Volume 89  ·   Issue 18  ·  2009

This issue published a subgroup analysis of 7510 patients from China in the international multicenter randomized controlled study of CREAT-ECLA (Effect of metabolic modulators on the mortality of acute myocardial infarction with ST-segment elevation) conducted by Yang Yanmin et al., to explore the correlation between different blood glucose levels and the short-term prognosis of acute ST-segment elevation myocardial infarction (STEMI). The results showed that the admitted patients with blood glucose levels of 4.5~5.5 mmol/L as the control, the blood glucose increased or decreased, and the mortality rate increased significantly; Multivariate Logistic regression analysis showed that the risk of death increased by 46% (OR 1.46, 95% CI 1.03-2.07, P =0.01), 58% (OR 1.58, 95% CI 1.13-2.22, P =0.02), and 126% (OR 2.26, 95% CI 1.42-3.14, P<0.01) in patients with hyperglycemia (>11.0 mmol/L).

A large number of epidemiological and clinical studies have confirmed that diabetes mellitus is closely related to cardiovascular disease (CVD). Some large-scale prospective studies with a follow-up period of 12 to 20 years, including the Framingham Study, the Multivariate Intervention Trial and the Nurses Health Study, have confirmed that diabetes mellitus is associated with a 2-to 5-fold increase in cardiovascular mortality by multivariate analysis [1-3]. The results of eastern and western studies on diabetes mellitus show that the prognosis of patients diagnosed with diabetes mellitus without myocardial infarction during a 7-year follow-up period is comparable to that of patients with myocardial infarction without diabetes mellitus [4]. Compared with non-diabetic individuals, diabetic patients develop coronary atherosclerosis earlier and progress to clinical cardiovascular events faster [5] CVD is the main cause of early death in type 1 and type 2 diabetic patients worldwide. In 1999, the American Heart Association clearly put forward the slogan "diabetes is cardiovascular disease" [6].

Objective The aim of study is to investigate the changes of structure and function of heart in diabetic rat after myocardial infarction,and to study the expression of the GLUT4 and the effects of trimetszidine on the ventricular remodeling.Methods Type 2 diabetes rat was made by feeding with a diet enriched with sucrose,fat and cholesterol for six weeks and then injecting streptozotion intraperitoneally,then the myocardial infarction by ligating coronary artery.The living rats were randomly divided into three groups twenty-four hours after operation:placebo;trimezidine and sham operated with diabetes.And other rats which was fed with normal diet were divided into myocardial infarction group without diabetes and sham operated group without diabete.The treat group was intragastric administrated with trimetazidine which was water.After six weeks,echocardiographic and hemodynamic studies were performed,ventriculars were weighed,myocardial infarct size and myocardial collagen volume fraction(CVF) of non-infarction area were detected also.GLUT4 mRNA in the myocardium away from infarction region were measured with fluorescent quantitation RT-PCR and GLUT4 protein were measured with Western blot.Results Six weeks after diabetes complicating with myocardial infarction,comparing with sham operated group without diabete,diabetes sham operated group and myocardial infarction group without diabete,LVDd of diabetes complicating with myocardial infarction group was increased significantly;the systolic and diastolic function with left ventricular were decreased significantly ,VWI and CVF were increased significantly;comparing with placebo group,diastolic function of left ventricular in trimetazidine group was improved significantly(4.7 ± 1.7 vs 6.8 ± 1.6,P＜0.05);CVF(3.9 ± 0.2)% vs (6.3 ± 0.4)%,(P＜0.05) was decreased significantly,but LVDd,VWI and the systolic function was not chang significantly.The expression of GLUT4 mRNA and protein in sham operated with diabetes and diabetic with myocardial infarction descended significantly compared with sham operated group without diabete (P ＜ 0.01 ).And in trimezidine group,GLUT4 protein moderately increased (P ＜ 0.05) compared with placebo group.Conclusion Trimetazidine could improve the diastolic function of left ventricular.The expression of GLUT4 mRNA and protein in type 2 diabetes complicating with myocardial infarction decreased.Trimetazidine could improve the expression of GLUT4 mRNA and protein in diabetes complicating with myocardial infarction and inhibite myocardial fibrosis.

