Renal replacement therapy is an effective treatment for end-stage diabetic nephropathy.This review summarized recent literatures on hemodialysis,peritoneal dialysis and renal transplantation for end-stage diabetic nephropathy.The purpose is to guide doctors for treating end-stage diabetic nephropathy more reasonably.

Total hip and knee replacements, which have developed for abou t forty years, have been widely used as effective surgical treatments for severe hip and knee diseases. This article discusses the recent advance in techniques of hip and knee replacement Chiefly in the aspects of hip or knee prosthesis des ign, improvement of materials and surgical techniques. In total hip replacement, second-generation cementing technique, new types of metal-on-metal prosthesi s and minimally invasive technique have been applied to enhance the stability, r educe the wear rate and facilitate the functional recovery. In knee replacement, mobile bearing and high flexion are great advancements made in design. The comp uter-aided operational technique has greatly improved the replacement.

Objective This study was to investigate the effects of branched-chain amino acid (BCAA) supplementation on the metabolism of glucose and gluconeogenesis. Methods 20 rowers were randomly assigned to supplemental group and control group. During 4 weeks of training, all athletes followed the same training program. After 4 weeks, tests were done on a rowing ergometer, which included an incremental test for 4 mmol/L lactate anaerobic threshold and 2km, 5km maximum intensity exercise. Blood samples were taken prior to, immediately post and 30min post exercise. Results The results showed that serum glucose, alanine values had no significant difference between BCAA group and control group in anaerobic threshold test. In 2km and 5km rowing ergometer exercise, serum glucose values in BCAA group were significant decreased immediately post exercise, but the values in control group were significant decreased both immediately post exercise and 30min post exercise. Serum alanine values in BCAA group were significant increased both immediately post exercise and 30min post exercise, but the values in control group were significant decreased immediately post exercise. Lactate concentrations increased in BCAA supplementation group and were significantly lower (P

This paper emphasizes the importance of the mechanism of renal tissue damage in conducting treatment of lupus nephritis in addition to the renal histology.There are at least 4 kinds of mechanisms related to the renal tissue damage of LN including circulating immune complex deposition,in situ immune complex formation,vasculitic change and thrombotic mircoangiopathy.Treatment according to the mechanisms of tissue damage will give rise to a much better result as compared with the classic treatment based on morphology alone.Multi-target immune theapy has been recommended for treatment of those severe and complicated LN.

Objective:To explore the application value of clopidogrel in patients with non ST segment elevation myo‐cardial infarction (NSTEMI) during emergency percutaneous coronary intervention (PCI) .Methods :A total of 168 NSTEMI patients treated in our hospital from Jan 2012 to Feb 2013 were randomly divided into clopidogrel group (n=84) and ticlopidine group (n=84) ,both groups received PCI .Therapeutic effect were observed and compared be‐tween two groups .Results:Compared with ticlopidine group , there were significant rise in percentage of TIMI blood flow grade 3 (88.1% vs .91.7% ) ,white blood cell counting [ (4.0 ± 2.9) 109/L vs .(7.2 ± 2.3) 109/L] and platelet counting [ (101 ± 35) 109/L vs .(141 ± 39) 109/L] ,and significant reduction in percentage of mild bleeding (40.5% vs .19.0% ) in clopidogrel group after operation 28d , P< 0.05 or < 0.01 ;compared with ticlopidine group , there were significant reductions in incidence rates of cardiovascular events (60.7% vs . 27.4% ) and adverse reactions (14.3% vs .10.8% ) in clopidogrel group after six‐month follow‐up ( P<0.05 both) .Conclusion:Clopi‐dogrel possesses satisfying therapeutic effect and high safety in patients with non ST segment elevation myocardial in ‐ farction during emergency percutaneous coronary intervention ,which is worth extension .

