Objective To investigate the relationship among ultrafiltration (UF), diurnal rhythm of blood pressure (BP) and cardiac structure and function in hemodialyzed(HD) patients. Method 42 hemodialyzed patients were studied. Intensified UF during routine HD were given to them for 4 weeks. Before and after 4 weeks, everyone received 24 hours ambulatory blood pressure monitoring and cardiac doppler and recorded diameter of left atrium (LAD) ,left ventricle (LVEDD), thickness of posterior wall of left ventricle during end stage of diastolic period (LVPWT) ,thickness of interventricular septum(IVST) ,ejection fraction (EF). Result In hemodialyzed patients, non-dipper hypertension was much more than dippers (P < 0.05). There was significant difference between nocturnal BP and cardiac structure before and after 4 weeks of hemodialysis ( P < 0.05 ). Conclusion Nocturnal hyperten- sion of hemodialyzed patients is related to hypervolemia. Intensive ultrafihration can improve nocturnal hypertension and eardiac function.

Objective To study the prognosis of polymyositis(PM) and dermatomyositis(DM) patients and its influence factors.Methods Sixty DM and 30 PM patients diagnosed according to the diagnostic criteria of Bohan and Peter in our hospital during 2000-2008 were used as study subjects.The patients were followed up till their death or to August 2009.Gender,age of disease onset,disease course,serum creatine kinase,interstitial lung disease,heart involvement,connective tissue disease(CTD),malignancies,and treatment with corticosteroids,immunoglobulin and immunosuppressive agents were assessed as predictive factors for the prognosis of patients.Characteristics of muscular biopsy from 20 cases were analyzed.Results The median age of the 90 patients(29 males and 61 females) was 51 years(range 6-74 years).The male and female ratio was 1∶2.The most commonly involved muscles were the proximal muscles of limbs(83.3%),followed by neck muscles(25.6%),laryngea pharyngeal muscles(12.2%) and masticatory muscles(2.2%).Among the 42 patients(46.7%)with lung disease,interstitial lung disease and hear involvement were found in 29(32.2%)and 13(14.4%)patients,respectively.Of the 13 patients complicated by connective tissue disease,DM and PM accompanying connective tissue disease were diagnosed in 9 and 4,respectively,and DM and PM accompanying malignancies were observed in 2 patients.Muscular or skin biopsy was performed for 23 patients,which showed typical inflammatory infiltration in 13,dermatomyositis in 3,and no significant lesion in 2 patients,respectively.Of the 18 patients who died during the follow-up,5(16.67%) and 13(21.67%) died of PM and DM,respectively.Seventy-two patients survived.Their 1-,5-,and 9-year survival rate was 90%,84.4%,and 80%,respectively.The complete and partial remission rate was 22.2% and 36.7%,respectively,with a relapse rate of 20%.Advanced age of disease onset(P=0.003 8),interstitial lung disease(P=0.011 3) and malignancies(P=0.004 9) were main causes of death.Malignancy(RR=6.34,P=0.001 2)was the factor for poor prognosis and long-term treatment with hormones and immunosuppressive agents is the protective factor for PM and DM.Conclusion Complete and partial remission can be achieved in 58.9% patients with DM and PM.Advanced age of disease onset,interstitial lung disease and malignancy are the factors for poor prognosis of such patients.Long-term treatment with corticosteroids and immunosuppressive agents are the protective factors.

Objective To investigate the application of PKH26 and molecular light imaging system in cartilage en?gineering. Methods Canine chondrocyte was labeled by fluorescent dye PKH26 and seeded into the porous cartilage acel?lular matrix scaffold. The cells/scaffold constructs were cultured in vitro for 1 week. Then the constructs were implanted into the dorsal pocket of nude mice. We utilized a molecular light imaging system to macroscopically observe cells/scaffold con?structs in vivo with fluorescence at the 4th weeks, and compared with X-rays taken at the same position. The fluorescence im?ages were compared with the immunohistochemical and immunofluorescent results of cartilage-like tissue in vivo. Results Luminescent images were acquired at the 4th weeks, a red color enhanced overlay of the luminescent image over X-ray photo?graphic image demonstrated the location of the implants and the cell viability and cell growth on porous CACM scaffold in vivo were very well. Histological results show that the safranin O, anti-collagenⅡimmunohistochemistry and toluidine blue stain of cartilage-like tissue is positive. Immunofluorescence examination demonstrated chondrocytes in the constructs whitch is showen red fluorescence, and anti-collagenⅡimmunofluorescent staining was showen in green while the overlap?ping image is showen in yellow. Conclusion This study outlines an applicable non-destructive method to evaluate cell growth in tissue engineering constructs in vivo using PKH26 and molecular light imaging system.

