Objective To analyze the etiologies,clinical characteristics and prognostic factors of patients with acute renal failure(ARF)admitted to the hospital at high altitude.Method This retrospective study included clinical data of patients with acute renal failure in the General Hospital of Tibet Military Command from May 2001 to April,2006.Results There were 85 male patients and 63 female patients with mean age(42.4?18.1)years old.Among 148 patients with acquired ARF,52.7% was iatrogenic or nosoeomal origin, demonstrating a trend of increasing.The ARF included pre-renal(n=48,32.4%),renal parenchymal(n= 90,60.8%)and post-renal(n=10,6.8%)in origin.Acute high altitude sickness(n=20)was the major causes of pre-renal ARF.Renal parenchymal ARF could be classified into glomerular vascular lesions(n=24), acute tubular necrosis(n=53),acute interstitial nephritides(n=12),and contusion of unitesticle(n=1).of 90 cases of renal parenchymal ARF,39 patients(43.3%)were induced by medicines.Lithiasis was the major causes of post-renal ARF.The mortality of ARF in our study was 42.6%.The mortality of patients contracted ARF in hospital was much higher than that of patients community ARF in community(55.1 vs 23.6%;P=0.01). There was no significant differences of the mortality between the patients with and without dialysis treatment. Univariate analysis showed that prognosis was correlated with age,the presence of hematuria and oliguria or anuria Hb,and the number of organ system failures.The logistic regression showed that age,Hb and the number of organ system dysfunction were the predictors of mortality.Conlusions The major causes of ARF at high altitude were acute high altitude sickness and the use of medicines with nephrotoxicity.The morbility and mortality of nosocomisl ARF increased significantly.Prevention of MODS is a key management to decrease mortality in severe ARF.

Objective To explore the effect of postasphyxial-serum in neonate on expression of serine protease Omi/HtrA2 in renal tubular cells(HK-2).Methods Human renal proximal tubular cell line HK-2 cell was used as target cell.The cultural cells in orifice were divided into control group and asphyxia-serum attacking group.Blood was cowected from asphyxia newborns by means of femoral venous puncture,then the serum was garthered,anticoagulated by liquemie,3 000 r/min centrifuged 20 min,abstracted serum,thermostatic waterbathed the serum at 56 ℃,so that to inactivate addiment,filtered germ by micropore filte,the attacking concentrtion of serum was 200 mL/L,the cells of the asphyxia-serum attacking group were attacked by asphyxia-serum,and the cells of control group were cultivated with normal nutritive medium when the cells was needed.After 24 hours,the cells were tixed,then the expression of Omi/HtrA2 in cytoplast was detected by the use of immunohistochemical method.Results Omi/HtrA2 was inaurate or yellow brown and localized to the cytoplast.The rate of the cell expressed Omi/HtrA2 was(9.0?2.5)% in control group,after stimulated with postasphyxial-serum,in asphyxia group the rate of the cell expressed Omi/HtrA2 was(25.15?3.5)%,there was significant difference between 2 groups(t=-15.322 P

Objective To evaluate the respiratory movement of the both lungs with four-dimensional CT(4DCT), and determine the optimal respiratory phase series CT images for radiation dose calculation. Methods From November 2005 to November 2006,thirty patients with lung cancer who received 4DCT scan were enrolled,including 15 left and 15 right lung cancer cases,25 men and 5 women. The media age was 55 (35-78) years old. After 4DCT scanning, the image was treated with Advantage 4D workstation,and then transmitted into Pinnacle station( Adac 7.4). The both lungs were automatically outlined using Pinnacle station with CT recognition value of-900 to-200 Hu. Then-the same physician examined the unreasonable parts and revised them. After the delineation was completed,the volume of 10 respiratory phases of lung was obtained. Results The average respiratory phase in inspiratory and expiratory phases was 78.87%±2.71% and 26.32%±3.17% in the tumor located lung,77.55%±2.81% and 24.73%±2.55% in the healthy lung. The maximum and minimum mean volume was 106.48%±3.00% and 94.23%±2.78% in the tumor located lung,107.47%±2.43% and 93.65%±2.32% in the healthy lung. The volume at the end of inspiratory and expiratory was 106.43%±3.07% and 94.63%±2.71% in the tumor located lung, 107.37%±4.62% and 93.98%±2.34% in the healthy lung. Conclusions The series CT images scan on 20% ,30% and 80% respiratory phases are reasonable for radiation dose calculation. The maximum and minimum average lung volumes are almost equal to those at the end of inspiratory and expiratory.

Objective To quantify the amplitudes of lung tumor motion during free-breathing using four dimensional computed tomography (4DCT), and seek the characteristics of tumors with large motion. Methods Respiratory-induced tumor motion was analyzed for 44 tumors from 43 patients. All patients un-derwent 4DCT during free-breathing before treatment. Gross tumor volumes (GTV) on ten respiratory phases were contoured by the same doctor. The eentroids of GTVs were autoplaeed with treatment software (ADAC Pinnacle 7.4f), then the amplitudes of tumor motion were assessed. The various clinical and anatomic fac-tors associated with GTV motion were analyzed. The characteristics of tumors with motion greater than 5 mm in any direction were explored. Results The tumor motion was found to be associated with T stage, GTV size, the superior-inferior (SI) tumor location in the lung, and the attachment to rigid structures such as the chest wall, vertebrae or mediastinum. The motion over 5 mm was observed in ten tumors, which were all lo-cated in the lower or posterior half of the lung, with the greatest motion of 14.4 mm. For 95% of the tumors, the magnitude of motion was less than I 1.8 mm, 4.6 mm and 2.7 mm along the SI, anterior-poste-rior (AP) and lateral directions, respectively. Conclusions Tumor motion due to breathing is associated with tumor location, volume, and T stage. The greatest motion was in the SI direction for unfixed tumor in lower-lobe, followed by tumor in upper-lobe posterior-segment.

