Chronic kidney disease(CKD)coexisting with cardiorenal syndrome(CRS)can be frequently seen in clinic,especially in older patients.The guidelines for clinical management of the condition include:typing of CRS according to reasons for cardiac and renal function impairment and symptoms,accurate understanding of the disease aggravation,correction of anaemia,fluid overload or sodium retention and diuretic resistant.Angiotensin-converting enzyme inhibitors,?-blockers and cardiac glycoside are safe and effective for those patients,but they should be used with caution and the patients need to be monitored closely.The long term effect for CRS needs to be studied by more and prospective clinical trials.

Objective To investigate the clinical value of screening and genetic counseling of Down ′s syndrome in the second trimester of pregnancy for prevention of birth defects .Methods Fetal risk assessments were conducted by detecting concentration of alpha fetoprotein (AFP), free chorionic gonadotropin (Free-βHCG) and free female three alcohol (uE3) in maternal serum from pregnant women in the second trimester of pregnancy (14 ~20 +6 weeks) and combining with maternal age , weight, gestational weeks, ultrasonography (neck soft tissue thickness, NT) using a professional software.The high risk pregnant women had voluntary choice of amniocentesis for prenatal diagnosis after genetic counseling and informed consent , while regular follow -ups were done to those with low risks .Results Among 3 673 cases of pregnant women , 246 cases were at the high risk of DS , 17 cases of Trisomy 18 syndrome , 19 cases of Neural tube defects ( NTD) , with the positive rates of 6.7%, 0.46%, 0.52%, respectively .The total positive rate of pregnant women at the age of over 35 years was higher than those at the age of below 35 years old (p<0.01).Conclusion The screening of Down′s syndrome in mid trimester is a noninvasive method with high detection rate .There is important clinical value in prevention of birth defects , but we should do a good job about genetic counseling and interpretation in the process of screening and follow-up.

Objective To observe the comparison of two different guide wire in endoscopic retrograde cholangiopancreatography (ERCP).Methods One hundred and twenty-four patients who were identified with ERCP indications were divided into the loach guide wire group (group A) and zebra guide wire group (group B) by random digits table,each with 62 cases.Intubation time,rate of successful intubation and postoperative complication was compared.Results The rate of of one-time successful intubation in group A was 95.2％(59/62),significantly higher than that in group B [82.3％(51/62)] (P ＜0.05).The average time of one-time successful intubation in group A was (1.38 ± 0.52) min,significantly lower than that in group B [(1.63 ± 0.61) min] (P ＜ 0.05).The rate of total successful intubation in group A was 95.2％(59/62),in group B was 96.8％(60/62),there was no significant difference (P＞ 0.05).The rate of postoperative hyperamylasemia and pancreatitis in group A was 12.9％ (8/62),in group B was 32.3％ (20/62),there was significant difference (P ＜ 0.05).Conclusion The application of the loach guide wire in ERCP operation is significantly better than that of the zebra guide.

Objective To introduce a new method for the treatment of complications after nasal prosthesis.Methods 38 cases with complications after nasal prosthesis were treated by buried-guiding suture method.Results All the 38 patients with nasal prosthesis,such as skewed,floating and sinking mobile,entirely obtained good results.Conclusions The buried guiding suture method in the noninvasive and minimally invasive condition can make the prosthesis relative stability,make expanded extra cavity close adhesion,narrow,finally reaching the tightly wrapped.This method may provide an external force,so that the prosthesis oblique position is corrected,and maintained in a desired position,avoiding operation failure.The effect of this procedure is good,which is a clinical reference method.

Objective Salient regions may express the main content (salient objects) in an image or scene.Since the number of implanted electrodes for visual prosthesis is limited,only the low-resolution image is used.Extraction of the salient regions may help capture salient objects in the scenes of visual prosthesis.Methods Salient regions detected by Itti model,one of salient detection models,have some differences with human visual perceptions and its salient objects boundary are also unclear.The Itti model was optimized by removing the orientation and the color characteristics,and converting the RGB image in an image or scene into the HSI color space with three new feature components of hue,saturation and intensity.In saliency map,the ratio of the salient point area in salient objects regions and the total salient point area was defined as salient accuracy and computed,which was used to compare the effects of the two methods of extracting salient map.Results Compared with the Itti method for extracting saliency map,the salient accuracy of the improved method was increased by about 20％,and the time for detecting the same salient regions by our method was shorter by nearly 50％.Conclusions The proposed algorithm can be an alternative method to extract salient map from a complex image or scene for retinal prosthesis with higher salient accuracy and less running time.

Objective To analyse the variability of spontaneous firing frequencies and firing patterns of a Hippocampal CA1 neuron with the changes of extracellular potassium concentration[K+]0 and ion channel conductance.Methods A 16-compartment cable model of a Hippocampal CA1 neuron was developed based on the Warman model with computer software MATLAB.The dendrites contained no active channels,while five active channels (INa,INap,IDR,IA,IM)were contained in soma.In the model,the calcium currents and potassium currents(ICm,,ICT and IAHP) regulated by calcium concentration were not included.ResultsSimulation results showed that the neuron could generate periodicspontaneous firing activity.The spiking frequency increased with the increasing of[K+]0 and sodium conductance and decreasing of potassium conductance.Spontaneous single neuron activity appeared in singlet or in grouped bursts of two or three spikes.Conclusion The variability of spontaneous firing frequencies and firing patterns of single neuron are relevant to[K+]0 and ion channel conductance.