Objective To investigate the number and function of circulating endothelial progenitor cell (EPC) in different vascular complications of type 2 diabetes (T2DM) and its associations with vascular endothelial function.Methods A total of 415 T2DM patients were recruited from the outpatients and inpatients of the Endocrinology Department at Union Hospital Assessments of cardiovascular disease and cerebrovascular disease were based on each patient's medical records.Peripheral vascular disease was diagnosed by bilateral ultrasonography bilaterally.Non-mydriatic fundus camera screening was used as a tool to identify diabetic retinopathy.Urinary albumin exceeding 30 mg/24 h occurring twice over a period of six months was diagnosed as diabetic nephropathy.Circulating EPC was quantified by flow cytometry.Colony forming count (CFU) and migration assay were used for evaluating the function of circulating EPC.Vascular endothelial function was assessed by flow-mediated brachial artery dilatation (FMD).Results There were four groups in the study:T2DM without vascular disease(TC,n =97) ,T2DM with macrovascular disease (TA,n = 106),T2DM with microvascular disease(TI,n = 100),T2DM with macro- and micro-vascular diseases(TAI,n = 112).The sequence of circulating EPC number and CFU in four groups was TA ＜ TAI ＜TI ＜ TC (532 ± 90,616 ± 93,768 ± 97 and 1045 ± 106 cell/ml ;21 ± 4,28 ± 5,43 ± 7 and 70 ± 9 unit/chamber) and there was a significant difference between any two groups (P ＜ 0.05 ).The results of migration were consistent with circulating EPC number( 125 ± 12;90 ± 9 cell/HP field)except there were no significant differences in TA and TAI groups(24 ± 6;28 ± 7 cell/HP field).Age,HbA1c,SBP,BMI and duration of T2DM were the independent risk factors of circulating EPC number in T2DM patients with macrovascular disease(P ＜ 0.05).Age,HbA1c and duration of T2DM were the independent risk factors of circulating EPC number in T2DM patients with microvascular disease (P ＜ 0.05 ).After the adjustment of traditional risk factors,the number of circulating EPC had a close correlation with FMD(standardized coefficien,t =0.61,P =0.01).Conclusion The number and function of circulating EPC decreased with different degrees in T2DM patients of different vascular diseases.Circulating EPC number was associated with endothelial function and can be considered as a surrogate biological marker of vascular endothelial function for T2DM.

Objective To evaluate the predictive value of different admission blood glucose levels for short-term mortality in patients with ST-segment elevation acute myocardial infarction (STEMI).Method An observational analysis of 7446 Chinese STEMI patients from a global randomized controlled trials were recruited within 12 hours of symptom onset According to the levels of admission glucose,these patients were divided into six groups,admission glucose ＜ 4.50 mmol/L was defined as the hypoglycemia group;glucose of 4.5-5.5 mmol/L a control;5.6-7.0 mmol/L,7.1-8.5 mmol/L (mild hyperglycemia group) and 8.6-11.0 mmol/L (moderate hyperglycemia group );glucose ＞ 11.0 mmol/L was the severe hyperglycemia group.The 30-day mortality was analyzed.Result Compared with the glucose of 4.5-5.5mmol/L group,thirty-day mortality increased in patients with hypoglycemia (10.2%,P ＜ 0.05 ),mild and moderate hyperglycemia (9.2%,P = 0.01 ;11.6%,P ＜ 0.01,respectively) and severe hyperglycemia (18.6% ,P ＜0.01 ).The highest mortality occurred in the severe hyperglycemia group.Multivariate logistic regression analysis showed that,as compared with glucose of 4.5-5.5 mmol/L,the mild and the moderate hyperglycemia groups had a mortality increasing of 46% (OR 1.46,95% CI 1.03-2.07,P = 0.01 ) and 58% fold (OR 1.58,95% CI 1.13-2.22 P=0.02) respectively;the severe hyperglycemia group had a risk of death of 2.26 folds (OR 2.26,95% CI 1.62-3.14,P = 0.05 ).Mild,moderate and severe hyperglycemia were independent predictors of 30-day mortality.Conclusion The 30-day mortality was higher in STEMI patients with mild,moderate and severe hyperglycemia at admission.Admission blood glucose level is an important factor associated with a short-term.

