Objective To investigate the expression of insulin resistance on glomerular podocyte lesion of patients with IgA nephropathy.Methods Fifty-one patients with IgA nephropathy diagnosed by renal biopsy were selected as our subjects.The expression of WT1,a marker of podocyte of the renal tissue of patients with IgA nephropathy,was detected by immunohistochemistry.The density of podocyte per glomerulus was calculated by using specific software.The insulin sensitivity index (ISI) was severed as the degree of insulin resistance.Results There were strong negative correlations between ISI and WT1,mean arterial blood pressure,triglyceride,plasma uricemia,serum creatinine,body mass index,glomerular sclerosis integral,integral,mesangial proliferation of vascular lesions integral(r =-0.521,P ＜ 0.05 ;r =-0.544,P ＜ 0.05;r =-0.646,P ＜ 0.01 ;r =-0.559,P ＜0.05 ;r =-0.741,P ＜0.01 ;r =-0.561,P ＜0.05 ;r =-0.740,P ＜ 0.01 ;r =-0.695,P＜0.01;r =-0.535,P ＜ 0.05 respectively).There was no significant relationship between ISI and 24 h quantitative urinary protein (r =-1.425,P ＞ 0.05).Conclusion Insulin resistance was involved in glomerular podocyte lesion and may contribute to the progression of IgA nephropathy.

Objective To investigate the effect of hyperlipidemia on glomerulus podocyte injury with IgA nephropathy.Methods Fifty-one IgA nephropathy patients with biopsy-proven were selected.Immunohistochemistry was applied to detect the expression of WT1,a marker of podocyte,in the renal tissue of patients with IgA nephropathy.The density of podocyte per glomerulus wascalculated using specific software.Results Triglyceride (TG) was positively correlated with glomerulus podocyte injury,serumcreatinine and glomerulosclerosis in IgA nephropathy (r =0.549,0.770,0.698,P ＜ 0.05 or ＜ 0.01 ),and there was no correlation with 24 h proteinuria.The expression of WT1 was significantly decreased in glomerulus of patients with IgA nephropathy (P ＜ 0.01 ).There was no correlation between the expression of WT1 and 24 h proteinuria,but the expression of WT1 was positively correlated with serum creatinine and glomerulosclerosis (r =0.765,0.679,P ＜0.01).Conclusion Hyperlipidemia may induce glomerulus podocyte injury in IgA nephropathy,and it may contribute to the progression of IgA nephropathy.

Objective To investigate the level of professional commitment of nursing baccalaureate students,and explore the relationship between the professional commitment and communication ability.Methods Questionnaires were used to investigate 430 nursing baccalaureate students who were studying in the school.Results The professional commitment of nursing students was in the middle level.Correlation analysis revealed that the communication ability was correlated with the professional commitment.Conclusions We should take measures to improve the competency of professional commitment of nursing undergraduate students,strengthen their communication ability,promote the construction of nursing staff.

