Objective:To evaluate the effects of rapamycin on the proliferation,apoptosis and cell cycle of glomerular mesangial cells induced by high glucose,and to explore its significance in the prevention and treatment of diabetic nephropathy. Methods:The rat GMC HBZY-1 was divided into four groups:control group,high glucose group,the first group of high glucose plus rapamycin,the second group of high glucose plus rapamycin. CCK-8 assay was used to detect the proliferation of cells, flow cytometry was introduced to evaluate the apoptosis and cell cycle of HBZY-1,Real-time PCR was used to detect the mRNA of AngiotensinⅡ(ANGⅡ),transfor ming growth factor beta1 ( TGF-β1 ) and vascular endothelial growth factor ( VEGF ) . Results: The proliferation level of HBZY-1 induced by high glucose was significantly increased,and the level of apoptosis decreased,and the expression level of ANGⅡ,TGF-β1 and VEGF was increased. Rapamycin significantly inhibited,and there was a dose dependent,and down regulated the expression of ANGⅡ,TGF-β1,and VEGF. For the cell cycle,the S phase cells in the high glucose group were significantly higher than those in the normal group (P<0. 05),and the S phase cell proportion was decreased after rapamycin intervention (P<0. 05). Conclusion:Rapamycin can inhibit the proliferation of HBZY-1 in high glucose,promote its apoptosis and lead to G1/S arrest,and down regulate the expression of ANGⅡ,TGF-β1 and VEGF.

BACKGROUND:Previous studies have showed thatTougu XiaotongCapsule (TGXTC) exertsbetter effects on osteoarthritis, byregulatingRho/Rock signaling pathway, inhibitingsignal transduction of chondrocyte mitochondrial apoptosis pathway,varyingthe rate and pattern of subchondral bone remodeling and improving the arrangement of subchondral bone colagen fibers and calcium-phosphate crystalization. OBJECTIVE:To observe the effects of the serum containing TGXTC and itsdisassembled recipeson chondrocytedegenerationof ratsviaWnt/β-cateninsignal pathway, and to explore the maintherapeutic method forosteoarthritis in theTGXTC. METHODS:FortySprague-Dawley rats were randomlyassigned to receivethe treatment ofTGXTC,Bushen Rougan(BSRG),Huoxue Qufeng(HXQF) and normal saline, respectively, according tothe dose conversion methods ofanimaltoanimal and animaltohuman. Thenvarious drug-containing serums wereprepared for thefolowingcelular experiment.After culture and passage, chondrocytesfromSprague-Dawley ratsat passage 3 were divided into five groups: blank control, model, TGXTC, BSRG, HXQF groups. Cels in the latter four groups wereculturedin appropriate drug-containing serums(normal salineserumfor the model group) for 72 hours, folowing intervention with interleukin-1β for 24 hours.Cels in the blank control group were cultured innormal saline serum.Afterwards, cels in al the five groups were colected for detecting expression ofWnt 4, β-cateninandmatrix metaloproteinase 13at mRNA and proteinlevels using real-time PCR and western blot assay, respectively. RESULTS AND CONCLUSION:Compared with theblank control group, the expressionof Wnt 4,β-catenin, matrix metaloproteinase 13 wassignificantly increasedin the model group. Compared with the model group, the expression of Wnt 4, β-catenin, matrix metaloproteinase 13 in the TGXTC, BSRG and HXQF groups were decreasedsignificantly, sequenced as TGXTC group

Objective To observe the CT and MR features of hepatic hydatid cyst, and to evaluate the diagnostic value of CT and MR. Methods CT and MR images were retrospectively analyzed in 42 patients with pathologically proved hepatic hydatid diseases, and the relative articles were reviewed. Results Hepatic echinococcosis granulosus occured in 85.71% patients, among which ring like pattern calcification, the ribbon calcification, multiple daughter vesicles and detached membranes within cyst were the main findings. Hepatic echinococcosis alveolaris occured in 14.29% patients, whereas the main finding included calcification, small vacuoles, peninsula sign, geographic sign and colliquative necrosis. For the diagnosis of hepatic hydatidosis, MR was better than CT in the judgement of the cyst wall, detached membranes and fibrous septum, but was inferior to CT in displaying calcification sign. Conclusion Hepatic hydatidosis can be diagnosed either with CT or MR, CT is superior to MR in integrated diagnosis of this disease.

