Objective To investigate the markers in early diagnosis of acute kidney injury (AKI) in patients undergoing heart surgery.Methods Markers included serum cystatin C (CyC),and urinary neutrophil gelatinase-associated lipocalin(NGAL),interleukin 18(IL-18),retinol binding protein(RBP)and N-acetyl-β-D-glucosaminidase(NAG).Twenty-nine cardiac surgical patients hospitalized were enrolled in the study.Serial blood and urine samples were collected immediately before incision and at various time intervals after surgery.The primary outcome measure was AKI.defined as a 50%increase in Scr from baseline. Results The cohort consisted of 29 patients aged(62.9±13.7)years,and baseline Scr was(73.2±11.9)μmol/L.There were no significant differences in demographics between cases and controls,while the aortic clamp time was predictably longer in AKI cases as compared to controls[(60.63±13.92)vs(43.00±9.20)rain,P<0.05].Each biomarker difiered significantly between cases and controls at least one timepoint.Optimal AUCs were for CyC at 10 houm with sensitivity (ST)0.71,specificity(SP)0.92,AUC=0.83(0.67-1.00),cut-off(CO)1.31 mg/L;NGAL at 0 hour with ST 0.84,SP 0.80,Auc=0.85(0.70-1.00),CO 49.15 μg/g Ucr;IL-18 at 2 hours with ST 0.85,SP 0.73,AUC=0.81(0.64-0.97),CO 285.65 ng/g Ucr;RBP at 0 hour with ST 0.75,SP 0.67,AUC=0.77(0.60-0.95),CO 2934.65μg/g Ucr and NAG at 4 hours with ST 0.86,SP 0.67,AUC=0.72(0.53-O.92),CO 37.05 U/mg Ucr.Using a combination of all the 5 biomarkers analyzed at the optimal time-point as above,an AUC of 0.98(0.93-1.02)(P<0.01)in this limited sample was able to obtain. Conclusions Application of serum and urinary biomarkers for the prediction of AKI in patients undergoing cardiac surgery is highly dependent on the sampling time.Of the evaluated markers,uNGAL has the best predictive profile.uRBP also shows similar predictive power.Combining all the five above biomarkers is able to predict significantly more cases,suggesting that the use of more than one marker may be beneficial clinically.

OBJECTIVE: To study the expression of angiopoietin receptor Tie-2 in the renal tissue of diabetic rats and the effects of Astragalus. METHODS: SD rats were randomly divided into normal control group, diabetes group and Astragalus-treated group. The expression of receptor Tie-2 in the renal tissue was assessed by using real-time quantitative polymerase chain reaction and immunohistochemical method. RESULTS: Glomerule Tie-2 protein expression was significantly elevated in the diabetes group as compared with the normal control group (P<0.01). Glomerule Tie-2 protein expression in the Astragalus-treated group was decreased as compared with the diabetes group (P<0.01). CONCLUSION: Tie-2 may play an important role in the pathogenesis of the early stage diabetic renal injury. The reno-protection effect of Astragalus may be mediated by down-regulating the expression of Tie-2 in the kidney tissue of diabetic rats.

