Volume overload or hidden lung congestion is emerging as a pervasive problem in end-stage renal disease (ESRD) patients on hemodialysis,which will lead to cardiovascular complications and impact the patients' life quality and survival time,so how to improve volume control in patients on hemodialysis is a urgent research hotspot.Recently,the ap plication of lung ultrasound for semi-quantitative assessment pulmonary congestion in patients on hemodialysis has received general concern.Lung ultrasound not only can detect excessive extravascular lung water in the early period of pulmonary congestion,but also can predict cardiac events and mortality in ESRD.Lung ultrasound is an effective,sensitive,real-time and non-invasive tool beside.The application and progresses of lung ultrasound in evaluation of pulmonary congestion in hemodialysis patients were reviewed in this article.

Adult ; Aged ; Female ; Fistula ; surgery ; Humans ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Pharyngeal Diseases ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

Objective To explore the clinical and serological features of patients with pneumomdiastinum (PNM) and dermatomyositis associated interstitial lung disease (DM-ILD).Methods A total of 145 polymyositis/dermatomyositis (PM/DM) patients hospitalized in our department from March,2010 to December,2012 were recruited.The sera,clinical and laboratory data were collected.Anti-aminoacyl-tRNA synthetase (anti-ARS) and anti-melanoma differentiation-associated gene 5 (MDA5) antibodies were detected by RNA-immunoprecipitation (RNA-IP) and ELISA,respectively.Anti-NXP2,anti-TIF1γ,anti-SRP,anti-SAE and antiMi2 antibodies were detected by immunoprecipitation-Western blotting.Variables were compared between DM patients with and without PNM,as well as between DM-ILD patients with and without PNM.Chi square test,Fisher's exact test,t test,Mann-Whitney U test and a multivariate logistic regression model were used for statistical analysis.Results A total of 11 DM patients (10 patients positive for anti-MDA5 and 1 patient positive for anti-Mi2) developed spontaneous PNM.No PM patient developed PNM.No differences of sex,age at the onset of DM,serum ferritin levels and C reactive protein (CRP) levels was observed between DM patients with and without PNM.Compared with DM patients without PNM,DM patients with PNM had significantly higher frequencies of rapidly progressive ILD (RP-ILD) (63.6％ vs 24.4％,x2=7.25,P=0.01),anti-MDA5 antibodies (90.9％ vs 52.4％,x2=5.86,P=0.02),clinically amyopathic DM (CADM) (63.6％ vs 22.0％,x2=8.57,P=0.007) and cutaneous ulcers (36.4％ vs 11％,x2=5.20,P=0.04),but significantly lower creatine kinase (CK) levels [58.5 (30.5,394.3) U/L vs 284 (73.0,917.0) U/L,t=207.5,P=0.04].The logistic multivariate analysis indicated that cutaneous ulcer was the only independent risk factor for the occurrence of PNM in DM [OR=5.98,95％ confidence interval (CI) (1.12,31.98),P=0.037].In the comparisons between DM-ILD patients with and without PNM,a higher frequency of CADM was observed in the PNM group (63.6％ vs 27.9％,x2=5.37,P=0.03),but no significant difference of the frequencies of RP-ILD,anti-MDA5 antibodies,cutaneous ulcers and CK levels was found in these two groups.All patients with PNM were treated with corticosteroids and immunosuppressants.During the follow-up period,6 patients died of respiratory failure.Conclusion Spontaneous PNM is a refractory complication with poor prognosis,and tends to occur in DM patients with RP-ILD,anti-MDA5 antibody,CADM diagnosis and low CK level,especially in patients with cutaneous ulcers.

