Acute kidney injury (AKI) has emerged as a major public health problem that leads to decreased survival. Renal tubular epithelial cells are mainly damaged cells in AKI. Renal tubular epithelial cell remodeling plays a vital role in AKI. The regulatory mechanism of renal tubule remodeling is not yet clear. This review is written to address the renal tubule remodeling regulation mechanism of AKI.

Objective To investigate the feasibility of different doses of dexmedetomidine required to prevent sufentanil-induced cough during anesthesia induction. Methods Two hundred and forty ASA Ⅰ or Ⅱ patients, aged 18-55 yr, weighing 45-78 kg, undergoing elective gynecological operations under general anaesthesia, were randomly divided into 4 groups ( n = 60 each) : Ⅰ -Ⅳ groups. Ⅱ -Ⅳ groups received iv infusion of dexmedetomidine 0.10, 0.25 and 0.50 fig/kg at a rate of 0.05 μg·kg-1·min-1 respectively before anesthesia induction. Anesthesia was induced with target-controlled infusion of propofol (target effect-site concentration 5 μg/ml) , when the BIS value reached 55, iv sufentanil 0.5 fig/kg was injected over 3 s. The occurrence and degree of cough were recorded within 1 min after sufentanil injection. Tracheal intubation was facilitated with succinylcholine 1-2 mg/kg after the observation. The adverse cardiovascular events (severe sinus bradycardia, hypotension) were also record ed from the start of dexmedetomidine infusion to 1 min after intubation. Results The incidences of cough were 25 % , 7 % , 7 % and 5 % , incidences of severe sinus bradycardia 0, 3 % , 15 % and 25 % , and incidences of hypotension 5% , 7% , 8% and 8% in Ⅰ - Ⅳ groups respectively. Compared with group Ⅰ , the incidences of cough were significantly decreased in Ⅱ - Ⅳ groups, while the incidences of severe sinus bradycardia increased in Ⅲ -Ⅳ groups (P ＜ 0.01) . There was no significant difference in the incidences of cough among Ⅱ - Ⅲ groups and in the degree of cough among the four groups (P ＞ 0.05). Conclusion Intravenous dexmedetomidine 0.10 μg/kg can be used to prevent sufentanil-induced cough during anesthesia induction.

Objective To investigate the phacoemulsification combined with trabeculectomy in glaucoma complicated with cataract treatment clinical curative effect.Methods 72 cases of glaucoma patients with cataract were randomly divided into the combined group and control group with 36 cases in each group,the combined group using phacoemulsification and trabeculectomy in the treatment,while the control group was treated with trabeculecto-my,combined group and control differences in visual acuity,intraocular pressure,anterior chamber depth and postoper-ative complications of patients were compared.Results After treatment,the two groups of intraocular pressure ( list the concrete data ) , anterior chamber depth ( list the concrete data ) were ( list the concrete data ) significantly improved (t=2.98,3.06,15.21,5.17,all P<0.05).In addition,the intraocular pressure after the operation of the combination group (10.65 ±1.58) mmHg,anterior chamber depth (2.41 ±0.81) mm compared with the control group after obvious difference (t=4.98,3.22,all P<0.05).In 1 weeks after operation,1 months and 3 months com-bined group's vision is significantly superior to the control group (t=2.87,3.38,4.01,all P<0.05).The incidence of complications of operation united group ( 11.11%) was significantly lower than the control group ( 25.00%) (χ2 =3.98,P<0.05).Conclusion Compared with the traditional method,phacoemulsification and trabeculectomy for glaucoma and cataract treatment has obvious curative effect,low incidence of adverse reactions,postoperative IOP control satisfaction,faster visual recovery characteristics,deserves generalization and application.

Objective:To uncover the molecules and signal transduction underlying apoptosis in lymphocytes in old rats.Methods:The rats were grouped into three of old rats control,young rats control,EF-treated group,and studied the gene expression in genome-wide scale with genechip.Results:Compared to young rats control,pro-apoptotic genes were up-regulated and anti-apoptotic genes were down-regulated in old rats.And pro-proliferation genes were down-regulated,the anti-proliferation genes were regulated reversely.Furthermore,a number of genes involved in signal transduction in immune activation and immune response showed lower expression level.But in EF-treated group,pro-apoptotic genes such as Caspase1、Caspase2、Caspase3、Caspase6、CalpainⅡ、Cathepsin S、Dnase ?、PKCdelta,and anti-proliferation genes including Rb were predominantly down-regulated.Anti-apoptotic genes such as Cathepsin B、Mtal、NF-kappa B、Notch,and pro-proliferation genes including c-Fos、c-Myc、c-Jun、PCNA、A-raf;CyclinG-associated kinase were regulated reversely.Especially many genes mediating apoptosis signal including CD2、CD3、CD5、TCR、IL-2、IL-2R(CD25)、CD28、CTLA4 were up-regulated.Conclusion:By a novel mean including up-regulation of anti-apoptotic and down-regulation of pro-apoptotic gene expression,up-regulation of pro-proliration and down-regulation of anti-proliferation gene expression,the normal lymphocyte function in old rats was reconstructed.Additionally EF can coordinate TCR/CD3、CD28、CTLA4、TGF?、IL-2R-mediated signal to reach its anti-apoptotic effects on lyphocytes in old rats. [

