Objective To investigate the value of clinical parameters in predicting the initiation of renal replacement therapy(RRT) in acute kidney injury (AKI) patients with cardiorenal syndrome (CRS).Methods A total of 75 AKI patients hospitalized with CRS were enrolled.All patients received pharmacologic therapy on the beginning 3 days.The patients whose heart function improved were divided into control group (n=39),and the patients whose heart function worsened were divided into RRT group (n=36).Clinical and laboratory data on the first day and the fourth day were collected and analyzed.The factors on the first day were labeled asⅠ ,and those on the fourth day were labeled asⅡ. The ratio of some parameters calculated were labeled asⅡ/Ⅰ .Area under curve (AUC) of receiver operating characteristic curve (ROC) of these factors was used to evaluate the sensitivity and specificity in predicting the initiation of RRT.Results The patients in RRT group had significantly higher levels of BNP-Ⅱ,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ (P ＜ 0.01),and lower levels of 24 hours urine volume-Ⅰ and 24 hours urine volume-Ⅱ (P ＜ 0.01).From ROC curve analysis,the AUC of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,creatinine Ⅱ / Ⅰ,BNP-Ⅱ levels and BNP Ⅱ/Ⅰ to predict RRT were 0.736,0.875,0.747,0.779 and 0.894 respectively.When the cutoff values of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,BNP-Ⅱ levels,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ were 905 ml (sensitivity 75％,specificity 94.9％),1450 ml (sensitivity 75％,specificity 100％),3360 ng/L (sensitivity 72.2％,specificity 100％),1.37 (sensitivity 75％,specificity 100％) and 1.25 (sensitivity 72.2％,specificity 94.4％) respectively,the value of the parameters to predict RRT was high.Conclusions The 24 hours urine volume,BNP levels after treatment and the dynamic changes of BNP levels and creatinine levels can be used as predictors of the initiation of RRT in the AKI patients with CRS.

Objective To compare the cardiac structure and function between diabetic and non-diabetic with different peritoneal transport type.Methods A total of 84 patients with continuous ambulatory peritoneal dialysis (CAPD) in our center for 6 months were enrolled in this study.Forty-six patients of subjects were diabetic,another 38 were non-diabetic.Patients were divided into four groups according to the results of peritoneal equilibration test (PET) and the ratio of creatinine concentration in dialysate solution and plasma (D/P creatinine concentration).Patients with D/P creatinine concentration ＞ 0.65 were with high permeability and otherwise were low permeability.The four groups were diabetic-H (high permeability) group,diabetic-L(low permeability) group,non-diabetic-H (high permeability) group,non-diabetic-L (low permeability) group.The levels of left atrial diameter (LAD),left ventricular diameter(LVD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF) were measured before and after 6-month peritoneal dialysis by ultrasonic doppler.Results Before peritoneal dialysis,there were no significant difference in the terms of all parameters among four groups(P ＞0.05).After 6 months of peritoneal dialysis,the albumin levels,IVST,LVPWT and LVEF in diabetic-L group,non-diabetic-L,diabetic-H group and non-diabetic-H group were ((36.57 ± 3.34),(37.21 ± 4.12),(34.19 ± 3.98),(34.51 ± 4.52) g/L respectively;F =9.034),((10.45 ± 1.12),(10.17 ± 1.35),(11.32 ± 1.09),(11.46 ± 1.38) mm respectively;F =7.525),((9.58 ± 1.42),(9.47 ± 1.31),(10.71 ± 1.40),(10.15 ± 1.41) mm respectively; F =4.963) and ((63.98 ± 4.73) ％,(63.92 ± 5.17) ％,(60.12 ± 5.12) ％,(61.43 ± 5.57) ％respectively ;F =6.984),and the differences were statistic significant (P ＜ 0.05).Compared to diabetic-H group and non-diabetic-H group,there were significant difference in the terms of all above indexes between diabetic-L group,non-diabetic-L (P ＜ O.05).Conclusion The peritoneal transport.type of diabetic patients is high permeability,which might be an important factor affecting cardiac complications in patients.

