Objective To investigate the effect of stage 1 acute kidney injury (AKI) on the prognosis of patients underwent cardiopulmonary bypass (CPB) cardiac operation. Methods A retrospective analysis was conducted. All patients aged ≥ 18 years who underwent cardiac operation with CPB admitted to Beijing Anzhen Hospital from July 1st, 2013 to December 31st, 2015 were enrolled. According to the standard of serum creatinice (SCr) of Kidney Disease Improving Global Outcomes (KDIGO) criteria, the AKI patients with stage 1 and non-AKI patients were served as the research objects. Perioperative clinical data of two groups were collected, and the prognosis was recorded during follow up to draw the Kaplan-Meier survival curve. Cox regression model was used to analyze the risk factors of prognosis in patients with stage 1 AKI experienced CPB during cardiac operation. Results A total of 5 823 patients were enrolled, of which 1 285 patients with AKI, and those in stage 1 was 998, accounting for 77.67% of total AKI patients; and 4 538 in non-AKI group. The mean follow-up period among survivors was (23.13±12.28) months. Compared with non-AKI patients, 30-day mortality of patients with stage 1 AKI was significantly increased [4.00% (40/998) vs. 0.40% (18/4 538), P < 0.01]. It was showed by Kaplan-Meier survival analysis that the cumulative survival rate of patients with stage 1 AKI was significantly lower than that of non-AKI patients (log-rank = 51.989, P < 0.001). It was showed by further subgroup analysis that the cumulative survival rate of patients with stage 1 AKI without serum creatinine (SCr) recovery was significantly lower than that of patients with SCr recovery from stage 1 AKI (log-rank = 43.580, P = 0.000). It was showed by Cox multivariate analysis that stage 1 AKI [hazard ratio (HR) = 2.725, 95% confidence interval (95%CI) = 1.810-4.230, P = 0.000] and prolonged CPB in patients undergoing cardiac operation (HR = 1.013, 95%CI = 1.001-1.017, P = 0.000), combined with coronary heart disease (HR = 1.046, 95%CI = 1.010-1.063, P = 0.005) and diabetes mellitus (HR = 1.060, 95%CI = 1.010-1.090, P = 0.002) were independent risk factors of death in patients undergoing CPB during cardiac operation. Conclusion Stage 1 AKI is the main stage of AKI and it is independently related to all-cause mortality in patients underwent cardiovascular operation using CPB.

Objective:Adjuvant arthritis(AA)rats interfered with recombinant hIL-10,methotrexate(MTX)separately,we detected the changes of T cell subsets in rat′s blood and IL-17 A in rat′s serum.Methods:AA rats interfered with recombinant hIL-10, MTX and IL-10 plus MTX.The changes of the CD4+and CD8+T cell subsets were detected by flow cytometry;the Levels of IL-17A in serum of rats were measured by ELISA method.Results:Compare to normal control group ,the CD4+T cell total quantity and CD4+/CD8+T cell Proportion was significantly decreased , there were significant differences between the treatment group and the untreated group(P<0.05 ), the IL-17A of treatment group was significantly decreased , there was a significant differences ( P<0.05 ).The combination group had significant difference compared with IL-10 group.Conclusion:Recombinant hIL-10 can down-regulate the blood of AA rats in the number of CD4 +T cells and CD4+/CD8+ratio,reduce serum levels of IL-17A.The combination group compared with the IL-10 group effect on serum IL-17A more significantly,the results displayed recombinant hIL-10 plus MTX in the treatment of rheumatoid arthritis can better play the role.

