To explore the risk factors of acute kidney injury(AKI)in adult primary nephrotic syndrome(PNS). Totally 185 patients with PNS were divided into AKI group(=51)and non-AKI group(=134).The demographic data and clinical and histological features at admission were compared between the two groups.The independent risk factors for AKI were evaluated by Logistics regression analysis. In 51 PNS patients with AKI,the common pathological types of AKI included minor glomerular abnormalities(29.4%),IgA nephropathy(25.5%),and membranous nephropathy(17.6%).The incidences of renal tubular casts and epithelial vacuoles in the AKI group were significantly higher than those in the non-AKI group(=0.004,=0.030).Males were more likely to suffer from AKI than females(=0.000).Patients in AKI group had significantly lower albumin level(=0.015)and higher levels of random urine protein,serum creatinine,uric acid,urea nitrogen,and triglyceride than non-AKI group(=0.030,=0.000,=0.000,=0.000,and =0.006),and polyserous and oliguria occurred more often in the AKI group(=0.000,=0.002).The AKI group had significantly higher incidences of high blood pressure and infections(=0.035,=0.000).Multivariate logistics regression analysis showed albumin(<25 g/L),serum creatinine(>96 μmol/L),urea nitrogen(≥6.8 mmol/L),uric acid(≥400 μmol/L),diabetes,infection,and renal tubular casts were the independent risk factors for AKI. AKI complicating PNS is associated with a variety of factors.Its independent risk factors include the levles of albumin,serum creatinine,urea nitrogen,and uric acid,diabetes,infections,and renal tubular casts.
Acute Kidney Injury ; etiology ; Adult ; Creatinine ; Female ; Humans ; Kidney ; Male ; Nephrotic Syndrome ; complications ; Risk Factors

Objective:To study the curative effect of hydrotalcite combined with omeprazole in the treatment of gastric ulcer with gastric bleeding. Methods:Seventy-six patients with gastric ulcer and bleeding in the stomach were selected and randomly divided into two groups. Thirty-two patients in the control group were treated with omeprazole alone while 44 patients in the observation group were treated with hydrotalcite combined with omeprazole. The therapeutic effects were compared between the two groups. Results:The total effective rate in the observation group was 100% while that was 87. 5% in the control group,and the difference between the two groups was statistically significant(P<0. 05). The comprehensive score of symptoms of the patients in the observation group was(4. 2 ± 1. 2)while that was(6. 2 ± 1. 4)in the control group,and the difference was significant(P<0. 01). The abdominal pain,abdominal distention and belching remission time in the observation group were slightly shorter than those in the control group(P<0. 05)and the time of hematemesis and hemafecia remission was significantly shorter than that in the control group(P<0. 05). After the 3-month treatment,the re-bleeding rate in the observation group was 6. 82%,which was slightly better than that in the control group,and the difference had no statistical significance(P<0. 05). The incidence of adverse reactions in the observation group was 9. 09% while that was 6. 25% in the control group,and there was no significant difference between the two groups(P>0. 05). Conclusion:Hydro-talcite combined with omeprazole in the treatment of gastric ulcer with gastric bleeding is effective and safe.

Objective To determine the median effective dosage of 0.5% ropivacaine for ultrasoundguided lateral popliteal sciatic nerve block. Methods Twenty-three ASA Ⅰ or Ⅱ patients of both sexes, aged 19-20 yr weighing 52-90 kg received lateral popliteal nerve block guided with ultrasound for foot and ankle surgery.The volume of 0.5% ropivacaine injected was determined by the response of the previous patient using an up-anddown technique. The initial volume was 18 ml. Each time the volume increased/decreased by 2 ml.Successful nerve block was defined as complete loss of pinprick sensation in both tibial and common peroneal nerve distribution with concomitant inability to perform plantar or dorsal flexion of the foot 30 min after injection. Results The median effective dosage of 0.5% ropivacaine resulting in complete block of the sciatic nerve in 50% patients was 13 ml (95% confidence interval 11.3-14.9 ml).Conclusion The median effective dosage of 0.5% ropivacaine for ultrasound-guided lateral popliteal sciatic nerve is 13.0 ml.

Objective To investigate correlation between the expression of TIG1 and the prognostic significance in acute leukemia (AL).Methods The TIG1 expression level of 75 AL and 20 normal control (NC) were measured by Real-Time Quantitative PCR(RT-QT-PCR).Results TIG1 gene expressed at a higher level in NC(0.0609±0.0281 ) than that in de novo AL(0.0057±0.0035)(U=-6.321,P=0.000).The expression of TIG1 in complete remission patients(AL-CR)(0.0409±0.0244)were lower than that in NC too(U=-2.582,P=0.01).The expression of TIG1 in AL-CR patients (83.3 ％) were higher than that in de novo AL (53.1％)(U=-6.366,P=0.000).In AL patients,the CR rate of high TIG1 level cases were higher than that in low level cases (x2=4.563,P=0.033).Conclusions Reduced expression of TIG1 may play an important role in the pathogenesis of AL.TIG1 can serve as a marker of poor prognosis in AL.