Aim To investigate the effects of ghrelin on alcohol-induced liver injury. Methods The alcoholic liver injury mouse model was induced by chronic etha-nol feeding ( 4-week ad libitum oral feeding with the ethanol liquid diet) plus a single binge ethanol (5 g· kg-1 ) feeding. The level of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in serum, malondiadehyde ( MDA ) content, superoxide dis-mutase (SOD) and glutathione peroxidase (GSH-Px) activities in liver homogenate were assayed by spectro-photometer. Hepatic pathological examination was ob-served by HE staining. The mRNA expression of proin-flammatory cytokines including TNF-α, IL-1β, IFN-γ, IL-6 and MCP-1 in the liver was measured by real-time PCR method. Results This chronic-plus-single-binge high dose ethanol feeding synergistically induced liver injury, inflammation and fatty liver change. Treatment with Ghrelin ( 5 , 10 , 20 μg · kg-1 ) significantly de-creased the enhanced level of transaminase ( ALT, AST) in serum, improved the pathologic change in liv-er, and reduced the infiltration of inflammatory cells induced by alcohol administration. Ghrelin also de-creased MDA content and increased the reduced SOD and GSH-Px level in liver homogenate. Furthermore, ghrelin decreased inflammatory cytokines mRNA ex-pression including TNF-α, IL-1β, IFN-γ, IL-6 and MCP-1 in the liver. Conclusion Ghrelin has protec-tive effects against alcoholic liver injury in mice via in-hibiting inflammation and suppressing oxidative stress.

Objective: To construct siRNA plasmid expression vector in order to knockdown E2F-3 activity. Methods: Sixty-four base-pair oligos for hairpin RNA expression, which targeted E2F-3 gene, were chemically synthesized and annealed. The pRNAT-U6.1/Neo vector was linearized with Bam HI and HindⅢ. Finally, the annealed oligos were inserted into the lined pRNAT-U6.1/Neo to construct RNAi plasmid(pRNAT-U6.1-E2F-3/Neo). The reconstructed RNAi plasmids were i-dentified by electrophoresis after digestion with BamHI and Hind Ⅲ, and were confirmed by sequencing analysis. Results: The recombinant pRNAT-U6.1-E2F-3/Neo vector was identified by polymerase chain reaction, and confirmed by sequencing analysis. The results demonstrated that 64 bp had been inserted into the expected site. Furthermore, the insertion sequence was exactly correct and no mutation site was found. Conclusion: The pRNAT-U6.1-E2F-3/Neo RNAi system was constructed successfully. This will facilitate the study of E2F-3 in bladder cancer cell lines.

Objective To establish a tree shrew model of Fusarium solani keractitis by injecting Fusarium solani conidia into the corneal stroma.Methods Fusarium solani was inoculated into Sabouraud culture medium and incubated at 26℃ for 7 days.Fungal suspension was collected and the number of spores was adjusted to 1 × 1010 CFU /mL on the blood cell count plate.Forty healthy tree shrews were randomly divided into experimental group (n=30) and control group (n=10).In the experimental group, 50 μL of fungal spore suspension was injected into the cornea center with a 29G needle, and 50 μL saline was injected in the control group.The models were evaluated by anterior segment photography, in vivo confocal microscopy, histopathology, and corneal tissue culture.Results The fungal infiltration, the degree of edema of corneal epithelial and endothelial cells, and the number of mycelium were positively correlated with time.The number of infiltrating inflammatory cells, mainly, neutrophils, reached a peak on the 7th day after modeling.The mycelial growth was parallel to the stromal fibers.After the successful establishment of the model, the corneal tissue culture showed the growth of Fusarium solani.The successful rate of modeling was 86%.Conclusions The tree shrew model of Fusarium solani keratitis is established by injecting spores of Fusarium solani into the cornea.

Objective To explore the incidences of ventilator-associated pneumonia (VAP)in intensive care units (ICUs)in China.Methods From October 2013 to September 2014,46 hospitals in 12 provinces and cities were se-lected to participate in the study,all patients admitted to ICUs were included,the incidences of VAP were surveyed and compared with data from the U.S.National Healthcare Safety Network (NHSN).Results A total of 17 358 patients were surveyed,the total patient-days were 176 096 d,the total catheter-days were 91 448 d,813 patients developed VAP,the incidence of VAP was 8.89/1 000 catheter-days,VAP mainly occurred in general ICUs (76.74%);the incidences of VAP were varied with patients in different types of ICUs,ranging from 4.50/1 000 catheter-days to 32.79/ 1 000 catheter-days.Conclusion The incidence of VAP in patients in ICUs at 46 hospitals in China is significantly higher than that reported by NHSN,even higher than the P90 .

