ObjectiveTo assess the effects of short-term (2-7 d) high-dose (80 mg/d) statins in the prevention of contrast-induced nephropathy ( CIN).MethodsWe searched PubMed, Embase,ScienceDirect,Scopus,Ovid andWileyInterScience with the key wordsof “ statins/statin/HMG-CoA reductaseinhibitor” ,“contrast ” and“ nephropathy/nephrosis/nephrotoxicity/kidneyfailure”inall languages from 1996 t0 2010 for RCT that assessed the preventive effect of short-term (2-7 d)high-dose( 80 mg/d) statins on CIN.ResultsFive trials with a total of 1009 patients were identifiedTwo studies were conducted in patients with CKD 3-5 stages ( GFR≤60 ml/min or serum creatinine≥97.2 μmol/L) and the remaining 3 studies were conducted in patients with CKD l and 2 stages.Analysis of the data in patients with CKD 3-5 stages did not reveal a statistically significant difference in CIN incidence between the statins and placebo groups (6.50％vs 7.2％ ).The relative risk ( RR)was 0.89 without evidence of heterogeneity (12 =Oqo,P=O.79).Analysis of the data in patients with CKD I and 2 stages revealed a significantly lower CIN incidence in the statins group( 3.60-/o )than that in the placebo group( 11.9％ ).The RR was 0.28 without evidence of heterogeneity( I2=0%, P =0.87 ). Conclusion Short-termhigh-dosestatins treatment may be benefical in reducing the incidence of CIN in patients with CKD l and 2 stages,while nobenefit has been shown in the patients with CKD 3-5 stages.

Hospital performance evaluation based on lean management is discussed in the paper, which covers all hospital staff by means of appropriate evaluation tools,accurate division of groups to evaluate,precise setting of evaluation indexes,refined relationship between evaluation and remuneration, and strict execution and feedback.This contributed to overall performance betterment of the hospital, and rational performance evaluation and remuneration patterns.

ObjectiveTo explore the relationship between the different body mass index (BMI) ranges and all cause mortality in hemodialysis (HD) patients. MethodsEligible studies assessing the effects of BMI ranges on all-cause mortality(published from 1966 to 2012 )were searched, using hemodialysis/haemodialysis and obese/body mass index/overweight andmortality/surwival/reverse epidemiology/obesity paradox in PubMed,Embase,ScienceDirect,Wilcy,Scopus and Ovid. Inclusion criteria were that trials reported mortality in HD patients according to the traditional WHO/NIH BMI classification,and BMI levels were acceptable within 2 kg/m2.The quality of the trials was evaluated using the assessing risk of bias in studies included in Cochrane reviews.The mortality rate in HD patients was the primary endpoint of the study.ResultsWith no significant heterogeneity ( I2 =0％,P =0.45 ),a fixed-effects model was used for analysis.Four studies with a total of 81 423 patients met final inclusion criteria.Compared to individuals with non-elevated BMI levels,the elevated group (BMI ≥25 kg/m2) was associated with lower all-cause mortality ( OR 0.67,95％ CI 0.65-0.68 ). In a risk-adjusted sensitivity analysis,elevated BMI levels remained protective against mortality( adjusted HR 0.94,95％ CI 0.92-0.96 ).ConclusionsHigh BMI levels are associated with lower all-cause mortality rate in HD patients.More stable hemodynamic status,cytokine and neurohormonal alternations,and nutritional status maybe contribute to the protective effects of BMI on the mortality of HD patients.There is a need for more prospective studies to elucidate underlying mechanisms.

Recurrence and metastasis is the main cause of death in breast cancer patients. Early detection and treatment of malignant breast cancer cells and metastasis are the hotspots of current resear-ches. The discovery of circulating tumor cells(CTC)may provide new ideas for the diagnosis and treatment of breast cancer. Detection of CTC will help the early detection of micrometastasis,the guidance of individ-ual treatment,and the evaluation of therapeutic effect and prognosis. Domestic and foreign research pro-gress of CTC was reviewed in this paper.