Objective To investigate the effect of euphorbiasteroid on inducing the apoptosis of HL-60 cells and demonstrate whether the Fas/FasL signaling pathway is involved in the induction of apoptosis. Methods HL-60 cells were treated with dose of 2.5,10,40 μg/ml of euphorbiasteroid in vitro for 24 h respectively.After that,cell counting Kit-8 was used to detect cell proliferation.The morphology of HL-60 cells were observed under light and fluorescent microscopy.The early cell apoptosis was detected by using flow cytometry with Annexin Ⅴ-FITC /PI double staining.The expressions of Fas,FasL,caspase-8 and caspase-3 mRNA were analyzed by the method of RT-PCR.The activities of caspase-8 and caspase-3 were examined by chromatometry.Results Compared with 1640 control group,HL-60 cell proliferation was inhibited significant-ly by euphorbiasteroid.The inhibition rates were (34.9 ±3.7)%,(54.6 ±5.2)% and (61.3 ±4.3)%respectively.Moreover,HL-60 cells exhibited typical morphological features.Early cell apoptosis rates of HL-60 cells were (23.4 ±3.1)%,(35.7 ±4.3)% and (53.2 ±3.9)% respectively.Furthermore,the expressions of Fas,FasL,caspase-3 and caspase-8 mRNA were up-regulated significantly after euphorbiasteroid administration in a dose-dependent manner (P<0.01 ).After treated with euphorbiasteroid,the activities of caspase-8 and caspase-3 were significantly enhanced (P<0.01 ).Conclusion The up-regulation effect of euphorbiasteroid on Fas/FasL signaling pathway might contribute to the apoptosis of HL-60 cells.

Objective To explore the relationship between serum magnesium level,abdominal aortic calcification(AAC) and mineral metabolism in continuous ambulatory peritoneal dialysispatients.Methods Sixty-two cases patients who were on Continuous Ambulatory Peritoneal Dialysis in Pritoneal Dialysis Center of Qingdao Municipal Hospital were enrolled prospectively.The AAC was detected by abdomen lateral plain radiographs,and the AAC score(AACs) was calculated.According to the AACs,the patients were divided into group A(AACs≤4 points) and group B(from >4 point to ≤15 point) and group C(AACs>15 point).And collected the patient′s clinical data and blood biochemical indicators.The serum magnesium levels of 3 groups were observed,and explored the relationship of serum magnesium and intact parathyroid hormone(iPTH),serum calcium,serum phosphorus.Results There were 41 cases of vascular calcification in 62 cases maintenance ambulatory peritoneal dialysis patients,and its incidence was 66.13%.Group levels of serum magnesium were in group A was (1.00±0.18) mmol/L,(0.89±0.10) mmol/L of group B,and (0.75±0.13) mmol/L of group C,the mean differences were significant(F=11.99,P<0.05),and the group A was significantly higher than the group B and C,the differences were significant(P<0.05),the group B was significantly higher than the group C,the difference was significant(P<0.05).There was negatively correlation between serum magnesium and iPTH(r=-0.288,P<0.05),serum phosphorus(r=-0.272,P<0.05) and AACs(r=-0.610,P<0.01).While there was no significant correlation of serum calcium(r=0.174,P>0.05).Conclusion Vascular is the calcification frequent complications in continuous ambulatory peritoneal dialysis patients.The serum level of serum magnesium may be correlated with the AAC,iPTH,serum phosphorus.

Objective To evaluate the effect of levonorgestrel-releasing intrauterine system (LNG-IUS) on insulin-like growth factor-Ⅰ (IGF-Ⅰ) and insulin-like growth factor-Ⅰ receptor (IGF-IR) expression after transcervical resection of polyp (TCRP).Methods 100 cases of endometrial polyps were selected.The control group (n =50) was treated with TCRP only,while the observation group (n =50) was treated with LNG-IUS after TCRP.The scores of pictorial blood loss assessment chart (PBCA),endometrial thickness,recurrence rate,mRNA expression of IGF-Ⅰ and IGF-IR in endometrial tissue were compared between the two groups.Results At 1,3,6,12 months follow-up,the PBAC score and endometrial thickness of observation group were significantly lower than control group (P ≤ 0.05).At 12 months after operation,the mRNA expression levels of IGF-Ⅰ and IGF-IR in the endometrium of the observation group were significantly lower than those of the control group (P ≤ 0.05).After 12 months of follow-up,the recurrence rates of the control group and the observation group were 16.0％ (8/50) and 4.0％ (2/50),respectively.The recurrence rate of the observation group was significantly lower than that of the control group (P ≤ 0.05).Conclusions TCRP combined with LNG-IUS treatment can significantly reduce EP recurrence,and down-regulation of the mRNA expression of IGF-Ⅰ and IGF-IR maybe its possible mechanism.