ObjectiveTo investigate the predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP) level on the capacity load of patients with maintenance hemodialysis (MHD).MethodsOne hundred and twenty patients undergoing MHD were divided into two groups according to blood pressure levels:bad blood pressure control group with 72 patients and good blood pressure control group with 48 patients.NT-proBNP levels were detected before and after dialysis,and cardiothoracic ratio,left ventricular mass index ( LVMI ),swelling index,number of occurrences of low blood volume and ultrafiltration volume were measured and compared between two groups.The correlation between NT-proBNP and the above indicators was analyzed.ResultsThe systolic blood pressure,diastolic blood pressure,NT-proBNP before dialysis,cardiothoracic ratio,LVMI,swelling index and number of occurrences of low blood volume in bad blood pressure control group respectively were (159.7±18.2) mm Hg (1 mm Hg =0.133 kPa),(95.3±14.8) mm Hg,(11 837.13±1374.26) ng/L,0.61±0.12,(174.36±21.35) g/m2,2.93±1.72,12cases/week,while the indicators in good blood pressure control group were ( 131.6±17.3) mm Hg,(86.5±13.2) mm Hg,(7649.54±1106.18) ng/L,0.52±0.11,( 151.83±18.94) g/m2,1.02±1.48,26 cases/sweek.There were significant differences between two groups (P ＜ 0.01 ).It was showed that NT-proBNP difference between before and after dialysis had significant positive correlation with ultrafiltration volume(P＜ 0.05).NT-proBNP before dialysis had a significant positive correlation with systolic blood pressure,diastolic blood pressure,cardiothoracic ratio,LVMI and swelling index (P ＜ 0.05 or ＜ 0.01 ),while had obvious negative correlation with the number of occurrences of low blood volume(P ＜ 0.01 ).ConclusionsNT-proBNP level of MHD patients has close correlation with blood pressure,cardiothoracic ratio,swelling index,number of occurrences of low blood volume and ultrafiltration volume.Detecting the level of NT-proBNP can better evaluate the changes of blood volume in dialysis patients,adjust dialysis prescription in time,and ensure the adequacy of dialysis.It has important significance to improve the quality of life of MHD patients.

Objective To explore the effect of elbow release and debridment with arthroscopy for elbow malfunction. Methods The study was carried out on 15 patients (male 11, female 4; age 21-63 years old, average 40.1 years old) with the use of arthroscopy to brisement accretion and articular capsule from August 2001 to December 2003. The mean course was 55.2 months (range, 8-24 months). The flexion angle of joint preopration was 15?-60?, average 30.4?, the extension angle was -80?--20?, average -51.2?. The diagnosis was osteophyma and liberum in 4. The old fracture of radius capitulum was in 2; the old fracture of ulnar olecranon in 2; the old fracture of condyle of humerus in 3; degeneration in 4. The brachial plexus anesthesia,the elbow hung to traction, interna and extra-pathway, to cut synovium and accretion fibers with shver, removal liberum and milling osteophyma, meanwhile brisement articular capsule. Pathology manifestation in arthroscopy: there were a lot hyperemia synovium and fiber accretion. There was cartilage exfoliation in 8, hyperplasy and liberum in 5, ossification of cicatricle in 2. The motion range of elbow was reexamined, if the extension function was restricted, release was performed on anterior soft tissue and capsule. If the flexion function was restricted, release was carried out on posterior capsule via posterior straight approach(3 cm supra point of olecranon). Results All patients recovered daily life and occupation postoperative 7 to 14 days. Transient ulnar nerve paralysis occurred postoperatively in one case, which recovered three months later. There were no blood vessel and nerve injury. The mean follow-up period was 14.1 months (range, 7-20 months). At the final follow-up, the flexion of joint post operation was 70?-120?, to improve average 60.5?; the extension of joint post operation was -20?--5?, to improve average 37.6?. In accordance with HSS scoring system, excellent 7, good 5, fail 3. Conclusion Using of arthroscopy to release elbow joint have many advantages such as less trauma, quick recovery and less sequela. The application in release with arthroscopy is a good way for elbow malfunction.

0.05). Conclusion CCM is a proper scaffold,on which KC and FB of tympanum maintain satisfactory proliferation and collagen secretion activity.

The endothelial cells activated by tumor cells are genetically stable and regress easily. Moreover, at the surface there are specific markers, which are easily accessible by system administration. This report review the studies of tumor treatment targeting at the activated endothelial cells.

Pain is a common complication after spinal cord injury. Clinical studies involve pain mechanisms, classifications and treatments,etc. Pain after spinal cord injury needs comprehensive treatment. However, each of these interventions may produce only small curative effect, so this article aims to emphasize the best evidences and provide clear, wise and prudent evidences for clinical decision by reviewing clinical researches about pain after spinal cord injury.

[Objective]To assess whether the canal compromise and the location of conus medullaris determine neurological deficit in burst fracture of the first lumbar vertebra(L1).[Method]Twenty-seven consecutive patients with L1 burst fracture were collected in the study.The compressive ratios of anterior and posterior heights of fractured vertebral bodies,the remains to the estimated ones of the original vertebral bodies were measured on the radiogram,the extent of spinal canal compromise was assessed by computed tomography,and the location of conus medullaris was determined by the MRI examination.The neurological status was evaluated according to the standard neurological classification of spinal cord injury(ASIA).[Result]The compressive ratio of the anterior height was 0.63,the posterior height was 0.91,the stenotic ratio of the canal mid-sagital diameter was 0.69,the stenotic ratio of the distance between pedicles was 1.14,and the stenotic ratio of canal area was 0.83.The group having the stenotic ratio of canal area below 0.5 was at significant risk of neurologic involvement than the control [above(or equal to) 0.5(P=0.049)],and the group with lower conus medullaris had more serious neurological deficit than the upper ones(P=0.046).[Conclusion]There is a significant difference of neurological deficit between the groups with the spinal canal stenosis level of more than 50% and less 50%,and the group with lower conus medullaris had more serious neurological deficit than the upper one.

