Objective To investigate the diagnostic value of laboratory evaluation of renal injury in early diagnosis index. Methods Eighty-six patients in in-patient and out-patient of the department of urology were tested in serum C (Cys C), serum creatinine (Cr) and serum UREA nitrogen (UREA). According to the diagnostics (sixth edition), we evaluated their values for diagnosis of renal injury by analyzing the characteristics of the work curve (ROC). Results According to the renal function indexes, 3 groups were divided such as group A (normal renal function control Ccr 80 mL/min) or the Cys C, Cr, and UREA in (0.47 ± 0.24) mg/L, (85 ± 14) μmol/L, and (4.55 ± 1.33) mmol/L, group B (a decrease in renal function reserves, and renal insufficiency 20 mL/min or less Ccr < 80 mL/min) of Cys C, Cr, and UREA in (1.59 ± 1.29) mg/L, (214 ± 173) μmol/L, and (11.04 ± 8.24) mmol/L and group C (renal failure and uremia Ccr < 20 mL/min) of Cys C, Cr, and UREA in (3.47 ± 0.75) mg/L, (669 ± 466) μmol/L, and (21.22 ± 13.10) mmol/L respectively. As reducing in Ccr, Cys C, Scr and UREA concentration increased and correlated with Ccr negatively. According to the mazimum Youden index, the critical values of Cys C, Cr, and UREA were 0.90 (mg/L), 115 (μmol/L) and 7.33 (mmol/L) separately, the sensitivity (%), specificity, positive predictive value (%), negative predictive value (%), diagnostic accuracy (%) and the area of the ROC curve (AUC) were Cys C (77.3%, 97.6%, 97.0%, 81.1%, 77.3%, 0.908), Cr (65.9%, 97.6%, 96.5%, 74.1%, 65.9%, 0.817), and UREA (63.6%, 97.6%, 96.4%, 72.8%, 63.6%, 0.785) respectively. The diagnostic accuracy showed that the Cys C > Cr > UREA. Their correspounding ROC curve (AUC) were in the area of 0.908, and 0.785 and 0817. Cys C had the highest AUC (0.908), and achieved a good diagnosis effect. Conclusion Renal damage laboratory indexes of in the early diagnosis, Cys C has a higher sensitivity and specificity to be worth of clinical promotion.

Objective To explore the value of combined use of laboratory indicators for diagnosis of early renal functional damage. Methods Eighty-six patients with various kidney diseases were enrolled in the Second Affiliated Hospital of Guangzhou Medical University. On admission,the serum Cystatin C(Cys C),creatinine(Cr), Urea,etc were determined. The value of using combined laboratory indicators in the diagnosis of renal functional damage was obtained through the analysis of the receiver operating characteristic curve(ROC curve);multiple variable indicators were grouped to establish multiple logistic regression models to be compared and evaluated. Results In the early and late renal injury groups(group B of 32 cases and group C of 12 cases),the serum levels of Cys C,Cr, and Urea were significantly higher than those in the normal renal function control group(group A of 42 cases),the elevation in level in group C being the most significant〔Cys C(mg/L):3.47±0.75 vs. 1.59±1.29,Cr(μmol/L):669±466 vs. 214±173,Urea(mmol/L):21.22±13.10 vs. 11.04±8.24,P<0.05 or P<0.01〕. The areas under the ROC curve(AUC)made by combinations of Cys C,Cr and Urea for the diagnosis of renal damage were 0.908,0.817 and 0.785. In the four different kinds of combination of the indicators,the AUC were sequentially arranged from large to small area as follows:Cys C+Cr+Urea=Cys C+Cr>Cys C+Urea>Cys C>Cr+Urea(0.920=0.920>0.911>0.908>0.809). In this sequence,the AUC made by Cys C+Cr+Urea and Cys C+Cr were equal,both 0.920, whose sensitivity was 75.0%,specificity 100.0%,positive predictive value 100.0%,negative predictive value 80.0%and diagnostic accuracy rate 87.5%. So,Cys C + Cr combination could be used to substitute Cys C + Cr + Urea, and the former clinical diagnostic effect was the best,much higher than that by using AUC whose curve was made by Cys C alone. Conclusion The value of using only one laboratory indicator for diagnosis of patients with early renal functional damage is not high,while applying Cys C+Cr combination can improve the diagnostic effect greatly,and its sensitivity and specificity are higher.

