Melanoma inhibitory activity protein(MIA),also referred to as cartilage-derived retinoic acid-sensitive protein(CD-RAP),is expressed not only in malignant melanoma,but also in chondrocytes.MIA/CD-RAP act as a biological marker for the evaluation of the status of cartilage in the study of cartilage destruction.This article reviews the biochemistry,construction,physiological function of MIA/CD-RAP in cartilage destruction and the research progress in these aspects.

Perioperative stroke refers to acute ischemic or hemorrhagic stroke that occurs before operation,during operation and within 30 days after operation.Although the levels of anesthesia and surgical treatment have improved in recent years,there is no significant decrease in the incidence of perioperative stroke.The traditional vascular risk factors,such as advanced age,hypertension,and diabetes,are also the risk factors for stroke onset.In addition,perioperative stroke is closely associated with the operation site,operation mode,anesthesia,and other perioperative events.The treatment and prevention of perioperative stroke is attracting more and more attention,including surgery,anesthesia,neurology and other clinicians.This article reviews the risk assessment,prevention,and treatment of perioperative stroke.

One hundred and two pregnant women with obstructive sleep apnea hypopnea syndrome (OSAHS) and 36 healthy pregnant women( control group)were enrolled in the study.Serum visfatin and macrophage migration inhibitory factor (MIF) levels were detected by enzyme linked immunosorbent assay (ELISA).The results showed that apnea-hypopnea index (AHI),mean arterial pressure(MAP),serum visfatin and MIF levels in pregnant women with OSAHS were significantly higher than those of controls ( all P＜ 0.01 ). In pregnant women,AHI,serum visfatin and MIF levels of patients having OSAHS with hypertension were significantly higher than those of patients with OSAHS only (all P ＜ 0.01 ).Patients with severe OSAHS had higher levels of visfatin and MIF than those with moderate OSAHS,and patients with moderate OSAHS had higher visfatin and MIF levels than those with mild OSAHS ( P ＜0.01 ).The AHI was significantly correlated with MAP,serum levels of MIF and visfatin ( r =0.75,0.71,0.68,respectively,all P ＜0.01 ) in pregnant women with OSAHS.

Objective Rapamycin (RAPA) is an anti-proliferative immunosuppressant and has been used to suppress rejection of transplanted organs. In present study, we observed the effect of rapamycin on epithelial-myofibroblast transition (EMT)of cultured HKC cells in vitro. Methods Cultured human proximal tubular epithelial cells (HKCs) were divided into three groups: blank control, treated with TGF-?1 (1 ?g/L) and treated with TGF-?1 (1 ?g/L) plus rapamycin (0.1, 1, 10, 100 ?g/L). The protein and mRNA for ?-SMA and E-cadherin in HKC cells were determined by Western Blot and RT-PCR.The mRNA level of Snail in HKC was detected by RT-PCR. Results Rapamycin dramatically abrogated TGF-?1 induced ?-SMA expression and restored E-cadherin expressionin HKC cells in a dose-dependent manner. At a concentration of 100 ?g/L, rapamycin almost completely blocked ?-SMA mRNA and protein expression induced by TGF-?1(1 ?g/L). Rapamycin also suppressed expression of ?-SMA in HKC cells at both mRNA and protein level in a time dependent manner.We also found rapamycin dramatically abrogated TGF-?1 induced Snail mRNA expression in HKC cells in a dose-dependent manner. Conclusion Rapamycin may inhibit EMT of tubular cells in vitro. The downregulation of Snail expression might be one of the mechanisms of rapamycin blocking EMT.

Objective To investigate the change of renal tubular function in elderly patients after use of β lactam antibiotic. Methods The elderly patients with pulmonary infection were treated with β lactam antibiotic,the dosage was 50%-70% of normal use. The renal tubular function indicated by urine α1-MG, β2-MG, pro/Cre, NAG/Cre and glomerulus function marked by eGFR, serum creatinine (Cre)), cystatin C were detected during drugs treatment and 7 days after stopping medications. Results The infection was controlled well in 3-7 days after treatment. Urine α1-MG, β2-MG, pro/Cre and NAG/Cre were abnormal before treatment, were elevated in 3, 14 days after using antibiotic, and came down to the level before treatment on 7 days after stopping treatment. The level of Cre and eGFR was (89.0±25.97) μmol/L and (26.39±8.17) ml/min before treatment, then elevated and decreased in 14 days after treatment, respectively, and down to the level before treatment on 7 days after stopping of antibiotic. Cystatin c was abnormal before treatment and did not change significantly after treatment and after stopping antibiotic. Conclusions It is important to protect renal tubular function and to adjust antibiotic dosage according to eGFR during using antibiotic in elderly patients to control infection.

