ObjectiveTo assess the effects of short-term (2-7 d) high-dose (80 mg/d) statins in the prevention of contrast-induced nephropathy ( CIN).MethodsWe searched PubMed, Embase,ScienceDirect,Scopus,Ovid andWileyInterScience with the key wordsof “ statins/statin/HMG-CoA reductaseinhibitor” ,“contrast ” and“ nephropathy/nephrosis/nephrotoxicity/kidneyfailure”inall languages from 1996 t0 2010 for RCT that assessed the preventive effect of short-term (2-7 d)high-dose( 80 mg/d) statins on CIN.ResultsFive trials with a total of 1009 patients were identifiedTwo studies were conducted in patients with CKD 3-5 stages ( GFR≤60 ml/min or serum creatinine≥97.2 μmol/L) and the remaining 3 studies were conducted in patients with CKD l and 2 stages.Analysis of the data in patients with CKD 3-5 stages did not reveal a statistically significant difference in CIN incidence between the statins and placebo groups (6.50％vs 7.2％ ).The relative risk ( RR)was 0.89 without evidence of heterogeneity (12 =Oqo,P=O.79).Analysis of the data in patients with CKD I and 2 stages revealed a significantly lower CIN incidence in the statins group( 3.60-/o )than that in the placebo group( 11.9％ ).The RR was 0.28 without evidence of heterogeneity( I2=0%, P =0.87 ). Conclusion Short-termhigh-dosestatins treatment may be benefical in reducing the incidence of CIN in patients with CKD l and 2 stages,while nobenefit has been shown in the patients with CKD 3-5 stages.

ObjectiveTo explore the relationship between the different body mass index (BMI) ranges and all cause mortality in hemodialysis (HD) patients. MethodsEligible studies assessing the effects of BMI ranges on all-cause mortality(published from 1966 to 2012 )were searched, using hemodialysis/haemodialysis and obese/body mass index/overweight andmortality/surwival/reverse epidemiology/obesity paradox in PubMed,Embase,ScienceDirect,Wilcy,Scopus and Ovid. Inclusion criteria were that trials reported mortality in HD patients according to the traditional WHO/NIH BMI classification,and BMI levels were acceptable within 2 kg/m2.The quality of the trials was evaluated using the assessing risk of bias in studies included in Cochrane reviews.The mortality rate in HD patients was the primary endpoint of the study.ResultsWith no significant heterogeneity ( I2 =0％,P =0.45 ),a fixed-effects model was used for analysis.Four studies with a total of 81 423 patients met final inclusion criteria.Compared to individuals with non-elevated BMI levels,the elevated group (BMI ≥25 kg/m2) was associated with lower all-cause mortality ( OR 0.67,95％ CI 0.65-0.68 ). In a risk-adjusted sensitivity analysis,elevated BMI levels remained protective against mortality( adjusted HR 0.94,95％ CI 0.92-0.96 ).ConclusionsHigh BMI levels are associated with lower all-cause mortality rate in HD patients.More stable hemodynamic status,cytokine and neurohormonal alternations,and nutritional status maybe contribute to the protective effects of BMI on the mortality of HD patients.There is a need for more prospective studies to elucidate underlying mechanisms.

Objective To investigate the effects of hepatitis B virus X (HBX) gene on cell morphology and transdifferentiation of human proximal tubular epithelial cells.Methods The eukaryotic vector pcDNA3.1-myc-HBX containing HBX gene was transiently transfected into HK-2 cells by lipofectamine mediation.The expression of HBX was confirmed by Q-PCR and Western blotting.Untransfected HK-2 cells and those transfected with empty vector were used as control.The morphology of HK-2 cells was observed by microscopy,the expressions of differentiation marker proteins α-SMA and E-cadherin were detected by Western blotting and Q-PCR,and the contents of IL-1,IL-6 and TNF-α in the supernatant were detected by ELISA assay.Results HBX was successfully expressed in HK-2 cells after transfection.After transfection of HBX gene,the shape of HK-2 cells became irregular,HK-2 cells significantly expressed E-cadherin and α-SMA,and had high levels of IL-1,IL-6 and TNF-α in the cell supernatant (P＜0.01).Conclusion Overexpression of HBX gene in renal tubular epithelial cells may damage cell morphology and promote the occurrence of epithelial-mesenchymal transdifferentiation,which may be related to the inflammatory microenvironment.