Objective To evaluate the therapeutic efficacy of agitating thrombolysis technique for Budd-Chiari syndrome complicated with inferior vena cava (IVC) fresh thrombus. Methods From August 2004 to March 2009, 5 patients of Budd-Chiari syndrome (four males and one female, aged 36-48 years) with IVC fresh thrombus were treated with agitating thrombolysis technique. After anpography of IVC the recanalization of IVC was performed, which was followed by agitating thrombolytic therapy. Finally,IVC was dilated with percutaneous transluminal balloon angioplasty. Clinical follow-up of IVC patency was conducted by color Doppler sonography. Results After agitating thrombolysis. The thrombi were completely disappeared in all 5 patients without single occurrence of pulmonary embolism. In all patients, IVC remained patency on color Doppler ultrasonograph after following up for a mean period of 23.8 months. Conclusion Agitating thrombolysis technique is a safe and effective treatment for Budd-Chiari syndrome complicated with IVC fresh thrombus.

Objective To investigate the clinical significance of N-terminal pro-B-type natriuretic peptide(NT-proBNP) detection in evaluation of acute type A aortic dissection (AAAD) prognosis .Methods Medical records of patients with confirmed diagnosis of AAAD were retrospectively analyzed .64 patients were enrolled in accordance with the inclusion and exclusion criteria ,and were di-vided into survival group(n=56) and death group(n=8) according to prognosis .Multivariate Logistic regression analysis was em-ployed to screen the independent risk factors which would affected the prognosis .Receiver operator characteristic ,ROC) curve was used to evaluate the predictive value of NT-proBNP for AAAD prognosis .Results Differences of history of smoking ,incidence sea-son ,disturbance of consciousness ,misdiagnosis ,low density lipid-cholesterol(LDL-C) ,fasting C-peptide(FCP) ,hypersensitive C-re-active protein(hs-CRP) ,cardiac troponin I(cTnI) ,NT-proBNP ,mean arterial pressure(MAP) and prothrombin time(PT) of pa-tients between the survival group and the death group showed statistical significance (P<0 .05) .Multivariate Logistic regression a-nalysis demonstrated that smoking history ,disturbance of consciousness ,high LDL-C ,high cTnI ,high NT-proBNP and low MAP were independent risk factors for patients with poor prognosis .ROC area under the curve(AUC) of NT-proBNP prediction for peri-operative mortality risk of patients with AAAD was 0 .697(P< 0 .05 ,95% CI:0 .643~0 .733) ,and its specificity and sensitivity were 75 .85% and 70 .07% ,respectively .When NT-proBNP was 909 .69 pg/mL ,its predictive value for AAAD was the best .Set the critical value as the threshold ,the patients above were divided into the threshold above group and the threshold below group . The survival rate of patients in the threshold below group [98 .18% (54/55)] was significantly higher than that in the threshold a-bove group[22 .22% (2/9)](χ2 = 7 .211 ,P< 0 .05) .Conclusion NT-proBNP level is closely related to the prognosis of patients with AAAD and NT-proBNP detection may be conducive to predicting high risk of AAAD .

Objective To investigate the satisfaction degree with nursing for discharged patients by telephone interview,and understand the nursing quality improvement during hospitalization of patients.Methods In January and December 2011,24 clinical departments were selected as the research object,10 patients were selected from each department.The questionnaires of satisfaction degree with nursing were adopted to investigate the satisfaction degree of patients by telephone interview.The difference of satisfaction degree with nursing were compared between January and December 2011.Results Compared with the results of January,there were statistical differences in overall mean score of satisfaction degree and the dimensions of service attitude,knowledge information,ward management and working ability.While the means of dimensions of basic nursing care and care-taking patient were in high levels.Conclusions The method of telephone interview to investigate the satisfaction degree of discharged patients is direct,real and objective.It is convenient for the hospital to understand the nursing quality and existing problems during hospitalization of patients,and offers scientific way for continuous improvement of nursing service.

