ObjectiveTo learn the clinical characteristics of concurrent acute-on-chronic liver failure (ACLF) and hepatorenal syndrome (HRS), and to investigate the predictive factors for HRS in patients with ACLF. MethodsA total of 806 patients with ACLF who were admitted to our hospital from January 2012 to May 2014 were selected and divided into two groups according to the incidence of concurrent HRS. Clinical indices and laboratory test results were analyzed in the two groups, and the multivariate logistic regression analysis was used to figure out independent indices for the prediction of HRS in patients with ACLF. A prediction model was established and the receiver operating characteristic curve was drawn to evaluate the accuracy of the prediction model. Comparison of continuous data between the two groups was made by t test, and comparison of categorical data between the two groups was made by χ2 test. ResultsIn all patients with ACLF, 229 had HRS and 577 had no HRS. The univariate logistic regression analysis showed that hepatic encephalopathy, peritonitis, infection, age, cystatin C (Cys-C), serum creatinine (SCr), blood urea nitrogen, albumin, prealbumin, total bilirubin, direct bilirubin, total cholesterol, K+, Na+, phosphorus, Ca2+, prothrombin time, prothrombin activity, international normalized ratio, and hematocrit were significant predictive factors for HRS. The multivariate logistic regression analysis showed that concurrent peritonitis, Cys-C, SCr, and HCO3- were independent predictive factors for HRS in patients with ACLF (OR=3.155, P＜0.01; OR=30.773, P＜0.01; OR=1062, P＜0.01; OR=0.915, P＜0.05). The model was proved of great value in prediction. ConclusionConcurrent peritonitis, Cys-C, SCr, and HCO3- are effective predictive factors for HRS in patients with ACLF.

AIM:To explore the effects of decorin on procollagen type I (PcI), mRNA expression,collagen type I synthesis and proliferation of synovial type B cells of stiff knee joint synovial membrane.METHODS:Type B cells of synovial membrane were isolated from the stiff knee joint synovial membrane and cultured in vitro.The cells were treated with decorin at concentrations of 0.1 mg/L, 5 mg/L and 10 mg/L.After cultured for 24 h, 48 h and 72 h, the cell proli-feration rates were measured by MTT colorimetric determination.Cell cycle distribution and apoptosis were analyzed by flow cytometry.The mRNA level of Pc I was detected by RT-PCR, while collagen type I was measured by Western blot.RE-SULTS:The proliferation of synovial type B cells was significantly inhibited, the percentage of synovial type B cells at G1 phase was significantly increased by 5 mg/L and 10 mg/L decorin (P<0.05), and PcⅠmRNA expression and collagen type I synthesis were significantly decreased.The cells with late apoptosis were not found in control group and experimental groups.CONCLUSION:Recombinant human decorin inhibits synovial type B cell proliferation and decreases PcⅠmRNA expression and collagen type I synthesis in synovial type B cells of stiff knee joint synovial membrane in vitro, suggesting that decorin potentially contributes to the therapy of human knee stiffness.

Objective To investigate the prevalence of plasmid-mediated quinolone resistance(PMQR) in Proteus mirabilis clinical isolated from urine. Methods Antimicrobial susceptibility test was performed using the microdilution method.And PMQR gene qnrA,qnrB,qnrC,qnrD,qnrS,aac(6′)-Ib-cr,qepA were amplified by PCR,then the PCR positive products were sequenced to identify their genotypes. Results In 41 strains of Proteus mirabilis from urine,the resistant rates to ciprofloxacin and levofloxacin were 41.5% and 29.3%,respec-tively.Among all clinical isolates,qnrA1 gene was detected in 2 strains,qnrB2 gene in 3 strains.PMQR gene qn-rB,qnrC,qnrD,qnrS,aac(6')-Ib-cr and qepA were not detected in all strains.Conclusions Clinical isolates of Proteus mirabilis from urine carry PMQR genes.The prevalent principal genotypes are qnrA1 and qnrB2 in these iso-lates.They are related to low levels resistance toquinolone.