Objective To investigate the risk factors of acute kidney injury(AKI) after intracoronary stent implantation in order to provide the basis for clinical prophylaxis and treatment.Methods Retrospectively analyzed 626 consecutive patients who underwent isolated intracoronary stent implantation in our institution from January 2007 to July 2011.Multivariate logistic regression model was constructed to identify the risk factors for the development of AKI defined as a serum creatinine (SCr) 130 to 199 μ mol/L or estimated creatinine clearance(Ccr) 30 to 60 ml/min per 1.73 m2.Results Ninety-three patients of 626 (14.9％) underwent isolated intracoronary stent implantation developed AKI.The results of the multivariate forward stepwise logistic regression analysis found that risk factors for the development of AKI following isolated intra-coronary stent implantation was associated with age (OR =1.570,95％ CI 1.308-1.885),ejection fraction (EF) ≤ 30％(OR =11.526,95％ CI 2.452-54.177),hypotension during perioperative and postoperation (OR =11.074,95％ CI 2.439-50.282),operation duration(OR =1.032,95％ CI 1.012-1.051),sex (OR =0.010,95％ CI 0.001-0.086),NYHA class Ⅲ & Ⅳ (OR =0.209,95％ CI 0.059-0.737),peripheral vascular disease (OR =0.528,95％ CI 0.286-0.973),chronic obstructive pulmonary diseases (OR =0.546,95％ CI 0.304-0.982),preoperation Cr (OR=1.418,95％CI 1.216-1.654) (and all P＜0.05).Conclusion AKI is the common complications after intracoronary stent implantation,especially age,EF ≤ 30％,hypotension during perioperative and postoperation,operation duration are independent risk factors.

Objective To explore the relationship between serum cardiac troponin I (cTnI) and high sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-alpha (TNF-α ) in patients with acute organophosphorus pesticide poisoning (AOPP) and their clinical significance.Methods One hundred and twelve patients with AOPP (without sudden death ) were as AOPP group.One hundred and twelve healthy controls were as control group.Serum cTnI,hs-CRP and TNF-α levels were determined by ELISA and compared between two groups.The relationship between serum cTnI and hs-CRP,TNF-α was analyzed.Time for atropinization and acetylcholinesterase activity recovery and days of hospitalization were observed.The effectiveness of AOPP patients in different serum cTnI levels was compared.Results Serum cTnI,hs-CRP and TNF- α levels in AOPP group[0.75 (0.26,0.99) μ g/L,11.57(5.13,21.62) mg/L,( 12.36 ±5.22) μ g/L] were higher than those in control group[0.01 (0,0.03) μ g/L,3.62(2.31,6.80) mg/L,(7.33 ±4.31 ) μ g/L] (P ＜ 0.01 ).Serum cTnI levels were positive correlation with serum hs-CRP and TNF- α levels in AOPP patients (r =0.53,0.62,P ＜ 0.01 ).Time for atropinization and acetylcholinesterase activity recovery and days of hospitalization in higher serum cTnI levels patients ( 56 cases ) [(7.31 ± 1.96),( 15.29 ± 3.66 ),(17.23 ± 3.62) d] was longer than that in lower serum cTnI levels patients (56 cases)[(5.32 ± 1.03),( 11.32 ± 2.59),( 13.66 ± 3.03) d](P＜ 0.01).Conclusions Cardiac insults in AOPP patients are related to inflammation.Sudden death-free AOPP patients with higher cTnI levels have less response to treatments.

Objective To dynamically monitor the base excess(BE) in traumatic brain injury(TBI) patients within 3 d after admission,and to assess the impact of the early BE on prognosis.Methods Blood BE was monitored for 3 d in 56 TBI patients.Patients were classified into mild group(15 patients),moderate group (22 patients) and severe group (19 patients) according to the scores of Glasgow coma scale(GCS).Patients were classified into survival group(42 patients) and dead group(14 patients) according to prognosis.Patients were classified into high BE group (35 patients,BE≥-8 mmol/L) and low BE group (21 patients,BE ＜-8 mmol/L).The relations among BE,degree of injury and prognosis were analyzed.Results The level of BE in mild group,moderate group and severe group was increased after treatment for 1,2,3 d than that before treatment.The level of BE was consistent with the degree of injury [mild group:(-3.02 ± 0.21)mmol/L; moderate group:(-8.49 ± 1.44) mmol/L;severe group:(-9.64 ± 1.19) mmol/L].The level of BE in mild group and severe group had significant difference than that in moderate group (P＜ 0.01).The level of BE in dead group before treatment and after treatment for 1,2,3 d was significantly lower than that in survival group [(-11.97 ±2.13) mmol/L vs.(-6.29 ± 1.16) mmol/L,(-9.84 ± 1.33) mmol/L vs.(-4.89 ± 1.78)mmol/L,(-8.78 ± 2.01) mmol/L vs.(-3.61 ± 1.43) mmol/L,(-7.84 ± 1.42) mmol/L vs.(-3.10 ±0.98)mmol/L] (P ＜0.01).The scores of APACHE Ⅱ before treatment and fatality rate in low BE group were significantly higher than those in high BE group [(24.84 ± 3.68) scores vs.(16.27 ± 2.21) scores,52.4％ (11/21) vs.8.6％(3/35)] (P ＜ 0.01).The scores of GCS before treatment in low BE group was significantly higher than that in high BE group [(7.56 ± 3.09) scores vs.(10.51 ± 2.43) scores](P ＜ 0.01).Conclusion The level of early BE is a good factor on evaluating the condition and prognosis in TBI patients.