：Objective To evaluatethe feasibility and efficacy of laparoscopic radical resection of gallbladdercarcinoma.Methods The clinical feature,pathological stage,surgical procedure,postoperativerecovery and follow-up results of 4 patients undergoing laparoscopic radical resection ofgallbladder carcinoma were retrospectively analyzed.Results A total of 4 cases weresuccessfully performed.No operative deaths and complications happende.Two patients died ofrecurrence at 17 and 40 months respectively.There were no port-site and abdominal wallmetastases occurred.Conclusion Laparoseopic radical resection of gallbladder carcinoma isa safe and feasible procedure on basis of technique.Nonetheless prospective randomizationstudy with a greater number of cases and a longer follow-up will be needed to evalut thelong-term results of it.

Objective To investigate the influencing factors on the prognosis of hilar cholangiocarcinoma.Methods The clinical data were retrospectively analyzed in 86 cases of hilar eholangiocarcinoma admitted into our hospital from Jan.2004 to July.2008.Results Of 86 cases with hilar eholangiocarcinoma,the mean survival time was 13.7 ± 2.3 months,1-year survival 57.3% and 3-year survival 29.7%.The mean survival time in patients with resection operation ( 19.4 ± 2.2 months ) was significantly longer than those with no operation ( 7.2 ± 1.2 months) (P ＜ 0.05 ).The mean survival time in patients with non-vascular resection group ( 23.4 ± 2.1 months ) was significantly longer than those with portal vein resection alone group (15.3 ± 1.4 months) and hepatic artery resection group (9.3 ± 0.9month) (P ＜ 0.05 ).Cox regression analysis showed that staging,tumor diameter and operative were the dependent prognosis factors while pathologic type,vascular resection and age not the dependent prognosis factors.Conclusion The prognosis of hilar cholangiocarcinoma correlates with operative approach,clinical stage and tumor diameter.A surgeon must be cautious to choose the surgical approach for treatment.

Objective To investigate the expression of NK cells receptor NKG2D from peripheral blood in patients with primary hepatic carcinoma and the relationship between NKG2D expression and cytotoxicity of NK cells.Methods Flow cytometry was used to determine the number of NK cells and the expression of NK cells receptor NKG2D from peripheral blood in patients with primary hepatic carcinoma (20 cases) ,hepatitis B cirrhosis (23 cases ),hepatitis B ( 20 cases ) and healthy control ( 20 cases ).The microplate reader was used to detect cytotoxicity of NK cells in all cases.Results Among killing rate of NK cell for K562 cell,the expression rate of NKG2D in NK cells,the number of NKG2D+ NK cells,NKG2D expression level of NK cells and the number of NK cells,the liver cancer group[(25 ±7)% ,6% ,0.7 × 107/L,15,(1.1 ± 0.6) × 108/L]decreased significantly as compared with the healthy group [(63 ± 7 )% ,36%,8.3 ×107/L,116,(2.7 ±1.1) × 108/L]and the hepatitis B group [(41 ± 8)%,16%,2.8 × 107/L,49,(1.9 ± 1.1 ) × 108/L](P ＜ 0.05 ) ;and there was a slight decrease as compared with the hepatitis B cirrhosis group[(29 ± 10)% ,7% ,0.6 × 107/L,29,(1.5 ± 1.2)× 108/L](all P ＞0.05 except NKG2D expression level of NK cells P ＜0.05).The activity of NK cells showed a obvious positive correlation with the number of NK cell and the positive rate of NKG2D in NK cells,the number of NKG2D+ NK cells and NKG2D expression level of NK cells (r=0.657,0.770,0.927,0.734,all P＜0.01).Conclusion The cytotoxicity and the NKG2D expression of NK cells decreased significantly from peripheral blood in patients with primary hepatic carcinoma.The activity of NK cells was closely related to the NKG2D expression level of NK cells.Enhancing the NKG2D expression level of NK cell may provide a new idea for adoptive immunotherapy of primary hepatic carcinoma.

