypoxic pulmonary hypertension (HPH), and to assess the expression of AM and adrenomedullin receptor (AMR) in the lungs of rats with HPH. METHODS: We exposed 10 rats to normobaric hypoxic conditions for 3 weeks to establish rat model of pulmonary hypertension; and 10 other rats were used as normoxic controls. Mean pulmonary arterial pressure (mPAP) was measured by a right cardiac catheterization. The thickness of pulmonary arterioles was measured by a computerized image analyzer. We used the reverse transcription-polymerase chain reaction (RT-PCR) to assess the change of expression of AM and AMR in lung of HPH rat model. RESULTS: Compared with the control group, hypoxic rats developed remarkable pulmonary hypertension, increment in the thickness of pulmonary arterioles and right ventricular hypertrophy (P展开更多
Objective: To compare the antihypertensive effects of tuina at Taichong (LR 3), Neiguan (PC 6) and Qiaogong (Extra) to screen the best tuina protocol for primary hypertension due to liver-fire flaming-up. Methods: A t...Objective: To compare the antihypertensive effects of tuina at Taichong (LR 3), Neiguan (PC 6) and Qiaogong (Extra) to screen the best tuina protocol for primary hypertension due to liver-fire flaming-up. Methods: A total of 102 patients with primary hypertension due to liver-fire flaming-up were randomly divided into a Taichong (LR 3) group, a Neiguan (PC 6) group and a Qiaogong (Extra) group according to the random number table, with 34 cases in each group. Patients in the three groups received 4-week tuina treatment with the corresponding acupoint respectively. The blood pressure was recorded by ben chtop mercury sphygmoma no meter before tuina, immediately after tuina treatment, 30 min and 60 min after tuina treatment with the patient in a supine position in a quiet treatment room. The total effective rate was observed. Results: The systolic and diastolic blood pressures of the three groups all decreased after treatment (all P<0.05). The decrease of systolic and diastolic blood pressure at different time points after treatment in the Qiaogong (Extra) group and the Taichong (LR 3) group were better than those in the Neiguan (PC 6) group (all P<0.05). Qiaogong (Extra) group had the highest total effective rate though there was no statistical differenee in the total effective rate among the three groups (P>0.05). Con elusion: Treati ng primary hypertensi on due to liver-fire flami ng-up with tuina at Taich ong (LR 3), Neigua n (PC 6) and Qiaogong (Extra) can reduce systolic and diastolic blood pressure respectively, among which Qiaogong (Extra) has the highest total effective rate.展开更多
Purpose: Renal denervation (RD) has been demonstrated to be an effective approach to reduce blood pressure for those with resistant hypertension. Yet, we aimed to explore the effect and possible mech- anism of RD o...Purpose: Renal denervation (RD) has been demonstrated to be an effective approach to reduce blood pressure for those with resistant hypertension. Yet, we aimed to explore the effect and possible mech- anism of RD on blood-pressure response to hemorrhagic shock in spontaneously hypertensive rats. Methods: A total of 48 male spontaneously hypertensive rats were randomized to three groups: study group, sham-operation group and control group. RD was achieved by cutting off renal nerves and swabbing phenol on it. Ten weeks after RD, 8 rats in each group were sacrificed to collect the kidney and heart tissues. The remaining rats were subjected to an operation to induce hemorrhagic shock which would lead to 40% loss of total blood volume, and observed for 120 min. The serum concentration of norepinephrine was measured before and three weeks after RD. Results: The blood-pressure and norepinephrine levels were reduced significantly after RD (p 〈 0.05), Systolic blood pressure and diastolic blood pressure of the surgerygroup were higher than those in the sham and control groups at 15, 30 and 45 min after hemorrhagic shock (p 〈 0.05), while no significant difference was observed at 60, 90 and 120 min (p 〉 0.05). Additionally, the beta-1 adrenergic receptor (β1 -AR) in the study group was significantly higher than those in the other two groups (p 〈 0.05) after hemorrhagic shock. Conclusion: This study demonstrated that RD could to some extent improve blood-pressure response to hemorrhagic shock in an established model of severe hemorrhagic shock in spontaneously hypertensive rats. The mechanism might be associated with uo-regulation of β1-AR.展开更多
