Chronic HBV infection may not only cause liver damage , but also lead to renal injury . HBV-related kidney injuries mainly include ( 1 ) HBV-associated glomerulonephritis , ( 2 ) hepatorenal syndrome, and (3) kidney injuries caused by long-term nucleos(t)ide analogues therapy.This paper mainly reviews the pathogenesis and therapeutic principle of HBV-related kidney injuries , so as to provide the foundation for clinical management .

Objective To investigate the potential mechanism of interleukin-1β(IL-1β)in H.pylori-related gastric carcinogenesis.Methods Human gastric cancer cell line(AGS),human gastric epithelial cell line(GES-1)and isolated parietal cells were treated with exogenous IL-1β(10 ng/ml)in the presence or absence of H.pylori(NCTC 11637).Cell proliferation and apoptosis were determined by MTT assay and flow cytometry,respectively. Expressions of cyclooxygenase-2(COX-2)mRNA and protein were examined using RT-PCR and flow cytometry,respectively.Acid secretion by parietal cells was tested using 14C-aminopyrine(14 C-AP) accumulation indirectly.H+/K+ ATPase α subunit mRNA expression was assessed using RT-PCR.Results The cell proliferation and H.pylori-related apoptosis in both GES-1 and AGS celL lines were stimulated and inhibited by IL-1β.IL-1β induced expression and upregulation of COX-2 mRNA in GES-1 and AGS cell lines,respectively.In addition,IL-1β continuously inhibited the ability of histamine-stimulated 14C-AP accumulation of isolated parietal cells accompanied by down-regulation of H+/K+ ATPase mRNA expression.Conclusions It suggests that IL-1β play an important role in H.pylori-related gastric carcinogenesis through two pathways:①to interfere gastric epithelial cell growth by up-regulating COX-2 expression,②to inhibit acid secretion from parietal cell by down-regulating H+/K+ ATPase expression.

Objective To study the effects of Qingjinkangkuoyin (QJKKY) on TNF-α and NE in rats with bronchiectasis.Methods Models were established by intrabronchially injecting with pseudomonas aeruginosa,and divided into 5 groups by random:the QJKKY high dose treatment group (given high dose of QJKKY into stomach),the QJKKY low dose treatment group (given low dose of QJKKY),the levofloxacin group (given levofloxacin),the model group (given normal saline),and the normal contrast group (given normal saline).After 2 weeks of treatment,the histopathology of lung tissue,the levels of TNF-α and inflammatory cells in peripheral blood and NE in rats' lung tissue were detected.Results Compared with the model group (160.425±9.9293)ng/L,QJKKY could decrease the level of TNF-α in blood significantly [high dose of QJKKY treatment group was (137.133±6.1646)ng/L,P＜0.05]; the expression of inflammatory cells in serum were decreased significantly by QJKKY [high dose of QJKKY treatment group was (1.106± 0.3580) 109/L,P＜0.05].Low dose of QJKKY treatment group was (1.086 ±0.2433) 109/L,(P＜0.05) ; the expression of NE in lung tissue were decreased remarkably by QJKKY [high dose of QJKKY treatment group(80.697 ±4.5877)ng/L,P＜0.05]; low dose of QJKKY treatment group is (80.747±3.6925)ng/L,(P＜0.05); and the histopathologic change of lung tissue in QJKKY treatment groups were ameliorated under light microscope by HE staining.Conclusion Qingjinkangkuoyin could cure bronchiectasis by decreasing the expression of TNF-αin peripheral blood and NE in rats' lung tissue.

Objective To explore the effects of H.pylori and crude extracted proteins secreted by H.pylori(broth culture filtrate protein,BCF-P)on acid secretion from isolated rabbit parietal cells.Methods Parietal cells from rabbit gastric mucosa were isolated and enriched with digestion and elutriation.H.pylori(NCTC 11637,CagA+ VacA+)were grown in liquid broth culture and BCF-P was precipitated with ammonium sulfate.The vacuolation activity of BCF-P was evaluated with neutral red dye uptake test in HeLa cell.Isolated parietal cells were incubated with H.pylori(bacteria/cell=100∶1)for 2 h and 16 h,or BCF-P(100μg/ml)for 1 h and 12 h.Acid secretion from parietal cells was studied using 14C-aminopyrine(14C-AP)accumulation indirectly and H+-K+ ATPase α subunit mRNA expression was assessed using RT-PCR.Results (1)BCF-P containing vacuolating cytotoxin(VacA)with vacuolation activity on HeLa cells had positive result on neutral red uptake test.(2)The basal expression of H+-K+ ATPase α subunit mRNA could be detected in isolated parietal cells and 14C-AP accumulation was significantly increased in response to the stimulation of histamine with different concentrations for 30 min(P＜0.05).These results indicated that the isolated parietal cells retain relative intact acid secretion function.(3)The histamine(1.0×104 mol/L)stimulated acid secretion was inhibited sustainedly in response to H.pylori by 81% at 2 h and by 94% at 16 h(P＜0.05).However,H+-K+ ATPase α subunit mRNA expression was up-regulated in tlle acute period(2 h)and was down-regulated in the chronic period (16 h)by H.pylori(P＜0.05).(4)BCF-P significantly inhibited the histamine-stimulated acid secretion by 24% at 1 h and by 58% at 12 h(P＜0.05),and this inhibition was accompanied by the down-regulated expression of H+-K+ATPase α subunit mRNA.Conclusions Intact H.pylori and VacA secreted by H.pylori could directly inhibit histamine-stimulated acid secretion from parietal cells and this inhibition may be mediated by the down-regulated H+-K+ ATPase expression.

