Objective To explore types and risk factors of recurrent ischemic stroke in ischemic stroke patients using antiplatelet drugs. Methods By retrospective study, 130 recurrent ischemic stroke patients using antiplatelet drugs (antiplatelet therapy group) and 101 recurrent ischemic stroke patients not taking antiplatelet drugs (non antiplatelet therapy group) were collected. Two groups of patients were divided according to the ischemic subtypes, and risk factors between different subtypes were analyzed. Results (1) Single factor analysis showed history of coronary heart disease and smoking are more frequent in antiplatelet therapy group with recurrent lacunar infarction (LI). History of coronary heart disease, diabetes, and high level of low density lipoprotein (LDL) are more frequent in antiplatelet therapy group suffer from recurrent atherosclerotic thrombosis (AT). (2)Logistic regression analysis showed the history of coronary heart disease , smoking are independent risk factors for recurrent LI in antiplatelet therapy group (P = 0.018, P = 0.027); history of coronary heart disease, diabetes, and high level of LDL are independent risk factors for recurrent AT in antiplatelet therapy group (P =0.003, P = 0.010, P = 0.002). Conclusions The history of coronary heart disease and smoking are independent risk factors for the recurrence of LI in patients with antiplatelet therapy. History of coronary heart disease , diabetes , and high level of LDL are independent risk factors for the recurrence of AT in patients with antiplatelet therapy. Combined coronary heart disease would increase both LI and AT recurrence.

Objective To evaluate the therapeutic effect of lentinan combined with conventional antituberculous therapy in women with pelvic tuberculosis.Methods A total of 90 women with pelvic tuberculosis were enrolled and recruited into a control group and a treatment group by random number table,45 in each group.The control group was treated with anti-tuberculosis program (2HRZE/4HRE),while the treatment group was treated with lentinan tablets on the basis of the control group.Both groups were treated for 6 months.Serum levels of carbohydrate antigen 125 (CA125) and erythrocyte sedimentation rates (ESRs) were determined before and after treatment,and the therapeutic effect was evaluated.Results After treatment,the serum CA125 level (28.61 ± 9.08 U/ml vs.39.72 ± 12.13 U/ml;t=4.919,P＜0.01) and the ESR (36.13 ± 8.33 mm/h vs.41.35 ± 12.45 mm/h;t=2.338,P＜0.05) in the treatment group were significantly lower than those in the control group.The negative rate of serum CA125 after treatment than before treatment in the treatment group (93.3％ vs.20.0％;X2=46.335,P＜0.01) and the control group (82.2％ vs.8.9％;X2=37.396,P＜0.01);but there was no difference in negative rate of serum CA125 after treatment between two groups (X2=1.6571,P=0.198).The total effective rate in the treatment group was significantly higher than that in the control group (93.3％ vs.77.8％;X2=4.406,P=0.036).Conclusion Lentinan combined with conventional antituberculous therapy is effective in treatment of pelvic tuberculosis in women.

Objective To study the effect of sitz bath with 1.6%concentrated brine solution and metronidazole on perianal infection in acute leukemia patients. Methods Seventy-six acute leukemia patients admitted from June 2010 to December 2014 with perianal infections were randomly divided into the control group and the observation group in equal number. The two groups were given routine nursing care and symptomatic supportive treatment . Apart from the basic nursing , the control group was treated with sitz bath with 10 min 1 ∶ 5000 potassium permanganate. The observation group was treated with sitz bath with 1.6% brine solution and 0.1%metronidazole two times every day and another one if defecation was done. The perianal infections of two groups were compared in 7 days. Result The total effectiveness in the observation group was significantly better than that of the control group (P < 0.05). Conclusions Sits bath with 1.6% brine solution and metronidazole two times a day is more effective than with 1 ∶ 5000 potassium permanganate. It is economic and convenient, safe and effective for the treatment of perianal infections and therefore worth popularizing in clinical application.

[Objective]To investigate the effect of Luteolin on mRNA expression ,protein expression and enzyme activity of 11β-Hydroxysteroid Dehydrogenase (11β-HSD) in rats.[Methods]Twenty-four rats were randomly divided into 4 groups and orally administrated with vehicle(1 % CMC-Na solution)or Luteolin(5,10 or 20 mg/kg daily)for 14 days. Gene expression of 11β-HSD I and 11β-HSD II in liver and kidney was determined with quantitative RT-PCR method. Protein expression was deter-mined with quantitative Western Blot method. The enzyme activity was expressed as the production rate of metabolites of prednisone and prednisolone.[Results]Luteolin significantly induced gene expression of 11β-HSD I and inhibited gene expression of 11β-HSD II in liver tissues ,significantly inhibited gene expression of 11β-HSD I and induced gene expression of 11β-HSD II in kid-ney tissues. Luteolin obviously up-regulated protein expression of 11β-HSD I and down-regulated protein expression of 11β-HSD II in liver tissues ,down-regulated protein expression of 11β-HSD I and up-regulated protein expression of 11β-HSD II in kidney tissues. Luteolin significantly induced activity of 11β-HSD I in liver and11β-HSD II in kidney.[Conclusions]Luteolin could change the activity of corresponding enzyme through affecting gene expression ,protein expression and enzyme activity of 11β-HSD I and 11β-HSD II in liver and kidney tissues in rat ,and affect in vivo activation of glucocorticoids and hormone level in liver and kidney.

