Objective To investigate the intervention of Amlodipine combined with alanine aminotransferase(ALT)-711 on blood pressure and preventing of target organ remodels of Spontaneously Hypertensive Rats(SHR),and to explore an optimized treatment design.Methods A total of 24 SHRs at 12-Week-old male were randomly divided into 4 groups,with 6 SHRs in each group.In the control group(Group A)the SHR were given normal saline 1 ml/(kg · d)via intragastric administration; the SHRs in Group B were treated with Amlodipine 1 mg/(kg · d) via ntragastric administration; the SHRs in Group C were treated with ALT-711 10 mg/(kg · d)via ntragastric administration;the SHRs were treated with Amlodipine 1 mg/(kg · d)combined with ALT-711 10 mg/(kg · d)via ntragastric administration in Group D.All groups were treated for 8 weeks,and the blood pressure in mouse tail were monitored.After 8 weeks,all SHRs were executed in the condition of anaesthedia.Right cervical artery,heart and kidney were measured through immunohistochemistry,histological stain and imagine analysis.The remodeling of vascular,heart,kidney were compared,and collagen volume fraction,advanced glycation end products (AGEs) and fibronectin (FN) expression were measured.Results (1) After treatment for 8 weeks,blood pressure of SHRs in the 4 groups were (184.72 + 15.14),(108.00 ±10.19),(155.64±10.03)and (99.83 ± 12.27) nun Hg in Group A,B,C and D,respectively.The blood pressure in Group D was the lowest in the 4 groups (F =14.6702,P ＜ 0.05),whereas it is not significantly different from Group B (P ＞ 0.05).(2) The mean thickness of carotid arteries were (0.450 ± 0.023),(0.380 ±0.021),(0.420 ±0.019) and (0.320 ±0.020) mm in Group A,B,C and D,respectively.The mean thickness of carotid arteries in Group D was the lowest in the 4 groups(F =4.1463,P ＜0.05).(3).The mean intimal area of carotid arteries were (19.0 + 1.3) × 105,(25.0 ± 1.4) × 105,(29.8 + 1.5) × 105 and (21.3 ±1.3) × l05 μm2 in Group A,B,C and D,respectively.The mean intimal area of carotid arteries in Group D was significantly smallest than the other 3 groups(F =4.4305,P ＜0.05).(4) The collagen content in different organs in the 4 groups after treatment 8 weeks:in carotid arteries,they were (6.25 ± 0.19)％,(3.56 ± 0.03) ％,(4.25 ± 0.12) ％ and (1.32 ± 0.05) ％ in Group A,B,C and D,respectively.The collagen content in Group D were significantly lower than the other 3 groups (F =4.9316,P ＜ 0.01).In myocardia:collagen content in Group A,B,C and D were (6.02 ± 0.21)％,(4.08 ± 0.14)％,(4.44 ± 0.11)％ and (1.13 ± 0.08) ％ respectively,and it was the lowest in Group D (F =4.2469,P ＜ 0.01).In kidney,the collagen content in Group A,B,C and D were (13.23 ±0.51)％,(7.28 ±0.35)％,(8.33 ±0.22)％ and (5.66 ±0.13)％ respectively,and it was the lowest in Group D(F=8.1038,P ＜0.01).(5).Express rate of AGEs in carotid arteries in Group A,B,C and D were (31.48 ±7.30)％,(20.55 ±5.91)％,(10.48 ±0.98)％ and (7.56 ± 0.68) ％ respectively,with the lowest expression in Group D (F =11.4537,P ＜ 0.01).Express rate of FN in carotid arteries in Group A,B,C and D group were (28.18 ±5.66)％,(17.26 ±5.83)％,(18.20 ±1.44) ％ and (15.12 ± 1.03) ％ respectively,with the lowest expression in Group D (F =9.0036,P ＜ 0.01).Conclusion Amlodipine combined with ALT-711 decreased blood pressure more effectively and prevented the remodel of target organ in SHRs than Amlodipine or ALT-711 alone.

Case analysis method,which was a new teaching mode,was proposed for some problems in current traditional teaching mode.The concrete operation content of case analysis method in lemological teaching was described.The results of the survey analysis showed that the teaching effectiveness of the new teaching mode was obviously better than that of traditional teaching mode.