Objective: To acquire the expression of E2F3 protein and mRNA in bladder transitional cell carcinoma (BTCC) tissue and normal bladder epithelial tissue, and the relationship between E2F3 expression and the biological behaviors of BTCC thereof. Methods: Immunohistochemistry was used to detect the expression of E2F3 in BTCC(n = 64) and normal bladder mucosa(n = 10). Immunohistochemistry result was analysed by Image-pro Plus software and the expression result was indicated by integrated optical density (IOD). The expression of E2F3 mRNA was investigated using RT-PCR analysis in fresh bladder tumor tissues and normal bladder mucosa. Results: The expression rate of E2F3 in BTCC (32.8%) was higher than that of normal bladder mucosa(P < 0.01). The expression rate of E2F3 was strongly correlated with the pathological grade and clinical stage (P < 0.05;P < 0.01). Immunohistochemistry result indicated that the IOD of E2F3 was significantly higher in BTCC than that of normal bladder mucosa (P < 0.01). The expression level of E2F3 was strongly correlated with pathological grade (P < 0.01). Conclusion: E2F3 was the diagnostic and prognostic index of BTCC, and provided theory basis about the gene target therapy in BTCC.

Objective To explore the associations between interferon induced helicase C domain 1 (IFIH1) gene single nucleotide polymorphism (SNP) rs1990760 C >T and polymyositis/dermatomyositis (PM/DM) in Chinese Han patients from Jiangsu area. Methods A total of 183 PM/DM patients and 400 healthy controls were included. SNP typing was performed by Taqman MGB probe method. The distributions of genotypes and alleles and Hardy-Weinberg equilibrium (HWE) were examined by χ2 tests or Fisherˊs exact tests. Results The distribution of IFIH1 rs1990760 genotypes of all patients group and the control group were consistent with HWE. The frequencies of T and C alleles were not significantly different between the PM/DM group (20.8% and 79.2%, respectively), the DM group (20.9% and 79.1%, respectively), the PM group (20.5%and 79.5%, respectively) and control group (18.0%and 82.0%, respectively). In recessive model (TT vs CT+CC) and additive model (TT vs CC), the frequencies of TT genotype in PM/DM group (6.6% vs 2.8%; χ2=4.8 and 4.54, respectively; both P=0.03) and in DM with interstitial lung disease (ILD) group (8.3% vs 2.8%;χ2=4.84 and 4.41, respectively; P=0.03 and 0.04, respectively) were significantly higher than those in the control group.In recessive model (TT vs CT+CC), the frequency of TT genotype in PM without ILD group was significantly higher than that in the control group (9.8% vs 2.8%, χ2=5.56, P=0.04). The genotype and allele distributions of rs1990760 were not significantly different between the anti-MDA5 positive group and control group. Conclusion The rs1990760 TT genotype of IFIH1 gene may be associated with the susceptibility of PM/DM in Jiangsu Han Chinese population, and the associations may differ based on the ILD status.

OBJECTIVEThis study aimed to improve students' ability in practical and theoretical courses of oral health education and to promote students' learning interest and initiative.

METHODSFourth-year students of the oral medical profession from 2006 to 2008 at Weifang Medical University were chosen as research objects for oral health education to explore the experimental teaching reform. The students were divided into test and control groups, with the test group using the "speak out" way of teaching and the control group using the traditional teaching method. Results of after-class evaluation of the test group, as well as final examination and practice examination of the two groups, were analyzed and compared.

RESULTSAfter-class evaluation results of the test group showed that the "speak out" teaching method was recognized by the students and improved students' ability to understand oral health education. The final examination and practice examination results showed that the score of the test group was higher than that of the control group (P < 0.01).

CONCLUSION"Speak out" teaching methods can improve students' ability for oral health education, in accordance with the trend of teaching reform.