Objective To evaluate the clinical effect of surgical operation for recovering the function of ulnar nerve with large segment defect. Methods Twentycases with the large segment defect of ulnar nerve were retrospectively analyzed from September 1999 to December 2006 in the hospital.All the patients were treated by the operation of nerve end-to-side neurorrhaphy . The broken end of ulnar nerve was anastomosed with the median nerve. And observed the recovery of the sensation and motion function of the little finger, interosseous muscles and claw hand, then compared with before. Results All cases were followed up for 8 to 36 months. The mean was 16 months. The sensation and motion function of the little fingers had better restoration after operation. No incision infection, anchylosis or myatrophy was occurred.Excellent(M4 + S4 +) ,Good (M3S3), moderate (M2S2), and poor effects (M1S1) were achieved respectively in 6, 4,2 and 0 cases based on the scale of XU' s grading standard.The excellent and good rate was 83.3%. Conclusion The nerve end-to-side neurorrhaphy was a effective treatment for the patients with large segment defect of ulnar nerve.

Objective To summarize the age-related changes and the risk factors of renal tubular function in the elderly male cases.Methods Totally 229 cases without chronic kidney disease were divided into two groups:group aged ＜80 years and group aged ≥80 years.We measured the urine routine,serum creatine,serum urea,urine β2-microglobin (β2-MG),urine α1-microglobin (α1-MG)and calculated the eGFR based on Cockcroft-Gault equation.Logistic regression was used to analyze the risk factors which may accelerate the progression of the renal tubular impairment.Results The average age of 229 cases was (76±10)years.There were 142 cases in the group of ＜80 years old and 87 cases in the group of ≥80 years old.The level of eGFR in the group of ≥80 years old was (55.0±12.7) ml/min,which was lower than that of the group of ＜ 80 years old (80.3 ± 18.0 ml/min) (t =9.882,P＜0.01).The level of urine SG was decreased in the group of ≥80 years old versus in the group of ＜80 years old(1.016±0.006 vs.1.013±0.006).The value changes of urine pH,urine β2-MG and urine α1-MG were of statistical differences between the two groups [(6.2±0.8) vs.(6.6±0.8),(0.96±1.02)mg/L vs.(2.08 ±3.56)mg/L,(6.67±3.57) mg/L vs.(8.71±6.59)mg/L].The correlation analysis showed that age correlated negatively with eGFR and urine SG(r =-0.692and r=-0.280,both P＜0.01)and positively with urine pH(r=0.255),urine β2 MG(r=0.262),urine α1-MG(r=0.228)(all P＜0.01).The Logistic regression analysis showed that coronary heart disease was an independent risk factor for the progression of renal tubular impairment (OR=4.251,P=0.002).Conclusions Renal tubular functions is decreased with ageing age in the elderly male,especially in the advanced elderly.The coronary heart disease is an independent risk factor of the progression of renal tubular impairment.

Objective To investigate the protective effect and mechanism of taurine on the cytotoxicity of iohexol on HK-2 cells. Methods HK-2 cells were exposed to iohexol at different dosage (25, 50, 100, 125 gI/L) for 6 h and at the dose of 100 gl/L for different time(2 h, 4 h, 6 h). Then taurine (3,12,24 mmol/L) was coincubated with iohexol (100 gI/L) for 6 h.Cell viability was assessed by CCK-8 assay. Cell apoptosis was determined by Hoechest 33342 flurescence stains,flow cytometry with Annexin V-FITC/PI double stains and caspase-3 activity by colorimetric assay. Bcl-2 and Bax expression were examined by Western blot. Intracellular ROS was detected by flow cytometry with fluorescent probe DCFH-DA. Results Iohexol decreased HK-2 cell viability and induced apoptosis in concentration-dependant and time-dependant manner (all P＜0.05). ROS was increased following iohexol (100 gI/L for 6 h) treatment (P＜0.05). Taurine increased cell viability and attenuated apoptosis in dose-dependant manner. The cell viability levels in taurine intervention (3,12,24 mmol/L) group were significantly increased compared with that in iohexol treated group respectively [(88.00±1.00)%, (91.33±0.58)%, (95.67±1.52) % vs (76.67±1.53)%, all P＜0.05]. Apoptosis rate by flow cytometry were decreased respectively [(8.84±1.75)%,(7.86±1.82)%, (6.30±1.50)% vs (11.98±0.39)%, all P＜0.05]. Caspase-3 activities were decreased respectively [(1.33±0.10), (1.27±0.06), (1.10±0.04) vs (1.42±0.13), all P＜0.05].Taurine up-regulated the expression of Bcl-2, and decreased the intracellular ROS (all P＜0.05).Conclusions Iohexol induces cell apoptosis and oxidative stress. Taurine attenuates direct cytotoxic effect induced by iohexol. The anti-oxidative stress effect and up-regulated Bcl-2 expression may partly account for the protection of taurine.

