Objective To explore the effect of upgrade of dialysate quality on the microinflammation in maintenance haemodialysis (MHD) patients. Methods Fifty-three MHD patients in Kidney Center of the First Affiliated Hospital,Medical College,Zhejiang University in January 2003 were enrolled in the prospectively study.The main end-points were survival at 8 years or weaning from haemodialysis during 8-year period including death, receiving renal transplantation or transferring to peritoneal dialysis.The endotoxin level of dialysate and patients' serum levels of interleukin-6 (IL-6),tumor necrosis factor α (TNF-α),C reaction protein (CRP),and albumin were recorded during the observation period. Results After the upgrade of water management system,endotoxin level of dialysate obviously decreased [(0.046±0.012) EU/ml vs (0.454±0.002) EU/ml,P＜0.01],and serum IL-6 [(3.947±3.624) ng/L vs (13.779±7.106) ng/L,P=0.036],TNF-α [(7.935±3.864) ng/L vs (12.804±8.017) ng/L,P=0.012] as well as CRP [(0.194±0.149) mg/L vs (0.561 ±0.309) mg/L,P＜0.01] decreased significantly,while serum albumin increased [(41.900±6.803) g/L vs (38.140±7.083) g/L,P=0.042].Hemoglobin level did not change significantly after the system upgrade,however,the dose of erythropoietin decreased [(93.0±12.7) U·kg-1·week-1 vs (131.0±10.1) U·kg-1·week-1,P=0.015]. Conclusions The upgrade of central dialysis fluid delivery and water management system by application of double reverse osmosis,high frequency heat disinfection and endotoxin filter can improve the quality of dialysate.Improvement of dialysate quality can ameliorate the microinflammation state of MHD patients.

Objective To compare the applications of four types of bacillus stearothermophilus spore reagents,in order to provide basis for the safe management of surgical instruments.Methods From September to December 2015,four types of bacillus stearothermophilus spore reagents that were often used in the disinfection supply center of Jiaozuo People's Hospital of He'nan province were investigated. They were SSI. K31 type bacillus stearothermophilus spore tablet of Beijing Sihuan (common bacterial tablet),self-contained Bacillus stearothermophilus spore reagent of Beijing Sihuan (48 h self-contained agent),1292 biological reagent of American 3M company (3M1292),and 1492 biological reagent of American 3M company (3M1492). They were cultured by steam sterilization of 132℃ for 480 seconds. The culture results were obtained at different time according to the different types of reagents. The number of vacuum and sterilization time were adjusted. The spore killing situation was recorded and analyzed.Results In the experimental tube culture of four types bacillus stearothermophilus spore reagents,the difference occurred in the common bacterial tablets because they were susceptible to other factors. The culture results of three self-contained reagents were in agreement. The time of common spore tablets was the longest. The time of 3M1492 was the shortest.Conclusions For common bacterial tablets,7 days is needed for the bacterial culture. In the transplantation process there is potential contamination chance,which might result in false positive results. The application of self-contained spore biological reagents can avoid false positive results and it is convenient and fast. The super rapid biological monitoring can interpret monitoring results in the shortest time so that the seamless joint of the surgical instruments can be achieved,which speeds up the turnover and produces higher practical value.

