[Objective]To investigate the correlation between proteinuria and anglopoietin-2(Ang-2)in patients with diabetes nephropathy.[Methods] The clinical data of 104 patients with diabetes nephropathy were analyzed retrospectively.All the patients were divided into non-pmteinuria group with 45 cases and proteinuria group with 59 cases according to the urinary albumin excretion rate(UAER).UAER was detected by radioimmunoassay.The level of serum Ang-2 was detected by double antibody enzyme linked immunosorbent assay.Blood pressure,glycosylated hemoglobin(HbA:c),fasting blood glucose(FBG),treacylglycerol(TG),total cholesterol(TC),creatinine(Cr),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were also detected.[Results]There was no significant difference in diastolic blood pressure,FBG,HbA1c,TG,TC,LDL-C,HDL-C between two groups(P＞0.05).Systolic blood pressure and Cr in proteinuria group[(140.1±17.4)mm Hg(1 mm Hg=0.133 kPa),(126.7±23.8)μmol/L]had statistical significance compared with those in non-proteinuria group[(126.3 ± 15.2)mm Hg,(70.3 ± 22.1)μ mol/L](P ＜ 0.05).The level of serum Ang-2 in proteinuria group was significantly higher than that in non-proteinuria group[(24.86±4.31)ng/L vs.(18.83±7.28)ng/L](P＜0.01).Partial correlation analysis showed that UAER was positively correlated with Ang-2(r=0.615,P＜0.01).[Conclusions] The level of serum Ang-2 increases significantly when there is renal damage in patients with diabetes nephropathy.

Objective To observe the effect and safety of tripterygium combined with huangkui capsule in the treatment of diabetic nephropathy.Methods 128 diabetic nephropathy patients were classified into two groups,observation group of 64 cases were treated with tripterygium combined with huangkui capsule and control group of 64 cases were treated with huangkui capsule.The clinical effect,urinary protein between the two groups were compared.Results The total effective rate in observation group ( 82.8％ ) was significantly higher than that in control group (65.6％) ( x2 =4.940,P ＜ 0.05 ).After treatment,the levels of 24h urinary microalbumin and α1-microglobulin were significantly decreased in both groups( t =4.131,3.912,7.253,6.517,all P ＜ 0.05 ).Moreover,the levels of 24h urinary microalbumin and α1-microglobulin in observation group were significantly lower than those in control group( t =5.114,4.526,all P ＜ 0.05 ).Conclusion Tripterygium combined with huangkui capsule in the treatment of diabetic nephropathy could enhance the clinical effects,degrade urinary protein lelves,and had less adverse effect.

ObjectiveTo investigate the effects of thyroid hormone tablets on the outcome of patients with primary nephritic syndrome.MethodsRadioimmunoassay(RIA) was used to determine the level of serum FT3,FT4 and TSH before and after the routine treatment in 36 healthy patients and 72 patients with primary nephritic syndrome and hypothyroidism.The curative effect of thyroid hormone tablets was observed.ResultsThe levels of FT3 and FT4 [ (1.67 ± 0.39)pmol/L,(8.3 ± 2.2 )pmol/L] in patients group were significantly lower than that in control group (t =12.635,16.304,P =0.041,0.032 ).But the level of TSH was not different before and after treatment( t =2.245,P ＞0.05).The levels of FT3 and FT4 after treatment were higher than before treateat (P ＜0.01 ).At the corresponding period,the levels of FT3 and FT4 in the observation group with thyroid hormone tablets were significantly higher than that in the group with routine treatment.At the same time,the treatment time for complete remission was also shorter,and after 12 months the catabatic rate (72.2％) was higher than routine treatment( x2 =21.04,P ＜0.05 ).ConclusionTreatment with,thyroid hormone tablets could shorten the course of the disease and increase the catabatic rate.

Objective To investigate the effect of transforming growth factor-β1 (TGF-β1)and Smad anchor for receptor activation(SARA) in high glucose induced epithelium to mensenchymal transition(EMT) in proximal tubule HKC cells.Methods The model of EMT in HKC cells by high glucose treatment was developed.After stimulation by 25 mmol/L glucose for 0,12,24,and 48 h,the cells were collected and total protein was extracted.Vimentin,E-cadherin,TGF-β1,SARA and Smad2 expression were detected by western blot analysis.Results At 0,12,24,and 48 h after treated with 25 mmol/L glucose the expression of E-cadherin was 1.13 ±0.31,0.74 ±0.14,0.63 ±0.18 and 0.32 ±0.12 respectively,with significantly difference between each group ( Ps ＜ 0.05 ) ; the expression of vimentin in HKC cells increased from 0.23 ± 0.09,0.34 ± 0.04,0.83 ±0.15 to 1.02 ±0.22 signifiantly(Ps ＜0.05).High glucose treatment also upregulated the protein expression of TGF-β1,with expression of 0.25 ± 0.08,0.44 ± 0.12,0.72 ± 0.21,and 0.92 ± 0.28 after treated with 25 mmol/L glucose for 0,12,24,and 48 h ( Ps ＜ 0.05 ).The protein expression of SARA significanlty decreased from 0.83 ±0.21,0.54 ±0.13,0.42 ±0.09 to 0.35 ±0.12(Ps ＜0.05),and the protein expression of Smad2 also significantly decreased from 1.14 ± 0.22,0.82 ± 0.15,0.61 ± 0.17 to 0.30 ± 0.13 ( Ps ＜ 0.05 ).Conclusion The upregulation of TGF-β1 might play a key role in high glucose induced EMT in proximal tubule HKC cells.The downregulation of SARA and Smad2 protein might contribute to TGF-β1 mediated renal fibrosis.

