In the patients with end-stage renal disease (ESRD) with hepatitis B virus (HBV) infection who underwent hemodialysis, the viral load of HBV DNA is relatively low and stable.For this phenomenon, some studies suggest that hemodialysis can reduce the HBV DNA load.The mechanism, which remains unclear, may be as follows: when HBV DNA enters the dialysate through the dialysis membrane, it was adsorbed onto the dialysis membrane;some virus particles were destroyed, and antiviral substances were produced in the course of hemodialysis.At present, there is no consensus on the mechanism responsible for the influence of maintained hemodialysis on the viral load of HBV DNA.This article reviews the factors involved in the influence of maintained hemodialysis on the viral load in ESRD patients with HBV infection and the recent progress.

Pancreatic encephalopathy (PE)is a serious complication of pancreatitis,with difficulties in early diagnosis and poor prognosis. This article introduces the possible pathogenesis of PE involving pancreatin activation,cytokines,infection,water and electrolyte imbalance, and vitamin deficiency,summarizes the clinical manifestations and laboratory features of PE,and points out that the clinical manifestations of PE lack specificity and there are no reliable biochemical indices or diagnostic criteria.This article also elaborates on the diagnosis and treat-ment strategies for PE and points out that the key to PE treatment is active and effective treatment of the primary disease.Most PE patients are improved with the control of pancreatitis.

Objective To evaluate the role of nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) singling pathway in reduction of myocardial ischemia-reperfusion (I/R) injury by zinc sulfate preconditioning in rats.Methods SPF healthy male Sprague-Dawley rats,weighing 250-280 g,aged 16-20 weeks,were used in this study.After the animals were anesthetized,their hearts were immediately removed and retrogradely perfused with an oxygenated K-H solution at 37 ℃ in a Langendorff apparatus.Forty isolated rat hearts were randomly divided into 4 groups (n=10 each):control group (group C),I/R group,zinc sulfate preconditioning group (group Zn) and zinc sulfate preconditioning plus Nrf2/ARE singling pathway blocker luteolin group (group Zn+Lut).After 20 min of equilibration,the hearts were continuously perfused for 100 min in group C,the hearts were perfused with 4 ℃ St.Thomas′ cardioplegic solution before ischemia and then subjected to 40 min global ischemia followed by 60 min reperfusion to establish the model of I/R in group I/R,200 μmol/L zinc sulfate 1.5 ml/kg was injected intraperitoneally,and 24 h later the model of I/R was established in group Zn,and in group Zn+Lut,the hearts were perfused for 3 min with K-H solution containing luteolin 50 μmol/L starting from the time point immediately before ischemia,and the other treatments were similar to those previously described in group Zn.Heart rate (HR),left ventricular end diabetic pressure (LVEDP),left ventricular developed pressure (LVDP) and the maximum rate of increase of left ventricular pressure (+dp/dtmax) were recorded at the end of equilibration and reperfusion.Coronary effluent was collected at the end of reperfusion to measure the levels of lactate dehydrogenase (LDH) and malondialdehyde (MDA).The expression of heme oxygenase-1 (HO-1),quinone oxidoreductase (NQO1),superoxide dismutase 1 (SOD1) and Nrf2 in myocardial tissues was detected by Western blot.Results Compared with group C,HR,+dp/dtmax and LVDP were significantly decreased,LVEDP was increased,and the levels of LDH and MDA in coronary effluent were increased at the end of reperfusion in I/R and Zn+Lut groups,and the expression of NQO1,HO-1,Nrf2 and SOD1 was up-regulated in I/R,Zn and Zn+Lut groups (P<0.05).Compared with group I/R,the HR,+dp/dtmax and LVDP were significantly increased,LVEDP was decreased,and the levels of LDH and MDA in coronary effluent were decreased at the end of reperfusion,and the expression of NQO1,HO-1,Nrf2 and SOD1 was up-regulated in group Zn (P<0.05).Compared with group Zn,HR,+dp/dtmax and LVDP were significantly decreased,LVEDP was increased,and the levels of LDH and MDA in coronary effluent were increased at the end of reperfusion,and the expression of NQO1,HO-1 and SOD1 was down-regulated(P<0.05),and no significant change was found in Nrf2 expression in group Zn+Lut (P>0.05).Conclusion The mechanism by which zinc sulfate preconditioning reduces myocardial I/R injury is related to activation of Nrf2/ARE singling pathway in rats.

Objective To study the treatment of intra-abdominal hypertension syndrome (IAHS) secondary to fulminant acute pancreatitis(FAP). MethodsWe retrospectively analyse therapeutic results of 14 IAHS cases secondary to FAP during the period of 1998～2003. ResultsFour out of the 6 cases receiving nonoperative therapy died with motality rate of 67.7% (4/6). Two out of the 8 cases treated by early surgery died. The motality rate was 25% (2/8), which was significantly different from that treated conservatively . ConclusionModerate to severe IAHS cases secondary to fulminant acute pancreatitis should undergo exploration in the early phase of disease to improve the prognosis of FAP.

