In recent years the incidence of acute kidney injury (AKI) has increased, with a high mortality rate and poor prognosis.The key of improving the prognosis of AKI is early diagnosis and intervention.Due to the lack of biomarkers of early diagnosis in AKI, the effective early treatment is generally delayed.Traditional diagnosis biomarkers such as serum creatinine and blood urea are delayed and affected by various factors.Recently, some new potential early diagnostic biomarkers have been found.MicroRNA(hereinafter referred to as the miRNA) is a kind of endogenous non-coding small RNA, and studies have shown that it is related to the development of AKI.

ObjectiveTo explore the role and mechanism of NGAL in the process of hypoxia/ reoxygenation (H/R) injury in human renal tubular epithelial cell (HK-2).MethodsThe H/R model of HK-2 cells was established in vitro (oxygen concentration ＜ 0.1％ ).The expressions of NGAL in the cells of H/R group and control group were determined by WB and real-time RT-PCR.The cell models were treated with 50,100,200,400 and 1 000 ng/ml of recombinant NGAL respectively.Cell proliferation and apoptosis of the treated groups and control group were detected by the MTT assay and Annexin V-FITC/PI staining to determine the appropriate NGAL concentration.The cell cycle distributions in the H/R group,NGAL treated H/R group and control group were detected by flow cytometry,and the expressions of bax/bcl-2 and caspase-3 were measured by real-time RT-PCR.The experiments were triplicated to obtain the mean values.Results The protein expression of NGAL/actin in H/R group (5.875 ±0.081 ) was higher than that of the control group ( 1.513 ±0.032),the differences between the two groups had statistic significance (t =96.89,P ＜0.05). While the gene expressions of NGAL/actin in HL/R groups (12.32 ± 1.27 ) and control group ( 1.00 ±0.00) had statistical significance of difference ( t =15.40,P ＜ 0.05 ).In MTT assay,the absorption values of the H/R group and control group were 0.97 ± 0.03 and 0.56 ± 0.04,the differences had statistic significance( t =18.680,P ＜ 0.05 ).And the absorption value of cells treated with different concentrations of NGAL (50,100,200,400,1 000 ng/ml) were 0.56±0.04,0.53 ±0.03,0.56 ±0.04,0.53 ± 0.03,0.54 ± 0.02,respectively.There were no significant differences between the H/R group and NGAL treated groups ( F =0.978,P ＞ 0.05 ),but the differences of absorption values in the control group and other groups had statistical significance ( F =105.20,P ＜ 0.05 ).The ratios of early apoptotic cells ( Annexin V positive,PI negative) in the control group and the H/R group were ( 1.0 ±0.2) ％ and ( 27.6 ± 1.4 ) ％ respectively with a statistical significance of difference ( t =33.590,P ＜0.05 ).After the treatment of NGAL ( 50,100 ng/ml),the ratios were ( 27.8 ± 1.1 ) ％ and ( 26.4 ±1.3 ) ％ and there were no significant differences compared to the H/R group ( t =0.250,P ＞ 0.05 ).When the H/R model was treated with 200 ng/ml of NGAL,the ratio of early apoptotic cells dropped to ( 19.4 ± 0.6) ％,leading to a statistical significance of difference ( t =10.350,P ＜ 0.05 ).However,in the H/R model treated with high concentration of NGAL (400,1 000 ng/ml),the ratios were ( 19.3 ± 1.1 )％ and ( 18.9 ±0.5 ) ％,which had no significant differences compared to the cells treated with 200 ng/ml of NGAL (t =0.130,0.630; P ＞0.05).Thus the study chose 200 ng/ml as the appropriate treating concentration of NGAL.In the control group,H/R group and 200 ng/ml,NGAL treated HR group,PI values were (30.2 ±0.4)％,(22.1 ± 2.7 )％ and (23.2 ± 3.7 )％ respectively.There were no significant differences between the H/R group and NGAL treated group (t =0.510,P ＞0.05),but there was still statistical significance in difference among the control group and the treated groups ( F =8.28,P ＜ 0.05 ).The ratio of bax/bcl-2 and the expression of caspase-3 detected by real-time RT-PCR were 1.00 ± 0.00,1.00 ± 0.00 in the control group,5.83 ±0.33,8.13 ±0.20 in the H/R group and 2.52 ±0.07,1.89 ±0.02 in the NGAL treated H/R group.The bax/bcl-2 ( F =485.30,P ＜ 0.05 ) and caspase-3 ( F =3456.78,P ＜ 0.05 ) did have statistical significances of difference among the three groups.ConclusionsNGAL acts as a protective factor against hypoxia-reoxygenation injury by regulating pro-apoptotic genes.It provides a new idea and evidences for the treatment of AKI caused by ischemia-reperfusion injury.