Objective To investigate the role of recombinant human interleukin 6 (rhlL-6) in calcification and osteogenic transition of cultured human umbilical artery smooth muscle cells (HUASMC), and the possible cell signal transduction way. Methods HUASMCs were isolated by the explant method. HUASMCs were treated with (treatment groups) or without (control group) rhIL-6. Alizarin Red S stain was applied for calcium deposition in extracellular matrix of control ceils and the cells treated with rhIL-6 50 μg/L at day 12. Calcium concentration in cell layer of control group and treatment group (treated with rhIL-6 10 μg/L and 50 μg/L, respectively) was determined calorimetrically by the o-cresolphthalein complexone method at day 3, 6, 9 and 12, and corrected by total cell proteins. The mRNA expressions of bone-specific alkaline phosphatase (BAP), osteopontin (OPN), bone morphogenetic protein-2 (BMP2) and osteoprotegerin (OPG) were estimated by real-time PCR in 12, 24 and 72 hours. OPN, BMP2 and OPG expressions were assessed by Western blotting and the BAP concentration at the same time was checked by fluorometry method . Electrophoretie mobility shift assays (EMSA) was used to detect the binding activity of transcription factor Cbfα1 with or without inhibitors of p38-MAPK (SB203580) and PKC (DHC) after 6 hours stimulation by rhIL-6 10 μg/L. Results rhIL-6 induced a positive Alizarin Red S stain and a time-dose-dependent increasing of cell layer calcium deposition.Compared with control group, rhIL-6 10 μg/L enhanced gene expression and protein levels of BAP and BMP2 at the early time (12 and 24 hours), and of OPN and OPG at later hours (24 and 72 hours). RhIL-6 still induced an increasing of binding activity of Cbfα1, which could be partially blocked by DHC but not SB203580. Conclusions rhIL-6 induces HUASMCs calcification and osteogenie transition in vitro, which may be one of the mechanism involved in IL-6 associated vascular calcification as observed in clinical studies. The role of IL-6 in HUASMCs may partially achieved through the PKC cell signal transduction way.

Objective To prospectively investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of acute kidney injury (AKI) following adult cardiac surgery. Methods Twenty-nine hospitalization patients undergone cardiac surgery were enrolled in the study. Serial blood and urinary samples were collected immediately before incision and at various time intervals after surgery. The primary outcome measure was acute kidney injury, defined as a 50% increase in the level of serum creatinine (Scr) from baseline. Results Fourteen of 29 developed acute kidney injury. The diagnosis time point with Ser was at 24 (10, 48) h after cardiac surgery. By contrast, the concentration of urinary NGAL rose from a median of 3.42(1.60, 9.92) μg/L at baseline to 20.51(13.42, 50.02) μg/L at admission to ICU (P=0.006),and the median concentration of urinary NGAL in patients who developed AKI was significantly higher at admission to ICU compared with patients who did not develop AKI [20.51 (13.42, 50.02) μg/L vs 2.91 (0.72,8.61) μg/L, P=0.002]. As to urinary NGAL at admission to ICU, the area under the receiver-operating characteristic (ROC) curve was 0.824, the sensitivity was 85.7% and the specificity was 80.0% with a cutoff value of 10.95 μg/L. Significant correlation was found between urinary NGAL at admission and the levd of Scr at 24 h in ICU (r=0.545, P=0.002), as well as estimated GFR (r=-0.546,P=0.002). Conclusion Urinary NGAL concentration is significantly higher in patients developing postoperative AKI at the early time of admission to ICU, which may be a useful early biomarker of AKI after adult cardiac surgery.

ObjectiveTo investigate the effects of pravastation intervention on tumor necrosis factor (TNF)-α-indueed ossifie calcification in human umbilical artery smooth muscle cells (hUASMCs). MethodshUASMCs were cultured by tissue explant in vitro, hUASMC were treated with TNF-α 50 μg/L and pravastatin of three different concentrations. The calcium deposition was determined by O-cresolphthalein eomplexone method. The mRNA expression of BAP and OPN was determined by real time-PCR. The protein expression of BAP, OPN and BMP-2 was determined by Western blotting. ResultsPravastatin inhibited the proliferation of hUASMC (r=-0.946, P＜0.01) and decreased the cell calcium deposition (r=-0.973, P＜0.01) in a dosedependent manner. Pravastatin down-regulated the expression of BAP, OPN and BMP-2 induced by TNF-α in a dose-dependent manner (mRNA, r=-0.972, P＜0.01;BAP protein, r=-0.820, P＜0.01;OPN protein, r=-0.972, P＜0.01;BMP-2 protein, r=-0.928, P＜0.01). ConclusionPravastatin can inhibit the proliferation of hUASMC, decrease the cell calcium deposition and inhibit the ossifie calcification of hUASMC induced by TNF-α.

