Objective To explore the efficacy and mechanism of combined hemodialysis-hemoperfusion in treating patients with end-stage renal failure associated cutaneous pruritus. Methods Eighty-one outpatients and inpatients with end-stage renal failure associated different degree of cutaneous pruritus were randomly divided into treatment group (combined hemoperfusion-hemodialysis, 50 cases) and control group (simple hemodialysis, 31 cases). At the pretreatment and 24 weeks posttreatment, all patients' serum creatinine, blood urea nitrogen, serum total calcium, serum phosphonium, serum intact parathyroid hormone and the intensity of cutaneous pruritus (visual analog scale,VAS) were determined detected. Results Compared with pretreatment, the intensity of cutaneous pruritus of patients in treatment group was obviously alleviated (P<0.01), but it was not alleviated in control group (P>0.05), there was significant difference between two groups (P<0.01). Compared with pretreatment, serum phosphonium and intact parathyroid hormone declined obviously in treatment group [(2.69±0.46) mmol/L vs (0.98±0.39) mmol/L and (632.78±76.89) ng/L vs(342.81±39.71) ng/L] ((P<0.01), but did not decline obviously in control group (P>0.05), there was significant difference between two groups (P<0.01). Conclusions Combined hemodialysis-hemoperfusion can obviously alleviate the intensity of cutaneous pruritus of patients with end-stage renal failure, but simple hemodialysis can not alleviate it,its mechanism may be that it can clean the internal irritant toxin which leads to cutaneous pruritus well.

OBJECTIVE:To determine the residues of 9 kinds of organochlorinated pesticides in Polygonum multiflorum.ME-THODS:Samples were extracted with ethyl acetate by ultrasonic wave assistant extraction and purified on Florisil solid-phase extraction column.The residues of organochlorinated pesticides were determined with capillary gas chromatography with GC-MS.The separation was performed on DB-5MS(30 m?0.25 mm,0.25 ?m) fused-silica capillary column with injector temperature of 230 ℃.The initial column temperature was 100 ℃,then raised to 220 ℃ at the rate of 8 ℃?min-1.The column temperature was ra-ised at 250 ℃ at the rate of 5 ℃?min-1 for 10 min.The column flow was 1 mL?min-1 and injection volume was 1 ?L.RESULTS:9 kinds of organochlorinated pesticides were completely separated within 30 minutes.The average recoveries ranged from 80.4% to 97.2%(RSD ranged from 3.5% to 7.4%,n=6).CONCLUSION:The method is sensitive and accurate for the content determination of the residues organochlorinated pesticides.

Objective To analyze the clinical characteristics and perinatal outcome of early-onset intrahepatic cholestasis of pregnancy (ICP).Methods A total of 305 ICP cases were collected in the First Affiliated Hospital of Chongqing Medical University between June 2006 and May 2012.According to the onset time of ICP,patients were divided into early-onset ICP group (onset time ＜ 28 gestational weeks) and lateonset ICP group (onset time ≥28 gestational weeks).The late-onset ICP group was further divided into 28-31 +6 gestational weeks and ≥32 gestational weeks according to the onset time.The biochemical indices and perinatal outcome of each group were assessed.Results (1) When the diagnosis was made for the first time,the maternal serum concentrations of total bile acid (TBA) and total bilirubin (TBIL) in early-onset ICP group were (41 ±9) and (32 ±9) μmol/L,respectively; while TBA and TBIL in late-onset ICP group were (32 ± 6) and (22 ± 9) μmol/L,and the difference between the two groups was statistically significant (P ＜ 0.05).(2) There was no significant difference in alanine aminotran-sferase (ALT) and aspartate aminotransferase (AST) between early-onset ICP group and late-onset ICP group (P ＞ 0.05).The ALT of early-onset ICP group and late-onset ICP group were (159 ± 50) and (145 ± 52) U/L,respectively; and AST were (151 ±49) and (138 ± 44) U/L,respectively.(3) The early-onset ICP group had significant higher (P ＜ 0.05) incidence of meconium staining (18.8％ vs.7.4％),fetal distress (22.9％ vs.8.9％),newborn asphyxia (14.6％ vs.5.4％),premature delivery (33.3％ vs.15.6％),developing into severe ICP (41.7％ vs.25.3％) and cesarean section (91.7％ vs.78.6％) when compared to the late-onset ICP group.No significant difference in the incidence of premature delivery,developing into severe ICP and cesarean section was found between the two types of late-onset ICE (4) There was significant differences in average birth weight and gestational weeks at delivery between the two groups [early-onset ICP group:(3113 ± 443) g and (36.3 ± 2.6) weeks] ; late-onset ICP group:[(3513 ± 450) g and (37.7 ±1.6) weeks].Conclusion The early-onset ICP patients presented worse clinical manifestations than lateonset ICP patients,and early-onset ICP is more likely to lead to premature delivery and fetal distress.

