Objective To explore the role of hemoglobin (Hb) level in mortality and morbidity of chronic kidney disease (CKD)patients,aiming to give some evidence for therapy of anemia.Methods Randomized,clinical trials (RCTs) were identified by searching Medline,Embase and the Cochrane library.All the analyses were performed using the Revman software available free from the Cochrane collaboration.Results Twenty-three trials involving 10 204 patients were identified.Overall,the high Hb target was associated with increased risk of all-cause mortality (RR=1.10,95％ CI 1.00 to 1.21),hypertension (RR=1.40,95％ CI 1.12 to 1.75),stroke and hospitalization (RR=1.07,95％ CI 1.00 to 1.14) compared with low Hb target (P＜0.05).No significant difference was found in the risks of non-fatal mycardial infarction (RR=1.13,95％ CI 0.79 to 1.62) and renal replacement therapy (RR =1.00,95％ CI 0.85 to 1.18).Conclusions Targeting low Hb target is beneficial to CKD patients based on reduced risk of hypertension,hospitalization,stroke and all-cause mortality.However,no significant difference is found in non-fatal mycardial infarction and renal replacement therapy.

ObjectiveTo assess the effects of short-term (2-7 d) high-dose (80 mg/d) statins in the prevention of contrast-induced nephropathy ( CIN).MethodsWe searched PubMed, Embase,ScienceDirect,Scopus,Ovid andWileyInterScience with the key wordsof “ statins/statin/HMG-CoA reductaseinhibitor” ,“contrast ” and“ nephropathy/nephrosis/nephrotoxicity/kidneyfailure”inall languages from 1996 t0 2010 for RCT that assessed the preventive effect of short-term (2-7 d)high-dose( 80 mg/d) statins on CIN.ResultsFive trials with a total of 1009 patients were identifiedTwo studies were conducted in patients with CKD 3-5 stages ( GFR≤60 ml/min or serum creatinine≥97.2 μmol/L) and the remaining 3 studies were conducted in patients with CKD l and 2 stages.Analysis of the data in patients with CKD 3-5 stages did not reveal a statistically significant difference in CIN incidence between the statins and placebo groups (6.50％vs 7.2％ ).The relative risk ( RR)was 0.89 without evidence of heterogeneity (12 =Oqo,P=O.79).Analysis of the data in patients with CKD I and 2 stages revealed a significantly lower CIN incidence in the statins group( 3.60-/o )than that in the placebo group( 11.9％ ).The RR was 0.28 without evidence of heterogeneity( I2=0%, P =0.87 ). Conclusion Short-termhigh-dosestatins treatment may be benefical in reducing the incidence of CIN in patients with CKD l and 2 stages,while nobenefit has been shown in the patients with CKD 3-5 stages.

?AlM: To analyze the quantitative changes of anterior segment by Pentacam anterior segment system and to evaluate the safety and effectiveness after implantable collamer lens ( lCL) implantation for high myopia.
?METHODS:Twenty- one patients with 39 eyes were implanted lCL in our hospital from September 2011 to February 2013. The follow-up was 6 ~ 12mo. Central anterior chamber depth ( ACD ) , anterior chamber angle ( ACA) , anterior chamber volume ( ACV) were measured by Pentacam preoperatively, 1wk, 1 and 6mo postoperatively. The distance between crystal lens and lOL ( lCL- vault ) were measured at 1wk, 1 and 6mo postoperatively. Preoperative uncollected visual activity ( pre - UCVA ) , best corrected visual acuity ( BCVA ) , postoperative uncorrected visual acuity ( post-UCVA) and intraocular pressure ( lOP) were recorded. The paired t-test was used to access the data preoperatively and postoperatively in the statistical way by using SPSS 18. 0 statistical software.
? RESULTS: Preoperatively, at 1wk, 1 and 6mo postoperatively, ACD were 3. 27±0. 22, 3. 02±0. 33, 2. 98±0. 31, and 2. 98±0. 32mm. ACA were (40. 39±5. 40)o, (26. 70±4. 47)o, (26. 96±4. 48)o, and (26. 95±4. 45)o. ACV were 207. 74±25. 43, 122. 87±17. 58, 128. 05±17. 84, and 128. 64±17. 50mm3 , respectively. There were statistically significant differences between preoperative and postoperative data in ACD, ACA, ACV (P<0. 05). The distances between crystal lens and lOL ( lCL-vault) were 0. 49±0. 13, 0. 46±0. 13, and 0. 46±0. 14 at 1wk, 1 and 6mo postoperatively. There were statistically significant difference between 1wk and the others (P<0. 05). There were statistically significant different between the preoperative BCVA and postoperative BCVA(P<0. 05). There was no contact between lOL and the crystal len. The anterior chamber angle was all open. There were no serious complications such as cataract, glaucoma, cystoid macular edema, retinal detachment, etc.
?CONCLUSlON:ACD, ACA, ACV by Pentacam anterior segment system are found to be decreased after the operation, but there is still a relative safe distance between lOL and the crystal len. lCL implantation is a safe, efficacy method in correcting high myopia, but the long-term effects will require further observation.

