Objective To study the effect of dialysis adcquacy,microinflammation and residual renal function on nutritional status of hemodialysis patients.Methods One hundred and fourteen patients were enrolled in this study.Kt/V,?_2-MG and serum iPTH were measured as markers of hemodialysis adequacy.Nutritional evaluation included MQSGA,Alb,Hb,TF,IGF-1,IGFBP-3 and anthropometrics such as HGS,BSF,TSF,MAC,MAMC and AMA.Serum IL-6,TNF-?and CRP were detected to assess microinflammation.Urinary volume of 24 hours was measured to investigate the residual renal function (RRF).Results (1)There were different correlations and regressive associations of Kt/V,iPTH and?_2-MG with HGS,MAMC,AMA,Alb,Hb,nPCR,IGF-1 and MQSGA respectively.(2) There were significant correlations and regressive associations of RRF to HGS,TSF,MAMC,Alb,nPCR and IGF-1 within the first year of hemodialysis.(3) There were different correlations and regression relationships of IL-6,TNF-?and CRP with HGS、MAMC、AMA、Alb、TSF、Hb、nPCR、IGF-1 respectively.(4) Multivariate analysis showed that Kt/V,iPTH,IL-6, TNF-?,?_2-MG and RRF were influencing factors,among them,Kt/V,iPTH,IL-6 and TNF-?were independent predictors of nutritional status.Conclusions Hemodialysis adequacy and micruinflammation may impact on nutritional status.Residual renal function may be involved in nutritional status in the first year of hemodialysis.Kt/V,iPTH,IL-6 and TNF-?are independent factors affecting nutritional status.

OBJECTIVETo explore the effect of Yixintai Granule (YG) on mRNA and protein expression levels of AQP2 in renal medulla of chronic heart failure (CHF) rabbits.

METHODSCHF rat model was established by ear marginal vein injection of adriamycin. Successfully modeled rabbits were divided into the model group, the high (8.4 g/kg), middle (4.2 g/kg), and low dose (2.1 g/kg) YG group, and the Furosemide group (2 mg/kg). Besides, a normal control group was set up. Equal volume of physiological saline was administered to rabbits of the model group and the normal control group by gastrogavage. YG at different doses was administered to rabbits of the 3 YG groups by gastrogavage. The intervention lasted for 4 weeks, once per day. After treatment the urine volume and pathomorphological changes of renal medulla tissue were observed. mRNA and its protein expression levels of AQP2 were detected.

RESULTSCompared with the normal control group, the urine volume decreased significantly, mRNA and protein expression levels of renal medulla AQP2 increased significantly in the model group (all P < 0.01). Compared with the model group, the urine volume increased significantly, and mRNA and protein expression levels of renal medulla AQP2 decreased significantly in all medicated groups (all P < 0.01). Compared with the low dose YG group, the urine volume significantly increased and the mRNA expression level of renal medulla AQP2 significantly decreased in the middle and high dose YG groups (all P < 0.01). The expression level of AQP2 protein significantly decreased in the high dose YG group (P < 0.01). Pathological changes of the renal medulla was the most obviously seen in the model group. But they were alleviated to various degrees in all medicated groups. They were more obviously attenuated in the middle and high dose YG groups.

CONCLUSIONYG could improve CHF possibly through down-regulating mRNA and protein expression levels of AQP2 in renal medulla, and elevating the urine volume.

Animals ; Aquaporin 2 ; genetics ; metabolism ; Chronic Disease ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Heart Failure ; drug therapy ; metabolism ; RNA, Messenger ; metabolism ; Rabbits ; Rats, Sprague-Dawley

OBJECTIVETo observe the clinical effect of combined treatment with safflor yellow powder injection and benazepril in treating patients with diabetic nephropathy (DN).

