Objective To evaluate the significance of cystatin C (CysC) in the diagnosis for early kidney injury of diabetes and hypertension by testing serum CysC and serum creatinine concentration and urinary albumin excretion (UAE) in patients with type 2 diabetes and primary hypertension.Methods Sixty-six patients with type 2 diabetes were selected,among whom the total 38 patients whose UAE were 30-300 mg/24 h were classified into early diabetic nephropathy (DN) group,and 28 patients whose UAE were ＜ 30 mg/24 h were classified into non diabetic nephropathy (NDN) group.Fifty-two patients with primary hypertension were selected,among whom the total 25 patients whose UAE were ≥ 30 mg/24 h were classified into hypertension with kidney injury group,and 27 patients whose UAE were ＜ 30 mg/24 h were classified into hypertension without kidney injury group.Sixty health people were selected as control group.The UAE,CysC and creatinine levels were detected.Results The CysC in early DN group was significantly higher than that in control group and NDN group [(1.84 ± 0.83)mg/L vs.(0.41 ± 0.62) and (0.66 ± 0.59) mg/L],and there was statistical difference (P ＜ 0.05).There was no statistical difference in CysC between NDN group and control group (P ＞ 0.05).There were no statistical differences in creatinine and UAE among the DN group,NDN group and control group (P ＞ 0.05).The CysC in hypertension with kidney injury group was significantly higher than that in control group and hypertension without kidney injury group [(0.93 ± 1.04) mg/L vs.(0.41 ± 0.62) and (0.69 ± 0.57) mg/L],and there was statistical difference (P ＜ 0.05).There was no statistical difference in CysC between hypertension without kidney injury group and control group (P ＞ 0.05).There were statistical differences in creatinine and UAE among hypertension with kidney injury group,hypertension without kidney injury group and control group (P ＞ 0.05).Conclusion CysC can be regarded as the value to judge early kidney injury,and it is very important inunderstanding patient's condition,by which appropriate treatment can be carried out to prevent or decrease the occurrence of chronic renal failure.

Objective To explore the expression of Tiaml in clear cell renal cell carcinoma and analyze its correlations to pathology of disease and prognosis.Methods The expressions of Tiam1 protein in 107 specimens of human clear cell renal cell carcinoma and 20 specimens of normal renal tissues were detected by immunohistochemical staining and its clinical significance was then analyzed.Results The expression of Tiam1 protein was higher in renal cancers than in the adjacent normal tissues ( P ＜ 0.01 ).Tiam1 protein expression rates were 47.6％ and 72.7％ in Ⅰ - Ⅱ and Ⅲ - Ⅳ tumors,while 49.3％ and 76.5％ in T1 - T2 and T3 - T4 tumors,respectively ( P ＜ 0.01 ).Expression of Tiam1 protein was higher in lymph node positive renal carcinoma tissues than in lymph node negative renal carcinoma tissues ( 71.7％ versus 47.5％,P ＜ 0.05 ).The expression of Tiam1 in carcinoma tissues showed a positive relationship with tumor vascular invasion (81.3％ versus 48.0％,P ＜ 0.01 ).In patients followed-up 5 - 8 years,Kaplan-meier analysis and the log-rank test showed that the 5-year survival was significantly different between the group of lower and higher Tiaml expression groups ( 84.4％ versus 46.8％,P ＜ 0.05 ).Conclusions The expression of Tiaml protein was higher in human primary renal carcinoma than in normal renal tissues.The positive rate of Tiam1 protein expression was related to classification,TNM stage,lymph node metastasis and vascular invasion.The detection of the expression of Tiaml protein may be helpful in the diagnosis and prognosis of renal carcinoma.

Intrahepatic cholangiocarcinoma (ICC) is a highly malignant tumor with poor prognosis. In the process of clinical diagnosis and treatment, only a small number of patients can receive surgical treatment in time, and the rest often have local infiltration or distant metastasis at the time of presentation, which can only prolong the overall survival by adjuvant therapy. At present, the main adjuvant treatments in clinical practice include chemotherapy, targeted therapy and immunotherapy. This article reviews the progress of systemic therapy and some clinical trials in patients with advanced unresectable ICC, to provide a reference for the clinical diagnosis and treatment of ICC.

Objective To observe the clinical effect of automated peritoneal dialysis(APD)in urgent-start peritoneal dialysis patients with stage 5 chronic kidney disease(CKD).Methods A total of 60 patients with end-stage renal disease who underwent urgent-start peritoneal dialysis in Shenyang Red Cross Hospital from June 2021 to December 2023 were selected as study objects.According to peritoneal dialysis,patients were divided into APD group and intermittent peritoneal dialysis(IPD)group,with 30 patients in each group.Renal function,electrolyte,parathyroid hormone,inflammatory factors,nutritional indexes,brain natriuretic peptide,blood pressure,urine volume,ultrafiltration volume and adverse reactions were compared between two groups.Results After treatment,serum creatinine,urea nitrogen,uric acid,potassium,phosphorus,parathyroid hormone,C-reactive protein,interleukin-6,brain natriuretic peptide,systolic blood pressure and diastolic blood pressure in two groups were significantly lower than before treatment,and urine volume was significantly higher than before treatment(P＜0.05).Serum creatinine,urea nitrogen,uric acid,potassium,phosphorus,parathyroid hormone,C-reactive protein,interleukin-6,brain natriuretic peptide,systolic blood pressure and diastolic blood pressure in APD group were significantly lower than those in IPD group,and ultrafiltration volume in APD group was significantly higher than that in IPD group(P＜0.05).After treatment,there was no significant difference in urine volume between two groups(P＜0.05).No serious complications and death were observed during treatment.Conclusion APD is safe and effective,and is a good choice for urgent-start peritoneal dialysis in stage 5 CKD patients.