Objective To assess peritonitis rate in peritoneal dialysis. Methods The peritonitis rate from 1999 Aug. 1st to 2004 Jun 30th in Renji Peritoneal Dialysis Center was analyzed retrospectively. Various methods including cohort-specific peritonitis incidence, negative binomial distribution model, median subject-specific peritonitis incidence and peritonitis-free survival were used for the analysis. Results Cohort-specific peritonitis incidence was 1756. 14 patient-month, the mean peritonitis rate estimated using the negative binomial model was 1/49.58 patient-month, median subject-specific peritonitis rate was 0, mean peritonitis-free survival time was 39. 71 months, the peritonitis-free time was inversely correlated with subject-specific peritonitis rate(P

BACKGROUND: Cardiac fibrosis, which results from the loss of balance between synthesis and degradation of cardiac matrix component, is the structural foundation of the stiffness of damaged myocardial tissues. Astragalus membranaceus, a traditional Chinese herb, has multiple functions such as exerting a tonic effect on the heart to induce diuresis. However,the effect of astragaloside Ⅳ on cardiac collagen is poorly known in practice.OBJECTIVE: To observe the effects of astragaloside Ⅳ on myocardial collagen and cardiac function in ischemic rats and to investigate the dosage and time effects of astragaloside Ⅳ.DESIGN: A completely randomized grouping design and randomized controlled trial.SETTING: Department of Pediatrics, the Affiliated Hospital of Medical College of Qingdao University.MATERIALS: The study was conducted in the Encephalopathy Research Institute, Medical College of Qingdao University, from July 2003 to February 2004. Totally 132 Wistar rats of cleaning grade were randomized into three groups: control group (n=11), ischemic group (n=10) and astragaloside Ⅳ group (n=121).METHODS: Rats in control group had thoracotomy, but did not have their left anterior descending coronary artery ligated; rats in ischemic group had thoracotomy and had their left anterior descending coronary artery ligated to establish acute myocardial infarction model; rats in astragaloside Ⅳ group were given astragaloside Ⅳ after surgical ligature of left anterior descending coronary artery. The changes in hemodynamic parameters, cardiac function and myocardial collagen were determined. The dosage and time effects of astragaloside Ⅳ on myocardial collagen and cardiac function were observed.MAIN OUTCOME MEASURES: ① The dosage and time effect of astragaloside Ⅳ on the content of myocardial collagen in the left ventricle of rats with myocardial infarction; ② The dosage and time effects of astragaloside Ⅳ on hemodynamics and cardiac function of rats with myocardial infarction.RESULTS: One hundred rats entered the results analysis. There were 10 in control group and ischemic group, respectively, and 80 in astragaloside Ⅳ group. The five dosage groups of astragaloside Ⅳ [2.5, 5.0, 10.0, 15.0 and 20.0 mg/(kg·d)] and the five postoperative time points (3, 7, 14, 21 and 28 days) had eight rats for each. Astragaloside Ⅳ at a dose of 15.0 mg/kg per day was found to have the most marked effect on ischemic myocardium, so this dose was chosen for observing time effect. ① After administration of astragaloside Ⅳ, the content of collagen in myocardial tissues of the infarcted area of left ventricle, the serum concentration of carboxyterminal procollagen type Ⅰ propeptide and aminoterminal procollagen type Ⅲ propeptide decreased gradually with the increased dose of astragaloside Ⅳ and with the prolonged action time of astragaloside Ⅳ [15 mg/(kg·d)] (P ＜ 0.05-0.01). The serum concentration of carboxyterminal procollagen type 1 propeptide and aminoterminal procollagen type Ⅲ propeptide returned to the level of control at a dose of 10 mg·kg-1per day and at 21 days after astragaloside Ⅳ administration, respectively. The content of collagen in myocardial tissues of the infarcted area of left ventricle was higher than that of non-infarcted area (P＜ 0.01); there were no significant changes in the content of cardiac collagen of right ventricle and non-infarcted area of left ventricle before and after astragaloside Ⅳ administration. ② The cardiac function of ischemic rats significantly improved after astragaloside Ⅳ administration (P ＜ 0.05-0.01); cardiac output, heart rate, stroke volume,mean aortic pressure, systolic aortic pressure, and the stroke work of left ventricle gradually returned to the level of control with the increased dose of astragaloside Ⅳ and with the prolonged action time of astragaloside Ⅳ.CONCLUSION: Astragaloside Ⅳ can inhibit the proliferation of cardiac collagen and improve cardiac function in rats with myocardial infarction.The content of myocardial collagen gradually decreases and cardiac function gradually improves with the increased dose of astragaloside Ⅳ and the prolonged action time of astragaloside Ⅳ.