METHODSSeventy-six patients with DN were randomly assigned to the treatment group (39 cases) and the control group (37 cases). Conventional treatment for lowering blood glucose was given to both groups, but to the control group 10 mg benazepril was given orally once a day additionally, while to those in the treatment group the same dosage of benazepril po. and 150 mg/d of safflor yellow powder injection by adding in 250 mL 0.9% normal saline for intravenous dripping. The therapeutic course for them all was 15 days, and all patients received two courses with an interval of 5 days. Changes of clinical symptoms, urinary albumin excretion rate (UAER), blood and urinary levels of beta2 -microglobulin (beta2 -MG), urinary level of alpha1-microglobulin (alpha1 -MG), D-dimer (D-D) and plasma fibrinogen (FIB) were observed.

RESULTSThe total effective rate in the treatment group was higher than that in the control group (84.62% vs 59.45 %, P < 0.05). The total score of syndrome in the treatment group was lower than that in the control group (P < 0.05). Levels of UAER, 132-MG in serum and in urine, alpha1-MG in urine were decreased significantly after after 2 courses of treatment in both groups, showing significant difference as compared with before treatment (P < 0.05 or P <0.01), and the decrements were more significant in the treatment group than those in the control group (P <0.05); while decrease of FIB, D-D only happened in the treatment group (P <0.01), so the post-treatment data in the treatment group were significantly lower as compared with those in the control group (P <0.01).

CONCLUSIONCombined therapy with safflor yellow injection and benazepril is superior to benazepril alone in reducing urinary albumin, improving renal function and blood hyperviscosity manner for patients with DN, suggesting the combination of the two could play their respective superiorities and act in cooperation for retarding the progression of DN.

Adult ; Albumins ; analysis ; Benzazepines ; administration & dosage ; Blood Glucose ; Diabetic Nephropathies ; drug therapy ; metabolism ; urine ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Kidney Function Tests ; Male ; Middle Aged

AlM: To investigate the association between the degree of anterioruveitis and related factors including inflammatory markers as well as sacroiliac joint imaging in patients with ankylosing spondylitis ( AS) .
METHODS: Anterior changes evaluated by slit lamp, erythrocyte sedimentation rate ( ESR ) , C - reactive protein ( CRP ) and magnetic resonance imaging of 55 cases with AS associateduveitis were retrospectively analyzed. A modified endotoxin-induced uveitis ( ElU ) clinical standard was used for uveitis grading. SPARCC sacroiliac scoring was used to evaluate bone edema of sacroiliac joint. The correlation between the degree of uveitis and sacroiliitis was assessed.
RESULTS: ln the 55 patients with AS, ElU grading scored 2-10, and SPARCC index scored 0-22. Further analysis showed that the severity of uveitis was significantly correlated with ESR (r=0. 869, P<0. 001) and CRP (r=0. 485, P<0. 001). The degree of anterior uveitis in AS patients was not correlated with inflammation of sacroiliac joint (r=0. 237, P=0. 081).
CONCLUSlON: Local autoimmunity of uveitis and sacroiliac joint inflammation with subsequent bone formation in AS might be mutually independent processes.

OBJECTIVETo explore the effect of a self-made guiding needle of steel wire in guiding the wire through the tibial tunnel for the treatment of avulsion fractures of tibial posterior cruciate ligament with open reduction and wire fixation.

METHODSFrom February 2011 to June 2014, a total of 22 patients with avulsion fractures of tibial posterior cruciate ligament underwent surgical treatments were analyzed, including 14 males and 8 females with an average age of 35.6 years old (ranged, 17 to 63 years old). According to Meyers classification, 9 patients were classified as type II, 13 patients were classified as type III. All the patients underwent open reduction and wire fixation with medial knee "L" shape approach. A wire guiding needle was used to guide the wire through the tibial tunnel during operation.

RESULTSWith the assistance of wire guidance needles, wires passed through the tibial tunnel rapidly during the operation in all the 22 patients. All the patients were followed up, X-ray imagings 6 months after operation showed the fractures healed well. The average follow-up time in all patients was 6 months (ranged, 6 to 12 months). The averaged Lysholm knee score in 22 knee was 92.7 +/- 3.4. All patients' posterior drawer test were negative.

CONCLUSIONSelf-made wire guiding needle can simplify the operation procedures in which the wires pass through the tibial tunnel, shorten the operation time, reduce the surgical trauma and complications, and be worthy of clinical application.

