Objective To evaluate the applicability of the simplified equation of MDRD to predict glomerular filtration rate(GFR)from serum creatinine in Chinese patients with chronic kidney disease(CKD),and refit the MDRD equation parameter estimates with Chinese patients data.Methods A total of 760 hospitalized CKD patients were investigated from 2002 to 2005.Patients'sex,age,height and body weight were recorded;plasma creatinine and ~ 99m Tc-GFR(standardized by body surface area)were measured in all patients;GFR was estimated with simplified equation of MDRD and Cockcroft-Gault;the accurancy of estimated GFR with MDRD and CG were compared with~ 99m Tc-GFR in different stage of CKD.Totally 670 patients were randomly selected as the training sample,the remaining 90 patients constituted the validation sample.We used stepwise multiple regression to refit the equation of MDRD and the regression models were developed by using the training sample.The refitting equation was then tested and compared with the other equation in the validation sample.Results (1)Both the MDRD and CG-GFR prediction equations seemd to systematically underestimate GFR,but the accurancy of MDRD equation was better than CG-GFR in stage Ⅰ~Ⅲ of CKD.(2)The bias of estimated GFR(MDRD or CG-GFR equation)with ~ 99m Tc-GFR was lower in stage Ⅰ~Ⅲ than in stage Ⅳ~Ⅴ of CKD.(3)Refitting of the MDRD equation parameter estimates to Chinese patients data set resulted in the following prediction equations:GFR=234.96?(Scr)~ -0.926 ?(Age)~ -0.280 ?0.828(Female).(4)Comparing with~ 99m Tc-GFR,the bias of estimated GFR calculated by the refitting MDRD equation was lower than that of estimated with MDRD or CG especially in the stage Ⅳ~Ⅴ of CKD in Chinese patients.Conclusion the simplified equation of MDRD can estimate GRF accurately,but the equation must be refitted in Chinese patients.

Objective Vimentin is the major protein consisting of intermediate filaments in normal and neoplastic mesenchymal cells.It has been regarded as a marker of epithelial mesenchymal transition( EMT) .How-ever,little is known about colorectal cancer( CRC) with Vimentin expression as a marker of EMT and prognosis. Methods We investigated the expression of Vimentin in CRC tissues and determined the correlations between Vimentin expression patterns and clinicopathologic characteristics and prognosis in CRC.In total,189 patients di-agnosed with CRC based on histopathological evaluation and those subjected to surgical resection at the Liaoning Province Cancer Hospital and Institute between 2000 and 2002 were examined.Immunohistochemical staining for Vimentin was performed for each specimen.Results Positive expression of Vimentin was significantly associated with the lymph node metastasis(pN stage,P=0.038),TNM stage(P=0.024).Survival analysis revealed that positive Vimentin expression was significantly related to poor prognosis ( P =0.016 ) .Multivariate analysis re-vealed that Vimentin expression was an independent prognostic factor for patient survival in colorectal cancer ( P=0.026) .Conclusion In conclusion,our data provide novel evidence for the clinical significance of Vimentin ex -pression as potential predictive biomarkers for identifying patients with lymph node metastasis or poor prognosis in CRC.

Objective To evaluate the clinical result of arterial reconstruction in critical limb isehemia. Methods Clinical data of 123 cases (137 lower extremities ) of critical limb ischemia ( Fontaine Ⅳ ), 79 males and 44 females, with a mean age of ( 74 ± 9 ) years, undergoing arterial reconstruction, were reviewed. Comorbidities included tobacco use (33. 33% ), coronary artery disease (43.09%), hypertension ( 50. 41% ), cerebral vascular disease ( 29. 27% ), and diabetes mellitus(52. 33% ). Result Perioperative mortality rate was 4. 88%, and 88. 89% cases were followed up with amean time of (18 ± 18) months and the mortality rate was 13.01%. The postoperative pateney rate of1 year, 2 years and 3 years was (81±4)% ,(68±6)% and (61±7)% respectively. Arterial occlusion occurred in 25 cases, 4 cases received reoperation and 9 cases received major amputation. Tissue healing rate was 78. 85% after half a year and 83. 65% after 1 year. The limb salvage rate was (81±4)% ,(71 ±5 )% and (65 ± 6)% after 1 year, 2 years and 3 years respectively. Conclusion Arterial reconstruction for the critical limb ischemia increases the limb salvage rate with satisfactory patency rate and improves the healing of ulcer.

