Child ; Chronic Disease ; Humans ; Kidney Diseases ; Kidney Failure, Chronic ; Renal Insufficiency, Chronic

Humans ; Kidney ; metabolism ; pathology ; Kidney Failure, Chronic ; metabolism ; therapy ; Kidney Transplantation ; Leptin ; metabolism ; Renal Replacement Therapy

Objective To investigate the prognostic risk factors for surgery in patients with cirrhotic portal hypertension.Methods One hundred and sixty one patients with cirrhotic portal hypertension who received surgery in our hospital in the past 10 years were studied.The data were entered into a pre-designed form.24 predictors including patients′ age,sex,degree of liver atrophy,ChildPugh classification,coagulation profile,splenic size,renal function,blood pH,base excess (BE),operative time,volume of ascites,and intraoperative and postoperative hemorrhage were recorded and analyzed.For each of the predictors,2-3 subgroups were compared.Results Seven predictors were clearly related to surgical prognosis:postoperative bleeding within 30h (B0.356,P＜0.001) and a bleeding volume ＞2 L were awarded 3 points; liver volume (B-0.160,P＜0.001) and severe liver atrophy (antero-posterior diameter of the left liver lobe ≤55 mm,oblique diameter of the right lobe ≤110 mm) were awarded three points; blood pH (B0.141,P＜0.001),pH＜7.35 was awarded 2 points; BE (B-0.123,P＜0.001),BE＜-3 (mmol/L) was awarded 2 points; decrease in PLT (B0.065,P =0.015),PLT＜ 3 (T/L) was awarded 2 points; intraoperative bleeding (B0.062,P=0.014),bleeding volume ＞2 L was awarded 2 points; decrease in RBC (B0.053,P=0.024),＜3(G/L) was awarded 1 point.Of the 147 patients who recovered from surgery,all had ≤3 points,except one who had 4 points.Of the 14 patients who died,all had ≥5 points except one who had 4 points.Conclusions Postoperative bleeding (＞2 L),severe liver atrophy (antero-posterior diameter of the left live lobe ≤55 mm,oblique diameter of the right lobe ≤110 mm),blood PH＜7.35,BE ＜-3 (mmol/L),PLT＜30 000(T/L),intraoperative major bleeding (＞2 L) and RBC＜3 (G/L) were significant prognostic risk factors for surgery.For patients who had a score of 5-6 points; death was likely following surgery.A score ≥8 points should be considered as a contraindication to surgery.To reduce operative mortality,active treatment should be given before surgery to keep the score to be 4 points or less.

Objective To investigate the clinical value of combined tests,including A-fetus protein(AFP)、cancer embryo agent(CEA),carbonhydrate agent 19-9(CA19-9)for the diagnosis of malignant tumors in digestive system.Methods Chemicalill-umination tests were used to detect serum levels of AFP,CEA and CA 19-9 in 821 patients with diseases of digestive system.Results The levels of AFP,CEA,CA19-9 in malignant group and the benign group were significantly higher than the control group(t=2.345,2.224,all P＜0.05;t=2.785,2.749,2.897,2.865,all P＜0.01＝;The levels of AFP、CEA、CA19-9 in malignant group were significantly higher than benign group (t=2.445,P＜0.05;t=2.745,2.819,all P＜0.01);The level of AFP in liver cancer group was significantly hisher than other groups(t=2.715,2.812,2.877,2.845,2.799,all P＜0.01);The level of CEA in hver cancer group was significantly lower in patients with liver colorectal cancer and pancreatic cancer(t=2.775,2.801,all P＜0.01);The level of CA19-9 in bile duct cancer group was significantly hisher than that of other cancers (t=2.733,2.851,2.788,all P＜0.01);The positive rates of liver、stomach、colorectal cancer、pancreatic cancer、bile duct cancer combined detection in three item were 91.0%,90.0,88.0%,90.0%,70.2%which were higher than the single check-positive rate of 85.0%,72.0%,67.5%,79.4%、55.3%(χ2=3.781,3.841,3.798,3.814,3.994,all P＞0.05).Conclusion The three tumor markers could be used as auxiliary diagnostic and ioint detection which could improve the detection rate in patients with malignant tumors of digestive system.

Objective To observe the analgesic effect of COX-2 inhibitors combined with PCA in treatment of the pain after total knee arthroplasty(TKA)and explore novai method for pain control after TKA. Methods This study was,a double blind,controlled,randomized,placebo-controlled,parallelgroup and single center study and obtained the consent of the Medical Ethics Committee of Chongqing Medical University.Inclusion criteria:the patients with severe trauma or degenerative knee,at age of 58-75 vears.ASA Ⅰ or Ⅱ, tolerance of the intravenous anesthesia.The same solvent formula of PCA was routinely prepared based on body weight after TKA.Intravenous injection of 40 mg Parecoxib plus 2 ml normal saline or injection of only 2 ml normal saline was done when closing the incision.which was recorded and prescribed by the researcher A.The same reagent waft,used continually every other 12 hours till48 hours.Celecoxib or placebo capsules was not usod orally at 72 hours until two weeks later.The knee ioint function was observed preoperatively and at days 3,7 and 15 after TKA. Results The study was completed in 60 patients including 30 patients in the group treated with Parecoxib and Celecoxib sequential therapy and 30 patients in placebo-control group.There was no statistical difference in aspects of general condition in both groups(P>0.05).There was no statistical difference in aspect of preoperative knee score between two groups(P>0.05).The analysis showed statistical difference in the knee function score at days 3.7 and 15 after operation(P<0.05 or0.01).Conclusions The COX2 inhibitors combined with PCA has definite analgesic effect on the pain after TKA,which positively correlates with early modified HSS evaluation of TKA.