Objective To review retrnspectively the urological complications in 1 223 kidney transplants.Methods A total of 1 223 kidney transplants were divided into ureteroneoeystostomy group (n = 948) and ttreteronreterostomy group (n = 275 ) according to the methods of urinary tract reconstruction.The incidence and management of urological complications such as urinary fistula,obstruction of ureter,vesicoureteral reflux (VUR) and urinary tract infection ( UTI) were summarized respectively.Results Overall,urological complications were encountered in 217 ( 17.7% ) cases,including 43 cases of urinary fistula (3.5%),35 obstruction of ureter(2.9%),14 VUR(1.1%) and 125 UTI (10.2%).Urinary fistula was 39(4.1% ) eases and 4 cases (1.5% ) (P ＜ 0.05 ),obstruction of ureter 22 (2.3%) & 13 (4.7%)(P＜0.05),VUR 14(1.5%)& 0(0%)(P＜0.05)and UTI 109 (11.5%)& 16(5.8%)(P＜0.01 ) in the ureteroneocystostomy group and reteroureterostomy group respectively.Seventy patients underwent surgical treatment.The 3-year survival rate of graft with urological complications and without urological complications were 82.3% and 84.7% respectively.Conclusions Ureteroureterostomy can decrease the incidence of urological complications after kidney transplantation.Most of urological complications require surgical interventions.The long-term graft survival is not affected by a correctly treated urological complication.

Objective To compare the clinicopatholngic parameters of gastric carcinoma between different phases and to investigate the prognostic factors for gastric carcinoma.Methods A total of 1016 consecutive gastric cancer patients were divided into two groups according to operating date,phase Ⅰ (1994 - 1996 ) and phase Ⅱ (2000 -2006).The clinicopathologic parameters and prognosis were compared between the two phases.The prognostic factors were analyzed and compared.Results There were significant differences in the constituent ratio of male and female patients,the proportions of early gastric carcinoma,different TNM staged patients,specialized operation and adjuvant chemotherapy (all P ＜ 0.05 ),but no significant differences in tumor location,peritoneal spread,lymph node metastasis and radical resection between the two phases.The overall 5-year survival rate and 5-year survival rate after curative resection were 48.1% and 61.5% respectively within phase Ⅱ ,significantly higher than 32.8% and 42.4% within phase Ⅱ (all P ＜0.01 ).Stratification analysis revealed that the survival rates of patients with curative resection,lymph node metastasis or not,advanced disease,different TNM stages,specialized operation,without adjuvant chemotherapy within phase Ⅱ ,were significantly higher than those within phase Ⅱ (all P ＜0.01).Multivariant regression analysis revealed that Borrmann type,histological type,depth of invasion,lymph node metastasis,curative resection,adjuvant chemotherapy and different phase were independent prognostic factors for gastric carcinoma.Conclusion The therapeutic efficacy of gastric carcinoma within phase Ⅱ was improved greatly as a result of elevated diagnostic rate of early gastric cancer,standardized radical operation and adjuvant chemotherapy.Gastric carcinoma within phase Ⅱ was improved highly.It was elevated diagnostic rate of early gastric cancer,standardized radical operation,and adjuvant chemotherapy that contribute to such improvement.

