Objective To compare the different micro inflammatory states between pafients undergone peritoneal dialysis and the pafients of chronic renal failure without dialysis,and to observe the condition of the occurrence of the micro inflammatory state in the peritoneal dialysis patients.Methods This study included 53 peritoneal dialysis patients who were followed-up in our dialysis center,34 chronic renal failure patients without dialysis and 47 normal controls,hs-CRP,IL-6,IL-8,TNF-? in venous blood were defected with empty stomach,and then compare the number of patients in each group.Results Patients'hs-CRP of the group of the PD is lower than that in the group of the chronic renal failure without dialysis,and higher than that in the normal people(P

Bevacizumab has been widely used in tumor targeting therapy,while the most common adverse reaction is renal impairment,manifested as proteinuria. The main mechanisms may include interfering podocytes-endothelial vascular endothelial growth factor(VEGF)axis signals,increasing glomerular pressure caused by secondary hypertension,subacute renal thrombotic microangiopathy caused by endothelial damage and so on. Thrombotic microangiopathy is the main renal pathological type,and other rare types include glomer-ular lesions,renal interstitial disease,and benign renal arteriolar nephrosclerosis. Therefore,urine protein excretion and renal function should be closely monitored during bevacizumab treatment period for timely treat-ment,dose reduction or even withdrawal if necessary to ensure renal function.

Objective To explore the effect and mechanism of relaxin on the production of extracellular matrix (ECM) excreted by high glucose stimulated human renal mesangial cells.Methods Cultured human mesangial cells (HMCs) were divided into three groups:(1) normal glucose group (NG,5.5 mmol/L D-glucose),(2) high glucose group (HG,30 mmol/L D-glucose),and (3) high glucose + relaxin group.Cell count kit (CCK8) was used to examine the cell proliferation.The levels of fibronectin and collagen type Ⅳ in the culture supernatants were examined with a solid-phase enzyme-linked immunoadsorbent assay (ELISA);Western blot method was used to detect the expression of α-smooth muscle actin (α-SMA) protein.The transforming growth factor-β1 (TGF-β1) mRNA expression was detected with quantitative polymerase chain reaction (qPCR) method.Results No proliferation and inhibition effects were observed in both normal and high glucose group.Compared to the normal glucose group,the levels of fibronectin,and collagen type Ⅳ increased significantly (57.28 ± 0.59 vs 41.85 ± 0.03,56.52 ± 0.88 vs 33.80 ± 0.24,P ＜ 0.01)after cultured 48 h in high concentration of glucose.Compared to the high glucose group,a significantly decreases of fibronectin and collagen type Ⅳ (47.08 ± 0.03 vs 57.28 ± 0.59,36.16 ± 0.52 vs 56.52 ±0.88,P ＜0.01) were observed in the relaxin treated group.The expressions of α-smooth muscle actin and TGF-β1 were decreased (P ＜0.01).Conclusions Relaxin can suppress the overproduction of ECM excreted by HMC cultured in high ambient glucose,and its mechanism is partly due to the inhibition of TGF-β1.

Objective To investigate the diagnostic value of serum homocystine (HCY) in renal diseases. Methods Serum HCY, creatinine, urea, albumin, parathyroid hormone (PTH), β2 microglobulin were measured in 167 patients with renal disease, and the HCY was compared with those traditional index in kidney diseases with the aim to deter-mine the role of HCY played in renal diseases. Results With the decreasing of glomerular filtration rate (GFR), the serum HCY level increased correspondingly. Compared with normal control group, there were statistically significant differences in the serum HCY when the GFR was below 90 mL/(min·1.73 m2).HCY was positively correlated with cre-atinine, urea, PTH and β2 microglobulin (P<0.05); negatively correlated with endogenous creatinine clearance rate (Ccr) (P<0.05). Conclusion HCY may be an important indicator for early diagnosis of the impairment of renal function in renal diseases. It can be used to indicate the degree of severity of renal impairment in patients with nephropathy.

Objective:Based on the current medical environment, to learn about cognition status of doctor-patient relationship among medical students and analyze causes of the tension between doctors and patients.Methods:Using the self-designed questionnaire "Clinical Medical Students' Cognition Survey on Occupational Status and Doctor-Patient Relationship", a cross-sectional survey was conducted on 527 medical students from 5-year and 7-year clinical program in Batch 2014 in a medical university in Heilongjiang Province. The survey mainly analyzed the causes of the tension between doctors and patients from the level of medical staff, patients and their families, hospitals and society. SPSS 22.0 was used for descriptive statistics and chi-square test.Results:The results showed that 93.7% of the medical students believed that the current doctor-patient relationship was not harmonious. There were cognitive differences among medical students in different gender ( P=0.029), first contact clinical grade ( P=0.003) and professional identity ( P<0.001). Conclusion:Medical students have a poor evaluation towards the current doctor-patient relationship. In order to construct harmonious doctor-patient relationship in the future, we can try to take measures such as carrying out relevant courses of doctor-patient communication, improving the medical students' communication skills and enhancing their professional identity.

Building a strong public health system has become an urgent task in the new era. Based on more than eight years of systematic research， we believe that five aspects need to be prioritized for a strong system. First， we should change the perspective on public health， using the word “gonggong jiankang” to replace “gonggong weisheng” and the word “gonggong jiankang tixi” to replace “gonggong weisheng tixi”， to lead the public health system development. Second， we should develop a suitable public health system and continuously improve the health capacity for governance. Third， we should make it clear that the goal of building a strong system is not far-fetched， and we need to consolidate the existing institutional advantages of China’s public health system： when encountering major problems， we can maintain a unified goal and mobilize the whole society to cooperate effectively to accomplish the goal. However， we need to make up for shortcomings one by one， especially to solve the key problem of lacking a strong coordination mechanism in daily work. Fourth， we should pursue excellence and consolidate the“suitable” mechanism proven in the process of coping with the COVID-19， so that efficient mechanisms to deal with major issues can be used in routine work， and efforts should be made to consolidate the advantages of prevention and control of infectious diseases and emergency response，so as to achieve the balanced development of regions categories and units.Finally， it is necessary to strengthen the coordination of government and research institutions， in the aspects of technological innovation， talent team building and accurate consulting services， and work together to pursue a suitable and strong system to realize the modernization of the health system and capacity for governance.