Objective To investigate the clinical features,diagnosis and treatment of pure redcell aplasia cased by human parvovirus B19 infection after renal transplantation.Method The clinical data including clinical symptoms and physical signs,laboratory and pathological examinations and outcomes of treatment in 8 cases at our hospital from Aug.2011 to Mar.2012 were analyzed retrospective,and relative literatures were reviewd.Result Pure red-cell aplasia occurred in all 8 cases 1 to 3 months after kidney transplantation,and one case had recurremt pure red-cell aplasia.The manifestations including recurrent reduction of hemoglobin,and pure red-cell aplasia was definitely diagnosed by bone marrow morphology,pathology,and polymerase chain reaction assay PVB19 DNA.Treatment of intravenous immunoglobulin and conversion of tacrolimus into ciclosporin was effective.Conclusion PVB19 is a rare but clinically significant infection that manifests as pure red cell aplasia during the early post-transplantation.Treatment of intravenous immunoglobulin and conversion of tacrolimus into ciclosporin in most cases was effective.

Objective To evaluate the effects of baseline and changes of peritoneal transport characteristics on the prognosis of maintaining peritoneal dialysis (PD) patients.Methods Five hundred and eight-six PD patients who started PD from September 11,2006 to October 30,2014 in a single center were included and followed up until March 30,2016.According to their baseline D/Pcr value in peritoneal equilibrium test (PET),the patients were divided into high transport (H) group (D/ Pcr 0.82-1.03),high average transport (HA) group (D/Pcr 0.65-0.81),low average transport (LA) group (D/Pcr 0.50-0.64) and low transport (L) group (D/Pcr 0.34-0.49).According to the changes of follow-up D/Pcr comparing with baseline D/Pcr,the patients were also divided into ascending group,descending group and no-change group.The patient and technical survival rates were estimated by Kaplan-Meier analysis.Cox proportional hazards analyses were used to analyze the risk factors for PD patient death and technical failure.Results There were 67 patients in L group,229 patients in LA group,252 patients in HA group,and 38 patients in H group.The patient survival rate in H group was significantly lower than those of L group (P=0.036),LA group (P=0.008) and HA group (P=0.041).There was no significant difference on technical survival rate among these 4 groups.According to the tendency of follow-up D/Pcr changes,there were 127 patients in ascending group,101 patients in descending group and 179 patients in no-change group.There was no significant difference on patient survival among these 3 groups (P=0.064).However in patients with a high transport rate (D/Pcr≥0.65),the patient survival was lower in descending group than those in ascending group (P=0.033) and nochange group (P=0.049).Age over 65 years old (HR=2.499),malnutrition during follow-up (HR=3.144),ultrafiltration less than 400 ml/d during follow-up (HR=1.863) and high sensitive C reactive protein≥ 10 mg/L (HR=4.526) were the independent risk factors for patient death (all P ＜ 0.05).Gender (HR=1.609),age over 65 years old (HR=1.929),ultrafiltration less than 400 ml/d during follow-up (HR=1.708),high sensitive C reactive protein ≥10 mg/L (HR=1.829),malnutrition (HR=1.876) and change of peritoneal transport function (HR=0.579) affect technical failure (all P ＜ 0.05).Conclusions The survival rate of PD patients with basal high peritoneal transit is relatively low,especially for patients with descending transport rate during follow-up.The concern on the peritoneal transport status is constructive for the prognosis of PD patients.

Objective To analyze the early renal function of donors after nephrectomy.Methods Clinical data of 467 cases of living kidney donors during the period from April,2010 and November,2014 in our center were retrospectively analyzed.Data on serum creatinine (Scr),glomerular filtration rate (GFR),serum uric acid (UA),and urine microproteins before operation and three days,seven days,one month and three months after operation were collected to evaluate the impact of nephrectomy on early renal function after operation for donators.Results Before operation and three days,seven days,one month,three months after operation,the average serum creatinine (Scr) level was (59.9±12.8),(85.8±21.0),(91.2±21.3),(92.8±21.6),(91.0±21.3) μmol/L,respectively; The GFR were (113.5±25.3),(75.1± 17.9),(70.3± 15.2),(68.5± 16.0),(69.5± 15.1) ml/min,respectively; The levels of uric acid were (292.60±79.58),(142.18±55.28),(228.41±66.39),(321.31± 83.72),(346.61±87.21) μmol/L,respectively; All these data above-mentioned after operation reached statistical significance compared with that before operation (P ＜ 0.05).Parameters including urine IgG,urine albumin,urine retinol-binding protein and urine β2-microglobulin post-operation time point were significantly different when compared with relative parameters pre-operation (P ＜ 0.05).Conclusions Nephrectomy has significant influence on GFR,uric acid,and urine microprotein for donors in the early stage after operation.It's worth to evaluate nephrectomy's long-term effect on the renal function of donors in clinical practice.