Objective To investigate the correlation between the NADPH oxidase p22phox-A930G polymorphism and hypertensive intracerebral hemorrhage in Chinese Han population in Shanghai area.Methods The patients with hypertensive intracerebral hemorrhage and normal controls were enrolled.The polymerase chain reaction and the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to detect the genotypes and alleles of NADPH oxidase p22phox-A930G.Results A total of 128 patients with hypertensive intracerebral hemorrhage and 151 healthy controls were enrolled.The levels of systolic blood pressure,diastolic blood pressure,glucose,and triacylglycerol,as well as the proportions of smoking and alcohol consumption in patients of the hypertensive intracerebral hemorrhage group were significantly higher than those of the control group (all P＜ 0.05).There were significant differences in AA,AG,and GG genotypes (42.2％,44.5％,and 13.3％ vs.63.6％,27.8％,and 8.6％,x2 =12.757,P =0.002) and in A and G allele (64.5％ and 35.5％ vs.77.5％ and 22.5％ ;x2 =8.734,P=0.001) frequencies between the hypertensive intracerebral hemorrhage group and the control group.Multivariatelogistic regression analysis showed that systolic blood pressure ≥ 140 mm Hg (1 mm Hg =0.133 kPa) (odds ratio [OR] 13.952,95％ confidence interval [CI] 7.242-26.879; P ＜ 0.001),apolipoprotein A ≥ 0.99 mmol/L (OR 3.139,95％ CI 1.012-9.733; P =0.048),and AG +GG genotype (OR 2.333,95％ CI 1.253-4.342; P=0.008) were the independent risk factors for hypertensive intracerebral hemorrhage.Conclusions Among the Chinese Han population in Shanghai area,the NADPH oxidase p22phox-A930G polymorphism is an independent risk factor for hypertensive intracerebral hemorrhage.

Circulating tumor cells (CTCs) play pivotal roles for monitoring the tumor metastasis and prognosis.The nanotechnology provides a favourable platform for CTCs detection,and enables CTCs to be more promising for practical application.Meanwhile,the nanoscale device by virtue of nanotechnology has broad application prospects in eliminating CTCs and offers a new direction in the field of anti-cancer.

Objective To explore the effect of different arch forms of maxillary models on stress distribution of peri-implant of All-on-4 implants with 3-dimensional finite element, and to provide evidence for the improvement of implant achievement ratio in clinic. Methods 3-dimensional finite element analysis models of Tapered,Square and Ovoid arch form maxillary based on the MBTTM Arch Form Templates were constructed by using Solidworks software.The cortical bone thickness was defined as 2 mm at all points.The implants with 13 mm in length were inserted between the mental foramina.The 2 posterior implants were set at 4 inclination angle,from 0°to 45°.All implants were splinted with superstructure.A 100 N pressure was applied to 2 kinds of loading positions on the superstructure models. The maximum Von-Mises stress on cortical bone around the implants was measured by using Abaqus software.Results The maximum Von-Mises value in maxillary cortical bone with All-on-4 implants in 3 arch forms showed significant differences. In Square model the concentration of stress was advanced with the increasing of implant inclination angle;In Ovoid model, the maximum Von-Mises value was observed at 1 5°in posterior region,and was increased significantly by pasted 15°in anterior region;In Tapered model,the Maximum Von-Mises value was increased greatly at 45°. Conclusion Arch forms have appreciable impact on stress distribution of peri-implant.In Square arch form,the inclination of implant should be avoided;in Ovoid arch form, the inclination angle should be under 15°;in Tapered arch form,the inclination should be under 30°.

