Objective To evaluate the acute effects of different calcium concentration dialysate (1.25 mmol/L, 1.5 mmol/L, 1.75 mmol/L) on calcium balance and intact parathyroid hormone(iPTH) in maintenance hemodialysis(MHD) patients with normal serum tCa, and to provide scientific basis for individualized calcium concentration dialysate formula. Methods Dialysate with different calcium concentration (DCa1.25, DCa1.5, DCa1.75) was used in twelve stable MHD patients. Serum tCa, iCa(normalized to pH 7.4) and iPTH were assessed before and after each dialysis session with different calcium concentration dialysate. The iCa from fresh dialysate, spent dialysate at every 30 minutes interval and final total mixed spent dialysate were examined respectively. Phosphorus removal was also determined. Arterial blood pressure(BP) was measured every 30 minutes during hemodialysis session. Results With the DCa1.25, mean calcium loss was 5.03 mmol, but no significant changes of serum iCa and tCa between pre dialysis and post dialysis were found. Serum iPTH increased from (127.17?89.22)pg/ml to (281.92?244.84)pg/ml significantly (P

Objective: To investigate the state of calcium-phosphorus metabolism and serum intact parathyroid hormone (iPTH) levels in end stage renal disease (ESRD) patients, to analyze clinical characters, and to provide scientific basis for clinical treatment. Methods: The data of 100 ESRD patients who received hemodialysis in Peking University First Hospital from January 2000 to July 2003 were analyzed retrospectively. Results: (1) The levels of serum total calcium were adjusted by serum albumin. There were 15 patients with hypocalcemia and 85 patients with normocalcemia or hypercalcemia. 31.8% of the latter took calcium-containing phosphate binders or/and vitamin D. In the 14 patients with hypocalcemia and 58 patients without low serum calcium who did not take calcium-containing phosphate binders or/and vitamin D, we found the levels of carbon dioxide combining power (CO 2CP) were lower in the group of hypocalcemia (P

Objective:To study the effects of Shixinyatong buccal tablets(SBT)in patients after the extraction of mandibular third molar.Methods:150 cases of patients were divided into 3 groups(n =50).After tooth extraction the patients in SBT,cephalosporin and control groups were given SBT at 0.6 g,4 times per day,cepholosporin 0.5 g,2 times per day and no drug respectively.At the 3rd and 5th day the patients were followed up and their local symptoms were scored.The data were statistically analyzed with SAS 9.0 soft ware.Results:Between SBT and cepholosporin or control group there was no statistical difference in demographic data and impac-tion types of the teeth(P >0.05).The total symptom integral,primary symptom integral,minor symptoms,wound pain,redness, swelling degree and oral odor in SBT group were lower than those in control group(P <0.05)at the 5th day after tooth extraction.Be-tween SBT group and cephalosporin group there was no significant difference(P >0.05)in the total symptom integral,primary symp-tom integral,secondary symptom integral at the 3rd and the 5th day.Conclusion:Shixinyatong buccal tablet is effective in the preven-tion of complications after the extraction of mandibular third molar.

Objective To evaluate the effects of strict dietary salt restriction on blood pressure and proteinuria in chronic glomerulonephritis (CGN) patients. Methods From October 2007 to April 2009, 32 CGN inpatients were enrolled. Among them, 15 patients followed a strict dietary salt restriction menu (sodium 100 mmol/d, potassium 50 mmol/d, protein (0. 8-1. 0) g · kg~(-1) · d~(-1) , calorie (105-125) KJ · kg~(-1) · d~(-1) ) for 7 days, while the other 17 patients were fed freely offered by hospital as controls. 24 h urinary sodium excretion (24h-UNa) was used to monitor the salt intake. No changes of drug therapy were made during the study. Blood pressure was monitored every day. 24-hour urinary protein and serum biochemical parameter were measured before and after the study. Results There was no significant difference of baseline 24h-UNa between the two groups [(135.1 ±50.4) mmol/d vs (137.4 ±28.6) mmol/d) ]. During the study, the average 24h-UNa of patients with strict dietary intervention was (97. 2 ± 8.6) mmol/d. Both SBP [ (117. 7 ± 10. 0) mm Hg( 1 mm Hg=0. 133 kPa) vs (106.2 ±9.9) mm Hg] and DBP [ (76. 3 ± 6. 1 ) mm Hg vs (67. 5 ± 5. 5 ) mm Hg] decreased significantly ( P < 0. 001 ) . Proteinuria decreased significantly too [ 1. 57 (0. 3-3. 0) g/d vs 0. 57 (0. 16-2. 72) g/d,P = 0. 006]. The reduction of SBP was positively correlated with the reduction of 24h-UNa (r =0. 572, P =0. 026) , while the reduction of proteinuria correlated with both the reduction of SBP (r = 0. 568, P = 0. 027) and 24h-UNa (r =0. 525, P =0. 044). In the control group, only SBP decreased significantly [ ( 122. 6 ± 15. 5) mm Hg vs (115.8 ±10.4) mm Hg, P = 0.02] without significant changes of DBP and proteinuria When comparing the subgroups who took ACEI/ARB from both groups, the reduction of proteinuria wasmore prominent of those from the study group than the control group [ - 0. 4 ( -0. 95-0. 07) vs 0. 07 ( - 0. 39-0. 42), P = 0. 014 ]. Conclusion Strict dietary salt restriction is effective in reducing blood pressure and proteinuria in CGN patients.