ObjectiveWith a GcneChip(R) cxpression analysis,98 known gencs and 31 exprcssed sequence tags (ESTs) were found to be differentially expressed between KK/Ta and BALB/c kidneys.To further screen the susceptibility genes for diabetic nephropathy,the temporal and spatial expression patterns of differentially expressed gene-adipsin were investigated.MethodsThe body weight,blood glucose,urinary albumin/creatinine ratio,and renal pathological changes of KK/Ta and BALB/c mice were measured at the 7,20,28 and 36 weeks of age.Total RNA was extracted from the kidney,heart,liver,lung,and brain.The temporal and spatial expression patterns of adipsin in diabetic KK/Ta mice were examined by competitive RT-PCR.The correlation analysis between adipsin expression and albuminuria level was carried out.ResultsThe mRNA expression of adipsin was found in the kidney,heart,lung,and brain,but not in liver.The expression of adipsin in diabetic KK/Ta mice at 20 weeks of age was significantly down-regulated in kidney,heart,and lung than that in age-matched BALB/c mice,and unaltered in brain.Adipsin expression in KK/Ta kidneys was significantly down-regulated with aging and negatively correlated to urinary albumin/creatinine ratio( r =-0.807,P ＜ 0.05).ConclusionsThe expression of adipsin mRNA was downregulated in kidney,heart,and lung in diabetic state.Adipsin expression in KK/Ta kidneys was negatively correlated to urinary albumin/creatinine ratio.It might be a candidate gene for diabetic nephropathy.

The article reviewed the effects of resistance training,aerobic exercise in patients with diabetes and pre-diabetes,based on the metabolic characteristics in patients with pre-diabetes,and aimed at providing theoretical reference for exercise in the prevention and control of diabetes mellitus.

Aim To investigate the protective effect of cinnamic aldehyde ( CA ) on hormone-induced osteo-clasts proliferation and bone resorption in vitro and its molecular mechanisms. Methods RAW264. 7 cells induced into osteoclast were treated with RANKL and M-CSF and then were divided into control group, dexa-methasone ( DEX ) group and different doses of CA (11. 6, 23. 2, 46. 4 μg·L-1 ) groups. OCs were ob-served after tartrate resistant acid phosphatase( TRAP) staining. The cell proliferation was determined by MTT assay at different time points. The expression levels of TRACP5 b in cell cultured supernatants were measured by ELISA. RT-PCR technique was applied to examine the transcriptional levels of RANK and NFATc1 . Re-sults In MTT assay, the proliferation of osteoclasts stimulated by dexamethasone was promoted seriously compared with negative control group ( P < 0. 05 ) . Meanwhile, DEX could strengthen the content of TRACP5 b and up-regulate the expressions of RANK and NFATc1 mRNA. After administration of CA, the proliferation was inhibited, while the enhanced expres-sion of TRAP5b was reversed,and the over-expressions of RANK and NFATc1 mRNA were obviously down-regulated in a time-and-dose-dependent manner ( P <0. 05 ) . Conclusion The results suggest that CA in-hibits proliferation and bone resorption of osteoclast in-duced by DEX, which may be mediated by down-regu-lation of RANK and NFATc1 mRNA.

OBJECTIVE:To investigate the relationship between Tacrolimus blood concentration and effectiveness after renal transplantation and to find factors affecting Tacrolimus blood concentration METHODS:Steady-state trough concentrations of Tacrolimus were collected from 80 renal transplantation patients RESULTS:The effective blood concentration of Tacrolimus was associated with course of treatment CONCLUSIONS:The therapeutic concentration of Tacrolimus was between 12ng/ml and 15ng/ml during the first 2 weeks after renal transplantation,then should be 8ng/ml～15ng/ml

Objective To investigate the effect of hydrogen-rich saline postconditioning on the expression of vascular endothelial growth factor receptor-1 (VEGFR1) during myocardial ischemiareperfusion (I/R) injury in rats.Methods Thirty-six adult male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 3 groups (n=12 each) using a random number table:sham operation group (group S),group I/R and hydrogen-rich saline group (group H2).Myocardial I/R was induced by 30 min ligation of anterior descending branch of the left coronary artery followed by 2 h reperfusion.In group H2,hydrogen-rich saline 5 ml/kg was injected intravenously at 5 min before reperfusion,while the equal volume of normal saline was given in group I/R.Left ventricular systolic pressure (LVSP),left ventricular enddiastolic pressure (LVEDP) and ± dp/dtmax were measured and recorded during reperfusion and at 120 min of reperfusion.The rats were sacrificed at 120 min of reperfusion,and myocardial specimens were obtained for determination of myocardial infarct size,contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (using ELISA),and expression of VEGFR1 (by Western blot).At 120 min of reperfusion,blood samples were collected from the common carotid artery to measure cardiac troponin I (cTnI) concentrations in serum.Results Compared with group S,LVSP and ± dp/dtmax were significantly decreased,LVEDP was increased,the myocardial infarct size was enlarged,cTnI concentrations in serum and contents of IL-6 and TNF-α were increased,and the expression of VEGFR1 was down-regulated at 120 min of reperfusion in H2 and I/R groups.Compared with group I/R,LVSP and ± dp/dtmax were significantly increased,LVEDP and myocardial infarct size were decreased,cTnI concentrations in serum and contents of IL-6 and TNF-α were decreased,and the expression of VEGFR1 was up-regulated at 120 min of reperfusion in group H2.Conclusion Hydrogen-rich saline postconditioning can reduce myocardial I/R injury possibly by upregulating myocardial VEGFR1 expression and inhibiting inflammatory responses in the myocardium of rats.

The reasonable selection of teaching cases is very important in performing PBL in department of nephrology.The department of nephrology in the first affiliated hospital of China medical university has practiced PBL teaching reform from 2004.It was recognized that the selection of teaching cases should meet the joint of the key kuowledge of subjects,should be able to promote the conformity between clinical and basic subjects,and should be able to match with a number of teaching objectives.With the deepening of teaching reform and the transformation of teaching philosophy,PBL teaching cases in nephrology should also be advanced with the updated development.