AIM: This study aimed at elucidated the possibility that prevent tissue from secondary injury by regulating polymorphonuclear neutrophil (PMN) apoptosis in vitro . METHODS:Neutrophils, isolated from peripheral blood, were incubated with sodium arsenite (Ars), tumor necrosis factor (TNF-?), interleukin-6 (IL-6), burned serum and traumatic serum, respectively. Apoptosis rate, expression of CD11b, respiratory burst and concentration of Ca 2+ were then measured. RESULTS:The elevation of PMN apoptosis rate was Ars concentration dependent, but activated PMN became insensitive to Ars. IL-6 delayed PMN apoptosis (compared with control at 24 h, P

OBJECTIVE To improve the surveillance and control of hospital infection.METHODS A series of management surveillance network information system for hospital infection were established by using SQL Server 2000 as database and Delphi 7.0 as program tool.The system included hospital infection case surveillance subsystem,antibiotic rational usage subsystem and the interface program of hospital information subsystem.RESULTS The hospital surveillance network connected the hospital infection department with the medical laboratory department and inpatient department,so the hospital infection data could be shared by all departments of hospital.CONCLUSIONS The system can improve work efficiency of hospital infection surveillance.

Objective To identify the outcome of pregnancy and the alteration of renal function in women with nephrotic syndrome. Methods From 2003 to 2007, 59 pregnant women with nephrotic syndrome in our hospital were enrolled in the study. Their clinical data were retrospectively analyzed, including the time of kidney disease onset, 24-hour proteinuria, serum albumin, serum creatinine, blood uric acid, blood pressure, fetal survival, fetal mortality, rate of premature delivery, birth weight of the newborn, and proteinuria, renal function, blood pressure of the patients during their postpartum follow-up. Logistic regression analysis was used to identify the risk factors influencing the outcome of the patients and the newborns. Results The average gestational week was (20.35±9.40) weeks when proteinuria was detected in these pregnant women. The 24-hour proteinuria ranged from 3.5 to 15 g/24 h (median 5.1 g/24 h). The serum albumin was between 10 and 28 g/L (median 22.5 g/L). The serum creatinine was between 32 and 825 μmol/L (median 84 μmol/L) and the serum uric acid ranged from 196 to 793 μmol/L (median 385.5 μmol/L). Pregnancy-induced hypertension syndrome occurred in 75% of the patients, among whom 55.5% suffered from preeclampsia. Forty-three (72.9%) newborns survived , among whom 76.7% (33/43) were premature births and 62.8% (27/43) were low birth weight infants. 50% of the pregnant women still had nephrotic syndrome after delivery. 75% of 24 patients with pre-existing chronic glomerulonephritis had increased proteinuria during pregnancy. Among the 38 patients with renal insufficiency, 36.8% had poorer renal function after delivery. 23.7% of the patients progressed into end stage renal failure after delivery, 80% of whom had serum creatinine ≥ 265 μmol/L. 89% of the patients had persistent hypertension after childbirth. The Logistic regression analysis indicated hyperuricemia during pregnancy (P=0.018, OR=1.012) and the increase of serum creatinine (P=0.039, OR=1.005) were risk factors of renal failure in pregnant women after delivery. Hyperuricemia (P=0.012, OR=1.006)was the risk factor of fetal death. Conclusions Pregnancy with nephrotic syndrome leads to a low fetal survival. Hyperuricemia is the most important risk factor of the poor outcome of pregnant women and newborn.

Objective To compare the efficacy between the two-cuff swan neck catheter and the Tenckhoff catheter in continuous ambulatory peritoneal dialysis (CAPD) patients prospectively. Methods One hundred and ten patients with end-stage renal disease (ESRD) were selected as candidates, who received catheter implantation and CAPD therapy for the first time. Patients were divided into group A (swan neck catheter group) and group B (Tenckhoff catheter group), 55 patients for each group. Catheters of beth groups had a straight end and were implanted by routine surgical procedure. One-year follow-up was performed and information was recorded such as complications, survival time, quit of dialysis, death, etc. Survival analysis was carried out by Kaplan-Meier method and Log-Rank tests. Results At the end of follow-up, 17 patients died, 3 received renal transplantation, 8 were transferred to hemodialysis, 3 went to other hospitals, and 79 patients (71.8%) remained in our department for CAPD. Twenty-six patients of both groups had peritonitis with a total of 35 occurrences. The total incidence of peritonitis was 0.32 times/patient year, with the detailed figure of 0.35 times/patient year for group A and 0.29 times/patient year for group B respectively (P0.05). The time interval between the catheter implanting and the onset of peritonitis was (30±29) weeks and (29±24) weeks for group A and group B respectively (P0.05). The risk of developing peritonitis in both groups was 26.97% within 1 year. Tunnel infection occurred in 2 patients and exit-site infections in 9 patients of two groups. The incidence of tunnel plus exit-site infections was 0.1 times/patient year. Incidence of tunnel infection and the exit-site infection for group A was lower than that of group B (0 vs 0.036 times/patient year and 0.06 times/patient year vs 0.11 times/patient year respectively). However, the difference was not significant (P0.05). Mechanical complications of catheter (catheter migration, omcntum wrapping, leakage of peritoneal dialysates, slip out of outer cuff), incidence of inguinal hernia and bellyache between two groups were not significantly different (P0.05). There were 4 cases of catheter drawing in each group. Both two groups had the same 12-month technical survival rate as 92.73%. Of 17 dead cases, 7 were in group A and 10 in group B (P0.05). The main death causes were cardiocerebral events (47.1%) and infections (23.5%). The 12-month survival rate was 86.34% for group A and 80.68% for group B (P0.05). Conclusions There are no significant differences of infection, mechanical complications, technical survival rate and patients' survival rate between two groups. The efficacy of swan-neck catheter is similar to Tenckhoff catheter in CAPD patients.