Objective To discuss the predisposing factors,prognosis and treatment of pancreatic encephalopathy(PE) in acute pancreatitis(AP). Methods Nineteen cases of AP complicated with PE were retrospectively studied. Results The occurrence rate of PE was 12.0%. PE often occurred in association with such factors as hyperpyrexia, water-electrolyte disturbance, and hypoxemia. Among the 19 patients,11 patients received surgical operation and 8 were treated conservatively.The total fatality rate reached 52.6%(10/19), significantly higher than other concurrently treated cases of severe acute pancreatits(SAP) (20.7%,P

Background and Purpose:Pancreatic cancer is malignant tumor of the digestive tract with poor prognosis and is not sensitive to conventional chemotherapy.This study investigates the safety and feasibility of regional arterial ligation followed by intra-arterial perfusion chemotherapy in 14 pigs divided into groups A,B and C.Methods:14 pigs were divided into 3 groups.Group A(n=5) underwent gastroduodenal artery ligation and catheterization through the right gastroepiploic artery.Group B(n=5) underwent splenic artery ligation and catheterization.Group C(n=4) underwent left periotic vein puncture.5-FU(20mg/kg) was perfused into these catheters in 60 min.Blood samples and pancreatic tissue were obtained for the purposes of the determination of drug concentration and pathological diagnosis.Results:At 80 min and 100 min the drug concentration in portal vein of group A and group B were higher than those of group C(P

Objective To evaluate the value of PCR-restriction fragment length polymorphism (PCR-RFLP),real-time PCR and multiplex ligation-dependent probe amplification (MLPA) in the genetic diagnosis of spinal muscular atrophy (SMA) and make laboratory support accessible to clinicians for the molecular diagnosis of SMA.Methods Methodological evaluation.Forty-one suspected SMA cases and 359 control individuals received in Shanghai Children's Medical Centre from March 2013 to June 2014 were detected for the deletion of exon 7 and 8 in the survival motor neuron gene 1 (SMN 1) by PCR-RFLP,realtime PCR and MLPA,respectively.Then the results of the three methods were compared and the benefits and limitations of the three methods were evaluated.Results The result of real-time PCR was in complete agreement with that of MLPA,showing that 29 suspected cases harbored homozygous deletions of SMN1 and 1 case possessed heterozygous deletion.Among the homozygous deletions,27 patients demonstrated absence of exon 7 and 8,and 2 cases demonstrated only the absence of exon 7.Meanwhile,both PCR-RFLP and MLPA analysis showed the same results that only 5 out of 395 control cases carried heterozygous deletion.As for cases without heterozygous deletions,PCR-RFLP demonstrated the same result with real-time PCR and MLPA but it missed all the heterozygous ones.Conclusions PCR-RFLP,the conventional SMA gene diagnosis method,was only capable of detecting homozygous deletion of exon 7 and/or 8 of SMN1,but was not as sensitive as to find out the carriers with heterozygous deletions.MLPA could detect the deletion and quantify the copy numbers of exon 7 and 8 of SMN1,efficiently,while the price was relatively high,which brings challenges for its application in the carrier screening of SMA.Compared with these two methods,realtime PCR with high throughput and low input was a rapid,acourate and economic method for the genetic diagnosis of SMA and carrier screening in large populations.

Objective To investigate the relationship between NF-kB activity of pancreatic acinar cells(PAC) and blood inflammatory cytokines ( IL-2, IL-6, IL-10, TNF-? and ICAM-1) in rat's ANP. Methods Fourty rats were randomly divided into two groups: ANP model group and contrast group. ANP was induced by retrograde injection of 5% sodium taurocholate into the pancreatic duct. NF-KB activity in the cell nuclear and IkBa activity in the cell spasm of PAC were measured by EMSA and Western-blot. Inflammatory cytokines were measured by ELISA. Results ANP model's NF-KB activity increased [(31.4?5.7) ?mol/L vs. (8.3?2.4) ?mol/L.(39. 4 ? 6. 4) ?mol/L vs. (10.7 ?2.6) ?mol/L. (33. 8?6.0)?mol/Lvs. (11. 5 ?2. 7) ?mol/L.(25. 7 ?4. 9) ?mol/L vs. (9.4 ?2.6) ?mol/L](P