Experimental course for integrative life science curriculum is designed for medical students ,which integrates basic knowledge and skills of cellular biology,biochemistry,genetics,molec-ular biology,molecular genetics,and immunology disciplines. Tongji University School of Medicine start-ed to implement integration-based new curriculum system since 2010. This article discussed on teaching philosophy,teaching content,teaching methods,teaching team construction and explored the effect and significance of experimental course for integrative life science curriculum.

OBJECTIVE:To provide reference for promoting rational use of essential medicines. METHODS:Combined with the actual situation of our hospital,a set of risk prevention and control system on essential medicine was constructed on the basis of relevant laws and regulations and support of information,and then implemented. RESULTS:The implementation of the system greatly promoted cognition of all medical staffs on reasonable,economical and safe use of essential drugs,standardized medication behavior and improved essential medicine use more reasonable. After the implementation of risk prevention and control system on essential medicines,medicine ratio of whole hospital decreased from 34.62% to 32.64%,inpatient medicine ratio decreased from 33.02% to 27.89%;essential medicine ratio of whole hospital rose from 31.22% to 43.34%,inpatient essential medicine ratio in-creased from 23.46%to 39.17%;the proportion of outpatient antibiotics prescriptions decreased from 15.04%to 13.46%,the utili-zation of inpatient antibiotics decreased from 62.11% to 48.47%. Various early warning were sent out 104 times in total,and 23 medical staff were punished due to irrational drug use. The prescription form and rationality of drug use were improved gradually. CONCLUSIONS:The construction of risk prevention and control system on essential medicine is one of the keys to the success of health care reform. It is suggested to make full use of thesystem+technologymeans,establish long-term mechanism for risk pre-vention and control,and constantly improve the system.

Objective: To investigate the predictive value of an early inflammatory response factor, Rho kinase activity for left ventricle remodeling (LVR) in patients with acute ST-segment elevation myocardial infarction (STEMI).
Methods: A total of 120 acute STEMI patients treated in our hospital from 2010-10 to 2013-06 were studied, all patients were ifrst time received primary percutaneous coronary intervention (PCI) with stent implantation. Rho kinase activity and B-type natriuretic peptide (BNP) were measured before PCI, echocardiography was conducted at 24 hours and 12 months after STEMI respectively to clarify LVR diagnosis. The patients were divided into 2 groups as LVR group, n=97 and Non-LVR group, n=23, the above indexes were compared between 2 groups.
Results: The level of Rho kinase was higher in LVR group than that in Non-LVR group, P<0.001, after adjustment, Rho kinase was the independent predictor for LVR (OR 3.36, 95%CI 2.01–5.78, P<0.001). The ROC of Rho kinase was 0.88 (95%CI 0.82–0.94) and the ROC of BNP was 0.54 (95%CI 0.41–0.70).
Conclusion: High Rho kinase activity could predict LVR in acute STEMI patients with primary PCI and stent implantation.

