Objective To prospectively evaluate the risk factors for the decline of residual renal function (RRF) in new peritoneal dialysis (PD) patients.Methods A total of 84 new PD patients in our PD center were included in this study.Clinical comprehensive assessment were made,and regression models was established to analyze the relationship between the decline of RRF and clinical indicators,which included the rate of peritonitis,systolic pressure,diastolic pressure,urine volume,24 h urinary protein,serum albumin,C-reactive protein(CRP),history of diabetes mellitus,and the use of angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB) drugs,cardiac functional grading,sodium and water retention and biochemical indicators.The primary outcome was defined as two consecutive urine volume ≤ 100 ml/24 h.Results The mean follow-up time was (11.7± 1.1) months,primary outcome occurred in 20 patients,accounting for 23.8％,and their average period progressed to the primary outcome was (10.5±2.0) months.The 20 patients had higher ultrafiltration volume [(551.6±328.2) ml vs (294.1±288.0) ml,P=0.001],higher systolic blood pressure [(145.2±16.5) mmHg vs (136.0±13.8) mmHg,P=0.016],worse cardiac functional grading [(1.7±0.8) vs (1.3±0.4),P=0.000],more serious water-sodium retention [(1.0±0.7) vs (0.6±0.5),P=0.012],higher peritonitis rates (35.0％ vs 4.7％,P=0.000),lower Kt/V [(1.7 ± 0.4) vs (2.0 ± 0.3),P=0.003],lower hemoglobin levels [(89.0± 14.9) g/L vs (99.5± 17.8) g/L,P=0.020],higher C-reactive protein levels [(19.4±34.4) mg/L vs(8.7±12.6) mg/L,P=0.017],higher Scr levels [(1 004.6±291.1) μmol/L vs (753.1±254.3) μ mol/L,P=0.000],lower serum calcium levels[(1.86±0.1) mmol/UL vs (2.02±0.2) mmol/L,P=0.000],higher serum phosphorus [(2.1±0.6) mmol/L vs (1.6±0.4) mmol/L,P=0.001] and higher calcium phosphorus product [(3.8±1.1) mmol2/L2 vs (3.1±0.8) mmol2/L2,P=0.010] as compared with those of the patients without the primary outcome.Based on the results of multivariable Cox regression analysis,ultrafiltration volume,cardiac functional grading,peritonitis,Kt/V and serum phosphorus level contributed to the decline of RRF significantly.Conclusion The higher Kt/V in PD patients plays a protective role,the higher ultrafiltration volume,the worse heart function,the more peritonitis rate and higher serum phosphorus predict more rapid declination of RRF.

CAS (Chrome azurol S) assay was a universal method for detecting the bacterial siderophores, and Sugar-Asn liquid medium has been applied to the studies on siderophores from Pieudomonas. In this paper, Asp has been substituted for Asn, and MSA-CAS agar plate was developed by integrating the MSA (sugar-Asp) medium and CAS bright blue dye, which has been used in the universal CAS assay. On the aspect of siderophores detection , 8 strains of 7 species from Pseudomonas had been screened on MSA-CAS agar plates and universal CAS assay respectively. The results showed that MSA-CAS agar was higher-sensitive and lower basic fluorescent than universal CAS assay.

A novel stable blue agar plate which is convenient to preparing and more effective than the universal chrome azurol sulfonate (CAS) assay established by Schwyn and Neilands was designed by replacing MM9 growth medium and pipes with certain concentrate of phosphorus buffer solution which pH could be stabled at 6.8. It is more suitable for screening over- siderophores production bacteria. Since OD_ 630 of the sample is usually out of the range of spectrophotometer with CAS assay solution when quantifying the siderophores and the outcome is not steady,the measuring wavelength had been changed to 680 nm corresponding to the middle of max absorbance and the correlation between siderophores concentrations and OD was unchanged. But the detecting sensitivity is elevated by enlarged the absorbance differences among samples with different productivity of siderophores at 680 nm .

