Objective To assess the value of serum creatinine(Scr),serum ?_2-microglobulin(?_2-MG),glomerular filtration rate(GFR),proteinuria index,and Cystatin C(Cys C)to detect impairing of expressing of diease in patients with chronic kidney disease.Methods Peripheral blood was collected from 54 chronic kidney diease:Scr was analyzed using RXL fully automated biochemistry assay instrument,then GFR was calculated;Cys C was measured using particle-enhanced nephelometric immunoassay(PENIA);?_2-MG was measured using chemiluminescent method,proteinuria index was measured by the product of duration and amount of proteinuria,nephropathological progress was measured using the degree of glomerular mesangial proliferation and the dgree of tubulointerstitial fibrosis.Results The level of serum Cys C,Scr,serum ?_2-MG,proteinuria index,and GFR of the CKD patients was correlated with nephropathological progressing.Conclusion In patients with chronic kidney disease serum creatinine,serum ?_2-micro-globulin,glomerular filtration rate,proteinuria index,and Cystatin C are markers of progessing of kidney disease.The sensitivity and correlation of GFR and serum Cys C are higher than others.

Objectives To investigate the expression features and roles of the costimulatory molecules and T lymphocyte subsets from patients with chronic nephritis.Methods The expression of the costimulatory molecules CD 28 and CD 137 on PBMC (peripheral blood mononuclear cells) and T lymphocyte subsets from 52 patients with chronic nephritis were studied by immunophenotyping and flow cytometry analysis.Results The T lymphocyte subsets from patients with chronic nephritis showed an obvious imbalance with reversing CD 4/CD 8 ratio,decreasing CD + 4T cells and increasing CD + 8T cells.The expression of the costimulatory molecule CD 28 on T cells was significantly lower compared with normal controls (P

Uterine papillary serous carcinoma is a special pathological type of endometrial cancer. It is similar to ovarian papillary serous carcinoma in histology and can have distant metastasis when it is still confined to the endometrium. As it is very aggressive and has a rather poor prognosis,complete surgical staging is necessary in the treatment,assisted by radiotherapy and chemotherapy. In this review,the author discussed the recent research advances in uterine papillary serous carcinoma.

Objective To evaluate the diagnostic value of 18F-FDG PET-CT in looking for tumor primary lesion with multiple bone metastasis.Methods 84 patients with suspected bone metastases were detected by routine imaging (X -ray,CT,MRI)in our hospital from May 2012 to September 2014 were selected,18F -FDG PET/CT were used to find the primary lesion.The final diagnosis were confirmed by tissue pathology or by clinical imaging follow -up.The diagnostic sensitivity,specificity and accuracy on tumor bone metastasis of 18F -FDG PET/CT were recorded.Results In 84 patients,primary tumor was found in 49 cases,of which 46 cases (54.8%)confirmed pri-mary tumor by operation or pathology,the other 3 cases were false positive;35 patients were diagnosed as non meta-static bone tumor by PET/CT,in which 34 cases were finally confirmed as non metastatic bone tumor by pathology and follow -up;accuracy,sensitivity,specificity of 18F -FDG PET/CT were 54.8%(46 /84),93.9% (46 /49)and 95.2%(80 /84);18 cases of lung cancer,9 cases of prostate cancer,7 cases of breast cancer,5 cases of lymphoma, 4 cases of renal cell carcinoma,2 cases of liver cancer,1 cases of Uterine sarcoma were included in 46 primary tumors.Conclusion 18F -FDG PET/CT has a higher specificity,accuracy as well as higher detection rate in search of multiple bone metastases,thus it is beneficial to the clinical therapy.

