Objective To explore the clinical significance of perioperative serum N-terminal pro-BNP(NT-proBNP)testing in patients with cardiac valve replacement.Methods The content of perioperative plasma NT-proBNP in 296 patients with cardiac valve replacement was detected,the relationship between preoperative plasma NT-proBNP content and heart function classification was analyzed,the postoperative changes were observed and the plasma NT-proBNP levels were compared among the death cases, the patients with complications and without complications.Results The left ventricular ejection fraction(LVEF)and plasma NT-proBNP content had statistical differences among different cardiac functional classifications(F =5.268,8.173,P <0.05),preopera-tive serum NT-proBNP level was positively proportional to the cardiac function classification(r =-0.776,P <0.01)and inversely proportional to LVEF(r=-0.472,P <0.05);on postoperative 1 d,plasma content of NT-proBNP reached the peak,there was sta-tistically significant difference compared with before treatment,(t=20.913,P <0.05),then which was gradually declined on post-operative 3,5,7 d.The preoperative plasma NT-proBNP content and postoperative plasma NT-proBNP peak levels in the death pa-tients and the patients with complications were higher than those in the patients without complications(P <0.05 ),the difference was statistically significant(P <0.05 ).Conclusion Preoperative plasma NT-proBNP concentration in the patients with cardiac valve replacement can reflect the cardiac function condition,the postoperative plasma NT-proBNP content is increased at the early stage,then gradually decreased,The increase of plasma NT-proBNP concentration before and after operation has a certain clinical value in predicting prognosis of the patients.

Objective To investigate the effect of pioglitazone on the expression of thrombospondin-1(TSP1)and transfor ming growth factor-β1 (TGF-131)in the kidney of diabetic rats.Methods Forty Sprague-Dawley(SD)rats were randomly divided into 4 groups:normal control(NC),streptozocin-induced diabetic mellitus(DM),diabetic rats treated with pioglitazone(DP)and normal control rats treated with pioglitazone(NP).24-h urine protein quantity,serum creatinine(Scr) and kidney hypertrophy index were measured after treatment for 10 weeks,and the expression of TSP1 and TGF-β1 in the kidney was detected by using RT-PCR and immuohistochemistry.Results As compared with DM group,urine protein level and kidney hypertrophy index were significantly attenuated in DP group(P<0.05),but there was no significant difference in plasma glucose between them(P>0.05).As compared with NC and NP groups,the expression of TSP1 and TGF-β1 was significantly elevated in the kidney of DM and DP groups(P<0.01).Both TSP1 and TGF-β1 expression in DP group was lower than in DM group(P<0.05).Conclusion Pioglitazone can exert a direct protective effect on the kidney in diabetic rats,which is independent of the role of insulin sensitizer,and the mechanism may be associated with the decreased TSP1 expression in the kidney.

High-efficiency exhalation disinfection device for the patient infected with SARS can also meet the disinfection requirements of the patients with severe respiratory communicable diseases. Connected with the exhaust vent of the breathing mask or the respirator by corrugated tubes, this device gathers exhalation containing a large amount of causative agents through the completely leakproof ductwork and then expels purified air after multiplicate disinfection by high temperature, high pressure and chemical disinfectant. The device can prevent the patient with severe respiratory communicable disease from polluting their surrounding air and thus cut off the route of transmission, reduce the infection rate and the death rate of the person and medical personnel who has made intimmate contact with the patient.

Objective To explore the role of NG2 proteoglycan in the pathogenesis of glomerulosclerosis. Methods Eukaryotic expression vectors carrying the small hairpin RNA (shRNA) for NG2 mRNA , named as Psilencer-NG2, was constructed. Then, rat mesangial cells (RMC) were transfeeted with Psilencer-NG2, Psilencer-NC (negative control), pcDNA/NG2 (NG2 over-expressive vector) and empty vector pcDNA 1 respectively. The expression of endogenous NG2 in RMCs was examined by real-time PCR and Western blotting. Cell proliferation was analyzed by MTT assay and flow cytometry. The expression of laminin was detected by real-time PCR. Results Transfection of pcDNA/NG2 into HBZY-1 cells resulted in over-expression of NG2 mRNA and protein (P<0.05, P<0.05). Transfection of Psilencer-NG2 led to reduced expression of NG2 mRNA and protein (P<0.01, P<0.01). The expression of laminin β1 significantly increased due to overexpression of NG2 and decreased by treating with NG2 siRNA. According to MTT assay, overexpreasion of NG2 significantly stimulated the proliferation of mesangial cells while NG2 silencing inhibited it. NG2 increased the cell number in S phase and decreased the cell number in G0/G1 phase, while silencing NG2 induced the decrease of cell number in S phase and the increase of cell number in G0/G1 phase. Conclusion NG2 actively participates in the pathogenesis of glomerulosclerosis by stimulating proliferation of RMCs and increasing the deposition of ECM.

