Epigenetics, which is called second genetic code precisely and controls the total metabolic processes of eukaryotic cells,has an inseparable correlation with human health and diseases. Among all the gene silencing mechanisms of epigenetic modifications,CpG islands of DNA promoter hypermethylation/histone mod-ifications are two major causes. Promoter methylation of specific genes,such as Ras protein activator analogue 1 may lead to aberrant activation of downstream signaling pathways,following by fibroblasts proliferation and kid-ney fibrosis. In recent years,epigenetic modifications have been proved to play a major role in preventing fibro-blasts to return to their quiescent stage,ultimately contributing to fibrosis in the kidney. This paper provides a glimpse of recent studies on epigenetic mechanisms of chronic kidney diseases,especially renal fibrosis,with an aim to provide new insights into pathogenesis research and clinical diagnosis and treatment.

MicroRNA could participate in a variety of physiological and pathological processes via iden-tifying the target genes by their seed sequences and regulating gene expression at post-transcriptional level. Glo-merular mesangial cell is one of the most chief cells of the glomerulus and plays an important role in the renal fi-brosis. The mesangial cellular proliferation and dysfunction may appear once attacked by pathogenic factors. Then,the extracellular matrix increases in the stimulation of inflammatory cytokines,eventually,resulting in glo-merular sclerosis and renal fibrosis. Reports have shown that series of microRNA could take part in the process of injury of mesangial cells and lead to renal fibrosis. MicroRNA could be a potential therapeutic target for early chronic kidney diseases.

Objective To observe the clinical effect of entecavir combined with oxymatrine in the treatment of patients with hepatitis B.Methods 74 patients with hepatitis B were randomly divided into two groups.The treatment group(40 cases) were given entecavir 0.5mg daily,oxymatine 600mg,intravenous daily.The control group (34 cases) were given entercavir 0.5mg daily.The HBeAg and Anti-HBe negative conversion rates,the HBV-DNA negative conversion rate and the ALT normalization rate after 1,3,6,9,12 months in treatment period and 6,12months in follow-up period were observed.Results After 1,3,6,9,12 months in treatment period and 6,12 months in follow-up period,the HBeAg and Anti-HBe negative conversion rates of the treatment group was 32.5％,45.0％,60.0％,60.0％,62.5％,62.5％ and 62.5％,while that of the control group was 5.9％,5.9％,8.8％,11.8％,11.8％,11.8％ and 11.8％,there was significant difference between them( x2 =5.46,12.83,25.22,21.68,24.79,24.79,24.79,all P ＜0.05).The ALT normalization rate of the treatment groups was 45.0％,67.5％,87.5％,90.0％,90.0％,90.0％ and 90.0％,while that of the control group was 20.6％,32.4％,41.2％,50.0％,52.9％,52.9％ and 52.9％,there was significantly difference between them ( x2 =4.60,10.36,20.67,14.47,12.08,12.08,12.08,all P ＜ 0.05 ).Conclusion Entecavir combined with oxymatrine in the treatment of patients with hepatitis B had a synergistic antiviral effect,high security and simple treatment.It was worthy to promote.

Primary nephrotic syndrome refers to one of the common glomerular diseases in children.Glucocorticoid is the first choice in the treatment of nephrotic syndrome, and the using cycle is long.Long term application of glucocorticoids can cause side effects, including Cushing′s disease, hypertension, decreased immune function, growth retardation and eye adverse reactions.Among eye adverse reactions, glaucoma and cataract are more common.Glucocorticoid-induced glaucoma and glucocorticoid-induced cataract are often concealed, and children often cannot accurately express their discomforts.At the same time, some clinicians lack the understanding of the adverse reaction, which is easy to cause missed diagnosis and misdiagnosis.Eventually, irreversible visual impairment occurred.Here, the etiology, pathogenesis, clinical diagnosis, and treatment of glucocorticoid-induced glaucoma and glucocorticoid-induced cataract are elaborated, thus aiming to improve clinicians′ understanding of glucocorticoid ophthalmopathy and the level of clinical diagnosis and treatment.

Objective To observe the clinical effect of sodium ozagrel combined with cinepazide treatment of cerebral arteriosclerosis , and the influence on hemorheology and blood lipid.Methods 112 cases of arteriosclerosis in patients with cerebral infarction were randomly selected from January 2015 to January 2016 in our hospital, and were randomly divided into observation group and control group ,56 cases in each group, the control group were treated with cinepazide treatment, patients in the observation group was combined with ozagrel sodium, clinical curative effect and blood rheology were compared between the two groups study, blood lipid.Results The observation group the total efficiency was significantly higher than the control group ( P<0.05 ) .After treatment, compared with before treatment, blood rheology parameters and blood lipid levels of two groups were significantly improved ( P<0.05 ) , and the patients in the observation group improved the hemorheological parameters and blood lipid level was significantly better than the control group ( P<0.05 ) .Conclusion Ozagrel sodium combined with cinepazide maleate in the treatment of cerebral arteriosclerosis process,can significantly improve the hemorheological parameters and blood lipids, and the clinical curative effect.

