Objective To investigate the effect of quality control circle on curative compliance in patients with chronic renal disease(CRD).Method One hundred CRD patients received health education by quality control circle.The curative compliance before using quality control circle was compared to that after using it.Results The rate of curative compliance after applying quality control circle(98.0%)was significantly higher that before(61.0%).Conclusion The qualty control circle can improve curative compliance of CRD patients.

Objectives To evaluate the relationship between the expression of B7-1 in liver tissue and the effect of interferon- alpha(α- IFN) treatment in patients with chronic hepatitis B(CHB).Methods The expression of B7 -1in liver biopsy specimens from 68 CHB patients was studied with immunohistochemistry before α-IFN treatment.Results B7-1 was expressed in 45(66.2%) liver tissues among 68 patients with CHB,but none in 5 normal controls.The total response ratio of α- IFN in patients with B7-1 positive was 66.7%(30/45),which was significantly higherthan 39.1%(9/23)in the patients with B7-1 negative(x2 =7.20,P <0.01).B7-1 expression was closely corelat-ed with the histological activity grade(HAI) and serum alanine transaminase(ALT) level.Conclusions The level of B7-1 expression in liver tissue may be regarded as an effective parameter for predicting α-IFN response in patients with CHB.

OBJECTIVE To investigate clinical characteristics of spontaneous bacterial peritonitis(SBP) in patients with severe type of viral hepatitis.METHODS A retrospective review of 120 cases of SBP associated with severe type of viral hepatitis was performed.RESULTS Clinical manifestations were as follows:fever 85.0%,abdominal tenderness 51.6%. 63.3% of the total white blood cells count in the ascitic fluid under 0.5×109／L,85.0% of polymorphonuclear cell ratio above 0.50.The positive culture of the ascitic fluid 24.2%,whereas 42.9% of the isolated microorganisms were Escherichia coli.CONCLUSIONS Clinical manifestations in SBP may be non-specific or absent.The total white blood cells count in the ascitic fluid are often under criteria for diagnosis.E.coli was the most common culture isolate.PMN ratio is the reliable parameter for the diagnosis of SBP.

Objective To explore the relationship between plasma prothrombin activity (PTA) and histopathological lesion of the liver in patients with viral hepatitis. Methods A retrospective review of plasma PTA level and hepatohistological grading was performed in 234 patients with chronic hepatitis B (CHB) and 54 patients with severe hepatitis diagnosed both clinically and pathologically. Results PTA level was obviously negatively correlated with the hepatohistological Ishak score (P

Objective To explore the effect of preventive antibacterial treatment on spontaneous bacterial peritonitis (SBP) in the patients with severe hepatitis. Methods 120 cases of the patients with severe hepatitis were divided into two groups randomly. The patients in group A (n=62) received preventive antibacterial treatment except therapy for protecting liver. The patients in group B (n=58) only received therapy for protecting liver and served as control. Results In the group A and group B, the SBP frequency was 27.4% (17/62) and 44.8%(26/58) respectively (? 2=3.95,P

Objectives To evaluate the relationship between the expression of B7-1 in liver tissue and the effect of interferon-alpha(?-IFN) treatment in patients with chronic hepatitis B(CHB).Methods The expression of B7-1 in liver biopsy specimens from 68 CHB patients was studied with immunohistochemistry before ?-IFN treatment.Results B7-1 was expressed in 45(66 2%) liver tissues among 68 patients with CHB,but none in 5 normal controls.The total response ratio of ?-IFN in patients with B7-1 positive was 66 7%(30/45),which was significantly higher than 39 1%(9/23)in the patients with B7-1 negative (? 2=7 20,P

Objective To investigate the effects and underlying mechanism of the scavenger receptor CD36 in high glucose-induced rat glomerular mesangial cells apoptosis.Methods The mesangial cells of rats were divided into 4 groups:control group (5.6 mmol/L glucose),mannitol group (24.2 mmol/L mannitol+5.6 mmo]/L glucose),high glucose group (30 mmol/L glucose),CD36 monoantibody group (30 mmol/L glucose+CD36 mono-antibody).The intracellular ROS level was detected by confocal microscopy with fluorescent probe CM-H2DCFDA.MDA,GSH-PX,8-OHDGA in cell supernatant were detected.Apoptosis was determined by flow cytometry followed by Annexin V-FITC/PI double stains.The expression of CD36,Bax and Bcl-2 were detected by RT-PCR and Western blotting.Results The expression of CD36 was detected in glomerular mesangial cells.The highest level was found in high glucose group in 24 hours.There was no significant difference found between control group and mannitol group with respect to intracellular ROS generation,MDA,8-OHDG,GSH-PX level,apoptosis rate,expression of CD36,Bax and Bcl-2 (all P ＞ 0.05).There was no significant difference in the expression of CD36 between CD36 mono-antibody group and high glucose group (P ＞ 0.05).Compared to control group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of CD36 and Bax were significantly increased,the GSH-PX level and the expression of Bcl-2 were significantly lower in high glucose group (all P ＜ 0.05).Compared to the high glucose group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of Bax were suppressed but the GSH-PX level and the expression of Bcl-2 increased in CD36 mono-antibody group (all P ＜ 0.05).The intracellular ROS level was positively correlated with apoptosis rate,protein expression of CD36 and Bax gene,was negatively correlated with Bcl-2 protein expression.Conclusions CD36 was involved in the high glucose induced apoptosis of mesangial cells which was potentially mediated by an increased level of oxidative stress.