Objective To investigate the relationship between the variation of endothelial progenitor cells (EPC) number and cardiovascular diseases (CVD) in maintenance hemodialysis (MHD) patients ,and discuss the function of EPC in the progression of CVD in MHD. Methods One hundred and fifteen MHD patients over 18 years whose dialysis vintage was over six months from Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine were enrolled. They were divided into CVD group and non ? CVD group by medical history, electrokardiographie (EKG), cardiac ultrasound, peripheral vascular imaging and cardiovascular imaging. Peripheral blood (5 ml) was collected for detecting EPC number by flow cytometry as CD34/CD133/vascular endothelial growth factor receptor 2 (VEGFR2) cells. The EPC number between CVD group and non?CVD group was compared. The relationship between the decrease of EPC number and CVD risks in MHD patients was analyzed by logistic regression analysis. In a three?year follow?up, the death and new CVD events of the two groups were compared in order to discuss the relationship between EPC number and adverse events. Results Among 115 MHD patients, the average age was 61.57 ± 12.76, male/female was 71/44, the average dialysis vintage was (86.24 ± 56.31) months, the average Kt/V was 1.69 ± 0.29 and average ultrafiltration volume was (2.48 ± 0.90) L. Forty?four patients in 115 (38.3%) were with concurrent CVD. The EPC number in CVD group was significantly lower than that in non CVD group (P=0.015). The CVD group had higher serum phosphate (P=0.013), higher glycosylated hemoglobin (P<0.001), but serum calcium, intact parathyroid hormone (iPTH) and other indicators had no significant difference between two groups. Multiple Logistic regression analysis showed that older age (OR=1.061), history of diabetes (OR=9.796), dialysis vintage (OR=1.015), serum phosphate (OR=3.766), decrease of EPC number (OR=0.909) were the independent impact factors of CVD events in MHD patients. There were 22 patients of the 115 MHD patients had encountered a new CVD event in a three?year follow?up between December 2012 and December 2015, 9 patients from the CVD group and 13 patients from the Non?CVD group, and there was no significant difference between two groups (P=0.776). Nine patients from the CVD group and 7 patients from the Non?CVD group died in the follow?up, and there was no significant difference (P=0.111). Seventy?one MHD patients from the non?CVD group were divided into two groups by the median of EPC number. There were 3 patients in the higher EPC number group encountered CVD events and 10 patients in the lower EPC number group encountered CVD events, which had significant difference (P=0.024). Conclusion The decrease of circulating EPC number may be related with CVD events in MHD patients. Even adjusted by age, sex, diabetes, dialysis vintage and serum phosphate, decreased EPC number is still the independent risk factor of CVD events in MHD patients. The decrease of EPC number in MHD patients may be used to predict the occurrence of cardiovascular events.

Objective To determine the socioeconomic factors and main causes of treatment failure among bacillary-positive pulmonary tuberculosis patients in Shanghai.Methods A 1:1 matched case-control study was performed.Ninety two cases who were treated longer than 18 months,and 85 controls who completed treatment during 2003-2004 in Shanghai were selected.Cases and controls were matched by sex,age,and previous treatment.Results Adjusted by sex,age,and previous treatment,the associated factors of treatment failure among bacillary-positive pulmonary tuberculosis patients were drug resistance (?2=14.764,P

OBJECTIVETo investigate the effect of one kind of regulating-qi and Nourishing-yin Chinese herbs Zuoguiyin on the expression of rats ovarian vascular endothelial growth factor (VEGF) and secreted protein acidic rich in cysteine (SPARC) during the period of peri-menopause.

METHODThe animal models of perimenopause rats were established by natural aging. Perimenopause rats were treated by intragastric administration (ig) with low (13.78 g x kg(-1)), middle (20.67 g x kg(-1)) and high (31 g x kg(-1)) dose of Zuoguiyin for 8 weeks. Expression of VEGF and SPARC mRNA were detected by RT-PCR. Immunohistochemistry was used to evaluate expression levels of VEGF protein.

