Objective To investigate the correlation between chronic kidney disease (CKD) and long-term outcomes in a large cohort of unselected patients with acute cerebral infarction.Methods Consecutive acute cerebral infarction patients hospitalized in Department of Neurology,General Hospital of Jinan Military Region were prospectively recruited from August 2010 to November 2013.The baseline data including age,sex,the National Institute of Health Stroke Scale (NIHSS) scores,type of Oxfordshire Community Stroke Project (OCSP:total anterior circulation infarct,partial anterior circulation infart,posterior circulation infarct and lacunar infarct),serum creatinine were recorded.Estimated glomerular filtration rate (eGFR) was calculated according to CKD epidemiology collaboration (CKD-EPI) equation.CKD was defined as eGFR ＜ 60 ml · min-1 · 1.73 m-2 body surface area.Patients were divided into eGFR≥60 ml · min-1 · 1.73 m-2 group and eGFR ＜ 60 ml · min-1 · 1.73 m-2 group.Recovery was assessed by modified Rankin Scale (mRS) 180 days after stroke by telephone interview (mRS≤2 reflected good prognosis,and mRS ＞ 2 reflected unfavorable prognosis).Multinominal Logistic regression analysis,Kaplan-Meier curve and log rank test were used.Results Eight hundred and fifty-two patients were enrolled,among them 93 patients were with CKD.Compared to patients without CKD,acute ischemic patients with CKD were older ((70.56 ± 11.86) years vs (63.11 ± 12.15) years,t =5.60,P =0.000),more likely with NIHSS ≥7 (59.14％ (55/93) vs 32.54％ (247/759),x2 =25.61,P =0.000),more likely with hypertension (89.25％ (83/93) vs 77.34％ (587/759),x2 =6.99,P =0.007),more likely with atrial fibrillation (29.03 ％ (27/93) vs 9.5 ％ (72/759),x2 =30.82,P =0.000),more likely with congestive heart failure (13.98％ (13/93) vs 3.03％ (23/759),x2 =24.54,P =0.000),more likely with tumour (6.50％ (6/93) vs 2.24％ (17/759),x2 =5.59,P =0.031).CKD was a independent prognostic factor for long-term poor outcome (OR =2.034,95％ CI 1.194-3.468) and long term mortality (OR =2.657,95％ CI 1.450-4.870).Kaplan-Meier estimate of patients without CKD for cumulative 180 days survival function for all-cause mortality was higher than those with CKD (79.57％ (74/93) vs 93.54％ (710/759),Log rank test:x2 =23.602,P =0.000).Conclusions Acute ischemic stroke patients with CKD are with more comorbidities.CKD is a independent prognostic factor for long-term poor outcomes and long term mortality in patients with acute cerebral infarction.

Objective To assess the safety and efficacy of abdominal radical nephrectomy and systematic lymph node dissection for treatment of renal carcinoma. Methods A total of 136 patients underwent radical nephrectomy and regional clearance of lymph nodes from July 2004 to June 2008.There were 92 males and 44 females in the study group.Ages ranged from 23 to 81 years,with a mean age of 54 years.The mean tumor diameter was 55 mm (range,15-170 mm).The tumor size detected by CT and MRI was consistent with that detected by B-ultrasound,98 were stage Ⅰ,13stage Ⅱ,12 stage Ⅲ,and 2 stage Ⅳ. Results All 136 cases underwent radical nephrectomy with retroperitoneal lymphadenectomy.All operations were successful without any major complication.The operative time was 90 to 180 min,with an average of 120 min,and blood loss was 20-400 ml,with an average of 50 ml.The pathological diagnoses were as follows: renal cell carcinoma 123 cases (90%), papillary renal cell carcinoma six cases(4%),chromophobic two cases(1.4%),oncocytoma two cases(1.4%),collecting duct two(1.4%),and others three cases(2.2%).Eight cases reported positive lymph nodes.Of the 136 cases,92 cases were T1 N0 M0,11 were T2 N0 M0,10 were T3 N0 M0,eight were T3 N1 M0 and two were T1 N0 M1.Ninety-five cases (70%) were followed-up at six to 40 months (mean,20 months).The one year and three year survival rates were 96% (91/95) and 86% (82/95),respectively.Conclusions Radical nephrectomy with systematic lymph dissection has advantages of accurate staging,effective resecting of renal tumors and preventing recurrence.Radical nephrectomy is an effective method for the treatment of renal carcinoma.

To investigate the effects of β-elemene on the ANG β -AT1 receptor pathway in rats with liver fibrosis,a model of hepatic fibrosis was induced by hypodermical injection of carbon tetrachloride (CCl4) into Wistar male rats.β-elemene was intraperitonealy administered into the rats for 8 weeks (0.1 mL/100 g body weight per day).Masson staining was used to observe the liver fibrosis of rats and liver functions were measured by enzymatic kinetic analysis.The content of hydroxyproline in liver tissues was detected by specimen alkaline hydrolysis.The level of plasma ANG Ⅱ in bloodplasma was detected by radioimmunoassay.The expression of AT1R in rat liver were measured using reverse transcriptional-polymerase chain reaction and immunohistochemistry respectively.The results showed that β-elemene could reduce the collagen disposition in liver and inhibit the progression of liver fibrosis.In addition,the levels of plasma ANG Ⅱ and the expression of hepatic AT1R in rats with liver fibrosis were also suppressed by β-elemene.It is concluded that the ANG Ⅱ -AT1 receptor pathway plays an important role in the development of hepatic fibrosis and β-elemene could down-regulate the levels of plasma ANG Ⅱ and the expression of hepatic AT1R in rats with liver fibrosis.