The optimal intensity of continuous renal-replacement therapy in severe acute kidney injury is uncertain,but the establishment of optimal dose of CRRT is the key to successful treatment.In this paper,the basis for setting dose of CRRT starts analysis of the current CRRT dose and the efficacy of the evidence in evidence-based medicine and problems and presents the need of severe acute renal injury for greater CRRT dose.The purpose is to guide clinicians to set an optimal CRRT dose and improve the prognosis of severe acute renal injury.

The paper reviews the causes of the anemia in patients with chronic kidney disease(CKD)and focuses on the diagnosis.Meanwhile,we also systematically introduce the treatment strategies for patients with anemia and CKD,especially for the reasonable clinical application of erythropoiesis-stimulating agents(ESAs)and iron.The problems in diagnosis and treatment of anemia in CKD patients are also proposed.The objective of this paper is to standardize the clinical diagnosis and treatment of anemia in CKD patients,so as to promote the treatment of CKD in grassroot hospitals.

Objective:To find out heatshock protein HSP27 interactingproteins in the hepatocellularcarcinoma(HCC).Methods:HSP27 interacting proteins in the human HCC HepG2.2215 cells were seperated and identified.HSP27 binding proteins were recovered by antiHSP27 antibody immunoprecipitation with the total proteins from HCC HepG2.2215 cells.After in-solution digested and analyzed by LC-ESI-ITMS/MS,the recovered protein complexes were identified by peptide sequence tags(PST)and database searching,and were confimed by immunoprecipitation and Western blot analysis.Results:Seven HSP27 binding proteins were firstly identified by database searching,which were HSP90,GRP-78 and HSP70 of HSP70 family members,lysyl hydroxylase,Keratin 9,Keratin 10,Keratin 1.The identified seven HSP27-interacting proteins by IP coupled with MS could be classified into three functional categories based on their functions:chaperones,cytoskeleton organization,metabolic enzymes.Conclusion:HSP27 in HCC is a related proteins involved in the regulation,by interacting with some peptides,or small molecule protein to control the tumor development.

Patients with systemic lupus erythematosus,especially lupus nephritis,are often accompanied by arterial and venous thrombus at various sites.Thrombosis is associated with the extrinsic and intrinsic coagulation pathway activated by inflammation and endothelium injury.Anticoagulant therapy can interrupt the cycle between inflammation and thrombus,which not only prevents and treats the thrombotic disease but also lessens the inflammatory reaction in kidney and attenuates the renal injury.

Oxidative stress is one of the important pathogenesis of diabetic nephropathy.In recent years,the role of oxidized low-density lipoprotein(Ox-LDL) in the occurrence and progress of diabetic nephropathy has been more and more concerned about,and becomes a hot spot once again.This paper makes a review of the formation and metabolic mechanism of Ox-LDL,the changes of Ox-LDL in the progress of diabetic nephropathy and its clinical significance,and a number of new treatments for Ox-LDL in recent years to further understand the role of Ox-LDL in the occurrence and progress of diabetic nephropathy,then to provide new ideas for effective clinical treatment of diabetic nephropathy. Abstract:Summ ary:Oxidative stress is one of the important pathogenesis of d iabetic nephropathy.In recent years,the role of oxi-d ized low-density lipoprote in(Ox-LDL) in the occurrence and progress of d iabetic nephropathy has been more and more concerned about,and becom es a hot spot once again.Th is paperm akes a review of the form ation and m etabolic m echan ism of Ox-LDL,the changes of Ox-LDL in the progress of d iabetic nephropathy and its c lin ical sign ificance,and a number of new treatm ents forOx-LDL in recent years to further understand the role ofOx-LDL in the occurrence and progress of d ia-betic nephropathy,then to provide new ideas for effective c lin ical treatm ent of d iabetic nephropathy.

The development of Continuous renal replacement therapies(CRRT) in saving the critically ill patients is rapidly because of its removing the toxins and inflammatory mediators,maintaining the balance of the internal enviroment and preventing the endothelial cell function.The aim of the present paper is to guide and standardize the clinical usage of CRRT in the primary hospitals,through clarifying some problems of CRRT in clinical practice,such as the selection of CRRT pattern,setting the blood flow rate and the prescription and dosage of replacement fluid in CRRT,the selection of anticoagulant and the anticoagulation strategy and the announcements in CRRT. Abstract:Summ ary:The developm ent of Continuous renal rep lacem ent therap ies(CRRT) in saving the critically ill patients is rap-id ly because of its removing the toxins and inflamm atory m ed iators,m aintain ing the balance of the internal envirom ent and preventing the endothelial cell function.The aim of the present paper is to gu ide and standard ize the c lin ical usage of CRRT in the prim ary hosp itals,through c larifying som e prob lem s of CRRT in c lin ical practice,such as the selection of CRRT pattern,setting the b lood flow rate and the prescription and dosage of rep lacem ent flu id in CRRT,the selection of anticoagu lant and the anticoagu lation strategy and the announcem ents in CRRT.

