Objective To evaluate the value of magnetic resonance imaging in diagnosis aortic diseases.Methods Fourty-nine patients with aortic diseases including 20 cases aneurysm,26 cases aortic dissection and 3 cases pseudoaneurysm were examinated with MRI SE and 9 cases of them underwent FFE cine.Results All cases of both groups showed the part,extent and modality of aortic disease.And mensuration the size of aneurysm.Aortic dissection of 26 cases showed aortic double lumen,18 cases showed intimal flap.Entry tears were 7 cases respectively.The involvements of aortic branches were 20 among 9 cases (including 1 case aneurysm and 8 cases aortic dissection)aortic branches respectively.Conclusion Aortic aneurysm and intraaneurysmal architecture can be clearly showed on MRI.MR is one of the optimal imaging techniques in diagnosing aortic disease.

Objective To study the effect of uremic serum on the calcification and osteogenic transition of cultured human umhilical artery smooth muscle cells(HUASMC).Methods Sera from 40 healthy controls(control group),40 nondialysis uremic patients(nondialysis group)and 45 uremic patients on dialysis(dialysis group)were detected fi)r biochemical indexes concerned and used to treat the cultured HUASMC.Alizarin red S stain was applied to examined calcium deposition in the cell layer.Calcium concentration was determined calorimetrically by the Ocresolphtha]ein complexone method,and corrected by total cell proteins.The mRNA expression of bone specific alkaline phosphatase(BAP),osteopontin(OPN)and bone morphogenelic protein 2(BMP2)was estimated by realtime PCR.OPN and BMP2 protein expression was assessed by Western blotting and fluorometry method was used to check the BAP concentration. Results Serum biochemical detection revealed thai both uremic groups had higher levels of phosphate,triglyseride,iPTH,C-reactive protein(CRP)and IL-6,and lower level of fetuin-A than healthy control(P＜0.05).Furthermore,dialysis serum had higher levels of triglyseride,CRP and IL-6 than nondialysis serum(P＜0.05).Compared with control group,both uremic scra induced more cell layer calcium deposition and higher mRNA and protein expression levels of BMP2,BAP and OPN(P＜0.05).Higher mRNA and protein expression levels of above factors were found in dialysis group as compared to nondialysis group(P＜0.05). Conclusions Uremic serum can induce HUASMC calcification and osteogenic transition in vitro,which may be one of the mechanisms involved in vascular calcification of ESRD patients.Microinflammatory state may promote the osteogenic transition and vascular calcification in dialysis patients.

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 incidence and the prognosis of acute kidney injury (AKI) and to find out the risk factors associated with the outcome for better understanding and preventing AKI among inpatients. Methods All the hospitalized patients were screened by Lab Administration Network of Renji Hospital,Shanghai Jiaotong University School of Medicine from Jan.to Dec.2009.Study cohort was comprised of all the patients with AKI defined by Acute Kidney Injury Network (AKIN) and with complete clinical data recorded.The incidence,etiology and distribution characteristics, prognosis of AKI in hospitalized patients were retrospectively analyzed.Logistic regression analysis was used to investigate the risk factors of patients and renal outcome. Results A total of 934 patients with AKI were enrolled.The incidence of AKI in hospitalized patients was 2.41％ (934/38 734).The ratio of male to female was 1.88∶1.Age was (60.82±16.94) years old.Increasing incidence could be seen with age rising.There was 63.4％ AKI found in surgical department,35.4％ in internal medicine department and 1.2％ in obstetric and gynecologic department.Pre-AKI,acute tubular necrosis (ATN),acute glomerular and renal vascular injury (AGV),acute interstitial nephritis (AIN) and post-AKI were accounted for 51.7％,37.7％,3.8％,3.5％ and 3.3％ of the causes of AKI,respectively.On day 28,the survival rate was 71.8％,complete renal recovery rate was 65.7％,partial renal recovery rate was 16.9％ and renal loss rate was 17.4％ among all the patients with AKI.The mortality of AKI with stage Ⅰ,Ⅱ and Ⅲ among inpatients was 24.8％,31.2％ and 43.7％ respectively.Multivariate Logistic regression analysis showed that renal injury drugs [odds ratio (OR)=2.313],hypotension (OR=4.482),oliguria (OR =5.267),the number of failure organs except kidney (OR =1.376) and requiring renal replacement therapy (RRT)(OR=4.221) were independent risk factors for death among AKI patients.The number of failure organs except kidney (OR=1.529) and RRT (OR=2.117) were independent risk factors for kidney loss. Conclusions AKI is one of the most common complications in hospitalized patients.The mortality is high and renal outcome is poor after AKI.The prognosis is closely associated with the severity of AKI.Renal injury drugs,hypotension,oliguria,the number of failure organs except kidney and requiring RRT are independent risk factors for death among AKI patients,while the number of failure organs except kidney and requiring RRT are independent risk.factors for renal loss.