Objective To explore the extent of lymphadenectomy by comparing the single left thoracotomy and cervico-right thoracic-abdominal triple incision during esophageal carcinoma radial surgery.Methods The clinical data of 95 patients with thoracic esophageal carcinoma underwent esophagectomy plus lymphadenectomy were studied.They were divided into two groups,left thoracotomy group(62 cases)and triple incision group(33 cases).The rates of lymph node metastasis and postoperative complications were analyzed statistically.Results A total of 1322 lymph nodes were dissected with an average of 13.9 lymph nodes in each case.The rates of lymph node metastasis were 45.3 ％(43/95)of all patients,40.3 ％ of left thoracotomy and 54.5 ％ of triple incision.The rates of lymph node metastasis in the neck for patients with upper or middle thoracic esophageal carcinoma were 25.0 ％(2/8)and 40.0 ％(4/10).The rate of abdominal lymph node metastasis was 53.8 ％(7/13)in lower thoracic carcinoma.The depth of tumor invasion (r =0.315,P =0.007)and tumor differentiation(r =0.239,P =0.017)were correlated to lymph node metastasis.Patients with tumor length ＞2 cm had higher rates of lymph node metastasis(x2 =34.2,P ＜ 0.001).The postoperative complication rates of left thoracotomy and triple incision were 25.8 ％(16/62)and 4.2 ％ (8/33).The mortalities rates of left thoracotomy and triple incision were 1.6 ％(1/62)and 3.0 ％(1/33).There was no significant difference in postoperative complication rates(x2 =0.017,P =0.869)and mortalities rates(x2 =0.047,P =0.651)between the two groups.Conclusion Tumor invasion,differentiation and length should be incorporated in the evaluation of lymph node status.Patients with upper and middle thoracic esophageal carcinoma should receive cervico-right thoracic-abdominal triple incision.Particular attention should be given to the resection of abdominal lymph nodes in patients with lower thoracic esophageal carcinoma.

Objective RNA interference refers to post-transcriptional gene silencing caused by double strands RNA.To investigate the effect of EGFR receptor on esophageal carcinoma,the expression vector of HER4 gene targeted small interfering RNA was constructed to observe its silencing effect in human esophageal carcinoma cell line Eca-109,in order to find a promising method for the gene therapy of this disease.Methods Two complementary oligo DNA strands targeting HER4 gene were designed and synthesized according to the principles of designing siRNA.After annealing,oligo DNAs were inserted into SUPER.neo+gfp vector,then enzyme digestion analysis and DNA sequencing were applied.After transfecting it into human esophageal carcinoma cell line,we detected the level of expression of HER4 gene through real-time quantitative PCR and Western Blot.Results The enzyme digestion analysis and DNA sequencing show that HER4 gene targeted small interfering RNA and its expression vector were constructed successfully,and after transfection,the expression of HER4 gene in esophageal carcinoma cell line was suppressed greatly.Conclusion HER4 gene targeted small interfering RNA and its expression vector were constructed successfully,and could decrease the expression of HER4 gene in Eca-109 cell line,which laid the foundation for the following experiment.

OBJECTIVE: To use IFNα injection as inhalant for there is no proper dosage form for aerosol inhalation and evaluate the feasibility of IFN-α off-label use. METHODS: The clinical studies in SARS and MERS were reviewed to discuss the efficacy and safety of IFN-α application in COVID-19. Meanwhile, the features of aerosol inhalation, characteristics of IFN-α and related clinical researches were analyzed to argue the possibility of IFN-α aerosol inhalation. RESULTS: IFN-α seems to be effective in relieving early symptoms but likely invalid in reducing mortality of severe patients, however, the exact therapeutic effect calls for further clinical tests. Proper atomization of IFN-α injection won't reduce biological activity of the protein, but absorption and utilization of IFN-α in lung may be unsatisfactory for the lack of sorbefacient. More than that, ingredients in IFN-α injection may increase risk of adverse reaction. CONCLUSION: The aerosol inhalation of IFN-α injection should be fully evaluated on the side of patients. If there is a lack of proper atomization device or operation staff, subcutaneous injection of IFN-α may be a tentative administration.

0.05). But Xuezhikang was superior to Pulagu in decreasing TG level and raising HDL C level ( P

Objective To investigate the effect of hydrogen peroxide (H_2O_2) on apoptosis and calcium ion concentration of skeletal muscle satellite cells (SMSCs) in rats, and to explore the protective effect of erythropoietin (EPO).Methods The cultured SMSCs were divided into five groups: control group,H_2O_2 group, 10, 20 and 40 U/ml EPO intervention groups.Apoptosis rates and calcium ion concentration of SMSCs were analyzed by flow cytometry, and the morphology of apoptotic cells was observed by Hoechst33258 staining.Results The apoptosis rates showed significant differences (all P<0.05) among (1.93±0.57)% in control group, (22.13±1.79)% in H_2O_2 group, (16.47±2.53)%, (4.97±0.55)% and (2.93±0.47)% in 10, 20 and 40 U/ml EPO intervention groups, respectively.And calcium ion concentrations in SMSCs were 12.67 ±0.32, 27.90±0.06 and 44.53±0.93 in 10, 20 and 40 U/ml EPO intervention groups, respectively.There was significant difference in calcium ion concentration between H_2O_2 group and control group (9.70±0.09 vs.51.37± 0.64, P< 0.05).Morphology of apoptosis was observed by Hoeehst33258 dye stains in 10, 20 U/ml EPO intervention group and H_2O_2 group, while there were less apoptotic bodies in 40 U/ml EPO intervention group and control group.Conclusions EPO might have protective effects on SMSCs injured by H_2O_2 through inhibiting apoptosis and calcium ion releasing from SMSCs.