There is significant evidence to show that many neurosurgical patients with hyponatremia, who were previously diagnosed with syndrome of inappropriate antidiuretic hormone secretion(SIADH), actually have cerebral salt wasting syndrome(CSWS). The critical difference between SIADH and CSWS is that CSWS involves renal salt loss leading to hyponatremia and volume loss, whereas SIADH is a euvolemic or hypervolemic condition. The primary treatment for CSWS is water and salt replacement. The mechanisms underlying CSWS are not understood but may involve ANP or other natriuretic factors and direct neural influence on renal function.

Objective To investigate the prevalences of metabolic disorders of glucose and lipids in the first degree relatives (FDP) of type 2 diabetic patients in Qingdao,China. Methods 1392 subjects were recruited,including 528 T2DM-FDR(parent and/or siblings have T2DM) and 864 NC-FDR(parent and siblings did not have DM). All subjects received both standard 75g oral glucose tolerance test and measurements of body weight,height,waist and hip circumference,percentage of body fat,blood pressure,blood lipid,and plasma uric acid. Results (1) The prevalence of diabetes was higher in DM-FDR than in NC-FDR (24.24% vs 17.01%,P

In order to ef fectively control the quality ofSophora lfos carbonisatus (flower and flower buds), this study established quality control methods and standard of the decoction pieces. Referring to the related methods in appendix of Chinese Pharmacopoeia (2010 Edition), the moisture, total ash, acid insoluble ash, alcohol extracts ofSophora lfos carbonisatus were measured, respectively, with rutin, quercetin as control substance. The eluents for rutin and quercetin are ethyl acetate - formic acid - water (8: 1:1) and chloroform - methanol - water (6.5:1:1), respectively and all TLC plates were observed at 365 nm. Total flavonoids are measured by visible - UV - spectrophotometric, and rutin and quercetin were determined by HPLC. The chromatographic conditions for rutin are: Kromasil C18 as the stationary phase, methanol -1% acetic acid (32:68) as mobile phase, flow rate: 0.8 mL·min-1, detection wavelength 257 nm,the column temperature 35℃; for quercetin: Kromasil C18 as the stationary phase, methanol -0.4% acetic acid (44:56) as the mobile phase, flow rate: 0.8 mL·min-1, detection wavelength 257 nm, the column temperature 40℃.The contents of moisture, total ash, acid insoluble ash, should not exceed 6%, 16%, 8.0% in flower and not exceed 6.0%,9.0%, 1.5% in buds, respectively. Under the conditions of TLC, in flower and flower buds, 2 reference substances can be separated well with others. Extract, total flavonoids, rutin, quercetin were no lower than 40.0%, 5.0%, 2.5%,0. 2% in flower and no lower than 45.0%, 10.0%, 5.0%, 0.9% in buds, respectively. The established standards can improve the levels of quality control, provide experimental data for safety and efficacy of clinical application of Sophora flos carbonisatus, and also offer supporting data for the Chinese Pharmacopoeia 2015 Edition.

Objective To assess the incidence,risk factors and mortality of acute kidney injury(AKI)in patients with chronic myelogeneous leukemia(CML)after myeloablative allogenetic hematopoietic stem cell transplantation(HSCT). Methods Renal function in 93 CML patients undergone myeloablative allo-HSCT was retrospectively analyzed by the RIFLE criteria. Results Thirty-nine patients (41.9%) developed AKI at a median of 40 days after allo-HSCT, including 24 AKI-R patients(25.8%), 10 AKI-I patients(10.8%) and 5 AKI-F patients (5.4%). The morbidity of AKI in patients with ≥Ⅲ acute graft-versus-host disease (aGVHD) and without ＜Ⅲ GVHD was (81.82±11.63)% and (36.59±5.32)% (P=0.0037)rospectively. The morbidity of AKI in patients with increased total bilirubin and without increased total bilirubin was (72.73±13.43)% and (37.04±5.37)%(P=0.0192) respectively. ≥Ⅲ aGVHD was peor-prognostic factor of AKI and RR was 2.773 [95%CI (1.073-7.167), P=0.035]. RR of AKI-I and AKI-F in patients with ≥Ⅲ aGVHD was 6.320195%CI (1.464-27.291), P=0.013]. The mortality within 100 days after allo-HSCT of patients with AKI was significantly different as compared to patients without AKI (P=0.001). Six-mouth survival rates of different class AKI patients after myeloablative allo-HSCT were (86.96±7.02)% (AKI-R), (70.00±14.49)% (AKI-I), 0 (AKI-F) (P=0.000)respectively. Conclusions AKI is one of the main complications in CML patients after myeloablative allo-HSCT. ≥Ⅲ aGVHD and increased total bilimbin are poor-prognostic factors of AKI, and higher morbidity of AKI-I and AKI-F can be found in patients with ≥Ⅲ aGVHD. With the deteriorated AKI, 6-month survival is decreased. RIFLE criteria is sensitive to the early diagnosis of renal function. Moreover RIFLE can monitor the progression of AKI and predict the clinical outcome.