Objective To investigate the effects of a variety of different methods of analgesia on postoperative pain and cognitive function in elderly esophageal cancer patients.Methods Sixty elderly pa-tients scheduled for the left into the thoracic esophageal cancer surgery were randomly divided into two groups (n =30).Group A:Before the closure of thoracic cavity to block intercostal nerve with 0.375% rop-ivacaine,followed by intravenous pumps for analgesia,formulation of sufentanil 3 μg/kg+flurbiprofen 100 mg,pump speed 2 ml/h,self-controlled analgesia 0.5 ml/pressing,locking time 15 min.Group B:Before the closure of thoracic cavity given sufentanil 10 μg+flurbiprofen 50 mg as loading dose followed by epidural analgesia pump,recipe with group A.Two groups were observed mini mental state examination (MMSE) score 1 d before surgery and 3,5,7 d after surgery,each time point visual analogue pain score (resting and exercise VAS)score postoperative within 48 h,BCS comfort score and effective pressing times of postopera-tive analgesia pump.Results Compared with group B,the rest and exercise VAS scores of group A at post-operative recovery,4,8,12,24,48 h were significantly lower (P <0.05);the BCS scores of group A at postoperative 4,8,12,24,48 h were significantly higher (P <0.05);the pressing times of group A at postoperative 4,8,12,24,48 h were significantly reduced (P <0.05);the MMSE scores of group A at postoperative 3,5,7 d were significantly higher (P <0.05);the incidence of POCD of group A on postop-erative 3,5,7 d were significantly lower.Conclusion Thoracic surgery perioperative multimodal analgesia (intercostal nerve block and intravenous analgesia)can relieve postoperative pain,reduce the incidence of POCD,improve the postoperative patient comfort and help postoperative patients with rapid recovery.

Objective To evaluate the changes of left atrial (LA)functions in patients with constrictive pericarditis (CP)after pericardiectomy by two-dimensional speckle tracking echocardiography (STE).Methods A total of 41 patients with CP underwent echocardiography before and after pericardiectomy.The procedure was performed to obtain global LA longitudinal strain,the septal and lateral walls'longitudinal strain,including peak negative strain (NS),peak positive strain (PS),and total strain (TS),using speckle tracking echocardiography.Thirty-five healthy volunteers were recruited as controls. Results After pericardiectomy,global LA peak negative strain and total strain of CP increased significantly (P <0.005).There were no obvious changes in global LA peak positive strain (P >0.05).And three components of LA longitudinal strain were still lower than normal (P <0.005).LA lateral wall's total strain,peak positive strain and peak negative strain improved apparently after pericardiectomy (P <0.005),only peak negative strain increased in LA septum (P < 0.01 ).Conclusions In the early postoperative period,LA reservoir and contractile function presented significant improvements,even notable in the lateral area when compared with septum.However,all three parts of LA function were still lower than normal.STE can regionally estimate LA functions in patients with CP after pericardiectomy.

Objective To investigate the effect of different puncture methods on dialysis adequacy in maintenance hemodialysis patients. Methods One hundred and twenty patients receiving maintenance hemodialysis were divided into the observation group and the control group according to the sequence of receiving the hemodialysis with 60 cases in each group. Patients in the observation group were treated with increasing distance arteriovenous fistula of more than 10 cm , while patients in the control group received normal dialysis care without changing the way of puncture. The difference of dialysis adequacy before and after intervention were compared between the two groups. Result The dialysis adequacy after intervention in the observation group was improved significantly compared with the control group (P<0.05). Conclusion The dialysis adequacy in patients with maintenance dialysis can be improved by increasing the puncture distance of internal arteriovenous fistula.

Objective To evaluate the left ventricular rotation and twist in the cardiac allograft by speckle tracking echocardiography.Methods Twenty-six heart transplant recipients underwent echocardiographic studies at 1st,3rd,6th and 12th month after heart transplantation.Twenty-six healthy subjects served as controls.Parasternal basal and apical short-axis images of left ventricle were recorded and then were analyzed using EchoPAC software.The curves of basal and apical rotation and left ventricular twist were obtained,Peak values of basal and apical rotation and left ventricular twist were measured and then statistically analyzed.Results There were no significant differences in left ventricular ejection fraction (LVEF) and fractional shortening (LVFS) between heart transplant recipients and controls (P ＞0.05).The left ventricular twist,apical rotation were significantly lower in heart transplant recipients at 1 st,3rd,6th and 12th month after surgery than those in controls (P ＜0.05) ;while basal rotation in heart transplant recipients had no significant difference when compared with controls (P ＞0.05).The left ventricular twist,apical and basal rotation in heart transplant recipients among 1 st,3rd,6th and 12th month after surgery had no significant difference (P ＞ 0.05).Conclusions Although the LVEF and LVFS of cardiac allograft seemed normal,the left ventricular twist,apical rotation were still significantly lower in heart transplant recipients than those in controls.Speckle tracking echocardiography can be used for accurate assessment of left ventricular twist in heart transplant recipients.

To investigate the effects of serum containing Yiqi Huayu Bushen Recipe, a compound Chinese herbal medicine, on expressions of aggrecan and type X collagen mRNAs of the degenerated intervertebral disc cells in patients with cervical spondylotic myelopathy.

