Objective: To study the possible mechanism of malnutrition in peritoneal dialysis patients. Methods: Multicenter prospective cohort study was designed . Forty-four peritoneal dialysis patients who survived two years after a cross-sectional study were included in the present study. We divided our patients into two groups according to the dietary protein intake(DPI) during follow-up period, DPI lower than 0.78 g/( kg?d) or DPI higher than 0.78 g/( kg?d). Patients' nutritional status was evaluated during the cross-sectional study and at the end of follow-up. 22 patients were divided into two groups according to the nutritional status improved or worsened in subjective global assessment (SGA) during the follow-up period. Besides nutritional status, patient's residual renal function, volume status and the incidence of cardiovascular event during the follow-up period were also evaluated. Results: Based on SGA , the incidence of malnutrition in low-DPI group was 60.9% in the cross-sectioned study and 45.5% after the follow-up. In high-DPI group, it decreased from 57.1% to 28.6%. The residual renal function declined significantly in worse nutritional status group, the incidences of volume overload and cardiovascular events during follow-up study were significantly higher in worse nutritional status group than that in improved nutritional status group. Conclusion: Malnutrition in peritoneal dialysis patients may not be simply due to lower protein intake. The changes in residual renal function, fluid overload and cardiovascular disease, accompanied with low dietary protein intake may be the possible cause of malnutrition in peritoneal dialysis patients.

Objective To investigate the early impact of incremental peritoneal dialysis.Methods 109 new peritoneal dialysis patients treated with incremental peritoneal dialysis were included in the present study.Clinical data,dialysis adequacy and nutritional status were evaluated at the initiation of dialysis and at 3 months after PD.Results The peritoneal dialysis patients achieved good results in the dialysis adequacy and nutrition at the end of the 3rd month.The patients' comorbidities reduced.BP and blood work improved significantly during the first 3 months.Conclusion Our results suggest that incremental PD improve patients clinical status even at the early stage of dialysis.

Objective: To investigate the impact of nutritional status, inflammation and cardiovascular disease on the mortality of 90 patients with continuous ambulatory peritoneal dialysis (CAPD) . Methods: A cross sectional study was performed in 90 clinically stable CAPD patients. Patients’ nutritional status (by SGA), chronic inflammation (by CRP), cardiovascular disease (CVD) were evaluated. All patients were followed for 24 months. Results: Thirty three of the 90 (36.67%) patients died during the follow up, five patients transferred to hemodialysis and 3 patients received transplantation. The causes of death were CVD in 12, infection in 13 and other causes in 7. Seventeen patients who died were malnourished. Malnourished patients had significantly higher mortality than well nourished patients ( P

OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

Objective: To investigate the multi-imaging diagnostic values, especially MSCT technology in patients with congenital aortic diverticulum with its clinical application. Methods: The MSCT ifndings in 12 patients with congenital aortic diverticulum were retrospectively analyzed. Results: There were 9 patients with right aortic arch and 1 with left aortic arch, all of them having coexisted aberrant subclavian artery which initially dilated like aneurysm by diverticulum changing (Kommerell diverticulum), and there was 1 patient with incomplete double aortic arch with atresia of left arch combining retro-esophageal aortic diverticulum (RAD) and 1 patient with ducts diverticulum. Echocardiogram only made the suggestive diagnosis of speeding up blood lfow or right aortic arch in 4 patients. While MSCT accurately displayed the diverticulum for the location, morphology and with or without other complications. The post-eroanterior chest radiograph indicated “double aortic node” as the special sign in 8 patients. The echocardiogram, X-ray and MSCT for correctly diagnosing the aortic diverticulum were as 0, 72.7% and 100% respectively. Conclusion: MSCT is a rather ideal non-invasive diagnosing method for aortic diverticulum, meanwhile X-ray could also make suggestive diagnosis; if MSCT and X-ray joint with echocardiogram examination may provide the effective supplement for valve structure and hemodynamics condition in relevant patients.

Objective To analyze the reason of hemoptysis after the bidirectional Glenn shunt procedure on complex congenital heart disease.Methods The feature of imaging data of 24 patients (1 6 males,8 females;age ranges:3-27 years;14 cases of single ventricle,3 cases of tricuspid Atresia,4 cases of pulmonary Atresia,3 cases of double Outlet Right Ventricle)after the bi-directional Glenn shunt procedure were retrospectively studied.Results Six patients had various degrees of hemoptysis (50 - 300 mL)after surgery,except for one case which has bronchiectasis on the left inferior lobe.The common feature of the other 5 cases present as plaque ground glass opacity and pulmonary arteriovenous fistula located at the corresponding subpleural field.After different therapy (three cases were performed endovascular management,2 cases were under expectant treatment),the lesion disappeared or obviously smaller which was clear evidence for the existence and bleeding of fistula.The occurrence of this disease in the present study was nearly 20.8%,which were accord with references.Conclusion Pulmonary arteriovenous fistula should be considered when crypto-genic hemoptysis happened after bi-directional Glenn shunt with complex congenital heart disease which exclude tuberculosis,bron-chiectasis or rupture and bleeding of MAPCAs.Multiple sliced CT angiography can be used to as the first line examination and sup-ply acute evidence for clinic therapy in time.