Objective To investigate the effects of two different resuscitation fluids of two different temperatures and two different target MAP on the outcome of hemorrhagic shock in rabbits. Methods Forty adult male rabbits weighing 2.3-3.2 kg were anesthetized with iv pentobarbital sodium 30-35 mg/kg and tracheostomized. Spontaneous breathing was maintained. Hemorrhagic shock was induced according to modified Wiggers method. used. The temperature of the fluids was 23 ℃ (B_1) and 45 ℃ (B_2) respectively. The target MAP was 60 mm Hg (C_1) and 80 mm Hg (C_2). Forty animals were randomly divided into 8 groups (n=5 each) : group A_1B_1C_1; group A_1B_1C_2; group A_1B_2C_1; group A_1B_2C_2; group A_2B_1C_1; group A_2B_1C_2 ; group A_2 B_2 C_1 and group A_2B_2C_2 .Arterial blood samples were obtained from femoral artery at 5 min before blood-withdrawal, immediately after shock was induced and at 1, 2, and 3 h of resuscitation for blood gas analysis and determination of blood lactate concentration and serum concentrations of TNF-α and IL-6. Hemodynamies and changes in mesenteric capillaries were continuously monitored. Results PaO_2 was significantly higher in animals resuscitated with HSD (A_2) than in animals resuscitated with HS (A_1). Blood lactate concentration was significantly higher in group A_1B_1 (HS-23℃) than in group A_2B_1 (HSD-23℃). There was no significant difference in blood lactate concentration between group A_1B_2 (HS-45℃) and group A_2B_2 (HSD-45℃). The 3 factors did not have different effects on mesenteric capillaries. The serum TNF-α and IL-6 concentrations were significantly higher in animals resuscitated with HS (A_1) than in animals resuscitated with HSD (A_2) .Conclusion The effect of resuscitation of hemorrhagic shock is better with HSD than with HS. The resuscitation fluid of 23 ℃ is superior to fluid of higher temperature. The target BP during resuscitation does not influence the outcome of resuscitation.

Objective To explore the expression of pentraxin-3 (PTX3) in placentas from patients with severe preeclampsia and the relationship between PTX3 and the pathogenesis of severe preeclampsia.Methods Fifty-three pregnant women who delivered from October 2010 to March 2011 in the First Affiliated Hospital of Chongqing Medical University were included in the study.Twenty-three women with severe preeclampsia were chosen as the preeclampsia group,and thirty healthy pregnant women were identified as the control group.All the women received cesarean section.The location of PTX3 protein in placentas was studied by immunohistochemical SP method.Quantitative real-time PCR technique and western blot analysis were employed to assay the levels of PTX3 mRNA and protein in placentas,respectively.Results ( 1 ) The location of PTX3 protein in placentas:PTX3 protein was expressed in placentas from both groups,and there was no difference of PTX3 distribution between normal and preeclamptic placentas.PTX3 was mainly located in perivascular stroma,decidual cells and terminal villi.Neutrophilic infiltration was observed in the preeclamptic placentas.(2)The expression of PTX3 mRNA and protein in placentas:the level of PTX3 mRNA in placentas from the preeclampsia group was higher than that in the control group( 1.98 ± 0.54 vs.0.87 ± 0.27,P ＜ 0.05 ).Compared with the control group,the level of PTX3 protein was significantly elevated in the preeclampsia group ( 1.42 ± 0.29 vs.0.56 ± 0.25,P ＜ 0.01 ).Conclusion The high expression of PTX3 in placentas from the preeclamptic patients suggests that PTX3 may be involved in the pathologic process of preeclampsia.

10mg/L(n=22) group,and CRP10mg/L group with CRP10mg/L group and the concentration of CRP inverse correlation with serum ALB,Fe,Hb levels.Conclusions The elevated concentration of CRP is considered to be the most common cause of decreased EPO or hyporesponsiveness to EPO in CRF anemia patients. CRP level can predict whether CRF anemia,dificult or easily degree of the anemia correction for CRF patients,all that provide evidence for improving CRF anemia.

Objective To investigate the changes of CD cells in splenic tissue in patients with portal hypertension(PHT) accompanied by hypersplenism to explore the features of immunological function in patients with PHT.Methods The resected splenic tissue was made into paraffin sections for the detection of number and distribution of CD_3~+,CD_8~+,CD_(20)~+ and CD_(68)~+ cells,with the control of those in healthy individuals.Results The numbers of CD_3~+,CD_8~+,CD_(20)~+ and CD_(68)~+ cells remarkably decreased in patients with PHT accompanied by hypersplenism compared with those in normal controls.In normal controls,the CD_(68)~+ cells mainly existed in splenic lymphocyte nodules and red pulp(RP),and in patients with PHT,they existed in splenic lymphocyte nodules and periarterial lymphatic sheath(PALS).Compared with the normal controls,the numbers of CD_(68)~+ in splenic lymphocyte nodules,red pulp and marginal zone(MZ) decreased in patients with PHT.Conclusion The number and distribution of CD cells are changed in patients with PHT accompanied by hypersplenism.With splenectomy,the immunological function may be improved and the abnormalities in routine blood parameters and liver function be corrected.However,the immunological indexes detected in the study can not completely show the systematic immunological function of the patients with PHT accompanied by hypersplenism.Thus we should conduct a long-term follow-up study on immunological function in these patients.

