Objective To observe the effect of angiotensin-converting enzyme inhibitors (ACEI) on anemia and erythropoietin (EPO) requirements in maintenance hemodialysis patients. Methods Ninety maintenance hemodialysis patients with hypertension and anemia were divided into 2 groups by random digits table, observation group (45 cases, using ACEI as antihypertensive treatment), control group [45 cases,using calcium channel blocker (CCB) as antihypertensive treatment]. The follow-up period after starting ACEI or CCB therapy was one year. The hemoglobin concentration, serum EPO, EPO requirements were compared after 0, 2, 4, 6, 8, 10, 12 months' treatment. Results In response to ACEI, the mean hemoglobin value in observation group decreased progressively, reaching statistical significance after 6 months, and it had significant difference compared with that in control group [6 months: (94.21±9.20) g/Lvs. (105.55±9.16) g/L,12 months: (95.90±6.75) g/L vs. (105.81±4.45) g/L,P <0.05]. The EPO requirements experienced a progressive increase in observation group and reached statistical significance after 8 months, compared with those in control group [8 months: ( 10 090.75±1918.35) U/week vs. (7010.32±1600.15) U/week, 12 months: (11 586.39±2009.76) U/week vs. (7068.48±1615.35) U/week,P<0.05].Serum erythropoietin concentration remained stable during the study in two groups. Conclusion ACEI can worsen anemia and reduce the efficacy of EPO in maintenance hemodialysis patients.

Objective To investigated the effects of long term use of very low protein diet(VLPD,0 3 g?kg-1?d-1) treatment on patients with chronic renal insufficiency without essential amino acids(EAAs) or related ketoacids supplement.Methods Thirty seven patients with established severe chronic renal failure (CRF)[Scr(588 2?123 5)?mol/L, Ccr(9 77?3 48)ml?min-1?(1 73m2)-1]were divided into 2 groups according to their actual protein intake: 20 patients with protein intake of (0 33?0 04)g?kg-1?d-1 were used as VLPD group, while other 17 CRF patients whose protein intake was 0 6 g?kg-1?d-1 were served as low protein diet group (LPD). Results All patients in VLPD group showed good compliance to this very low protein diet,and no one presented signs of protein malnutrition during the observation. The concentrations of serum albumin and transferrin were maintained in normal ranges during the follow up period despite the transferrin levels in both groups gradually decreased as time went on. The serum concentration of transferrin was higher in VLPD patients than that in LPD patients at the end of study (P

A rapid, sensitive and convenient LC-MS/MS method was developed for the determination of γ-aminobutyric acid (GABA) in human plasma. d2-γ-Aminobutyric acid (d2-GABA) was synthesized as internal standard (IS). After extraction from human plasma by protein precipitation with acetonitrile, all analytes were separated on a Luna HILIC column (100 mm x 3.0 mm, 3 μm) using an isocratic mobile phase of water: acetonitrile: formic acid (20 : 80 : 0.12) with a flow rate of 0.5 mL x min(-1). Acquisition of mass spectrometric data was performed in multiple reaction monitoring mode (MRM) in positive electrospray ionization using the transitions of m/z 104 --> 69 for GABA and m/z 106 --> 71 for d2-GABA. The method was linear in the concentration range of 5.00 to 1 000 ng x mL(-1). The intra- and inter-day precisions were within 9.9%, and accuracy ranged from 99.1% to 104%, within the acceptable limit across all concentrations. The method was successfully applied to a pharmacokinetic study of GABA tablets in healthy Chinese volunteers.
Chromatography, Liquid ; Humans ; Tandem Mass Spectrometry ; gamma-Aminobutyric Acid ; blood

Acute Kidney Injury ; Humans ; Terminology as Topic

Objective To understand the therapeutic effect of clindamycin combined with compound sulfamethoxazole tablets on pneumocystis pneumonia(PCP)associated with acquired immunodeficiency syndrome (AIDS).Methods 97 AIDS patients with PCP in a hospital from January 2014 to March 2015 were randomly divided into control group (n=49,received compound sulfamethoxazole )and trial group(n=48,received clindamycin on the basis of com-pound sulfamethoxazole ),levels of partial pressure of oxygen in arterial blood (PaO2 ),arterial blood oxygen satu-ration(SaO2 ),serum albumin(ALB),and lactic dehydrogenase (LDH)in two groups of patients before and after treatment were recorded.Results Levels of PaO2 ,SaO2 ,ALB,and LDH between two groups of patients before treatment was not significantly different(all P >0.05).After treatment,PaO2 in control group and trial group were (73.01 ±4.62)mmHg and(84.92 ±5.34)mmHg respectively,SaO2 were (75.81 ±4.28)% and(90.86 ±5.94)%respectively,ALB were (32.62±4.41 )g/L and(43.95 ±5.03)g/L respectively,LDH were(416.53 ±30.77)U/L and(331 .58±20.86)U/L respectively,levels of PaO2 and SaO2 in trial group were both higher than control group , difference in ALB and LDH between two groups of patients after treatment were both statistically significant(both P <0.05).The total effective rate of trial group was 89.58% (n=43),which was higher than 69.39%(n=34)in control group (χ2 =6.04,P =0.014).Conclusion Clindamycin combined with compound sulfamethoxazole tablets has good therapeutic effect on AIDS and PCP,which is worthy of clinical popularization and application.