Autoimmune activities have been implicated in the pathogenesis of hypertension.High levels of autoantibodies against the second extracellular loop of α1-adrenoceptor(α1-AR autoantibody,α1-AA) are found in patients ...Autoimmune activities have been implicated in the pathogenesis of hypertension.High levels of autoantibodies against the second extracellular loop of α1-adrenoceptor(α1-AR autoantibody,α1-AA) are found in patients with hypertension,and α1-AA could exert a α1-AR agonist-like vasoconstrictive effect.However,whether the vasoconstrictive effect of α1-AA is enhanced in hypertension is unknown.Using aortic rings of spontaneously hypertensive rats(SHR) and normotensive Wistar-Kyoto(WKY) rats,we observed the vasoconstrictive responses to α1-AA with phenylephrine(α1-AR agonist) as a positive control drug.Aortic nitrotyrosine levels were also measured by ELISA and immunohistochemistry.The results showed that the aortic constrictive responses to α1-AA and phenylephrine(both 1 nmol L-1-10 μmol L-1) were greater in SHR than in WKY rats.Endothelial denudation or L-NAME(a non-selective NOS inhibitor)(100 μmol L-1) increased α1-AA- or phenylephrine-induced vasoconstrictions both in SHR and WKY.However,selective iNOS inhibitor 1400W(10 μmol L-1) enhanced the α1-AA-induced aortic constriction in WKY,but not in SHR.The aortic nitrotyrosine level was significantly higher in SHR than WKY,as shown by both ELISA and immunohistochemistry.These results indicate that the vasoconstrictive response to α1-AA is enhanced in SHR,and this altered responsiveness is due to endothelial dysfunction and decreased NO bioavailability.The study suggests an important role of α1-AR autoimmunity in the pathogenesis and management of hypertension especially in those harboring high α1-AA levels.展开更多
Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom. Here we reported a case of compartment syndrome in the upper limb followi...Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom. Here we reported a case of compartment syndrome in the upper limb following an adder bite in the thenar eminence. Elevated compartment pressure was documented and immediate surgical fasciotomy was practiced. The patient achieved complete recovery with a good functional result. We discussed the controversies on fasciotomy and non-invasive measures in such a situation, and recommended intracompartmental pressure monitoring during the management of compartment syndrome following adder bites.展开更多
文摘AIMTo study the diagnostic accuracy of transient elastography (TE) for detecting clinically significant portal hypertension (CSPH) in Indian patients with cirrhotic portal hypertension.METHODSThis retrospective study was conducted at the Institute of Liver, Gastroenterology, and Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, on consecutive patients with cirrhosis greater than 15 years of age who underwent hepatic venous pressure gradient (HVPG) and TE from July 2011 to May 2016. Correlation between HVPG and TE was analyzed using the Spearman’s correlation test. Receiver operating characteristic (ROC) curves were prepared for determining the utility of TE in predicting various stages of portal hypertension. The best cut-off value of TE for the diagnosis of CSPH was obtained using the Youden index.RESULTSThe study included 326 patients [median age 52 (range 16-90) years; 81% males]. The most common etiology of cirrhosis was cryptogenic (45%) followed by alcohol (34%). The median HVPG was 16.0 (range 1.5 to 30.5) mmHg. Eighty-five percent of patients had CSPH. A significant positive correlation was noted between TE and HVPG (rho 0.361, P < 0.001). The area under ROC curve for TE in predicting CSPH was 0.740 (95%CI: 0.662-0.818) (P < 0.01). A cut-off value of TE of 21.6 kPa best predicted CSPH with a positive predictive value (PPV) of 93%.CONCLUSIONTE has a fair positive correlation with HVPG; thus, TE can be used as a non-invasive modality to assess the degree of portal hypertension. A cut-off TE value of 21.6 kPa identifies CSPH with a PPV of 93%.
基金Supported by The National Natural Science Foundation of China,No.81171444
文摘Regional portal hypertension is a rare cause of upper gastrointestinal bleeding.We reported an extremely rare case in which regional portal hypertension was associated with both the splenic arteriovenous fistula and chronic pancreatitis.In June 2010,our patient,a 41-year-old man,was admitted to a local hospital due to a sudden melena and dizziness without haematemesis and jaundice.The splenic arteriovenous fistula in this patient was successfully occluded through transcatheter arterial embolization.At the 12-mo follow-up,our patient was in good condition.
