Objective To investigate the value of clinical parameters in predicting the initiation of renal replacement therapy(RRT) in acute kidney injury (AKI) patients with cardiorenal syndrome (CRS).Methods A total of 75 AKI patients hospitalized with CRS were enrolled.All patients received pharmacologic therapy on the beginning 3 days.The patients whose heart function improved were divided into control group (n=39),and the patients whose heart function worsened were divided into RRT group (n=36).Clinical and laboratory data on the first day and the fourth day were collected and analyzed.The factors on the first day were labeled asⅠ ,and those on the fourth day were labeled asⅡ. The ratio of some parameters calculated were labeled asⅡ/Ⅰ .Area under curve (AUC) of receiver operating characteristic curve (ROC) of these factors was used to evaluate the sensitivity and specificity in predicting the initiation of RRT.Results The patients in RRT group had significantly higher levels of BNP-Ⅱ,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ (P ＜ 0.01),and lower levels of 24 hours urine volume-Ⅰ and 24 hours urine volume-Ⅱ (P ＜ 0.01).From ROC curve analysis,the AUC of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,creatinine Ⅱ / Ⅰ,BNP-Ⅱ levels and BNP Ⅱ/Ⅰ to predict RRT were 0.736,0.875,0.747,0.779 and 0.894 respectively.When the cutoff values of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,BNP-Ⅱ levels,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ were 905 ml (sensitivity 75％,specificity 94.9％),1450 ml (sensitivity 75％,specificity 100％),3360 ng/L (sensitivity 72.2％,specificity 100％),1.37 (sensitivity 75％,specificity 100％) and 1.25 (sensitivity 72.2％,specificity 94.4％) respectively,the value of the parameters to predict RRT was high.Conclusions The 24 hours urine volume,BNP levels after treatment and the dynamic changes of BNP levels and creatinine levels can be used as predictors of the initiation of RRT in the AKI patients with CRS.

Objective To analyse the relationship between lymphatic vessels invasion and clinical pathological features of papillary thyroid carcinoma ( PTC ) .Methods The expressions of D2-40 and CK19 were examined in the 104 specimens of PTC using immunohistochemical staining with combined monoclonal antibodies and cocktail double enzyme labeled antibody( D2-40/CK19) stainings.The two methods were compared in the diagnosis of PTC metastasis, and the factors affecting lymphatic vessels formation were analyzed.Results The positive rate of lymphatic vessels invasion was 37.5%(39/104) by using immunohistochemical staining with combined monoclonal antibodies and 53.8%( 56/104 ) by cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining ( P<0.05).The lymph node metastasis rate was 83.9%(47/56) in the group with lymphatic vessels invasion, significantly higher than that without invasion 22.9%(11/48, P<0.01).The age of patients, diameter of primary tumor were the influence factors of lymphatic vessels invasion in PTC patients(P<0.05 and P=0.063).Conclusion Cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining is a better method to detect lymphatic vessels invasion in PTC than immunohistochemical staining with combined monoclonal antibodies.

Two-dimensional electrophoresis(2-DE) is an important technique in proteomics research.The 2-DE system for proteome of Monascus ruber was established by comparing and analyzing the infection caused by different kinds of mediums,lysis buffer and the condition of rehydration.By cultivating the Monascus ruber with YES for 6 days,extracting total protein by TCA-acetone,lysis buffer with 8 mol/L urea,2 mol/L thiourea,4 % CHAPS,1 % DTT and 2 % Bio-lyte,an ideal 2-DE map with higher resolution and better legibility was obtained,which laid a foundation for the further studies on proteome of Monascus ruber.

Objective:To explore the effects of Bailing capsules combined with salvianolate on inflammatory cytokines, renal vas-cular endothelia and renal function in diabetic nephropathy inⅣphase. Methods:Totally 60 patients with diabetic nephropathy in IV phase were randomly divided into the control group (30 cases) and the treatment group (30 cases). The control group was given the conventional and salvianolate therapy, and the treatment group was treated with Bailing capsules additionally. The treatment course was 3 months. The changes of serum creatine(SCr), urean itrogen (BUN), creatinine clearance rate (Ccr), ethelin (ET-1), interleukin-6 (IL-6), tumor necrosis factor (TNF-a) and C-reactive protein (CRP) were detected before and after the treatment. Results:After the 3-month treatment, SCr, BUN, IL-6, TNF-a, CRP and ET-1 were significantly decreased in the two groups with statistical signifi-cance, and Ccr was significantly increased in the treatment group (P<0. 05), and the changes in the treatment group were significant-ly better than those in the control group (P<0. 05). After the treatment, the blood glucose, blood lipids, glycosylated hemoglobin and the other indicators had no significant changes in the two groups (P>0. 05). There was no significant difference in the incidence of adverse drug reactions between the two groups (P>0. 05). Conclusion:The combination of Bailing capsules and salvianolate can re-duce the inflammatory reaction and improve renal vascular endothelial function and renal function in the patients with diabetic nephrop-athy in Ⅳ phase with promising safety and few adverse reactions.