Objective To explore the effect of Da Vinci robot?assisted laparoscopic radical prostatecto?my on the respiratory function of elderly in Intensive Care Units( ICU) . Methods Thirty?nine elderly patients received Da Vinci robot?assisted laparoscopic radical prostatectomy ( RARP ) from January 2015 to April 2016 and 25 cases received conventional laparoscopic radical prostatectomy from January 2014 to December 2014 ad?mitted into ICU were retrospectively analyzed. Their comorbidities,blood loss and transfusion during surgery,ate?rial blood gas(ABG) analysis and respiratory complications after operation,clinical outcomes between the two groups were compared. Results Compared with conventional laparoscopic radical prostatectomy,RARP group spent more time in surgery((4. 23±1. 44) h vs. (3. 25±1. 31) h,t=2. 783,P<0. 05),more patients need venti?lation(11 vs. 1,χ2=4. 378,P<0. 05) . ABG analysis showed respiratory and metabolic acidosis with lower pH (7. 29±0. 09 vs. 7. 35±0. 05,t=3. 886,P<0. 05),HCO3?((20. 05±2. 50) mmol/L vs. (22. 86±2. 53) mmol/L,t=3. 473,P<0. 05),BE(-5. 11±3. 94 vs.-3. 64±1. 17,t=5. 018,P<0. 05) and higher pCO2(46. 15±8. 31 vs. 40. 25±6. 57,t=2. 475,P<0. 05),Lac((3. 54±1. 99) mmol/L vs. (2. 91±1. 39) mmol/L,t=2. 254,P<0. 05) . Conclusion RARP may cause carbon dioxide retention and respiratory complications on elderly pa?tients. It may reduce postoperative respiratory complications by shortening surgery time,lowering pneumoperitone?um pressure,hyperventilation,recruitment maneuvers and chest physical therapy.

Objective To investigate the correlation of CT image features of mesenteric fibromatosis and its pathological characteristics.Methods Data of 12 mesenteric fibromatosis proved histopathologically in PLA General Hospital and Jiangsu Taizhou People's Hospital from March 2006 to March 2015 were retrospectively reviewed.Results There were 5 males and 7 females with ages ranging from 13 to 67.On the CT image,the masses varied from 3.9 cm to 33.0 cm in diameter.8 of them were round or oval well-circumscribed masses,and 4 were irregular with blurry border.10 of 12 cases were totally similar density,which was ranged from 27 HU to 39 HU.Contrast enhanced CT scan showed moderate enhancing masses in l0 of 12 cases.Macroscopic examination of these specimens revealed that the sections of 11 were solid,firm,grey and yellowish,and 1 was solid-cystic.On the histopathology,the masses consisted of homogeneous spindle shaped fibroblasts,myofibroblasts and collagen.Tumor cells were embedded in a collagen network interrupted by fibrotic sections.Immunohistochemical analysis revealed that the tumor cells expressed Vimentin,H-caldesmon and β-catenin.Conclusions Mesenteric fibromatosis is a rare disease with characteristic CT images,which were based on their pathological characteristics.CT images form the basis of preoperative diagnosis of this disease.

Objective To explore the value of detection of blood flow in the brachial artery after forearm standard internal fistula (wrist radial artery-cephalic vein)operation by color Doppler ultrasound in the assessment of internal fistula function.Methods The data of the blood flow in the brachial artery after forearm standard internal fistula operation detected by color Doppler ultrasound in 103 patients were retrospectively studied.In detecting the blood flow in the brachial artery,350 ml/min and 500 ml/min were used as demarcation points and the patients were divided into dysfunction,uncertainty and good function group.In internal fistula dysfunction,dialysis flow <200 ml/min was taken as the golden criterion.ROC curve was constructed and analyzed.Results In using Doppler ultrasound to detect the blood flow in the brachial artery and to diagnose the standard internal fistula dysfunction,the area under ROC curve was 0.949 (P <0.001)and 95% of confidence interval was (0.909,0.989).The best diagnostic demarcation point was 470 ml/min.In using the blood flow 350 ml/min and 500 ml/min in the brachial artery as demarcation points and dividing the patients into dysfunction,uncertainty and good function group,the area under the ROC curve was 0.916 (P <0.001 )and 95% of confidence interval was (0.857,0.975 ).Conclusions The accuracy of using Doppler ultrasound to detect the blood flow in the brachial artery and to diagnose the standard internal fistula dysfunction is higher.Using 350 ml/min and 500 ml/min as demarcation points,the grouping method is of higher clinical applied value.