文摘AIM:Adrenomedullin (ADM) is a potent vasodilator peptide. ADM and nitric oxide (NO) are produced in vascular endothelial cells.Increased ADM level has been linked to hyperdynamic circulation and arterial vasodilatation in cirrhotic portal hypertension (CPH).The role of ADM in non-cirrhotic portal hypertension (NCPH) is unknown,plasma ADM levels were studied in patients with NCPH,compensated and decompensated cirrhosis in order to determine its contribution to portal hypertension (PH) in these groups. METHODS:There were 4 groups of subjects.Group 1 consisted of 27 patients (F/M:12/15) with NCPH due to portal and/or splenic vein thrombosis (mean age:41±12 years),group 2 consisted of 14 patients (F/M:6/8) with compensated (Child-Pugh A) cirrhosis (mean age:46±4), group 3 consisted of 16 patients (F/M:6/10) with decompensated (Child-Pugh C) cirrhosis (mean age:47±12). Fourteen healthy subjects (F/M:6/8) (mean age:44±8) were used as controls in Group 4.ADM level was measured by ELISA.NO was determined as nitrite/nitrate level by chemoluminescence. RESULTS:ADM level in Group 1 (236±61.4 pg/mL) was significantly higher than that in group 2 (108.4±28.3 pg/mL) and group 4 (84.1±31.5 pg/mL) (both P<0.0001) but was lower than that in Group3 (324±93.7 pg/mL) (P=0.002).NO level in group 1 (27±1.4 μmol/L) was significantly higher than that in group 2 (19.8±2.8 μmol/L) and group 4 (16.9±1.6 μmol/L) but was lower than that in Group 3 (39±3.6 μmol/L) (for all three P<0.0001).A strong correlation was observed between ADM and NO levels (r=0.827,P<0.0001). CONCLUSION:Adrenomedullin and NO levels were high in both non-cirrhotic and cirrhotic portal hypertension and were closely correlated,Adrenomedullin and NO levels increased proportionally with the severity of cirrhosis,and were significantly higher than those in patients with NCPH. Portal hypertension plays an important role in the increase of ADM and NO.Parenchymal damage in cirrhosis may contribute to the increase in these parameters.
文摘In bilateral pbeochromocytoma, localization of the dominant adrenal is challenging but highly important since the removal of dominant side can markedly improve cardiovascular outcomes. To demonstrate the usefulness of glucagon-stimulated BAVS (bilateral adrenal venous sampling) in determining the dominant adrenal to be removed, the authors reviewed records of patients who underwent BAVS with glucagon stimulation from 1997-2010. Nineteen out of 44 patients were diagnosed with bilateral pheochromocytoma. Mean age at diagnosis was 33 ± 14 years. Duration of hypertension was 5 ± 6 years with highest systolic BP (blood pressure) of 186 ±30 mmHg and diastolic BP of 113 ±18 mmHg. Headache (68%) is the most common symptom followed by paroxysmal hypertension (58%). Majority were taking 〉 3 anti-hypertensive drugs. On glucagon-stimulated BAVS, 63% had right adrenal dominance. Three patients, who were hypertensive for 1, 6 and 12 years, underwent removal of the dominant adrenal. On follow-up (mean period = 36 months), there was marked improvement in BP control [pre-op vs. post-op: (systolic) 160-240 mmHg vs. 120-150 mmHg; (diastolic) 90-110 mmHg vs. 70-90 mmHg] and reduction in number of anti-hypertensive medications (from 3-5 to 2 classes of drugs). BAVS with glucagon stimulation is a valuable tool in the identification of the dominant adrenal to be removed in patients with bilateral pheochromocytoma to alleviate chronic hypertension.
文摘Objective The aims of the present study were to investigate the associations of 46 A〉G, 79 C〉G, 491 C〉T and 659 C〉G genetic variants of the human beta 2-adrenergic receptor (β2-AR), ADRB2, gene with essential hypertension (EH) in Xinjiang Kazakans population.Methods A gender-matched case-control (271 hypertensive cases and 267 normotensive controls) study was used to investigate the associations of the four variations in the coding region of ADRB2 with EH. The genotypes of the variants were identified by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) methods. Results 46 A〉G, 79 C〉G and 659 C〉G polymorphisms were common in the Kazakan population, but 491 C〉T was a mutation (frequency ofT allele was only 0.003) and only found in EH group. The fxequency distributions of genotypes and alleles for 659 C〉G between the EH and control groups was significantly different (P〈0.05), while those for 46 A〉G and 79 C〉G polymorphisms were not statistically different. Logistic regression analysis suggested that the G allele of 659 C〉G polymorphism was a risk factor for hypertension (minor allele vs common homo; odds ratio, 13.240, 95% CI, 4.052-43.274; P〈0.05). Covariance analysis showed that systolic and diastolic blood pressure levels in GG+CG group of 659 C〉G were significantly higher than those in the CC group, but no significant difference of blood pressure were found between common homo and minor allele for 46 A〉G and 79C〉G polymorphisms. Haplotype analysis showed that two hyplotypes, HI: 46A-79C-491C-523C(48%)and H5:46A-79C-491C-659G, were associated with EH.Conelusion ADRB2 genetic variants may play independent roles in the molecular genetic mechanism of EH in Xinjiang Kazakans population (d Geriatr Cardio12010; 7:52-57).
