Objective Proteomics changes from the proteserum which isolated from the rat model of renal ischemia/reperfusion(I/R) injury are detected and investigated by the matrix-assisted UV laser desorption ionization time of flight mass sperctra (MALDI-TOF MS). Methods After the establishment of rat renal ischemia-reperfusion model,the serum samples which we selected respectively in 6,12,24 hours after reperfusion in each group were detected by MALDI-TOF MS analysis. And the peptide fingerprint which existed differences in each group were analyzed to identify.SPSS13.0 software was used to the analysis the data. At the same time,we used Mascot Search to determine their nature in protein database. Results ①the serum which was analyzed by IMAC-Cu bead was detected and had statistically significant peptide fingerprint in the m/z 2481 Da.②the results obtained from peptide mass fingerprint (PMF) were analyzed by Mascot search program for protein identification. We identified it as rat fibrinogen fragment.Conclusion Fibrinogen in kidney ischemia/reperfusion (I/R) injury plays an important role.

Chronic hepatitis C virus ( HCV) infection has been reported in association with several extrahepatic complications, among which mixed cryoglobulinemia is the most documented. Clinical manifestations of HCV related cryoglobulinemia include skin lesions, glomerulonephritis, peripheral neuropathy, and widespread vasculitis.The therapy may be directed to eradicate HCV infections, suppress B-cell clonal expansion and cryoglobulin production, and ameliorate symptoms.This paper reviews the research progress on pathogenesis, clinical manifestations, diagnosis and treatment of HCV related cryoglobulinemia.

Objective Decline in cognitive function caused by diabetes has become a research hotpots.The article aims to explore the relationship between serums regulated upon activation normal T cell expressed and secreted(RANTES) and cognitive dysfunction of newly diognosed T2DM patients, and provide a new way of prevention and treatment for newly diagnosed T2DM patients with cognitive dysfunction.Methods We retrospectively analyzed the general information and clinical biochemical indexes of the 123 patients who were first diagnosed of T2DM from March 2015 to September 2016 in Tangshan Worker''s Hospital.The levels of serum RANTES were measured by enzyme-linked immunosorbent assay (ELISA), and the cognitive function of all patients was assessed by Mini-mental State Examinatlon(MMSE)and Repeatable Battery for the Assessment of Neuropsyehologic Status(RBANS).Finally, newly diognosed T2DM patients were divided into T2DM non-cognitive disorder group and T2DM cognitive disorder group according to the MMSE score.We analyzed whether there are differences among general information,serum RANTES level and RBANS cognitive function score of two group patients.The correlations of RANTES with general information and cognitive scores were analyzed by single factor correlation and multiple stepwise regression analysis.Results ①The level of serum RANTESin T2DM cognitive disorder group[(2.62±0.37)mmol/L] was significantly higher compared to that in T2DM noncognitive disorder group[(2.29±0.36)mmol/L], and there was significant difference(P<0.001).②The instant memory,visual span,attention,delayed memory score and RBANS score of T2DM cognitive disorder group were(70.90±14.71)、(92.90±15.50)、(87.80±16.45)、(88.02±14.28)、(82.92±11.07), which were significant declined compared to those of T2DM non-cognitive disorder group [(85.28±13.97),(104.18±12.69),(101.51±12.94),(96.42±10.30),(95.84±9.94)], and there was significant difference (P≤0.05).There was no statistically significant difference between the two groups′ verbal function score [(96.08±7.87),(99.31±9.83)] (P=0.056).③The RANTES was negatively correlated with the total score of instant memory, visual span, verbal function, delayed memory score and RBANS score in T2DM patients(the valuue of r were-3.48、-2.35、-2.01、-3.02、-4.17).Conclusion There was a significant correlation between serum RANTES level and cognitive dysfunction, and elevated serum RANTES level could be used as an important indicator for monitoring newly diognosed T2DM patients with cognitive dysfunction.

Objective To investigate the medical and pharmaceutical knowledge of patients with chronic diseases and analyse the influence factors of rational administration in patients ,to provid data to support the establishment of pharmaceutical service mode . Methods 386 cases of patients with chronic diseases were asked to finish the questionnaires for the medical and pharmaceutical knowledge ,and factors affecting the rational drug were analyzed by single factor and multiple factors Logistic regression analysis . Results Among the 386 patients ,cardiovascular and celebralvascular disease ratio was the highest(53 .3% ) ,followed by respiratory system diseases(13 .8% ) and the musculoskeletal system diseases (11 .50% );The averaged score of 386 patients was 1 .76 ± 0 .78 , medication knowledge was at a general level;single factor analysis results showed that there was significant difference(P<0 .05) between rational drug-use and abuse of drugs among patients in number ,form of payment ,marital status ,income ,education level , taking drug knowledge lectures ,combined treatment .Multivariate Logistic regression analysis showed that education level ,partici-pation in lectures ,drug combination ,disease species had a significant impact on the rational drug use among patients with chronic disease(P<0 .05) .Conclusion The pharmaceutical knowledge that patients with chronic disease mastered is unsatisfactory ;and unreasonable behavior of medication is common scence .Education level ,participation in lectures ,drug combination ,the number of diseases have great influence on the rational use of drugs in patients with chronic diseases .A kind of effective pharmaceutical service mode should be established for patients with chronic diseases by clinical pharmacists .This is a very meaningful work for rational ad-ministration .