Objective To report clinical characteristics and genetic results of two sisters suffered from congenital adrenal cortex hyperplasia (17-α-hydroxylase deficiency), and relevant literatures were reviewed. Methods Clinical manifestation and laboratory examination data of two sister cases of 17-α-hydroxylase deficiency enrolled in Capital Institute of Pediatrics in March 2016 were analyzed. Sanger sequencing and MLPA for CYP17A1 genes were performed and the parents' genes were also verified. Results The two patients were four years and 10 years old, both suffered from hypokalemia after infections, and hypergonadotrophin gonad hypofunction. One case was with slightly high blood pressure. Laboratory test results showed potassium fluctuation tendency in 1.9~4.0 mmol/L, 17-OHP and DHEA was decreased. Enhanced CT showed different degree of adrenal gland enlargement. Chromosome examination of the older sister is 46, XY. Both sisters demonstrated heterozygous mutation of CYP17A1 gene. The molecular genetic analysis suggested a c.985_987delTACinsAA from father and a deletion spanning exons 1-7 of the CYP17A1 gene from mother. Conclusion 17-α-hydroxylase enzyme deficiency can be diagnosed before adolescence. Clinical hypokalemia with unknown reason and high blood pressure may indicate the disease. The diagnosis can be confirmed with gene sequencing of CYP17A1.

Objective Intradialytic hypotension (IDH) is one of the common complications during hemodialysis,however its diagnostic criteria are highly controversial at present.In order to fully understand the prevalence of IDH in our center and figure out which diagnostic criteria is better for Chinese maintenance hemodialysis (MHD) patients,we choose several IDH definitions by reviewing published literatures and analyze their association with mortality.Methods The patients were recruited from Blood Purification Center of Ruijin Hospital undergoing hemodialysis during July 2012.Pre-,intra-and post-dialysis blood pressure were recorded.Patients' clinical characteristics,laboratory results and cardiac ultrasound results were collected.Based on several IDH definitions,we investigated the prevalence rate of IDH and its frequency among MHD patients.SPSS 23.0 was used to analyze data and conduct survival analysis.Results Totally 219 MHD patients underwent 16084 hemodialysis in 6 months.The prevalence rate,overall and individual frequency of IDH fluctuated between 45.21％-100.00％,4.64％-37.60％ and 0.00％-33.00％ respectively.For every IDH criteria,the patients were recruited into the group IDH(+) if they ever met the corresponding definition,otherwise the group IDH(-).Survival analysis found that IDH (the criteria of an absolute systolic blood pressure (SBP) ＜ 90 mmHg or with a decrease of SBP≥ 20 mmHg) could decrease the risk of patients' cardiovascular mortality but was not relevant to all-cause mortality.Further analysis showed these patients had better cardiac functions mainly reflecting in lower Pro-BNP (2880 ng/L vs 6909 ng/L),lower prevalence rate of left ventricular hypertrophy (52％ vs 83％) and higher left ventricular ejection fraction (65.0％ vs 62.5％) than IDH(-) patients.No correlation was found between other IDH criteria and mortality.Conclusions The prevalence rate,overall and individual IDH frequency of IDH are of high variability when diagnosed by different IDH criteria.All IDH episodes defined by our selected definitions are of no association with all-cause mortality.An absolute SBP ＜ 90 mmHg or with a decrease of SBP≥20 mmHg can decrease the risk of cardiovascular mortality due to their better cardiac function.Large scale researches should be conducted to find optimal IDH definition and explore the association of IDH and mortality.

Purpose　Both the working standard and corresponding sample(GRAN75)were first calibrated by WHO international standard for G-CSF.Methods　MTT method by NFS-60 cells was used. The results were calculated by (4,4)method.Results　Three batchs working standards were prepared,two batchs were freeze-dry and the prescription was same as WHO international standard for G-CSF,one batch was injection and the prescription was same as corresponding sample(GRAN75).The biological potency and the FL% of average potency were 3.062×106 、4.276×106IU/ampoule、1.635×107IU/ml and 5.529%、4.291%、4.244% for working standard, and 1.880×107IU/ml and 5.175% for corresponding sample,respectively.Conclusion　The working standard which calibrated could be used as working standard in the measurement of rhG-CSF biological activity.