Objective To determine the correlation between serum asymmetric dimethylarginine (ADMA) and non-spoon-shaped blood pressure of non-dialysis chronic kidney disease (CKD) patients,also to observe the impact of the serum ADMA level on the structure and function of left ventricle.Methods One hundred and twenty cases of non-dialysis CKD patients underwent 24-hour ambulatory blood pressure monitoring were divided into three groups:CKD1-2,CKD3,CKD 4-5.Serum ADMA concentration was measured using liquid chromatograph and other clnical data such as uric acid (UA),left ventricular mass index (LVMI),24 h urine protein,and high-sensitivity C-reactive protein (hs-CRP) were collected for further statistical analysis.Results (1) With the decline of renal function,ADMA concentration was increased,from CKD 1-2 (1.70±0.48) μmol/L rose to CKD 4-5(4.46±1.56) μmol/L (P ＜ 0.05).(2)There were 42 cases of CKD patients with hypertension and 78 cases of CKD patients with normal blood pressure.The serum ADMA levels in hypertension group was significantly higher than those in non-hypertensive group [(3.53±1.70) μmol/L vs (2.01±0.65) μmol/L,P ＜ 0.05].(3)There were 50 cases of non-spoon-shaped normotensive CKD patients and 28 cases of spoon-shaped normotensive CKD patients.Serum ADMA level and LVMI in non-spoon-shaped group were significantly higher than that in spoon-shaped group when kidney functions appeared to be equal (P ＜ 0.05).(4)Serum ADMA level was positively correlated with UA(r=0.352,P ＜ 0.01),LVMI (r =0.345,P＜ 0.05),24 h urine protein(r =0.200,P ＜ 0.05),and high-sensitivity C-reactive protein (r =0.309,P ＜ 0.01),but negatively correlated with the left ventricular ejection fraction (LVEF)(r =-0.329,P ＜ 0.01) and estimated glomerular filtration rate (eGFR)(r =-0.011,P ＜ 0.01).Multiple regression results showed that eGFR,UA,LVMI,hs-CRP,24 h urine protein were associated with ADMA level.The regression equation was Y =1.991-0.011 × [eGFR] + 0.002 × [UA] + 0.008 × [LVMI] + 0.036 ×[hs-CRP]-0.084× [24 h urinary protein].Conclusions Serum ADMA level begins to increase in early stage CKD and it progressively increases with the decline of renal function,also the non-spoonshaped blood pressure ratio and the left ventricular damage increase.Kidney function,urine protein and microinflammatory state may impact on the serum ADMA level.

Objective To study the effect of Chinese herbs on human scalp hair growth in vitro. Methods Organ culture of human scalp hair follicles was used to study the effects of extracts of Crataegus cuneata, Ligustrum lucidum, Polyporus umbelatus and Bletilla striata mixture and ginseng saponin on hair growth. Results Low doses of mixture extracts(1.28 ?g/mL and 6.4 ?g/mL) markedly enhanced the hair growth and lengthened the period of hair growth, while high doses of mixture extracts(4 mg/mL and 20 mg/mL) sharply inhibited hair growth and shortened the period of hair growth. High doses of ginseng saponin (40 ?g/mL and 200 ?g/mL) also had an inhibiting effect on hair growth. Conclusion This observation suggests that extracts of Crataegus cuneata, Ligustrum lucidum, Polyporus umbelatus and Bletilla striata mixture can promote hair growth in vitro.

Objective To detect the esophageal and fundal varices and their related collateral ves-sels by multi-detector row CT ( MDCT) in helping to find out the objective evidences for selecting treatment measure and predicting prognosis. Methods Fifty-one patients with clinical diagnosis of cirrhosis were in-cluded in this study. Esophageal varices were confirmed by endoscopy in all patients, of which 31 accompa-nied with fundal varices. All patients underwent MDCT angiography to demonstrate collaterals between the systemic and portal circulation as well as the esophageal varicose. Results Good or excellent image quality was obtained in all patients. Gastric fundal varices were found in 31 of 51 patients (60. 8% )by endoscopies. By MDCT angiography esophageal varies were confirmed in all patients, gastric fundal varices were in 32 of 51 (62. 7% ). There are high degree of concordance Kappa =0. 876 between them. Esophageal varices were supplied mainly by the left gastric vein ( LGV) , by anterior branch of LGV alone in 30 of 51 (58. 8% ). There were paraesophageal veins in 21 of 51 patients (41.2%). Gastric fundal varices were supplied by LGV in 24 of 32 patients (75% ), by short gastric veins /posterior gastric veins in 3 of 32 patients (9. 4% ) and by short gastric veins /posterior gastric veins and LGV together in 5 of 32 patients ( 15. 6% ). Short gas-tric veins and posterior gastric veins participate in forming of esophageal varices in these patients. Conclusion MDCT angiography shows an excellent vascular maps and highly in concordance with endoscopy in terms of the detection of esophageal and gastric fundal varices. Esophagal varices were supplied mainly by LGV, more than half of them were by its anterior branch, and paraesophageal veins participated to it in some patients too. The blood flow in gastric fundal varices were supplied from LGV in most of the patients, and the rest from short gastric veins.