Objective To analyze the relationship between the radiation doses to mediastinal lymph nodes regions and the regional failure patterns when involved field radiation therapy (IFRT) was used for limited-stage small cell lung cancer (SCLC).Methods The mediastinal lymph node regions (group 1 to 10) of the iimited-stage SCLC patients received definitive radiotherapy were contoured in treatment planning system.The intentional or incidental radiation doses to each lymph node regions were recorded.In-field recurrence,marginal recurrence and out-of-field recurrence were respectively defined as the volume of failed lymph nodes located within the 80％ iso-dose lines,in the 80％-20％ iso-dose lines and beyond the 20％ iso-dose lines of prescribed doses.Results A total of 1 216 lymph node regions in 76 patients were contoured.The median follow-up time was 17.4 months.At diagnosis,lymph node regions with metastatic rates ＞50％ were 4R (68.7％),4L (57.9％),10R (57.9％),2R (56.6％) and 7 (51.3％).The positive lymph node regions were all subjected to prescribed doses.The lymph node regions that received incidental radiation doses of more than 3 000 cGy were:3P,4L,7,6,4R,5,2L.The median lymph node failure-free time was 9.8 months.In this study,only 1 patient developed out-of-field mediastinal lymph nodes failure.The rest of out-of-field recurrences and marginal recurrences were developed in the supraclavicular regions or contralateral hila.Conclusions When IFRT is used to treat mediastinal lymph node regions for patients with SCLC,negative mediastinal regions can be subjected to considerable incidental radiation doses.Out-of-field recurrences of the mediastinal lymph node regions are rare.This is contributed by the incidental radiation dose to these regions.

The production technology for the first generation of biofuels has been made great achievements and some countries, such as USA, EU countries, and Brazil, have formed successful biofuel industrial chains. Cellulose ethanol, a representative of the second generation of biofuels and a kind of more promising alternative fuels, has not yet got enough key technological breakthroughs and its large scale commercial production still needs rather some time to realize. Now it is in the early stage of transition to the second generation of biofuels. Taking the development of second generation of biofuels as their national policies, many countries have developed long-term development plans and objectives, and provided a good policy environment and strong support for it. Thus institutes and enterprises are engaging and successing in addressing key issues relating to the development of biofuels. At the mean time, some important issues relating to the sustainable development of biofuels have attracted people's attention.

Biomass resources are strategically vital for the sustainable development of a country.The United States has recently made a variety of plans or roadmaps and taken significant actions in order to promote the R&D of biomass resources.These plans and actions for the key issues in the development of biomass resources were analysed.

Objective To observe the efficiency of exenatide in treatment of type 2 diabetes mellitus patients with inadequately controlled blood glucose in plateau area. Methods Eighteen type 2 diabetes mellitus patients whose blood glucose was not well controlled by metformin, sulfonylureas or insulin therapy were selected in this study. Exenatidewas added to the original therapy for 3 months, and the changes of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), blood lipid levels (TG, TC, LDL-C, HDL-C), and body weight were observed. Results After 3 months of treatment with exenatide, FBG, 2hPBG, HbA1c, body mass index, and blood lipid levels (TG, TC, LDL-C) were significantly reducedas compared with thosebefore treatment (P<0. 05). Conclusion Exenatide can effectively control blood glucose, decrease body mass index, and improve the blood lipid level in type 2 diabetes mellitus patients living in plateau area.

Objective To investigate the role and intracellular signal transduction mechanism in the injury of renal tubular cells induced by postasphyxial-serum in neonate.Methods Human renal proximal tubular cell(HK-2 cell) was used as target cell. The experiment was designed as:control group, asphyxia group ,and pyrrolidine dithiocarbamate (PDTC)blocking group. The attacking concentration of serum was 20%, and the apoptosis rate of HK-2 cells was detected by flow cytometer.Results Compared with controls[(13.3?1.70)%],after being stimulated with postasphyxial-serum, the apoptosis rate of HK-2 cells of asphyxia group [(46.73?3.68)%] and PDTC blocking group [(31.19?2.79)%]were significantly increased(P

Objective To investigate the role of postasphyxial-serum of neonate in inducing injury of human renal proximal tubular cells(HK-2 cells).Methods HK-2 cells were used as target cell.The neonatal different concentration postasphyxial-serum of 1,3,7 days after asphyxia were used as attacking means.The experimental groups were divided into 15 groups:the 2.5%,5.0%,10.0%,(20.0%) attacking concertration groups of 1,3,7 day after asphyxia and control group of each concertration.The culture medium and concertration of the control group and the experimental groups were the same.The changes of morphology were observed under inverted microscope,the cell viability was measured by 3-(4,5-dimethyl-2-thiazoly1)-2,5-diphenyl-2H-tetrazolium bromide(MTT) method and the leakage rate of lactate dehydrogenase(LDH) was determined by biochemical methods.Results Compared with control group,the changes in morphology of HK-2 were most serious and obvious,the cell viability were obviously decreased(all P