Objective To investigate the risk factors of contrast-induced nephropathy (CIN) in patients after coronary angiography.Methods Two hundred patients underwent coronary angiography were enrolled in this study.The patients were divided into CIN group and non-CIN group according to the occurrence of CIN after coronary angiography of 48-72 h,and then the related risk factors of CIN were analyzed.Results Thirteen cases of CIN were found in 200 patients,and the occurrence rate was 6.5％(13/200).Logistic regression analysis showed that risk factors of CIN included primary renal insufficiency,diabetes,contrast agent dose and advanced age (P ＜ 0.05).Conclusion Primary renal insufficiency,diabetes,contrast agent dose and advanced age are risk factors of CIN in patients after coronary angiography.

AIM:To investigate the safety and complications of femtosecond laser corneal small incision lenticule extraction(SMILE) procedure and discuss the prevention and treatment.METHODS: We retrospectively studied the complications of 403 patients(799 eyes) with myopia and myopic astigmatism treated by SMILE.RESULTS: All the patients underwent the operation successfully.Only 1 case(1 eye)suffered from dark spot and changed to femtosecond laser-assisted LASIK(FS-LASIK), 5 cases(5 eyes, 0.6%) suffered from the suction loss, 11 cases (17 eyes, 2.1%) developed opaque bubble layer.All patients gained perfect uncorrected visual acuity(UCVA) (20/20).The best corrected visual acuity(BCVA) did not decrease after operations.The incidence of haze and diffuse lamellar keratitis was low (0.3% and 0.4%, respectively)and no other complications were observed.There was 9 eyes in 6 patients (1.1%) found regression of refraction at 6mo after surgery, while the UCVA of rest patients reached 1.0 at 3mo after surgery.CONCLUSION: The SMILE procedure has high safety for myopia and myopic astigmatism.Effective prevention and management of the complications is the key to achieve the satisfactory visual acuity.

Cornea is the major refractive components of the eye. As a viscoelastic tissue, cornea exhibits complicated biomechanical properties: non - linear elasticity, anisotropy and viscoelasticity. The biomechanical properties play an important role in keeping the normal structureand function. Changes in biomechanical properties are always earlier than the clinical symptoms. So quantitative measurement of the biomechanical properties benefits the early diagnosis and treatment of diseases. Different methods to measure the biomechanical properties of cornea were reviewed in detail, including classic ex vivo destructive tests, commercially available in vivo measuring methods and other emerging methods with the potential for clinical application but not validated for in vivo measurement. The operating principles, advantages as well as limitations of these methods were also described.

Objectives To study the impact of initial age of treatment on testicular morphology and function in male pa-tients with multiple pituitary hormone deficiency using human chorionic gonadotropin (hCG) and human menopausal gonadotro-pin (hMG). Methods Patients with multiple pituitary hormone deficiency were treated with hCG and hMG while keeping other hormone levels normal. Correlations among their testicular volume, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and height, bone age were analyzed. Results After 6-month hCG and hMG treatment, the penis length of 54 male patients was significantly increased from (2.58 ± 0.69) cm to (4.19 ± 0.77) cm , and penis circumference was also increased from (3.71 ± 1.36) cm to (5.95 ± 1.26) cm;the testicular volume was increased from (1.76 ± 1.49) ml to (5.20±2.30) ml;height was increased from (147.01 ± 12.29) cm to (151.98 ± 11.52) cm and bone age was increased from (11.22 ± 2.71) years to (11.64 ± 2.72) years;the differences before and after treatment were statistically significant (all P<0.01). As the patients' age increased, their testicular volume and testosterone level increased slowly, and significant differences amongst each age group were found (P<0.05). The in-creased value of testicular volume, serum FSH and LH levels, and height growth tended to be negatively correlated to the initial age of therapy (r=-0.517~-0.334, P<0.05). Conclusions Early and proper treatment in male patients with multiple pituitary hormone deficiency using hCG and hMG improves testicular function and secondary sex characteristics.

MicroRNAs (miRNAs) are evolutionarily conserved small noncoding RNAs of-22 nucleotides that exist in a wide variety of organisms,including animals,plants and virus.Mature miRNAs are able to control gene expression at a post-transcriptional level,either by blocking mRNA translation or inducing their degradation.Hepatitis B virus X protein (HBX) is a 17000 protein that is implicated to play a crucial role in hepatocarcinogenesis.Recently,many studies have shown that HBX is associated with miRNA regulation,and is involved in regulating fundamental biological processes of tumor in cell proliferation,differentiation and apoptosis.

Objective The K-ras gene plays a major role in the development , progression, and drug selection for the target treatment of colorectal cancer .The aim of this study was to evaluate the feasibility of detecting K-ras mutation in colorectal cancer by high-resolution melting ( HRM) analysis and to investigate the relationship between K-ras mutation and the clinicopathological parame-ters of colorectal cancer. Methods We collected the tissue samples of colorectal cancer from 179 patients, detected the mutations in codons 12 and 13 of the K-ras gene, and analyzed the relationship between K-ras mutation and the clinicopathological parameters of the patients. Results In the 179 cases of colorectal cancer, K-ras mutation was found in 77 (43.02%), significantly higher in those aged ≥60 years than in those aged <60 years (55.17% vs 33.70%, P<0.05).Multivariate logistic regression analysis showed a significant influence of age on K-ras mutation (OR=1.506, 95%CI:1.028-2.011, P<0.05). Conclusion HRM analysis is a rapid, sensitive, and inexpensive diagnostic tool for the detection of K-ras mutation, and K-ras mutation is associated with the age of colorectal cancer patients .