Objective To observe the changes of irisin in patients before and after hemodialysis (HD),as well as the differentiation of irisin change in patients with diabetes mellitus and protein energy waste.Methods Clinical parameters of patients on maintenance hemodialysis (MHD)in Shanxi People's Hospital from September 2016 to November 2016 were collected.A total of 33 cases were enrolled——14 cases of diabetic MHD group and 19 cases of non-diabetic MHD group as divided according to etiology.Based on the presence of protein energy waste,patients were also grouped into 17 cases with and 16 cases without protein waste.Before and after HD,the non parametric test was used to compare the changes of irisin in each group.Results After HD,the irisin value of 33patients with ERSD decreased,with the difference being statistically significant [0.666(0.218,1.365) ng/L vs 0.977(0.202,1.820) ng/L,P=0.01].The difference was not statistically significant in the diabetes MHD group;statistically significant in the non diabetes group [0.666(0.178,1.351) ng/L vs 0.913(0.100,1.497) ng/L,P ＜ 0.05];and not statistically significant in the protein energy group.The irisin of diabetic MHD group and non-diabetic MHD group were compared after HD:the difference was not statistically significant.Conclusions After HD,plasma irisin levels were reduced in patients with end-stage renal disease.Diabetes and protein wasting effects are not important for irisin at HD.

Objective We aim to evaluate and discuss the feasibility of Hyaline imaging of three-dimension sonography in observation of paravaginal support structure in normal nonporous women.Methods Total of 45 normal infertile women were chosen.Three-dimensional volume datasets were collected at rest by transperineal ultrasound.The three-dimensional Hyaline images were acquired off-line.We observed the morphologic features of paravaginal support structure on the axial plane in middle vagina and measured the anteroposterior and lateral horizontal distances between bilateral paravaginal support structure and ureter.The consistency between two sonographers were analyzed by intraclass correlation coefficient (ICC).Results In three-dimensional Hyaline imaging sonogram,paravaginal support structure was appeared as typically tenting-like shaped.The anteroposterior distances between paravaginal support structure and center of ureter were listed as followed:left (-0.31 ± 1.29) mm,right (0.47 ± O.99) mm.While the lateral horizontal distances were left (12.67 ± 6.70) mm,right (13.01 ± 5.75) mm.There were no statistical differences between bilateral both anteroposterior and lateral horizontal distances.The consistency between two sonographers for distinguishing paravaginal support structure on the middle-vaginal plane and measuring distances between paravaginal support structure and center of ureter was remarkably high (ICC is 0.87 and 0.82).Conclusions Hyaline imaging technology of three-dimensional pelvic floor sonography could be used to observe paravaginal support structure in women.The normal paravaginal support structure is typically showed as bilateral symmetrical tenting-like structure,which is on the same level as the center of ureter.It provides normal anatomic radiological evidence and helps study defect of paravaginal support structure caused by pregnancy or delivery.

Objective To observe the expression of parathyroid hormone - related peptide (PTHrp) receptor in tibial growth plate and its effects on tibial extension in chronic renal insufficiency rats. Methods Two-week-old male Sprague-Dawley rats were randomly divided into sham group, model group and enalapril group, each with 20 rats. In model group and enalapril group rats had chronic renal insufficiency induced by left ureteral obstruction, and rats were respectively given saline and enalapril by gavage after the operation. In sham group, left ureter was only exposed without ligation, and rats were given saline. The urine was collected 4 weeks after the operation and the total protein content was measured. Then all rats were killed. The concentrations of PTHrp, creatinine and urea nitrogen in intracardiac blood were detected. HE staining and Masson staining were performed on the left kidney to observe pathological changes of glomeruli and renal tubules. The total length of bilateral tibia was measured. The number of columnar cells in the growth plate proliferative zone was measured by safranin O staining and the expression of PTHrp receptor in the growth plate was detected by immunohistochemistry. Results The 24 h urine total protein, creatinine and urea nitrogen in model group were higher than those in sham group (all P＜0.05), while these 3 renal functional parameters in enalapril group were lower than those in model group (all P＜0.05). In model group and enalapril group rats had higher blood concentrations of PTHrp than that in sham group (all P＜0.05), but blood PTHrp in enalapril group was lower than that in model group (P＜0.05). HE staining and Masson staining showed that in the model group rats had severe tubular dilation, inflammatory cell infiltration and the tissue fibrosis, while in enalapril group renal tubules slightly dilated and had a few inflammatory cell infiltration and tissue fibrosis. Compared with those in the sham group, in model group the tibia length, the chondrocyte number of column structure in the growth plate proliferative zone and the PTHrp receptor decreased (all P＜0.05). But in enalapril group those indexes increased than model group (all P＜0.05). Conclusions Chronic renal insufficiency rats had increased PTHrp concentration in the blood but decreased PTHrp receptors expression in tibial growth plate, which lead to their limited tibial extension.