Objective To review the experiences of re-operational effect for occluded arterial bypass in lower limbs. Method We analyzed the re-operational effect of 19 patients (20 limbs) with occluded arterial bypass in lower limbs from May 1996 to Fab 2004. A total of 31 operations were performed in these patients. Results The patent rate of simple thrombectomy in 18 cases was only 27.7% (5/18) with a rate of re-obstruction of 72. 3%(13/18). The period of patent outflow of another 13 re-operations with rebuilt of in-flow or out-flow varied at 4 days to 11 months. The patent rate in this group was 61.5% (8/13). The rate of re-obstruction was 38. 5% (5/13). The overall patent rate of re-operation was 41.9% (13/31). The average patent period was 9. 1 months (3-29 m). The operative mortality rate in 19 patients was 5. 3% (1/19). The limb salvage rate of 19 limbs in 18 patients was 73. 7%(14/19). The amputation rate was 25%(5/20). Conclusion The main cause of late re-obstruction of bypass procedure was endothelial proliferation and development of lesions. The effect of rebuilt of in-flow or out-flow was better than thrombectomy only. Duplex follow-up helps to find restenoses and manage the proliferated lesions before a bypass becomes occluded.

Objective:To study expressions of CD117 and CD34 in the patients with acute promyelocytic leukemia(APL,M3) and in M1-M2 subtype from FAB classification for acute leukemia(AL).The focus of the study would be laid on the clinical significance of CD117/CD34 co-expression in the patients of M3 subtype.Methods:Researched cases of acute nonlymphoblastic leukemia(ANLL) were divided into two groups:M1-M2 subtype and M3 subtype.Flow cytometery(FCM) was used to detect the rates of positive expression of CD117 and CD34 on bone marrow mononuclear cell(BMMNC) in 54 patients of M3 and 63 patients of M1-M2 subtype respectively.Meanwhile,we compared the differences between the rates of expression of CD117 and CD 34.And,the rates of CD117/CD34 co-expression in patients of M1-M2 subtype and M3 subtype were studied.Results:Our results revealed that the positive rates of CD117 expression in M1-M2 subtype and M3 subtype were 71.4%(45/63) and 66.7%(36/54) respectively(P=0.58).The positive rates of CD34 expression in M1-M2 subtype and M3 subtype were 66.7%(42/63) and 11.1%(6/54) respectively(P=0.000).The positive rates of CD117/CD34 co-expression in M1-M2 subtype and M3 subtype were 71.1%(45/63) and 7.4%(4/54) respectively(P=0.000).Conclusion:CD117 may be used as immunology marker for leukemia of myeloid origin.CD34 had lower expression in M3 subtype than in M1-M2 subtype.The positive rate of CD117/CD34 co-expression in M3 subtype was significantly lower than that in M1-M2 subtype,which can help for diagnosis of M3 subtype and help differentiate M3 subtype from M1-M2 subtype as well.

Objective To explore the value of 18F-fluorodeoxyglucose（18F-FDG）PET-CT and CT in diagnosing bronchioloalveolar carcinoma （BAC）.Methods The PET-CT and CT findings of 15 patients with BAC pathologically confirmed were retrospectively analyzed.Results According to 18F-FDG PET-CT,there was definite diagnosis of malignant in 8 cases（53.3 %）,no exclusion of malignancies in 2 cases （13.3%）,definite diagnosis of benign tumors in 5 cases（33.3%）.The misdiagnosis rate of 18F-FDG PET-CT is higher.According to CT,there was definite diagnosis of malignant tumors in 11 cases（73.3 %）,no exclusion of malignancies in 2 cases（13.3%）,definite diagnosis of benign tumors in 2 cases（13.3%）.Conclusion The false negative rate and the misdiagnosis rate are high when SUVmax as 2.5 was employed as criteria in the diagnosis of BAC.To improve diagnosis accuracy and decrease misdiagnosis of BAC,we should be familiar with the CT images of different BACs and adjust the SUVmax as a diagnosis value.

Objective To evaluate imaging findings and treatment experience in central venous stenosis without a history of previous catheterization in hemodialysis patients. Methods Clinical data of 5 haemodialysis cases of central vein stenosis without a previous catheterization history in our hospital from July 2006 to July 2008 were analyzed retrospectively. Results Patients were three women and two men aged 43 to 65 years with mean age(53±8)years and all had arm swelling as the main complaint.The vascular accesses were located at the wrist in all the patients.The mean duration of the vascular accesses from the time of creation was(33.6±35.4)months.Venography showed occlusion in 2 cases and stenosis in 3 cages of central vein including 1 case of stenosis in brachiocephalic vein.1 case of stenosis beth in branchiocephalic vein and subclavian vein,1 case of stenosis in two segments of subclavian vein.The stenosis of branchiocephalic vein was fixed anterior to the tracheal and CT showed the compression of the vein by the aorta.Symptoms were resolved by the treatment of PTA.subclavian vein-contralateral subclavian vein bypass and ligation of the access. Conclusions Central venous stenosis in haemodialysis patients without a history of catheterization may be due to the intimal hyperplasia of the compression site or valve which is accelerated by the high flow of vascular access.Venography is the first choice for the diagnosis and the current management of central venous stenosis is far from being effective for the long term.

