Objective To ivevstigate the feasibility, the effects and the therapy of peritoneal dialysis(PD) on severe acute pancreatitis (SAP). Method From January,2001 to Jaly 2006,48 patients of SAP were divided randomly into PD group and non-PD group in Qingzhou hospital. Both groups were treated by the conventional mode of therapy. In PD group , using the concept of PD,24 patients of SAP were treated with PD and NPD group were treated only with common therapy. The release time of abdominal pain and distention, CT scores, APACHE II scores, the time of hospital stay, cost of treatment in hospital, operative rate and rate of complications and recovered rate of the two groups were compared. Simutaneously. the concentration of serum and fluid filtrated inflammatory cytokines TNFα,IL-6,IL-8,IL-10 and CRP were also determined pro and post the therapy. Results In the PD and NPD group, the duration for disappear-ance of abdominal pain and tenderness,and amelioration for abdominal distension was (19.70 ±7.32) hvs. (81.46±36.68) h and (23.16±6.95) h vs.(78.19± 29.26) h;So that the PD group was precede to that in NPD group ( P < 0.05). The concentration of serum and fluid filtrated pro-inflammatory cytokines TNFα, IL-6, IL-8 and CRP at each observation points after PD was decreased significantly (P <0.05) in the PD group. But the concentration of the serum and fluid filtrated anti-inflammatory cytokines IL-10 was increased significantly (P < 0.05) as compared with that of the NPD group. Conclusions Through PD, the imbalance of pro-inflammatory and anti-inflammatory cytokines has been corrected at early stage of SAP. But the PD is method that is easy, quick, small wou-ndell,few complicated and effective in patients with early-phase SAP, and will be of great value in wide application and further study.

Objective To investigate the significance of renal tubular dysfunction in patients with refractoriness nephrotic syndrome(RNS)and the effect of interference treatment of Valsartan (VAL).Methods 79 cases of RNS and 68 healthy controls were recruited into the study. The 79 patients of RNS were divided randomly into the VAL group and the dipyridam group. On the basis of routine therapy, the VAL group was given VAL(80mg/d),and the dipyridam group taken dipyridam (150mg/d)orally for 12 weeks The glomerular tubular function(u-RBP,α1-MG,β2-MG,mAlb,NAG)were detected and the pathologic changes of tubukinterstitium were observed by using the methods of ELISA, biochemistry and scoring of the pathologic damage of tubulointerstitium before and after 12 weeks of VAL treatment in all of the cases. Results Urinary RBP,α1-MG,β2-MG,mAlb and NAG in all patients with RNS was evidently higher than that in healthy controls(P＜0.01).Those had positive correlations with damages of tubulointerstitium(r=0.436,0.626,0.499,0.668,0.657,P＜0.01).The interference outcome displayed that the excretion rates of urinary series of protein after oral use VAL in treatment group were markedly lower, while the control group had no distinct change. Conclusion There were various injury of tubulointerstitium and the disfiguration of renal tubular function in all cases with RNS. Damages of renal tubular function had positive correlation with tubulointemtitium injury and renal globular injury. Interference treatment with ARB in patients with RNS could improve renal tubular function, which is of great significance in delaying the progress of RNS.

Objective To summarize the causes of patients with fever of unknown origin (FUO) and to analyze the relationship between infectious diseases and FUO,in order to provide envidence for experiential therapy.Methods Clinical data of 374 FUO inpatients at He'nan Provincial People's Hospital from June 1,2009 to May 31,2013,including gender,age,diagnosis and department were analyzed retrospectively.Results Three hundred and twenty-seven cases among the overall 374 FUO patients (87.4％) were eventually etiological diagnosed based on supplementary examinations or diagnostic treatment.As for the causes of fever,209 were infection,accounting for 55.9％,among which 78 cases (20.9％) were diagnosed with tuberculosis,23 cases (6.1％) brucellic diseases,19 cases (5.1％) rickettsia infection.Meanwhile,the noninfectious diseases,such as connective tissue diseases (47,12.6％),hematonosis (37,9.9％) as well as the solid tumors (13,3.5％) also constituted considerable shares of the causes for FUO.However,the causes of 47 cases (12.6％) were not identified before discharge.Conclusions Infectious diseases are the main cause of FUO,in which tuberculosis accounts for the majority.Brucellosis and rickettsia infection also account for a considerable proportion.The causes of most FUO cases could be identified through detailed analysis of clinical data and supplemental examinations.

