Objective To observe the effects of Triptolide on the expression of toll-like receptor 4 (TLR4) in renal ischemia/reperfusion (I/R) injury in rats. Methods A renal I/R model was established. Rats were randomly separated into the following experimental groups. Group 1, shamoperated control (n = 15) : rats were subjected to surgical manipulation, without the induction of renal ischemia. Group 2, I/R (n = 18): rats were subjected to left renal ischemia for 45 min followed by reperfusion. Group 3, TRI + I/R (n = 18): Before the I/R procedure (as in group 2), rats were intraperitoneally injected with TRI (0.4 mg/kg), once every day, three times. Rats were killed at the 1st, 3rd, and 5th day after I/R injury. The parameters of renal function were determined by autobiochemical analyzer. The expression of TLR4 was detected by RT-PCR and Western blotting. Results As comparedwith the sham-operated control group, serum BUN and Cr levels were significantly increased in the rats undergoing I/R procedure at the 1st, 3rd, and 5th day (P＜0. 01). After the treatment with TRI, the levels of BUN and Cr and the expression of TLR4 in the renal tissues were significantly decreased (P＜0. 05). Conclusion TRI could relieve renal I/R injury in rats by inhibiting the TLR4 expression.

Objective To assess the prognostic value of tumor burden measured by 18F-fluorodeoxy glucose-positron emission tomography ( FDG PET) imaging for stage Ⅲ NSCLC). Methods Fifty-six patients with lung cancer were analyzed, to whom staging PET-CT scans before treatment concurrent chemoradiotherapy and 2-year follow-up were performed. , Relationship between overall survival (OS) and metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) were determined.Results The estimated median OS for the cohort were 14. 5 months. Kaplan-Meier analysis showed that MTV had a significant effect on OS (x2 =5.42 ,P =0. 014). No significant relationship was found between SUVmax and OS ( x2 = 0. 74, P = 0. 391 ). According to multivariate Cox regression analysis, MTV and SUVmax wereassociatedwithincreaseddeath ( x2 = 5.54, P = 0.019; x2 = 4.47, P = 0.031 ). Conclusions This study shows that higher tumor burden assessed by PET MTV is an independent unfavorable prognostic factor in lung cancer, MTV is valuable for predicting overall survival and could be a prognostic factor.

ObjectiveTo investigate the protective effect of ozone oxidative preconditioning (OzoneOP) on apoptosis induced by acute renal ischemia/reperfusion (I/R) injury in rats.Methods The right kidneys of rats in control group were excised.A rat I/R model was established in I/R group.In OzoneOP group,the renal OzoneOP was induced by rectal insufflation of 5.0～5.5 ml oxygen plus ozone (ozone 50 mg/L,1 mg· kg- 1 · d- 1,once every day).The parameters (blood urea nitrogen and creatine )of renal function were determined by auto-biochemical analyzer. The concentrations of malondialdehyde (MDA) and superoxide dismutase (SOD) were measured by using chromometry.Cytochrome c (CytC) was examined by using immunohistochemistry and Western blotting.The mRNA expression levels of TNF-α,IL-1β and IL-6 in the renal tissue were detected by using RT-PCR.ResultsCompared with the control group,the blood urea nitrogen,creatine,MDA and the release of CytC were increased significantly in I/R group.After OzoneOP,the levels of blood urea nitrogen,creatine,MDA,CytC and the mRNA expression levels of TNF-α,IL-1-β and IL-6were significantly decreased and SOD levels were significantly increased.ConclusionOzoneOP could relieve renal I/R injury of rats by improving antioxidation capability,cutting down cytokines contents and inhibiting the release of CytC from mitochondria.

Objective To evaluate the precision,accuracy,linear range and anti-interference performance of HbA1c assay by u-sing Primus Trinity Ultra2 automated analyzer.Methods According to Document EP published in 2004 by American Clinical and Laboratory Standards Institution(CLSI)and relative literatures,the precision,accuracy,linear range and anti-interference perform-ance were evaluated.Results The within-run and between-run CVs of HbA1c determination were both less than that announced by manufacture.In the tests of samples with certain concentrations,all the results were within the verification range respectively.In the linear verification,regression equation between the theoretical and measured values demonstrated that r2 >0.95,and a value was within the range of 0.97-1.03.For Primus Trinity Ultra2 the limit of interference effect didn′t exceed the allowable error at the medical decision concentrations.Conclusion The precision,accuracy,linear range and anti-interference was evaluated of the Primus Trinity Ultra2 automating HbA1c all could meet the manufacture′s declaim and the clinical needs.