文摘Objective: To explore the direct and/or the enhancing antihypertensive effects of wind-dispelling herbs involvingFangfeng (Saposhnikoviae Radix) and Baizhi (Angelicae dahuricae Radix) using liver-yang hyperactivity renalhypertension rat. Methods: Model rats with hyperactivity of liver-yang hyperactivity were prepared using male SD rats.Once successful, the rats were randomly divided into groups and given medicine by gavage for 4 weeks. Blood wascollected from the abdominal aorta to prepare serum. Serum nitric oxide (NO) concentration was determined bychemical colorimetry. The contents of ET, TXB2 and 6-K-PGF1a were determined by enzyme linked immunosorbentassay (ELISA). Results: Compared with the control model group, the blood pressure, serum ET and TXB2 of rats in thewind dispelling medicine group was not significantly reduced, while those of rats in captopril group, Tianma GoutengDecoction I group (TGD group) decreased significantly (P 〈0.05 for both). Interestingly, the blood pressure, serum ETand TXB2 of rats in the combination group (wind dispelling medicine & TGD) decreased significantly compared withboth wind dispelling medicine group and TGD group. Meanwhile, the levels of serum NO and 6- K-PGF1a in thecombination group was much higher than those in the wind dispelling medicine group or TGD group (P 〈0.05 for both).However, the levels of serum NO and 6- K-PGF1a in the wind dispelling medicine group was not significantly increasedcompared with the model group. Conclusion: There is no direct pressure lowering effects of wind dispelling medicinealone, while wind dispelling medicine could potentiates the antihypertensive effects of Tianma Gouteng Decoction I.Besides, the synergistic effects may be related to decreased ET and TXB2 levels and the increased NO and 6- K-PGF1alevels.
文摘Diesel spray is injected at high pressure. So, upper stream region of spray is high Weber number condition. However, even if the fuel is injected at high pressure, the downstream region of spray is corresponding to relatively low Weber number condition. Thus, KH (Kelvin-Helmholtz) model modeled for high Weber number conditions and MTAB (modified Taylor analogy breakup) model are used for primary and secondary breakup processes respectively. This study is focused on the development of new hybrid breakup model The calculations are performed by LES (large eddy simulation) incorporated into KIVA code. LES of non-evaporating diesel spray are performed using KH & RT (Rayleigh-Taylor) model, MTAB model and KH-MTAB model. Then, LES with these models were compared with experimental results. As the result, the availability of KH-MTAB model is showed. It is found that KH-MTAB is good agreement with experimental results of penetration and SMD (Sauter mean diameter) in relatively low density conditions.
基金ThisworkwassupportedbyagrantfromNationalNaturalScienceFoundationofChina (No 39770 339)
文摘OBJECTIVE: To investigate the role of adrenomedullin (AM) in the development of hypoxic pulmonary hypertension (HPH), and to assess the expression of AM and adrenomedullin receptor (AMR) in the lungs of rats with HPH. METHODS: We exposed 10 rats to normobaric hypoxic conditions for 3 weeks to establish rat model of pulmonary hypertension; and 10 other rats were used as normoxic controls. Mean pulmonary arterial pressure (mPAP) was measured by a right cardiac catheterization. The thickness of pulmonary arterioles was measured by a computerized image analyzer. We used the reverse transcription-polymerase chain reaction (RT-PCR) to assess the change of expression of AM and AMR in lung of HPH rat model. RESULTS: Compared with the control group, hypoxic rats developed remarkable pulmonary hypertension, increment in the thickness of pulmonary arterioles and right ventricular hypertrophy (P
文摘Objective: To compare the antihypertensive effects of tuina at Taichong (LR 3), Neiguan (PC 6) and Qiaogong (Extra) to screen the best tuina protocol for primary hypertension due to liver-fire flaming-up. Methods: A total of 102 patients with primary hypertension due to liver-fire flaming-up were randomly divided into a Taichong (LR 3) group, a Neiguan (PC 6) group and a Qiaogong (Extra) group according to the random number table, with 34 cases in each group. Patients in the three groups received 4-week tuina treatment with the corresponding acupoint respectively. The blood pressure was recorded by ben chtop mercury sphygmoma no meter before tuina, immediately after tuina treatment, 30 min and 60 min after tuina treatment with the patient in a supine position in a quiet treatment room. The total effective rate was observed. Results: The systolic and diastolic blood pressures of the three groups all decreased after treatment (all P<0.05). The decrease of systolic and diastolic blood pressure at different time points after treatment in the Qiaogong (Extra) group and the Taichong (LR 3) group were better than those in the Neiguan (PC 6) group (all P<0.05). Qiaogong (Extra) group had the highest total effective rate though there was no statistical differenee in the total effective rate among the three groups (P>0.05). Con elusion: Treati ng primary hypertensi on due to liver-fire flami ng-up with tuina at Taich ong (LR 3), Neigua n (PC 6) and Qiaogong (Extra) can reduce systolic and diastolic blood pressure respectively, among which Qiaogong (Extra) has the highest total effective rate.