Objective To explore the effect of Quercetin on the long-term memory and PARP-1/AIF signal path in neonatal rats with hypoxic-ischemic brain damage (HIBD). Methods Fifty-six 7-day-old SD rats were randomly divided into sham-operation group, HIBD group, low dose of Quercetin group (20 mg/kg), and high dose of Quercetin group (40 mg/kg), each of 14 rats. Except for sham-operation group, in the other groups HIBD model were made by right common carotid artery ligation and anoxiate. The Quercetin groups were injected with the corresponding doses of Quercetin immediately once a day continuously for 7 days after the model was made,. Sham-operation group and HIBD group were intraperitoneally injected with normal saline at the same time. Neural function was evaluated by Hanging wire test and Vertical pole test at 21 days old. The capacity of learning and memory was detected by Morris water maze at 28 days old, and then rats were killed and brains were taken. HE was used to observe the pathological changes of hippocampus. Western blot were used to detect the expression of PARP-1 and AIF in hippocampus. Results Compared with sham-operation group, the neural function and learning and memory ability decreased significantly in HIBD group. Those ability in both low dose and high dose of Quercetin groups were remarkably increased in comparison with HIBD group, and there were statistic differences (P??0.05). Conclusion Quercetin could improve long-term learning memory in newborn rats with HIBD, and the mechanism may be down-regulation of PARP-1/AIF cell apoptosis signaling pathway, inhibition of neuronal apoptosis, and thus play a role in protection of brain.

Inflammatory response clearly occured in pathologically vulnerable regions of the Alzheimers disease (AD) brain. Many proinflammatory mediators, such as IL-1, IL-6,TNF-? and TGF-?, were significantly up-regulated in the pathophysiological process of AD. In addition to their traditional actions as proinflammatory molecules, AD-specific interactions of the cytokines and amyloid ?(A?) may be pathophysiologically relevant, and there was a reciprocal relationship within the cytokines inducing and being induced by A?.

Objective: To investigate the relationship between serum albumin level and severity of coronary heart disease (CHD). Methods: A total of 237 patients admitted in our hospital from 2008 to 2009 and undergoing coronary angiography were enrolled. CHD severity was evaluated according to clinical types, number of diseased coronary vessels and coronary artery score respectively, and patients were divided into non-CHD group (n=84), angina pectoris group (n=92) and myocardial infarction group (n=61). Serum total protein, albumin and globulin were measured in all patients on second day after admission. Relationship among indexes of CHD severity and serum proteins were analyzed. Results: Compared with non-CHD group, there was significant decrease in albumin level [(40.22±3.56) g/L vs. (39.81±3.56) g/L vs. (38.68±3.43) g/L, P<0.05] in angina pectoris group and myocardial infarction group. Spearman correlation analysis indicated that serum albumin level was significant negatively correlated with clinical types (r=-0.18, P=0.005), number of diseased coronary vessels (r=-0.195, P=0.003) and coronary artery score (r=-0.188, P=0.004). Serum total protein, globulin and ratio of albumin/globulin were not significantly correlated with clinical types, number of diseased coronary vessels and coronary artery score (P>0.05). Conclusion: Serum albumin level is negatively correlated with severity of coronary heart disease. Low serum albumin may be a risk factor for coronary heart disease.

Objective To explore the protective effects of Quercetin on hypoxic ischemic brain damage (HIBD). Methods Forty-eight 7-day-old SD rats were randomly divided into sham-operation group, HIBD group and Que treatment group, 16 rats each. HIBD group and Que treatment group were treated by ligation of right common carotid artery to make anoxia and build HIBD model; sham-operation group had the separation of the right common carotid artery only. Que treatment group were injected intraperitoneally with quercetin (40 mg/kg) once a day for 7 days immediately after modeling while sham-operation group and HIBD group received equivalent normal saline at the same time. The rats in each group were scored of neurological function at 1 h after the last administration, and the ability of spatial learning-memory was tested by Morris water maze at the age of 28 days. After performing the test above, all rats were decapitated and the brains were taken. Pathological changes of hippocampus were observed by HE staining; the expression of brain-derived neurotrophic factor (BDNF) and nerve growth associated protein (GAP-43) in hippocampus CA1 area were detected by immunohistochemistry. Results There were significant differences in neurological deficit score and learning-memory ability among the three groups (P<0.01), and neurological deficit score was the highest and the learning-memory ability was the lowest in HIBD group. Pathological examination showed that the structure of hippocampal neurons was intact in sham-operation group. It was loose and disorder, and even loss of neurons in HIBD group. Compared with the HIBD group, the loose in the structure of hippocampal was lighter, and the number of neurons was increased in the Que treatment group. There was statistical difference in the positive expression of BDNF and GAP-43 in the hippocampal CA1 area among the three groups (P<0.01), with those in HIBD group being lower than in Que treatment group and sham-operation group and those in treatment group being lower than in sham-operation group (P<0.01). Conclusions Quercetin can enhance the expression of BDNF and GAP-43 in hippocampal CA1 region, promote nerve regeneration, improve the long-term learning-memory ability of HIBD neonatal rats, and protect the brain.