Diagnosis, Differential ; Humans ; Hyponatremia ; diagnosis ; etiology ; therapy ; Inappropriate ADH Syndrome ; diagnosis ; etiology ; therapy

Objective To study the dynamic changes and clinical significance of D-D, t-PA and PAI in patients with acute renal failure during the process of different methods of blood purification. Methods Thirty-seven ARF patients were divided into three groups: HD group, HDF group and HF group. Plasma D-D level, t-PA and PAI activity were determined 1 hour, 4 hours before and after treatment. Normal control group consisted of fourteen healthy people. Results ① Plasma D-D level and PAI activity in ARF patients were obviously higher than those in control group, while t-PA activity was lower(P0.05). ③ After 4 hours of the treatment, compared with HD group, HDF and HF groups had significant difference in plasma D-D level, t-PA and PAI activity(P

Aged ; Anthracosis ; complications ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Humans ; Lung ; metabolism ; pathology ; Lung Neoplasms ; complications ; metabolism ; pathology ; Male ; Middle Aged ; Retinoblastoma Protein ; metabolism

OBJECTIVETo evaluate the clinical efficiency of selective cyclo-oxygenase-2 (COX-2) inhibitor compared to traditional nonselective NSAIDs for the prevention of heterotopic ossification (HO) after total hip arthroplasty (THA).

METHODSBy searching Medline, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Science Citation Index et al, only randomised controlled studies of selective COX-2 inhibitors VS nonselective COX-1 and COX-2 inhibitors for the prevention of HO after THA were included. The quality assessment of included studies was evaluated according to the standard of the Cochrane Collaboration, and the data were analysised by statistic software Stata 10.0. The HO incidence of both groups in different degrees was compared.

RESULTSFour eligible randomised controlled trials of totally 808 patients were included. Meta-analysis results showed that no statistically significant difference was found in overall incidence of HO (RR = 1.08, 95% CI: 0.71-1.64,P = 0.73), incidence of moderate severe HO (Brooker II and III) (RR = 0.83, 95% CI: 0.48-1.42, P = 0.49) and any grade of Brooker classification between two groups. In all included studies, 16 patients receiving nonselective COX inhibitor (4.4%) discontinued treatment because of gastrointestinal toxicity,whereas 10 patients in the selective COX-2 inhibitor group (2.7%) discontinued for gastrointestinal side effects.

CONCLUSIONThe selective COX-2 inhibitors are as equally effective as nonselective NSAIDs for the prevention of HO after THA. Considering the side effects of nonselective NSAIDs, selective COX-2 inhibitors were recommend for the prevention of HO after THA.

Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Arthroplasty, Replacement, Hip ; adverse effects ; Cyclooxygenase 2 Inhibitors ; adverse effects ; therapeutic use ; Cyclooxygenase Inhibitors ; adverse effects ; therapeutic use ; Humans ; Ossification, Heterotopic ; prevention & control ; Randomized Controlled Trials as Topic

Objective To explore the relationship between adjustment of immunosuppressant and prognosis in renal transplantation recipients with pulmonary infection. Methods The clinical data of 98 patients with pulmonary infection following renal transplantation were retrospectively analyzed.Patients were divided into two groups: conventional group (n = 45) and immunosuppressant adjustment group (n = 53). The mortality, recovery time and rejection rate in two groups were analyzed under the statement of serious infection (SOFA≥12) and slight infection (SOFA＜ 12) by sequential organ failure assessment (SOFA) score. Results When the SOFA scores ≥ 12, the mortality and recovery time in immunosuppressant adjustment group were significantly lower than in conventional group (P＜0.05), but there was no significant difference in the rejection rate between two groups (P＞0.05). When the SOFA scores ＜11, there was no significant difference in mortality and recovery time between the two groups (P＞0.05). The incidence of rejection in immunosuppressant adjustment group was significantly higher than in conventional group (P＜0.05).Conclusion Mortality could be decreased and course of anti-infection treatment could also be shortened by adjusting the immunosuppressant in renal transplantation recipients with serious pulmonary infection (SOFA≥12). Immunosuppressant agent was proposed to maintain the original treatment protocol when the infection was slight (SOFA＜12).

Objective To analyze the distribution of main pathogens,antimicrobial susceptibility,and clinical characteristics of osteoarticular infection,and provide evidence for clinical treatment.Methods A retrospective sur-vey was conducted on clinical data and pathogenic results of hospitalized patients with osteoarticular infection diag-nosed by etiology and pathology in Peking University First Hospital from 2009 to 2016,surveyed data were analyzed statistically.Results A total of 99 cases of bacterial osteoarticular infection were enrolled,100 strains of pathogenic bacteria were isolated,gram-positive bacteria accounted for 67.00%,49.00% of which were Staphylococcus spp., Enterobacteriaceae bacteria accounted for 67.74% of 31 strains of gram-negative bacteria.Isolation rate of methicil-lin-resistant Staphylococcus aureus (MRSA)was 16.13%,resistance rates of Staphylococcus spp.to fluoroquino-lones and rifampicin were both lower than 30%.Complication with other site infection (urinary tract infection,in-testinal infection,bloodstream infection)was an independent risk factor for gram-negative bacterial steoarticular in-fection (P＝0.027,OR＝10.536,95% CI:1.300－85.417).Conclusion Staphylococcus spp.is still the main pathogen causing osteoarticular infection,proportion of MRSA is low.Patients with urinary tract infection and in-testinal infection as well as long duration of implant should be considered the possibility of gram-negative bacterial infection when they develop steoarticular infection.