ObjectiveTo observe the clinical effect ofbenazepril combined with alprostadil in the treatment of diabetic nephropathy.MethodsNinety-four cases with diabetic nephropathy were divided by random digits table method into two groups with 47 cases in each:observation group (treated with benazepril combined with alprostadil) and control group(treated with benazepril).The clinical effect,24 h urinary microalbumin,serum urea nitrogen and serum creatinine of the two groups were observed and compared.ResultsThe total effective rate of observation group was 80.9％(38/47),and significantly higher than that in control group[68.1％(32/47)](P＜0.05).The levels of 24 h urinary microalbumin,serum urea nitrogen and serum creatinine of the two groups before treatment had no significant difference (P＞0.05).The levels of 24 h urinary microalbumin,serum urea nitrogen and serum creatinine in observation group after treatment were (212.15 ± 25.59 ) mg,(7.52 ± 1.81 ) mmol/L and ( 105.62 ± 8.51 ) μmol/L,while the levels in control group were(332.46 ±38.71) mg,(9.06 ±2.43) mmol/L and(122.29 ± 11.98) μmol/L.The levels all improved after treatment compared with those before treatment,and the levels of observation group were obviously lower than those of control group respectively (P＜ 0.05).ConclusionsBenazepril combined with alprostadil in the treatment of diabetic nephropathy can improve the clinical effect significantly as well as the kidney function.Therefore,it deserves the application in clinic.

Doctors and nurses from general outpatient and emergency department usually lack the treatment experience of hemophilia,therefore,emergency system and diagnostic criteria for hemophilia is es-sential.Physicians of emergency department should be trained on identifying the undiagosed patients with inherited bleeding disorders and assessing the condition of bleeding.Prompt clotting factors replacement therapy should be given to the patients with hemophilia once bleeding is suspected.Physicians should be aware that inhibitors make the emergency treatment more complicated.

Peripheral blood gene expression profiling represents the pattern of expression of all genes in peripheral blood cells.By comparing the different gene expression of peripheral blood between cancer patients and healthy control or patients with alternative types of tumors,we can draw genes of different expression and further analyze the characteristic gene expression profiling to assist diagnosis and treatment.There have been remarkable advance in study of peripheral blood gene expression profiling in head and neck tumors,chest tumors,abdominal tumors,urinary tract and male reproductive system tumors,gynecological tumors and so on,which lay a foundation for further clinical applications.

Objective To investigate the etiology,prognosis and risk factors of hospitalized elaerly patients with acute renal failure(ARF).Methods The clinical data of elderly patients with ARF in our hospital from De-cember 2003 to December 2006 were studied prospectively.The clinical features were comparea with those of the non-aged patients with ARF during the same period.Results Of 320 patients,135(42.2%)were identified with the onset of ARF.Infections and postrenal obstructive diseases were the major causes of ARF in the elderly.Fifty-one dead patients in the young,thirty-one in the 60-79 years old group,and twenty in the above 80 years old group(P<0.05).The results of logistic regression analysis suggested that oliguria,previous renal inadequacy and heart failure were the related risk factors of prognosis.Conclusion The incidence and mortality of hospitalized elderly patients with ARF are high.With the rising of age.the mortality of ARF increases.Dialysis in time might improve the progno-sis of ARF.

Objective To investigate the cause,prognosis and risk factors of hospitalized patients with acute renal failure(ARF). Methods The clinical data of patients with ARF in our hospital from December 2003 to December 2006 were studied retrospectively. Results There were 108 744 admissions during the study period and 320 met with the diagnostic criteria of ARF.Of 320 ARF patients,135(42.2%)were indentified with the onset of the disease over or at the age of 60.Infection,heart failure and drug were the major causes of ARF.The overall mortality rate of ARF patients was 31.9%.The mortality rate of the elderly was significantly higher than that of the non-elderly.The Logistic regression analysis revealed that heart failure,respiratory failure and malignant tumor were the related risk factors of prognosis.The mortality in replacement therapy group was lower than that in conservative treatment group (23.2% vs 35.6%,P＜0.05).Conclusions The incidence and mortality of hospitalized patients with acute renal failure are high.The prognosis of replacement therapy group is better than conservative treatment group.

Objective To study expression and clinical significance of nm23 genes in primary breast carcinomas. Methods The expression of nm23 was detected by immunohistochemical S-P method in 286 cases of primary breast carcinomas. Results The positive rate of nm23 expression was 65.7%. There was not a significant correlation between the positive rate of nm23 and patients' age, tumor pathological types. There was a significant relation between the expression of nm23 and tumor clinical stage, axillary lymph node metastasis, and the positive rate of nm23 expression in the cases of clinical stage I without axilliary lymph node metastasis was significantly higher than that in the cases of clinical stage III with axilliary lymph node metastasis. Conclusion The expression of nm23 gene was negatively related with clinical stage and axilliary lymph node metastasis in breast carcinomas, which indicated that nm23 gene expression may serve as an index for predicting lymph node metastasis and the prognosis of breast carcinoma.