Objectives To investigate the risk factors of cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction (AMI).Methods The medical date of hospitalized patients with AMI from January,2013 to February,2014 in Hunan Provincial People~ Hospital were reviewed.A total of 265 patients with AMI was divided into CRS1 and non-CRS1 groups.The univariate comparison and multivariate Logistic regression analysis were performed to obtain the CRS1 risk factors.Results In the 265 AMI patients,CRS1 was found in 59 patients (22.3％).Age,history of diabetes,Killip classification,left ventricular ejection fraction (LVFF),baseline serum creatinine,blood urea nitrogen,uric acid,baseline evaluated glomerular filtration rate (eGFR),serum sodium,the left anterior descending artery lesion,emergency percutaneous coronary intervention (PCI),β-blocker,and angiotensin converting enzyme inhibitor/angiotensin receptor antagonist (ACEI/ARB) were statistically different between CRS1 and non-CRS1 groups (all P ＜ 0.05).Multivariate logistic regression showed that age,history of diabetes,Killip classification,reduced LVEF,reduced eGFR,hyponatremia,the left anterior descending artery lesionn,emergency PCI non-undergo,and β-blocker non-use were independent risk factors for CRS1 after AMI.Conclusions CRS1 is a common complication in AMI patients,which is associated with many factors.Our data suggest that patients with AMI should be more comprehensively assessed and monitored,thereby preventing the occurrence of CRS1.

Objective To investigate the role of nurses in civil cardiac death organ donation work.Methods Cooperating,propagating and promoting in civil cardiac death organ donation; building a bridge between the families of organ donation,donor coordinators,physicians and hospital ethics committees; participating in organ donation medical ethics assessment work; cooperating with the doctors do intend to maintain organ donation,access and preservation; protecting donors remains.Results During the time of July 2011 to November 2013,we successfully completed 52 cases of civil cardiac death organ donation cooperating with doctors,and got 41 liver,which entered the national organ allocation system for distribution.Conclusions The nurses will play a more and more important role in work of civil cardiac death organ donation cooperating with doctors.

Objective To investigate the correlation between the remnants of extrahepatic bilie duct with the prognosis of biliary atresia after Kasai operation.Methods From Sep.2005 to Sep.2011,93 cases of biliary atresia [51 boys and 42 girls,ages at operation:61 days(40-121 days)] in Tongji Hospital Affiliated of Tongji Medical College of Huazhong University of Science and Technology were operated with Kasai procedure,and the diagnosis of type Ⅲ biliary atresia was based on the cholangiography and the intraoperative findings.According to whether there was fibrotic remnant plates of porta hepatis or not,type Ⅲ biliary atresia cases were grouped into 2 subtypes:subtype A,in which there was fibrotic remnant plates of porta hepatis (n =80) ; subtype B,in which there was no fibrotic remnant plates,but solid cords structure like hepatic duct was observed(n =13).Specimens of the remnants were colleted in operation and pathologic section detected the degree of bile ductular proliferation in the remnants.Postoperatively,all of the patients were followed up.The contents included the cholangitis occurrence rate,the jaundice disappearance rate and survival rate during postoperative 2 years.Results The patients had more bile ductular proliferation in subtype A (x2 =18.49,P ＜0.05).There was no significant difference in incidence of cholangitis in postoperative 1 month between the 2 groups (x2 =0.01,P ＞ 0.05).The jaundice disappearance rate in postoperative 6 months of subtype A was higher than the rate of subtype B(x2 =9.19,P ＜ 0.05).The survival rate during postoperative 2 years of subtype A was higher than the rate of subtype B(x2 =4.49,P ＜ 0.05).Conclusions There are higher jaundice disappearance rate and 2 years survival rate in type Ⅲ biliary atresia with the fibrotic remnant plates of porta hepatis,which suggest that there is more bile ductular proliferation in the extrahepatic remnants which is good for biliary drainage in subtype A after Kasai operation,and it can slow down hepatic injury and have a long-term good life quality.