From the aspect of social and demographic factors, disease-related factors, social support, coping style and other factors outlined in diabetic patients with diabetes distress, and diabetes theoretical development and current situation of diabetes distress interventions were reviewed, in order to implement targeted interventions for diabetes patients.

Objective:We investigated the changes of the proteins in the rat arterial smooth muscle cells induced by homocysteine.Detected the mechanism by which homocysteinemia leads to atherosclerosis. Methods:The rat arterial smooth muscle cells of primary culture were planned to be the experimental systems.Extracted the proteins from the smooth muscle cells which were induced by homocysteine and control.After 2-D electrophoresis,the map was analyzed by imaging systems. Results:After cells promoted by homocysteine, twenty-eight proteins of the smooth muscle cells changed.Twelve proteins were found to differ in quantity(11 higher and 1 lower).Sixteen proteins were seen to be unique in one region or the others(12 points of protein appear after Hcy stimulating,4 points of protein disapear after Hcy stimulating). Conclusion:The protein of rat arterial muscle cells changed after promoted by homocysteine.We considered that the proteins were related to the proliferation of the smooth muscle cells.

3.0 cm in diameter were given multiple overlapping ablations that encompassed the entire lesions as well as an approximately 0.5 cm rim of normal liver tissue. The operation was performed under local anesthesia in association with systemic analgesia. Results The procedure was successfully accomplished in all the 26 patients. Adverse reactions happened at 2~5 postoperative days, including local pain and discomfort, pyrexia, and elevations of ALT levels. No bile leakage or hemorrhage occurred. Follow-up observations in 23 patients for 1~5 years (mean, 2 years and 8 months) showed a complete response (CR) in 22 patients and a partial response (PR) in 1 patient by one mission of PRFA, the effective rate (CR+PR) being 100%. The hepatic cavernous hemangiomas decreased by a mean of 68.8% (range, 41.2%~81.5%) in diameter. Conclusions Minimally invasive PRFA is a safe and effective therapy for HCHs in properly selected patients by experienced hands.

Objective To evaluate the efficacy, safety and complications of minimally invasive percutaneous radiofrequency ablation(PRFA) therapy for hepatic cavernous hemangioma(HCH). Methods Twelve patients with total 15 HCHs (2.5cm to 9.5cm) were treated by using RF-2000 generator and 10-needle LeVeen electrode percutaneously guided by B-ultrasound. Tumors larger than 3cm were treated by multiple overlapping ablations that encompassed the entire lesions as well as an approximately 0.5cm rim of normal liver tissue. Results The procedures were successful and the patients recovered well without the complications of bleeding or bile leakage after mean 48-month follow up period. Spiral CT scanning showed that the contrast enhancement was disappeared within the lesions or at their periphery in all cases. The mean diameter of the ablated HCHs reduced 68%. Conclusion The results suggested that PRFA therapy was a minimally invasive, simple, safe, and effective approach for treating HCHs in selected patients.

Antiphospholipid syndrome(APS) is a autoimmune system disorder caused by thrombosis and is usually accompanied with persistent positive. Antiphospholipid antibodies profiles(aPLs) is the key to diagnosing APS. The most frequently detectable aPLs in current clinical applications are anticardiolipin antibodies (aCL), anti-β2 glycoprotein Ⅰantibodies (anti-β2 GPI), and lupus anticoagulant (LA).However, it is found that the current laboratory diagnostic standard for APS based on these three aPL have many defects. The standard can′t meet the clinical needs. In this article, the research and development of antiphospholipid antibody in recent years are summarized, and the clinical value of non-classified standard antibodies such as IgA antibody isotype and anti-domain 1 β2-glycoprotein I antibody are reviewed.

