Objective: To investigate the differential expression of matrix metalloproteinases-1 / tissue inhibitor of metalloproteinase-1 (MMP-1/TIMP-1) between normal kidney,kidneys of patients with autosomal dominant polycystic kidney disease(ADPKD),and the original kidneys after renal transplantation(OKRT).Methods: DNA microarray technique was used to analyze the differential gene expression in the above 3 tissues.Semi-quantitive RT-PCR was performed to verify the differentially expressed genes.Results: There were 463 differentially expressed genes between normal kidney and ADPKD tissues and 130 differentially expressed genes between ADPKD and the OKRT tissues.Expression of MMP1/TIMP1 in the ADPKD and the OKRT tissues were significantly higher than that in the normal kidney tissue(P

Objective:To investigate the influence of sirolimus on the disease progression of a rat model of autosomal dominant polycystic kidney disease(ADPKD)-HanSPRD with chronic renal insufficiency.Methods: Twenty 6-month-old male ADPKD heterozygous(Cy/+) rats with chronic renal insufficiency were divided into 2 groups at random(n=10).Rats in experimental group received intragastric administration of sirolimus(0.2 mg?kg~(-1)?d~(-1)) for 45 days and those in control group were bred routinely.The general state and renal function of rats were monitored throughout the treatment.The rats were sacrificed 45 days later and both kidneys were harvested,weighed;and the 2-kidney/total body weight(2K/TBW) ratio was determined.Then the kidneys were subjected to immunohistochemistry examination and the numbers of cells positive of proliferating cell nuclear antigen(PCNA) were counted.Results: There was no death in the 2 groups and all rats gained weights,with no significant difference between the 2 groups.Blood urea nitrogen(BUN) increased progressively in both groups,with the increase in experimental group lower than that in the control group by 12.5% on 45 days after administration(P

Problem-based learning(PBL) teaching mode was applied in Urology practice of the medical students.The externs were organized to analyze and discuss a real case,having grasped enough knowledge of relative diseases,and to provide their advice about the diagnosis and treatment,changing question mark into a full stop.And then their conclusions were verified by post-operational follow-up.PBL teaching mode can increase the students'study motivations and interests and the ability to resolve practical problems,master medical knowledge,train their clinical thinking and enhance the quality of teaching and thus it is an effective teaching mode.

Objective To study the anatomic relationship between the thoracic transverse process and adjacent bony structures and its clinical significance for thoracic screw fixation.Methods The present anatomic measurement used 45 dry cadaveric specimens of the normal adult thoracic vertebrae.We measured the distances from the horizontal midline of the transverse process to the superior,middle and inferior margius of the pedicle,the height of the anterolateral transverse process sheltered by ribs,and the position at the horizontal midline of the transverse process corresponding to the vertebral body.Results The horizontal midlines margius of the transverse processes of T1 to T10 are localized in the plane ranging from the superior to the inferior margins of the pedicle.The midlines of the transverse process are closer at T6 and T7 while more apart at T9 and T10.From T1 to T8,the anterolateral transverse process is totally or mostly sheltered by ribs,but the shelter is much less at T9 and T10.The horizontal midline of the transverse process corresponds to the upper 1/3 or middle 1/3 of the vertebral body.Conclusion Thoracic screw fixation across the transverse process to the vertebral body is safe,reliable and feasible in clinic.

Objective:To prepare pioglitazone hydrochloride ( PGH) sustained-release pellet capsules and study the in vitro disso-lution. Methods:The preparation was prepared with a bottom spray fluidized bed, and the formula and technology were optimized by orthogonal test. Results:The method was simple and easy to operate, the reproducibility of the formula and technology was good, and the pellets had obvious sustained-release property. Conclusion:The formula and technology are easy and controllable, and the stability of sustained release pellets is good.