Objective To analyze the impac factors of serum N?terminal pro?brain natriuretic peptide (NT?proBNP) in patients with renal failure in non?dialysis phase, and to determine the cut?off point of as a diagnostic values in these patients with heart failure (HF). Methods Cross?sectional study was applied. Clinical data of 145 patients (37 cases of CKD4, 89 cases of CKD5, and 19 cases of acute renal injury (AKI) with renal failure in non?dialysis phase were collected. Comparison between groups and lineal regression analysis were utilized to investigate the impact factors of NT?proBNP, and the receiver operating characteristic curve (ROC curve) to select a better cut?off point of diagnosis in these patients with HF. Results (1) Compared with patients without HF, patients with HF had significantly higher edema, cardiac troponin I, serum phosphorus concentration, and left atrial diameter (LA), while ALB and left ventricular ejection fraction (LVEF) were decreased (P<0.05). (2) The NT?proBNP was divided into 4 groups with four points: First groups of 36 cases, NT?proBNP 1 ?862 ng/L, second groups 37 cases, 866?2670 ng/L, third groups 37 cases, 2790?20 000 ng/L, fourth groups 35 cases, 20 900?35 000 ng/L. With the increase of NT?proBNP levels, the occurrence of AKI and CKD4 decreased gradually while the occurrence of CKD and edema were significantly increased (P<0.01). Systolic blood pressure, troponin I, uric acid, serum phosphorus, parathyroid hormone, 24 hours urine protein, LA, interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVPW) level gradually increased. Hb, ALB, calcium, CO2, eGFR, LVEF significantly decreased (P<0.01). The serum NT?proBNP of patients with HF was significantly higher than that of patients without HF (19 150 ng/L vs 1530 ng/L, P<0.01). The serum NT?proBNP of patients with edema was significantly higher than that in patients without edema (5460 ng/L vs 1630 ng/L, P<0.01). (3) Single factor linear regression analysis indicated that higher NT?proBNP was positive correlated with HF, edema, cardiac troponin I, uric acid, serum phosphorus, LA, IVS and LVPW (P<0.05), while negative correlated with Hb, eGFR, ALB, serum calcium, CO2, LVEF (P<0.05), and not correlated with eGFR, uric acid, serum calcium (P>0.05). (4) The best cut?off point of NT?proBNP predicting HF in patients with renal failure in non?dialysis phase was 3805 ng/L, AUC=0.848, 95%CI 0.786?0.910. Sensitivity was 82.4%, specificity 74.5%, positive predictive value 62.1%, negative predictive value 87.3%, positive likelihood ratio 3.2, negative likelihood ratio 0.24. Conclusions The level of NT?proBNP>20 000 ng/L is mainly found in end?stage renal disease patients with HF. HF is a main factor for the increase of NT?proBNP in patients with renal failure in non?dialysis phase. High phosphorus viremia, anemia, and hypoalbuminemia are closely related to NT?proBNP. Therefore NT?proBNP predicting HF should take into account the effects of these confounding factors in these patients.

Objective To evaluate the efficacy of long-pulsed tunable Nd: YAG laser on capillary hemangioma and to analyse its influencial factors. Methods A retrospective review was conducted on 124 patients with 135 vascular lesions treated with long-pulsed tunable Nd:YAG laser from February, 2007 to January, 2008. Working parameters, including spot size (3-5 mm), pulse duration (10-30 ms) and fluence (120-200 J/cm2) were determined based on the size, color and depth of lesions and adjusted according to the immediate reaction of lesions. The interval of two treatments was 1 month. Results Of the 135 lesions, 100 experienced a more than 95% subsidence, 22 achieved 60%-94% subsidence, 11 got 30% -59% subsidence, and 2 reached less than 30% subsidence. The cure rate and effective rate were 74.07% and 90.37% respectively. Smaller lesions showed a better response to the treatment than larger ones (P<0.0001), whereas the sites and depth of lesions had no effect on the efficacy (both P>0.05). Atrophy scar occurred in 4 (2.96%) lesions, and blisters in 12 (8.89%) lesions after the treatment. No purpura or pigmentary changes occurred. Conclusion The long-pulsed tunable Nd:YAG laser is an effective treatmnt for capillary hemangioma with fast action and few side reactions.

The association between the polymorphism of SLC17A1 gene and hyperuricemia in Uyghur population in Xinjiang region was explored by Chi-square test.A total of 1 024 patients with hyperuricemia and 1 033 healthy volunteers were included.The genotype frequencies of CC,CT,and Tr in hyperuricemia and healthy controls were 24.9％,53.14％,21.96％ and 29.7％,47.52％,22.77％,respectively.There was statistical difference in SLC17A1 rs9467596 genotype frequencies between hyperuricemia cases and controls (x2 =7.492,P =0.024).CT genotype could increase the risk of hyperuricemia compared with CC genotype (OR =1.334,95％ CI 1.082-1.644).No statistical significance among the genotypes was found in age,body mass index,blood pressure,blood glucose,triglyceride,total cholesterol,High-density lipoprotein-cholesterol,low-density lipoprotein-Cholesterd,blood urea nitrogen,and Creatinine.The polymorphism of rs9467596 in SLC17A1 may be a genetic marker to assess risk of hyperuricemia among Xinjiang Uyghur population.