Objective To investigate the effect of hypoxia on vascular endothelial growth factor (VEGF) expression and secretion in human renal fibroblasts. Methods Human renal fibroblasts were primary cultured from donor kidney, and cells in passage 3 were used in this experiment. Hypoxia was induced by incubation in a gas-tight box gassed with 10% CO2/10% H2/80% N2 for 24 hours. VEGF mRNA levels were measured by semi-quantitative RT-PCR method. VEGF proteins expressed on cell surface were measured by flow cytometry. VEGF proteins secreted into supernatants were measured by ELISA method. Results Hypoxia caused a 2. 5-fold increase of VEGF mRNA level in human renal fibroblasts. Hypoxia also induced significant increases of VEGF proteins on cell surfaces (mean fluorescence intensities: 1. 053?0. 055 vs 0.763?0.057, n=4,P

Objective: To construct an angiopoietin-like protein 2(ANGPTL2) expression vector and obtain ANGPTL2 over-expression endothelial cell strains.Methods: Plasmid phrGFP-C was used to amplify hrGFP protein coding sequence by polymerase chain reaction.The amplified sequence was cloned into the A multiple cloning sites of pIRES to construct plasmid pIRES-hrGFP.Complementary oligonucleotides containing the recognition sequence of BamH I,Sal I,Xba I and SSe8387 I were synthesized,annealed and cloned into a BamH I site on the backbone of plasmid pIRES-hrGFP to obtain vector pIRES-hrGFP-MS.ANGPTL2 cDNA was cloned by RT-PCR while human renal RNA was used as the templet and then inserted into the B multiple cloning sites of the vector pIRES-hrGFP-MS.The newly constructed ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 was linearized by Xba I and introduced into human umbilical vein endothelial cells.ANGPTL2 over-expressed endothelial clones were screened out by G418 selection and identified by the expression levels of both hrGFP and ANGPTL2 genes in these cell clones.Results: The ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 was constructed successfully and two ANGPTL2 over-expression endothelial strains were obtained.The cells displayed a significantly extended appearance quite different from that of the control cells.Conclusion: The successful construction of the ANGPTL2 expression vector pIRES-hrGFP-MS-ANGPTL2 and the obtainment of two ANGPTL2 over-expression HUVEC strains have paved the way for further investigation into the function of ANGPTL2 and its possible role in diabetic nephropathy.

This study was to investigate the influnce of 4 weeks of living high-training low on exercise performance of rowers. Twenty rowers were divided into two groups: ten subjects spent 8-10h per night in a tabernacle simulated at an altitude of 2500m in normobaric hypoxia; 10 control subjects slept at near sea level. During the 4-week periods, all rowers were trained at the same relative or at the same intensity of work in normoxia state. The red cell volume (RCV) , haemoglobin mass (Hb) and hematocrit (HCT) were measured before test, 15th and 30th day of study,and measurements were done on a rowing ergometer at sea-level, which included an ergometer test at 4 mmol/L lactate anaerobic threshold and performance in exercise tasks of 2km, 5km, and a Wingate Anaerobic Test before test and 30th day of study. The results showed that adaptation to simulated moderate altitude can stimulate red cell production sufficiently: increase in red cell volume (RCV) , haemoglobin mass (Hb) and hematocrit (Hct). And there were significant increases in all important parameters at 4 mmol/L lactate anaerobic threshold as well as performance of 5km, while the performance of 2km showed no significant improvement, the mean values of both mean power per kilogram body weight and peak power per kilogram body weight were not increased significantly. In the control group, there were no significant changes in the all abovementioned parameters. The results of this study indicate that living high-training low can improve the aerobic energy-supply systems. We conclude that 4-week of living high and training low can improve sea level endurance performance in rowers.

Objective To assess the diagnostic and curative efficacy of laparoscopy combined with hysteroscopy for tubal infertility. Methods A combined use of laparoscopy and hysteroscopy was performed in 62 cases of tubal obstructive infertility (124 oviducts), which had been tentatively diagnosed by lipiodol hysterosalpingography (HSG). Results Out of the 62 cases, 11 cases (22 oviducts) were found bilaterally unobstructed (17.7%, 22/124), 8 cases (8 oviducts) were found unilaterally unobstructed (6.5%, 8/124). Tubal interstitial or isthmus obstruction was observed in 40 oviducts (32.3%, 40/124) and hydrosalpinx in 54 oviducts (43.5%, 54/124). The consistency ratio between lipiodol HSG and endoscopy in the diagnosis of tubal obstruction was 75.8% (94/124). Tubal catheterization under hysteroscope and laparoscope was adopted in the 40 ducts of interstitial or isthmus obstruction, and 30 were cured, 5 perforated and 5 failed. Laparoscopic salpingostomy and salpingolysis was employed successfully in 54 tubes. Conclusions Combined use of hysteroscopy and laparoscopy is useful in the diagnosis and treatment of tubal obstruction and infertility tentatively diagnosed by HSG.