Adolescent ; Adult ; Bone Wires ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Young Adult

OBJECTIVETo observe the effects of puerarin on activity of dimethylarginine dimethylaminohydrolase (DDAH) in human umbilical vein endothelial cells (HUVECs) cultured with oxidized free radical (OFR), to explore the effect of puerarin on metabolic mechanism of asymmetric dimethylarginine (ADMA).

METHODSHUVECs of the 3rd - 6th passage cultured with modified Jaffe's method were divided into 4 groups, the blank control group cultured with DMEM medium, the OFR group cultured with DMEM medium containing 0.1 mmol of OFR per liter, the puerarin group 1 and 2 cultured with DMEM medium containing 0.1 mmol of OFR per liter as well as 0.5 mg/ml and 1.0 mg/ml of puerarin respectively. After being incubated for 24 h, activity of nitric oxide synthase (NOS), contents of nitric oxide (NO), ADMA, endothelin (ET), and L-citrulline (L-cit) in the supernate were measured, and DDAH protein expression in the lysate was detected by Western blotting.

RESULTSCompared with those in the blank control group, ADMA and ET contents were higher, while the levels of NO and L-cit and the activity of NOS were lower markedly, but the DDAH expression changed insignificantly in the OFR group. These abnormalities were restored significantly in the puerarin groups.

CONCLUSIONThe increase of ADMA in OFR injured HUVECs was correlated with the reduction of DDAH activity and irrelevant to DDAH expression. Puerarin could promote ADMA metabolism through increasing DDAH activity, and improve NOS activity, thus to reduce the impairing of OFR on endothelial function.

Amidohydrolases ; metabolism ; Arginine ; analogs & derivatives ; metabolism ; Blotting, Western ; Cells, Cultured ; Culture Media ; Endothelial Cells ; cytology ; drug effects ; metabolism ; Endothelins ; metabolism ; Free Radicals ; chemistry ; pharmacology ; Humans ; Isoflavones ; pharmacology ; Nitrates ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; Nitrites ; metabolism ; Oxidation-Reduction ; drug effects ; Umbilical Veins ; cytology

OBJECTIVETo observe targeted expression of recombinant lentivirus-mediated (Lv)-hTERTp-TK and Lv-hTERTp-tumstatin in HepG2 cells, and explore the inhibitory effect of their combination on HepG2 cells both in vitro and in vivo.

METHODSLv-hTERTp-TK and Lv-hTERTptumstatin were used to infect HepG2 and L02 cells at different MOIs. Transfection efficiency was observed by fluorescence microscopy. Expression of TK and tumstatin mRNA was detected by reverse-transcriptase PCR. Proliferation and apoptosis were detected by MTT and flow cytometry, respectively. The HepG2 cells were examined by real time-PCR and western blotting to determine expression level of bcl-2 and VEGF mRNA and protein.A murine hepatocellular carcinoma model was established by injecting 1 * 10(7) HepG2 cells into 30 BALB/c nude mice. The modeled mice were randomly divided into a control group, mock group, Lv-hTERTp-tumstatin group, Lv-hTERTp-TK group, and combination group for four weeks of injections at regular intervals of PBS, Lv-hTERTp-null, Lv-hTERTp-tumstatin, Lv-hTERTp-TK, and Lv-hTERTp-tumstatin plus Lv-hTERTp-TK, respectively.Changes in tumor volume and weight, and cell morphology of tumor and major organs, were assessed by hematoxylin-eosin staining.Microvascular density of tumor tissue and cell apoptosis were assessed by immunohistochemical and TUNEL staining, respectively.

RESULTSThe Lv-infected HepG2 cells, and not the Lv-infected L02 cells, expressed TK and tumstatin. Lv-hTERTp-TK and Lv-hTERTp-tumstatin, alone or in combination, inhibited proliferation and increased apoptosis of the HepG2 cells, but the combination was more effective than either alone (P less than 0.05). None of the treatments affected proliferation or apoptosis of the L02 cells (P more than 0.05). The combination also led to a greater reduction of bcl-2 and VEGF than either alone (all, P less than 0.05). Tumor growth was significantly inhibited by the combination (P less than 0.05). In vivo, the combination treatment induced the greatest amount of apoptosis of the HepG2 cells. Cell morphology of major organs such as liver, spleen and kidney were similar to the control group. The combination also produced the most significant effect on tumor microvascular density (P less than 0.05) and the highest apoptosis index (P less than 0.05).