Objective To investigate the complications of therapeutic endoscopic retrograde cholangiopancreatography(ERCP) in patients with metabolic syndrome and their prevention. Methods Clinical data of 300 patients who underwent therapeutic ERCP in the First Affiliated Hospital of Soochow University from March 2013 to January 2016 were analyzed retrospectively. Among these patients, 100 of them(group A)had metabolic syndrome and 200 others(group B)did not. Age, sex and post-operative hyperamylasemia,acute pancreatitis,infection of biliary tract and upper gastrointestinal bleeding of two groups were compared. In addition,effects of BMI,TG,BP and FPG on the occurrence of complications in group A were analyzed. Results No difference was found in age and sex between group A and B(P>0.05),but group A had higher incidences of post-operative hyperamylasemia[16.0%(16/100)VS 6.0% (12/200)],acute pancreatitis[14.0%(14/100)VS 4.0%(8/200)], infection of biliary tract[12.0% (12/100)VS 4.0%(8/200)]and upper gastrointestinal bleeding[8.0%(8/100)VS 1.0%(2/200)] (P<0.05). Meanwhile, patients had higher incidences of complications(post-operative hyperamylasemia, acute pancreatitis,infection of biliary tract and upper gastrointestinal bleeding)when BMI[56.10%(46/82) VS 22.22%(4/18)],TG[56.41%(44/78)VS 27.27%(6/22)],BP[64.29%(27/42)VS 39.66% (23/58)]or FPG[54.44%(49/90)VS 10.00%(1/10)]increased in group A(P < 0.05).Conclusion Patients with metabolic syndrome have a higher incidence of complications after therapeutic ERCP than patients without. Therefore,careful preparation, post-operative observation and intervention are essential when patients with metabolic syndrome undergo therapeutic ERCP.

To investigate the apoptotic effect of flavonoid compound GL-V9 on human gastric cancer cells and its potential mechanism, MGC-803 and BGC-823 cells were treated with GL-V9. MTT assay was performed to assess the growth inhibition effects on MGC-803 and BGC-823 cells under different concentrations of GL-V9. Annexin V-FITC/PI staining assay was employed to observe the apoptotic rate of GL-V9 cells with the treatment of GL-V9. DAPI staining was performed to observe the nuclear morphological changes using fluorescence microscopy. Activation of caspase-9 and caspase-3 was analyzed by Western blotting. Ca2+ concentration in gastric cancer cells was detected by Fluo-3 AM staining assay. Results showed that GL-V9 could inhibitcell viability, change the nuclear morphologyl, activate caspase-9 and caspase-3 and induce the apoptosis in gastric cancer cells. The mechanism of the induction of apoptosis in MGC-803 cells under the treatment of GL-V9 may aetivate the Ca2+ associated mitochondrial apoptosis pathway.

In clinical application, a microneedle system that continuously delivers drugs is of great value for the delivery of some vaccines and hormone drugs. In this study, a controlled-release chitosan-based microneedle array (PVA/CS-MN) was designed, combining microneedle patches with drugs for controlled-release of drugs. Here we report the optimization of the preparation process of PVA/CS-MN. The appearance, morphology, mechanical properties, dissolution and swelling properties, and in vitro penetration properties of the MN arrays were characterized. The PVA/CS-MN prepared by the optimal process showed good morphology and mechanical properties. PVA/CS-MN can smoothly open microchannels on the skin and achieve controllable dissolution and swelling functions. Ascorbic acid (l-ascorbic acid) was used as a model drug to prepare a Vc-PVA/CS-MN. In vitro transdermal diffusion experiments showed that the Vc-PVA/CS-MN released about 57% of the drug within 1 h. About 66.7% of the drug was slowly released within 12 h, and a total of 92% of the drug was released after 7 days. The controllable sustained-release properties and excellent drug delivery efficiency of PVA/CS-MN provide a new option for sustained transdermal drug delivery.
Ascorbic Acid ; Chitosan ; Delayed-Action Preparations ; Drug Delivery Systems ; Hormones ; Vaccines