Objective To investigate the abnormity of blood lipids and uric acid ,and to analyze their relationship in health exami-nation population over 18 years in Yangzhou .Methods Totally 28 202 individuals receiving the health examination from October 2011 to August 2012 in the physical examination center of this hospital were enrolled in our study .Total cholesterol(TC) ,triglycer-ide(TG) ,low density lipoprotein cholesterol(LDL-C) ,high density lipoprotein cholesterol(HDL-C) and blood uric acid(UA) were detected ,and the relationship between age and sex with the abnormity of blood lipids and uric acid and the relationship between UA levels and blood lipids were analyzed .Results Among the detection population ,the detection rates of abnormal TG ,abnormal TC , abnormal HDL-C ,abnormal LDL-C and hyperuricemia were 31 .5% ,32 .1% ,15 .9% ,18 .4% and 17 .3% respectively .Compared with females ,males had the higher rates of abnormal blood lipids and UA (P<0 .05) .The rate of abnormal blood lipids was in-creased with age increase before 50 years old ,the > 50 -70 years old group had the highest abnormity rate of blood lipids ,then which was gradually decreased after 70 years old .The morbidity rate of hyperuricemia was increased with age .Compared with nor-mal UA group ,the hyperuricemia group had the higher rate of abnormal blood lipids (P<0 .01) .Conclusion The health examina-tion population over 18 years have the higher abnormity rate of blood lipids and uric acid ,which is significantly correlated with age and sex ;the increase of uric acid has certain correlation with abnormal blood lipids metabolism .Both blood lipids and uric acid are the risk factors of cardiocerebralvascular diseases ,rational dietary structure and periodic physical examination have the important significance to prevent the occurrence of these diseases .

Objective To investigate the relationship between interaction of peroxisome proliferators-activated receptor alpha (PPARα), cytochrome P450 oxysterol 7α-hydroxylase (CYP7B1) and estrogen receptor (ER) and intrahepatic cholestasis in pregnant rats. Methods Eighty clean SD pregnant rats were selected and divided into four groups randomly with 20 in each. Since the 13th day of pregnancy,rats in the control group was injected subcutaneously with refined vegetable oil 2.0 ml · kg-1 · d -1 , those in the low-dose, moderate-dose and high-dose groups received 17-α-ethynylestradiol (EE) 1.0 mg · kg-1 · d-1,1.25 mg · kg-1 · d-1 and 1.5 mg · kg-1 · d-1, respectively. All rats were sacrificed at the 21at day of pregnancy and maternal hepatic tissues were collected. The serum levels of alanine aminotransferase(ALT), aspartate transaminase (AST), total bile acid (TBA) and bilirubin (BIL) were determined by enzyme linked immunosorbent assay (ELISA). The mRNA expressions of PPARα, CYP7B1, Erα and Erβ in maternal rat livers were examined by real-time PCR. Results (1) Biochemical indicators: the serum levels of ALT,AST, TBA and BIL were significantly lower in the control group than in the rest 3 groups,respectively [ control group: (41.1 ± 2.8 ) U/L, (44.4 ± 3.6) U/L, (26.4 ± 5.6 ) μmol/L and( 2.8 ± 0.2)U/L;low-dose group: (48.2 ±3.4) U/L,(47.9 ±3.7) U/L,(36.4 ±4.2) μmol/L and (4.2 ±0.2) U/L;moderate-dose group: (70.4 ± 5.3 ) U/L, (68.4 ± 5.6) U/L, (64.3 ± 3.8 ) μmol/L and ( 6.2 ± 1.2)U/L; high-dose group: (72.4 ±7.6) U/L, (70.2 ±3.8) U/L, (72.4 ±7.8) μmol/L and (8.2 ±2.2)U/L, P<0.05], and those in the moderate or high-dose groups were higher than in the low-dose group (P<0.05). (2) mRNA expression of Erα and Erβ: the mRNA expression of Erα in pregnant rat livers increased in a dose-dependent manner, which were all significantly higher than that in the control group,respectively ( low-dose group: 0.76 ± 0.02 ); moderate -dose group: ( 0.99 ± 0.04; high-dose group:1.21 ±0.01 ;control group:0.65 ±0.01, P <0.05), but no difference was found among the 4 groups in the mRNA expression of Erβ ( P > 0.05 ). (3) mRNA expression of CYP7B1 and PPARα: the mRNA expression of CYP7B1 in pregnant rat livers increased from the low-dose group to the high-dose group, and were all higher than that of the control group ( low-dose group: 0.93 ± 0.01; moderate-dose group: 0.99 ±0.06; high-dose group: 1.22 ± 0.04; control group: 0.75 ± 0.02, P < 0.05 ). However, the mRNA expression of PPARα decreased from the low-dose group to the high-dose group, and were all lower than that of the control group (low-dose group: 0.83 ± 0.05; moderate-dose group: 0.71 ± 0.02; high-dose group:0.64 ± 0.03; control group: 1.35 ± 0. 05; P < 0.05 ) . Conclusions The down regulated mRNA expression of PPARα, caused by higher dose of estrogen, may increase the expression of CYP7B1 due to the ineffectiveness of the inhibition of PPARα on CYP7B1, which may further stimulate the Erα activity and then induce intrahepatic cholestasis. Abnormal expression of PPARα, CYP7B1 and ER may play a role in the pathogenesis of estrogen-induced intrahepatic cholestasis.