Objective To investigate the effect of microRNA-101 (miRNA-101) on atrial fibrosis in human chronic atrial fibrillation (AF). Methods Right atrial appendages were obtained from 59 patients (30 with AF) undergoing cardiac surgery, including 47 patients with valve heart disease and 12 patients with congenital heart disease. The expression of miRNA-101 was determined by quantitative real-time PCR in the right atrial appendages of patients with and without AF. The cell-specific localization of miRNA-101 was detected by in situ hybridization assay. The mRNA and protein expression levels of transforming growth factor β typeⅠreceptor (TGFβRⅠ) and collagen type I (COL1) were determined by quantitative real-time PCR and Western-blot assay, respectively. Collagen in the right atrial appendages was observed by Masson staining assay. Results The expression of miRNA-101 was found to be significantly down-regulated in AF patients compared with patients with sinus rhythm (SR) (P < 0.05). The result of miRNA-ISH showed that miRNA-101, which was highly distributed within the connective tissues of heart, was down-regulated at about 24.9% in patients with AF compared with patients with SR. No significant differences at the mRNA expression level of TGFβRI was found between patients with AF and patients with SR (P > 0.05). But the protein expression of TGFβRI in patients with AF was significantly higher than that of patients with SR (P < 0.05). The mRNA and protein expressionsl of COL1 were significantly higher in patients with AF than thoset of patients with SR (P < 0.05). The collagen was significantly increased in patients with AF than that of patients with SR (P < 0.05). Conclusions Downregulation of miRNA-101 may contribute to atrial fibrosis in human atrial fibrillation by targeting TGFβRⅠ.

Objective to analyze the relation between glycosylated hemoglobin (HbA1c) of pregnant women with gestational diabetes mellitus (GDM) and neonatal blood glucose.Methods HbA1c values of 743 pregnant women with GDM are detected,and according to HbA1c level,they were divided into 3 groups,such as G1 (HbA1c＜5.5％),G2 (5.5％≤HbA1c≤6.5％) and G3 (HbA1c＞6.5％).Newborn babies' blood glucose values of the women in each group are monitored respectively in the 1st hour and at the 4th and 8th hour.Neonatal hypoglycemia and incidence of threshold blood glucose in the three groups are compared by SPSS 17.0 software.Results (1) The incidence of neonatal hypoglycemia in G1 and G2 are both higher than thatin G3 in the 1st hour (P＜0.05).The incidence of neonatal hypoglycemia in G3 is higher than that in G1 and G2 at the 4th and 8th hour (P＜0.05).(2) With time extending,the incidence of neonatal hypoglycemia declines in G1 and G2 (P＜0.05),but there is no obvious decline in G3 (P＞0.05).(3)The incidence of threshold blood glucose in G3 and G2 are higher than that in G1 in the 1st hour,and at the 4th,8th hour(P＜0.05),and there is no obvious statistical difference between G2 and G3 (P＞0.05).(4)With time extending,the incidence of threshold blood glucose declines in G1 (P＜0.05),but it doesn't decline in G3 evidently(P＞0.05).And there was no obvious decline in G2 in the 4 hours after babies were born(P＞0.05).(5)A mother's HbA1c level has a negative correlation with her baby's blood glucose in 1 hour after birth(r=-0.401,P＜0.05).Conclusion The higher HbA1c level of pregnant women with GDM increases,the higher risks of their neonatal hypoglycemia and threshold blood glucose are.

0.05). Conclusion Oral administration of prednisone can prevent modrate and severe OHSS and may have no effect on pregnant rate of IVF.

AIM: To observe the role of confocal microscopy in infectious keratitis management.
METHODS:Totally 466 patients (467 eyes) diagnosed as infectious keratitis from January 2010 to December 2013 were retrospectively studied. the corneas were examined early by in vivo confocal microscopy. The characteristics of their images and clinical features were studied and summarized.
RESULTS:All patients were recorded, the average age was 54. 4±13. 0 years, in which 264 cases (56. 7%) were male, and 202 cases ( 43. 3%) were female. In the 466 patients, 190 (40. 8%) were fungal keratitis, 148 (31. 8%) were viral keratitis, 125 (26. 8%) were bacterial keratitis and 3 ( 0.6%) were acanthamoeba keratitis. There were fungal hyphae in the images of fungal keratitis. Amebic cysts were found in acanthamoeba keratitis.
CONCLUSION:Confocal microscope can help the early diagnose and treatment of infectious keratitis. It is a noninvasive imaging technique that provides high resolution images of ocular structures at a cellular level and infectious keratitis represents one of its most important clinical uses.