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 learn the influence the gentamycin on C57BL/6J mice hear and cochlear hair cell ribbon synapses CaV1.3 calcium protein amount. To explore the relationship between hear loss and its dosage correlation change and significance. METHOD: The fixed amino glucoside to C57BL/6J mice was used to make abdominal cavity injection mold every day. The auditory brain-stem response ABR was used to measure the hear of mice in 7th, 14th, 28th after the injection. Immunofluorescence method was used to observe cochlear basement membrane of hair ribbon synapse CaV1.3 calcium channel proteins in the distribution and expression. Inner hair cells synaptic membrane was immune fluorescent tags with CtbP2 and CaV1. 3. RESULT: With the growth of the injected drugs, ABR threshold increased,but all the hair cells and shape had no obvious change. However the amount of hair rib bon synapse CaV1.3 calcium ion channel proteins in the expression had significant differences (P < 0.01). CaV1.3 calcium ion channel proteins increased slightly lower than normal at 7th day, significantly decreased at 14th day, had increased, increased quantity compare with 14th day, but at 28th day after intraperitoneal injection of gentamicin. CONCLUSION The increasing,decreasing and increasing trend of cochlear hair cells CaV1.3 proteins in the environment of amino glucoside drug toxicity showed that the increase of hair ribbon synapse CaV1.3 proteins may have a compensatory effect on the drug toxicity. With the increase of the drug toxicity effect, this kind of decompensated function could be the listening decline, which may be one of the mechanism of damage to hearing.
Animals ; Calcium Channels, L-Type ; metabolism ; Evoked Potentials, Auditory, Brain Stem ; Gentamicins ; pharmacology ; Hair Cells, Auditory, Inner ; drug effects ; metabolism ; Mice ; Mice, Inbred C57BL ; Proteomics

Objective To compare the effects of two different approaches of insulin delivery on hyperglycemia.Methods 26 poorly controlled diabetic patients were studied by two methods of intensive insulin delivery.⑴Continuous subcutaneous insulin infusion(CSⅡ) group(n=6),including 4 cases of type 1 DM,2cases of type 2 DM;⑵Multiple subcutaneous insulin injection(MSⅡ) group(n=20),including 3 cases of type 2 DM,17 cases of type 2 DM.The target BGs for both groups were premeal and bedtime BG3≥3 6mmol/L ≤7 2mmol/L for at least 3 days.Results Both groups had reached the target BGs,the CSⅡ groups more close to normal level.The average durations of treatment were significantly different;CSⅡ(8 3?1 3)d,MSⅡ(13 6?2 4)d for the two groups (t=5 136,P0 05).The hypoglycemia incidence in CSⅡ was(0 67?1 3)time/case,in MSⅡ(2 15?1 4)time/case(t=2 305,P

Objective To study the effect of recombinant human erythropoietin (rHuEPO) on in aged patients undergoing maintenance hemodialysis. Methods Blood pressure and its mechanism 52 elderly patients undergoing maintenance hemodialysis divided into two groups, HBP group (23 cases with hypertension) and NBP group(29 cases without hypertension). The plasma vasoactive substances were measured by radioimmunological methods. Fifteen cases in NBP group as EPO group were given a bolus of venous injection of rHuEPO (3 000 IU), others in NBP group (14 cases) were injected 0.9% saline as control group. The plasma vasoactive substances were assayed before and 1, 3, 6, 9, 12, 18, 24, 30, 44 hours after therapy with or without rHuEPO. Results (1) The plasma dopamine (DA) in HBP group were significantly higher than that of NBP group. (2) Endothelin levels increased transiently but DA levels increased steadily in EPO group. Conclusions The study suggests that the effect of rHuEPO induced on hypertension in the elderly patients undergoing maintenance hemodialysis is associated with the increasing plasma DA.