Objective To evaluate clinical significance of two real-time fluorescence quantitative PCR kits for quantitative detection of HBV DNA and detection performance at different viral load levels.Methods A series of calibrators with different concentrations(1×106,5×105,1×105,5×104,1×104,5×103,1×103,5×102,1×102,1×101 kIU/L) were prepared with AB-type sera using the second generation WHO international standard (NIBSC code:97/750). HBV viral load in the sera of 78 patients,30 healthy blood donors and 10 calibrators were detected by real-time fluorescence quantitative PCR HBV DNA test kit from PIJI Bio-Technical Development Company Ltd (PG kit) and Cobas AmpliPrep/Cobas TaqMan HBV test kit. The correlation of the two methods was evaluated, and the performance of the two kits different viral load levels was evaluated. The false negative rate was analyzed. Negative control, low positive control and high positive control were included in every batch. Results Both two kits showed the correct results for the 10 specimens from the WHO international standards. The lowest detection limit of HBV DNA for Roche Cobas AmpliPrep/Cobas TaqMan HBV test and PG kit were 2.00 (kIU/L, lg) and 3.00 (kIU/L,lg) ,respectively. There was linear correlation between the results from Roche Cobas AmpliPrep/Cobas TaqMan HBV test and PG kit ( R2=0.938 7, P < 0.01 ), the upper limit of Roche kit had coincided with theoretical value. The samples with HBV DNA level above the upper limit of detection were diluted and retested to obtain the precise result. The result form Roche Cobas AmpliPrep/Cabas TaqMan HBV test [(8.35±0.20) kIU/L, lg] was higher than that from PG kit [(7.73±0.42 ) kIU/L, lg] (t=3. 776, P <0.05) . The detection of 108 serum samples showed that the level of HBV DNA detected by Roche Cobas AmpliPrep/Cobas TaqMan HBV test [(5.88±1.64) kIU/L, lg] was higher than that by PG kit [(5.25±1.55 kIU/L,lg] (t=12. 297 ,P <0.01 ). The correlation coefficients were high in samples with high HBV viral load[HBV DNA(>5.00 and≤7.00) kIU/L,Ig,R2=0. 779 7, P <0.01 ;HBV DNA( >7.00 ands≤9.00) kIU/L,lg,R2=0.603 7, P <0.01]. The correlation coefficient was low in samples with low HBV viral load[HBV DNA ( > 3.00 and≤5.00) kIU/L, lg, R2=0. 417 3, P <0.01 )]. When HBV DNA ( >3.00 and≤4.00) kIU/L,lg,the false negative rate was 33.3% (5/15). When HBV DNA ( > 1.08and≤3.00) kIU/L,lg,none of positive samples was detected with PG kit. Conclusions PG kit is not as good as Cobas AmpliPrep/Cobas TaqMan HBV test . The linear correlation between the results from the two kits is good. The correlation between the results detected with PG kit and Cobas AmpliPrep/Cobas TaqMan HBV test is higher in the high viral load groups than in the low viral load group. It is suggested that PG kit had a narrower linear range.

Objective To analyze the prognosis and risk factors for antineutrophil cytoplasmic antibody?associated vasculitis (AAV) patients on maintaining dialysis. Methods AAV patients on maintaining peritoneal dialysis (PD) or hemodialysis (HD) in First Affiliated Hospital Zhejiang University from June 2007 to June 2015 were included, and were followed up until death, kidney transplant, changed dialysis modalities or January 31, 2016. Patients were divided into PD group and HD group for comparison. Their survival rates and risk factors were analyzed by Kaplan?Meier analysis and COX regression model respectively. Results A total of 123 cases were chosen, with a median duration of dialysis for 854 (388, 1573) days, and with 88 cases (71.5%) on HD and 35 cases (28.5%) on PD. Fifty?two patients (42.3%) were more than 65 years old. At the median follow?up time of 36 months, 39 patients (31.7%) died. The main causes of death were cardiovascular events (30.8%) and infection (23.1%). COX regression analysis showed that patients older than 65 years old (HR=3.289, P=0.001), with cardiovascular disease (HR=3.241, P=0.003) and interstitial pneumonia (HR=2.173, P=0.048) at the dialysis onset were independent risk factors affecting survival. Conclusions Factors including age (older than 65 years), pre?dialysis cardiovascular disease and interstitial pneumonia were independent risk factors affecting survival of AAV patients on maintaining dialysis, then infections and cardiovascular events were the main causes of death.