Objective To evaluate contrast-enhanced ultrasonography (CEUS) in diagnosis of small hepatocellular carcinoma (SHCC) ( ≤ 2. 0 cm) with liver cirrhosis after contrast-enhanced CT (CECT) examination. Methods Forty five patients with liver cirrhosis received CECT and CEUS examinations before operation or needle biopsy and the diagnosis was confirmed by pathological examination.CEUS and CECT findings of 51 liver space-occupying lesions from 45 patients were retrospectively analyzed.Results Among all 51 lesions detected CEUS and CECT found 49 and 35, respectively. The typical characteristics of SHCC were "fast-in and fast-out" and "fast-in and slow-out". The sensitivity of CEUS and CECT in diagnosis of SHCC was 88. 9% (32/36) and 69. 4 % (25/36) respectively ( x2 = 3. 02, P =0. 08);the diagnostic accuracy was 84. 3 % (43/51 ) and 56. 9% (29/51 ) respectively ( x2 = 1.46, P =0. 22). Among 16 lesions missed by CECT, 12 were detected by CEUS. Conclusions CEUS and CECT show the similar diagnostic rate for typical SHCC ,however, CEUS is more sensitive for atypical lesions. With high time resolution, CEUS have advantages for follow-up study of benign liver lesions.

Objective To improve the treatment of abnormal calcium-phosphorus metabolism in hemodialysis patients, and observe its influence on the quality of life. Methods Implemented the kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for bone metabolism and disease in hemodialysis patients, improved the treatment of abnormal calcium-phesphoms metabolism in hemodialysis patients. After 1 year, the values were compared between before and after application of K/DOQI guidelines, including albumin-adjusted serum calcium, phosphorus, calcium × phosphorus (Ca × P) product, and intact parathyroid hormone (iPTH) and their achieved target range rates. The quality of life were evaluated by using the kidney disease questionnaire (KDQ). Results One year later, the levels of serum calcium, phosphorus, Ca × P product, and iPTH were all decreased (P<0.01 or <0.05) compared with before the application of K/DOQI guidelines. The percentage of patients fell within the guideline range were as follows: 74.42% (32/43), calcium; 62.79%(27/43), phosphorus; 55.81%(24/43), Ca × P product; 60.47%(26/43), iPTH; 25.58%(11/43), all four criteria, higher than before (P<0.01 or <0.05). The scores of KDQ in global indices and symptom scores of physical symptoms, fatigue, depression, relationships with others and frustration dimension were also all increased (P<0.01). Conclusion The state of calcium-phospberns metabolism in hemodialysis patients is improved, the quality of life is also enhanced.

Objective To observe the effect ofprostaglandin E1 intravenously in the improvement of the function of renal glomeruli and renal tubules in hypertensive patients complicated with microalbuminuria.Methods Totally 60 hypertensive patients complicated with microalbuminuria and nocturia who had received losartan for above 12 weeks,according to random number table method were divided into treatment group and control group,with 30 cases in each group.Original antihypertensive drugs were used continuously in treatment group and control group,and patients in treatment group received prostaglandin E1 intravenously for 3 courses of treatment,with losartan and other antihypertensive drugs routinely.Using self-contrast before and after treatment and contrast with control group,the change of urinary level of microalbumin (mALB),osmotic pressure,β2-microglodulin (β 2-MG) and N-acetyl-β-D-glucosaminidase (NAG) were compared.Results The blood pressure after treatment in both groups were decreased,but there was no statistically significant difference compared with that before treatment (P ＞ 0.05).After treatment of 12 weeks,urinary levels of mALB,β 2-MG and NAG in treatment group were lower than those in control group [(88.6 ± 14.2)μg/min vs.(123.9 ± 14.8) μg/min,(0.84 ±0.41) mg/L vs.(1.61 ±0.49) mg/L,(30.2 ± 10.5) U/L vs.(75.7 ± 12.8) U/L],and osmotic pressure was higher than that in control group [(591 ± 71) mmol/L vs.(454 ± 67) mmol/L],the difference had statistical significance (P ＜ 0.01).Conclusion Prostaglandin E1can reduce the renal ischemic state in early stage of hypertensive renal damage and can improve renal function.

Objective To explore the effect of modified type B lynch uterine suture combined with calcium in the prevention and treatment for uterine atony postpartum hemorrhage.Methods 63 pregnant women with postpartum hemorrhage risk factors which would be underwent cesarean delivery were randomly divided into the study group (32 cases) and the control group (31 cases).The study group was given intravenous calcium gluconate (10ml) 10 min before the operation,and modified type B lynch uterine suture in the operation.The control group was only given the same dose of oxytocin of the study group.Results The amount of bleeding intraoperation and 24h after the operation was (182.6 ± 47.7) ml and (214.1 ± 63.8) ml,respectively,the time of intraoperative uterine contractions was (3.8 ± 1.3)min,the degree of hemoglobin decreased 24h after the operation was (9.2 ±2.0) min in the study group,which were less than those of the control group(t =7.26,2.97,2.39,4.01,all P ＜ 0.05).There was no statistically significant difference in puerperal morbidity and neonatal asphyxia between the two groups (all P ＞ 0.05).Conclusion The modified type B lynch uterine suture combined with calcium could effectively prevent and treat uterine atony postpartum hemorrhage,and could not increase the rate of neonatal asphyxia and puerperal morbidity.

