Inhibitors of differentiation(Id) are negative regulators of basic helix-loop-helix(bHLH) type transcription factor.There are four related members of the Id family called Id-1,Id-2,Id-3 and(Id-4) in mammalian cells.Since the identification of Id proteins in 1990,the roles of Id in cell proliferation,differentiation,development,maturation,apoptosis and tumorigenesis have been widely investigated.This article focuses on the role of Id in tumorigenesis.

Objective To investigate the advantages of emergent ureteroscopy for the treatment of acute obstructive renal failure resulted from upper ureteral calculi.Methods A total of 123 cases of acute renal failure caused by bilateral upper ureteral calculi was treated with ureteroscopic exploration,ballistic lithotripsy,catheter indwelling,and percutaneous nephrolithotomy.Results The serum BUN(blood urea nitrogen) and Cr(creatinine) were decreased to normal levels 2～10 days after operation in 100 cases(81.3%);the levels of Cr were maintained at 188.6～232.3 ?mol/L 10～15 days after operation in 22 cases.In 1 case of congenital solitary kidney(renal failure caused by chronic contralateral ureteral calculous obstruction),a hemodialysis was needed on the 3rd day after operation,and the serum Cr was 810 ?mol/L on the 15th day after operation and was dropped to normal after 2 months postoperatively.In 4 cases of previous unilateral nephrectomy or congenital solitary kidney,azotaemia remained at 3 months after operation.Conclusions Emergent ureteroscopy for acute renal failure caused by calculous obstruction possesses advantages of immediate obstruction relief,effective renal function protection,little trauma,low complication rate,and simple performance.

Objective To study the predictive value of high-sensitivity C-reactive protein (hs-CRP) to perineonate mortality in early onset severe pre-eclampsia (EOSPE) pregnant women. Methods Seventy-five pregnant women with EOSPE (EOSPE group) and 75 pregnant women with gestational hypertension (control group) were selected. The serum tumor necrosis factor (TNF)-α, interleukin (IL)-2 and hs-CRP levels were detected. The data of perineonate death in EOSPE group were recorded, then the pregnant women were divided into death subgroup and survival subgroup. Results The hs-CRP, TNF-αand IL-2 levels in EOSPE group were significantly higher than those in control group:(7.2 ± 2.1) mg/L vs. (2.5 ± 1.0) mg/L, (28.9 ± 5.3) ng/L vs. (12.4 ± 3.5) ng/L and (134.3 ± 34.6) ng/L vs. (104.2 ± 28.5) ng/L, and there were statistical differences (P<0.05). In EOSPE group, 18 perineonates died (death subgroup), and 57 perineonates were survival (survival subgroup). The hs-CRP in death subgroup was significantly higher than that in survival subgroup: (8.9 ± 1.3) mg/L vs. (7.1 ± 1.2) mg/L, and there was statistical difference (P<0.05). But there were no statistical differences in TNF-αand IL-2 between death subgroup and survival subgroup (P>0.05). Receiver operating characteristic curve analysis result showed that the best threshold of hs-CRP for predicting the perineonate mortality caused by EOSPE was 7.98 mg/L, and the area under the curve was 0.779 (95％CI 0.637 to 0.922), with a sensitivity of 0.83 and a specificity of 0.68. Conclusions Inflammatory reaction is involved in the pathophysiological process of EOSPE, and hs-CRP is a good index to predict perineonate death in EOSPE pregnant women.

