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 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

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

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.

By preventing mesenchymal stem cells (MSCs) from adhering to precoated agarose to create a model of MSC suspension in vitro, we investigated anoikis in MSCs and the role of caspase-3 in the anoikis. The cultured MSCs were randomly divided into 3 groups: the anoikis group, caspase-3 inhibitor group and control group. Before experiment, we coated dishes with 1.5 % agarose; in the anoikis group, MSCs were put into the precoated dishes; and in the inhibitor group, caspase-3 inhibitor and MSCs were also put into the precoated dishes; but there were not intervention in the control group. MSCs were collected at 2 h, 6 h, 12 h and 24 h. The alteration of caspase-3 activity was evaluated by caspase-3 fluorometric assay and western blot analysis. The apoptosis rates were detected by flow cytometry. MSCs were round and suspended sufficiently in the anoikis and inhibitor groups. Caspase-3 fluorometric assay showed that there were significant differences in statistics between the anoikis group and the others (P<0.05). Western blot analysis discovered that caspase-3 expression in the anoikis group was more than that in the control and inhibitor groups (P<0.05). Flow cytometry showed that the apoptosis peak appeared in all the three groups, but it increased dramatically in the anoikis group. The apoptosis rates in the inhibitor and control groups were low and stable. And there were significant differences in statistics between the anoikis group and the others (P<0.05). MSCs will undergo anoikis in suspended condition if they are separated from the extracellular matrix. Caspase-3 inhibitors can suppress caspase-3 activity and reduce the apoptosis rate significantly. Caspase-3 plays a vital part in induced MSC anoikis in vitro. MSCs suspension culture system might be set up with argorose and caspase-3 inhibitor.

BACKGROUND: The researches of Pulling and Rotating Oblique Pulling Manipulation focus on clinical research and biomechanical changes of lumbar functional units, and the mechanical characteristics of manipulation are little reported.OBJECTIVE: To study the characteristics of the Pulling and Rotating Oblique Pulling Manipulation by digital method, so as to provide quantitative basis for inheritance, teaching and learning, promotion, and basic research of the manipulation.METHODS: The force-time curve and the force of the manipulators were tested and recorded with the multi-point membrane pressure measurement system. The kinetic parameters (the average load force, the average minimum force and the maximum impact force) were shown. The values of = the flip time, flip speed and impulse were measured by the test analysis system.RESULTS AND CONCLUSION: (1) The average load force was (145.86±34.80) N, duration was (1.43±0.46) s, the average minimum force was (72.24±13.87) N, the maximum impact force was (446.21±143.98) N, the flip time was (0.55±0.15) s, flip speed was (914.52±259.18) N/s, and the impulse was (256.21±82.30) N?s. (2) The rising slope of the impulse was (93.96±6.94), and the falling slope was (-82.70±26.10). (3) To conclude, the characteristics of manipulation from hand are analyzed in views of digitization, which provides an objective evaluation index for Lin's manipulation.

Objective To explore the efficacy of proximal femur locking plate(PFLP) for the treatment of unstable femoral intertrochanteric fractures in elderly patients.Methods Data of 120 cases of patients with unstable femoral intertrochanteric fractures who were treated by PFLP were retrospectively analyzed.There were 56 males and 64 were females,aging from 62 to 78 year-old (average,69.4 year-old).85 cases were left hip,and 35 cases right hip.According to AO fracture classification,there were 12 cases of A2.2,23 A2.3,34 A3.1,29 A3.2,and 22 A3.3.According to Evans intertrochanteric fractures classification:there were 93 cases of type Ⅲ,19 type Ⅳ,and 8 type Ⅴ.Operation time,length of hospital stay,fracture healing time,postoperative complications and hip joint Harris scores were recorded.Results All patients were followed up for 8-14 months (average,12.4 months).Their operating time were 51-80 min (average,63.1 min);X-ray exposure were 8-15 times (average,11.6 times);intraoperative blood loss were 70-120 ml (average,92.7 ml);postoperative drainage volume were 50-100 ml (average,61.7 ml),and length of hospital stay were 7-14 d (average,10.2 days).The healing time ranged from 12 to 32 weeks (20.4 weeks average).14 cases had delayed union,and healing time was 8-10 months.In addition,4 cases had deep vein thrombosis (after thrombolysis therapy the vein was recanalized);2 had internal fixation broken,who were then treated with PFNA Ⅱ,and bone healed after 6 months;5 had hip varus,who were then treated via hip replacement,and no hip prosthesis fracture were found.No other complications occurred in the remaining patients.At the latest follow-up,according to Harris hip score:there were 38 cases with excellent results,71 good,9 fair,and 2 poor,and the rate of excellent and good was 90.8％ (109/120).Conclusion PFLP for the treatment of unstable femoral intertrochanteric fractures has advantages of less invasion,less complication,reliable fixation and high fracture healing rate,thus it is suitable for unstable intertrochanteric fractures in elderly patients.