Objective To evaluate the relationship between calmodulin protein kinase Ⅱ (CaMK Ⅱ) and levosimendan against arrhythmias induced by myocardial ischemia-reperfusion (I/R) in rats in vitro.Methods Thirty male Wistar rats,weighing 250-300 g,were randomly divided into 3 groups (n =10 each) using a random number table:control group (group C),I/R group and levosimendan group (group L).Their hearts were rapidly excised and perfused in a langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 36.5-37.5 ℃.At 20 min of equilibration,the hearts were perfused with K-H solution for 60 min in group C.The hearts were subjected to 30 min of ischemia followed by 30 min reperfusion with K-H solution in group I/R.The hearts were subjected to 30 min of ischemia followed by 30 min reperfusion with K-H solution containing 300 nmol/L levosimendan in group L.Left ventricle developed pressure (LVDP),left ventricle end-diastolic pressure (LVEDP),+ dP/dt-dP/dtmax and heart rate (HR) were recorded immediately before ischemia and at 15 and 30 min of reperfusion.Arrhythmia was recorded during reperfusion and scored.Specimens were obtained from the apex of heart at 30 min of reperfusion for determination of the intracellular calcium concentration ([Ca2 +] i).Myocardial specimens were obtained from the left ventricle at 30 min of reperfusion to detect CaMK Ⅱ activity.Results Compared with group C,arrhythmia score,[Ca2+]i and CaMK [Ⅱ activity were significantly increased,and LVDP,+ dP/dtmax,-dP/dtmax and HR were decreased,and LVEDP was increased at 15 and 30 min of reperfusion in group I/R.Compared with group I/R,the number of ventricular premature beat,arrhythmia score,[Ca2+] i and CaMK Ⅱ activity were significantly decreased,and LVDP,+ dP/dtmax,-dP/dtmax and HR were increased,and LVEDP was decreased at 15 and 30 min of reperfusion in group L.Conclusion Inhibition of CaMK Ⅱ activity is involved in the mechanism by which levosimendan decreases the development of arrhythmias induced by myocardial I/R in rats.

The spindle assembly checkpoint ( SAC) is an important monitoring mechanism to monitor the connection between centromeres and microtubules and to ensure proper chromosome separation in human .Mitotic arrest defective protein(Mad)family,as an important part of SAC,plays a crucial role in the process of mitosis. Mutations or altered expressions of Mad may lead to abnormal separations of chromosomes and play a partial role in tumorigenesis ,poor prognosis and chemotherapy drug resistance .

Objective To analyze the incidence of complications during and after interventional therapy for common con-genital heart disease (CHD) in children. Methods From January 2011 to December 2013, interventional therapy of common congenital heart disease which include ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA) and pulmonary valve stenosis (PS) were performed in 2356 patients. Among them, 159 patients who developed complications during and post to interventional therapy were retrospectively analyzed. Results The overall complication rate was 6.75%(159/2356) (11.40% post VSD occlusion, 7.50% post ASD occlusion, 3.09% post PDA occlusion, 1.63% post percutaneous balloon pulmonary valvuloplasty (PBPV) ).The rate of arrhythmia was 4.41%(102/2356). The severe complication rate was 2.71%(64/2356) (3.62%post VSD occlusion, 2.21%post ASD occlusion, 2.53%post PDA occlusion, 1.63%post PBPV). The intraoperative severe complication rate was 0.51%(12/2356);the early severe complication rate was 1.99%(47/2356);the late severe complication rate was 0.21%(5/2356). Interventional therapy rate was 0.13%(3/2356); cardiovascular surgery rate was 0.64%(15/2356);conservative treatment rate was 1.95%(46/2356). The mortality rate was 0.08%(2/2356). Conclusions The complications and mortality rate of interventional therapy for CHD in children are relatively low, but cannot be ignored. The complication could be reduced by choosing proper indications, following the operational procedures and careful operative follow-up.