BACKGROUND: Ischemia-reperfusion injury in the myocardium after cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) is an important pathologic basis of post-cardiac arrest of syndrome (PCAS), and apoptosis is one of the major mechanisms in myocardial ischemia-reperfusion injury. To lessen myocardial ischemia-reperfusion injury after cardiac arrest and CPR, it is important to reduce energy consumption and to increase energy supply in the myocardium. This study aimed to observe changes of cell apoptosis and expression of Bcl-2 and Bax protein on the myocardium after CPR in rats, and the protective effects of different doses of exogenous phosphocreatine (creatine phosphate, CP) on them. METHODS: A total of 32 male adult Sprague-Dawley rats were randomly divided into 4 groups: control group (group A), CPR group (group B), low-dose CP group (group C, CP 0.5 g/kg at beginning of CPR and 1.0 g/kg at 2 hours after CPR) and high-dose CP group (group D, CP 1.0 g/kg at beginning of CPR and 2.0 g/kg at 2 hours after CPR). Cardiac arrest was induced by asphyxiation and CPR started at 7 minutes after asphyxiation in groups B, C and D. Myocardium samples were taken at 24 hours after CPR. Cardiomycytic apoptosis was detected by the TdT-mediated dUTP-biotin nick end labeling (TUNEL) method. The expression of Bcl-2 and Bax protein was measured by immunohistochemistry. RESULTS: Cardiomyocytic apoptosis index (AI) and expression of Bcl-2 and Bax protein increased more significantly in groups B, C and D than in group A (P<0.01), but Bcl-2/Baxratio significantly decreased (P<0.01). Cardiomyocytic AI and expression of Bcl-2 and Bax protein decreased more significantly in groups C and D than in group B (P<0.01), but Bcl-2/Bax ratio increased more significantly (P<0.01). Cardiomyocytic AI and expression of Bcl-2 and Bax protein decreased more significantly in group D than in group C (P<0.05), but Bcl-2/Bax ratio increased more significantly (P<0.05). CONCLUSION: Exogenous phosphocreatine, especially at a large dose, could inhibit cardiomyocytic apoptosis and alleviate myocardial injury after CPR in rats.

Objective To study the characteristics,diagnosis and therapeutic principles of postmenopausal ovarian masses. Methods The clinical data of 261 postmenopausal women were reviewed to understand the characteristics,best diagnostic measures and therapeutic principles of postmenopausal ovarian masses. Results Among the post-(menopausal) ovarian masses,27.9% were malignant and 5.36% were boundary.No symptoms were found in(44.4%) of the patients.Before operation,the characteristics of masses can be identified by B-mode sonography,color Doppler sonography and CA-125 detection.Simple adnexectomy was performed for most of the benign ovarian masses and cytoreductive surgery for malignancies. Conclusion Regular examinations should be performed on postmenopausal women for ovarian masses,and B-mode sonography,color Doppler sonography and CA-125 detection be employed in the case of necessity.Once the ovarian masses are confirmed,surgeries may be the best choice for patients.

Objective To investigate the relationship between KRAS,NRAS and BRAF gene mutations and clinicopathological parameters in patients with colorectal carcinoma (CRC).Methods By using TagMan real-time PCR method KRAS/NRAS/BRAF hotspot mutations were detected in 260 cases of CRC.The associations between KRAS/NRAS/BRAF mutation status and clinical pathological characteristics were analysed in different groups divided by gender,age,tumor size,tumor differentiation.Results (1) The KRAS hotspot mutations were G12D,G12A,G12R,G12C,G12V,G12S in codon 12 and G13 C,G13D in codon 13.They were identified in 43.1％ CRC.KRAS mutation rate was higher in females than in males (P =0.05) and the mutation rate in patients ≥ 60 years was significantly higher than that in patients ＜ 60 years(P =0.008).The incidence of metastasis and mortality were higher in KRAS mutant than in KRAS wild type (P =0.004,P =0.037).(2)The NRAS hotspot mutations were in codon1 2,13 and 61.They were identified in 4.6％ CRC.NRAS mutation rate was significantly higher in patients ≥ 60 years and well-differentiated tumors (P =0.032,P =0.042).(3) The mutation rate of BRAF V600E in CRC patients was 4.6％.BRAF V600E mutation rate was significantly higher in patients ≥60 years,with distant metastases and tumors ＞ 5 cm (P =0.032,P =0.026,P =0.038).The incidence of metastasis and rucurrence and mortality were higher in BRAF mutant (P =0.030,P =0.002,P =0.007).Conclusions In CRC patients,KRAS mutations correlate with demographic factors,metastasis and mortality,NRAS mutations correlate with age and tumor differentiation,while BRAF mutation correlate with age,tumor size,metastasis,recurrence and mortality.