BACKGROUND:O-arm navigation integrates CT image quality and the flexible mobility of the C-arm. Surgery for severe spinal deformity is very difficult, with high incidence of nerve injury, so it is a chalenging surgery for spinal surgery. The role of O-arm in the correction of spinal deformity is particularly important. OBJECTIVE:To explore the effect and safety of pedicle screw placement in severe spinal deformity under the guidance of O-arm navigation system. METHODS:Clinical data of 25 patients with severe spinal deformity with the aid of O-arm navigation were retrospectively analyzed. We observed pedicle screw insertion, operation time, intraoperative blood loss, correction of scoliosis and correction of kyphosis, and assessed the safety of screw insertion. RESULTS AND CONCLUSION:(1) Totaly 326 pedicle screws were implanted in 25 patients. According to NEO classification, 280 pedicle screws (92%) belonged to grade 0 (no perforation of pedicle cortex). Grade 1: perforation of pedicle cortex, < 2 mm, including 44 screws (8%); grade 2: perforation of pedicle cortex, > 2 mm, < 4 mm, including 0 screw (0%); grade 3: perforation of pedicle cortex, > 4 mm, including 0 screw (0%). (2) Operation time was (272.3±17.3) minutes. Intraoperative blood loss was (1 710.0±229.1) mL. (3) Cobb angle of scoliosis was changed from (70.5±6.0)° preoperatively to (22.8±4.8)° postoperatively. Cobb angle of kyphosis was changed from (72.0±5.2)° preoperatively to (28.1±5.7)° postoperatively. Significant differences were detected (P< 0.05). (4) These findings verify that with the guide of the O-arm navigation system, the accuracy of screw insertion is high. The risk of intraoperative nerve injury was reduced. The scoliosis and kyphosis deformity were improved effectively.

The medical records of patients underwent thoracic surgery with cardiopulmonary bypass (CPB) from July 1,2013 to May 30,2014 were collected and reviewed,the patients who developed postsurgical acute kidney injury (increase in postsurgical serum creatinine＞26.6 μmol/L) during hospital stay were excluded,and a total of 1 509 cases were enrolled in the study.Age,gender,body weight,presurgical complications,presurgical ejection fraction,serum concentration of creatinine on presurgical day 1,CPB duration during surgery,aortic clamping time,volume of blood transfused,duration of intensive care unit stay,mechanical ventilation time,length of hospital stay,and the highest serum concentration of creatinine were collected.The patients were divided into 2 groups according to the increase in postsurgical serum creatinine concentrations (the difference between the highest serum concentration of creatinine during hospital stay and the serum concentration of creatinine on presurgical day 1):no increase in creatinine group (n =508) and minimal increase in creatinine group (increase in postsurgical serum creatinine concentrations≤26.6 μmol/L,n=1 001).All the patients were followed up by telephone,and the fatality was recorded.Kaplan-Meier and log-rank analyses were used to analyze the survival condition,and the risk factors for fatality were identified by using multivariate Cox regression analysis.Compared with no increase in creatinine group,age was significantly increased,the constituent ratios of coronary heart disease,hypertension,diabetes mellitus,and pulmonary hypertension were significantly increased,CPB duration and length of hospital stay were significantly prolonged (P＜0.05),and no significant change was found in the fatality rate on postsurgical day 30 in minimal increase in creatinine group (P＞0.05).The patients were followed up for (298±104) days,and Kaplan-Meier analysis showed that the long-term fatality rate was significantly higher in minimal increase in creatinine group than in no increase in creatinine group (P＜0.05).Multivariate Cox regression analysis showed that age,presurgical coronary heart disease,CPB duration and minimal increase in postsurgical creatinine were the risk factors for fatality,and among these factors,minimal increase in postsurgical creatinine resulted in a 9％ increase in the fatality rate.In conclusion,minimal increase in postsurgical creatinine can not only prolong the length of hospital stay,but also increase the long-term fatality rate in the patients undergoing cardiac surgery with CPB.