Objective To investigate the changes in prevalence of nutritional risk and undemutrition in patients with head and neck cancer during radiotherapy.Methods In this longitudinal observational study,a convenience sampling method was used to recruit patients with head and neck cancer who were receiving radiotherapy in Beijing Cancer Hospital.Nutritional Risk Screening 2002 (NRS 2002) was applied to assess the prevalence of nutritional risk in the patients,and Patient-Generated Subjective Global Assessment (PG-SGA) and body composition test to determine the prevalence of malnutrition (undernutrition) before,during and after radiotherapy.Results 56 patients finished the three follow-up exams.Along with the progress of radiotherapy,the scores of NRS 2002 increased gradually (1.64±1.09 vs.2.30 ±1.06 vs.3.14 ±1.07,x2 =46.639,P＜0.001),and the prevalence of nutritional risk also increased gradually (21.43％ vs.37.50％ vs.71.43％,x2 =29.700,P ＜0.001);the total scores of PG-SGA [1 (1-13) vs.6 (1-15) vs.12 (1-18),x2 =63.206,P＜0.001] and dimensions of weight [0 (0-4) vs.1 (0-4) vs.3 (0-6),x2 =40.798,P＜0.001],intake [0 (0-2) vs.1 (0-2) vs.2 (0-4),x2=64.707,P＜0.001] and symptoms [0 (0-7) vs.2 (0-10) vs.6 (0-11),x2 =61.562,P ＜ 0.001] all increased gradually with statistical significance.The prevalence of malnutrition in different stage of radiotherapy were significantly different (x2 =64.999,P ＜ 0.001).The body composition analysis in 40 patients showed that all the indicators of body composition decreased significantly along with the progress of radiotherapy.There was a great loss in patients' body weight during radiotherapy,especially the fat-free mass.Conclusions The prevalence of nutritional risk and undernutrition may increase in patients with head and neck cancer during radiotherapy.Lean body mass accounted for most of the weight loss.We should pay more attention to those patients' nutritional status during radiotherapy.

AIM: To study the clinical significance of determining serum anti-endothelial cell antibodies (AECA) and thrombopoietin (TPO) in the differential diagnosis of idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE). METHODS: Serum AECA and TPO in 76 patients with ITP, 41 patients with SLE and 50 normal individuals were detected by ELISA method. RESULTS: Serum AECA level in SLE and ITP was much higher than that in normal group (P0.05), but serum TPO level in SLE was much higher than that in ITP and normal groups (P

OBJECTIVEThe glucocorticoid dexamethasone (DEX) can induce palatal cleft; however, the mechanism involved remains unclear. E-cadherin is an important cell adhesion molecule, and it can significantly affect cell fate and embryonic development. Recent studies have indicated that E-cadherin expression in palatal epithelial cells is suppressed in normal palate fusion. This study aimed to determine whether the change in E-cadherin expression is related to the incidence of cleft palate in DEX-induced mice.

METHODSMice were divided into the experimental group and the control group. Pregnant mice were injected with DEX on E10.0-E12.0, whereas mice in the control group were injected with normal saline. Hematoxylin and eosin (HE) staining, immunohistochemistry, and real-time quantitative polymerase chain reaction were employed to evaluate the effect of DEX on fetal mouse palatal processes, particularly the changes in E-cadherin and β-catenin expression levels in the phases of the experimental and control groups.

RESULTSData indicated that the incidence of cleft palate in the DEX group was 43.59% (17/39), whereas that in the control group was only 3.03% (1/33). The results of HE staining showed that the obviously shortened palatal processes could not contact and fuse with one another in the DEX-treated mice model compared with those in the control group. The ectopic expression of E-cadherin in embryonic palatal mesenchymal cells was also analyzed. The expression levels of E-cadherin and β-catenin in the experimental group were higher than those in the control group.

