Objective To evaluate the efficacy and safety of cinacalcet on secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD). Methods Patients with ESRD and SHPT for the treatment with calcimimetic agents were included in this study. MEDLINE (1996.1-2014.9), OVID (1963.1-2014.9), Chinese Wanfang database (1996.1-2014.9), CNKI (1996.1-2014.9) and the clinical control test database of Cochrane Library were searched . Related literature, including published or unpublished papers, and meeting procedding were hand-searched. Quality assessment and data extraction were conducted by two independent investigators. Meta-analysis was conducted by RevMan 5.2. Results Nineteen randomized controlled trials involving 7 702 patients were included. The meta-analysis showed that compared with conventional therapy,cinacalcet can significantly decrease serum parathyroid hormone in dialysis patients [WMD=-301.54 μg/L, 95%CI:(-344.38)-(-258.7)μg/L, P<0.05], decrease serum level of calcium [WMD=-8.3 mg/L, 95%CI:(-9.1)-(-7.4)mg/L, P<0.05], and decrease serum level of phosphorus [WMD=-3.4 mg/L, 95%CI:(-4.6)-(-2.3) mg/L, P<0.05]. The total incidence of adverse events was similar (RR=1.03, 95%CI:0.98-1.09, P>0.05). Cinacalcet increased nausea (RR =2.05, 95%CI :1.53-2.75, P<0.05), vomiting (RR =2.00, 95%CI:1.78-2.23, P<0.05), diarrhea (RR=1.15, 95%CI:1.03-1.30, P<0.05), and asymptomatic hypocalcaemia (RR=7.60, 95%CI:5.61-10.30, P<0.05), but they were usually transient, and mild to moderate in severity. The mortality was similar (RR=0.97, 95%CI:0.89-1.05, P>0.05). Conclusion Results confirm that cinacalcet suppresses parathyroid hormone and decreases calcium and phosphorus in secondary hyperparathyroidism patients receiving dialysis. Cinacalcet increases risks of nausea, vomiting, diarrhea and hypocalcaemia,without increasing mortality.

Objective To assess the effect of hemoperfusion (HP) and hemodiafiltration (HDF) on elimination of para?thyroid hormone (PTH) from plasma in long-term hemodialysis patients.Methods MEDLINE (1966—2013.8), Embase (1974—2013.8), Chinese Wanfang database (1996—2013.8),CNKI(1979—2013.8)and the clinical control test database of Cochrane Library were searched. Published reports, unpublished studies and abstract from conference were retrieved manu?ally, all of which include studies of effect of PTH elimination through hemoperfusion and hemodiafiltration. Quality assess?ment and data mining were conducted by two independent investigators who performed meta-analysis using RevMan 5.2. Re?sults A total of 12 reports (400 patients) met the inclusion criteria and were included in this study. The meta-analysis showed that the elimination rate of PTH in long term hemodialysis patients was similar between using hemoperfusion and us?ing hemodiafiltration(WMD=-0.34,95%CI:-12.66-11.98,P=0.96). What’s more the elimination rate ofβ2-MG were also similar(WMD=-2.92,95%CI:-16.64-10.8,P=0.68)between those two treatments. However,The remission rate of pruritus was higher in patients using HP group than in HDF group(RR=1.33,95%CI:1.08-1.62,P=0.006). Conclusion HP and HDF can effectively clear PTH in chronic hemodialysis patients, but there was no statistically different between the two treat?ment methods.

Abstract: Suxamethonium chloride is a depolarizing muscle relaxant used in general anesthesia. In overdose, it causes adverse reactions such as bradycardia, arrhythmia, cardiac arrest, and death. The article reviews the progress on testing methods of suxamethonium chloride such as infrared spectroscopy, chemical color reaction, chemical titration, enzyme electrode, chromatography and mass spectrometry.
Anesthesia, General ; Arrhythmias, Cardiac/chemically induced* ; Biosensing Techniques ; Bradycardia/chemically induced* ; Chromatography ; Drug Overdose ; Heart Arrest/chemically induced* ; Humans ; Mass Spectrometry ; Neuromuscular Depolarizing Agents/analysis* ; Spectrophotometry, Infrared ; Succinylcholine/analysis*

