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.

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 explore the relationship between the different body mass index (BMI) ranges and all cause mortality in hemodialysis (HD) patients. MethodsEligible studies assessing the effects of BMI ranges on all-cause mortality(published from 1966 to 2012 )were searched, using hemodialysis/haemodialysis and obese/body mass index/overweight andmortality/surwival/reverse epidemiology/obesity paradox in PubMed,Embase,ScienceDirect,Wilcy,Scopus and Ovid. Inclusion criteria were that trials reported mortality in HD patients according to the traditional WHO/NIH BMI classification,and BMI levels were acceptable within 2 kg/m2.The quality of the trials was evaluated using the assessing risk of bias in studies included in Cochrane reviews.The mortality rate in HD patients was the primary endpoint of the study.ResultsWith no significant heterogeneity ( I2 =0％,P =0.45 ),a fixed-effects model was used for analysis.Four studies with a total of 81 423 patients met final inclusion criteria.Compared to individuals with non-elevated BMI levels,the elevated group (BMI ≥25 kg/m2) was associated with lower all-cause mortality ( OR 0.67,95％ CI 0.65-0.68 ). In a risk-adjusted sensitivity analysis,elevated BMI levels remained protective against mortality( adjusted HR 0.94,95％ CI 0.92-0.96 ).ConclusionsHigh BMI levels are associated with lower all-cause mortality rate in HD patients.More stable hemodynamic status,cytokine and neurohormonal alternations,and nutritional status maybe contribute to the protective effects of BMI on the mortality of HD patients.There is a need for more prospective studies to elucidate underlying mechanisms.

Objective: To investigate the awareness of monkeypox prevention knowledge and its influencing factors among inbound personnel, so as to provide insights into intensified health education for monkeypox prevention and control. Methods: Inbound personnel at ages of 16 years and older were sampled using a convenient sampling method from centralized medical isolation observation points in Gongshu District, Hangzhou City in November and December 2022. Participants' demographic features, history of travel in countries where monkeypox cases were reported and awareness of monkeypox prevention knowledge were collected through questionnaire surveys, and factors affecting the awareness of monkeypox prevention knowledge were identified using a multivariable logistic regression model. Results: A total of 306 questionnaires were allocated, and 293 valid questionnaires were recovered, with an effective response rate of 95.75%. The respondents included 192 men (65.53%) and 101 women (34.47%), and hand a median (interquartile range) age of 36 (16) years. The overall awareness of monkeypox prevention knowledge was 44.71%, and the awareness rates of preventive measures, source of infection, transmission route, susceptible populations and clinical manifestations were 82.94%, 79.18%, 75.09%, 60.75% and 60.07%, respectively. Multivariable logistic regression analysis showed that workers (OR=0.179, 95%CI: 0.040-0.800), self-employed individuals (OR=0.090, 95%CI: 0.018-0.451), and those with other occupations (OR=0.157, 95%CI: 0.034-0.728) had lower awareness of monkeypox prevention knowledge than students, and individuals who had never heard of monkeypox (OR=0.056, 95%CI: 0.007-0.447) had lower awareness of monkeypox prevention knowledge than those who had heard of it. In addition, individuals who were not concerned about monkeypox epidemics (OR=0.048, 95%CI: 0.004-0.563) had lower awareness than those who were very concerned. Conclusions Inbound personnel have low awareness of monkeypox prevention knowledge, and occupation, having heard of monkeypox and concern about monkeypox epidemics may affect the awareness of monkeypox prevention knowledge. Intensified health education about monkeypox is required to improve the preventive awareness among inbound personnel.

Objective To investigate the effects of hepatitis B virus X (HBX) gene on cell morphology and transdifferentiation of human proximal tubular epithelial cells.Methods The eukaryotic vector pcDNA3.1-myc-HBX containing HBX gene was transiently transfected into HK-2 cells by lipofectamine mediation.The expression of HBX was confirmed by Q-PCR and Western blotting.Untransfected HK-2 cells and those transfected with empty vector were used as control.The morphology of HK-2 cells was observed by microscopy,the expressions of differentiation marker proteins α-SMA and E-cadherin were detected by Western blotting and Q-PCR,and the contents of IL-1,IL-6 and TNF-α in the supernatant were detected by ELISA assay.Results HBX was successfully expressed in HK-2 cells after transfection.After transfection of HBX gene,the shape of HK-2 cells became irregular,HK-2 cells significantly expressed E-cadherin and α-SMA,and had high levels of IL-1,IL-6 and TNF-α in the cell supernatant (P＜0.01).Conclusion Overexpression of HBX gene in renal tubular epithelial cells may damage cell morphology and promote the occurrence of epithelial-mesenchymal transdifferentiation,which may be related to the inflammatory microenvironment.