BACKGROUND: Graft selection and histological fate for anterior cruciate ligament reconstruction is a hot topic in the fields of reconstruction and repair of anterior cruciate ligament.OBJECTIVE: To review structure of anterior cruciate ligament and graft selection.METHODS: Articles were retrieved from Medline database with the key words of "Anterior cruciate ligament, implant,reconstruction" between January 1980 and January 2010. inclusion criteria: ① Reconstructive surgery of anterior cruciate ligament injury; ② graft selection of anterior cruciate ligament. Exclusion criteria: ① the old literatures; ② repetitive studies. A total of articles related to reconstruction of anterior cruciate ligament were retrieved, but 33 ones were included in the final analysis. The old, duplicated, and similar studies were excluded.RESULTS AND CONCLUSION: At present, the major therapy for anterior cruciate ligament injury includes arthroscopy and arthroscopy-assisted reconstruction. For clincal application, there are a lot of grafts, including autogenous grafts, allografts,heterologous allograft, biological materials, artificial materials and tissue engineering grafts. Autogenous semitendinosus tendon and gracilis tendon or autogenous bone-patellar tendon (middle 1/3)-bone (BPTB) are mainly used for anterior cruciate ligament reconstruction at home and abroad.

Objective To study the effects of CD2-associated protein (CD2AP) on podocyte adhesion and extension ability and to explore its possible mechanism. Methods Conditionally immortalized murine podocyte cell line was cultured in RPMI 1640 medium at 33℃permissive conditions. The podocytes were transfected with CD2AP small interfering RNA (siRNA) and serambing sequences labeled with fluorescein were taken as control. The transfected podocytes were trypsinized and seed into collagen IV coated plates. The relative cell adhesion and cell area were examined 90 min later. Apoptotic rates of CD2AP siRNA transfected podoeytes and different PAN concentrations incubated podoeytes were detected by flow cytometer. The distribution of F-actin was observed under laser scanning confoeal microscope. Nephrin protein expression and its phosphorylation level were examined by immunofluorescence and Western blot. Results The relative ceil adhesion of CD2AP siRNA transfected podocytes was apparently lower than that of control group[(41.72±6.07)% vs (64.46±8.53)%, P<0.05]. The cell area analysis had the similar result. The apoptotic rate of CD2AP siRNA transfected podocytes was significantly higher than that of the controls [(5.73±0.61)% vs (3.26±0.45)%, P<0.05]. 100 mg/L PAN could markedly induce podocytes to apoptosis and impair cell adhesion ability (P<0.05). Nevertheless, no significant difference was found in cell body spreading (P>0.05). The distribution of F-actin in CD2AP depletion podocytes was apparently altered. The expression of nephrin protein and its phosphorylation level was conspicuously descended to some degree (P<0.05). Conclusions CD2AP depletion facilitates podocyte apoptosis and impairs cell adhesion function. Cytoskeleton confusion and nephrin signaling weakness caused by CD2AP depletion may he partly responsible for the decline of cell adhesion and spreading.

Objective To investigate the correlations of ATP-binding cassette transporter A1 (ABCA1) protein expression in renal interstitium with foam cells formation,tubulointerstitial lesion and serum cholesterol in glomerulonephropathy.Methods Five patients with Alport syndrome,28 patients with membranous proliferative glomerular nephritis (MPGN),35 patients with focal segmental glomerulosclerosis (FSGS),36 patients with idiopathic membranous nephropathy (IMN) and 34 patients with IgA nephropathy (IgAN) were enrolled in the study.Expression of ABCA1 protein was detected by immunohistochemical method.The relative area of foam cells in renal interstitium was semi-quantified and the correlations of ABCA1 protein expression in renal interstitium (except for renal tubules) with the relative area of foam cells,integration of tubulointerstitial lesion (TIL) and serum cholesterol were examined using t test and linear correlation analysis.Results In renal interstitium,monocyte-macrophages,foam cells and renal tubular epithelial cells expressed ABCA1 protein.ABCA1 protein expression in renal interstitium with foam cells infiltration was significantly higher as compared to that without foam cells infiltration (P＜ 0.05),but there was no correlation between ABCA1 expression and foam cells area (P＞0.05).In MPGN,FSGS,IMN patients,there was a positive correlation between ABCA1 protein expression in renal interstitium and integration of TIL (P＜0.05).There was a positive correlation between serum cholesterol level and ABCA1 protein expression in renal interstitium (P＜0.05).Conclusions In glomerulonephropathy,cholesterol may promote the ABCA1 expression in renal interstitium.ABCA1 may have double-effects on transportation of cholesterol.ABCA1 may take part in the process of tubulointerstitial lesion.