Objective To evaluate the effect of continuous renal replacement therapy (CRRT) on the remove of inflammatory mediators and the function of endothelial cells in patients with multiple organ dysfunction syndrome (MODS). Methods Thirty patients with MODS were enrolled in this study. All of the patients underwent CRRT for at least 24 hours. Peripheral blood levels of IL-1β, IL-4, IL-6, IL-10, TNF-α, E-selectin, sVCAM-1, slCAM-1 and PAF-AH were measured at the beginning and 3, 6, 12, 24 h after initiation of CRRT. Results Nineteen patients survived after 14 days and 17 patients survived after 28 days during therapy. The clinical oxygenation and bemodynamics were improved after 6 h of CRRT. Among inflammatory mediators, the levels of TNF-α, IL-6, IL-10 rose gradually from the beginning [(462.24±331.03) ng/L, (106.39±90.82) ng/L, (124.51±118.39) ng/L), and reached the peak at 12 h [(887.88±975.46) ng/L, (132.01±118.14) ng/L, (167.01±161.66) ng/L], and the levels of IL-1β, IL-4 decreased from initiation of CRRT. But there were no significant differences in the levels of above cytokines between at the beginning and at the end of CRRT. There were significant differences in the levels of cytokines between survival and death group. The level of IL-6 in death group [(145.45±14.28) ng/L] was significantly higher than that in survival group [(106.03±10.86) ng/L]. The level of IL-10 in death group [(94.93±16.09) ng/L] was significantly lower than that in survival group [(143.06± 12.24) ng/L]. Levels of E-select, sVCAM-1 and sICAM-1 elevated from the beginning and reached the peak at 12 h, but no significant differences were found between intiation and the end of CRRT. The level of PAF-AH increased after initiation, and there was a significant difference between beginning and the end of CRRT. Levels of cytokines for endothelial cell function were significantly different, such as E-selectin [(287.13±42.70) μg/L vs (266.26±65.26) μg/L], sVCAM-I [( 1697.25± 475.24) μg/L vs (1488.10±691.67) μg/L], sICAM-1 [(975.33±142.50) μg/L vs (835.40±332.41) μg/L], and PAF-AH [(9.07±6.38 ) μg/L vs (16.32±8.95)μg/L]. Conclusions Clinical oxygenation and hemodynamics can be improved, and endothelial cell function can be improved partly by CRRT. There were no significant differences of inflammatory mediator levels between initiation and the end of CRRT. IL-6 and IL-10 can be used as predicators for prognosis of MODS patients.

Objective To observe the efficacy and adverse reaction of the test drug hepatitis B immunoglobin on the post market.Method Employed by the methods of multiple center's clinical trials and using the recommended dosage of hepatitis B immunoglobulin for intravenous administration,the clinical efficacy of either prevention or treatment for hepatitis B recurrence and drug related adverse reactions were observed.This consisted of 22.1 months,13 hospitals,and 525 patients with hepatitis B related liver transplantation.Result The results showed a contrasting probability of adverse reactions for different doses among the observation period.Within 6 months postoperatively with a greater or equal to recommended drug dose,the infection rate was less than 4％.In contrast,the infection rate was greater than 12％ in the group with less than the recommended drug dose.Conclusion There was an obvious dose effect relationship,and the drug safety and recommended treatment rationality were verified.

Purpose To investigate the clinical characteristics and Oxford classification of IgA nephropathy patients with hyperurice-mia. Methods 151 IgA nephropathy patients confirmed by renal biopsy in 2013 were analyzed retrospectively. The patients were di-vided into the two groups:IgA nephropathy patients with or without hyperuricemia. Morphological changes were evaluated with Oxford classification scoring system and Lee’s grades. A comparative analysis of clinical manifestations and pathological injuries was performed between the two groups. Results Incidence of hyperuricemia in IgA nephropathy patients was 48. 3% and was more common in young men. Hypertension was associated with hyperuricemia. Oxford classification of IgA nephropathy patients with hyperuricemia was pre-dominant M1E0S1T0 and Lee’s grades presented with grade Ⅲ. The outstanding histopathologic features with higher plasma uric acid levels indicated higher tubulointerstitial chronicity, higher glomerular sclerosis ratio, accompanied by a decline in glomerular filtration rate. There was no significant difference of vascular lesions. Conclusions The prevalence of hyperuricemia in IgA nephropathy pa-tients is high. Oxford classification shows IgA nephropathy with hyperuricemia are associated with more severe tubulointerstitial lesions and lower GFR.

Objective To investigate the effect of cell death by HIV-1 infection on gene 90K/Mac-2BP by RNA interference (RNAi) in U937 cell line.Methods We used human monocyte-macrophage cell line U937 as the cell model.Cells were infected by HIV-1 ( R5-tropic) 5 days, and then stained by PE-Annexin V and PerCP-7-AAD.90K/Mac-2BP in U937 cell line was knocked down , and these cells were infected by HIV-1 for 5 days.Then, cells were stained by PE-AnnexinV and PerCP-7-AAD.Apoptosis were examined upon flow cytometry .Results The percentages of Annexin V+cells without 90K/Mac-2BP knock-down were (16.27 ±0.30)% by HIV-1 infection.The percentages of them with 90K/Mac-2BP knock-down were (31.26 ±0.35)%, (25.76 ±0.30)%, (23.69 ±0.33)% respectively.The increase of cell apoptosis rate for HIV-1-infected U937 cells by 90K/Mac-2BP siRNA transfection was significantly greater than that for HIV-1-infected untreated cells (P﹤0.01).Conclusion The apoptosis of HIV-1-infected U937 cells was regulated by the expression of 90K/Mac-2BP.

