Objective To investigate the changes of serum and urinary adiponectin (ADPN) levels and insulin resis-tance (IR) states in patients with chronic kidney disease (CKD), and to explore their relationship thereof. Methods A total of 487 patients with CKD stages 2-5 were enrolled in this study, and 30 healthy subjects were served as control group. The se-rum ADPN levels in urine samples were examined by ELISA. The level of fasting insulin (FINS) was detected by radioimmu-noassay. Blood routine test, liver and kidney functions, blood glucose, serum lipids, 24 h urinary protein excretion and endoge-nous creatinine clearance rate (Ccr) and body mass index (BMI) were observed and calculated. The differences of ADPN lev-els in serum and urine samples and homeostasis model assessment for insulin resistance (Homa-IR) were compared between groups. Results The serum and urine ADPN levels and Homa-IR were higher in CKD patients than those of controls (P＜0.05). With the decline in renal function, the ADPN and Homa-IR levels were increased gradually (P＜0.05). The value of se-rum ADPN was significantly higher in patients with CKD stages 3-5 and high Homa-IR. The ADPN levels and Homa-IR were positively related to lipid parameters and 24 h urinary protein, and negatively correlated with hemoglobin and serum al-bumin in patients with CKD (P ＜ 0.05). Conclusion CKD patients had higher ADPN level and more significant IR. The ADPN and IR were correlated with serum lipids, hemoglobin, albumin and urinary protein. Dynamic monitor of ADPN level may have clinical significance in judging metabolic disorders in CKD patients.

Objective To explore the role of ripply1 in zebrafish dorsal-ventral development .Methods Using ze-brafish whole-mount in situ hybridization to examine the ripply1 expression pattern in early embryo development .To analyse the expression pattern changes of dorsal-ventral marker genes at shield stage and the morphological changes at 24 hpf (hours post-fertilization) after overexpression of ripply1 by injecting synthetic mRNA at 1-cell stage.Using Tol2 transposon technology to obtain a ripply1 promoter driven GFP transgenic fish and to identify promoter region that recapitulates endoge -nous ripply1 expression pattern .Results The in situ hybridization results revealed that ripply1 specifically expresses in the future dorsal region at shield stage .Overexpression of ripply1 caused an enhanced expression of dorsal marker genes and a reduction of ventral marker genes .Embryos overexpressing ripply1 also showed severely dorsalized phenotype , with enlarged head, reduced ventral yolk extension , and shortened posterior trunk and tail regions , and the formation of a secondary trunk axis.Transgenic fish revealed the maternal expression of ripply1 and suggested that a 1.2 kb promoter-driven GFP is able to recapitulate the endogenous gene expression pattern .Conclusion ripply1 may participate in the early development of dor-sal-ventral axis in zebrafish embryo .

Objective To investigate the efficacy and safety of atorvastatin combined with clopidogrel in the treatment of elderly patients with angina pectoris.Methods 90 elderly patients with angina pectoris were randomly divided into the observation group and control group,45 cases in each group.All patients were given conventional treatment and atorvastatin,the observation group was given clopidogrel based on this.The TC,TG,HDL-C,LDL-C,angina attack frequency,duration and adverse reactions,adverse cardiac events of two groups before and after treatment were compared,and the clinical effect was evaluated.Results The total effective rate of the observation group was 9 3.3 ％ (42/45),whichwassignificantlyhigherthan75.6％ (34/45) inthecontrolgroup (x2 =5.67,P ＜ 0.05).After treatment,the TC,TG,HDL-C,LDL-C of two groups were significantly improved than before treatment (t =5.34,4.78,4.56,4.92,4.31,3.92,4.11,4.62,all P ＜ 0.05),the improvement in the observation group was significantly better than that in the control group (t =4.20,4.08,3.98,4.03,all P ＜ 0.05).After treatment,the angina attack frequency and duration of two groups were significantly decreased compared with before treatment (t =6.22,5.78,4.12,4.02,all P ＜ 0.05),and the observation group decreased significantly than the control group(t =4.23,3.99,all P ＜ 0.05).3 cases of adverse reactions and 1 case of adverse cardiac events occurred in observation group,2 cases of adverse reaction and 3 cases of adverse cardiac events occurred in control group.Conclusion Atorvastatin combined with clopidogrel in the treatment of elderly patients with angina pectoris can regulate blood lipid and improve the symptoms of angina pectoris.

Objective To investigate the cause of refractory hiccups. Method 34 patients with refractory hiccups admitted to our hospital from January 1996 to December 2003 were examined with gastroscopy. The correlation of hiccups with reflux esophagitis and the efficacy of omeprazole treatment were studied. Results 10 patients were proven endoscopically to have esophagitis and duodenal ulcer, and the other 24 were suffering from esophagitis. According to Tokyo classification, 14 cases were having grade III esophagitis, and 20 were grade IV. All patients received omeprazole 20mg twice daily and cisapride 10mg thrice daily, and hiccups disappeared after 3 days. Conclusion Refractory hiccups may be the initial or primary symptom in moderate-severe esophagitis in aged people. Proton pump inhibitor therapy is effective in stopping refractory hiccup.