ObjectiveTo study the outcome of renal transplantation in polycystic kidney disease (PKD) and its influencing factors.MethodsFrom 1978 to 2002, 46 PKD patients undergoing renal transplantation (PKD group) and 46 cases of other diseases (non-diabetic nephropathy;control group) were retrospectively analyzed. Patient/renal survival rate (1, 3 and 5 years after re nal transplantation) and postoperative complications were evaluated.ResultsA comparable overall patient (1, 3 and 5 years: 95.7?% , 91.3?% , 91.3 ?% PKD vs 97.8?% , 95.7?% , 93.5?% controls) and transplant sur vival rate (1, 3 and 5 years: 93.5?% , 89.1?% , 87.0?% PKD vs 95 .7?% , 89.1?% , 87.0?% controls) was found in both groups. Infectious complications with the exception of urinary tract infections (UTIs: PKD 43.4 ?% vs 10.9?% ) were diagnosed in similar frequency in the graft recipien ts. PKD patients were significantly more affected by UTIs than the control group (P

Objective To evaluate the efficacy of retroperitoneoscopic radical nephrectomy.Methods From October 2001 to September 2006,a total of 108 patients underwent retroperitoneoscopic radical nephrectomy in our department.The tumors sized 1.0-8.0 cm in diameter with a mean of(4.3?2.9)cm.Before the operation,42 patients were in stage T1N0M0,54 in stage T2M0N0,and 12 in stage T3aN0M0.Results The operation time was 35-180 min with a mean of(63.5?30.3)min,and the blood loss was 20-1500 ml [mean,(75?23)ml].Totally 3 patients were converted to open surgery.The intra-and postoperative complications included hemorrhage caused by the injury of the inferior vena cava or renal artery(4 cases),wound infection(3 cases),and hypercapnia(8 cases).The patients were followed up for 6-36 months(over 12 months in 61 cases),during which 2 patients died of pulmonary metastasis one year after the surgery,1 patent died of liver metastasis 7 months after postoperation,the other 105 patients survived without tumor.The 1-year survival rate was 98.4%(60/61);and 3-year survival rate was 85.7%(18/21).Conclusions Retroperitoneoscopic radical nephrectomy is mini-invasive and effective for renal carcinoma.The patients recover quickly after the surgery.The procedure is worth being wildly used.

Objective:To study the differential gene expression pattern between autosomal dominant polycystic and normal kidney tissue,and to deduce the etiological factor and treatment for autosomal dominant polycystic kidney disease(ADPKD).Methods: The cDNA probes were prepared by labelling normal kidney tissue mRNA and ADPKD tissue mRNA with Cy3-dUTP and Cy5-dUTP separately through reverse transcription.The probes were then hybridized with the DNA microarrays(PCR products of(4 096) human cDNAs onto specially treated glass slides) and the fluorescent signals were scanned with ScanArray 4000 scanner.Semi-quantitive RT-PCR was performed to test the expression level of 4 related genes.Results: Of the 4 096 genes screened,463 genes showed obvious changes.Expression of 206 genes was upregulated in the polycystic kidney tissue,especially cyclin D_(2),MMPs,TIMP1 and fibroblast activation protein;expression of 257 genes was downregulated,especially phosphatase 1A and acid phosphatase 1.The expression of genes tested by RT-PCR was in accordance with those detected by cDNA microarray.Conclusion: ADPKD may be related to the upregulation of cyclin,MMPs,and various kinds of growth factors,and drugs like inhibitors of CaM and MMPs might have therapeutical effects on ADPKD.