AIM:To study the potential pathological role of abnormal expression of endogenous angiopoietins in progressive glomerulosclerosis.METHODS:80 male Wistar rats were randomly allocated into sham operation group(sham,n=25),unilateral nephrectomy group(UNx,n=25)and UNx+daunorubicin(DRB)group(n=30).The rats in DRB group were intravenously injected with DRB(5 mg/kg)on the seventh and the fourteenth day respectively after excising one kidney.Then,at week 1,2,4,6 and 8,5,male Wistar rats from each group were taken randomly for determining 24 h urinary protein quantitative measurement(24hUPQ),BUN,Scr,and the kidneys were examined by electronic microscope,PAS staining,immunohistochemical staining and in situ hybridization histochemistry.RESULTS:There was a trend towards an increase respectively in levels of 24hUPQ,Bun,Scr,GSI in DRB from week 2 to week 8.Electronic microscope revealed that podocyte injury presented in DRB group.Expression of Ang1 mRNA and protein in glomerulus in DRB group decreased,while expression of Ang2 protein in glomeruli in DRB group increased.In DRB group,expression of Ang1 protein had a negative correlation with 24hUPQ,BUN,Scr,GSI,expression of Ang2 protein and CoIV protein.Expression of Ang2 protein had a positive correlation with 24hUPQ,BUN,Scr,GSI,expression of CoIV protein.CONCLUSION:Podocyte injury may lead to glomeruli abnormally express angiopoietins.A decrease in expression of Ang1,and upregulation in expression of Ang2 may facilitate progressive glomerulosclerosis in the rat.

AIM: To establish a model of subtotal nephrectomy (SNx) and investigate the changes of apoptosis and apoptosis-related genes (Bax, bcl-2, caspase-3, caspase-8 and caspase-9) in the rat remnant kidney. METHODS: Remnant kidneys were produced in adult male SD rats by 5/6 nephrectomy. The renal function and histopathological changes were evaluated at 1, 2, 4, 8, 12, 16, 26 and 40 weeks after operation. The tissues of remnant kidneys were collected to detect apoptosis cells by in situ end-labeling of cleaved DNA (TUNEL) and proliferating cells by determining the proliferating cell nuclear antigen (PCNA). The expression of Bax, bcl-2, caspase-3, caspase-8 and caspase-9 was measured by RT-PCR and Western blotting. The proteins were detected by immunohistochemistry staining. The relation between apoptosis, proliferation, glomerulosclerosis and renal interstitial fibrosis was also observed. RESULTS: The results showed the renal pathological dynamic changes in 5/6 nephrectomy remnant kidneys were tubule-interstitial inflammation and fibrosis, as well as glomerulosclerosis. There were transient increases in both proliferating and apoptotic processes in glomerulus, tubules and interstitium. Apoptosis was increased and most of apoptotic cells were detected in tubular epithelial cells and interstitial area. The mRNA and protein expression of Bax, caspase-3, caspase-8 and caspase-9 were increased in all course, and peaked at week 4 and 40 in the SNX rats. The successive changes of these parameters were parallel to the level of focal inflammation in interstitium. Glomerulosclerosis index was related with focal inflammation cells and 24 hours urine protein (r=0.788, 0.822; P

AIM:To observe the expression of connective tissue growth factor(CTGF)in unilateral ureteral obstruction(UUO)rats,and to explore its pathogenic role in renal tubulointerstitial fibrosis.METHODS:48 Wistar rats were randomly divided into sham-operated and UUO group.The rats were sacrificed at day 1,3,7,and 14.The degree of tubulointerstitial damage was scored according to the Masson staining.The mRNA and protein levels of CTGF,transforming growth factor-?1(TGF-?1),collagen Ⅰ(Col Ⅰ),and plasminogen activator inhibitor-1(PAI-1)were detected by reverse transcriptional-polymerase chain reaction(RT-PCR)and immunohistochemistry,respectively.Expression of CTGF protein in the kidney was also assessed using Western blotting.RESULTS:TGF-?1 mRNA level began to increase as early as 1 day after UUO.This increase was followed by the elevation of CTGF mRNA level,which began to increase at third days after UUO(P