Objective To discuss the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL) for residual or recurrent stones in the kidney or upper ureter after open surgery.Methods A total of 46 cases of residual or recurrent stones in the kidney or upper ureter after open surgery were included in the study.A pigtail catheter was inserted into the ureter transurethrally under ureteroscope to create an artificial hydronephrosis.Then a renal fistulization,usually on middle or upper calyx,was made.The stones were identified under ureteroscope,fragmented with a pneumatic ballistic lithotriptor,and extracted by using a grasping forceps.The renal fistulization tube was indwelled for drainage.Results The stones were completely removed on one session in 20 cases(43.4%),on two sessions in 15 cases(32.6%),and three in 8 cases(17.3%).Residual stones were seen in 3 cases(6.5%),with a size of 0.1 cm ? 0.1 cm ? 0.2 cm ～ 0.5 cm ? 0.5 cm ? 0.6 cm.Stones were removed through one working channel in 18 cases(39.1%),two channels in 20 cases(43.5%),and three channels in 8(17.4%).Conclusions The MPCNL is miuimally invasive and effective in the treatment of residual or recurrent stones after open surgery.

Objective To investigate the clinical epidemiological characteristics of gastric carcinoma detected by endoscopy in Gansu province.Methods Data of patients with gastric carcinoma,which was detected by endoscopy and confirmed pathologically from January 1977 to December 2006 in 163 hospitals of Gansu province,were reviewed.The endoscopic findings,clinical manifestations and epidemiological features were retrospectively analyzed.Results A total of 34,116 patients were diagnosed as gastric carcinoma with the overall screening rate as 5.30%,which was decreasing in the recent years.The rate of cardiac and noncardiac cancer was 18.5%and 81.5%,respectively,and the rate of cardiac cancer raised from 16.1%to 20.0%in the last decade.The tumor was most likely detected in antrum(38.63%).The male/female ratio of gastric cancer is 3.56:1.The screening rate of gastric carcinoma was the highest in Wuwei district (8.19%).The poorly differentiated adenocarcinoma accounted for 49.64%in all patients.Conclusion Gastric carcinoma occurs most frequently in Wuwei district of Gansu province and was mostly detected in gastric antrum.The most common pathological type is poorly differentiated adenocarcinoma.In the past three decades,the detection rate of gastric cancer is decreasing,SO is that of cardiac cancer,and that of the early gastric cancer is relatively low.

Objective To investigate the changes in serum level of vascular endothelial growth factor (VEGF), nitric oxide (NO), erythropoietin (EPO) and plasma level of carbon monoxide (CO) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and their clinical significance. Methods Sixty-four patients diagnosed as OSAHS by polysomnography (PSG), were divided into two groups according to apnea-hypopnea index (AHI), 20 in mild group [5/h≤AHI≤20/h, with a mean of (12± 5)/hi and 44 in moderate-severe group[AHI > 20/h, with a mean of (63±23)/h]. Blood samples were obtained from all the patients after PSG for measurement of levels of serum VEGF, NO and EPO and plasma CO. Results Levels of serum VEGF [(101±91) ng/L], NO [(10.3±3.3) μmol/L]and plasma CO [(0.56±0. 35) mg/L]in moderate-severe OSAHS group were significantly higher than those in mild group (all P <0.05). There was no significantly difference in serum level of EPO between the two groups (P> 0.05). Levels of serum VEGF, NO and plasma CO in OSAHS patients positively correlated with AHI and percentage of time with percutaneous arterial blood oxygen saturation lower than 0. 9 (SLT90) of all sleep time (all P < 0. 05), but reversely correlated with the lowest arterial blood oxygen saturation (LSaO2) at night (P>0.05). No correlation between EPO and all the indicators was found (P>0.05). Multiple linear regression analysis showed that LSaO2 was an independent risk factor to affect levels of serum VEGF and plasma CO (R2=0.198, P=0.001, and R2=0.210, P=0.000, respectively) and SLT90 was an independent risk factor to affect serum level of NO (R2= 0. 148, P=0.004) in OSAHS patients. Conclusion Hypoxia at night is a main cause leading to increased level of serum VEGF, NO and plasma CO in OSAHS patients.

