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.

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.

?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.

A simple, rapid and accurate method is described for the determination of icariin in Fuchun Tablets by reversed-phase high-efficiency liquid chromatography. The samples were first extracted with 70% alcohol for 50 minutes The resulting solutions were chromatographed on aYWG-C18 column.By using a mobile phase of methanoltetrahydrofuran-water (26.5:15.9:56.7) and a detection wavelength at 274 nm, the recovery for 101.02%, CV=2.4%,are obtained.The method can be employed for the quality control of Fuchun Tablets.

Objective To investigate the distribution and drug resistance of Chryseobacterium meningosepticum(CM)in our hospital.Methods The status of drug resistance of 73 strains of CM isolated from our hospital in the past 5 years was statistically analyzed.Metallo-β-lactamase producing isolates were screened by double-disk synergy test.Results The rate of metallo-β-laetamase producing Chryseobacterium meningosepticum(CM) accounted for 37.0%,which mainly distributed at intensive care unit(ICU).The resistant rates of CM clinical isolates to piperacillin/tazobactam,vancomycin and levofloxacin were 45.2%,40.6% and 28.5%,respectively.Conclusion CM displays multi-resistance to antibiotics.Antimicrobial agents should be selected rationally by clinicians according to antimicrobial susceptibility test results.

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.

Interventional radiology has lot of advantages in dealing with various emergencies. The technique is minimally-invasive,highly-effective and immediately-efficient,moreover,it integrates the diagnosis with the therapy perfectly. Besides,the interventional techniques applied in emergency medicine include not only the vascular interventions,such as embolization,embolectomy,etc,but also the nonvascular interventions,such as tracheal stent implantation,percutaneous vertebroplasty and so forth. However,importance has not been attached to the clinical use of interventional therapy in emergency medicine so far. It is imperative for us to promote the acceptance of interventional therapy in emergency medicine as well as to popularize the technique in clinical practice.

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°.