Objective Pulmonary sequestration (PS) is a rare disease,and its clinical symptoms are usually related to subsequent pulmonary infections.We analyzed the clinical characteristics of PS complicated by aspergillosis,and reviewed related literature,so as to disclose the association between these two diseases.Methods Sixty-nine patients with surgery-confirmed PS in Peking Union Medical College Hospital between January 1990 and December 2013 were retrospectively analyzed,including seven cases complicated by aspergillosis.Clinical manifestation,imaging and surgery of these patients were analyzed.Literature focusing on PS complicated by aspergillosis in pubmed data base was reviewed.Results In these seven patients,four cases were male,and three cases were female.Age at diagnosis ranged from 29 to 58 years old.The interval from onset to definite diagnosis ranged from two weeks to 20 years.Clinical symptoms included productive cough in seven cases,hemoptysis in three cases,chest pain in two cases,and fever in one case.All cases were intralobar PS with four in the left lower lobe and three in the right lower lobe.Consolidation in chest CT was noted in six cases.Cavitation was positive in three cases.Surgery of lung lobe resection was performed in all patients.Aberrant arteries were found during operation with the origin from aortic artery in four cases,phrenic artery in two cases,and intercostal artery in one case.Aspergillosis was diagnosed by pathology in six cases and by lung tissue culture in one case.Conclusions PS complicated by aspergillosis is extremely rare,but the trend of an increase in recent years has been noted.Strict and cautious examinations for microorganisms and pathology will help find relatively insidious aspergillosis.

Objective To investigate the difference and treatment strategy of malignancy-associated dermatomyositis and other para-neoplastic neurological syndromes (PNS).Methods The clinical characteristics of a patient with malignancy-associated dermatomyositis and poly radiculoneuropathy was reported and the relevant literature was reviewed.Results Patients with dermatomyositis had increased risk of malignancies,and should routinely screened.Dermatomyositis and polyradiculoneuropathy was clinically similar,but could rarely be seen in the same malignant patient.Malignancy -associated dermatomyositis and PNS had similar pathogenesis.The treatment strategy of both was similar.Malignancy specific treatment should be initiated and immune suppressive agents should be prescribed concurrently.Conclusion Rheumatolgists should aware the association between dermatomyositis and potential underlying malignancies.Multiple para-neoplastic syndromes could be seen in the same patient,but the diagnosis should be considered as one.

Objective To evaluate the effect of preoperative intramuscular injection of of dextromethorphan in three dosages on fentanyl consumption in postoperative PCA in order to optimize its pre-emptive analgesia dose. Methods 80 ASA Ⅰ-Ⅱ patients underwent spine operations under general anesthesia were randomly divided into four groups, who respectively received intramuscular dextromethorphan 10mg (DM10 group), 20mg (DM20 group), 40mg (DM40 group), or normal saline (CON group) respectively. The PCA fentanyl consumption as well as VAS pain scores were observed 4h, 24h, and 48h after the operation. Results Although there was no significant differences in pain VAS score between the four groups, the fentanyl consumption was significantly lower in groups DM20 and DM40 compared with group CON and DM10. However, there was no significant difference between group DM20 and group DM40. Conclusion Preoperative IM dextromethorphan shows a dose-dependant fentanyl spare effect on postoperative PCA, and a dose of 20mg seems to be optimal for preoperative use.

Objective Taking methyl nonyl ketone as index to establish pharmacokinetic compartment model for study volatile oil from the whole herb of Houttuynia cordata by pharmacokinetic parameters in rabbits in vivo. Methods Using GC to determine the blood concentrations of methyl nonyl ketone in the volatile oil from whole herbs of H. cordata in rabbit plasma. The GC system used a capillary SPB-5 column and helium as carrier gas; the initial temperature was at 90 ℃, then raised to 190 ℃ by 10 ℃/min and kept for 5 min; the injector temperature was 250 ℃ and the FID detector temperature was 300 ℃; the injection volume was 5.0 ?L with splitless injection mode; n-hexane was used as solvent and n-pentadecane as interior standard substance. The blood concentration value of methyl nonyl ketone was fitted with 3P97 procedure. Results A capillary GC method was established for the detemination of methyl nonyl ketone in the volatile oil from whole herbs of H. cordata in rabbit plasma. Methyl nonyl ketone linearity was good (r=0.987 0) within 0.04—60.0 ?g/mL.The blood concentration-time course of precision in rabbit plasma conformed to two compartment model. Conclusion The experiment provides pharmacokinetic evidence for the rational administration and the further development of H. cordata and some methods for pharmacokinetic study of volatile oils from traditional Chinese medicinal materials.