Objective To study the expression of WWOX, ErbB2 and Ki67 protein in non-small cell lung cancer(NSCLC) and the relationships with cell proliferation. Methods WWOX and ErbB2 protein expressions were evaluated by immunohistochemistry in 81 NSCLC patients (50 squamous cell carcinomas,31 adenocarcinomas and 20 adjacent normal lung tissues) and the correlations with histopathologic cell proliferation were analyzed. Results WWOX expression was absent/reduced in 72.8% of NSCLC, while it was normal in 80.0% of adjacent normal lung tissues. WWOX expression was strongly associated with tumor histology, histologic grade and lymph node metastasis ( X2 = 5.44, P = 0.019 ; X2 = 4.740, P = 0.029, X2 = 4.51, P = 0.034 ), reduced WWOX expression was higher in squamous cell carcinomas and in poorly differentiated tumors. The overexpression of ErbB2 was associated with TNM stage and lymph node metastasis ( X2 = 6.90, P = 0.009 ; X2= 5.68, P=0.017). WWOX expression was negatively related to the overexpression of ErbB2 (r=-0.239, P <0.05 ). WWOX expression intensity was nega-tively related to the high index of cell proliferation (r=-0.252, P<0.05 ). Conclusion The loss of WWOX ex-pression plays different roles in tumorigenesis of NSCLC and is related to high aggressiveness of tumors. The loss of WWOX expression and the overexpression of ErbB2 can estimate the prognosis of NSCLC.

Objective To isolate enterovirus 71 from a death children,and analyze whether the neurovirulence was related to the variation of nucleotide and amino acid. Methods Enterovirus 71 was isolated from throat swabs which were colleted from Shandong Linyi People's Hospital. The full length genome was sequenced by amplification with RT-PCR and sequencing of 9 overlapped gene fragments covering full length of the genomes. The nucleotide and amino acid sequenced was aligned by BLAST, Bioedit and MEGA 4. Results A strain of enterovirus 71 was isolated and named as SDLY107. The full length was 7405 bp. The results of homology analysis of overall nucleotide sequence showed that strain Fuyang. Anhui. P. R. C/17.08/2 had highest homology (98.6%)with strain SDLY107, and the homology was 80.0% between strain SDLY107 with prototype strain BrCr/70,and 86. 5% between strain SDLY107 with nerve strain MS/87. Phylogenetic analysis showed that the phylogeny was close between SDLY107 with some isolated strains from Chinese Mainland, such as Beijing, Henan, Guangxi, Sbenzhen, Lanzhou, Fuyang, Chongqing and Zhejiang strains, which was clustered for C4 subtype. The results of amino acid sequence analysis showed that there were 2 mutations, E947D and K1873R, for strain SDLY107. Conclusion SDLY107 belonged to C4 subtype, amino acid mutations E947D and K1873R of which may be relevant to the pathogenicity of EV71.

Objective To evaluate previous gastroscopy before percutaneous coronary intervention (PCI) for the risks and benefits of concomitant use of proton pump inhibitors (PPIs) after PCI in patients with non-acute coronary syndrome (non-ACS).Methods The data of 673 non-ACS patients who underwent PCI with stenting were retrospectively analyzed.They were divided into concomitant use of PPIs group and non-PPIs group,then subdivided into high-,moderate-and low-risk groups according to risk factors associated with adverse upper gastrointestinal (GI) events.The incidences of adverse cardiovascular events and adverse upper GI events were compared among groups.Findings of previous gastroscopy were also included.Results Only 82 patients (12.2％) underwent gastroscopy within 5 years before PCI,of whom,27 (32.9％) were diagnosed as having peptic ulcer,and 55.6％ (15/27) of whom were in concomitant use of PPIs.Compared with the non-PPIs group,the rate of adverse cardiovascular events in the concomitant use of PPIs group was significantly higher (22.6％ vs.8.9％,P ＜0.01),and the highest rate (41.7％) was in the high-risk group.However,the corresponding rate of adverse upper GI events was the lowest (4.2％).In the moderate-risk group,90.5 ％ (344/380) of patients were older than 65 years with concomitant use of NSAIDs.The rate of gastroscopy within 5 years before PCI in these patients was remarkably lower than that in patients who had the history of upper GI disease with concomitant use of NSAIDs (concomitant use of PPIs group 14.1％ vs.54.5％ ; non-PPIs group 7.5％ vs.28.0％ ; P ＜ 0.01).In the concomitant use of PPIs group,the rate of adverse cardiovascular events in the former was notably higher than that in the latter (20.5％ vs.9.1％,P ＜0.01),but the rate of adverse upper GI events within 1 year after PCI were similar (9.0％ vs.9.1％).Conclusion Previous gastroscopy before PCI could provide the baseline information of upper GI disease,which may be helpful for the evaluation of concomitant use of PPIs after PCI so as to decrease the incidence of adverse cardiovascular events.Special attention should be paid to those patients older than 65 years in the moderate-risk group and concomitant use of NSAIDs.