Objective To investigate the relationship between the serum uric acid (SUA) levels and the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Methods Consecutive patients with spontaneous intracerebral hemorrhage admitted within 24 hours after onset were prospectively included.SUA levels was measured on the next morning after admission.Modified Rankin Scale (mRS) was used to ascertain clinical outcome at 30 days.The patients were divided into a good outcome group (mRS＜2) and poor outcome group (mRS≥3).Results A total of 92 patients with spontaneous intracerebral hemorrhage were included,and 46 of them (50％) were men,the mean age was 63 ± 12 years.At 30 days after onset,22 patients (23.9％) had a good outcome and 70 patients (76.1％) had a poor outcome.Univariate analysis showed that the Glasgow Come Scale (GCS) score in the good outcome group was significantly higher than that in the poor outcome group (13.85 ± 2.80 vs.11.21 ± 2.51; t=4.186,P=0.000),while hematoma volume (25.65 ±5.33 cm3 vs.34.60± 8.97 cm3,t=4.430,P=0.000) and SUA levels (324.90± 86.02 μmol/L vs.458.63 ±72.77 μmol/L; t =7.193,P =0.000) were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that the lower GCS score (odds ratio [OR]1.810,95％ confidence interval [CI]1.382-2.382; P =0.001),larger hematoma volume (OR 1.156,95％ CI 1.045-1.280; P=0.005) and higher SUA levels (OR 2.127,95％ CI 1.055-4.287; P=0.035) were the independent predictive factors for the short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.Conclusions The increased SUA levels may predict the poor short-term clinical outcome in patients with spontaneous intracerebral hemorrhage.

Objective To analyze and compare the incidence of cerebral vasospasm (CVS) in patients with aneurismal subarachnoid hemorrhage(aSAH) in China and in Europe.Methods A literature search was performed for all the papers investigating the incidence,diagnosis, treatment or prognosis of CVS after aSAH using the MEDLINE and China Knowledge Resource Integrated Database (CNKI) from January 1, 1990 to December 31, 2010.The incidences of angiographic CVS, symptomatic CVS and CVS-related infarcts were recorded.The incidences of CVS between Chinese and white men in Europe were compared. Results A total of 237 articles were searched via CNKI and reference reviews, and 9 of the studies met the inclusion criteria. A total of 172 articles were searched via MEDLINE and reference reviews, and 18 of the studies met the inclusion criteria. The risk of occurring symptomatic CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe (relative risk,2. 063, 95％ confidence interval 1.816-2. 343, P ＜0. 001). Conclusions The incidence of CVS in patients with aSAH in Chinese was significantly higher than that in white men in Europe,indicating the pathogenesis of CVS may have genetic basis.

Objective To study the relationship between oxidative stress and endothelial cell apoptosis in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS). Methods Sixth-seven patients definitely diagnosed by potysomnography (PSG) as OSAHS were divided into three groups according to their apnea-hypoventilation index (AHI), 14 in mild group (5 < AHI≤20), 21 in moderate group (20 < AHI≤40) and 32 in severe group (AHI 40). And, 18 healthy persons (AHI <5) were recruited as controls. Blood samples were obtained form all of them after PSG performance for measuring apoptotic endothelial cells (CD146AnnV+) and serum levels of superoxide dismutase (SOD) and malondialdehyde (MDA). Results Serum level of MDA and CD146AnnV+ in moderate and severe OSAHS group were significantly higher than those in control group (all P < 0.05). Serum level of SOD in moderate and severe OSAHS group was significantly lower than that in control group (P < 0.05). CD146AnnV+ correlated positively with AHI, the longest apnea time (LAT) and oxygen desaturation index (ODI) (r = 0.778, 0.609 and 0.689, respectively, all P < 0.05) and correlated reversely with saturation of arterial blood oxygen at night (SaO2min) (r =-0.635, P < 0.01). CD146AAnnV+ correlated positively with serum level of MDA (r = 0. 698, P < 0.01), and correlated reversely with serum level of SOD (r =-0.705, P < 0.01). Results of linear multivariate regression analysis showed that AHI, serum levels of SOD and MDA were independent risk factors for endothelial cells apoptosis in patients with OSAHS. Conclusions There existed oxidative stress due to intermittent hypoxia in patients with OSAHS, which could be one of the major causes in exacerbating endothelial damage.