Objective To evaluate the predictive value of urinary neutrophil gelatinase-associat-ed lipocalin (NGAL) and interleukin-18 (IL-18) for delayed graft function (DGF) in kidney transplan-tation. Methods Serial urine samples collected at 0, 12 and 24 h after operation from 86 kidney transplantation patients were analyzed by enzyme-linked immunosorbent assay for NGAL, IL-18 and RBP. Results Fifteen patients developed DGF. At 12 h after transplantation, the level of urine NGAL elevated significantly (1712.75±474.6 vs. 863.1±199.8 without DGF, P<0. 001). The in-creases of urine IL-18 (29. 2±4.1 vs. 28.7±4.2 without DGF, P>0. 05) was not significant. At 24 h, both urine NGAL(2905.0±1108.1 vs. 911.8±221.0 without DGF,P<0. 001) and IL-18(211.3± 34.0 vs. 86.9±22.8 without DGF, P<0. 001) increased significantly, whereas the changes of urine RBP and serum creatinine (SCr) were not significant. ROC analysis showed that the area under the curve of NGAL and IL-18 were 0. 90 and 0.76 respectively, the cut-off values were 996.5 ng/mg and 148.5 ng/mg, the diagnostic sensitivities in DGF were 90.2% and 76.3%, specificities were 82.6% and 66.4% respectively. Conclusions Both urine NGAL and IL-18 could potentially be early predic-tive marker of DGF. The level of NGAL elevated earlier than IL-18, which may be more effective in predicting DGF.

Objective To compare the clinical features and endoscopic findings of Crohn's disease(CD) and intestinal tuberculosis(ITB) in order to differentiate CD from ITB. Methods The clinical and endoscopic data from 168 patients with CD and 156 patients with ITB between June 2003 and February 2009 were retrospectively analyzed. Results The salient features of CD were male patients in predominance (male : female was 108 :60) and high incidence of colectomy (CD 33.3% vs ITB 10.9%, P<0.01). Diarrhea (66.1%), hematochezia (32.1%), perianal disease (16.1%), intestinal obstruction (28.0%) were more frequent in CD patients than in ITB patients (47.0%, 7.7%, 3.4%, 9.4% respectively, all P values<0.05). The salient features of ITB were night sweating, pulmonary tuberculosis, ascites, hyperglobulin, increased erythrocyte sedimentation rate and the positive serum antibody to mycobacterium. The endoscopic examination showed that the fissure-shape ulcer, grid-shape ulcer, cobblestone sign and intestinal stricture were more frequent in CD patients than in ITB patients (all P values <0.05). Whereas the circular ulcer and involved ileocecal valve with fixed bouche shape were more common in ITB patients (P<0.05). Conclusions The clinical characteristics are different in CD and ITB patients. The endoscopic findings including fissure-shape ulcer, grid-shape ulcer, circular ulcer, cobblestone sign and the status of involved ileocecal valve are important in the differentiation of ITB from CD.

OBJECTIVETo evaluate the basic principles of surgical correction of concealed penis.

METHODSFrom Jan. 1999 to Dec. 2002, 63 cases of concealed penis, aged from 1 year and 6 months to 19 years with a mean age of 7 years and 2 months, were corrected with two different approaches: 37 cases of group A with obesity were corrected by anchoring micrus tissue onto the pubis at the base of the penis, and 26 cases of group B by fixing the subcutateous tissues at both sides of the penile shaft to the deep tunica albuginea at the penile root. Then prepuce plasty was carried out.

RESULTSSix-month postoperative follow-up found adequate exposure of the penis in all of group A, prepuce oedema in 7 cases, abdomen fat liquidization in 3 cases, unsatisfactory recovery of incision hollow in 3 cases and patchy numbness of the glans in 1 case. The 25 cases of group B had satisfactory exposure of the penis, with no obvious prepuce oedema, 1 case with retraction of the penis 7 days after operation.

CONCLUSIONSVarious surgical procedures could be adopted for concealed penis, and the key to the satisfactory appearance is the restoration of penile tunicae and the fixation at the base of the penis. Further study is needed to determine the natural history of these disorders as well as which conditions and what age will benefit most from surgical intervention.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Infant ; Male ; Penis ; abnormalities ; surgery ; Retrospective Studies

Objective: To analyze the essential medicines supply of medical institutions at county-level in Shaanxi Province and to provide empirical evidences and suggestions to improve relevant policies. Methods:A strati-fied cluster random sampling method was used to choose the institution samples. A survey was conducted to study the supply of essential medicines in 2012. Indicators include the variety and amount of essential medicines procured, the medicine shortage condition, and the rate of winning the bid for essential medicine. Results:Essential medicines ac-counted for 69 . 1% of all medicines;and procurement of essential medicines accounted for 42 . 4% of all procurement spending on medicines. Of the top 25 chemical products of essential medicines, provincial supplementary medicines accounted for 33. 9%;and among the top 25 traditional Chinese medicines of essential medicines, the provincial sup-plementary medicines accounted for 51. 9%. All 27 medical institutions faced a shortage of medicines. There were 47 kinds of essential drugs in urgent need were out of bid. Conclusion:Essential medicine supply of medical institutions at county-level is in good condition;however, more attention needs to be paid to medicine shortage. We should take measurements to standardize the process of bidding for essential medicines and strengthen the management of medi-cine shortage in order to better meet patients’ needs.