Objectives This study was designed to observe the correlation of the levels of serum N-terminal pro-brain natriuretic peptide(NT-proBNP) and high sensitivity C-reactive protein(hs-CRP) between the 3rd day after acute myocardial infarction(AMI) and after 3 months of left ventricular remodeling(LV remodeling) and to establish the predictive levels of NT-proBNP,hs-CRP for LV remodeling after AMI.Methods The blood samples from 106 patients with the first AMI and echocardiography were examined on the 3rd day and after 3 month.LV remodeling was estimated by the changes of left ventricular end-diastolic volume(LVEDV) during the 3rd day and after 3 month.Based on the change of LV remodeling,the 106 patients were divided into two groups:LV remodeling group(defined as the change rate of LVEDV more than 20%) and non-LV remodeling group.Results The correlation coefficients of the change of LVEDV were 0.706 for serum NT-pro BNP and 0.596 for hs-CRP.With a cutoff value of 0.20,the area under the ROC curve(AUCs) was(0.892) for NT-proBNP and 0.825 for hs-CRP.There was no statistically difference between NT-proBNP and hs-CRP.The ROC plot indicated that NT-proBNP was superior to hs-CRP for predicting LV remodeling.Conclusion The level of serum NT-proBNP appropriately reflects LV remodeling after AMI and shows more efficacious than the level of serum hs-CRP.The level of serum NT-proBNP on the 3rd day after AMI and LV remodeling were positively correlated with the level after 3 months.

Objective To investigate the application of combined detection of three serum markers,anti-cyclic citrullinated peptide antibody (anti-CCP),rheumatoid factor (RF),anti-keratin antibodies (AKA),for the diagnosis of rheumatoid arthritis.Methods This was a prospective study.Serum samples were randomly obtained from 137 RA patients,265 other autoinmmune diease patients,and 111 normal controls.All of the volunteers were outpatients or inpatients of Peking University Third Hospital from January 2011 to September 2013.Levels of AKA,anti-CCP antibody,RF were measured by indirect immunofluorescence,chemiluminescence,and immune turbidimetry,respectively.The values of 3 serum biomarkers and their varied combinations for RA diagnosis were systemically assessed.The results were compared using fourfold table chi-square (x2) test.Results When using one serum marker,anti-CCP had the highest accuracy (80.39％),Youden's index (YI) (0.51),and Kappa (κ) value (0.55) for the diagnosis of RA.While using three serum markers,anti-CCP + (AKA/RF),AKA /(anti-CCP + RF),anti-CCP/(AKA + RF) and (AKA + RF)/(anti-CCP + RF)/(AKA + anti-CCP) had the highest accuracy (80.94,80.94,80.66),YI (0.51,0.51,0.50),and κ value (0.55,0.56,0.54).Conclusion AntiCCP is the vital marker for RA diagnosis.Anti-CCP + (AKA/RF),AKA/(anti-CCP + RF),and (AKA +RF)/(anti-CCP + RF)/(AKA + anti-CCP) are the most ideal combinations for RA diagnosis.

OBJECTIVE: To evaluate the extent of endolymphatic hydrops as shown by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D FLAIR MRI) performed 24 hours after bilateral intratympanic gadolinium administration and discuss the positive rate of endolymphatic hydrops in vestibule and cochlea. METHOD: Twenty-four hours after bilateral intra-tympanic 8 times diluted gadolinium administration, three-dimensional fluid-attenuated inversion recovery MRI, using a three-Tesla unit, was performed in 48 patients, and then assessed the extent of endolymphatic hydrops in the MRI images. RESULT: Forty-eight patients showed different levels of enhancement of perilymth in the inner ear. In these patients, obvious signs of endolymphatic hydrops were visualized in vestibule,including 8 slight hydrops, 17 mild hydrops and 23 severe hydrops with a diagnostic rate of 83.3%. There were almost no complications in all 48 patients after bilateral intra-tympanic injection except short vertigo in some of them. CONCLUSION 3D FLAIR MRI resonance imaging has a high positive diagnostic rate in assessing endolymphatic hydrops of Ménière's disease and provides direct imaging evidence for diagnosing Ménière's disease.
Cochlea ; Contrast Media ; Ear, Inner ; Ear, Middle ; Gadolinium DTPA ; Humans ; Imaging, Three-Dimensional ; Injections ; Magnetic Resonance Imaging ; Meniere Disease ; diagnosis ; Vestibule, Labyrinth