Objective To evaluate the value of acute kidney injury network (AKIN) criteria for predicting hospital mortality in post-cardiosurgery elderly patients. Methods From October 2006 to January 2007, the elderly patients who underwent coronary artery bypass grafting or valve replacement operation were enrolled in this study. The medical data included gender, age, operation type, perioperative hemodynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed according to the AKIN criteria, and severity of illness was determined after surgery by calculating Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ) score. Results A total of 225 patients underwent cardiac surgery during this period, 169 patients were male (75. 1%), while 56 were female (24. 9%), mean age was (66. 7±5. 0) years old. The overall hospital mortality rate was 5.8% (13/225). According to AKIN criteria, there were 125 patients with acute kidney injury (55.6%), and the hospital mortality of stage 1, 2 and 3 patients were 2. l%(2/96), 9. 1% (1/11) and 50. 0% (9/18) respectively. A significant increase was observed in mortality based on AKIN criteria (P<0. 01). By applying the area under the receiver operating characteristic curve, the AKIN criteria had a good discriminative power. Conclusions Both the incidence and mortality rate of acute kidney injury in the post-cardiosurgery elderly patients are high, the AKIN criteria is a simple and valuable method with a good prognostic capability for evaluating acute kidney injury.

OBJECTIVETo study the distribution and antibiotic resistance of the isolated pathogens from children with infectious diarrhea in Guangzhou.

METHODSThe fecal samples of 2 409 children with infectious diarrhea between January 2006 and December 2007 were collected and cultured. Pathogenic bacterium were isolated and identified by biochemical and serological methods. The antibiotic susceptibilities were tested by the Kirby-Bauer method.

RESULTSA total of 448 isolates of pathogenic bacterium (18.6%) were obtained, including Shigella (n=159), enteropathogenic Escherichia coli (n=141), Salmonella (n=76), Vibrion (n=11), fungus (n=41), and C jejuni (n=20). All of isolates of the three major pathogenic bacterium, Shigella, enteropathogenic Escherichia coli and Salmonella, were susceptible to imipenem and less than 10% of the isolates were resistant to the third generation cephalosporins and beta-lactamase inhibitors. However, the isolates showed a high resistance to ampicillin and sulfamethoxazole/trimethoprim (>75%).

CONCLUSIONSShigella, enteropathogenic Escherichia coli and Salmonella were major pathogenic bacterium of diarrhea in children from Guangzhou. The major isolates were susceptible to imipenem, the third generation cephalosporins and beta -lactamase inhibitors, but were resistant to ampicillin and sulfamethoxazole/trimethoprim.

Adolescent ; Bacteria ; drug effects ; isolation & purification ; Child ; Child, Preschool ; Diarrhea ; drug therapy ; microbiology ; Drug Resistance, Microbial ; Female ; Fungi ; drug effects ; isolation & purification ; Humans ; Infant ; Male

Background and purpose:TrkB,a neurotrophic tyrosine kinase receptor,serves as a potent and specific suppressor of anoikis of non-malignant epithelial cells,and induces high invasion capacity in these cells.TrkB over-expression has been associated with chemotherapy resistance and poor survival in neuroblastoma and some other highly aggressive cancers.However,the relationship of the expression of TrkB to anoikis resistance in ovarian cancer cells has rarely been reported in literature.This study investigated the expression and significance of anoikis- suppressor TrkB in OVCAR-3 ovarian cancer cells.Methods:The expression of TrkB and its ligand BDNF was evaluated in OVCAR-3 ovarian cancer cells under different culture conditions by RT-PCR and Western blot.Results: TrkB mRNA was overexpressed in multicellular spheroids(cell-spheroids,anchorage-independent culture,AIC)as compared to that in OVCAR-3 cells(adhesive-cells,adhesive culture,AC),(35.3?0.7)% versus(23.5?0.5)%;but BDNF mRNA expression was the opposite to the above situation,(41.4?0.6)% versus(32.24?0.7)%(P