Objective To discuss the effect of PI3K-AKT signaling pathway regulated by microRNA-155(miRNA-155)targeted protein tyrosine phosphatase non-receptor type 21(PTPN21)on the proliferation,migration and invasion of hepatocellular carcinoma(HCC)cells.Methods Lentivirus transfection was used to silence the expression of miRNA-155 in human Huh7 HCC cells,and real-time fluorescent quantitative polymerase chain reaction(RT-qPCR)was used to detect the silencing effect of miR-155.After obtaining stable cell lines,the cell lines were randomly divided into Blank group(normal Huh7 cells),shNC group(Huh7 cells+empty miR-155 vector),sh-miR-155(Huh7 cells+miR-155 silencing),sh-miR-155+Recilisib group(Huh7 cells+miR-155 silencing+PI3K-AKT agonist),shNC+Recilisib group(Huh7 cells+empty miR-155 vector+PI3K-AKT agonist).Dual luciferase assay was used to determine whether PTPN21 was the downstream of miR-155.The cell proliferation ability of cells in each group was detected by MTT assay.The apoptosis level of each group was tested by flow cytometry.The invasion and migration ability of cells was assessed by Transwell assay.Western blot analysis was used to observe the differences in protein expression of PTPN21,PI3K,P-PI3K,AKT,P-AKT,and apoptosis-related proteins including BAX,BCL-2 and caspase-3 in all groups.Results The expression level of miR-155 in sh-miR-155 group was lower than that in Blank group and shNC group(P＜0.000 1),and the difference in miR-155 expression level between Blank group and shNC group was not statistically significant(P＞0.05).MTT results showed that A values of Huh7 cells at 2,3,4 and 5 day in sh-miR-155 group were lower than those in Blank group and shNC group(P＜0.000 1),while these differences between Blank group and shNC group were not statistically significant(P＞0.05).In sh-miR-155 group the A values at 2,3,4 and 5 day were lower than those in sh-miR-155+Recilisib group and shNC+Recilisib group(P=0.0052 and P＜0.0001,respectively),while the A values at 2,3,4 and 5 day in sh-miR-155+Recilisib were lower than those in shNC+Recilisib group(P＜0.000 1).There was no significant differences in cell migration and number of invasion cells between the Blank group and shNC group(P＞0.05).After activation of PI3K-AKT signaling pathway,the migration and invasion capacity of HCC cells in the shNC+Recilisib group were significantly enhanced when compared with the Blank group(P＜0.000 1).In contrast,the number of migrated and invaded Huh7 cells after miR-155 silencing was significantly lower than that in the Blank group and shNC group(P＜0.000 1)and this phenomenon became reversed by PI3K agonist.Compared with the sh-miR-155 group,in the sh-miR-155+Recilisib group the migration and invasion ability of HCC cells was enhanced(P=0.000 2).Lentiviral transfection of Huh7 human HCC cells to silence miR-155 and downregulate miR-155 inhibiting PTPN21 regulation of the PI3K-AKT signaling pathway,thus inhibiting the invasion,migration and proliferation ability of HCC cells and promoting the apoptosis of HCC cells.Conclusion miR-155 inhibits the migration,invasion and proliferation of HCC cells through targeting PTPN21 regulation of PI3K-AKT signaling pathway.The miR-155 may be a potential therapeutic target for HCC in the future.(J Intervent Radiol,2024,32:44-51)