Objective To detect the distribution of H.pylori ureA, vacA s1 gene and cagA subtype(ABC, ABD, ABAB, AAD, et al) in patients with digestive diseases in Guangzhou and investigate the relationship with the pathological findings of gastric mucosa.Methods A total of 227 randomly selected gastric mucosa from patients with digestive diseases were enrolled in the research, including 46 without pathological changes, 130 with chronic gastritis, 29 with peptic ulcer, 15 with atrophic gastritis and 7 with gastric cancer.Real-time PCR assay were used to detect Helicobacter pylori ureA gene and vacA s1 gene.EPIYA motifs in the 3′ region of cagA were amplified by conventional PCR followed by subtype sequencing. The conserved gene ureA was used to detect H.pylori infection.Results Among the 227 patients with digestive diseases, 50.7% (115/227) patients were H.pylori positive, in which 91.3%(105/115) carried vacA s1 and 78.3% (90/115) carried cagA. Four types of cagA-EPIYA subtype were detected, including ABC 17.8%(16/90), ABD 78.9%(71/90), AAD 2.2%(2/90) and ABAB 1.1%(1/90).In the non-pathological change group, 32.6% (15/46) were H.pylori positive, in which 28.3% (13/46) carried vacA s1 and 26.1% (12/46) carried cagA;in chronic gastritis group, it was 48.5% (63/130), 43.8% (57/130) and 36.2% (47/130), respectively;in ulcer group, it was 72.4% (21/29), 65.5% (19/29) and 55.2% (16/29), respectively;in atrophic gastritis group, it was 66.7% (10/15), 66.7% (10/15) and 66.7% (10/15), respectively;in gastric cancer group, it was 85.7% (6/7), 85.7% (6/7) and 71.4% (5/7), respectively.The distribution of H.pylori among the 4 groups had statistical significance (χ2=16.72;P<0.01). H.pylori was more prevalent in ulcer, atrophic gastritis and cancer group than in inflammation group and non-pathological change group (χ2=16.02;P<0.01).In patients infected by H.pylori, there was no significant difference in the distribution of vacA s1 gene as high virulence factors among non-pathological change, inflammation, ulcer, atrophic gastritis and cancer group (χ2=2.00;P=0.74), as well as cagA (χ2=3.44;P=0.49) and EPIYA subtypes (χ2=3.66;P=0.45).Conclusions H.pylori infection is significantly associated with the pathological change of gastric mucosa for patients with digestive diseases in Guangzhou, while the relationship with the pathogenicity of H.pylori with high virulence genotype is not significant.More samples and diseases reclassification are needed to make an advanced analysis of the effect of H.pylori with high virulence in gastrointestinal diseases development.

Objective To prepare a novel ultrasound contrast agent , targeted phase-shift lipid nanoparticles mediated by tumor homing and penetrating peptide tLyP-1 ,and to evaluate its characteristics . Methods The nanoparticles were prepared by filming-rehydration and acoustic-vibration methods .The morphology ,distribution ,particle size and zeta potential were detected . After heating and irradiating of low intensity focused ultrasound ( LIFU) ,the phase-shift characteristic and the enhancement effect in vitro were observed . The tumor homing and cell-penetrating properties of the nanoparticles were examined by confocal laser scanning microscopy and flow cytometry . The cytotoxicity of the nanoparticles was evaluated by CCK 8 assay . Results The size and distribution of nanoparticles were uniformed . The size and zeta potential of nanoparticles were ( 399 .50 ± 29 .98) nm and ( 3 .28 ± 1 .72) mV ,respectively . When the nanoparticles were heated to a temperature of 45 ℃ or after irradiated by LIFU ,nanoparticles generated phase-shift and enhanced ultrasound imaging in vitro ( P < 0 .05 ) . The confocal laser scanning microscopy showed that nanoparticles mediated by tLyP-1 can targetedly aggregate to cell membrane of MDA-MB-231 and penetrate into the cell ,but not to HUVEC . The flow cytometry showed that intracellular fluorescence intensity of nanoparticles mediated by tLyP-1 in MDA-MB-231 group was higher than that in control groups ( P <0 .05) . The CCK8 assay indicated that different concentrations of nanoparticles had no significant effects on cell activity ( P > 0 .05 ) . Conclusions A novel ultrasound contrast agent , targeted phase-shift lipid nanoparticles mediated by tumor homing and penetrating peptide tLyP-1 ,is prepared successfully . It can target to MDA-MB-231 cell and penetrate into the cell in vitro ,and enhance ultrasound imaging in vitro after LIFU irradiation ,which expected to become a novel tumor targeted ultrasound contrast agent and achieve ultrasound molecular imaging at the level of tumor cell .

Objective To investigate of the change of peripheral blood lymphocyte subsets and blood cell antibodies in aplas‐tic anemia and its clinical significance .Methods The lymphocyte subsets CD3+ ,CD3+ CD4+ ,CD3+ CD8+ ,CD4+ /CD8+ ,CD3-CD19+ ,CD3-CD16+CD56+ from 25 aplastic anemia(including SAA 7 cases ,NSAA18 cases) ,and hematocyte antibody detection (granulocyte ,erythrocyte ,platelet cytomembrane) and 20 controls were examined by flow cytometry .Results CD4+ T lymphocyte percentage ,CD4/CD8 ratio ,the percentage of CD56+ in aplastic anemia patients significantly decreased(P<0 .05) .Blood cell anti‐bodies (platelet antibody ,erythrocyte antibody ,granulocyte antibody) were significantly higher than the control group (P<0 .05) . Conclusion Aplastic anemia cellular immune function in patients is abnormal ,and antibody positive rate is high ,and it prompt that humoral immunity is also abnormal .