ObjectiveTo investigate the changes of serum myocardial enzymes and high density lipoprotein cholesterol(HDL-C) in children with septic shock.MethodsFifty-two children with septic shock in our hospital from Jan 2006 to Mar 2011 were divided into severe septic shock group( n =27 ) and mild septic shock group ( n =25 ).The serum creatine kinase-MB ( CK-MB ),α-hydroxybutyrate dehydrogenase (α-HBDH),lactic dehydrogenase(LDH) and HDL-C were analysed in both two groups on 1,2,4,7,10,15 d,and compared with 32 normal children as control group.Meanwhile,the children's condition,death cases and cured time were recorded.ResultsThe levels of serum CK-MB [ ( 32.084 ± 4.595 ) U/L,( 61.481 ±5.639) U/L],α-HBDH/LDH(0.694 ±0.080,0.884 ±0.079) in mild and severe septic shock groups were higher than those of normal control group[ (21.675 ± 3.453) U/L ] and (0.443 ± 0.065 ) ( P ＜ 0.01 ) ;the levels of serum HDL-C[ (0.646 ±0.067) mmol/L,(0.310 ± 0.124) mmol/L ] in the two septic shock groups were decreased significantly than that of control group[ ( 1.012 ±0.156) mmol/L] (P ＜0.01 ).Five cases died in the severe septic shock group while no cases died in mild septic shock group.The times of CK-MB recovered[ (9.82 ±1.76) d vs (4.68 ± 1.22) d],α-HBDH/LDH recovered[ (7.23 ± 1.38) d vs (3.76 ± 0.83 ) d] and HDL recovered[ ( 12.14 ± 2.21 ) d vs ( 6.48 ± 1.33 ) d ] were more slowly in severe septic shock group than those of mild septic shock group( P ＜ 0.01 ).ConclusionThe higher of the serum CK-MB and α-HBDH/LDH,and the lower of HDL-C in septic shock children,the disease is more severe,the recovery time is longer and a worse prognosis may occur.

The culture conditions of Saccharomyces cerevisiae sp.strain by 1.1 b were optimized for the production of D-(-)-mandelate dehydrogenase which is useful for the asymmetric bioreduction of benzoylformate to form D-(-)-mandelate.The optimum medium(per liter)consistes of 60 g peptone,30 g maltose, 0.5 g MgSO_4,0.01 g ZnSO_4,1.0 g KCl.After optimization of the culture medium,the enzyme production in shake flasks is enhanced from 2.56 to 20.21 U/L.The optimum fermentation conditions were determined as follows:medium volume 100 mL(i.e.,40%for a 250-mL shake flask),pH 6.5,inoculum size 10%,temperature 30℃,and cultivation time 25 h.

AIM　This study was conducted to identify the human CYP isoforms responsible for the biotransformation of clivorine in human liver microsomes and the mechanism of metabolism-induced hepatotoxicity of clivorine. METHODS　Human liver microsomes were used to investigate the metabolism of clivorine in vitro. Selective CYP-450 inhibitors and cDNA expressed human CYPs were used to study their effects on the formation of hepatotoxic metabolites and the metabolism of clivorine and the principal CYP-450 isoform involved in the formation of hepatotoxic metabolite. RESULTS　Four metabolites, namely dehydroretronecine(DHR), 7-glutathionyl-dehydroretronecine(7-GSH-DHR), 7,9-diglutathionyl-dehydroretronecine(7,9-diGSH-DHR) and clivoric acid were found in the microsomal incubations. Chemical inhibition studies indicated that the metabolism of clivorine and the formation of pyrrolic metabolites as well as the bound pyrroles were strongly inhibited by CYP3A inhibitor ketoconazole(Ket). Whereas α-naphthoflavone(Nap), sulfaphenazole(Sulp), quinidine(Qui), diethyldithiocarbamate(DDC) have no significant effects on the metabolism of clivorine and the formation of pyrrolic metabolites in human liver microsomes. The results of metabolism of clivorine by cDNA expressed human CYPs showed that only CYP3A4 was found to be capable of catalyzing the metabolism of clivorine, while CYP1A2, CYP2C9, CYP2D6 and CYP2E1 did not play significant roles in the metabolism of clivorine and the formation of pyrrolic metabolites. CONCLUSION　The resultsdemonstrated that the pyrrolic metabolites were the major in vitro metabolites of clivorine and CYP3A4 was the major CYP isoform involved in clivorine metabolism and the formation of hepatotoxic pyrrolic metabolites in human liver microsomes. CYP3A4 plays a key role in the clivorine induced hepatotoxicity.

ObjectiveTo understand the urban preference for outpatient pre-registration in large hospitals,and probe into the influencing factors,for recommendations to improve outpatient preregistration at the hospitals.Methods With Nanjing City as an example,the authors used tailoreddesigned questionnaire and qualitative interviews to investigate the preference of 1200 households of local residents regarding outpatient clinical pre-registration service at the tertiary hospitals.Results Age,education and economic factors are found to be the most important influential ones for urban preference in their outpatient pre-registration at large hospitals.Other factors include traditional approaches to outpatient clinic,inconvenience for outpatient pre-registration,and concerns for appointment breaking.Conclusion in order to increase their preference for outpatient pre-registration at large hospitals,hospitals should work to explore and improve approaches for outpatient pre-registration,and better their service quality,which will involve greater participation of both the hospital staff and residents.