PNAS-4 is a novel pro-apoptosis gene identified latetly. In recent years, there has been a large number of research reports on the basic studies about PNAS-4 in cancer gene therapy and gene therapy of PNAS-4 alone or combined with chemotherapy or radiotherapy manifested a good application prospect, but its molecular mechanisms to promote apoptosis is not clear yet. In this paper, recent research about PNAS-4 in cancer gene therapy is briefly reviewed, and recent hypotheses on its molecular mechanisms to promote apoptosis are especially elucidated. Based on its newly identified characteristics of structural domain, we made a point that PNAS-4 might regulate functions of some target protein related to apoptosis by deSumoylation as a new deSumoylating isopeptidase, and consequently promote apoptosis.
Apoptosis ; Apoptosis Regulatory Proteins ; genetics ; Genetic Therapy ; Humans ; Neoplasms ; therapy ; Sumoylation

The lipoprotein-associated phospholipase A2 (Lp-PLA2), a subtype of the phospholipase A2 superfamily, is produced primarily by macrophages and lymphocytes. Lp-PLA2specifically hydrolyzes oxidized phospholipids on oxidized low-density lipoprotein particles,resulting in production of lysophosphatidylcholine and oxidized fatty acids. Lp-PLA2 is expressed in atherosclerotic plaques and in macrophages within a fibrous cap of unstable plaque.Studies haw shown that the plasma Lp-PLA2 activity increases significantly in patients with ischemic stroke, and Lp-PLA2 may become an independent risk factor for predicting ischemic cerebrovascular events. The selective Lp-PLA2 inhibitor can reduce the inflammatory response,enhance the stability of plaques, and inhibit the formation of atherosclerotic plaques, and may become a new class of drugs for preventing the formation of atherosclerotic plaques.

Objective　To observe the effects and explore the mechanism of orthopia by using viscoelastic substance (sodium hyaluronate)in adherent strabismus(AS).Methods　A total of 29 cases(33 eyes)of AS which were caused by various factors were performed strabotomy,in which sodium hyaluronate was poured into cap tenon space and /or around ocular muscles in which preserved after operation.Ocular movement was requested in 12～24 hours post-operation lest ocular muscles adhered to other tissues again.The main index we observed were the effectiveness of strabotomy and ocular movement.Results　All 33 eyes achieved good results:17 eyes(51.5%) were cured,26 eyes(78.8%) obtained distinct improvement(DI). The operative results have reference to the cause of adherent strabismus,period of muscular adherence and visual function post-operation.No complications were found.Conclusion　 Our observation support that sodium hyaluronate can prevent ocular muscles from re-adhering to other tissues around after strabotomy.Most of the patients can obtain better effects by this viscoelastic therapy.

OBJECTIVE To analyze the risk factors of the Catheter-Related Blood Stream Infection(CRBSI) in the intensive care unit(ICU),and to approach effective methods for preventing the CRBSI in ICU.METHODS With the method of objective investigation,all patients in ICU from Jan,2008 to Dec,2008 were studied.The risk factors of CRBSI were investigated.RESULTS 257 patients entered the study.A total of 147 cases suffered from the nosocomial infection(NI).The incidence rate of the NI was 57.2%.Among these,36 cases were dignosised of the CRBSI,and the case-infection rate was 14.07%.The number of CRBSI account for 24.49% of the patients who suffered from the NI.The nosocomial infection rate perday the CRBSI was 16.57‰.It was significantly higher than that of the general wards′.The pathogen detection showed the main pathogen was the G+ bacteria,accounting for 54.04%.Then was the G-bacteria,accounting for 37.84%.The fungus accounted for 8.11%.11 unusual drug resistance bacteria were found(6 ESBLs positive bacteria and 5 MRS bacteria).CONCLUSIONS The incidence of the CRBSI is related to the following reasons: days and the sites of the catheter being placed,the procedure the medical personnel done,the immune function of the patients,and the utilization or unutilization of the high-nutrition drugs through the vein.According to these reasons,strict aseptic technique,reasonable choice of the catheter site,shortening the duration the catheter insertion,and maintaining catheter unobstructed are the keys to prevent the incidence of the CRBSI.