Objective To investigate the value of echocardiography in assessing the right heart function of patients with chronic obstructive pulmonary disease (COPD). Methods Forty-four COPD patients who were treated in Beijing Anzhen Hospital of Capital Medical University, from April 2016 to April 2017, were selected as COPD group; and 12 healthy physical examiners were included in healthy control group during the same period. Patients were divided into COPD with pulmonary hypertension (PH) group and COPD without PH group. All subjects were routinely examined by transthoracic echocardiography. The parameters of right heart function of all subjects were measured by echocardiography according to 2010 guideline of American Society of Echocardiography (ASE). Independent sample t test was used to compare echocardiographic routine parameters and recommended parameters of ASE guideline between COPD group and healthy control group. One-way analysis of variance was used to compare the routine parameters of echocardiography and the recommended parameters of the ASE guide in the patients of COPD with PH group and COPD without PH group and the healthy control group. SNK-q test was used for comparison between groups. Results The right ventricle diameter (RVD) in group COPD was wider than that in healthy control group [(20.68±4.21) mm vs (18.17±1.75) mm], and the difference was statistically significant (t=2.92, P=0.005). There was no significant difference in the right ventricular outflow tract (RVOT), main pulmonary artery diameter (MPAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) between the COPD group and the healthy control group. Compared with the healthy control group, the diameter of right ventricle basal segment in the COPD group increased [(35.92±8.12) mm vs (27.75±3.17) mm], tricuspid annular plane systolic excursion (TAPSE) decreased [(19.61±4.08) mm vs (22.67±2.67) mm], right ventricular index of myocardial performance (RIMP) increased [(0.52±0.10) cm/s vs (0.43±0.04) cm/s)], and the differences were statistically significant (t=3.39, P=0.001; t=-2.44, P=0.019; t=4.31, P ＜ 0.001). There was no significant difference in right atrium area, E/A, E/E' and S' between COPD group and healthy control group. There was no significant difference in RVOT, RVD, MPAD, LVEDD, LVESD and LVEF in the patients of COPD with PH group and COPD without PH group and in the healthy control group. There was no significant difference in the right atrium area, E/A, E/E', TAPSE and S'. The right ventricular basal segment diameter and RIMP of COPD with PH group and COPD without PH group were higher than those of healthy control group [(37.99±9.66) mm, (34.47±6.70) mm vs (27.75±3.17) mm; (0.54±0.13) cm/s, (0.51±0.08) cm/s vs (0.43±0.04) cm/s]. The differences were statistically significant (q=6.960, 4.905, 5.796, 4.348, all P＜0.05). However, there was no significant difference in right ventricular basal segment diameter and RIMP between COPD with PH group and COPD without PH group. The RVWT of COPD with PH group was higher than that of COPD without PH group [(5.29±0.69) mm vs (4.54±0.70) mm], and the difference was statistically significant (t=3.313, P=0.002). Conclusions The method recommended in the ASE guidelines for this study was more sensitive than conventional methods for the detection of changes in the structure of the right heart. The change of the right ventricular structure was the first manifestation of right heart involvement in COPD patients, and then the systolic function of the right ventricle diminished. The long-term effect of pulmonary hypertension was thickening of the right ventricular wall at the early stage and then enlargement of the right ventricle.

Powdery mildew (Pm) caused by the infection of Blumeria graminis f.sp.tritici (Bgt) is a worldwide crop disease resulting in significant loss of wheat yield.To profile the genes and pathways responding to the Bgt infection,here,using Affymetrix wheat microarrays,we compared the leaf transcriptomes before and after Bgt inoculation in two wheat genotypes,a Pm-susceptible cultivar Jingdong 8 (S) and its near-isogenic line (R) carrying a single Pm resistant gene Pm30.Our analysis showed that the original gene expression status in the S and R genotypes of wheat was almost identical before Bgt inoculation,since only 60 genes exhibited differential expression by P =0.01 cutoff.However,12 h after Bgt inoculation,3014 and 2800 genes in the S and R genotype,respectively,responded to infection.A wide range of pathways were involved,including cell wall fortification,flavonoid biosynthesis and metabolic processes.Furthermore,for the first time,we show that sense-antisense pair genes might be participants in wheat-powdery mildew interaction.In addition,the results of qRT-PCR analysis on several candidate genes were consistent with the microarray data in their expression patterns.In summary,this study reveals leaf transcriptome changes before and after powdery mildew infection in wheat near-isogenic lines,suggesting that powdery mildew resistance is a highly complex systematic response involving a large amount of gene regulation.