Objective To find the effect of chronic renal failure on the development of neointimal hyperplasia and the role of monocyte chemokine-1 (MCP-1) after arteriovenous fistula in mice.Methods We created AVF (common carotid artery to jugular vein in an end-to-end anastomosis) in mice with or without chronic renal failure (renal ablation or sham operation).The outflow of AVF was harvested at 3 weeks postoperative the vascular tissue.The pathological changes were examined.The level of blood urea nitrogen (BUN) and the degree of intimal hyperplasia were analysed.The protein and mRNA expression of alpha smooth muscle actin (SMA), Ki-67,NF-κB and MCP-1 were detected by immunohistochemistry, RT-PCR and Western blot.Results 1)Compared with the control group, the blood BUN level of the experimental group was significantly higher and the intimal hyperplasia was more serious, meanwhile, the lumen was more narrow (P<0.05).2)In the experimental group, the expression of α-SMA, Ki-67, NF-κB and MCP-1 was significantly increased (P<0.05).3)MCP-1 promoted the proliferation of vascular smooth muscle cells.Conclusions Chronic renal failure promote the development of neointimal hyperplasia, which may be related to the increase of MCP-1 expression.

OBJECTIVE: To evaluate the cost-effectiveness of 3 therapeutic schemes in the treatment of chronic Hepatitis B with YMDD mutation.METHODS: 90 patients were randomly assigned into three groups: the patients in Group A were assigned to receive Adefovir Dipivoxil in combination with Lamivudine for 12 weeks followed by administration of Adefovir alone for 36 weeks;Group B received Adefovir in combination with Lamivudine for 48 weeks,while Group C received Entecavir alone for 48 weeks.The cost-effectiveness of the 3 groups were analyzed.RESULTS: In the three groups(A,B,and C),the cost-effectiveness ratios for HBV DNA negative-conversion ratewere 12 685.6,15 481.3,and 31 462.2,respectively and the incremental cost-effectiveness ratios of Group B and Group C were 29 501.5 and 106 907.8 respectively as against Group A.The cost-effectiveness ratios of the three Groups(A,B,and C) for serum alanine aminotransferase normalization rate were 12 685.6,14 284.9,31 462.2 respectively,and the incremental cost-effectiveness ratios of Group B and Group C were 19 618.5 and 106 907.8 respectively as against Group A.The cost-effectiveness ratios of the three Groups(A,B,and C) for HBeAg/HBeAb seroconversion rate were 76 227.9,93 120.3,and 209 664.0 respectively,and the incremental cost-effectiveness ratios of Group B and Group C were 178 350.0 and 1 267 621.4 respectively as against Group A.In Group A,1 case showed rtA181V mutation and another one showed rtN236T mutation after 48-week treatment.CONCLUSION: Group B(ADV in combination with LAM) is more cost-effective in the treatment of chronic hepatitis B with YMDD mutation.

Objective To study the presence of CD4+CD25+regulatory T cells and hepatitis B virus(HBV)specific cytotoxie T lymphocyte(CTL)in peripheral blood and liver tissues of patients with chronic hepititis B(CHB)and its clincial significance.Methods One hundred and fifty-seven HBV-infected patients,including 20 cases of acute hepatitis B,115 cases of chronic hepatitis B,and 22cases of HBV-related liver cirrhosis,and 20 healthy controls were enrolled in this study.Peripheral blood was collected and liver tissues were obtained from some of the enrolled subjects.The CD4+CD25+regulatory T cells and HBV specific CTL were analyzed using flow cytometry and cytokine flow cytometry(CFC).The comparison between groups was done by t test.Results The percentages of CD4+CD25+ regulatory T cells in the peripheral blood of patients with acute hepatitis B and CHB of mild,moderate and severe degree were(2.87±0.94)%,(3.53±1.56)%,(4.59±2.98)%and(3.65±1.73)%,respectively,which were higher than that of controls(2.36±0.60)%(t=2.04,5.97,3.30 and 3.17,respectively,P<0.01).The percentages of HBV specific CTL in the peripheral blood of patients with mild,moderate and severe degree of CHB and HBV-related liver cirrhosis were (0.189±0.152)%,(0.103±0.110)%,(0.118±0.120)%and(0.098±0.101)%,respectively,which were significantly lower than that of acute hepatitis patients [(0.815±0.360)%](t=10.09,11.87,9.17 and 8.96,respectively,P<0.01).CD4+CD25+ regulatory T cells and HBV specific CTL in liver tissues were both higher than those in the peripheral blood.Conclusion CD4+CD25+regulatory T cells may play an important role in anti-HBV immune response through inhibiting CD8+T eell function.