Background Tight junctions are thought to play a significant role in the maintenance of the corneal epithelial defense for the eye,and the restoration of the tight junctions is critical during epithelial wound healing after refractive surgery.However,there are few reports about this study. Objective The aim of this study was to investigate and compare the expression of occludin in corneal epithelium following flap-free epipolis laser insitu keratomileusis (Epi-LASIK) and laser-assisted subepithelial keratectomy ( LASEK ). Methods Forty-eight clean New Zealand white rabbits were randomized into 2 groups,and 24 rabbits for each group.Flap-free Epi-LASIK and LASEK were performed in the right eyes of the rabbits in two groups,and other 2 age matched normal rabbits were as normal controls.The animals were sacrificed and the corneal samples were obtained at 1,2,3,5 days after surgery.Immunofluorescence staining was used to detect the expression of occludin in the corneal epithelium,and RT-PCR was used to identify the level of occludin mRNA in the central cornea. Results Occludin protein was expressed innormal corneal epithelium and showed the green fluorescence with the regular arrangement.The fluorescence intensity was lower in 1 -2 days in LASEK group with the irregular arrangement;while the fluorescence signal in corneal epithelium was stronger in flap-free Epi-LASIK group.3-5 days after surgery,the fluorescence intensities were bothenhanced in two groups.RT-PCR showed that the relative expression of occludin mRNA in corneal epithelium was 0.11 ±0.02,0.25 ± 0.03,0.43 ± 0.04 in LASEK group 1,2,3 days after surgery,respectively,and was lower than those of flap-free Epi-LASIK group ( 0.20± 0.04,0.44 ± 0.04,0.76 ± 0.04 ),showing significant differences between these two groups ( t =6.476,12.898,17.315,P＜ 0.05 ).No significant difference was seen in the expression of occludin mRNA in 5 days after surgery between two groups( t=-0.733,P＞0.05).The relative values of occludin mRNA expression in corneal epithelium were gradually increased with time prolongation,presenting a significant difference among various time points ( Ftime =768.903,P =0.000). Conclusions The reformation of occludin in flap-free Epi-LASIK group is faster than that in LASEK group.Therefore,flap-free Epi-LASIK is prominant in reducing the stimulated symptoms and complication after the surgery.

Objective To investigate expression and significance of matrix metalloproteinase-2(MMP-2),MMP-9 and tissue inhibitor of metalloproteinase-1(TIMP-1) in rats with glomerular sclerosis made by doxorubicin.Methods Forty Wistar male rats(8-week-old) were randomly assigned into 2 groups:sham operated and model groups.Rats in model group were nephrectomized after anesthesia and injected with adriamycin(5 mg/kg) after 1 week.Rats in sham operated group was subjected to sham operation and injected with normal saline after 1 week through the tail vein.All rats were killed in the 12th week.Immuno-histochemistry was performed on renal tissue to detect Collagen Ⅳ(Col-Ⅳ),fibronectin(FN),MMP-2,-9 and TIMP-1.Results Immunohistochemistry staining indicated that expressions of MMP-2,-9 in model group decreased significantly compared to sham operated group(Pa

Objective To study the expression of ?-smooth muscle actin(?-SMA)in glomerulosclerosis rats and its relationship with renal function.Methods Forty healthy Wistar rats were equally divided into 2 groups including sham operated group and model control group.Rats in model groups were uninephrectomized and injected with daunorubicin(5 mg/kg)after 1 week through the tail vein.Twenty-four hours of urinary protein excretion,serum creatinine(Scr),blood urea nitrogen(BUN)were measured at the 12th week.Renal pathology was evaluated.Immunohistochemistry(SupervisionTM)was performed on renal glomeruli tissue to detect the expression of ?-SMA.Reverse transcription polymerase chain reaction(RT-PCR)was used to examine the expression levels of ?-SMA mRNA in glomeruli.SPSS 13.0 software was used to analyze the two variables.Results In model control group,the urinary protein,Scr,BUN significantly increased(Pa

Objective To investigate the clinical characteristics and mutations of guanosine triphosphate eyclohydrolase (GCH) Ⅰ gene in patients with dopa-responsive dystonia (DRD). Methods Five families with 18 affected family members and 17 patients with sporadic DRD were examined. Patients were allocated into 3 groups according to onset time, either in childhood, or in adolescence or adult. Interview, physical examination, psychologic testings and CT/MR scan were performed. Mutation screening was performed on 26 patients and 1 normal family nember. Thirty-five healthy control subjects were matched for age and sex. Statistical analysis were conducted with the use of SPSS 13.0 computer software. Results(1)Most of patients started with dystonia. The main clinical manifestation was dystonia too. There was no difference among 3 groups.(2) There were significant differences in diurnal fluctuation among 3 groups(15/15,6/6,7/14, χ2=13.125,P=0.001). Diurnal fluctuation negatively correlated with age (r=-0.720, P<0.01).(3)The differences in postural tremor were also found among 3 groups (7/15,5/6,1/14, χ2=8.073, P=0.018). Postural tremor positively correlated with age (r=0.399, P=0.018).(4)There were differences in exaggeration of tendon among three groups(11/15,1/6,4/14, χ2=8.309, P=0.016). Exaggeration of tendon reflexes negatively correlated with age (r=-0.429, P=0.010).(5)The scores of Hamilton Depression Scale and Hamilton Anxiety Scale in patients were higher than those in controls.(6)DNA sequencing revealed a heterozygous A224G missense mutation(Tyr75Cys)located within exon 1 in one autosomal dominant inheritance family. Conclusions The manifestations of DRD varies. The clinical course is closely correlated with age. A missense mutation(A224G)in coding region of the GCH 1 gene probablyleads to the occurrence of DRD.