Objective:To treat the mixed and deeper infantile hemangioma with ladder dosage propranolol, and to explore its efficacy and safety.Methods:A total of 98 infants with hemangioma were treated by ladder treatment of propranolol.Before treatment,comprehensive assessments of electrocardiogram(ECG),heart color ultrasound, blood glucose,liver function,kidney function,myocardial enzymes and blood routine were conducted.After excluding contraindications,the dose of propranolol incrementally doubled from 0.5 mg·kg-1·d-1 to 4.0 mg·kg-1·d-1.Propranolol was taken 3 times a day.Before and after medication for 1 and 2 h,ECG was monitored.The changes of tumor size,texture,color and other changes or an onset of adverse reactions were dynamicly observed.The infants were visited every month.The efficacy was evaluated using Achauer system.Results: After medication,98 cases had different degrees of color changes or tumor consistency softening.After the dosage of propranolol was increased to 4.0 mg·kg-1·d-1,the change of tumor was the fastest.According to the 4-grade method, there were 84 cases(85.71%) as gradeⅣ (excellent),2 cases (2.04%) as grade Ⅲ (good),4 cases (4.08%) as gradeⅡ (medium)and 8 cases (8.16%) as gradeⅠ (poor).The curative effect of mixed hemangioma was better than that of deeper hemangioma(P<0.05).The recovery time of 74 cases of hemangiomas was 6 months.The major adverse reactions were heart rate decline(5/98,5.10%),drowsiness(3/98,3.06%),diarrhea(7/98,7.14%),loss of appetite (1/98,1.02%), and convulsions (2/98,2.04%).After treatment,all adverse reactions disappeared.Two months after drug withdrawal there were 4 cases of recurrence,and they were continously treated with propranolol.Conclusion: The efficacy of oral ladder dosage propranolol in treatment of mixed and deeper infantile hemangioma is increased significantly and there are no significant adverse reactions.

Objective In embryology, the pancreas is formed by fusion of the ventral pancreas(VP) and the dorsal pancreas(DP) during the seventh week of gestation. The aim of this study was to clarify whether there were differences in the clinicopathological characteristics of the carcinoma of pancreatic head(PhCa) arising from the VP and DP. MethodsResected specimens from 43 cases with PhCa were studied histologically and immunohistochemically. The VP and DP were distinguished by islet shape and amount of cells producing pancreatic polypeptide(PP) in normal pancreatic parenchyma adjacent to the main tumor. ResultsThere were 20 cases of PhCa from VP(VP-group) and 23 cases of DP (DP-group) in this study. The prognosis of the 20 patients in VP-group was significantly better than that of the 23 in DP-group ( P

Aim To investigate the effects of irbesartan on Wnt/β-catenin signaling pathway in tubular epithelial-mesenchymal transition(EMT)in HKCs induced by high-glucose.Methods Human kidney proximal tubular epithelial cell line(HKCs)cultured in vitro was divided into four groups:normal-glucose group,mannitol control group,high-glucose group and high-glucose plus irbesartan group.Immunocytochemistry staining was used to observe the expression of β-catenin;the protein expression of Wnt4,β-catenin,E-cadherin and α-SMA was assessed by Western blot;Wnt4 and β-catenin mRNA were detected by reverse transcription-polymerase chain reaction(RT-PCR).Results Compared with normal-glucose and mannitol control group,both the protein and the mRNA of Wnt4 were up-regulated in HKCs stimulated by high-glucose.α-SMA expression significantly increased but E-cadherin decreased in HG group.The cytoplastic and nuclear fraction of β-catenin enhanced with highglucose stimulation.But no difference of the total protein and mRNA of β-catenin was observed between highglucose-treatment and control groups.Highglucose induced Wnt4 and β-catenin expression in a time-dependent manner,both peaking at 24 h.Irbesartan reduced the promotional effect of HG on Wnt4 and α-SMA expression,and nuclear translocation of β-catenin.HG-mediated inhibition of E-cadherin was also restored by irbesartan.Conclusion These data supported a functional role for Wnt/β-catenin signaling pathway during epithelial-mesenchymal transition of HKCs induced by high glucose and suggested that irbesartan might reverse tubular EMT by regulating activity of Wnt/β-catenin pathway.

The effect of fumigation and washing with leek in the treatment of hemorrhoids is significant and its cost is low, and the ancient literature has a lot of discussion on it, but it is not common in modern clinical application. Therefore, the ancient literature can provide references for the modern clinical study about using fumigation and warshing with leek to treat hemorrhoids,but this method still needs a deep research.