Objective To study the changes in pulmonary diffusing capacity (DL), alveolar capillary membrane diffusing capacity (Dm) and pulmonary capillary blood volume (Vc) in patients with severe acute respiratory syndrome (SARS), and to elucidate the underlying pathophysiogical mechanism of reduction of pulmonary diffusing capacity. Method Spirometry was performed in 26 SARS patients and 12 healthy individuals in resting condition. DLco were measured by single breath method, estimations of Dm and Vc were done by the method of Roughton and Forster. Results DLco in SARS patients was significantly lower than that in normal control, the same was true for Dm and Vc. The severer the pulmonary lesion, the heavier the damage to the pulmonary diffusing funetion. Conclusion The changes in Dm and Vc were both found in patients with SARS. Their measurements were helpful for detecting pulmonary involvement in SARS and defining the reason of DL abnormality in SARS. Dm and Vc were important and sensitive for monitoring pulmonary diffusing function in SARS patients

Objective To analyze the related literature of natural orifice translumenal endoscopic surgery(NOTES),discuss the development status and direction of the NOTES.Methods NOTES related documents were retrieved from the China National Knowledge Internet(CNKI),Wanfang Data,China Biomedical Literature Database(CBM) and Superstar Medalink.The related project were statistically analyzed.Status quo and development direction were analyzed.Results The journal of NOTES literature was scattered,involving numerous departments,especially the gastroenterology,urology,oncology,obstetrics and gynecology.The largest number of NOTES were reported in the vagina,followed by the stomach and the rectum.The post agencies and the area were mainly in the developed areas of strong scientific research colleges and universities and clinical teaching hospitals.The most published types of literature at present were the research and review of NOTES combined laparoscopy,and more basic research literature.The directions of collecting the reseach of NOTES by keywords were main from several aspects:NOTES combined with laparoscopy for colorectal cancer,urology,hepatobiliary surgery,cardiothoracic surgery,and so on;NOTES in animal experimental study;the application range included NOTES devices,work space, artificial interface for disease,and development of NOTES.Conclusion NOTES is the current research hotspot.Currently the domestic development is relative lag,which is in the primary stage of development.The basic research of NOTES need further study and clinical application need to strengthen,otherwise,application of NOTES instrument need to speed.

Objective:Dipeptidyl peptidase I(DPPI),a lysosomal cysteine protease for serine proteases activation,highly expressed in granule immune cells.This study used collagen induced arthritis(CIA) rat model to investigate the effects of Triperygium Wilfordii Polyglucoside(TWP) on DPPI activity and the pharmacological mechanism in RA treatment.Methods:Rats were divided into four groups randomly,the blank control group,the CIA model group,the high dose (5.0 mg/100 g body-weight) and low dose(2.5 mg/100 g body-weight)treatment group.Bovine collagen-Ⅱ plus complete Freund′s adjuvant injected twice in rats.Physical assessments were carried out.12 days post-injections,the rats of treatment group were intragastric administered with TWP every day.The rats were killed after two week administrations.Serum and synovial membrane homogenates were collected and DPPI activity was detected by fluorescence substrate.Joint HE staining and cell counting were carried out,Zymography was used to detect the MMP-2/9 activity in synovial fluids.Total protein in synovial membrane homogenates were measured by BCA method.Results:TWP could reduce the number of CIA synovial tissue mast cells,inhibited DPPI activity in the synovial fluids and in serum.The expression levels of MMP-2/9 activity and synovium total protein content were also reduced by TWP.Conclusion:Triperygium Wilfordii Polyglucoside has inhibitory effects on DPPI activity on CIA rats,which might be the one of the pharmacological mechanisms in RA treatment.