ObjectiveTo study the clinical features of the bilateral frontal brain contusion with cerebral hernia center and its treatment strategies. MethodsThe clinical data of 76 patients with cerebral central hernia were restropectively analyzed. ResultsIn 76 patients,there were 53 cases survive,23 cases died.The life and survival quality of these patients were evaluated according to the Karnofsky scale systerm :46 patients underwent surgery,including 35 cases with good recovery,8 cases with long-term coma or unable to look after themselves,3 cases with death;10 cases underwent a expectant treatment,of which,6 cases with good recovery,4 cases with long-term coma or unable to look after themselves.The other 20 cases died of central brain stem failure,with a central hernia when admissioned. ConclusionPatients with bilateral frontal brain contusion were extremely complicated with central hernia,and had a suddenly deteriored condition.Close observation of changes were critical importance.The surgery should be carried out before "diencephalon period",for most recovery well after surgery.Patients with diffuse brain swelling should go under the depressioning surgery as earlier as possible.

Objective To investigate the value of application of multi-slice helical CT(MSCT) indiagnosis of basicranial fracture. Methods Sixty-two patients with basicranial fracture were scanned withthin-section scanning mode after conventional CT scanning The images were transferred to the work-station for reconstruction including multiplanar reconstruction (MPR), volume rendering (VR). Comparison between thin-section scanning images and conventional CT scanning images were performed. Results Compared with the conventional CT scanning (67.9% and 45.0% respectively),the rates of fracture displayed of images acquired from thin-section scanning in diagnosis of fractures of anterior and middle cranial fossa (100.0% and 95.0% respectively) ,P＜0.01. The two scanning mode in diagnosis of fractures of posterior cranial fossa( 88.9% and 100.0% respectively )differed from each other unstatistically(P＞0.05 ). ConclusionThe thin-section scanning of MSCT can improve the diagnostic correctness of basicranial fracture.

Objective To evaluate the effect of dexmedetomidine on postoperative outcomes in pa-tients undergoing off-pump coronary artery bypass grafting ( OPCABG) . Methods One hundred and twen-ty-two patients of both sexes, aged 40-75 yr, with body mass index of 18. 5-32. 0 kg∕m2 , of American So-ciety of Anesthesiologists physical status Ⅲ or Ⅳ, with New York Heart Association Ⅱ or Ⅲ, with lelf ventricular ejection fraction>40％, scheduled for elective OPCABG, were divided into 2 groups ( n=61 each) using a random number table method: dexmedetomidine group ( group D) and control group ( group C) . Dexmedetomidine was intravenously infused in a loading dose of 0. 6μg∕kg at 15 min before anesthesia induction, followed by a continuous infusion of 0. 4 μg · kg-1 · h-1 until the end of surgical procedure in group D. The equal volume of normal saline was given instead in group C. The emergence time, extubation time, length of intensive care unit stay and postoperative length of hospital stay were also recorded. Results Compared with group C, the extubation time, length of intensive care unit stay, and postoperative length of hospital stay were significantly shortened, and the emergence time was prolonged in group D ( P<0. 05) . Conclusion Dexmedetomidine can promote postoperative outcomes in the patients undergoing OPCABG.

Objective: To investigate the incidence and risk factors contributing to post-transplant diabetes mellitus (PTDM) in kidney transplant recipients within one year post-transplantation. Methods: A total of 293 non-diabetic kidney transplant recipients were retrospectively analyzed. Patients were divided into non-PTDM group and PTDM group according to the diagnostic criteria of diabetes mellitus. The incidence of PTDM was calculated and the potential risk factors of PTDM were analyzed by univariate and multivariate Logistic regression analysis. Results: Among the 293 non-diabetic patients, 36 patients developed PTDM within 1 year, with an incidence of 12.3%. Multivariate Logistic analysis showed that age (OR 1.055, 95% CI 1.014-1.098, P=0.009) , body mass index [odd ratio (OR) 1.231, 95% confidence interval (CI) 1.084-1.398, P=0.001], polycystic kidney as the primary disease (OR 1.508, 95% CI 1.006-2.262, P=0.047) , 2-hour postprandial blood glucose (OR 1.186, 95% CI 1.04-1.53, P=0.011) , HbA1c (OR 1.732, 95% CI 1.075-3.428, P=0.015) and 1-hour postprandial blood C-peptide (OR 0.869, 95% CI 0.804-0.939, P=0.001) were independent risk factors for PTDM in kidney transplant recipients within 1-year post-transplantation. Conclusion Patients with older age, obesity, polycystic kidney as the primary disease, higher level of HbA1c and 2-hour postprandial blood glucose, and lower level of 1-hour postprandial blood C-peptide may have higher risk of developing PTDM.