RESULTCompared with that in the control group, ovarian expression levels of VEGF mRNA and its protein in rats during peri-menopause increased significantly (P < 0.01). Middle and high dose of Zuoguiyin could both down-regulate the expression of VEGF in ovaries of praesenilis rats, and the difference has statistical significance (P < 0.01). Expression levels of SPARC mRNA in rat ovaries during peri-menopausal period decreased obviously compared to that in the control group (P < 0.01). Middle and high dose of Zuoguiyin could greatly promote ovarian SPARC mRNA expression of praesenilis rats (P < 0.01).

CONCLUSIONThe abnormal changes of VEGF and SPARC may play an important role in the aging process of ovary. Zuoguiyin, one kind of regulating-qi and Nourishing-yin Chinese herbs, can improve ovarian vascular formation through down-regulating the expression of VEGF meanwhile up-regulating the expression of SPARC. And it may delay aging by this way.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Gene Expression ; drug effects ; Humans ; Models, Animal ; Osteonectin ; genetics ; metabolism ; Ovary ; drug effects ; metabolism ; Perimenopause ; drug effects ; metabolism ; Rats ; Rats, Wistar ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

Objective To prospectively study the difference of urinary N-acetyl-β-D-glucosaminidase( UN-AG) and retinol binding protein(URBP) in contrast-induced nephropathy (CIN). Methods The clinical data of 150 patients undergoing coronary angiography were documented. The urine and blood samples before,24 hours after and 48～72 hours after the procedure were collected;Serum creatinine (SCr) and urinary ereatinine (UCr)were tested by enzymic method. UNAG and URBP were tested by ELISA in CIN and control group. CIN was defined as an increase in SCr of ≥44 μmol/L or >25% from baseline 48 ～72 h after the procedure. 27 age- , sex- , results of coro-nary angiography-matched cases were taken as control group. Results CIN was diagnosed in 13 of 150 patients (8.7%). In CIN group, UNAG/UCr were significantly higher than that in control group[ 1.97 (1.06,2.64) U/mmol vs 1.07 (0, 68,1.88 ) U/mmol, Z = 2.076, P = 0.039 ] before ;24 hours after the procedure, UNAG/UCr was signifi-cantly up-regulated in CIN group from baseline level [ 2.82 ( 1.88 ,4.26) U/mmol vs 1.97 (1.06,2.64) U/mmol, Z =2.607,P =0. 009]. ROC curve analysis showed that baseline UNAG could be used as an early predictor for CIN, the AUC =0. 776 ,P =0.023 ;when cut off value = 8.08 U/L,the sensitivity and specificity of UNAG were 0. 771 and 0. 713 respectively. The percentage of patients of UNAG over 8.08 U/L in CIN group was significantly higher than that in control group[77.1% (10/13) vs 29.6% (8/27) ,Z =2. 564,P =0. 011 ] ,the related risk factor is 5.58,95% CI was 1.24 ～ 25.08. Conclusion UNAG could be used as a predictor of CIN before the procedure and its postprocedure 24 h level maybe useful in early diagnosis after the procedure.

Objective To investigate the effect of high glucose on the expression of liver X receptors (LXRs) and ATP-binding cassette transporter A1 (ABCA1) in human macrophages (THP-1 cell line). Methods THP-1 monocytes were differentiated into macrophages by induction of phorbol 12, 13-dibutyrate (PMA). Surface markers of macrophages were identified by CD68 immunohistochemistry. The macrophages were cultured with different concentration (5.6, 11.1, 22.2 and 33.3 mmol/L) of glucose and different time (0, 0.5, 2, 6, 12, 24, 48, 72 h). Real time PCR and Western blotting methods were used to examine the mRNA and protein expression of LXRs and ABCA1. Results As compared to 5.6 mmol/L glucose, macrophage LXRβ and ABCA1 were decreased significantly at both mRNA and protein levels in dose-and time-dependent manner (P<0.05). Conclusion Hyperglycemia may play a role in the pathogenesis of arteriosclerosis through the inhibition of LXRs and ABCA1 expression in diabetic patients.