Objective To investigate the clinical efficacy and safety of the cytokine-induced killer cells (CIK) treated in patients with advanced pancreatic cancer. Methods 74 cases (hospitalized from January 2012 to December 2013) with advanced pancreatic cancer (Ⅲ ~ Ⅳ stage) were selected. The patients were randomly divided into two groups: CIK cells treated group (38 patients) and chemotherapy group (36 cases). Patients in CIK cells group received CIK cell infusion therapy , and patients in chemotherapy group received only gemcitabine. The efficacy and safety of all patients were observed. Results The efficacy rate of CIK cells group was 29.0%, with no statistical significance compared to chemotherapy alone group (16.7%). Disease control rate was 63.2%, with statistical significance compared to the chemotherapy group (38.9%). The PFS was 3 months (95%CI:2.5 ~ 3.5), OS 6.8 months (95%CI:6.1 ~ 7.5). 6-month survival rate 41.7%, with statistically significance compared to chemotherapy group. Conclusion CIK cells treated in patients with advanced pancreatic cancer is feasible and safe , and can improve disease control rate , improve immunity and produce clinical benefit in patients.

Aim To investigate the effects of dipfluzine(Dip) on proliferation and collagen synthesis in cultured neonatal rat cardiac fibroblasts(CFB)stimulated by angiotensin Ⅱ(AngⅡ),and to explore the action mechanisms of dipfluzine.Methods CFB were treated with AngⅡ to induce fibrosis model.The effect of Dip on proliferation of CFB was observed by MTT coloricmetric assay;synthesis of collagen was observed by the hydroxyproline concentration detemined;cell cycle distribution and PCNA proein were determined with flow cytometer(FCM);The expression of collagenⅠmRNA,collagen Ⅲ mRNA and TGF-?_1 mRNA was examined using semi-quantitative RT-PCR analysis;The protein expression of cPKC? and ERK_1 in CFB was observed by immunohistochemical staining.Results ① Within a concentration coverage,Dip inhibited CFB proliferation and collagen synthesis(P

A novel antimicrobial peptide, named as perinerin (GenBank accession No. P84117), was isolated and characterized from Asian marine clamworms, Perinereis aibuhitensis Grube. Perinerin showes powerful and broad activity against both grampositive and gramnegtive bacteria in vitro, especially on Pseudemonas aeruginosa. To obtain large amounts of active perinerin and characterize its main physiochemical features, The perinerin weve expressed in Pichia pastoris. Intact perinerin gene amplified by the modified gene SOEing method(Gene splicing by overlap extension)was cloned into expression vector pPICZ?A and obtained recombinant vector pPICZ?APEN, then pPICZ?APEN was expressed in the Pichia pastoris GS115. The expressed sample was analyzed by TricineSDSPAGE. The results showed that Pichia pastoris was a suitable system producing the secreted form of perinerin. Bioactivity assay showed that the recombinant perinerin had marked antimicrobial effects.

Objective To explore the efficacy and safety of 980 nm diode laser therapy for treatment of benign prostatic hyperplasia (BPH). Methods Data of 170 patients with BPH treated with 980nm diode laser system were reviewed. The mean operative time, blood loss, surgical complications, the international prostate symptom score (IPSS), bladder residual urine volume and flow rate changes were collected and analyzed. Results One hundred and seventy cases were safe during the perioperative period. The average operation time was (74 ± 11) min, surgical removal of prostate tissue mass of (54±12) g, blood loss (72±11) ml. There was no TUR syndrome occurred. 170 patients were followed up 2 to 24 months. The IPSS decreased from preoperative 25.0±5.5 to 9.0±2.5. The maximum flow rate increased from preoperative (6.2±2.3)ml/s to post-operative (17.4±3.5) ml/s. The residual urine volume decreased from preoperative (210.0±25.6) ml to postoperative (25.2±4.6) ml. All the differences were statistically significant (P＜0.05). Conclusion Transurethral vaporization of 980 nm diode laser could be a safe and effective treatment modality for BPH.