Objective To screen and characterize the serum protein biomarkers in nephroblastoma so as to establish the proteins as the specific serum biomarkers for diagnosis and prognosis monitoring.Methods The differential protein peaks were located by detecting serum samples of preoperative and postoperative patients and normal children using the SELDI-TOF MS technology.After purification,the differential proteins were further analyzed by LC-MS/MS and the protein sequences searched in database.Results Two peaks with m/z of 6455.5 and 6984.4 were selected as potential biomarkers.They were weakly expressed in nephroblastoma(intensity:1029 ± 364,297 ± 126)but highly expressed in normal individuals(2108 ± 837,753 ± 226);another peak with m/z of 9190.8 was weakly expressed in preoperative sera(283 ± 154) but highly expressed in serum samples of postoperative patients and normal children(5974 ± 657,6231 ±519).The protein at 6455.5 and 9190.8 were identified as apolipoprotein C-Ⅲ and haptogloblin respectively.Conclusion The detection of differentially expressed apolipoprotein C-Ⅲ and haptogloblin may have potential utilities for serum diagnosis,malignancy classification and prognosis monitoring of nephroblastoma and is worthy of further studies and applications.

：Objective To analyze thecharacteristics of female chronic constipation (CC),contributing factors of severeconstipation and the correlation between female CC and pelvic floor dysfunction (PFD) soas to provide references for the diagnosis and treatment of female CC.Methods Five hundredand sixty-one CC outpatients meeting Rome Ⅲcriteria atclinics of gastroenterology from ten Beijing hospitals were recruited during March-May2007.After data input and verification,formulated the standard of severe CC.Results Thepeak age of CC onset was 20 - 29 years in female patients while 60 - 69 years in malepatients.F:M = 3.04:1.A wide range of CC symptoms were present and straining was the mostcommon one (381,76% ).However,a significant difference between females and males was shownin defecation by manually pelvic floor supporting(female 26/69,38%,male 3/20,15% in manualassisted defecation,P ＜0.05 ) and urinary incontinence when coughing(female 95/422,22.5%,male 13/139,9.4%,P ＜ 0.01 ).Severity of CC,its manifestations and pelvic floordysfunction were closely correlated with frequencies of pregnancy and delivery.ConclusionOwing to anatomic features of female pelvic floor and physiological nature of pregnancyand delivery,the early onset of CC in female patients should attract sufficient attentionof multi-disciplinary clinicians.

Objective To investigate the prevalence,clinical features of latent autoimmune diabetes in adults (LADA) from phenotypic type 2 diabetic patients and the relationship between LADA and metabolic syndrome (MS).Methods Sera from 1711 phenotypic type 2 diabetic patients were screened for glutamic acid decarboxylase antibody (GAD-Ab) and protein tyrosine phosphatase antibody (IA2-Ab) through radioligand assay.The prevalence of LADA and its relation with clinical features were analyzed.Results (1)The prevalence of LADA in phenotypic type 2 diabetic patients was 6.7% (115/1711),the positive frequency of GAD-Ab and IA2-Ab was 6.0% and 2.4% respectively.(2)The prevalence of LADA from phenotypic type 2 diabetic patients with a duration of diabetes less than 1 year which was much higher than that of patients with a duration over 1 year (10.4% vs 5.9%,P ＜ 0.01 ).(3) The prevalence of LADA was higher in patients with younger age at onset,lower body mass index and lower level of postprandial C peptide and without diabetes family history.(4) 51.3% of LADA patients were suffered from at least one kind of metabolic disorders besides hyperglycemia,21.7% of them were with MS.The prevalence from high to low of those metabolic disorders were as follows:hypertension,dyslipidemia,overweight/obesity.Conclusion (1) 6.7% of phenotypic type 2 diabetic patients were LADA,of whom early diagnosis of diabetic type should be made to guide clinical therapies.(2)More than 1/5 patients with MS were found in LADA patients,indicating an overall screening and intervention of metabolic disorder factors is important in LADA patients.

