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.

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.

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.

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 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 study the effects of basic fibroblast growth factor gene in enhancing collateral vessel formation of coronary artery in the ischemic myocardium of swine.Methods All swines were distributed into the operation control group(n=6) and treatment group.The treatment group was further divided into 2 groups according to the route of injection either through the right coronary artery or the left coronary(n=6 respectively).The animal models of AMI were prepared by ligating the left circumflex(LCX) coronary artery.Two weeks after the operation,2?000 ?g of pcDNA_3-bFGF eukaryotic expression plasmid was directly injected into the coronary artery by catheter.Two weeks after the gene injection,evaluation of collateral circulation formation was made by means of coronary angiography and immuohistological staining ect.Results (1) Through immuotistological staining,the vessels count in both treatment groups was more than that in the control group;(2) Selective coronary angiography at 4 weeks after the operation showed that the number of newly formed collateral vessels in the bFGF gene treatment group was more than that in the control group.On the other hand,more collateral vessels were found in the group through left coronary injection compared with the group through right coronary injection.Conclusion Intra-coronary artery injection of bFGF gene can improve collateral vascular formation in the ischemic myocardium of swine.

Objective To prepare mouse polyclonal antibody against human Nanog by genetic immunization and to identify this antibody by Western blot and immunofluorescence. Method The antigenicity fragment (A16-V101) of human Nanog (hNanog) was chosen by analysis of Accelrys software, and its cDNA (258bp) was amplified from plasmid containing full-length cDNA of hNanog, then it was cloned into pBQAP-TT to construct recombinant plasmid pBQAP-TT-hNanog for genetic immunization. Mice were immunized with this recombinant plasmid and two other adjuvant plasmids-pCMVi-GMCSF and pCMVi-FIT3L, which help to enhance the antibody's generation. After 12 weeks, we obtained mouse anti-hNanog antibody from mice blood serum. The antibody titer was determined by enzyme-linked immunoadsordent assay (ELISA), and its specificity was identified by Western blot in human renal protein. Using this antibody, we detected hNanog expression in HKC cells of hNanog-AAV2 transfection. Results Recombinant plasmid pBQAP-TT-hNanog for genetic immunization was confirmed to be correct by restriction digestion and sequencing. The result of ELISA showed that the antibody titer was 1∶3 200. This antibody recognized a band of 34kD hNanog protein in human renal protein by Western blot. Immunofluorescence showed that Nanog protein was mainly located in the nuclei in hNanog transgene HKC cells. Conclusion Genetic immunization can offer mouse anti-hNanog polyclonal antibody of high titer and high specificity.