Objective To compare the efficacy and safety of leflunomide (LEF) combined with medium/low dose corticosteroids and full dose of corticosteroids in the treatment of IgA nephropathy. Method Primary IgAN patients diagnosed by renal biopsy with 18?65 years old and eGFR≥30 ml·min?1·(1.73 m2)?1 and proteinuria>0.5 g/24 h were enrolled in a prospective controlled clinical study. They were randomly divided into leflunomide combined with medium/low dose corticosteroids (LEF group) and corticosteroids alone (steroid group). The primary outcomes were (1) end stage renal disease or dialysis (2) 50% increase in serum creatinine above the baseline. Secondary outcome was the remission of proteinuria. Results Ninety patients completed the follow?up. The 24?hour proteinuria at baseline were 2.00(1.10, 2.88) g and 1.87(1.13 ,3.08) g in LEF group and steroid group respectively. Compared with baseline, it was significantly decreased in both groups at 6 months [0.30(0.11, 0.93) g, 0.30(0.14, 1.33) g] and 12 months [0.30(0.09, 0.82) g, 0.32(0.14, 0.66) g], (P<0.05). Estimated glomerular filtration rate (eGFR) at baseline, 6 months and 12 months were (80.39 ± 28.56), (87.12±28.70) and (88.20±30.26) ml·min-1·(1.73 m2)-1. It was decreased in steroid group (P<0.05), while no significant difference was detected in LEF group[baseline (87.63 ± 27.35), 6 months (86.91 ± 32.45), 12 months (90.06 ± 30.00) ml·min-1·(1.73 m2)-1, P>0.05]. At 6 and 12 months, there was no significant difference in terms of 24?hour proteinuria, serum creatinine and eGFR (CKD?EPI) between groups (P>0.05). There was no statistically significant difference in adverse events between groups during the treatment (9/40 cases in LEF group and 11/50 cases in steroid group, P>0.05). The average follow?up was 79 months, and there was no difference in the renal prognosis between the two groups. Multivariate Cox regression analysis revealed that serum creatinine at baseline and renal interstitial inflammatory cell infiltration predicted the risk of the progress of IgA nephropathy. Conclusion Leflunomide plus medium/low dose corticosteroids has a similar effect as full dose of corticosteroids in IgA nephropathy and does not increase the risk for adverse events during the treatment.

Objective: To analyze the interactions between different structural types of volatile oil components (VOCs) and skin lipid molecules, and investigate the mechanism of volatile oil in Chinese materia medica (VOCMM) as penetration enhancers. Methods: In this study, 210 different structural types of VOCs were selected from the VOCMM penetration enhancer database, and the molecular docking experiments were conducted with three main lipid molecules of skin: ceramide 2 (CER2), cholesterol (CHL), and free fatty acid (FFA). Each VOC was docked individually with each lipid molecule. Cluster analysis was used to explore the relationship between the binding energy of VOCs and their molecular structures. Nine specific pathogen-free (SPF) Sprague Dawley (SD) rats were randomly divided into Control, Nootkatone, and 3-Butylidenephthalide groups for in vitro percutaneous experiments, with three rats in each group. The donor pool solutions were 3% gastrodin, 3% gastrodin + 3% nootkatone, and 3% gastrodin + 3% 3-butylidenephthalide, respectively. The penetration enhancing effects of VOCs with higher binding energy were evaluated by comparing the 12-hour cumulative percutaneous absorption of gastrodin (Q12, µg/cm²). Result: (i) Most of the VOCs were non-hydrogen bonded to the hydrophobic parts of CHL and FFA, and hydrogen bonded to the head group of CER2. Among them, sesquiterpene oxides showed the most pronounced binding affinity to CER2. The VOCs with 2 − 4 rings (including carbon rings, benzene rings, and heterocycles) demonstrated stronger binding affinity for three skin lipid molecules compared with the VOCs without intramolecular rings (P < 0.01). (ii) According to the cluster analysis, most of the VOCs that bond well to CER2 had 2 − 3 intramolecular rings. The non-oxygenated VOCs were bonded to CER2 in a hydrophobic manner. The oxygenated VOCs were mostly bonded to CER2 by hydrogen bonding. (iii) The results of Franz diffusion cell experiment showed that the Q12 of Control group was 260.60 ± 25.09 µg/cm2, and the transdermal absorption of gastrodin was significantly increased in Nootkatone group (Q12 = 5 503.00 ± 1 080.00 µg/cm², P < 0.01).  The transdermal absorption of gastrodin was also increased in 3-Butylidenephthalide  group (Q12 = 495.40 ± 56.98 µg/cm², P > 0.05). (iv) The type of oxygen-containing functional groups in VOCs was also an influencing factor of binding affinity to CER2. Conclusion The interactions between different types of VOCs with different structures in the VOCMM and three skin lipid molecules in the stratum corneum were investigated at the molecular level in this paper. This research provided theoretical guidance and data support for the screening of volatile oil-based penetration enhancers,  and a simple and rapid method for studying the penetration-enhancing mechanism of volatile oils.