Objective:To conduct a clinical tretrospective study on the effect of Silymarin Meglumine Tab on acute and chronic hepatitis B and to explore the related clinical significance. Methods: 41 cases and 205 cases of hospitalized patients pathologically diagnosed as acute and chronic hepatitis B respectively by liver tissuse puncture were divided into three group: ① Silymarin Meglumine Tab group; ② Ganyanling group; ③ complex group consisting of Silymarin Meglumine Tab and Gangyanling and diammonium glycyrrhizinate. To detect the index of routine liver function test before and after the treatment and analyze the hospitalization treatment course. Results: Compared with before treatment, liver functions of acute and chronic hapatitis B were improved to certain extent within each group after treatment (P0.05). The hospitalization treatment time of acute hepatitis B of the three group were almost the same, but the hospitalization treatmeng time of chronic hepatitis B of the Silymarin Meglumine Tab group was 2-4days less than that of the Ganyanling group and the complex group. Conclusion: As far as Silybini Meglumine Tab was concerned, it was better for chronic hepatitis B than acute hepatitis B because it was less complicated to administer the medicine, relieving the liver's burden of metabolism, and hospitalization treatment time was shorter, relieving patients' financial burden,which suggested that it was important to administer proper amount of medicine while taking into consideration protecting the liver's compensation function. If consideration was given to stimulating liver microcirculation with small dosage of TCM, so as to promote the exchange of the liver metabolite in blood, or detoxication and expulsion of toxin, it was likely to be more advantageous to the restoration of liver function and the liver tissue structure.

Objective To establish a time-resolved immunofluorometric assay (TRFIA) to detect seurm CⅣ(collagenⅣ). Methods The antibodies to CⅣwere coated on mircoplate and the europium-labeled monoclonal antibody of CⅣ. The luminescent enhancement system was used as enhancement solution which contained mainly 2-naphthoy trifluoroacetone. we established A sandwich time-resolved fluoroimmunoassay (TRFIA) was established to measure the seurm CⅣin 127 patients with hepatitis and 30 normal controls. Results The sensitivity of assay was 12. 8?g/L. The coefficient of variation for inner-batch and inter-batch were 4. 54% and 8. 06%,respectively. The recovery was 98. 6%. The serum level of CⅣwas 46. 06?22. 21?g/L in normal control,47. 25?22. 58?g/L in acute hepatitis, 129.01?53.68?g/L in mild chronic hepatitis,277. 90?92.36?g/L in moderate chronic hepatitis,413.90?162.24?g/L in serious chronic hepatitis,568. 60?210.40?g/L in liver cirrhosis. As compared to normal control,higher concentrations of CIV (P

Squamous cell carcinoma (SCC) of the renal pelvis is extremely rare and hardly to be diagnosed due to its lack of specificity in clinical manifestations and traditional imaging features. We reported a case with history of multiple operations for double kidney stones, who was admitted to our hospital twice due to "right kidney ureteral stones, left kidney complex stones, chronic renal insufficiency and urinary tract infection" . During this period, a total of 6 surgeries were performed. In the first 19-day hospitalization, right transurethral ureteroscopic lithotripsy and right percutaneous nephroscope lithotripsy(PCNL)were performed respectively. And 20 days later, the patient was admitted to hospital again for management of left complex kidney stones, and the left side PCNL was performed for 4 times within 27 days. During the two hospitalizations, no tumor was reported during the three times of contrast-enhanced CT examination of the urinary system. The patient continued to have fever after the 4th time of left PCNL, with failure of anti-infection treatment. Then, the of the left renal pelvis was considered clinically, and left nephrectomy was suggested after communication with the patient and his family members. Postoperative pathology confirmed renal pelvis SCC. After surgery, the patient’s temperature was back to normal and then discharged. The patient died 3 months after discharging due to the systemic metastasis.