Objective To observe the expressions of Akt and ERK phosphorylation in abdominal aortic aneurysm of rat model, and explore the pathogenesis of abdominal aortic aneurysm. Methods The rat model of abdominal aortic aneu-rysm was established. The diameter of abdominal aorta was measured and the extended rate of the aorta was calculated. HE staining was used to observe the change of pathology. Immunohistochemistry and Western blot methods were used to detect the expressions of Akt and ERK phosphorylation in the level of protein. Results The dilation of aorta was significantly high-er in abdominal aortic aneurysm group than that of saline group and normal group (P＜0.05). HE staining showed structural disorder and inflammatory cell infiltration in abdominal aortic aneurysm group. The results of immunohistochemistry and Western blot results showed that phosphorylation of Akt expression was significantly higher in abdominal aortic aneurysm group than that of saline group and normal group (P＜0.05). There was no significant difference in phosphorylation of ERK expression between three groups (P>0.05). Conclusion PI3K/Akt signaling pathway may be involved in the development of abdominal aortic aneurysm.

Objective To study the effects of enteral nutrition( EN) on inflammatory factors and cardiac function in elderly patients with heart failure ( HF ) . Methods A total of 96 elderly patients with HF were enrolled in this study and randomly divided into treatment group A,treatment group B and control group( n= 32 in each group) . Patients in group A were provided with 500 mL of EN daily for 1 month, and those in group B were provided with the same dose of EN for 3 months. Control group was treated with normal diet. The nutrition status of each group was assessed by NRS2002. Meanwhile,all patients were evaluated by New York Heart Association(NYHA) class and left ventricle eject fraction(LVEF). The levels of BNP,IL-6, CRP and TNF-α were also measured before and after nutrition treatment. Results In group A and group B,BMI,TSF,AMC, TP,ALB and HGB increased. Symptoms of HF alleviated quickly and LVEF increased compared to the baseline. The levels of BNP,IL-6,CRP and TNF-α were significantly lower after treatment(P<0. 05) in both treatment groups,and the change in group B was more obvious(P<0. 01) than group A. However,in control group,there is neither evident improvement in cardiac function or nutrition status,nor in inflammatory factor levels. Conclusion Adding EN support to the normal treatment of heart failure in elderly malnourished patients with HF not only improves the function of heart and nutrition status, but also helps to support immune system so as to alleviate acute inflammatory response. The benefits from EN depend on the duration of therapy.

Objective To explore the correlation and significance between adult nut-cracker phenomenon (NCP) and varicocele. Methods The clinical characters of 226 adult patient (including inpatients and outpatients)with NCP diagnosed by color Doppler ultrasound examination were analyzed retrospectively, whose chief complaints were asymptomatic bematuria or/and orthostatic proteinuria (microalbuminuria). The ratio of left renal vein inner diameter before and after being compressed≥2 was regarded as the criteria of diagnosis of NCP. Among 226 cases, 184 male NCP patients were taken as study group, and the incidence of varicocele was tested. One hundred and fifty-six male adults who had physical examination in the same period and whose ages matched with study group were taken as control group, they were not NCP patients examined by color Doppler ultrasound. The incidence of varicocele was compared between two groups. The indexes associated NCP were examined in detail in study group. Logistic regression analysis was used to study the correlation between NCP and left varicocele. Results There were 184 male patients in study group, among which there were 22 patients with left sub-clinical varicocele (accounted for 11.96%), 47 patients with left varicocele (accounted for 25.54%).The total incidence of varicocole was 37.50%(69/184). There were 156 male adults in control group, among which there were 13 patients with sub-clinical varicocole(accounted for 8.33%), 8 patients with varicocele (accounted for 5.13%).The total incidence of varicocele was 13.46%(21/156). The total incidence of varicocele in study group was significantly higher than that in control group (P=0.000). In study group, there were 22 patients with left sub-clinical varicocele,with average age (24.73±1.03) years. The inner diameter of left renal vein(LRV) in front of spine was (3.65±0.11) mm(a),the inner diameter of LRV at left side of spine was (8.41±0.11)mm(b), and b/a ratio was 2.31± 0.06. The angle between superior mesenterie artery (SMA) and abdominal aorta(AA) was (15.95±0.59)°. There were 47 patients with left varicocele, with average age(26.62±1.74)years. The inner diameter of LRV in front of spine was (3.43±0.08)mm(a),the inner diameter of LRV at left side of spine was (8.72±0.14) mm (b), and b/a ratio was 2.54±0.08. The angle between SMA and AA was (14.54±0.53)°. In study group, Lagistic regression analysis proved that male patients with NCP were complicated with varicocele easier when the angle between SMA and AA became smaller, the inner diameter of LRV at the left side of spine (b)and age increased. Conclusions Male adult patients with NCP are complicated with left varicocele, which is significantly higher than that in non-NCP male adults at the same age. It shows that NCP is one important cause for varicocele and there is a close correlation between NCP and varicocele in male adults.