Objective To assess the effectiveness of absorbable screws and metallic devices for treating tibial plateau fractures.Methods Fifty-seven cases of tibial plateau fractures were treated with internal fixation using absorbable screws(Group A),cannulated screws(Group B)and condylar buttress plates(Group C)in our hospital.According to Schatzker classification,there were 15 cases with typeⅠfractures,21 with typeⅡ,nine with typeⅢand 12 with typeⅣ,who were followed up for 6-51 months. Statistical analysis was performed to compare bone union and functional restoration of the knee between three groups.Results Bone union was achieved in all cases.Based on Merchant scale for knee func- tion,excellence rate was 84%(16/19)for Group A,92%(11/12)for Group B and 85%(22/26) for Group C,with no significant statistical difference.Conclusion Absorbable screws is as effective as metallic devices for treating tibial plateau fractures and has advantages of minimal invasion,few complica- tions and avoiding secondary operation.

Objective To evaluate the effect of heparin binding epidermal growth factor-like growth factor (HB-EGF)on liver regeneration after partial orthotopic liver transplantation.Methods Fourty SD rats were used to establish the model of partial orthotopic liver transplantation with ameliorated two-cuff technique.Then all the rats were divided into 2 groups:experiment group and control group.Twenty rats of experiment group were adminis- tered 500?g/kg HB-EGF via vena caudalis immediately after operation twice a day,while the same volume of saline was administered to the rats in control group.Five rats in each group were selected randomly and killed at the 6th hour,day 2,4 and 7 after operation,respectively.The serum levels of albumin(Alb)and alanine aminotransferase (ALT)in the blood sample were detected.Every liver was removed and weighed.The expression of Ki-67 was de- tected by using immunohistochemistry assay.The regeneration activity of hepatocytes was evaluated by flow cytom- etry.Results The wet weights of liver in experiment group were all significantly higher than that in control group at the 6th hour,day 2 and 4 after transplantation(P

This study tested the effects of the gastrointestinal pulse train electrical stimulation with different parameters and at different locations on the neuronal activities of the lateral hypothalamus area (LHA) in obese rats in order to find the optimal stimulation parameter and location. Eight gastric electrical stimulations (GES) with different parameters were performed and the neuronal activities of gastric-distension responsive (GD-R) neurons in LHA were observed. The effects of stimulations with 8 parameters were compared to find the optimal parameter. Then the optimal parameter was used to perform electrical stimulation at duodenum and ileum, and the effects of the duodenal and ileac stimulation on the GD-R neurons in LHA were compared with the gastric stimulation of optimal parameter. The results showed that GES with the lowest energy parameter (0.3 ms, 3 mA, 20 Hz, 2 s on, 3 s off) activated the least neurons. The effects of GES with other parameters whose pulse width was 0.3 ms were not significantly different from those of the lowest energy parameter. Most gastric stimulations whose pulse width was 3 ms activated more LHA neurons than the smallest energy parameter stimulation, and the effects of those 3 ms gastric stimulations were similar. Accordingly, the lowest energy parameter was recognized as the optimal parameter. The effects of stimulations with the optimal parameter at stomach, duodenum and ileum on the LHA neuronal activities were not different. Collectively, gastrointestinal electrical stimulation (GIES) with relatively large pulse width might have stronger effects to the neuronal activities of GD-R neurons in LHA of obese rats. The effects of the GIES at different locations (stomach, duodenum and ileum) on those neurons are similar, and GES is preferential because of its easy clinical performance and safety.

Objective HupA is one of the potential drugs which can be used to treat Alzheimer's disease(AD).The aim of this study was to explore the pharmacokinetics and biodistribution of HupA in vivo by using 11C-HupA.Methods A total of 25 SD rats were studied.They were divided into 5 groups (5 rats in each group).All had intravenous injection of 22 MBq(in0.2 ml)11C-HupA through tail vein.Dynamic im-aging Was acquired from 5 to 90 minutes after injection.Venous blood and organ activities were collected at 5,15,30,60.and 90 minutes after injection.Percentage activity of injected dose per gram of tissue(%ID/g)was calculated to characterize the biodistribution of tracer in different brain regions: frontal,apical, temporal,occipital,cerebellum,hippocampus,striatum,thalamencephalon, and brain stem, Variance analysis using SPSS 11.5 software was performed and compared among the study groups.Results 11C-HupA was character-istic for its quick clearance from blood,with half time T1/2 of (14.61±1.77) min,and clearance rate (CL)macokinetics of 11C-HupA in rats corresponded to a one-compartment model.with an activity curve(area 11C-HupA distribution in different brain regions,being greater in cerebral cortex,hippocampus,hypothala-mus and brain stem. Conclusions Pharmacokinetic study of 11C-HupA in brain was fast.convenient and showed high specificity and sensitivity.Its ability to quantitatively evaluate brain function and its character-istic distribution in mice provided some evidence for monitoring therapy in AD patients.