Objective To evaluate the precision and uncertainty and comparison analysis of 6 items blood lipids index among 5 different Beckman AU biochemical testing systems ,such as triglyceride(TG) ,total cholesterol(TCHO) ,high density lipoprotein cholesterol(HDL‐C) ,low density lipoprotein cholesterol(LDL‐C) ,apolipoproteins A1(APOA1) ,apolipoproteins B(APOB) .Meth‐ods According to the document the EP15‐A2 of national Committee for Clinical Laboratory Standards ,6 items blood lipids index were respectively detected by 5 different Beckman AU biochemical testing systems to obtain precision and comparison .The intra‐and inter‐precision and results of comparability among different system were low than 1/4 or 1/3 or 1/2 CLIA′88 as evaluation standard ,respectively .The measurement uncertainty of these items were evaluated by the calibrator uncertainty and internal quality control and external quality control .Results The intra‐and inter‐or day‐to‐day precision and relative bias were accepted by clinical requirements .The expanded measurement uncertainty for TG was 0 .079 mmol/L and 0 .035mmol/L .The expanded measurement uncertainty for TCHO was 0 .248 mmol/L and 0 .157 mmol/L .The expanded measurement uncertainty for HDL‐C was 0 .144 mmol/L and 0 .018 mmol/L .The expanded measurement uncertainty for LDL‐C was 0 .140 mmol/L and 0 .186 mmol/L .The ex‐panded measurement uncertainty for APOA1 was 0 .148 mmol/L and 0 .090 mmol/L .The expanded measurement uncertainty for APOB was 0 .104 mmol/L and 0 .058 mmol/L .Conclusion The results of 6 items blood lipids index respectively show well preci‐sion and significantly correlation among 5 different Beckman AU biochemical testing systems and the results were comparable ,and the influence factor of detection results were expression directly by evaluating the measurement uncertainty of 6 items blood lipids index .This way of assessment is simple .

Objective To analyze morbidity and prognosis of acute kidney injury (AKI) in patients with acute leukemia after myeloablative allogenetic hematopoietic stem cell transplantation (HSCT).Methods Renal function and related clinical data in 66 patients receiving myeloablative alloHSCT were retrospectively analyzed.Renal function was evaluated by RIFLE criteria,which defines AKI as three grades of severity-risk (AKI-R),injury (AKI-I) and failure (AKI-F).Results Thirtyseven recipients (56.1%) developed AKI at a median of 29 days after allo-HSCT,including AKI-R(19 recipients,28.8 %),AKI-I (11 recipients,16.7 %),AKI-F (7 recipients,10.6 %).Compared with baseline value,serum creatinine level in the recipients was significantly increased at the 21st day after transplantation (P＜0.05).During 100 days after HSCT,the morbidity of AKI-F in recipients with HVOD and without HVOD were respectively (55.56 ± 22.22)% and (9.01 ± 4.75)% (P＜0.01).The morbidity of AKI in recipients with or without increased total bilirubin was respectively (68.75 ± 24.54)% and (8.38 ± 4.17)% (P＜0.01).The morbidity of AKI in recipients with or without increased CsA concentration was respectively (66.67 ± 10.29) % and (44.44 ± 8.28) % (P＜0.05).100-day survival rate in recipients after myeloablative allo-HSCT without AKI,with AKI-R,AKI-I and AKI-F was respectively (89.66 ± 5.66) %,(83.88 ± 8.54) %,(81.82 ± 11.63) % and (42.86 ± 18.7) % (P＜0.05).Conclusion AKI is one of the main complications in patients with acute leukemia after myeloablative allo-HSCT.The influence of different class AKI on the mortality was different.The earlier diagnosis,prophylaxis and treatment of AKI by the RIFLF criteria might increase the survival rate in recipients with HSCT.