BACKGROUND: Previous studies have confirmed that rabbit bone marrow mesenchymal stem cells (BMSCs) can differentiate into osteoblasts under osteogenic induction in vitro, stably express the specific phenotype of osteoblasts and have osteogenic ability. Calf cortical bone scaffold with partial cancellous bone has good biocompatibility and degradability, which can be used as a carrier material of bone marrow mesenchymal stem cells. OBJECTIVE: To combine rabbit BMSCs with calf bone composite according to the basic principles of bone tissue engineering and to observe the osteogenesis in the New Zealand white rabbits after implantation of BMSCs/calf bone composite into the ilium, thereby providing a direct evidence for preliminary clinical application of tissue-engineered bone products.METHODS: BMSCs/calf cortical bone scaffold with partial cancellous bone (tissue-engineered bone group), simple calf heterogeneous bone (heterogeneous bone group) or autologous iliac bone (autologous iliac bone group) was randomly implanted into the rabbit ilium. The changes of implant surface and tissue reactions around the implant were observed.X-ray examination was performed to observe osteogenic changes at 4, 8, 12, 24 weeks after implantation. Immunohistochemistry staining was used to observe the expression of bone morphogenetic protein 2.RESULTS AND CONCLUSION: After heterogeneous bone implantation, the wound healed well, and there were no systemic or local inflammation and toxicity reactions in all groups. The X-ray results showed that at postoperative 24 weeks, the implant was basically fused with the host bone in the tissue-engineered bone group, but the fusion was unsatisfactory in the heterogeneous bone group. The process of ossifications from cartilages was observed in all groups by hematoxylin-eosin staining, and bone morphogenetic protein 2 was positive for immunohistochemical staining. Findings from in vivo experiments indicate that rabbit BMSCs seeded onto the calf cortical bone scaffold with partial cancellous bone could construct tissue-engineered bone by osteoinductation in vitro in the rabbits.

Objective To determine if pregnancy affects the toxicity of bupivacaine and to investigate the effect of Shenfu injectio,a preparation of Chinese herbal medicine,on central nervous system and cardiac toxicity of bupivacaine in pregnant rats.Methods Twenty-four SD rats weighing 320-360 g were assigned to 3 groups(n =8 each):Ⅰ non-pregnant control group,Ⅱ pregnant control group and Ⅲ Shenfu injectio pretreatment group. The animals were anesthetized with isoflorane(2%-4%)-O_2 inhalation which was stopped before bupivacaine infusion was started.Femoral artery was canunlated for MAP monitoring and blood sampling and femoral vein was cannulated for bupivacaine infusion.MAP,HR and ECG were continuously monitored.All animals in the 3 groups received continuous infusion of 5% bupivacaine at 2 mg?kg~(-1).min~(-1).In group Ⅲ Shenfu injectio 10 ml?kg~(-1) was injected intraperitoneally(IP)30 min before bupivacaine infusion whereas in the two control groups(group Ⅰ and Ⅱ)equal volume of normal saline was injected IP instead of Shenfu injectio.The duration between the beginning of bupivacaine infusion and onset of convulsion/arrhythmia(QRS≥90 ms)/asystol was recorded and the amount of bupivacaine infused was calculated.Results There was no significant difference in the amount of bupivacaine causing convulsion and asystol between group Ⅰ and Ⅱ but the amount of bupivacaine causing arrhythmia was significantly larger in group Ⅰ(non-pregnant) than in group Ⅱ(pregnant control group)(P＜0.05).The amount of bupivacaine causing convulsion,arrhythmia and asystole was significantly larger in Shenfu injectio pretreatment group(group Ⅲ)than in pregnant control group(group Ⅱ)(P＜0.05 or 0.01).Conclusion Bupivacaine- induced cardiotoxicity is increased in pregnant rats and Shenfu injectio pretreatment can reduce the systemic toxicity of bupivacaine in pregnant rats.

Objective To follow up the rehabilitation, education, and assistive devices utilization of school age children with cerebral palsy. Methods From 2012 to 2015, 80 children with cerebral palsy were called their parents with telephone and filled in the questionnaires. Results 69 children (85.25%) continued to receive rehabilitation, 11 children (13.75%) stopped rehabilitation. 42 children (56.25%) received education in ordinary schools, 15 children (18.75%) received education in special schools, 4 children (5.00%) were nursed in nursing institu-tion, 16 children (20.00%) stayed at home and did not receive any education. The main problem and needing at present were receiving reha-bilitation, receiving school education, relief the rehabilitation cost of more than one institution, etc. 61 children (76.25%) ever applied for as-sistive devices, 19 children (23.75%) did not. The feedback of application process in order were smoothly;applied, but didn't get;the assis-tive devices that received was inappropriate. 29 children (73.75%) needed assistive devices currently, 21 children (26.25%) did not. When asked the category of needed assistive devices at present, 19 parents (20%) answered that they did not know the category of assistive devices well or they did not know which kind of assistive devices they needed. Conclusion It is important to provide quality and quantity rehabilita-tion and education service, popularize the knowledge of assistive devices and their clinical application for cerebral palsy children. Assistive devices providing departments should do more communication with cerebral palsy children and their parents, in order to reduce the waste of resources, and increase the rational use of resources, and provide more benefits for children with disabilities.