Objective To evaluate the feasibility of assessing osteoarthritis (OA) in hip dysplasia using 3D delayed gadolinium-enhanced MRI of cartilage (dGEMRIC).Methods Thirty-five hips in 20 patients with radiographic evidence of hip dysplasia underwent 3D-dGEMRIC scanning.Clinical symptoms were assessed with the Western Ontario and McMaster Universities Osteoarthritis ( WOMAC ) questionnaire.Radiographic measurement of lateral center-edge angle and T(o)nnis grading were performed on the X-rays.Hips of T(o)nnis grade 1were included in the group of hips with early OA,while the hips with no evidence of OA and without pain symptom were included in the group of hips with normal morphology.The 3D-dGEMRC scans were completed on a 1.5 T MR scanner.The data of 3D-dGEMRIC was reconstructed radically.The dGEMRIC indices were measured on six sites of periphery zones of hip cartilage on reconstructed images.The dGEMRIC indices among different groups were analyzed by non-parametric tests.The differences of dGEMRIC indices among six sites in the group of early OA or the group of normal morphology were analyzed by Wilcoxon test.Results The mean dGEMRIC indices of six sites were lower in group of T(o)nnis grade 1than in group of T(o)nnis grade 0 ( Z =- 2.149,P =0.032 ),and lower in group of T(o)nnis grade 2 than in group of T(o)nnis grade 1( Z =- 1.990,P =0.047 ).The dGEMRIC indices of the anterior site,anterosuperior site,superior-anterior site,and superior site were significantly different between the group of hips with early OA and the group of hips with normal morphology (Z =-2.333--2.041,all of the P values were lower than 0.05).In the group of hips with normal morphology,the dGEMRIC indices of superior-anterior site of hip were lower than superior site(P =0.028).In the group of hips with early OA,the dGEMRIC indices of superior-anterior site were lower than the other sites except for anterior-superior site ( Z =- 3.041- - 2.277,all of the P values were lower than 0.05 ).Conclusions 3 D-dGEMRIC might be a sensitive technique for detection of glycosaminoglycans alteration in early OA and staging of OA in hip dysplasia.Radial reconstruction could provide an accurate assessment of OA,and the results demonstrated that early cartilage alteration could be detected in the anterior to superior sites of hips,and the earliest cartilage alteration may occur in the superior-anterior site of hips.

Objective To explore the relationship between the index of SPECT myocardial viability teat of the left ventricle and long-term cardiovascular adverse events following the coronary artery bypass graft.Methods Clinical data were selected from the coronary-heart-disease patients with CABG and the isotopic SPECT test of myocardial viability prior to the operation in the Fuwai Cardiovascular Hospital,the Chinese Academy of Medical Science from January 1,1999 to December 31,2005.Total 709 patients were included in this study.Regular follow-up in patients was performed following operation.Investigate the nuclear medicine documents of the patients above;make the semi-quantitative scores of myocardial viability prior to operation by the 17-segment method of ventricle.Through the COX multi-factor analysis of the statistical methods to explore the relationship between the index of the myocardial viability and the long-term cardiac adverse events selected in advance.Results The mean duration of follow-up was(3.43±2.42)years.The COX multi-analysis revealed that the total score of left ventricular myocardial viability is the independent impact factors for long term cardiac death,long terrm re-hospitalization rate and long term composite end points events.The cut off values of total score of left ventricular myocardial viability for long term cardiac death,long term re-hospitalization rate and long term composite end points events is 15,9,13 respectively.Conclusion The total score of left ventricular myocardial viability of SPECT is independently associated with long-term events,and the cut values of myocardial viability total score for long-term cardiac death,re-hospitalization and composite MACE events are 15,9,and 13 respectively.For the groups with total scores above and below the cut off values,there is significant difference of long term cardiac events risk between groups.

Objective To assess the treatment efficacy and safety of lanthanum carbonate (LC) in patients on maintenance hemodialysis. Methods MEDLINE (1996—2014), Embase (1974—2014.12), Pubmed (1996—2014.12), Cochrane library, Chinese Wanfang database (1996—2014.12) and CNKI (1979—2014.12) were searched. Lanthanum carbonate and hemodialysis were used as Chinese and English search terms respectively, and the articles met the inclusion and exclusion criteria were used as supplements. Quality assessment and data mining were conducted by two independent investigators who performed Meta-analysis using RevMan5.2. Results Nine trials with 2 674 participants were included in this study. The Meta-analysis showed that there were similar blood levels of calcium [WMD=-0.24,95%CI:(-0.61)-0.14, P=0.21], phosphorus [WMD=0.14,95%CI:(-0.02)-0.30,P=0.08] and phosphate control rates (RR=0.91,95%CI:0.70-1.17, P=0.44) between control group and lanthanum carbonate group. There were lower incidence rates of hypercalcemia (RR=0.17, 95%CI:0.06-0.47, P=0.000 7) and blood levels of calcium-phosphorus product [WMD=-2.17,95%CI:(-3.99)-(-0.35), P=0.02], and higher levels of parathyroid hormone (iPTH, WMD=105.69, 95%CI:70.38-141.00, P<0.000 01) and bone-specific alkaline phosphatase (BAP, WMD=6.47, 95%CI:0.43-12.50, P=0.04) in these two groups. There were no significant differences in incidence rates of gastrointestinal adverse events between two groups. Conclusion Lanthanum carbonate should be used as preferred choice of phosphate binders to control serum phosphorus in patients on maintenance hemodialysis.