Objective To analyze the clinico-pathological characteristics, prognostic factors and the rational therapy for the uterine papillary serous carcinoma(UPSC). Methods Thirty-three cases of UPSC were treated in our hospital between January 1996 and December 2005. The clinico-pathologic characteristics, treatment and prognosis were retrospectively analyzed. Results The three-year overall survival for patients with stage Ⅰ, Ⅲ and Ⅳ was 77.4%,53.3% and 12.1%, respectively. Patients with late stages and deep myometrial invasion were associated with a worse prognosis by univariate analysis(P

Objective To assess the efficacy of fish oil in the treatment of IgA nephropathy using the method of Meta-analysis. Methods Randomized controlled trials of fish oil in the treatment of IgA nephropathy were searched in the database of Cochrane library,PubMed, EMBASE and CNKI. Data extracted from the literatures were analyzed with Revman software (version 5.0). Results In comparison with the controlled group, proteinuria in the fish oil group was significantly decreased [SMD=-0.27, 95%CI (-0.52 to -0.03), P=0.03], while the renal function deteriorated [SMD=0.30,95%CI(0.05 to 0.55), P=0.02]. Conclusion Fish oil can decrease the proteinuria of IgA nephropathy, but can not prevent renal function from deterioration.

Objective The purpose of this study was to evaluate gene amplification by chromogenic in situ hybridization (CISH) and the protein expression of Her-2/neu gene in patients with uterine papillary serous carcinoma ( UPSC) and to determine its prognostic value.Methods Thirty-six patients with confirmed pathologic diagnosis of UPSC in Cancer Hospital of Fudan University from Jan.1996 to Jan.2006,were analysed retrospectively.CISH was performed to assess Her-2/neu gene amplification,and protein expression was evaluated by immunohistochemistry (IHC).The prognostic factors were analyzed by log-rank test or Cox proportional hazard model.Results Among 36 cases with UPSC,13 patients (36.1% ) showed moderate staining (++) to strong staining (+++) for Her-2/neu protein,while amplification of the Her-2/neu gene by CISH was observed in 4 of the 36 (11.1% ) cases.Her-2/neu protein over-expression was significantly associated with advanced surgical stage and worse prognosis by univariate analysis ( P = 0.030 and P = 0.002,respectively),while the multivariate analysis shown that only Her-2/neu protein over-expression and deep myometrial invasion were associated with a poor prognosis ( P < 0.05 ).In 13patients with Her-2/neu protein over-expression,the mean survival period with chemotherapy was shorter than those without chemotherapy (20 vs.42 months,P = 0.370 ).Conclusion Her-2/neu protein over-expression is significantly associated with advanced surgical stage UPSC and poor survival outcome,and might reduce the chemotherapy sensitivity.

Objective To study the effect of different dialysis modalities on pruritus in elderly maintenance hemodialysis patients.Methods Totally 51 patients were randomly divided into hemoperfusion combined with hemodialysis group (HD+ HP),hemodiafiltration group (HDF) and hemodialysis group (HD).Plasma β2-microglobulin(β2-MG) and intact parathyroid hormone (iPTH) were measured by means of radio immunoassay at pre and post dialysis,4 weeks and 8 weeks after dialysis,cutaneous pruritus was scored.The remission rate of itching was calculated at 8 weeks after dialysis.The parameters were compared among different groups.Results The level of plasma β2-MG was lower in HD+HP group after dialysis than pre dialysis [(13.48±3.05)mg/L vs.(16.27±4.73) mg/L,t＝2.044,P＜0.05],at 4 weeks and 8 weeks after dialysis,its levels were decreased to (10.97±3.25)mg/L(t＝3.808,P＝0.002)and (6.47±2.35)mg/L(t＝7.650,P＝0.000),respectively.The levels of iPTH were also found decrease from(887.5 ± 242.7)ng/L to (688.3 ±223.4)ng/L(t＝3.384,P＝0.004)at 4 weeks and (467.2±102.5) ng/L(t＝6.578,P＝0.000) at 8weeks after dialysis in HD+HP group (all P＜0.01).There were differences of the levels of plasma β2-MG and iPTH at 4 weeks and 8 weeks after dialysis in HDF group (all P＜ 0.05),but no differences of the levels of plasma β2-MG and iPTH during every period were found in HD group(all P＞0.05).The scores of cutaneous pruritus were decreased from (21.17± 5.01) scores to (13.37±2.85) scores(t＝ 5.580,P＝0.000)at 4 weeks and (8.52±4.38) scores(t＝7.838,P＝0.000)at 8 weeks after dialysis in HD+ HP group,and also the scores at 4 and 8 weeks after dialysis in HDF group (all P＜0.01),but there were no significant differences of the scores during every period in HD group (all P＞0.05).The remission rate of itching was better in HD+ HP group than in HDF group [88.24％ (15/17 cases) vs.58.82％ (10/17 cases),x2＝14.44,P＝0.000],better in HDF group than in HD group 23.53％ (4/17 cases) (x2 ＝4.37,P＝0.037).Conclusions HD+HP is superior to HDF in efficiently clear β2-MG and iPTH,and relief cutaneous pruritus,but HD can poorly clear β2-MG and iPTH or relief itching.

