Objective To compare the clinical effects between continuous renal replacement therapy (CRRT) and intermittent haemodialysis (IHD) for the treatment of sepsis-induced acute kidney injury (AKI). Methods A prospective study was conducted. Seventy-three patients with sepsis-induced AKI admitted to the intensive care units (ICUs) of Tianjin Hospital and Tianjin First Center Hospital from January to December in 2014 were enrolled. They were randomly divided into two groups: CRRT group (n = 35) and IHD group (n = 38). Data were recorded for the patients in two groups before treatment, including acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, mean arterial pressure (MAP), urine volume, and the levels of C-reactive protein (CRP) and serum creatinine (SCr) before and 1 week after treatment, the time of recovery of urine volume, the length of ICU stay, the duration of organ support, and the incidence of cardiovascular events. Results There was no statistically significant difference in APACHE Ⅱ scores (21.63±2.46 vs. 21.34±2.46), MAP [mmHg (1 mmHg = 0.133 kPa): 71.26±10.70 vs. 75.74±15.17], urine volume (mL: 404.00±79.13 vs. 438.97±87.17), CRP (mg/L: 100.94±14.73 vs. 95.17±27.03), and SCr (μmol/L: 394.02± 50.26 vs. 390.47±54.42) before treatment between CRRT group and IHD group (all P > 0.05). One week after treatment, compared to the IHD group, CRRT could dramatically reduce the levels of CRP (mg/L: 41.05±10.15 vs. 60.21±14.78, t = 6.401, P < 0.001), SCr (μmol/L: 185.97±65.48 vs. 232.02±71.93, t = 2.862, P = 0.006), urine output recovery time (days: 7.94±3.06 vs. 11.08±3.71, t = 3.923, P < 0.001), the length of ICU stay (days: 9.54±3.39 vs. 13.42±3.89, t = 4.521, P < 0.001), organ support time (days: 3.23±2.70 vs. 6.34±3.36, t = 4.343, P < 0.001), and the incidence of cardiovascular events [23.53% (8/35) vs. 39.47% (15/38), χ2 = 5.509, P = 0.025]. Conclusion Compared to IHD, CRRT can more efficiently help patients with sepsis-induced AKI in removing excessive water, metabolic waste, and lower the levels of pro-inflammatory cytokines, maintain homeostasis of the internal environment, lower the adverse effects on cardiovascular system, so that it significantly improve the prognosis of patients, shorten the time of organ support and the length of ICU stay.

Objective To study the expression of p73 gene in lung cancer and tumorigenesis, progression of lung cancer in the elderly. Methods The expression of p73 protein in 65 cases of lung cancer, adjacent tissues of cancer and normal tissues was determined by immunohistochemical SABC method. The results were analysed by combining the clinicopathological data and the prognosis. Results The results showed (1)the expression level of p73 protein in the cancer group was significantly different from the rest groups(47 7%,9 2%,4 6%, P 0 05),but it was correlated with the clinical stage (60 5%,22 7%) and survival time of the patients (72 2%,16 0%, P

Objective To observe the effect of passive smoking on Clara cells and secretion of Clara cell secretory protein (CC16) in rat lung tissue and to find some relations between passive smoking and chronic inflammation in the lung. Methods 40 male rats were randomly divided into 4 groups: passive smoking for 1 month (group 1), 2 months (group 2), and 3 months (group 3) and control group (n=10). The change of Clara cell ultrastructure was detected through transmission electron microscope and the lung pathology was examined by HE stain. The expression of CC16 mRNA in the lung was detected by RT-PCR. The number of Clara cells and synthesis of CC16 were detected by immunohistochemistry, the CC16 level in BALF was detected by ELISA. Results The ultrastructure of Clara cells in group 3 was destroyed greatly and the formation of pneumatocele was observed. The percentage of Clara cells in terminal bronchioles in group 2 and group 3 significantly decreased than that of the control(P

To study the cartilage differentiation of mouse mesenchymal stem cells (MSCs) induced by cartilage-derived morphogenetic proteins-2 in vitro, the MSCs were isolated from mouse bone marrow and cultured in vitro. The cells in passage 3 were induced into chondrogenic differentiation with different concentrations of recombinant human cartilage-derived morphogenetic proteins-2 (0, 10, 20, 50 and 100 ng/mL). After 14 days of induction, morphology of cells was observed under phase-contrast microscope. Collagen II mRNA and protein were examined with RT-PCR, Western blotting and immunocytochemistry respectively and the sulfate glycosaminoglycan was measured by Alcian blue staining. RT-PCR showed that CDMP-2 could promote expression of collagen II mRNA in an dose-dependant manner, especially at the concentration of 50 ng/mL and 100 ng/mL. Immunocytochemistry and Western blotting revealed a similar change. Alcian blue staining exhibited deposition of typical cartilage extracellular matrix. Our results suggest that mouse bone marrow mesenchymal stem cells can differentiate into chondrogenic phonotype with the induction of CDMP-2 in vitro, which provides a basis for further research on the role of CDMP-2 in chondrogenesis.
Bone Marrow Cells/*cytology ; Bone Morphogenetic Proteins/*pharmacology ; Cell Differentiation/*drug effects ; Cells, Cultured ; Chondrocytes/*cytology ; Chondrogenesis/drug effects ; Chondrogenesis/physiology ; Mesenchymal Stem Cells/*cytology ; Recombinant Proteins/pharmacology