Objective To investigate the effect of hepatitis B virus X (HBX) gene on apoptosis and immune molecules of human proximal renal tubular epithelial cell line (HK-2).Methods The eukaryotic vector pcDNA3.1-myc-HBX containing HBX gene was transiently transfected into HK-2 cells by lipofectamine mediation.Untransfected HK-2 cells and those transfected with empty vector were used as controls.The TLR4 expression was detected by real-time PCR and Western blotting.The apoptosis of cells and expression of MHC-Ⅱ and CD40 were detected by flow cytometry,and the contents of IL-4 and IFN-γ in the supernatant were detected by EIISA.Results Compared with control groups,the number of apoptotic cells was significantly increased in the HBX transfection group (P ＜ 0.05),and the expressions of TLR4,MHC-Ⅱ and CD40 were also significantly increased in the HBX transfection group (all P＜0.05).IFN-γ level in the supernatant of HBX transfection group was higher (P ＜ 0.05),but IL-4 level was lower as compared to control groups (all P ＜ 0.05).Conclusions Over-expression of HBX gene may induce apoptosis of HK-2 cells and upregulate the expression of immune molecules of renal tubular epithelial cells leading to injury of cells and dysfunction of immunomicroenviroment.

To evaluate the efficacy of a variety of lacrimal duct obstruction diseases treated by Nd: YAG laser lacrimal duct forming surgery using Meta analysis.
●METHODS: Relevant database in 1995 - 2012 and other network resources were retrieved by computer and manual, using MetaAnalyst software on the Meta analysis. Analysis of indicators: disease prevalence between men and women, the prevalence of various lacrimal duct diseases and the effective rate of Nd: YAG laser lacrimal duct forming surgery to treat a variety of lacrimal duct obstruction diseases.
●RESULTS: According to the inclusion and exclusion criteria, 38 subjects were selected, the cumulative number of patients included 4638 cases, the men combined prevalence was 23%; the women combined prevalence was 77%; lacrimal punctum occlusion combined prevalence was 6. 0%, combined treatment efficiency was 88. 1%; lacrimal canaliculus obstruction combined prevalence of 17. 9%, combined efficiency was 85. 6%;lacrimal common canaliculus obstruction combined prevalence was 14. 0%, 92. 7% of the combined effective rate; nasolacrimal duct obstruction combined prevalence of was 43. 6%, 93. 3% of the combined effective rate;chronic dacryocystitis combined prevalence was 18. 4%, 76. 6% of the combined efficiency. All study has heterogeneity. Selection of random effects model combined effect size. Model was statistically significant (P<0. 001).
●CONCLUSlON: The prevalence of lacrimal duct obstruction diseases of women are higher than men, lacrimal canaliculus obstruction in the lacrimal duct obstruction is in the lowest prevalence, nasolacrimal duct obstruction is the main type of lacrimal duct obstruction disease, Nd: YAG laser lacrimal forming surgery has slightly efficacy different in various lacrimal duct obstruction diseases.

Objective To investigate the effects of hepatitis B virus X (HBX) gene on cell morphology and transdifferentiation of human proximal tubular epithelial cells.Methods The eukaryotic vector pcDNA3.1-myc-HBX containing HBX gene was transiently transfected into HK-2 cells by lipofectamine mediation.The expression of HBX was confirmed by Q-PCR and Western blotting.Untransfected HK-2 cells and those transfected with empty vector were used as control.The morphology of HK-2 cells was observed by microscopy,the expressions of differentiation marker proteins α-SMA and E-cadherin were detected by Western blotting and Q-PCR,and the contents of IL-1,IL-6 and TNF-α in the supernatant were detected by ELISA assay.Results HBX was successfully expressed in HK-2 cells after transfection.After transfection of HBX gene,the shape of HK-2 cells became irregular,HK-2 cells significantly expressed E-cadherin and α-SMA,and had high levels of IL-1,IL-6 and TNF-α in the cell supernatant (P＜0.01).Conclusion Overexpression of HBX gene in renal tubular epithelial cells may damage cell morphology and promote the occurrence of epithelial-mesenchymal transdifferentiation,which may be related to the inflammatory microenvironment.