OBJECTIVETo investigate the effect of early high-loading-dose tirofiban on platelet activity for patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.

METHODSA total of 120 acute STEMI patients were treated with 300 mg aspirin and 600 mg loading dose clopidogrel and randomized to high-dose tirofiban (25 µg/kg bolus followed by 0.15 µg×kg(-1)×min(-1) infusion for 36 hours, n = 40), standard-dose tirofiban (10 µg/kg bolus followed by 0.15 µg×kg(-1)×min(-1) infusion for 36 hours, n = 40) or control (no tirofiban, n = 40) before angiography. Inhibition of platelet aggregation (IPA) was assessed before angiography, at 10 min and 24 hours after tirofiban infusion, and at 12 and 24 hours after stopping tirofiban infusion by the thrombelastography assay.

RESULTSThere was no significant difference in baseline of IPA between the 3 groups (P > 0.05). IPA was significantly higher in high-dose tirofiban group compared with standard-dose tirofiban and no tirofiban group at 10 minutes after tirofiban infusion [(84.2 ± 12.0)% vs. (67.8 ± 26.8)% and (31.5 ± 21.9)%, all P < 0.01]. At 24 hours after tirofiban infusion, the IPA of high-dose and standard-dose tirofiban was similar [(93.0 ± 9.8)% vs. (88.5 ± 18.1)%, P > 0.05] and was significantly higher than no tirofiban group [(40.4 ± 22.8)%, all P < 0.01]. IPA was similar at 12 and 24 hours after stopping tirofiban use among the 3 groups (all P > 0.05). The maximum amplitude of high-dose tirofiban and standard-dose tirofiban groups at different time points was similar (all P > 0.05), and maximum amplitude in both tirofiban groups was significantly lower than in no tirofiban group at 10 min [(47.2 ± 7.6) mm and (50.0 ± 9.8) mm vs. (57.7 ± 6.5) mm, all P < 0.01] and at 24 hours after stopping tirofiban infusion [(54.6 ± 5.6) mm and (54.3 ± 9.0) mm vs. (59.6 ± 4.0) mm, all P < 0.01].

CONCLUSIONEarly use of high-loading-dose of tirofiban on top of 600 mg loading dose clopidogrel is more efficient on inhibiting platelet activity than standard dose of tirofiban in patients with acute STEMI undergoing primary primary percutaneous coronary intervention.

Aged ; Blood Platelets ; Emergency Treatment ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; physiopathology ; Percutaneous Coronary Intervention ; Platelet Activation ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; administration & dosage ; therapeutic use ; Treatment Outcome ; Tyrosine ; administration & dosage ; analogs & derivatives ; therapeutic use

Objective To explore the value of two-dimensional ultrasound speckle-tracking imaging (STI) in assessing the left ventricular torsion (LVtor) in patients with apical hypertrophic cardiomyopathy (AHCM). Methods Thirty-four patients with AHCM and 21 healthy volunteers underwent two-dimensional echocardiography. High frame rate two-dimensional images of left ventricular short-axis views at the levels of mitral annulus and apex were obtained. Peak rotation (Prot) and the time to Prot, peak rotation velocity on basal and apical plane in left ventricular short-axis views, the peak twist (Ptw) and time to peak twist, half time of untwisting (HTU) were measured using two-dimensional strain software while twisting rate (Untw R) was calculated. All the above indices were compared between patients and healthy volunteers. Correlation was analyzed between HTU and E, A, E/A ratio. Results Compare with healthy volunteers, Prot and time to Prot and peak rotation velocity on apical plane in AHCM significantly increased, so did Ptw and peak rotation velocity of left ventricular (all P<0.05). HTU delayed with the Untw R and peak untwisting velocity decreased in the AHCM group (all P<0.05). There was negative correlation between HTU and E/A ratio in patients with AHCM. Conclusion When the left ventricular systolic function maintained normal in patients with AHCM, the peak rotation on apical plane and the LVtor increased with Untw R decreased. STI can sensitively evaluate the function alteration of myocardium in patients with AHCM.