Objective To investigate the association of CTLA-4 + 49A/G and CT60 gene polymorphisms with type 1 diabetes (T1DM) and thyroid autoimmunity.Subjects Three hundred thirty-two T1DM patients and 476 controls were recruited in the study.Method The CTLA-4 + 49 A/G and CT60 polymorphisms of CTLA-4 gene were analyzed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method.Thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) were determined by radioimmunoassay.Glutamic acid decarboxylase antibody (GADA) and proteintyrosine phosphatase antibody (IA-2A) were measured by radioligand immunoassay.Results (1) The CTLA-4 + 49 A/G polymorphism was significantly associated with T1DM complicated with thyroid autoimmunity (OR=2.43,P＜0.01) and with T1DM alone (OR= 1.66,P＜0.05).(2) The CTLA-4 CT60 polymorphism was also significantly associated with T1DM complicated with thyroid autoimmunity (OR=2.67,P ＜0.01) and with T1DM alone (OR = 1.60,P =0.02).(3) T1DM with thyroid autoimmuntiy was characterized by a significantly higher frequency of CTLA-4 CT60 GG genotype (77.8% vs 62.3%,P ＜0.05) and GADA (77.8% vs 57.4%,P ＜0.05) compared to the patients without thyroid antibodies.Conclusion CTLA-4 + 49 A/G and CT60 gene polymorphism coders genetic susceptibility to type 1 diabetes,particularly in patients with thyroid autoimmunity.

Objective In order to explore the regulating effects of Egr-1 promoter sequences in transcriptional targeting by 5-fluorouracil (5-Fu) on the expression of hematopoietic growth factor genes.Methods The human GM-CSF cDNA and enhanced green fluorescent protein (EGFP) eDNA were linked together with IRES and then inserted into the expression vector pCIneo under control of the Egr-1 promoter (Egr-EG).The vector was transferred into human bone marrow stromal cell line HFCL by lipofectinTM.The transfected cell clones (HFCL/EG) have been selected by the addition of G418.The cells are exposed to the clinically important anticancer agent 5-fluorouracil.The activity of EGFP in HFCL/EG cells was detected by flow cytometry.The post-chemotherapeutical expression of GM-CSF in HFCL/EG was confirmed with ELISA and Western blot and RT-PCR respectively.The effect of N-acetylcysteine (a free radical scavenger) on GM-CSF production post-exposure to 5-Fu was examined.The HFCL/EG cells were transplanted intravenously into B16 melanoma in C.B-17 combined immunodeficient (SCID) mice.5-Fu was given i.p.at Day 3.The white blood cell numbor in peripheral blood,the expression of EGFP and GMCSF and in human stremal cell engrafted in recipient mice were detected by flow cytometry and RT-PCR respectively.Tumor volume in tumor-bearing mice was calculated.Results The results indicated that the activity of EGFP and the amounts of secreted GM-CSF in HFCL/EG cells exposed to 5-Fu increased as compared to non-5-Fu group with flow cytometry,RT-PCR and ELISA respectively.N-acetyleysteine significantly decreased the concentration of GM-CSF in HFCL/EG cells treated with 5-FU.In contrast to two control groups,HFCL/EG (Egr-1 regulatory element-derived expression of GM-CSF gene therapy) resulted in a proportionally obvious increase in the number of white blood cell after chemotherapy and no significant difference was found for tumor inhibition in recipient mice.Conclusions These in vitro data provide an experimental basis for use of gene therapy of hematopoietic growth factor gene regulated by Egr-1 promoter to protect hematopoiesis from 5-Fu-injury effects.

The patient was a 33-year-old female who was admitted to Peking Union Medical College Hospital on November 19, 2008 due to episodic increased blood pressure and palpitations for 1 month. The highest blood pressure at the time of attack was 180/110 mm Hg (1 mm Hg =0.133kPa), and the fastest heart rate was 115 beats/min. She was accompanied by cold sweat, chest tightness, dyspnea, abdominal pain, numbness in the limbs and near-death feeling. She was attacked 2-3 times a day, and each time lasted 5-20 minutes to relieve. During the remission period, she was asymptomatic and had normal blood pressure. Since the onset of the disease, she lost 5 kg of weight. She was diagnosed as "pheochromocytoma" in a foreign hospital. She denied history of hypertension, diabetes and heart disease. She denied taking drugs or drugs. She worked in a foreign company and was under great mental stress. Physical examination: body temperature 36.1℃, heart rate 75 beats/min, breathing 16 beats/min, blood pressure 125/75 mm Hg.