Multiple myeloma is common in the older population and is treated mainly with chemotherapy. However, chemotherapy-related side effects imitate the clinical manifestations of Sheehan's syndrome, which leads to misdiagnosis and missed diagnosis, particularly for older patients without a clear history of postpartum hemorrhage. Therefore, when older women with malignant myelomas show refractory hyponatremia and gastrointestinal disorders while under chemotherapy, a diagnosis of Sheehan's syndrome should be considered. The early detection of the disorder will guarantee timely individualized treatment.

Objective To evaluate the efficacy of long-pulsed tunable Nd: YAG laser on capillary hemangioma and to analyse its influencial factors. Methods A retrospective review was conducted on 124 patients with 135 vascular lesions treated with long-pulsed tunable Nd:YAG laser from February, 2007 to January, 2008. Working parameters, including spot size (3-5 mm), pulse duration (10-30 ms) and fluence (120-200 J/cm2) were determined based on the size, color and depth of lesions and adjusted according to the immediate reaction of lesions. The interval of two treatments was 1 month. Results Of the 135 lesions, 100 experienced a more than 95% subsidence, 22 achieved 60%-94% subsidence, 11 got 30% -59% subsidence, and 2 reached less than 30% subsidence. The cure rate and effective rate were 74.07% and 90.37% respectively. Smaller lesions showed a better response to the treatment than larger ones (P<0.0001), whereas the sites and depth of lesions had no effect on the efficacy (both P>0.05). Atrophy scar occurred in 4 (2.96%) lesions, and blisters in 12 (8.89%) lesions after the treatment. No purpura or pigmentary changes occurred. Conclusion The long-pulsed tunable Nd:YAG laser is an effective treatmnt for capillary hemangioma with fast action and few side reactions.

Purpose To investigate the role of PTEN in podocyte injury in patients with diabetic nephropathy ( DN) . Methods Uri-nary samples from 30 patients with DN and 10 healthy volunteers were collected to detect the level of PCX by ELISA. Renal biopsies were reviewed to observe the morphological changes. All patients with DN were divided into three groups by glomerular lesion. The ex-pression of p-Akt and PTEN in glomeruli was detected by immunohistochemistry. Results The levels of PCX in the urine were signifi-cantly higher in patients with DN compared with those in healthy volunteers, and gradually increased along with glomerular lesion aggra-vating. The expression of p-Akt and PTEN increased in patients with DN compared with healthy volunteers. Although the expression of p-Akt and PTEN decreased with the aggravation of glomerular lesion, they were still higher than that in volunteers. There were obvious-ly positive correlation between the level of PCX and 24-h urinary protein and negative correlation between the level of PCX and the ex-pression level of p-Akt and PTEN. Conclusion PTEN down-regulation may be associated with podocyte injury in DN, which may be associated with the phosphorylation of Akt.

Aim To investigate the mechanism of high mobility group protein B1(HMGB1)and tumor necrosis factor α-induced protein-3(TNFAIP3)involved in cell proliferation in lupus nephritis(LN)patients and human mesangial cells(HMC).Methods Immunofluorescence and immunohistochemistry technique were employed to detect HMGB1,TNFAIP3 and IκBα expression levels in glomerular cells of type Ⅳ LN patients.BrdU incorporation technology was used to detect cell proliferation level in HMC after stimulated by recombinant HMGB1.TNFAIP3 and IκBα expression levels in HMC were detected after HMGB1 stimulation by Western blot.Results The expression levels of HMGB1 and TNFAIP3 were increased in LN patients,while IκBα was decreased.HMC proliferation levels increased significantly after HMGB1 stimulation.At the same time,30 minutes after HMGB1 stimulation,the expression level of TNFAIP3 was significantly increased(P<0.05),while IκBα decreased(P<0.05)and then p65 increased significantly(P<0.05),compared with control group.Conclusion HMGB1 and TNFAIP3 are probably involved in mesangial cell proliferation by activating of NF-κB signaling pathways in LN pathogenesis.