文摘Purpose: Renal denervation (RD) has been demonstrated to be an effective approach to reduce blood pressure for those with resistant hypertension. Yet, we aimed to explore the effect and possible mech- anism of RD on blood-pressure response to hemorrhagic shock in spontaneously hypertensive rats. Methods: A total of 48 male spontaneously hypertensive rats were randomized to three groups: study group, sham-operation group and control group. RD was achieved by cutting off renal nerves and swabbing phenol on it. Ten weeks after RD, 8 rats in each group were sacrificed to collect the kidney and heart tissues. The remaining rats were subjected to an operation to induce hemorrhagic shock which would lead to 40% loss of total blood volume, and observed for 120 min. The serum concentration of norepinephrine was measured before and three weeks after RD. Results: The blood-pressure and norepinephrine levels were reduced significantly after RD (p 〈 0.05), Systolic blood pressure and diastolic blood pressure of the surgerygroup were higher than those in the sham and control groups at 15, 30 and 45 min after hemorrhagic shock (p 〈 0.05), while no significant difference was observed at 60, 90 and 120 min (p 〉 0.05). Additionally, the beta-1 adrenergic receptor (β1 -AR) in the study group was significantly higher than those in the other two groups (p 〈 0.05) after hemorrhagic shock. Conclusion: This study demonstrated that RD could to some extent improve blood-pressure response to hemorrhagic shock in an established model of severe hemorrhagic shock in spontaneously hypertensive rats. The mechanism might be associated with uo-regulation of β1-AR.
基金supported by the National Natural Science Foundation of China (81000107,30670835,81071072,31171088)the National Basic Research Program of China (2011CB933500)grants from Key Laboratory of Medical Electrophysiology of Sichuan Province (MEPSCKL2011-01)
文摘Autoimmune activities have been implicated in the pathogenesis of hypertension.High levels of autoantibodies against the second extracellular loop of α1-adrenoceptor(α1-AR autoantibody,α1-AA) are found in patients with hypertension,and α1-AA could exert a α1-AR agonist-like vasoconstrictive effect.However,whether the vasoconstrictive effect of α1-AA is enhanced in hypertension is unknown.Using aortic rings of spontaneously hypertensive rats(SHR) and normotensive Wistar-Kyoto(WKY) rats,we observed the vasoconstrictive responses to α1-AA with phenylephrine(α1-AR agonist) as a positive control drug.Aortic nitrotyrosine levels were also measured by ELISA and immunohistochemistry.The results showed that the aortic constrictive responses to α1-AA and phenylephrine(both 1 nmol L-1-10 μmol L-1) were greater in SHR than in WKY rats.Endothelial denudation or L-NAME(a non-selective NOS inhibitor)(100 μmol L-1) increased α1-AA- or phenylephrine-induced vasoconstrictions both in SHR and WKY.However,selective iNOS inhibitor 1400W(10 μmol L-1) enhanced the α1-AA-induced aortic constriction in WKY,but not in SHR.The aortic nitrotyrosine level was significantly higher in SHR than WKY,as shown by both ELISA and immunohistochemistry.These results indicate that the vasoconstrictive response to α1-AA is enhanced in SHR,and this altered responsiveness is due to endothelial dysfunction and decreased NO bioavailability.The study suggests an important role of α1-AR autoimmunity in the pathogenesis and management of hypertension especially in those harboring high α1-AA levels.
文摘Compartment syndrome after an adder bite is extremely rare, whose effects are only secondary to the cytotoxic and hemorrhagic effects of venom. Here we reported a case of compartment syndrome in the upper limb following an adder bite in the thenar eminence. Elevated compartment pressure was documented and immediate surgical fasciotomy was practiced. The patient achieved complete recovery with a good functional result. We discussed the controversies on fasciotomy and non-invasive measures in such a situation, and recommended intracompartmental pressure monitoring during the management of compartment syndrome following adder bites.