Most lung cancers are found in advanced stage and can only be treated with palliative care, resulting in a short survival time. If lung cancer can be diagnosed early in clinic, the survival time of patients will be obviously improved. There are many reasons for the late detection of lung cancer, but the main reason is the lack of effective early diagnosis methods for high-risk groups. The possibility of cure of early tumors with microaggressive carcinoma in situ is nearly 100%. If more early lung cancer can be detected, it will undoubtedly improve the prognosis of patients. Therefore, new diagnostic methods need to be developed to improve the survival rate of lung cancer patients.

Gamma aminobutyric acid receptor agonists are the most commonly used sedative drugs in intensive care unit (ICU) patients, but there is evidence that α 2 receptor agonists have more obvious advantages. Richer et al. conducted a study to compare the efficacy and safety of long-term sedation with dexmedetomidine and midazolam in mechanically ventilated patients, and the results were published in JAMA (JAMA, 2009, 301:489-499).

It is still unknown whether proteinuria affects nocturnal blood pressure in patients with non-diabetic nephrotic syndrome (NS) in the early stage of chronic kidney disease. Andoh and colleagues from the Department of Nephrology, Yokohama City University School of Medicine, Japan, investigated the relationship between 24-h blood pressure rhythm,proteinuria and hypoalbuminemia in these patients and evaluated the autonomic nervous function of these patients. The results were published in Hypertens Res, 2009, 20.

There has been a debate about which diet is the most effective in treating obesity. Whether a diet based on protein, carbohydrate or fat is better? Dr. Sacks of the Department of Nutrition at the Harvard School of Public Health designed a 2-year randomized clinical trial to compare the effects of different dieting regimens on body weight. These regimens involved different nutrient intakes, but all of them were in line with the principles of cardiovascular health. The results were published in the New England Journal (NEngl J Med, 2009, 360:859-873).

A 58-year-old female was admitted to the hospital because of "repeated swelling and pain in the right lower back for 7 years, aggravated for 1 month". The patient developed swelling and pain in the right lower back without obvious inducement 7 years ago, and the B-ultrasound in the local hospital showed right kidney stones. The symptoms were relieved after anti-inflammatory and antispasmodic symptomatic supportive treatment, and the symptoms of the patient were repeated after that. Two months ago, the patient felt obvious aggravation of pain in the right lower back, and was diagnosed with multiple gallbladder stones, multiple stones in the right kidney, and right hydronephrosis. She was admitted to the hospital for further diagnosis and treatment. Physical examination: general condition: good, percussion pain in the right kidney area (+), no tenderness percussion pain in the left kidney area, no palpable mass in the kidney areas, and no edema in both lower limbs. Auxiliary examination: hematuria routine, blood biochemistry was normal.

A 51-year-old male was admitted to the emergency department on December 27, 2007 with intermittent attacks of right hypochondrial pain for more than 10 years, aggravated for 3 days, and numbness and pain in left foot for 10 days. He had a history of allergic rhinitis for 30 years, and underwent right middle and lower lobectomy 20 years ago due to bronchiectasis.

Neurofibromatosis type I (NF1) associated with bilateral adrenal pheochromocytoma is rare [1], and it is rarely reported in China [2]. NF1 associated with bilateral adrenal pheochromocytoma has not been reported in China, and one case was treated in our hospital in 2007. The results are reported as follows.

Jointly hosted by the Chinese Medical Association, the Cardiovascular Branch of the Chinese Medical Association, the Board of Directors of the Chinese Congress of Interventional Cardiology (CIT), the Cardiovascular Research Foundation/TCT of the United States, EuroPCR of Europe, CCT of Japan, the Latin American Society of Interventional Cardiology (SOLACI) and the Angioplasty Summit-TCT Asia Pacific of Korea, CIT2009 was held at the Beijing International Convention Center from March 18 to 22, 2009. The conference was chaired by Academician Gao Runlin, Chairman of the Cardiovascular Branch of the Chinese Medical Association and Editor-in-Chief of Chinese Medical Journal.