Triple-negative breast cancer (TNBC) represents a distinct subtype of breast cancer, characterized by unique clinical traits including early lung metastasis, elevated recurrence rates, and diminished survival prospects. Owing to the lack of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression, concrete therapeutic targets remain elusive, thereby confining available clinical treatment methods. In the context of advanced TNBC, chemotherapy remains the predominant therapeutic approach. In recent years, with the in-depth study of tumor microenvironment, new immunotherapy targets have been discovered one after another. Thus, immunotherapy-based combined therapy strategies have brought new hope in patients with advanced TNBC.

Objective To determine the distribution of HCV genotypes in patients with chronic hepatitis C,study the distribution of genotype in different gender and the relationship between genotypes and serum HCV-RNA levels.Methods Two hundred and six cases of HCV RNA positive patients(all with relevant clinical data) receiving pegylated interferon therapy were collected from May to December 2010.HCV RNA was detected in 206 hepatitis C patients from 40 hospitals in China by Roche Cobas AmpliPrep/Cobas TaqMan HBV test,and genotype was determined by Abbott RealTime HCV G enotype Ⅱ .The distribution of genotypes in the gender was analyzed by chi-square test analysis.The relationship between genotypes and serum HCV RNA levels was detected by single factor analysis and two independent sample t test analysis.Results There were seven different subtypes of HCV in 206 samples,including genotype 1,7 cases(3.4% ,7/206); genotype 1a,2 cases(1.0%,2/206); genotype 1b,123 cases (59.7 %,123/206); genotype 2,32 cases(15.5 %,32/206); genotype 3,27 cases(13.1%,27/206); genotype 6,6 cases(2.9% ,6/206) ;genotype 1/6,5 cases(2.4% ,5/206) ;genotype 2/4,1 cases(0.5%,1/206).There was no significant difference between HCV genotype and gender in 132 cases with genotype 1 and 65 cases with non-genotype 1(genotype 2,3,6) (x2 = 0.000,P ＞ 0.05).There was significant association between quantity of HCV RNA and genotype in 188 patients with HCV(F = 3.371,P＜ 0.01).The 197 patients with HCV single genotype were divided into five groups in terms of region(East,South,West,North and Center).There was no significant difference between HCV genotype 1 and non-genotype 1 in the five groups(x2 = 5.840,P ＞ 0.05).Conclusions It is suggested that HCV 1 b is the most prevalent type in China,followed by HCV 2.There is no significant difference between HCV genotype and gender.The levels of HCV RNA with genotype 1b are significantly higher than those with genotype 3.The levels of HCV RNA with genotype 2 are significantly higher than those with genotype 3.The levels of HCV RNA with genotype 6 are significantly higher than those with genotype 3.

Objective To discuss whether preoperative extracorporeal shock wave lithotripsy (ESWL) could improve the efficacy of percutaneous nephrolithotomy (PCNL) for complicated renal calculi. Methods 160 cases of complicated renal calculi patients were divided into observation group (80) and control group (80) at random. Take conventional PCNL treatment for control group, and ESWL treatment one day before conventional PCNL treatment for observation group. Record the operation time, intraoperative blood loss, postoperative calculi clearance rate, complications, treatment costs, hospital stays of two groups of patients, then compare the curative effects between the two groups. Results Results are very different in the two groups, and the therapeutic effect of observation group is much better than control group (P < 0.05). Conclusions For complicated renal calculi, compared with conventional PCNL, in reducing the residual stone rate shorting the operation time, reducing the operation number, complications, treatment costs and the length of hospital stay, PCNL preoperative ESWL have obvious advantages. It is a kind of both economic and safe and effective treatment method.