Objectiv e To investigate the correlation between ( CAG) n repeat polymorphism of androgen receptor(AR)geneandmalebreastcancer.Methods 40casesofmalebreastcancerand40controlswerecol-lected.DNA was extracted from peripheral blood and the AR gene CAG coding exon sequences for PCR amplifica -tion,sequencing and calculated the number of CAG repeats frquency .χ2 test and Logistic regression analysis were used assess the AR gene CAG repeat length frequency affect the number of male breast cancer risk .Results There was statistically significant difference in male breast cancer cases and controls the number of CAG repeat length frequency.Man for whom the(CAG)n≥22 repeat sequence had 3.52 times risk of male breast compared (CAG)n≤22(OR=3.52,P=0.036).Conclusion AR gene CAG repeat length is a predictor of the frequency of male breast cancer risk .Longer CAG repeats can increase the risk of male breast cancer .

OBJECTIVETo investigate the feasibility of ear reconstruction using local expanded scarred skin flap.

METHODWe used local postauricular expanded scar skin flaps to reconstruct external ear in 24 patients.

RESULTSOf these cases, 22 flaps survived completely. In 2 patients, the cartilage framework exposed over the upper pole of helix region because of undue tension in suturing the tissue edges. One year's follow-up revealed satisfactory results.

CONCLUSIONUsing the expanded scarred skin flap for ear reconstruction is practical and effective, when there's no normal skin available in the local area.

Adolescent ; Adult ; Child ; Ear, External ; surgery ; Female ; Humans ; Male ; Rhinoplasty ; Surgical Flaps ; Tissue Expansion

Objective To investigate the expression of regulators of G protein signaling(RGS), including RGS2, RGS3 and RGS4 in OLETF rats, as well as the effects of metformin on these expressions. Methods LETO rats were used as control group. Eight-week-old male OLETF rats were assigned to two guoups randomly:model and trial(metfomin dose during 8~(th) to 22~(nd) weeks:300mg kg~(-1)·d~(-1);during 23rd to 28th weeks:400 mg·kg~(-1) ·d~(-1))groups. Expressions of RGS mRNA in aorta and heart werequantified by real-time PCR. Results RGS2, RGS3 and RGS4 mRNA of the thoracic aorta and left ventricle were significantly higher in model group than in control group (P<0.01). Compared with model group, metformin significantly reduced their mRNA in trial group (P<0.01). Conclusions Upregulation of RGS2, RGS3 and RGS4 mRNA expression in the thoracic aorta and left ventricle of OLETF rats is in correlation with cardiovascular lesions; while downregulation of their expression is in correlation with the action of metformin.

Objective To analyze the outcomes and the prognostic factors of hematopoietic stem cell transplantation (HSCT) in combination with imatinib for Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL). Methods All 32 patients with Ph+ ALL achieved hematologic complete remission (CR) at time of transplantation, including 27 cases in the first CR (CR1) and 5 in CR2. Nineteen patients achieved molecular remission (MR). Among 32 patients, 4 received autologous HSCT (AHSCT), and 28 allogeneic HSCT (allo-HSCT). The conditioning regimens comprised of total body irradiation (TBI), cyclophosphamide, fludarabine and cytarabine. The median number of transfused mononuclear cells was 5. 6 × 108/kg, and that of CD34+ cells was 2. 94 × 106 /kg. Thirty-one patients were administrated imatinib orally before transplantion, at a dose of 400～600 mg/day, and 16 patients after transplantation, including 7 for prevention at a dose of 300～400 mg/day and 9 for salvage treatment at a dose of 400 ～ 600 mg/day. Results Hematopoietic reconstitution was achieved in all 32 patients. Three-year estimate of overall survival (OS) was (62. 1±8. 6)%, leukemia-free survival (LFS) (59. 2 ± 8. 7)%, relapse rate (RR) (17. 7 ± 7. 2)% and transplant-related mortality (26. 2 ± 8. 0) %. All 4 undergoing AHSCT were alive, and 3 out of them were in continuous CR with durations of 14, 18 and 67 months respectively. The univariate analysis for prognosis in allo-HSCT showed that the OS of HLA-matched sibling donors group was 76. 5 %,higher than that of unrelated or haploidentical donors group (27. 3 %, P＜0. 05), and so was LFS (70. 6 % vs 27. 3 %, P＜0. 05). RR in patients achieving MR at time of transplantation was 5. 6 %,lower than that in those not achieving MR (40. 0 %, P＜0. 05). RR in patients in CR1 at time of transplantation was 12. 5 %, lower than that in those in CR2 (50 %, P ＜0. 05). Conclusion Imatinib improved the outcomes of HSCT for Ph+ ALL, especially to patients achieving MR at time of transplantation and transplantation in early stage (CR1).