Multidrug resistance (MDR) is the main obstacle for cancer to cure,failure of chemotherapy and relapse.Cancer stem cells (CSCs) are driven force for tumorigenesis,the evolution of metastasis and recurrence,and the most fundamental reason for cancer drug-resistance.The primary drug resistance mechanism includes:ABC transporters strengthening CSCs drug resistance,high level expression of the anti-apoptotic genes,DNA repair capacity enhancement and hypoxic niches,and so on.To study CSCs biological characteristics and clarify the resistance molecular mechanisms,and to develop a targeted therapy for CSCs,and then to overcome and reverse the multidrug resistance of CSC,will enhance cancer cure rate and reduce the relapse rate.

Objective To investigate the effect of hepatitis B virus X (HBX) gene on apoptosis and immune molecules of human proximal renal tubular epithelial cell line (HK-2).Methods The eukaryotic vector pcDNA3.1-myc-HBX containing HBX gene was transiently transfected into HK-2 cells by lipofectamine mediation.Untransfected HK-2 cells and those transfected with empty vector were used as controls.The TLR4 expression was detected by real-time PCR and Western blotting.The apoptosis of cells and expression of MHC-Ⅱ and CD40 were detected by flow cytometry,and the contents of IL-4 and IFN-γ in the supernatant were detected by EIISA.Results Compared with control groups,the number of apoptotic cells was significantly increased in the HBX transfection group (P ＜ 0.05),and the expressions of TLR4,MHC-Ⅱ and CD40 were also significantly increased in the HBX transfection group (all P＜0.05).IFN-γ level in the supernatant of HBX transfection group was higher (P ＜ 0.05),but IL-4 level was lower as compared to control groups (all P ＜ 0.05).Conclusions Over-expression of HBX gene may induce apoptosis of HK-2 cells and upregulate the expression of immune molecules of renal tubular epithelial cells leading to injury of cells and dysfunction of immunomicroenviroment.

Objective To investigate the expression of Delta-like 4 (DLL4) in pancreatic cancer and its clinical significance.Methods The expression of DLL4 in pancreatic cancer was examined by immunohistochemistry method.The microvessel density (MVD) was calculated after CD34 staining specifically for microvessel endothelium; and their correlations and relationship between them and clinicopathological parameters as well as prognosis of pancreatic carcinoma was investigated.Results The expression of DLL4 in pancreatic cancer was significantly higher than that in normal pancreatic tissue (68.3％ vs 20％,P ＜ 0.01).The over-expression of DLL4 in pancreatic cancer was related to degree of differentiation,TNM staging,lymph node metastasis and invasion depth,while not related to the size,location and histological types.The MVD in pancreatic cancer tissues was notably higher than that in normal tissues (34.9 ± 13.2 vs 18.9 ± 2.2,P ＜0.01).MVD was correlated to degree of differentiation,lymph node metastasis,but not related to the size,location and histological types.DLL4 expression was closely associated with prognosis.COX model analysis showed that TNM staging and DLL4 expression were independent prognostic factors for pancreatic cancer.Conclusions The over-expressions of DLL4 may play an important role in metastasis and invasion of pancreatic cancer.Expression of DLL4 and TNM staging is useful for predicting the prognosis of patients with pancreatic cancer.

Objectives To investigate the role and mechanism of p38 mitogerra activated protein kinase (p38MAPK) in up-regulation of prostanoid 2 induced by uric acid in rat glomerular mesangial cells (GMCs).Methods Rat glomerular mesangial cells were cultured in vitro,then stimulated with different concentrations of uric acid (50,100,300 μmol/L),or stimulated with different concentrations of uric acid (50,100,300 μmol/L) after pretreatment with p38MAPK specific inhibitor SC68376 (10 μmol/L) for 30 min.Activated p38MAPK was detected by Western blotting.The expression of prostanoid 2 was measured by ELISA.Cyclooxygenase-2 mRNA expression was determined by RT-PCR.Results Uric acid could activate p38MAPK and up-regulate the mRNA expressions of prostanoid 2 and cyclooxygenase-2 in rat glomerular mesangial cells (all P ＜ 0.05).SC68376 inhibited those effects of the above-described induced by uric acid.Conclusion Uric acid can promote the expression of prostanoid 2 in rat glomerular mesangial cells,whose mechanism may be related to the activation of p38MAPK and the promotion of cyclooxygenase-2 synthesis,and further up-regulation of prostanoid 2 expression.

Six organic compounds were isolated from the marine sponge Topsentia sp. collected from the South China Sea. Their chemical structures were identified by 1H-NMR, 13C-NMR,IR,MS and GC-MS as cholesterol(Ⅰ); 24-ethylidenecholest-5-en-3?-ol(Ⅱ); phenylacetic acid(Ⅲ); 4-hydroxybenzaldehyde(Ⅳ);indole-3-carboxaldehyde(Ⅴ); thymine(Ⅵ).