Objective To explore the effect of using pedicle skin flaps for treatment of skin and soft tissue defects.Methods From January 2004 to September 2010,87 patients with skin and soft tissue injury which had been treated by using pedicle skin flaps without vessel anastomosis were retrospectively analyzed,including 61 males and 26 females with an average age of 40 years (range,14-61).The pedicle skin flaps selected were known vessel skin flaps or unknown vessel random skin flaps.The reconstruction treatment increased multiple selections of skin flaps for patients.Skin and soft tissue defects were located at the hand in 21 cases,at the lower extremities in 66.The kinds of skin flaps included adjacent transposition flaps in 50 cases,distal skin flaps in 37.The areas of the skin flaps were 2.0 cm×1.5 cm-18 cm×12 cm.Donor sites were as follows:lower leg in 61 cases,abdomen in 18,and hand in 8.Results Three patients appeared skin flaps hematoma after operation,which were removed immediately with no effect on flaps survival.Pedicle skin flap was compressed due to unstable fixation in 1 case,which made distal flap tissue necrosis approximately 2 cm in width.After dressing change for 6 weeks,the flaps got survival.Thirty seven patients underwent the second stage operation for breaking the perdicle 3 weeks after the first operation.All 87 patients were obtained follow-up for an average of 13 months (range,3-60).The total of 90.80％ patients treated with pedicle skin flaps were satisfied with the results.Conclusion Pedicle skin flap surgery can be performed more easily with less limitations of surgical designs.The survival rate of the flap is high,and the treatment of pedicle skin flaps could be well applied for soft tissue defects.

Objective To investigate the efficacy of statin on carotid plaque stability in elderly patients assessed by K trans (the combination of E and F) of dynamic contrast material enhanced (DCE) magnetic resonance (DCE MR) imaging.Methods 37 elderly patients with carotid artery of low echo or mixed echo plaque in carotid artery patches were screened by B type ultrasound.According to the standard of 2011 ESC/EAS guidelines,all patients were divided into two groups:normal level of LDL-C group achieving LDL-C target and high level of LDL C group not achieving target of LDLC.Plaque area and size of lipid-rich necrotic core were measured by 3.0T enhancement magnetic resonance,and K trans was measured by DCE-MR dynamic contrast material enhanced (DCE) magnetic resonance (MR) imaging.and serum hs-C-reactive protein level was detected within 1 week.Results Plaque area,size of lipid-rich necrotic core,ratio of lipoid core over plaque area,K trans and serum level of hs-CRP were less in normal LDL-C level group than in high LDL-C level group [(2.06±0.45) mm2 vs.(3.63±0.62) mm2,(0.52±0.05) mm2 vs.(1.49±0.01) mm2,2 cases (11.8％) vs.14 cases (70.0％),(0.041±0.009) min1 vs.(0.079±0.011) min-1,(1.60±0.27) mmol/L vs.(2.80 ± 0.34),all P＜0.05].Linear regression analysis revealed that there was no significant correlations of K trans with the size of lipid necrotic core (r=0.19,P＞0.05) and hs-CRP (r=0.23,P＞0.05).Conclusions Dynamic contrast material enhanced (DCE) magnetic resonance (MR) imaging is a quantitative method assaying atheromatous plaque components; K trans may be a new indicator to measure the stability of plaques; Statin can stabilize plaques through inhibiting the proliferation of Vasa vasorum in plaque angiogenesis,anti-inflammatory and reducing the size of lipidrich necrotic core.

Objective To explore the significance of language proficiency in bilingual perception in Chinese-English late bilingual subjects with block-design functional magnetic resonance imaging (bfMRI).Methods Thirteen right-handed Chinese Han healthy male late bilinguists who had limited English proficiency were scanned while listening to short sentences in Chinese and English.Based on blood oxygenation level-dependent (BOLD) signal efficacy,functional images were collected using a 1.5-T MRI.Statistical parametric mapping 2 (SPM2) was used to analyze the data of functional images (P＜0.001,KE＞ 100).Results For Chinese familiar voices,more significant activation was observed in the right superior temporal gyrus than that for English familiar voices.On the contrary,more significant activations for English familiar voices were observed in the left precuneus,middle frontal gyrus and left posterior cingulate cortex compared with that for Chinese familiar voices.For Chinese unfamiliar voices,more significant activations were observed in the right middle temporal gyrus and right medial frontal gyrus than that for English unfamiliar voices.In contrast,more significant activations by English unfamiliar voices were observed in the right inferior frontal gyrus,middle frontal gyrus and left middle temporal gyrus compared with that for Chinese unfamiliar voices.Conclusion Language proficiency may play an important role in different language perception from auditory level.