CONCLUSIONThese findings indicated that DEX could induce E-cadherin gene upregulation and ectopic expression, as well as high β-catenin expression, thereby inhibiting the growth of mesenchyme cells and cleft palate.

Animals ; Cadherins ; genetics ; metabolism ; Cleft Palate ; chemically induced ; embryology ; Dexamethasone ; adverse effects ; Disease Models, Animal ; Epithelial Cells ; Female ; Glucocorticoids ; Immunohistochemistry ; Mice ; Pregnancy ; beta Catenin ; metabolism

Objective To evaluate the effects of sevoflurane preconditioning on zonula occludens-1 (ZO-1) during myocardial ischemia-reperfusion (I/R) in rats in vitro.Methods Adult male Wistar rats,weighing 250-300 g,were anesthetized with intraperitoneal pentobarbital 30 mg/kg and heparinized.Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃.Eighteen isolated rat hearts were randomly assigned into 3 groups (n =6 each) using a random number table:control group (group C),group I/R and sevoflurane preconditioning group (group S).At 10 min of equilibration,the hearts were perfused with K-H solution for 110 min in group C,the hearts were perfused with K-H solution for 20 min,and then subjected to 30 min of ischemia followed by 60 min of reperfusion in group I/R,and the hearts were perfused with K-H solution saturated with 3％ sevoflurane for 15 min followed by 5 min washout,and then subjected to 30 min of ischemia followed by 60 min of reperfusion in group S.At the end of equilibration,immediately before ischemia,and at 15 and 60 min of reperfusion (T1,2),HR,left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP),+ dp/dtmax and-dp/dtmax were recorded.The development of arrhythmias was recorded during reperfusion and scored.At 60 min of reperfusion,myocardial specimens were obtained from the apex of heart for determination of the expression of ZO-1 in myocardial tissues (by Western blot) and for observation of distribution of ZO-1 and connexin43 (Cx43) (by immunofluorescence).Results Compared with group C,HR,LVDP,+ dp/dtmax and-dp/dtmax were significantly decreased and LVEDP was increased at 15 and 60 min of reperfusion,scores of arrhythmia was increased,and ZO-1 expression was down-regulated in I/R group.Compared with group I/R,HR,LVDP,+ dp/dtmax and-dp/dtmax were significantly increased and LVEDP was decreased at 15 and 60 min of reperfusion,arrhythmia was decreased,and ZO-1 expression was up-regulated in group S.ZO-1 and Cx43 were co-localized at the intercalated disk.ZO-1 was redistributed in the lateralization of the membrane and co-localized with Cx43 in group I/R.The incidence of ZO-1 lateralization was significantly decreased in group S.Conclusion The mechanism by which sevoflurane preconditioning decreases reperfusion arrhythmia is related to inhibition of down-regulation of expression and redistribution of ZO-1 and inhibition of redistribution of Cx43 in rats.

Objective To investigate the clinical characteristics of polymyositis/dermatomyositis (PM/DM) complicated with venous thromboembolism (VTE).Methods Medical records of patients with PM/DM at Peking Union Medical College Hospital from Jan 2000 to Oct 2014 were reviewed to identify VTE.The comparisons of various categorical clinical manifestations between groups were evaluated using t-test and x2 test.Results Twenty-three PM/DM patients developed VTE,which accounted for 1.86％ of the 1 235 PM/DM patients hospitalized during the same period.Among these 23 patients (18 female and 5 male),5 patients had PM and 18 patients had DM.With respect to the occurrence of VTE,no significant difference was found between DM and PM or between male and female.Their age was (57±7) years (range:47-71 years old),significantly older than patients without thrombosis [(47±13) years,t=-3.191,P=0.001].Twenty-one patients (75％,21/28) developed VTE in the first year after the diagnosis of PM/DM.The incidence rate ratios (IRR) for DVT in PM/DM were 1.46％ (18/1 235) and for PTE was 0.73％ (9/1 235),in which 4 cases complicated with lower extremity DVT.Most patients exhibited active disease and high levels of D-Dimer during the emergence of VTE.Conclusion Patients with PM/DM have an increased risk of VTE,especially in older patients and at the early stage after the diagnosis of PM/DM,indicating that more attention should be paid to these patients in the clinic.