Objective: To investigate the effect of metformin on the expressions of activating transcription factor-6(ATF6)and Caspase12 in hippocampus of type 2 diabetic rats. Methods: GK male rats with random blood glucose≥11.1 mmol/L were orally administrated with normal saline(DM group)and metformin(MET group, 85 mg·kg^-1·d^-1)for 8 weeks(n=10 each group). Wistar male rats were selected as normal contorl group(NC, n=10). After 8 weeks of continuous medication, body weight and fasting plasma glucose(FPG)were measured, and the morphology of HE stained cells and the expressions of ATF6 and Caspase12 by immunohistochemistry staining in the CA1 area of hippocampus were detected. Results: Compared with NC group, the body weight of DM and MET groups decreased(P<0.05), but there was no significant difference between DM and MET groups(P>0.05). In comparison with NC group, FPG levels in DM and MET groups were markedly increased(P<0.05)while FPG level in MET group was significantly lower than that in DM group(P<0.05). The normal nerve cells in the CA1 region of hippocampal were lower in DM and MET groups than those in NC group, especially in DM group. The protein expressions of ATF6 and Caspase12 in DM and MET groups were higher than that in NC group(all P<0.05), and the expressions of the two protein in MET group were significantly decreased as compared with DM group(P<0.05). Conclusion Metformin reduces the expressions of ATF6 and Caspase12 in hippocampus of type 2 diabetic rats, which may be related to its protective effect on brain. (Chin J Endocrinol Metab, 2018, 34: 594-597)

Objective:To investigate the protective function and mechanism of β-hydroxybutyrate (β-HOB) on cisplatin (CP)-induced nephrotoxicity.Methods:C57BL/6 male mice aged 10 weeks were randomly divided into the following three groups: control group (no special treatment), β- HOB+CP group (mice received intraperitoneal injection of 20 mmol/kg β-HOB for 10 days), CP group (received intraperitoneal injection of normal saline for 10 days). CP group and β-HOB+CP group were given once cisplatin (20 mg/kg) intraperitoneal injection on the 8th day in the experiment. On the 10th day, all the mice were sacrificed. Renal pathology was evaluated by HE staining; blood samples were collected for blood urea nitrogen (BUN) and serum creatinine (Scr) measurement; immunohistochemistry staining was performed to detect the protein level of Caspase3, Cleaved-caspase3, mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) in renal tissues; Western blotting was used to detect the relative expression levels of p-MAPK/MAPK and p-NF-κB/NF-κB. In vitro experiment, HK-2 cells were set into three groups: control group, CP group, β-HOB+CP group, and β-HOB+CP+Sappanone A (Sap, MAPK-p38 activator) group. The expression levels of p-MAPK, p-NF-κB, Caspase3 and Cleaved-caspase3 were tested by cell immunofluorescence. The cell apoptosis and mitochondrial membrane potential (MMP) were examined by flow cytometry. DNA damage was detected by TUNEL staining. Results:In vivo experiments, the renal pathological injury score, BUN and Scr in CP group were significantly higher than those in control group (all P<0.05), while renal pathological injury score, BUN and Scr in β-HOB+CP group were lower than those in CP group (all P<0.05). The protein expression levels of p-MAPK, p-NF-κB, Caspase3 and Cleaved-caspase3 in CP group were higher than those in control group, while these indexes in β-HOB+CP group were lower than those in CP group (all P<0.05). In vitro experiments, compared with CP group, the MMP was higher in β-HOB+CP group; the ratio of cell apoptosis, the expression of Caspase3, Cleaved-caspase3, p-MAPK and p-NF-κB, and the number of TUNEL staining positive cells were significantly lower (all P<0.05). Compared with β-HOB+CP group, the MMP in β-HOB+CP+Sap group was lower; the ratio of cell apoptosis, the expression of Caspase3 and Cleaved-caspase3, and the number of TUNEL staining positive cells were significantly higher (all P<0.05). Conclusions:β-HOB can alleviate the acute renal injury induced by cisplatin, which may be related to the reduction of apoptosis and inhibition of MAPK/NF-κB pathway.

Literature analysis,expert consultation,case analysis and other methods were used to establish a public hospital specialty operation evaluation system suitable for high-quality development,including 2 first-level indicators of medical ability and economic operation and 13 second-level indicators.Urology surgery in the pilot hospital was taken as an example to carry out surgical operation effect evaluation.To strengthen the evaluation of public hospital specialized operation,it should pay attention to the evaluation of medical capacity,strengthen the cooperation of functional departments,and improve the supporting policies of operation,for better promoting the development of high-quality operation of hospitals.