Objective To observe the efficacy and safety of venlafaxine on cognitive function in patients with post stroke depres-sion(PSD) .Methods 72 patients of cognitive dysfunction with PSD were selected and randomly divided into observation group and control group with 36 cases in each .The control group was treated with therapy for acute stroke .The observation group was treated with venlafaxine based on the treatment of control group .After 12 weeks of treatment ,the mini mental state examination(MMSE) , the Montreal cognitive assessment scale(MoCA) and activities of daily living scale(ADL) were used to evaluated the efficacy of the two groups before ,fourth weeks after and twelfth weeks after the treatment .The scores of the two groups were compared .The oc-currence of adverse reaction of the observation group was recorded .Results After 4 weeks treatment of the observation group ,the MoCA was (18 .52 ± 4 .37) .MMSE score was (20 .61 ± 4 .85) ,which were significantly higher than before treatment .And the ADL score was (35 .27 ± 4 .75) ,significantly lower than before treatment(all P<0 .05) .After 12 weeks of treatment ,the MoCA score of observation group was (20 .14 ± 5 .26) .MMSE score was (22 .46 ± 4 .59) .Which were all significantly higher than those of control group .While the ADL score was (29 .85 ± 5 .07) ,significantly lower than the control group(all P<0 .05) .The observation group with 2 cases had mild gastrointestinal discomfort ,2 cases with dizziness .Conclusion Venlafaxine can improve cognitive function in patients with post stroke depression .It can significantly improve patients′self-care ability and is safe .It can be further applied in the clinic .

Objective To observe the impact of different culture conditions on the growth of the endothelial progenitor cells(EPCs) from rat peripheral blood. Methods Mononuclear cells obtained from rat peripheral blood were isolated by using density gradient centrifugation. According to the culture medium added with vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and the dishes were precoated with fibronectin or not, the mononuclear cells were divided into different groups and cultured under different conditions in vitro to compare the differences of the growth conditions. The different growth conditions were recorded and the result was calculated by statistics software. At last, the cells were identified by immunohistochemistry and immunofluorescence. Results The mononuclear cells from rat peripheral blood grew in the manner of keeping close to the wall in vitro. The cells and cell colonies cultured for 7 days hinted:under the same culture conditions, precoating FN was beneficial to the adherent proliferation of EPCs (t=4.43, P＜0.05; t=3.70, P＜0.05). Excluding the impact of fibronectin, growth factors could promote mononuclear cells differentiation to EPCs, indicating that growth factors enhanced proliferation of EPCs (t =-13.22, P＜0.01; t =-10.96, P＜0.01). Immunohistochemistry and immunofluorescence showed that, at day 4, 7, 10 of cells cultured, CD34 and CD133 expressions were increased gradually [(35.7±4.2)%, (60.1±3.8)%, (81.8±6.4)%; (3.2±0.9)%, (18.4±7.3)%,(32±3.8)%, respectively]; at day 14, both were decreased [(32.1±5.4)%, (1.9±2.7)%]; but Flk-1was increased at day 4, 7,10, 14 [(31.2±3.5)%, (40.6±5.3)%, (71.2±8.4)%, (81.5±4.1)%].Conclusions Fibronectin is conducive to adhesion and proliferation of EPCs. VEGF and bFGF play an important role in the differentiation of EPCs. The success culture of EPCs in vitro will provide a sufficient number of seed cells for its application in vascular tissue engineering, and offer new ideas for peripheral blood stem cell transplantation for the treatment of various diseases.

Objective To investigate the clinical effect of fluticasone propionate combined with noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease (COPD).Methods 88 cases of COPD patients from October 2014 to October 2016 in our hospital were selected and randomly divided into two groups of the control group observation group with 44 cases in each group.The control group was treated with conventional treatment, the observation group was treated with fluticasone propionate plus noninvasive positive pressure ventilation, and then the curative effect of the two groups was compared.Results The total effective rate of observation group was 100% higher than that of the control group 70.5%, the difference was statistically significant (P<0.05), after treatment, the observation group of FVC (2.50 +0.32) L, FEV1 (1.36 +0.20) L, FEV1%(51.23+4.32), PaO2(10.51+2.10) kPa, PaCO2(5.15 +1.19) kPa, compared with the control group, the difference was statistically significant (P<0.05), the observation group recurrence rate 4.5% was lower than the control group 13.6%, the difference was statistically significant (P <0.05).Conclusion COPD patients with fluticasone propionate combined noninvasive positive pressure ventilation, can effectively improve lung function, reduce disease recurrence rate, a significant effect.

OBJECTIVE To study characteristics and drug resistance of the pathogens of hospital acquired pneumonia(HAP)in cadre ward.METHODS Retrospectively analyzed the commonly encountered pathogens and their antibiotic resistance of HAP in cadre ward from Jan 2005 to Dec 2007.RESULTS A total of 174 strains bacteria were isolated.The top five pathogens were Pseudomonas aeruginosa(17.82%),Klebsiella pneumoniae(14.94%),Staphylococcus aureus(13.22%),Acinetobacter baumannii(9.20%)and Candida albicans(8.62%).Both Gram-negative bacteria and Gram-positive cocci were multiple drug-resistant.CONCLUSIONS The incidence of HAP in cadre ward is high and Gram-negative bacteria are the main pathogens.The strains isolated are multiple drug-resistant.It is important to study the characteristics and drug resistance of the pathogens.