Objective To investigate the distribution characteristics of pathogenic bacteria in infectious donors from organ donation after citizen's death and preventive strategies for renal transplant recipients. Methods Clinical data of 412 donors and 803 recipients from organ donation after citizen's death were retrospectively analyzed. All donors underwent culture of airway secretions, urine, blood and renal lavage fluid. The incidence rate of infection, distribution and composition ratio of pathogenic bacteria of donors from organ donation after citizen's death were observed. The scores of all donors were evaluated according to the length of intensive care unit (ICU) stay for donors, the situation of abdominal trauma and the results of body fluid culture, etc. According to the score, the recipients received different infection prevention regimes. The incidence rate of donor-derived infection (DDI) and clinical prognosis of the recipients were analyzed. Results A total of 243 donors were diagnosed with infection in 412 donors from organ donation after citizen's death with an infection rate of 59.0%. In total, 456 strains of pathogenic bacteria were isolated, mainly derived from the airway secretions (71.7%). Gram-negative bacteria dominantly consisted of Klebsiella pneumoniae and acinetobacter baumannii. Gram-positive bacteria mainly included staphylococcus aureus and fungus mainly included yeast-type fungus. Three recipients (kidneys from 2 donors respectively) developed DDI with an incidence rate of 0.4%. Conclusions The infection rate of donors from organ donation after citizen's death is relatively high. It is effective to prevent the incidence of DDI by grading the risk of infection of donors and adopting rational preventive plan according to the score.

Objective:To analyze the association of pre-transplant risk factors with diabetes mellitus after renal transplantation and examine the significance of preventing the occurrence in kidney transplantation recipients.Methods:A total of 290 kidney transplantation recipients were retrospectively reviewed at our transplantation center from August 2018 to May 2020.Diabetes mellitus after renal transplantation was employed as a primary outcome index.Multivariate Logistic regression model was utilized for constructing A (without adjusting for covariates)、B(covariates include: gender, dialysis mode, type of donation)and C(covariates include: gender, dialysis mode, type of donation, calcineurin inhibitor, antiproliferative drugs, primary disease, fasting blood glucose, 1 h postprandial blood glucose, fasting C peptide, 1 h and 2 h postprandial C peptide, fasting C-peptide index, 1 h postprandial C-peptide index, albumin, triglycerides, total cholesterol)to evaluate the relationship between diabetes mellitus after transplantation and age, body mass index, 2 h postprandial blood glucose(2 h-PG), HbA1c, and 2 h postprandial C-peptide index(2 h-CPI).Results:In model A, age [odds ratio(OR)1.1, 95% confidence interval( CI)1.0~1.1], BMI(OR 1.2, 95% CI 1.0~1.3), 2 h PG(OR 1.2, 95% CI 1.1~1.4), HbA1c(OR 2.7, 95% CI 1.5~4.9), 2 h-CPI(OR 0.7, 95% CI 0.5~1.0), model B/C had similar results with A. Age, BMI, 2 h PG and HbA1c were all risk factors for diabetes mellitus after transplantation while 2 h-CPI was a protective factor.Quartile stratification was analyzed by regression model.And trend test was significant( P<0.05). Conclusions:Age, BMI, 2 h PG, HbA1c and 2 h-CPI are correlated with diabetes mellitus after kidney transplantation.

Objective To analyze the risk factors for the occurrence of post transplantation diabetes mellitus (PTDM) in renal transplant recipients, establish a prediction model for PTDM and evaluate its prediction value. Methods Clinical data of 915 renal transplant recipients were retrospectively analyzed. According to the occurrence of PTDM, all recipients were divided into the PTDM group (n=78) and non-PTDM group (n=837). The main indexes of recipients were collected. The risk factors for the occurrence of PTDM in renal transplant recipients were analyzed by univariate and multivariate analysis. The prediction model for PTDM was established and its prediction value was evaluated. Results Family history of diabetes mellitus, body mass index (BMI), preoperative 2 h postprandial blood glucose and preoperative glycosylated hemoglobin were the independent risk factors for the occurrence of PTDM in renal transplant recipients. The prediction model for PTDM was logit (P)=2.199×family history of diabetes (yes=1, no=0)+0.109×BMI+0.151×2 h postprandial blood glucose (mmol/L)+0.508×glycosylated hemoglobin (%)-9.123. The results of receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of these 4 predictors combined for predicting PTDM in renal transplant recipients was 0.830 [95% confidence interval (CI) 0.786-0.873], the cut-off value was 0.0608, the sensitivity was 0.821, the specificity was 0.700, and the Youden index was 0.521 (P < 0.05). Conclusions Family history of diabetes mellitus, BMI, preoperative 2 h postprandial blood glucose and preoperative glycosylated hemoglobin are the independent risk factors for the occurrence of PTDM in renal transplant recipients. The prediction model for PTDM combined with4 predictors yield relatively high prediction value for PTDM.