Objective To investigate the possible mechanism of curcumin inhibition to murine melanoma growth.Methods Melanoma cell line B16F10 was injected subcutaneously into the outer side of mouse right thigh to establish a melanoma-bearing mouse model.Seven days after the establishing the model, these mice were treated with intraperitoneal injection of curcumin at 50 and 100 mg/kg respectively or RPMI 1640 culture medium as control.Fourteen days later,the mice were killed,tumor weight was calculated;the tumor nuclear factor?B activity and survivin mRNA expression were measured by Western blot and RT-PCR,respectively.Results The tumor weight was significantly lower in the curcumin-treated mice than that in the controls (P

Objective To explore the feasibility of detecting death-associated protein(DAP) kinase promoter hypermethylation in the tumor tissues and plasma of patients with gastric adenocarcino- ma,and to evaluate the effect of DNA hypermethylation and autofluroscene spectrums of gastric juice on diagnosing gastric carcinoma.Methods Primary tumor tissues and plasma and gastric juice of 50 patients with gastric adenocarcinoma were collected.Gastric mucosa tissue,plasma and gastric juice of 20 patients with chronic superficial gastritis and 20 patients with benign gastric ulcer and 30 patients with chronic atrophic gastritis were collected as controls.After sodium-bisulfite treatment,extracted DNA was amplified for DAP kinase promoter hypermethylation by methylation-specific polymerase chain reac- tion.At the same time the gastric juice autofluroscene spectrums(the excitation wavelength was 288 nm,whereas the range of emission wavelength was 300-800 nm)were detected.Results Among the samples from 50 patients,p16 and DAP kinase hypermethylation were detected in 74.4% and 68.1% of tumor tissues,52.0% and 58.0% of plasma,58.6% and 76.0% of gastric juice.No hypermethylation was detected in samples of chronic superficial gastritis and serum of patients with gastric ulcer.Among the patients with gastric ulcer,p16 and DAP kinase hypermethylation were detected in 10.0% and 20.0% of tissues,5.0% and 15.0% of gastric juice.Among the samples from 30 patients with chronic atrophic gastritis,p16 and DAP kinase were detected in 10.0% and 23.3% of tissues,3.3% and 3.3% of sera,3.3% and 20.0% of gastric juice.The intensity of gastric juice autofluroscence spectrums of patients with gastric carcinoma was much higher than those in controls.The sensitivity of p16 and DAP kinase hypermethylation and autofluorescence spectrums together were 95.6% and 97.8% respectively.Con- clusions Promoter hypermethylation of the p16 and DAP kinase gene detected in plasma and gastric juice consists with that in primary tumor tissues of patients with gastric adenocarcinoma.The combination of DNA hypermethylation and autofluorescence spectrum has a good future in diagnosing gastric carcinoma.

Objective To observe the changes of the intercellular spaces of squamous epithelium of lower esophagus in gastroesophageal reflux disease(GERD).Methods Eleven outpatients with GERD symptoms more than 3 months [6 with nonerosive reflex disease(NERD)and 5 with erosive esophagitis(EE)]and 5 healthy volunteers were recruited.All of them underwent endoscopy and 24-hr ambulatory pH monitoring.Biopsies were taken in lower esophagus(2 cm above Z-line)for electron microscope examination.Results Intercellular spaces of esophageal epithelial cell in volun teers,NERD patients and EE patients were (0.374?0.073)?m,(1.308?0.079)?m and (1.332?0.144)?m respectively,with significant differences between the control group and the NERD or EE group.There was no difference between NERD group and EE group.Conclusions Dilated intercellular spaces were seen in both NERD and EE cases,which was significantly different from the control cases.

Articular cartilage defects are commonly found in clinics. It is always a great challenge for the repair of cartilage defects due to the limited self-regeneration after injury. Tissue engineering,a newly emerging biotechnique to regenerate cartilage with chondrogenic potential cells and biodegradable scaffolds in vivo and in vitro,provides a promising method to solve the challenge in cartilage defects repair. To regenerate cartilage with favourable structure and function,it is essential to gain a deep insight into the biochemical structure,biomechanical property and their relationship of articular cartilage. This article gives an introduction to the biochemical structure,biomechanical property and their relationship of both native and tissue-engineered cartilage.