Objective To explore the correlation of metabolic disorder of newly diagnosed type 2 metabolism(T2DM) and nonalcoholic fatty liver disease (NAFLD).Methods A total of 117 patients with newly diagnosed T2DM in Beijing Ditan Hospital Affiliated to Capital Medical University from June 2014 to June 2015 were enrolled.Patients were divided into two groups:T2DM with NAFLD of 57 cases and T2DM without NAFLD of 60 cases.Body mass index (BMI),waist circumference (WC),liver and kidney function,serum lipid,glycosylated hemoglobin A1c (HbA1c),fasting glucose,fasting insulin and C-peptide (FCP) were detected.The insulin resistance and β-cell function were assessed by homeostasis model assessment insulin resistance (HOMA-IR) and HOMA-β.Results The incidence of NAFLD in T2DM patients was 51％ (that was,60 cases of T2DM patients with NAFLD),compared with 2TDM group,the metabolic index of T2DM without NAFLD was significantly increased (blood triglyceride (TG):(2.58 + 1.8) mmol/1 vs.(1.22 + 0.4) mmol/l,fasting blood glucose:(11.5+6.1) mmol/l vs.(9.2+4.3) mmol/l,serum uric acid:(465.3+65) umol/l vs.(325.3+72) umoL/l;P =0.03,0.03,0.02);HOMA-IR was more serious ((4.9 ± 2.8) vs.(3.8 ± 2.7);P =0.03);insulin β-cell function was compensatory more obvious ((49.2 ± 27) vs.(29.5 ± 18);P =0.02);prevalence rate of obesity,hypertension and diabetic ketoacidosis (DKD),diabetic retinopathy (DR),diabetic peripheral neuropathy(DPN) were significantly increased(P＜0.05).Logistic regression analysis showed that,smoking(OR=1.405,95％CI:1.262-1.567),male(OR=1.037,95％CI:1.015-1.063),BMI(OR=1.113,95％CI:1.278-2.531),WC (OR =1.624,95％ CI:1.162-1.761) and TG (OR =1.823,95％ CI:1.2822.563) were risk factors of NAFLD (P ＜ 0.05).Conclusion T2DM patients with NAFLD have severer insulin resistance than those without NAFLD.The β-cell function of those patients is compensatory increased.NAFLD prevalence rate significantly increase in patients with obesity,especially in male diabetic patients who smoking.

BACKGROUND:The infection after spinal internal fixation was its serious complications. A number of studies have shown that erythrocyte sedimentation rate and C-reactive protein are of great importance in judging infections. OBJECTIVE:To analyze the trend of change of erythrocyte sedimentation rate and C-reactive protein for patients without infection after the cervical fixation. METHODS:Total y 56 patients, who underwent cervical fixation from October 2013 to July 2014, were retrospectively analyzed, and then divided into anterior cervical group (n=29) and posterior cervical group (n=27). Patients in the anterior cervical group underwent anterior cervical decompression bone graft internal fixation. Patients in the posterior cervical group underwent posterior cervical unilateral open door decompression internal fixation. The peripheral blood was col ected before fixation and at the early morning of the 1, 3, 6, 9 days after fixation. Erythrocyte sedimentation rate and C-reactive protein values were determined. The fol ow-up of patients was more than one year. Signs of infection did not appear. RESULTS AND CONCLUSION:(1) General rule:After the cervical fixation, the erythrocyte sedimentation rate was increased significantly and reached a peak on postoperative day 6. The peak level gradual y decreased but has not returned to normal at the 9 postoperative days. The C-reactive protein increased significantly on the first postoperative day and reached a peak on postoperative day 3. The peak level rapidly decreased but has not returned to normal at the 9 postoperative days. The level of erythrocyte sedimentation rate of patients in the posterior cervical group was significantly higher than that in the anterior cervical group at 3, 6 and 9 days after internal fixation (P<0.05). There was no significant difference in the C-reactive protein between these two groups (P>0.05). (2) These results demonstrate that C-reactive protein is an important indicator of monitoring the inflammatory response of patients after cervical internal fixation, which was conductive to the judgment of early infection after internal fixation. The abnormal inflammatory indices of erythrocyte sedimentation rate and C-reactive protein do not suggest a presence of blade infection after internal fixation. C-reactive protein can reach the peak at 3 days after fixation. It is recommended to check blood at 2 and 3 days. If there is no apparent rebound, then the possibility of infection is smal . It may indicate the presence of infection if the inflammatory indices increased again or decreased slowly after the decrease.