Objective To explore the mechanism of multi-medicine drug resistance in human ovarian cancer cell line COC1/5-Fu. Methods The apoptosis and the tolerance of COC1/5-Fu cell induced by 5-Fu were analyzed by FACS. The expression of apoptosis related genes, such as p53, bcl-2, bcl-xl and bax, in COCI/5-Fu cell line were analyzed by RT-PCR. Results The COC1/5-Fu cell has some de-gree of drug resistance to 5-Fu and several other commonly used kind of chemotherapy medicine, among of which, drug resistance of 5-Fu reach 107.0 times and Paclitaxel reach 9.0 times compared with COC1. When COC1 was treated with the concentration of 5-Fu (0μmo/L, 30μmo/L or 150 μmol/L), the AI was (6.5±1.0) %, (14.0±4.0) % and (20.0±5.0) %, respectively. The rate of apoptosis increased 1.2 time and 2.1 time, compared with not treated with 5-Fu, which were significantly different (P<0.05). But when COC1/5-Fu was treated with the same concentration of 5-Fu (30 μmo/L or 150 μmoL/L), the AI was (6.7±0.7)%, (7.1±2.2)% and (6.5±2.0)%. When treated with the same concentration of 5-Fu (30 μmo/L or 150 μmol/L) , the proportion of apoptosis was significantly increased, G0/G1 phase was increased, and S and G2/ M phases were reduced in COC1 cells, but the proportion of apoptosis and cell cycle was not changed in COC1/5-Fu cells. The expression of bcl-xl , bcl-xs and bax mRNA were significantly increased and the expression of p53 and cpp32 mRNA were significantly decreased in resistant COC1/5-Fu cells , compared with COC1 cells. Conclusion wtp53 gene mutation is related with cell cycle change of ovary cancer cell and drug resistance, which is one of multi- medicine drug resistance mechanisms of COC1/5-Fu.

Objective To evaluate the efficacy of double filtration plasmapheresis (DFPP) in the treatment of patients with refractory rheumatoid arthritis (RA). Methods Eighty-two patients were randomly aesigned,42 to the DFPP group and 40 to the no-DFPP group. All patients previously experienced an incomplete response to 2-3 dis-ease-modifying antirheumatic drugs (DMARDs) and 1-2 nonsteroidal anti-inflammatory drugs (NSAIDs) or predni-sene. All patients received sulphasalazine (SASP,0.75 g three times daily) plus methotrexate (MTX, 10 mg orally once weekly). DFPP was performed once a week for 2-3 sessions. A total of 121 plasmapheresis procedures were per-formed in 42 patients. Control patients did not receive sham DFPP. The efficacy measures recorded one day after the final treatment and latest month in follow up for 12～24 months included the American College of Rheumatology 20% ,50% ,and 70% improvement criteria (ACR20, ACR50, and ACR70), the Health Assessment Questionnaire estimate of disability (HAQ); and the disease activity index. Results Patients in the DFPP group had ACR 20, ACR 50 and ACR 70 improvements of 100% ,92.9% and 81.0%,as compared with the patients in no-DFPP group 17.5% ,0,and 0 (P<0.001). Significant change from baseline was observed in HAQ scores in the DFPP group but not in the no-DFPP group (P<0.001). The changes from baseline in the disease activity scores were significantlygreater than in the no-DFPP group (P<0.001). Conclusion DFPP therapy significantly alters the signs and symp-toms of refractory RA. There are significant increases in physical function and improvement in quality of life.