Objective To analyze the risk factors of mucous plug caused byMycoplasma pneumoniae pneumonia (MPP) in children and guide clinical therapy to decrease the incidence of sequela caused by airway inlfammatory obstruc-tion.Methods We conducted a retrospective study of the clinical data of 116 children with MPP who received ifber broncho-scope from January 2012 to January 2014 admitted to the respiratory department of the Children's Hospital of Hebei provience. Based on the airway mucosal lesions seen through the bronchoscope, the subjects were divided into the mucous plug group (n=67) and the control group (n=49). Gender, age of onset, febrile course, pleural effusion, white blood cell counts, neutrophil ratio, C reactive protein (CRP), serum lactate dehydrogenase level (LDH), initial time of received macrolides and ifber bronchoscope were compared between the two groups. If the Results of single factor analysis showedP<0.05, the indicators were analyzed by the logistic regression analysis. The receiver operator characteristic (ROC) curve was drawn to evaluate the predictability of logistic regression model.Results The Results of single factor analysis showed that age of onset, febrile course, CRP, serum LDH, pleural effusion cases in the mucous plug group were higher than those in control group (P<0.05). The Results of the logis-tic regression analysis showed that older than three years (OR=7.45), febrile course more than 10 days (OR=4.01), the level of CRP and LDH higher than 40 mg/L (OR=5.41) and 350 U/L (OR=3.63) were respectively the risk factors of mucous plug caused by MPP in children. The area under the ROC curve is 0.846 (95%CI: 0.773-0.919,P=0.000).Conclusions MPP children with age older than three years, or with febrile course more than 10 days, or with the level of CRP and LDH higher than 40 mg/L and 350 U/L has the possibility of forming a mucous plug.

Objective To evaluate the efficacy and safety of combination therapy with domestic bezafibrate and fluvastatin in patients with combined hyperlipidemia. Methods 180 patients with combined hyperlipidemia were randomly divided into two groups. They were assigned to receive 40 mg fluvastatin (n = 90) or a combination of 400 mg bezafibrate and 40 mg fluvastatin (n = 90) for 24 weeks. Results After 24 weeks treatments, the serum TC, LDL-C levels were reduced (P <0.01) and HDL-C level was increased more significantly (P <0.05) in the combi-nation therapy group. Conclusion Combination therapy with bezafibrate (400 mg) and fluvastatin (40 rag) is more effective than fluvastatin(40 mg) monotherapy.

Objective: To evaluate the diagnostic performance of conventional ultrasound, compression elastography (CE) and acoustic radiation force impulse imaging (ARFI) in diff erential diagnosis of benign and malignant breast tumors. Methods: A total of 98 patients with liver lesions were included in the study. The images of conventional ultrasound, CE and the values of virtual touch tissue quantiifcation (VTQ) of breast lesions were obtained. hTe diagnostic performance of conventional ultrasound, CE and ARFI were assessed by using pathology as the gold standard, and then evaluate the diagnosis effciency of these three approaches in differential diagnosing benign and malignant breast tumors. Results: The specificity, sensitivity and accuracy in the diagnosis of malignant breast tumors for conventional ultrasound were 80.0%, 81.1% and 81.7%, respectively, whereas for CE elastic score were 85.7%, 86.7% and 86.3%, respectively. With a cutoff value of 3.71 for the SR, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 97.1%, 83.3% and 88.4%, respectively. With a cutoff value of 3.78 m/s for VTQ, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 94.3%, 91.7% and 92.6%, respectively. The difference in diagnosis efficiency among ARFI, CE and conventional ultrasound in differential diagnosis of benign and malignant breast tumors was signiifcant (P<0.05). Conclusion: Conventional ultrasound, CE and ARFI are all useful for the differential diagnosis of benign and malignant breast tumors. But the diagnosis effciency of ARFI is superior to CE and conventional ultrasound. The three approaches can help each other in differential diagnosis of benign and malignant breast tumors.