Objective To evaluate the role of nuclear factor erythroid 2-related factor 2 (Nrf2)/ antioxidant response element (ARE) signaling pathway in reduction of myocardial ischemia-reperfusion (I/R) injury by ischemic preconditioning in the rats.Methods Healthy male Sprague-Dawley rats,weighing 250-300 g,aged 4-6 months,were used in the study.Their hearts were excised,and retrogradely perfused with K-H solution at 37 ℃ in a Langendorff apparatus.Forty isolated hearts were randomly divided into 4 groups (n=10 each) using a random number table:control group (group C),I/R group,ischemic preconditioning group (group IPC),and ischemic preconditioning +Nrf2/ARE signaling pathway blocker luteolin group (group IPC+L).After 20 min of equilibration,the hearts were continuously perfused for 100 min in group C.After 20 min of equilibration,the hearts were subjected to 40 min ischemia at 32 ℃ followed by 60 min of reperfusion in group I/R.In group IPC,ischemic preconditioning was induced by 6 cycles of 10 s ischemia followed by 10 s reperfusion starting from the time point immediately after 20 min of equilibration,and then the hearts were subjected to 40 min ischemia at 32 ℃ followed by 58 min of reperfusion.In group IPC+L,after 20 min of equilibration,the hearts were perfused with K-H solution containing lueolin 50 μmol/L for 3 min before ischemia,and the other treatments were similar to those previously described in group IPC.Left ventricular developed pressure (LVDP),left ventricular end-diastolic pressure (LVDEP),heart rate (HR),and the maximum rate of increase of left ventricular pressure (+dp/dtmax) were recorded at the end of equilibration and reperfusion.At the end of reperfusion,left ventricular myocardial tissues were obtained for examination of the ultrastructure of myocardial cells and for determination of the expression of Nrf2,heme oxygenase-1 (HO-1),quinone oxidoreductase 1 (NQO1),and superoxide dismutase 1 (SOD1) mRNA and protein (by real-time polymerase chain reaction and Western blot,respectively).Results Compared with group C,the HR,+ dp/dtmax and LVDP were significantly decreased,and LVEDP was significantly increased at the end of reperfusion in I/R and IPC+L groups,and the expression of Nrf2,HO-1,NQO1 and SOD1 mRNA and protein was significantly up-regulated in I/R,IPC and IPC+L groups (P＜0.05).Compared with group I/R,the HR,+dp/dtmax and LVDP were significantly increased,and LVEDP was significantly decreased at the end of reperfusion,the expression of Nrf2,HO-1,NQO1 and SOD1 mRNA and protein was significantly up-regulated (P＜0.05),and the pathological changes were significantly attenuated in group IPC,and no significant change was found in the parameters mentioned above in group IPC+L (P＞0.05).Compared with group IPC,the HR,+dp/dt and LVDP were significantly decreased,and LVEDP was significantly increased at the end of reperfusion,and the expression of HO-1,NQO1,SOD1 mRNA and protein was significantly down-regulated (P＜ 0.05),no significant change was found in Nrf2 mRNA and protein expression (P＞0.05),and the pathological changes were significantly aggravated in group IPC + L.Conclusion Ischemic preconditioning reduces myocardial I/R injury through activating Nrf2/ARE signaling pathway in the rats.

AIM To investigate the effects of safflower yellow on myocardial injury in patients with severe sepsis.METHODS Using prospective research methods,ninety-two patients with severe sepsis treated in our hospital from Jan.2013 to Mar.2016 were divided equally into two groups:control group (routine treatment) and observation group (routine treatment + safflower yellow).In addition,6 and 72 hours after the treatment,heart-type fatty acid binding protein (H-FABP),creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) of patients were detected,and the changes of left ventricular ejection fraction (LVEF) and sequential organ failure assessment (SOFA) scores were observed;length of ICU stay,cumulative incidence of major adverse cardiac events (MACE) and 28-day survival also were recorded at the same time.RESULTS In admission,there were no differences in the levels of H-FABP,CK,CK-MB and LVEF,SOFA scores between the two groups.After 6 hours treatment,the levels of H-FABP,CK,CK-MB and SOFA score in the observation group were lower than those in the control group;the two groups had higher levels of H-FABP,CK and CK-MB than those before the treatment,SOFA score was lower than that before the treatment;After 72 hours treatment,H-FABP,CK,CK-MB and SOFA score were lower than those after 6 hours treatment;SOFA score in the observation group was lower than that in the control group;there were no differences in H-FABP,CK and CK-MB between the two groups.The observation group had a lower cumulative incidence of MACE than the control group.There was no statistical difference in LVEF and length of ICU stay after the treatment between the two groups.The observation group had a higher 28-day survival than the control group,the difference was statistically significant (76.08％,35/46 vs 54.35％,25/46;x2 =4.529,P =0.033).The level of serum H-FABP in severe sepsis patients was negatively correlated with LVEF (r =-0.270,P =0.009).CONCLUSION Therapeutic effects of safflower yellow on myocardial injury in patients with severe sepsis is superior to routine treatment with the improvement of the prognosis of patients to a certain extent.