Objective:To observe oncosis in human peripheral blood T lymphocytes.Methods:Peripheral blood T lymphocytes of healthy adult was separated with Percoll(1.073 g/ml)and harvested by using nylon column.The cultured cells were divided into control and dexamethasone(DXM)group,and cell morphology was observed through light microscope,electron microscope and fluorescent microscope.And incidence rate of oncosis was analyzed by flow cytometry.Results:①Oncosis could be observed in cultured T lymphocyte after 96h.②In different concentrations of DXM group(1?10-6,1?10-5,1?10-4,1?10-3mol/L),The incidence of oncosis T lymphocytes was(3.49?0.42)%,(5.17?0.48)%,(8.44?0.72)%,(17.93?1.50)%.③During different cultured period(48,72,96,120h),The oncositic rate of T lymphocytes in DXM group was(0.53?0.10)%,(6.36?0.80)%,(20.60?1.59)%,(25.56?1.76)%.Conclusion:Oncosis can be seen in human peripheral blood T lymphocytes,and DXM could induce oncosis.

Objective To observe the effect of ambroxol hydrochloride combined with intervention in chronic obstructive pulmonary disease and evaluate its clinical effect. Methods A total of 88 patients with chronic obstructive pulmonary disease (COPD) who were treated in Changxing Hospital of Zhejiang Province from March 2014 to April 2017 were randomly divided into study group and control group. The control group was treated with ambroxol, and the study group was given comprehensive nursing intervention on the basis of control group. The clinical treatment of the two groups was observed.Results After treatment, the total effective rate of the treatment group was 95.45％ (42/44), the control group was 77.27％(34/44), the difference was statistically significant (P<0.05); there were no significant differences in blood gas analysis (PaO2, PEF) and lung function (MVV, Fres, Zrs, R5-R20, Cdyn) before treatment, after treatment, the improvement of the indicators in the study group was significantly better than the reference group (P<0.05). Conclusion Ambroxol combined with comprehensive nursing intervention for chronic obstructive pulmonary disease, can effectively improve the clinical treatment effect, help to improve lung function, promote the recovery of the disease, with clinical application value.

Arab countries have long tradition of using traditional medicine which enjoys mass foundation among local people. Recently, China's import and export trade of traditional medicine products with Arab countries showed an increasing trend year by year. With the implementation of the Belt and Road Strategy, Arab countries played a more important role in China's foreign trade. With the aim of promoting the spread of traditional Chinese medicine (TCM) in Arab countries, cooperation with relevant countries shall be differentiated. The Gulf region is economically advanced with its people enjoying prosperity, where is suitable for developing TCM product and service trade. The Levant has strong advantages in traditional medicine research, where academic communication shall be frequented. Countries in north Africa enjoy profound traditional friendship with China, where are suitable for dispatching Chinese foreign aid medical team to promote TCM. Meanwhile, we are supposed to take advantage of Confucius Institute and Chinese culture centers as platforms to spread TCM culture, to strengthen cooperation with medical universities and research institutions in the target countries, to enroll more Arab students to study TCM, to develop international standard Chinese-Arabic basic nomenclature of Chinese Medicine, and to carry out Traditional Arabic & Islamic Medicine researches.

Objective: To deeply investigate the influential factors of mental health in medical students by structural equation modeling.Methods: 480 medical students were tested with SCL-90,adolescent self-rating life events check list and simplified coping style questionnaire,then theoretical model were established and confirmed for the relationships of life events,satisfaction degree with their profession,coping styles and mental health.Results: Study stress,human relations,satisfaction degree towards their profession and coping styles closely correlated with mental health status,and the structural equation modeling fitted the data very well,GFI and AGFI were both larger than 0.90.Conclusion: Use of structural equation modeling has more advantages than the traditional statistical methods,but it should combine with professional knowledge when it is used.

Glucokinase (GK) is considered to be the key regulatory enzyme in glucose metabolism, whose activity changing will lead to glucose metabolic disturbance and diabetes. Recently, people have realized that there is a good extensive perspective in diabetes research by means of glucokinase investigation. In this paper, we review the mechanism of diabetes resulting from abnormality of glucokinase activity and the status of glucokinase activators, propose the viewpoint that glucokinase is a powerful target for diabetes therapy and research, and illuminate that searching of glucokinase activators is the guidance in the future.

Objectives:To observe the clinical features,related factors,prevention and treauments of complications on early enteral nutrition(EN) in severe head injured patients.Methods:360 patients with severe head injuries were enrolled in this study.GCS score was used to assess the patient's situation.After nasogastric(jejunal) tube was inserted,enteral nutrition was started from 48 hours after injury.The maximal EN volume(mL/d) in the first week after injury,time used for reaching to TEN(d),number of patients that achieved TEN in the first week following injury,blood glucose,serum albumin and ALT were observed.The complications due to enteral nutrition were analyzed. Results:Features of complications with early EN were that the abdominal distension,vomiting and aspiration were found in the first week and diarrhea occurred in the following weeks.A positive correlation between abdominal distension,vomiting and nasogastric tube was noted,while diarrhea had a negative correlation to GCS score and albumin level. Conclusions:The complications related to early enteral nutrition after severe head trauma correlated inversely to the degree of injury and serum albumin level.Utilization of nasojejunal tube could decrease the incidences of abdominal distension and vomiting.