Objective To explore the effects of application of one-hand double-lumen simultaneous locking tech-nique on reduction of occlusion using high pressure resistant double-lumen PICCs. Methods Convenience sampling method was used to recruit 73 patients assigned into the experimental group,using one-hand double-lumen simulta-neous locking technique;66 patients were assigned into the control group,using routine locking method. The rate of PICC occlusion was recorded. Results The rate of incomplete occlusion was 8.22% in the experimental group,and 17.42% in the control group,the rate of complete occlusion in the experimental group was 0,and 0.76% in the control group,and the difference was statistically significant(P<0.05). Conclusion The one-hand double-lumen simul-taneous locking technique is easy and convenient to conduct. It can effectively reduce occlusion using high pres-sure resistant double-lumen PICCs.

Objective We aimed to assess the sedative effects by intravenous injection of fentanyl on neonates with mechanical ventilation. Methods We divided 142 neonates with mechanical ventilation into the observation group (92 cases) and the control group (50 cases). The observation group received intravenous injection of fentanyl, while the control group was given no sedative medication. The pain and sedation was assessed before ventilation, 1 and 2 hours after ventilation and later every 4 hours by adoption of NPASS evaluation inventory. Results The scores of pain at different time points 2 hours after medication in the observation group were lower than those in the control group, especially 24 hours after medication. The mean airway pressure and oxygen concentration required by the observation group was lower than those of the control group. But no difference was seen in blood oxygen saturation between the two groups. Conclusions Intravenous injection of fentanyl was proper in the application of sedative treatment for neonates with mechanical ventilation. N-PASS inventory could effectively assess the pain and sedation condition and ensure the safe medication.

Objective Compare the analgesia effects of using different intervention method among neonatal infants, and then find out the most effective method. Methods Divided 120 neonatal infants into the control group, the NNS group and the position group, there were 40 cases in every group. Using the N-PASS scale evaluated the pain degree at the points of 1 and 5 minutes respectively after stimulation among the 3 groups. Results There was significant difference between the 3 groups on the pain degree,P

ObjectiveTo investigate the expression and activity of Rho-associated kinase 1 (ROCK1) in renal tissues of uninephrectomized diabetic rats,and to explore the possible mechanism of renal protection of spironolactone.Methods The model rats were established by a single intraperitoneal injection of streptozotocin(STZ) after uninephrectomy and randomly divided into sham operation group(N),uninephrectomized control group?,uninephrectomized diabetic group (D),and spironolactone treated group (S).Four and 8 weeks later,biochemical indexes and renal morphology were detected.Expressions of ROCK1 and connect tissue growth factor (CTGF) were examined by immunohistochemistry and real-time PCR.Protein expression of p-MYPT1 was examined by Westem blotting.Results After 4 and 8 weeks,compared with group N and C,blood glucose,systolic blood pressure,24-h urinary protein,kidney weight/body weight (KWI) were significantly increased (P＜0.01),and extracellular matrix proliferation and basement membrane thickening were found in group D.After 8 weeks in group D,Alb significantly decreased and Scr significantly increased (P＜0.05).In group D,protein and mRNA expression of ROCK1 and CTGF increased significantly and protein expression of p-MYPT1 increased significantly as well with time.Treatment with spironolactone could partially reverse those changes. ConclusionsExpression and activity of ROCK1increase in renal tissues of uninephrectomized diabetic rats and are positively correlated with the expression of CTGF.Spironolactone can protect the kidney of diabetic rats in early stage probably through decreasing the expression of ROCK1,CTGF and inhibiting the activation of ROCK1.

Objective To investigate the effects of antisense p21 oligodeoxynucleotide (p21 ASODN) on the expression of p21 protein and extracellular matrix in cultured human glomerular mesangial cells (HGMC) under high glucose medium. Methods HGMCs were transfected with 50 nmol/L or 100 nmol/L p21 ASODN or scrambled control oligodeoxynucleotide (SCODN) using lipofectamine 2000. After incubation under normal (5.5 mmol/L) or high (30 mmol/L) glucose media and different times, HGMCs lysates were collected and the expression of p21, fibronectin and laminin was examined by Western blot. The secretion of fibronectin and laminin by HGMCs in supernatants of culture media was also detected with EOSA. Results High glucose media significantly stimulated the expression of p21, increased the syntheses and secretion of fibronectin and laminin in cultured HGMCs in a time-dependent manner. Transfection of HGMCs with p21 ASODN not only decreased p21 protein level caused by high glucose media, but also attenuated the expression and secretion of fibronectin and laminin in supematants of HGMCs lysates and culture media. Meanwhile, SCODN had no significant effects on the expression of p21, fibronectin and laminin. Conclusions High glucose promotes the expression of p21 , fibronectin and laminin in cultured HGMCs. Transfection of HGMCs with p21 ASODN can decrease p21 protein level caused by high glucose media, and attenuate the expression of fibronectin and laminin in supematants of HGMCs lysates and culture media. Modulation of p21 expression in HGMCs may work as an effective way to mitigate the progression of diabetic nephropathy.

Objective To study the effects of simvastatin on proliferation and apoptosis in rat mesangial cells in vitro, and to investigate the signal pathways involved in apoptosis induced by simvastatin. Methods Cultured mesangial cells were treated with simvastatin. Proliferation of mesangial cells was examined by MTT assay. Simvastatin-treated apoptotic mesangial cells were observed by electron microscopy. Propidium iodide (PI) staining and flow cytometry were employed for quantitative measurement of apoptosis. Caspase-3 activation was determined by CaspGLOW Green Caspase-3 Staining Kit. Results (1)Simvastatin significantly inhibited proliferation of mesangial cells compared with control (P