Objective To evaluate the functional magnetic resonance (MR) imaging in the assessment of renal involvement and pathological changes in patients with lupus nephritis (LN).Methods Seventeen patients with LN and 10 healthy controls underwent coronal echo-planar diffusion-weighted (DW) MR imaging and blood oxygen level dependent (BOLD) MR imaging of the kidneys with a single breath-hold time of 16 s.The apparent diffusion coefficient (ADC) and R2* value of the kidneys were calculated with high b values (b=500 s/mm2).The correlation between the renal injury variables and the ADCs or R2* values was evaluated.Results The mean ADC value of kidneys in patients with LN was (2.43+0.24)×10-3 mm2/s,the mean R2* values of the renal cortex and medulla were (11.72+2.35)/s and (13.07+2.35)/s respectively,which were all significantly lower than those in volunteers (P=0.045,P=0.048and P=0.001,respectively).In the patients with LN,the mean ADC values were positively correlated with estimated glomerular filtration rate (eGFR) (r=0.558,P＜0.05).There was a negative correlation between the ADC values of the right kidneys and pathological chronic indexes (r=-0.493,P＜0.05).Moreover,the R2*values of the renal medulla were negatively correlated with 24 hours proteinuria,serum creatinine,pathological active indexes.The patients were assigned to group A (class Ⅲ,Ⅳ,Ⅴ,n=8) and group B class Ⅴ + Ⅲ and Ⅴ + Ⅳ,n=9).The tubulointerstitial lesions in group B were more severe than those in group A,while the mean ADC values and R2* values of the renal cortex in group B were lower as compared to group A.Conclusion DW MR imaging and BOLD MR imaging may be used to non-invasively monitor the disease activity and evaluate the efficacy in lupus nephritis.

Objective　The effects of nitric oxide(NO) on the endotoxin-induced tissue damage,especially intestinal injury and bacterial translocation are still poorly known, although its involvement in vasodilatation and hypotenion in shock is much clear. So, the intestinal damage and bacterial translocation were observed in this study in endotoxemic rats after treatment with Nω-nitro-L-arginine(LNNA),the special inhibitor of NO synthase(NOS),and L-arginine,the substrate of NOS.Methods　The endotoxemia was conducted with administration of lipopolysaccharide(O111B4,10mg/kg,i.p.),animals were treated with LNNA(4mg/kg,i.p.)or L-arg(40mg/kg,i.p.).Intestinal molondialdehyde(MDA) content and Diamine oxidase(DAO) activity were determined,and mesenteric lymph nodes were cultured.Results　The results showed that endotoxin decreased intestinal DAO acitivity but increased MDA content and incidence of bacterial translocation to mesenteric lymph nodes.These effects of endotoxin were aggregated by inhibition of NO production with LNNA, but attenuated by L-arg.Conclusion　We concluded that inhibition of NO formation might enhance endotoxin-induced intestinal damage and bacterial translocation,which suggested that NO might play a protective role in this endotoxemia model.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD2 Antigens ; metabolism ; Child, Preschool ; Chromosome Breakage ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Ki-1 Antigen ; metabolism ; Lymphoma, Large-Cell, Anaplastic ; drug therapy ; metabolism ; pathology ; Mucin-1 ; metabolism ; Prednisone ; therapeutic use ; Receptor Protein-Tyrosine Kinases ; genetics ; metabolism ; Vincristine ; therapeutic use

Objective:To investigate the effects of rituximab on lymphocytes and immunoglobulin in the treatment of focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD).Methods:The subjects were FSGS and MCD patients admitted to Ruijin Hospital affiliated to Shanghai Jiaotong University on July 1, 2014 and July 1, 2019. All the enrolled patients were confirmed by clinical examination and renal biopsy, and received rituximab treatment (4 infusions of 375 mg/m 2 with the interval of 7-14 d). The levels of immunoglobulin IgA, IgG, IgM, and lymphocytes of CD19 +, CD20 +, CD3 +, CD3 +CD4 +, CD3 +CD8 + and natural killer cells (CD56 +CD16 +) were compared between baseline and the third month, the sixth month, the ninth month and the twelfth month after treatment. Results:Ninety-six patients with FSGS or MCD were enrolled in this study. The midian age was 28 years old (14-77 years old). The ratio of men to woman was 1.8∶1. There were 65 cases of MCD and 31 cases of FSGS. After rituximab treatment, the 24 h-proteinuria was significantly lower than that before treatment, and the serum albumin level was increased (both P<0.05). After rituximab treatment of 3 months, 6 months, 9 months and 12 months, CD19 + and CD20 + lymphocyte counts were significantly decreased (all P<0.01), and gradually recovered after 6 months. Compared with baseline, at 3, 6, 9, 12 months after rituximab treatment, the level of blood IgG was significantly increased ( P=0.004,<0.001,<0.001,<0.001, respectively), and the level of blood IgM was significantly decreased ( P<0.001, =0.008, =0.005,<0.001, respectively) but the median level still within the normal range (400-3 450 mg/L). The level of blood IgA was not significantly changed (all P<0.05). T lymphocytes (CD3 +, CD3 +CD4 + and CD3 +CD8 +) and natural killer cells (CD56 +CD16 +) showed no significant difference from baseline (all P>0.05). Conclusions:Rituximab can effectively eliminate CD19 + and CD20 + lymphocytes, and has little influence on peripheral blood lymphocyte count and immunoglobulin level except CD19 + and CD20 + lymphocytes. The standard administration of rituximab is safe for patients with FSGS and MCD.