Objective To study the therapeutic window of rapamycin(RPM) concentration in primary recipients of renal transplantation. Methods An open label, multi center study was performed. One hundred primary renal allograft recipients with cadaveric donors were enrolled from 4 transplantation centers in China. The immunosuppressive regimen was triple therapy,i.e.RPM combined with CsA and steroid. A loading dose of RPM 6 mg/d was administered within 48 hours after transplantation, then a maintaining dose of 2 mg/d was administered. The whole blood concentration of RPM was measured by HPLC method. Results The whole blood concentration of RPM in this group was (6.65?2.75)ng/ml, the 10th and 90th percentile for RPM concentration was 3 2 ng/ml and 10 26 ng/ml,respectively.9 5%(8/84)patients suffered from acute rejection during the 6 month period after transplantation in this study, and the concentration of RPM in these was lower than that in non rejection patients(P=0.001). Hyperlipidemia and liver dysfunction were the most frequently adverse events, and RPM concentration was significantly associated with the concentration of triglyceride. Conclusions 4～8 ng/ml is a suitable level for RPM concentration. Regular drug monitoring and reasonable dose modulation may increase the validity and security of RPM.

Objective To investigate whether the excessive production of reactive oxygen species (ROS) in the mitochondria of the rostral ventrolateral medulla (RVLM) can inhibit the high salt-induced hypertension response.Methods A total off 32 male rats were divided into two groups:two groups were given normal salt diet (0.3％ NaCl) for 8 weeks (n=16) and high salt diet (8％ NaCl) for 8 weeks (n=16,induced hypertension model) respectively.The two groups were divided into four groups,two groups were given α-lipoic dissolving in 0.9％ normal saline (60 mg/kg),two groups were fed with saline for 9 weeks.There were ffour groups:the experimental group (n=8,the hypertension model sample fed α-lipoic acid),the model group (n=8,the hypertension model sample fed saline),the control group (n=8,normal salt diet sample fed α-lipoic acid) and the blank control group (n=8,normal salt diet sample ffed saline).Monitored the change of the arterial pressure and detected the expression off superoxide by immunofluorescence at the end of the experiment,measured the expression of NAD(P)H NOX2,NOX4 and Cu/Zn-SOD in RVLM by Western blot;determined the expression differences of oxidative stress related substances such as mitochondrial malondialdehyde(MDA)in RVLM by ELISA.Results The mean arterial pressure (MAP) in the experimental group was lower than that in the model group,the difference was statistically significant (P＜0.05);in the experimental group and the model group the intensities of fluorescent-labled dihydroethidium(DHE) were 60.2±3.1,99.1±3.8;the numbers of positive neurons in Cu/Zn-SOD were 20.8±1.1,6.9 ± 1.2;the numbers of NOX2 positive neurons were 12.3 ± 3.5,25.1 ±5.4;the numbers of NOX4 positive neurons were 10.1±2.2,13.3±4.1,the difference was statistically significant (P＜0.05).Western blot showed that the NOX2 levels of the experimental group and the model group were 78.9 ± 2.0,112.7 ± 3.8;the levels of NOX4 were 63.2± 2.1,99.4 ± 1.7.The levels of Cu/Zn-SOD in RVLM of the experimental group and the model group were 19.7 ±1.6,10.3± 1.2,the difference was statistically significant (P＜0.05);the levels of mitochondrial superoxide dismutase (SOD) were (33.1±3.8),(15.2±1.7)U/mg,the difference was statistically significant (P＜0.05).The levels of mitochondrial glutathione (GSH) in the experimental group and the model group were (5.2±0.9),(2.3±0.5)μmol/g;the levels of norepinephrine (NE) were (325.8 ± 7.3),(467.9 ± 6.1) pg/mL,the difference was statistically significant (P＜0.05).Conclusion α-lipoic acid could decrease the expression of NOX2,NOX4 and the bioenergy of mitochondria enzyme,and increase the intracellular antioxidant ability in the RVLM during the development of hypertension to inhibit the oxidative stress response in the development of hypertension.

OBJECTIVE: To explore the genetic basis for a fetus with autosomal recessive polycystic kidney disease (ARPKD). METHODS: Fetal tissue and peripheral blood samples were respectively obtained from the abortus and the couple. Following extraction of genomic DNA, genetic testing was carried out. RESULTS: The fetus was found to carry compound heterozygous variants of the PKHD1 gene, namely c.5336A>T (p.N1779I) and c.9455delA (p.N3152Tfs*10), which were respectively inherited from the husband and wife. CONCLUSION The c.5336A>T and c.9455delA variants of the PKHD1 gene probably account for the ARPKD in the fetus. Above results have enabled genetic counseling and prenatal diagnosis for the couple.