Objectives To investigate the role and mechanism of p38 mitogerra activated protein kinase (p38MAPK) in up-regulation of prostanoid 2 induced by uric acid in rat glomerular mesangial cells (GMCs).Methods Rat glomerular mesangial cells were cultured in vitro,then stimulated with different concentrations of uric acid (50,100,300 μmol/L),or stimulated with different concentrations of uric acid (50,100,300 μmol/L) after pretreatment with p38MAPK specific inhibitor SC68376 (10 μmol/L) for 30 min.Activated p38MAPK was detected by Western blotting.The expression of prostanoid 2 was measured by ELISA.Cyclooxygenase-2 mRNA expression was determined by RT-PCR.Results Uric acid could activate p38MAPK and up-regulate the mRNA expressions of prostanoid 2 and cyclooxygenase-2 in rat glomerular mesangial cells (all P ＜ 0.05).SC68376 inhibited those effects of the above-described induced by uric acid.Conclusion Uric acid can promote the expression of prostanoid 2 in rat glomerular mesangial cells,whose mechanism may be related to the activation of p38MAPK and the promotion of cyclooxygenase-2 synthesis,and further up-regulation of prostanoid 2 expression.

Objective To evaluate the risk factors for gestational diabetes mellitus(GDM) and gestational impaired glucose tolerance (GIGT). Methods A prospective case-control study was performed in 85 women with GDM, 63 cases with GIGT and 125 cases as control recruited from Feb 2004 to Aug 2004 in Peking University First Hospital. Univariate analysis and multivariate logistic regression were used to identify risk factors of GDM and GIGT. Results (1)The mean age,and body mass index (BMI) before pregnancy and larger maternal weight gains during pregnancy were significantly different between GDM/GIGT and control group ( P

Objective To analyze the implementation effect of formative assessment in nutri-tion and food hygiene. Methods 55 students of Class One from grade 2010 majoring in preventive medicine were taken as the control group, with 56 students of Class Two as the experimental group.The control group used the summative assessment , while the experimental group used the formative assessment. Results were analyzed by course examinations and questionnaire surveys. SPSS 17.0 soft-ware was used and the measurement data were expressed by x±s. Statistical analysis was performed using t test, test, rank sum test, a Yuan linear correlation analysis, with the level of test α=0.05. Results The experimental scores and final scores of experimental group students were significantly higher than the control group and the difference was statistically significant(P values were 0.001, 0.000). The experimental group's overall result is closer to the negative skewed distribution. The ex-perimental group's average score of 89 points is significantly higher than the control group's average score of 79 points(P<0.01), and the usual results and the final results were positively correlated(r=0.865, P<0.001). The survey indicated that the students recognized the application of formative assess-ment in teaching process . Conclusion Formative assessment can help improve the teaching and learning quality in nutrition and food hygiene.

Objective To investigate the effect of hepatitis B virus X (HBX) gene on apoptosis and immune molecules of human proximal renal tubular epithelial cell line (HK-2).Methods The eukaryotic vector pcDNA3.1-myc-HBX containing HBX gene was transiently transfected into HK-2 cells by lipofectamine mediation.Untransfected HK-2 cells and those transfected with empty vector were used as controls.The TLR4 expression was detected by real-time PCR and Western blotting.The apoptosis of cells and expression of MHC-Ⅱ and CD40 were detected by flow cytometry,and the contents of IL-4 and IFN-γ in the supernatant were detected by EIISA.Results Compared with control groups,the number of apoptotic cells was significantly increased in the HBX transfection group (P ＜ 0.05),and the expressions of TLR4,MHC-Ⅱ and CD40 were also significantly increased in the HBX transfection group (all P＜0.05).IFN-γ level in the supernatant of HBX transfection group was higher (P ＜ 0.05),but IL-4 level was lower as compared to control groups (all P ＜ 0.05).Conclusions Over-expression of HBX gene may induce apoptosis of HK-2 cells and upregulate the expression of immune molecules of renal tubular epithelial cells leading to injury of cells and dysfunction of immunomicroenviroment.

Objective To investigate the efficacy of combined monitoring of motor evoked potentials with transcranial electrical stimulation (TES-MEP),somatosensory evoked potentials (SEP) and spontaneous electromyo-graphy (s-EMG) in tuberculosis surgery involving the thoracic,lumbar and sacral vertebrae.Methods Twenty-seven patients with tuberculosis of the thoracic vertebrae (T2-L2) received intra-operative SEP and TES-MEP monito-ring.Combined SEP,TES-MEP and spontaneous EMG monitoring were employed in 11 patients with tuberculosis of the lumbar or/and sacral vertebrae (L3-S1).SEP and TES-MEP were used to precisely observe the status of the sen-sory and motor pathways; s-EMG responses were used to more accurately localize nerve root irritation.ResuIts (1) SEP monitoring was successful in all of the operations.TES-MEPs were successfully monitored in 35 of them (92.1％).Combined motor and sensory monitoring was successfully achieved in 35 cases (92.1％).Abnormal SEPs were observed in 3 cases (7.9％),while abnormal MEPs were observed in 11 cases (28.9％).Abnormality in both the SEP and TES-MEP occurred in 2 cases (5.3％).There were 9 cases (23.7％) where the SEPs were nor-mal and the TES-MEPs were abnormal.In only 1 case (2.6％) was the SEP normal and the MEP abnormal.The false negative rate was 0％ with combined SEP and TES-MEP monitoring,while the false positive rate was 5.3％.There were 2 cases complicated by post-operative neurological deficits.(2) Spontaneous EMG monitoring can accu-rately determine the functioning of lumbar nerve roots during lumbar or lumbosacral tuberculosis surgery.Among 5 cases where EMG responses were observed,4 cases occurred during the spinal canal and nerve root decompression,1 case occurred in the orthopedic reset phase.Conclusions (1) During tuberculosis surgery involving thoracic,lumbar or sacral vertebrae,combined monitoring of SEPs and TES-MEPs can reflect the physiological and pathological condition of the spinal cord after ruling out interfering factors.This can improve monitoring and help assure the safety of lumbar surgery.(2) Intra-operative s-EMG monitoring can accurately reveal nerve root function in real time,help-ing to avert nerve root injury in lumbar and lumbosacral tuberculosis surgery.