Objective To explore the changes of pubescent immune response in the schizophrenia offspring induced by poly(I:C) during pregnancy and the effects on white matter.Methods The obtained pregnant rats were randomly divided into model group(n=6) and control group (n=5), receiving either poly (I:C) at a dose of 10 mg/kg diluted in 0.9％ NaC1 solution or vehicle solution alone (sterile pyrogen-free 0.9％ NaC1) on gestation day 9 (GD9).Immunohistochemical technique(IHC) was applied to detect the changes of microglias and astrocytes in the prefrontal cortex(PFC) and hippocampus(HC) of partly offsprings in the two groups at the sixth week,as well as Luxol fast blue(LFB) for the changes of white matter.The other offsprings of each group were selected for behavioral assessment at the eighth week.Results The results of prepulse inhibition test showed that PP2, PP4 and PP8 of model groups were significantly lower than that of the control group at young adult(P＜0.01).In passive avoidance test, and the T1 results of model group were significantly higher than those of the control group, the T results of model group were lower than those of control group (P＜ 0.01).Immunohistochemical results indicated that the number of microglias in the model group((264±33)/mm2, (271 ±38)/mm2) was significantly increased in PFC and HC than that in the control group((140±29)/mm2, (169±37)/mm2, P＜0.05) ,which was accompanied with significant morphological changes, while the OD value of astrocyte protein expression in the frontal lobe and hippocampus had no obvious difference between the model group and control group(P＞0.05).The OD value of LFB staining for myelin in the model group(0.29±0.02) was significantly decreased compared with that in the control group(0.33±0.03)(P＜0.01).Conclusion The young adult offsprings with prenatal infection present obvious schizophrenia-like behavior, meanwhile, the microglias activation and demyelination changes in white matter are observed,which provides more evidence for the relationship between immune response and white matter in the pathogenesis of schizophrenia.

ObjectiveTo investigate characteristics in vitro and contrast-enhanced effect in vivo with self-made nano-scale ultrasoud-enhanced contrast agent.MethodsNano-lipid microbubbles were prepared by machine vibration and low-speed centrifugation.The surface potential and the microbubbles size were assessed by Zetasizer nano ZS90.The bubbles dispersity and micromorphous were observed under light microscopy and electron microscope.The characteristics of microbubbles were studied at various times at 4℃ environment.The enhancement duration time and intensity of nano-lipid microbubbles in nude mice livers,kidneys and subcutaneous implanted tumors were observed,and compared with micro-scale microbubbles.ResnltsThe mean diameter of nano-lipid microbubbles was (580.6 ± 36.3) nm.The contrast imaging study in vivo showed the nano-lipid microbubbles could significantly enhance ultrasonic imaging in nude mice livers,kidneys and subcutaneous implanted tumors.ConclusionsSelf-made nano-scale ultrasoudenhanced contrast agent showed good stability and contrast-enhancement effect in vitro,and provide a experimental basis for ultrasound imaging and therapeutics of malignant tumors.

Objective To explore the conditions and methods for cryopreservation and proliferation of mouse spermatogonial stem cells (SSCs). Methods SSCs were isolated from six-day-old Kunming mouse using two-step enzymatic digestion and Percoll discontinuous density gradient centrifugation. Cells were frozen with different freezing medium and cooling rate. After thaw, they were cultured in mimimum essential medium alpha (MEMα) supplemented with 10% fetal calf serum (FCS) and 100μg/L glial cell line-derived neurotrophic factor (GDNF). The survived and proliferating SSCs were examined by WST-8 colorimetric assay. Alkaline phosphatase andreverse transcription-polymerase chain reaction (RT-PCR) were performed to confirm if the cultured 96 hours germ cells were still stem cells. Results The best method to cryopreserve SSCs is using cryoprotector containing 10% dimethyl sulfoxide(DMSO), 10% FCS, 0.07mol/L sucrose and 1℃/min cooling rate, and the viability of cells in this method is more than 84%;Although the cell viability in non-programmed freezing method is less than that in the programmed freezing method, it is a simple and effective cropreservation method for mouse SSCs. What is more, the anchoring time of SSCs in this method is 8-12 hours after thaw, SSCs begin to proliferate 24 hours later, and rapid proliferation appears on the 48 hours, colonies are composed by 20-25 cells in 96 hours, when SSCs proliferated nearly 5 times.Conclusion The culture condition we used is suitable for proliferation of frozen-thawed SSCs.