Objective To observe the correlation of histologicalactivity(HAI) of chronic hepatitis B (CHB) with CCL20 expression, and to investigate the impact of CCL20 expression in CHB infection. Methods On the basis of established competitive quantitative RT-PCR with an internal standard, the expression of the CCL20 in the hepatocytes in different infected patterns of HBV infected cells and liver biopsies were quantified and at the same time its correlation to HAI were explored. Results In the cell levels, the expression quantity of CCL20 in control cells (HepG2), persistent HBV infected hepatocytes( HepG2. 2. 15) are (2. 65 ± 0. 02) pg/106 cells, ( 1.22± 0. 04) pg/106 cells, respectively. There were significantly differences between them ( t = 39. 66, P < 0. 01 ). The expression of CCL20 was enhanced in hepatocytes stimulated by PMA but their expression pauern was not changed. Moreover, CCL20 expression in liver biopsies with CHB was (3.54 ± 0. 65 ) pg/20 mg and CCL20 expression in control groups was ( 8. 74±0. 56) pg/20 mg. The expression of CCL20 between two groups was different (t =30. 09,P <0. 01 ) and correlation lied in between HAI and CCL20 expression in liver biopsies of CHB patients ( r = 0. 675, P =0. 023 ). Conclusion CCL20 expression was down-regulated and it was correlated to HAI of liver biopsies in CHB patients.

BACKGROUND: Continuous blood purification can remove cytokines and inflammatory mediators, maintain homeostasis and prevent the occurrence of multiple organ dysfunction syndrome in patients with severe pancreatitis, which has become the main therapy for severe pancreatitis. Since the hemodialysis technology began to be applied clinical y, the biological and physicochemical properties of hemodialysis membrane materials have been studied. A variety of hemodialysis membranes have been developed in order to improve the biocompatibility and anticoagulant effect in vitro. OBJECTIVE: To investigate the application effect of hemodialysis membranes on severe pancreatitis. METHODS: Ten Wistar rats were selected to make rat models of severe pancreatitis and then were randomized into two groups (n=5 per group): homophone membrane group and polysulfone membrane group. Hemodialysis- related biochemical parameters were detected in the two groups. RESULTS AND CONCLUSION: Compared with the homophone membrane, ultrafiltration coefficient, creatinine clearance, blood urea nitrogen clearance, phosphorus clearance, number of circulating endothelial cel s, and levels of plasma nitric oxide and asymmetric dimethylarginine were significantly lower in the polysulfone membrane group (P < 0.05). Vitamin B12 clearance and amount of pre-congestion increased significantly in the polysulfone membrane group as compared with the homophone membrane (P < 0.05). These findings indicate that the polysulfone membrane for hemodialysis has good biocompatibility, and keeps a stable environment in vivo for severe pancreatitis patients.

Objective To investigate the correlation between developmental function and pathological behavior in children with autism. Methods A total of 154 children with autism were tested with Revised Chinese Version Psycho-Educational Profile (C-PEP) during 2011 to 2014. Results The scores of fine movement, hand-eye coordination, and oral language of developmental function were lower in the girls than in the boys (t>2.120, P<0.05). Among the children with autism aged 2-7 years, the developmental function was better in the older group than in the younger group (P<0.05);however, it was not better in the children aged 8-10 years and>10 years than in those aged 6-7 years. There was no difference in the scores of pathological behavior between the girls and the boys (P>0.05). Some pathological behaviors were milder in the older group than in the younger group (P<0.05). The scores ofP(pass) in developmental function were positively correlated with the scores ofA(absence) in pathological behavior (P<0.01), and negatively correlated with the scores ofS(severe) in pathological behavior (P<0.01). The scores ofF(fail) in developmental function were negatively correlated with the scores ofA(absence) in patho-logical behavior (P<0.01), and positively correlated with the scores ofS(severe) in pathological behavior (P<0.01). Conclusion Develop-mental function of children with autism is highly correlated with pathological behavior, and the rehabilitation and education of children with autism aged above 7 years should be concerned.

Simulation teaching is helpful to learn general principles of solving complex problems,making decisions,resource management and teamwork behaviors during clinical treatment in order to prevent,ameliorate and resolve critical incidents and crisis situations.The medical staff will improve their medical,cognitive and social skills in the recognition and treatment of realistic and complex medical situation.