Purpose To investigate the expression of Beclin1, LC3 and mTOR in colorectal cancer ( CRC) and their significance. Methods Immunohistochemistry, Western blot and real-time PCR were employed to detect the expression of Beclin1, LC3 and mTOR in CRC. Results The positive expression rate of Beclin1, LC3 and mTOR in 242 cases of CRC was 90. 50%, 87. 19% and 46. 28%, respectively, which were higher than that in adjacent tissues ( P<0. 05 ) . Moreover, the expression of LC3 in moderately and poorly differentiated CRC was higher than that in well differentiated CRC, and the positive rate of LC3 in CRC with lymph node metastasis was higher than that in CRC without lymph node metastasis. The overexpression of mTOR was related to lymph node metasta-sis (P<0. 05), but both differentiation degree and lymph node metastasis were not associated with Beclin1 (P>0. 05). The expres-sion of LC3 was positively correlated with Beclin1 and negatively correlated with mTOR in colorectal cancer (rs =0. 593, P<0. 01, rs= -0. 165, P<0. 01), and the expression of Beclin1 was not associated with mTOR (P>0. 05). Kaplan-Meier survival analysis re-vealed that the five-year survival rate of patients without nodal metastasis, positive expression of Beclin1, LC3 and negative expression of mTOR was higher than those with nodal metastasis, negative expression of Beclin1 and LC3, and positive expression of mTOR. Cox survival analysis results revealed that LC3, mTOR and lymphnode metastasis were independent prognostic factors. The results of IHC, real-time PCR and Western blot in fresh CRC tissues indicated that the expression of Beclin1, LC3 and mTOR in colorectal cancer was significantly higher than that in adjacent tissues (P<0. 05). Conclusions The aberrant expression of Beclin1, LC3 and mTOR may be associated with the development and progression of colorectal cancer. The simultaneous detection of Beclin1, LC3 and mTOR genes in colorectal cancer may be helpful for the evaluation of the progressive degree and the judgment of prognosis.

OBJECTIVE: To establish an HPLC method for the determination of the contents of the related substances in metoclopramide.METHODS: The sample was separated on C18 column with the mobile phase consisted of acetonitrile-0.02 mol?L-1 phosphonic acid solution(19∶81) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 275 nm;the column temperature was kept under room temperature and the injected volume was 20 ?L.The contents of the related substances in metoclopramide were computed by self-control method of main constituent.RESULTS: Under the above described chromatographic conditions,metoclopramide was completely separated from its impurities.A good linearity between impurities' peak area and metoclopramide(contrast solution) concentration was achieved when the concentrations of impurities were over the range of 0.05%～4.0%.The lowest detectable limit of metoclopramide was 0.3 ng,and the contents of the related substances were all less than 0.26%.CONCLUSION: The method is convenient,accurate,sensitive and,specific,and it can be used for the determination of the related substances in metoclopramide.

Objective: To observe clinical efficacy of oral folic acid (FA) intervene in hyper-homocysteinemia (HHcy) patients combining coronary artery disease (CAD) and heart failure (HF), to study the effect of blood level of Hcy on cardiac function. Methods: A total of 126 relevant patients with blood level of Hcy>15 μmol/L were randomly divided into 2 groups:Routine group, the patients received anti-platelet therapy, statins, beta-blockers, diuretics, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonist and FA group, in addition to above mentioned therapies, the patients also received FA 5 mg/day. n=63 in each group and all patients were treated for 3 months. Fasting blood levels of Hcy, BNP and left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT) were compared between 2 groups at pre- and 3 months post-treatment. Results: ① Based on NYHA classification, the patients with cardiac function at II, III, IV had accordingly increased blood levels of Hcy, BNP and LVEDD, while decreased LVEF and 6MWT, all P<0.05. ② Blood levels of Hcy were positively related to BNP (r=0.733, P<0.001) and LVEDD (r=0.511, P<0.001), negatively related to LVEF (r=-0.382, P<0.001) and 6MWT (r=-0.410, P<0.001). ③ With 3 months treatment, FA group and Routine group showed decreased Hcy level as (8.43 ± 1.87) μmol/L vs (3.29 ±1.68) μmol/L and BNP (891.84 ± 456.10) pg/ml vs (682.24 ± 463.79) pg/ml, reduced LVEDD (4.33 ± 1.231) mm vs (2.06 ± 1.73) mm, while elevated LVEF (6.59 ± 2.28) % vs (2.52 ± 2.37) % and 6MWT (142.97 ± 55.15) m vs (86.35 ± 59.06) m, all P<0.05. Conclusion: Increased blood level of Hcy is risky for HF occurrence, FA may treat HHcy and further improve the cardiac structure and function in HF patients.