To evaluate the efficacy of heparin combined with low molecular heparin against early thrombosis in chronic patients after native arteriovenous fistula ( AVF) . Methods: A total of 299 patients were enrolled in the study from January 2012 to December 2014 and randomly divided into two groups. The control group received 5000IU low molecular heparin after the operation for 7 days and the trial group received 3 000u heparin additionally through free arterial end and venous terminal during the operation. The thrombosis formation rate and adverse drug reactions ( ADR ) of one week and 4 weeks after the operation were observed in the two groups. Results:One week after the operation, the thrombosis formation rate in the control group and the trial group was 3. 4% and 0, respectively, and four week after the operation, that was 4. 8% and 0. 67%, respectively. The incidence of ADR showed no statistical-ly difference between the two groups (P>0. 05), and no severe ADR appeared in both groups. Conclusion:Heparin combined with low molecular heparin may be more effective and safer in the prevention of primary thrombosis in the patients after AVF.

Objective To analyze the clinical characteristic of spontaneous bacterial peritonitis (SBP) in patients with severe viral hepatitis, and explore its clinical classification and significance. Methods A retrospective research of 120 cases of SBP associated with severe viral hepatitis was performed, and main clinical symptoms and physical signs appeared at the early onset were classified and explored. Results Clinical manifestations of SBP in patients with severe viral hepatitis included 5 types, which were conventional type(41.7%, 50/120), symptomless type(15.8%, 19/120), hepatic coma type(13.3%, 16/120), refractory aacites type (17.5%, 21/120), and shock type (11.7%, 14/120). The germieuhure positive rate of SBP with hepatic coma type and shock type were relatively high, and the survival rate of these patients were low. Conclusions Clinical manifestations of SBP in patients with severe viral hepatitis may be atypical, and its classification help to enhancing the understanding and early diagnosis of SBP, and decreasing missed diagnosis. The prognosis of SBP in patients with hepatic coma type and shock type was poor, and then it must be taken high into account more than ever before in the clinical practice.

Objective To investigate the HBV reactivation status and clinic outcomes in the renal allograft recipients with inactive HBsAg carriers,and explore the preventive measures.Methods A retrospective analysis of clinical manifestation was processed in 88 cases of inactive HBsAg carriers before and after renal transplantation.Preoperative liver function in all cases was normal and serum HBsAg positive,HBV DNA＜106 copies/L.Tacrolimus (or cyclosporine A) + mycophenolate mofetil (MMF) + prednisone were given in prevention of rejection after transplantation.In 88 cases,56 cases were given nucleoside analogues (acid) for prophylactic antiviral therapy,in which 31 cases were given lamivudine (LAM) (LAM group),25 cases were given entecavir (ETV) (ETV group) ; The rest 32 cases were not given prophylactic antiviral therapy,only receiving routine liver-protecting therapy (inosine,glucurolactone) (control group).Incidence of HBV re-activation,liver function,response to treatment and the pathological changes of hepatic tissue were observed.Results During the follow-up period,the incidence of HBV reactivation in LAM group and ETV group was 45.2％ and 28.0％ respectively,significantly lower than in control group (84.4％,P＜ 0.05).In prophylactic treatment groups,HBV reactivation occurred later,liver function damage was milder,and HBV DNA load peak was lower (P＜0.05).In LAM group,HBV reactivation occurred in 14 cases,including 10 cases occurred during administration of LAM,and ETV treatment was given for about 2 months,serum HBV DNA levels in 7 cases were under detection line;in the rest 4 cases,HBV reactivation occurred in patients with treatment less than 1 year and noncompliance,who withdrew medicine blindly.After the original scheme of antiviral therapy was done,serum HBV DNA levels in 3 cases were under detection line,and the effect was not obvious in one case.In control group,HBV reactivation occurred in 27 cases.Fourteen cases therefore accepted nucleoside (acid) analogs antiviral therapy,and HBV DNA levels in 10 cases were under detection line.Histological examination revealed the liver with fibrotic cholestatic hepatitis changes in 9 patients,including 8 cases in control group,and 1 case in LAM group due to blind withdrawal of medicine.Conclus(i)on LAM and ETV prophylactic use may decrease the HBV reactivation rate in inactive HBsAg carriers after renal transplantation,reduce the severity of liver damage and the occurrence of fibrotic cholestatic hepatitis.