Objective To compare clinical efficacy and safety between standard double-and single-dose of basiliximab in renal transplantation.Methods A total of 121 patients undergoing allogeneic cadaveric renal transplantation in Department of Urology of Renmin Hopsital of Wuhan University from January 2008 to May 2011 were recruited as study subjects.Among them,53 patients were assigned into the double-dose of basiliximab group and they were intravenously administered with 20 mg of basiliximab before and 4 d after surgery according to product description.Sixty-eight cases were allocated in the single-dose of basiliximab group and they were given with 20 mg of basiliximab before renal transplantation.The changes of immune function in two groups during perioperative period were monitored.The incidence of adverse reactions including delayed graft function (DGF),acute rejection,pulmonary infection and the survival of patients and renal grafts were statistically compared between two groups.Results There was no significant difference in preoperative humoral immune and cellular immune function between two groups.Compared with preoperative period,cellular and humoral immune function in both groups were inhibited by varying degree at 5 d after surgery (both in P <0.05).Compared with patients in the single-dose group,cellular and humoral immune functions were evidently suppressed in the double-dose group (both in P <0.05).Compared with the parameters assessed at 5 d after surgery,cellular and humoral immune functions were restored to varying degree at 15 d after surgery,whereas still significantly lower than preoperative levels (CD3,CD4,IgM and IgA).Partial parameters (CD8 and IgG)were persistently inhibited and continued to decline compared with the levels at 5 d after surgery.The incidence of DGF was 8% in the double-dose group,and 7% in the single-dose group.During 1-year follow-up,the rejection rates in the double-and single-dose groups were 13% and 12%,and the incidence of pulmonary infection was 9% and 10%.No statistical significance was noted between two groups in terms of these parameters (all in P >0.05).The 1-year survival of patients in the double-and single-dose groups was 94% and 98%,93% and 96% for the survival of renal grafts.No statistical significance was found between two groups (both in P >0.05).Conclusions Both double-and single-dose of basiliximab are efficacious in renal transplantation and do not increase the incidence of adverse reaction.The 1-year survival rates of patients and renal grafts between two groups are almost equivalent.Detection of immune function during perioperative period effectively guides individualized immune induction therapy.

Objective: To investigate the safety and efficacy of the Weitan Waifu patch on the postsurgical gastroparesis syndrome (PGS) of gastrointestinal cancer. Methods: The multi-center, double-blind, randomized controlled trial was conducted with superiority design. Patients with PGS of gastrointestinal cancer diagnosed in 4 AAA hospitals and the abdominal symptom manifested as cold syndrome by Chinese local syndrome differentiation were recruited. These patients were randomly divided into two groups according to 1∶1 proportion. Placebo or Weitan Waifu patch was applied in control group or intervention group, respectively, based on the basic treatments, including nutrition support, gastrointestinal decompression, promoting gastric dynamics medicine.Two acupuncture points (Zhongwan and Shenque) were stuck with placebo in control group or patch in treatment group. The intervention course was 14 days or reached the effective standard. Results: From July 15, 2013 to Jun 3, 2015, 128 participants were recruited and 120 eligible cases were included in the full analysis set (FAS), and 60 cases in each group. 88 cases were included in the per-protocol set (PPS), including 45 cases in the treatment group and 43 cases in the control group. In the FAS, the clinical effective rate in the treatment group was 68.3%, significantly superior than 41.7% of the control group (P=0.003). The medium time of effective therapy in the treatment group was 8 days, significantly shorter than 10 days in the control group (P=0.017). In the FAS, 3 adverse events occurred in the treatment group, including mild to moderate decrustation, pruritus and nausea. The incidence rate of adverse events was 5.0% (3/60) and these symptoms were spontaneously remitted after drug withdrawal. No severe adverse events were observed in the control group. There was no significant difference between these two groups (P=0.244). Conclusion: Weitan Waifu patch is a safely and effectively therapeutic method for patients with PGS (cold syndrome) of gastroenterological cancer. Trial registration International Standard Randomized Controlled Trial Number Register, ISRCTN18291857