Objective To investigate the clinical characteristics and laboratory examinations in incident dialysis effect on the prognosis of elderly patients undergoing hemodialysis.Methods Ninety-three patients aged 65 years or older initiating hemodialysis were enrolled from Hemadialysis Center of Beijing Hospital from January lst,2007 to June 30th,2016.The duration time of HD of all patients was more than three months.Patients were divided into death group and non-death group.The clinical characteristics and laboratory examinations were compared between the two groups.Cox proportional hazards regression was used for the multivariate analysis to determine independent prognosis factors.Results The average year of patients was 74.2±6.5 years old with 43 months of median time of follow-up.The first two causes of death were infection (n =25,49.0％) and cardiovascular and cerebrovascular diseases (n =16,31.4％).Cox single factor regression analysis showed that the older ages,diabetic nephropathy being the cause of end-stage renal disease (ESRD),complicating with diabetes mellitus or congestive heart failure,the higher Charlson cardiovascular diseases score,ALB being under 35 g/L were correlated with poor outcome respectively(P＜0.05).Cox multivariate regression analysis indicated that older ages (HR =1.056,P =0.021),diabetic nephropathy being the cause of ESRD (HR =2.661,P =0.001),the higher Charlson cardiovascular diseases score (HR =1.675,P =0.010),central venous catheters being vascular access(HR=1.167,P=0.048) on incident dialysis were the main risk factors for mortality in elderly patients.Conclusion The older ages,diabetic nephropathy being the cause of ESRD,the higher Charlson cardiovascular diseases score,central venous catheters being vascular access on incident dialysis are independent risk factors influencing survival of elderly patients.

Objective:To analyze the association of clinical characteristics and laboratory indicators at initial maintenance hemodialysis(MHD)with long-term prognosis in advance-aged patients, and to find influencing factors for the prognosis in advance-aged MHD patients.Methods:This retrospective study was conducted at the Nephrology Department of Beijing Hospital between April 2007 and January 2018.A total of 61 patients receiving first-time hemodialysis at ≥ 80 years of age and undergone regular dialysis for 3 months or longer were enrolled.All patients were followed-up until death or the end of July 1, 2018.Patients were divided into the survivor and non-survivor groups, and differences in clinical characteristics and laboratory indicator values were compared between the two groups.Influencing factors for prognosis in advance-aged MHD patients were analyzed by using multivariate Cox regression.Results:For the 61 subjects, the median follow-up time was 25.8 months.During the follow-up, 32 patients died(52.5%). The main death causes were infectious diseases(40.6%, n=13)and cardiovascular and cerebrovascular diseases(37.5%, n=12). The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 75.4%(46/61), 54.1%(33/61), 37.7%(23/61), 22.9%(14/61)and 16.4%(10/61), respectively.The median survival time was 25.8 months for all patients, 27.5 months for patients aged 80-84 years, and 14.9 months for patients aged 85 years and over.The non-survivor group had a higher male ratio(65.6% or 21/32 vs.37.9% or 11/29, χ2=4.678, P=0.031)and lower levels of hemoglobin(85.4±13.0 vs.95.0±17.6 g/L, t=2.867, P=0.019)and albumin(30.3±5.0 vs.34.6±4.8 g/L, t=3.039, P=0.001)than the survivor group.Kaplan-Meier curves indicated that the survival rate decreased with age, and subjects aged less than 85 years had a higher survival rate than subjects aged 85 years and older(the median survival time: 14.9 months vs.27.5 months, Log Rank P=0.006); patients who received continuous renal replacement therapy(CRRT)before dialysis had lower survival rates than patients who did not receive CRRT(the median survival time: 7.8 months vs.29.2 months, Log Rank P=0.002); patients with high serum levels of albumin(≥33 g/L)had higher survival rates than patients with low serum levels of albumin(<33 g/L)(the median survival time: 29.2 months vs.18.9 months, Log Rank P=0.003). Multivariate Cox regression analysis showed that age at initial dialysis( HR=1.136, 95% CI: 1.005-1.285, P=0.041), female( HR=0.409; 95% CI: 0.169-0.994, P=0.048), serum albumin level( HR=0.836, 95% CI: 0.772-0.906, P<0.001)and CRRT before dialysis( HR=6.161, 95% CI: 1.848-20.538, P=0.003)were independent predictors of all-cause mortality in advance-aged patients. Conclusions:Advance-aged patients undergoing hemodialysis have complicated clinical conditions and poor prognosis.Age, gender and serum albumin level at initial dialysis and CRRT before dialysis are independent predictors of prognosis in these patients.