Objective To analyze the therapeutic effect and prognosis of peritoneal dialysis in patients with end-stage polycystic kidney disease.Methods A retrospective analysis was performed on patients with polycystic kidney disease who were treated with peritoneal dialysis for more than 3 months between July 2007 and September 2016 in the Second Hospital Affiliated to Soochow University.A total of 45 patients were enrolled in this study.Another 45 patients of non-diabetic nephropathy were selected as the control group matched by gender,age,and time of PD initiation.The information of the two groups such as general data,dialysis related complications,incidence of peritonitis,prognosis was recorded.Survival analysis was performed using the Kaplan-Meier method and Log-rank test.The risk factors affecting patients' survival were analyzed with Cox regression model.Results There were no significant difference in pre-dialysis age,sex ratio,blood pressure,urine volume,body weight,eGFR,biochemical data,and the proportion of hypertension and diabetes mellitus in the polycystic kidney group and control group.24 h ultra-filtration volume,4 h D/Pcr,Kt/V and Ccr between the two groups showed no significant difference (all P ＞ 0.05).The incidence of peritonitis and the time of the first peritonitis in the two groups respectively as one episode per 82.4 months vs one episode per 81.5 months,(35.8±22.8) months vs (34.5±20.9) months had no statistical difference.The ratio of hernia (6.6％ vs 2.2％),thoracic and abdominal leakage (4.4％ vs 2.2％),dialysate leakage (0 vs 0),catheter dysfunction (4.4％ vs 6.6％),exit-site infections (11.1％ vs 6.6％),tunnel infections (4.4％ vs 2.2％) and non PD related infections (11.1％ vs 13.3％) had no significant difference.The 1-year,3-year,5-year patient survival of two groups respectively were 95.2％ vs 93.3％,78.9％ vs 75.0％,67.6％ vs 64.9％ (P=0.475),and 5-year technique survival was 78.7％ vs 76.7％ (P=0.623),demonstrating no obvious difference.Cox regression analysis showed that age and serum albumin were risk factors for the survival of patients.Conclusions The effect and prognosis of peritoneal dialysis in patients with polyeystic kidney and non polyeystic kidney were similar.Peritoneal dialysis is not the contraindication of polycystic kidney.Peritoneal dialysis can be used as a routine renal replacement therapy in patients with polycystic kidney disease.

OBJECTIVE To study the mechanism of drug-resistance of multi-resistant Pseudomonas aeruginosa,and provide the guideline for treatment and control of P.aeruginosa infection in hospital.METHODS Fifty strains of multi-resistant P.aeruginosa were selected with K-B susceptibility method.The three-dimensional method was taken to differentiate the various beta-lactamases.The relative drug-resistance gene was detected by polymerase chain reaction(PCR).RESULTS Among 50 strains of multi-resistant P.aeruginosa,there were 2 strains(4%)producing ESBLs,20 strains(40%)producing AmpC beta-lactamases,and 11 strains(22%) producing ESBLs and AmpC beta-lactamases at the same time.There were 8 positive genes in the detected drug-resistance gene,the most common sources of gene were CTX(56%),OprD(60%) and aac(6′)-Ⅱ(60%),respectively.CONCLUSIONS The main beta-lactamases are AmpC beta-lactamases and the main genotype is CTX in the multi-resistant P.aeruginosa cultured in our area.The main course of imipenem-resistance was deletion of outer membrane proteins,and the aminoglycoside modifying enzyme gene and disinfectant-resistance gene in multi-resistant P.aeruginosa are acquired.In order to reduce the drug-resistance strains and control the infection of P.aeruginosa,antibiotics should be used reasonably according to drug susceptibility testing clinically.