Objective To evaluate the prognostic value of RAS association domain family 1A gene (RASSF1A) methylation in patients after hepatocellular carcinoma (HCC) hepatectomy.Methods A total of 260 patients with HCC who underwent hepatectomy were enrolled.HCC tissues and tumor adjacent tissues which were 2 cm away from the tumor edge of the patients were obtained.The clinicopathological data of patients were collected.The methylation of RASSF1A in HCC tissues and corresponding tumor adjacent tissues was determined by methylation specific polymerase chain reaction (PCR).The correlation between the expression rate of RASSF1A methylation and clinicopathological characteristics was analyzed by chi-square test.Log-rank test was performed to analyze the relation between RASSF1A methylation and overall survival rate.Univariate and multivariate Cox statistical techniques were used to identify the influence factors in the prognosis of HCC.Results Among 260 HCC tissues and corresponding tumor adjacent tissues,RASSF1A promoter hypermethylation was detected in 214 HCC tissues (82.3 ％) and 101 corresponding tumor adjacent tissues (38.8％),and the difference was statistically significant (x2 =102.824,P ＜ 0.01).There was no correlation between RASSF1A methylation and age,gender,liver cirrhosis,α-fetoprotein level,maximum diameter of tumor,Barcelona Clinic Liver Cancer (BCLC) stage,hepatitis B virus (HBV) infection,smoking and alcohol drinking (all P＞0.05).The 5-year overall survival rate of patients with negative RASSF1A methylation was 93％,while that of patients with positive RASSF1A methylation was 51 ％,and the difference in overall survival rate between the two groups was statistically significant (x2 =26.556,P ＜ 0.01).Univariate and multivariate Cox regression analysis indicated that liver cirrhosis,BCLC stage and RASSF1A methylation were the main influence factors in the death of patients with HCC after surgery (Wald=16.767,8.791,16.286; all P＜0.01).Conclusion RASSF1A methylation is not only one of the predictive factors of survival rate in patients with HCC after hepatectomy,but also an independent prognostic factor of HCC.

ObjectiveTo investigate the effects of mefformin on the levels of serum retinol-binding protein 4 (RBP-4),high sensitive C reactive protein (hs-CRP) and tumor necrosis factorα (TNF-α) in patients with impaired glucose tolerance(IGT) and metabolic syndrome(MS). MethodsSixty patients with IGT and MS were divided into mefformin treatment group (30 cases) and life-style intervention group (30 cases) by random digits table. Body mass index (BMI),the levels of HbAic, HOMA-IR, blood fat, RBP-4,hs-CRP, TNF- α were measured both before and 16 weeks after treatment in the two groups and compared.ResultsThe levels of HbA1c, HOMA-IR, RBP-4, hs-CRP and TNF- α were significantly lower in mefformin treatment group than those in life-style intervention group [(5.09 + 0.26 )％ vs. (5.69 ± 0.49 )％, 2.95 ± 0.63vs. 3.49 ± 0.78, ( 18.69 ± 6.50) mg/L vs.(26.20 ± 6.97) mg/L, (2.37 ± 0.53) mg/L vs.(2.99 ± 0.57) mg/L,(9.49 ± 2.37) μ g/L vs. ( 14.33 ± 2.62) μ g/L] (P ＜ 0.01 ). The results of multiple linear regression showed that correlations were found between the changes of RBP-4 and BMI,HOMA-IR,hs-CRP,TNF-α(β =0.284,0.506,0.274,0.230,P ＜0.01 ),and HOMA-IR was the most important limiting factor. Conclusions Mefformin can improve insulin sensitivity of the patients with IGT and MS, and depress the levels of RBP-4,hs-CRP and TNF- α. Meanwhile mefformin has anti-inflammatory effect.

Histocytochemistry ; methods ; Humans ; Pathology, Clinical ; methods ; Specimen Handling ; methods ; Staining and Labeling ; methods