Objective To observe the changes of hippocampal NogoA-NgR1 signaling on postoperative cognitive function (POCD) in aged mice, and explore the potential underling mechanism.Methods Isoflurane anesthesia and laparotomy were applied to establish the POCD model.Forty aged male C57BL/6 mice were randomly divided into the following four groups (n=10): group O2+saline (group OS), group O2+NEP1-40 (group ON), group isoflurane anesthesia+laparotomy surgery+saline (group SS), and group isoflurane anesthesia+laparotomy surgery+NEP1-40 (group SN).Cannula placement was performed into lateral ventricle 7 days before the surgery.Animals were subjected to an administration of NEP1-40 (20 μg/2 μl) or isochoric saline via intracerebroventricular injection once daily for 8 consecutive days, injection was given from 2 h before isoflurane anesthesia to the last behavioral test.Open field test was performed at 5th d after operation.Contextual and cued fear conditioning training and testing were exhibited at 6th and 7th d after operation, respectively.The hippocampus was harvested 2 h after the behavioral test.Western blot was used to detect the expressions of NogoA, NgR1, RhoA, ROCK2 and GAP43.Golgi staining was applied to measure the changes of dendritic spines in hippocampal CA1 area.Results Compared with the groups OS and ON, the freezing time in the contextual fear conditioning test was significantly decreased, the contents of NogoA, NgR1, RhoA and ROCK2 were significantly increased, the content of GAP43 and the number of dendritic spine were significantly decreased in group SS (P<0.05).Compared with the group SS, the freezing time in the contextual fear conditioning test was significantly increased, the contents of RhoA and ROCK2 were significantly decreased, the content of GAP43 and the number of dendritic spine were significantly increased in group SN (P<0.05).Conclusion Over-activated of hippocampal NogoA-NgR1 signaling participated in the pathogenesis of POCD in aged mice.

Objective To study the correlation of expression of DNA topoisomerase Ⅱ alpha (TOP2A)with expressions of human epidermal growth factor receptor 2 (HER2)and phosphatase and tensin homolog (PTEN)and gene mutation of phosphatidylinositol 3-kinase (PI3K)in breast cancer so as to provide reference for prognosis of the cancer and evaluation of drug efficiency.Methods This study enrolled totally 96 breast cancer patients. Tumor specimens were resected.The gene expressions of TOP2A,HER2 and PTEN were analyzed using branched DNA-liquid-chip,and PI3K gene mutation was detected by xTAG-liquid-chip.Correlations between gene expressions and gene mutation were further explored by Spearman correlation analysis so as to clarify the relationship between TOP2A and HER2 signaling pathway gene.Results Co-expression of TOP2A and HER2 was strong,and TOP2A tended to be highly expressed in the presence of high expression of HER2 (P =0.01).The expression of PTEN was not significantly correlated with the expression of TOP2A,whereas the mutation of PI3K had a positive association with the high expression of TOP2A (P =0.004).Conclusion Anthracycline drug resistance factor TOP2A may be related to the critical factors of HER2 signaling pathway,suggesting that HER2 expression and PI3K mutation may be key factors in regulation of TOP2A expression,which would provide important evidence for chemotherapeutic resistance.

120 age- and body mass-matched Lewis rats underwent anastomosis of vessels and bronchus using cuff technique and 60 rats received orthotopic left lung transplantation. All procedures were done by one operator. The feasibility and reliability of this technique was determined by examining graft patency usng X-ray, gross and histological examinations. The successful rate of the surgery was 96.7%, mean warm ischemic time was (14.5±3.2)min. On gross examination, grafts were well perfused and ventilated.Recipients of 14d after transplantation showed excellent chest X-ray signs and perfect graft function. The animal model established in this study has been verified to be a safe, simple and reproducible model.

Objective To investigate the expression patterns of fibroblast growth factor 23 (FGF23) in osteoblast and its responses to calcium, phosphate, exogenous PTH and 1,25(OH)_2D~3. Methods The primary rat calvarial osteoblasts were cultured in MEM medium which containing 10% FBS, then were harvested when cells were in half-confluence, confluence, osteoid deposition and osteoid mineralization stages respectively. The procedure was monitored under microscopy. Total RNA was extracted from cells according to the Trizol procedure. FGF23 mRNA levels were determined by Real-time PCR. Further, the confluent osteoblasts were treated with 3.2 mmol/L CaCl_2, 4.4 mmol/L β-glycerophosphate, 10~(-9) mol/L rhPTH(1-34) and 10~(-8) mol/L 1,25(OH)_2D_3 respectively for 3 days, and same volume of the medium was added as the control. The gene expressions were determined by Real-time PCR. Results FGF23 expression was transiently up-regulated at cell confluent stage and down-regulated after that. The FGF23 mRNA levels were 7.5-fold higher in confluent cells compared with that in half-confluent cells (P<0.001). The markedlly stimulating effect (about 16 times) on FGF23 expression was stimulated by exogenous 1,25(OH)_2D_3 treatment while no significant effect was found on FGF23 mRNA levels by CaCl_2,β-glycerophosphate, and rhPTH(1-34) treatments when compared with the control. Conclusions The FGF23 expression in osteoblast is developmental stage-related and its powerful stimulator is 1,25(OH)_2D.