CONCLUSIONThe HTERT promoter can induce targeted expression of TK and tumstatin in HepG2 cells. Lv-hTERTp-TK combined with Lv-hTERTp-tumstatin can significantly inhibit proliferation and induce apoptosis of human HepG2 cells in vitro and in vivo, which may be related to down-regulation ofbcl-2 and VEGF.

Animals ; Apoptosis ; Autoantigens ; genetics ; Carcinoma, Hepatocellular ; therapy ; Cell Line, Tumor ; Collagen Type IV ; genetics ; Down-Regulation ; Flow Cytometry ; Gene Transfer Techniques ; Genetic Therapy ; Genetic Vectors ; Hep G2 Cells ; Humans ; Lentivirus ; Liver Neoplasms ; therapy ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Telomerase ; genetics ; Transfection ; Vascular Endothelial Growth Factor A ; metabolism

BACKGROUND: In recent years, precision medicine has become a hot topic in the medical field. The application of precision medicine to osteonecrosis of the femoral head is wider than before. OBJECTIVE: To summarize the current status and progress of precision medicine to osteonecrosis of the femoral head. METHODS: A computer-based search of PubMed and CNKI databases was performed for literatures about application and prospect of precision medicine for osteonecrosis of the femoral head in and outside China published within the past 10 years using the keywords of "precision medicine, osteonecrosis of the femoral head, three dimensional (3D) printing, computer assisted navigation, minimal invasive, gene" in English and Chinese. RESULTS AND CONCLUSION: (1) In the study on the prevention and treatment of osteonecrosis of the femoral head, 3D printing technology, computer assisted navigation technology, precision minimally invasive orthopedic technology, research and treatment of gene are four effective ways to achieve precise and personalized healthcare. (2) The appearance of precision medicine, a novel medicinal model, enriches the treatment of osteonecrosis of the femoral head and enhances the curative efficacy of the disease. It brings the new dawn to the patient and provides some new clues for medical workers and researchers engaged in the clinical and basic researches of osteonecrosis of the femoral head.

BACKGROUND: Precision medicine pays attention to the depth characteristics of the disease and the high precision of the treatment, and is a precise and accurate personalized approach of the diagnosis and treatment of the disease. In recent years, it has gradually become the hotspot of the medical field. As a new concept of medicine and medical model, its value in clinical treatment of orthopedics has been gradually highlighted. OBJECTIVE: To summarize the current status and progress of precision medicine in the field of orthopedics.METHODS: A computer-based search of PubMed and CNKI databases was performed for literatures about application and prospect of precision medicine in the field of orthopedics in and outside China published within the past 10 years using the keywords of "precision medicine, Orthopedics, bone, 3D printing, computer assisted navigation, minimal invasive, gene". RESULTS AND CONCLUSION: (1) In the study on the prevention and treatment of the disease of orthopedics, 3D printing technology, computer assisted navigation technology, precision minimally invasive orthopedic technology, and gene research are four effective way to achieve precise and personalized healthcare. (2) The appearance of precision medicine, a novel medicinal model, enriches the treatment of the disease in the field of orthopedics and enhances the curative efficacy of the disease. Precision medicine brings the new dawn to the patient and provides some new clues for medical workers and researchers engaged in the clinical and basic research of the disease in the field of orthopedics.

Osteonecrosis of the femoral head (ONFH) is a common refractory disease in orthopedics, and the rate of disability is very high, and its pathogenesis is unknown. TCM has unique advantages in the prevention and treatment of ONFH, and it has gradually received attention. This article reviewed the clinical application status of TCM for prevention and treatment of ONFH in recent years from ONFH's TCM name, etiology, pathogenesis, syndrome differentiation, and clinical treatment, with a purpose to provide a reference for the clinical treatment of ONFH.