Objective To evaluate retrospectively the difference and complementary of contrastenhanced ultrasound (CEUS) and contrast-enhanced magnetic resonance (CEMR) in early diagnosis and differential diagnosis of small hepatocellular carcinoma (SHCC)(≤2.0 cm) in patients with liver cirrhosis.Methods Forty-five patients with space-occupying lesions in cirrhotic livers were included, who were referred to CEUS and CEMR before operations. Numbers as well as diagnosis results were recorded respectively,and all cases were confirmed by pathological examination. Results Seventy-five lesions were found after CEUS and CEMR,with 69 and 58 respectively. Forty-one lesions were diagnosed pathologically as SHCC by surgery or needle biopsy. Overlapping exited in enhanced mode between CEUS and CEMR.Most SHCC displayed as mode Ⅰ "fast-in and fast-out" and mode Ⅱ "fast-in and slow-out" in both examination,which can be considered as a reliable criterion. The diagnostic accuracy of CEUS and CEMR was 77. 3% (58/75) and 62. 7% (44/75) respectively (0. 50＜ P ＜0. 75). Differences of the diagnostic accuracy of SHCC with atypical enhanced mode between CEMR and CEUS were statistically significant.Conclusions There is no significant difference of diagnostic accuracy of SHCC between CEMR and CEUS.Both of these two examing procedure have its own advantages for atypical lesions, which accounts for its diagnostic difference of small SHCC and benign lesions.

Objective To explore the feasibility of fabricating a novel cartilage acellular matrix/chitosan hybrid scaffold for cartilage tissue engineering. Methods Human cartilage microfilaments about 100 nm-5 μm were prepared after pulverization and made into 1% suspension after decellularization. The suspension was mixed with 2% chitosan acetic acid solution, and then hybrid scaffolds were fabricated using a simple freeze-drying method. The scaffolds were cross-linked and were investigated by histological staining,SEM observation, porosity measurement, water absorption rate, biomechanical properties, and biocompatibility analysis. MTT test was also done to assess the cytotoxicity of scaffold leaching liquor. Canine chondrocytes were isolated and seeded into the scaffold. Cell proliferation and differentiation were analyzed using inverted microscope and SEM. Results The histological staining showed no chondrocyte fragments remained in the scaffolds, and anti-col Ⅱ immunohistochemistry staining were positive. SEM observation show the scaffold has good pore interconnectivity with pore diameter (136.2±34.9) μm, 81.4%±3.5% porosity and 1525.7%±129.3% water absorption rate. The longitudinal elastic modulus of the scaffold was (1.940±0.335) MPa. MTT test showed that the scaffold leaching liquor did not exert any cytotoxic effect on BMSCs. Inverted microscope and SEM micrographs indicatod that cells covered the scaffolds uniformly, and majority of the cells showed the round or elliptic morphology with much matrix secretion. Conclusion Novel cartilage acellular matrix/chitosan hybrid scaffold had similar extracellular matrix as cartilage, good pore diameter and porosity,appropriate biomechanical character, non-toxicity and good biocompatibility, which make it a suitable candidate as an alternative cell-carrier for cartilage tissue engineering.

Objective To investigate the effects of the novel scaffold on repairing large,high-loadbearing osteochondral defects of femoral head in a canine model.Methods The biphasic scaffolds were fabricated using cartilage extracellular matrix (ECM)-derived scaffold (cartilage layer) and acellular bone matrix (bone layer) by phase separation technique.Articular high-load-bearing osteochondral defects with a diameter of 11-mm and the depth of 10-mm were created in femoral heads.The defects were treated with constructs of a biphasic scaffold seeded with chondrogenically induced bone marrow-derived mesenehymal stem cells (BMSCs).The outcomes were evaluated for gross morphology,histological,biomechanical and micro-CT analysis at the third and sixth month after implantation.Results The gross and X-ray results showed femoral head slightly collapsed at the third month and severely collapse at the sixth month.Histological analysis showed cartilage defects were repaired with fibrous tissue or fibrocartilage with severe osteoarthritis and the varied degrees of the collapse of femoral heads were presented.Micro-CT showed that the values of bone volume fraction in defect area were always lower than those of the normal area in the femoral heads.Biomechanical analysis showed rigidity of the subchondral bone in defect area was significantly lower than that in normal area in the femoral heads at the sixth month.Conclusion The ECM-derived,integrated biphasic scaffold seeded with chondrogenically induced BMSCs could not successfully repair the large high-load-bearing osteochondral defects of the femoral head.