Objective To assess the applicative effect of the flipped classroom in nutrition and food hygiene. Methods 48 students of Class One from Grade 2011 majoring in preventive medicine were taken as the TBL group, with 49 students of Class Two as the flipped classroom group. The TBL group used TBL and the formative assessment, while the flipped classroom group used the flipped classroom and the forma-tive assessment. The teaching effect was evaluated through the unified examination and teaching satisfaction questionnaire survey. SPSS 17.0 statistical software was used for the data t test between the groups, and Wilcoxon test, chi square test were used for the linear correlation analysis of the usual grade and final grade of the flipped classroom group. Results The experimental scores (9.21 ±1.14) and the final scores (66.76±4.53) of the flipped classroom group students were significantly higher than the experimental scores (8.31±1.01) and final scores (61.31±4.37) of the TBL group and the difference was statistically significant (t=4.50, P=0.004; t=5.45, P=0.003). The excellent distribution of the flipped classroom group's overall results were higher than that of the TBL group (u=21.36, P=0.002). The usual scores and the final scores were positively correlated (r=0.960, P=0.000) in the flipped classroom group. The results of the question-naire showed that the flipped classroom group students' satisfaction with the positive impact the teaching methods had on all aspects of their own was higher than that of TBL group (P<0.05). Conclusion The flipped classroom teaching can help improve the students' learning enthusiasm, thinking activity and com-municative competence.

ObjectiveTo investigate the expression and distribution of Toll-like receptor 4 (TLR4) in renal tissue of HBV associated nephropathy (HBV-GN) and its role in the pathogenesis and clinical manifestations of HBV-GN.MethodsRenal tissues were sampled from 48 HBV-GN patients confirmed by renal biopsy and 154 non-HBV-GN patients.The distribution of TLR4 in renal tissue and the relationship between the distribution of TLR4 and HBsAg were detected by immunohistochemistry.Integrating case record,correlations between the expression of TLR4 with clinical parameters including pathology,glomeruli,kidney tubules lesions,renal interstitial inflammatory infiltration and blood serum HBV were analyzed.ResultsTLR4 mainly distributed in the renal tubular epithelial cells and interstitial areas as brownish red and granular,which was in consistent with HBsAg distribution.The TLR4 positive rate and score in HBV-GN group were higher than those in non-HBV-GN group (P ＜ 0.05 ).TLR4 positive score was slightly higher in mesangial proliferative glomerulonephritis group and focal segmental glomerulosclerosis group,which had no significant difference (P ＞ 0.05).Kidney tubules lesions were strongly associated with TLR4 expression (r =0.748,P ＜ 0.001 ) which increased with aggravation of renal interstitial fibrosis ( r =0.569,P ＜0.001 ),tubular atrophy ( r =0.577,P ＜ 0.001 ) and inflammatory cell infiltration ( r =0.684,P ＜0.001 ).No obvious correlation with glomeruli lesions was observed ( r =0.293,P =0.053 ).Negative correlation could be seen between TLR4 and the renal function ( R2 =0.784),systolic blood pressure ( R2 =0.869),high sensitivity C-reactive protein (R2 =0.979) and urinary protein (R2 =0.615 ) by regression analysis.Other clinical parameters had no statistical significances.ConclusionsThe expression of TLR4 is abnormal in the renal tissue of HBV-GN patients,mainly in renal tubular epithelial cells and interstitial,which is consistent with the distribution of HBsAg.Its intensity is closely related with renal interstitial lesions,renal function changes and inflammatory cell infiltration.A speculation,that HBV can promote abnormal expression of TLR4 in renal tissues of HBV-GN which may be involved in the lesion progress of HBV-GN,is made upon our study.