Objective To evaluate the protective effect of taurine on renal injury induced by high energy shock wave in rabbits.Methods Twenty rabbits were divided into the experimental (n=10)and the control group (n=10) at random.Both the groups were exposed to 1500 shock waves at 12.75 KV.In the experimental group, taurine (150 mg/kg) was given intravenously during the shock, while normal saline was given in the controls. Malondialdehyde(MDA) and superoxide dismutase(SOD) in serum were measured and the histological changes, the expression of heat shock protein 70(HSP70) in kidney were determined 3 days after the shocks.Results The level of MDA was(2.2±0.4) ,(2.1±0.4)mmol/L, and the level of SOD was (56.4±9.9) ,(55.8±10.1)μU/L respectively in the experimental and the control group before the shock.There was no significant difference between the two groups(P＞0. 05). After the shock, the level of MDA and SOD was (2.7±0.7)mmol/L, (55.3±5.7)μU/L respectively in the experimental group. There was no significant difference(P＞0.05) compared with the level of before the shock's. While in the control group, the level of MDA and SOD was (5. 7±0. 7) mmol/L, (33. 3±3. 5)μU/L respectively.There was significant difference (P＜0.05) compared with the level of before the shock's. The renal tubule scores of the experimental group and the control group after shocks were 7.2±0.8 and 31.8±1.9, respectively. And the HSP70 scores were 25.2±4.1 and 6.4±0.9, respectively. There was significant difference between the two groups (P＜0.05).Conclusions Taurine can effectively protect kidney from injury induced by high energy shock wave in rabbit.The mechanism may be related with its antioxidant capacity and inducing the synthesis of HSP70 in kidney.

Objective:To help hospitals at different levels develop and provide patients with high-quality medical services.Methods: Primary data were gathered through face-to-face surveys with questionnaires employed.Totally 195 questionnaires and 134 valid questionnaires were collected.Analysis of variance,independent-sample test,and cross-table combining z-test were used to complete data analysis.Results: Research outcome indicates there is no significant difference in outpatients' satisfaction level among hospitals at different levels,similar to outpatients' loyalty level.There are different affecting factors on outpatients' recommendation and satisfaction.Conclusion: Hospitals should be clear of patients' satisfaction level,evaluate patients' loyalty objectively,and make great effort on patients' concerning aspects.

Objective:To explore the influencing factors on outpatients′ satisfaction of medical service.Methods: 195 samples coming from 5 provinces: Shandong,Hebei,Liaoning,Heilongjiang and Jilin province,and Tianjin City were all from the outpatients′ pupulation within a year,and were investigated with questionnaires.The data were collected by face-to-face survey,and totally 134 valid questionnaires were gathered.We use the following methods to complete data analysis: independent sample t-test,and analysis of variance,analysis of correlation,expecting to find the personal factors to affect outpatient satisfaction.Results: research outcome indicates that gender has no effect on outpatient′s satisfaction;while indexes as age and education level have significant influence.

Objective To evaluate the efficacy of PAD regimen (bortezomib, doxorubicin, dexamethasone) and VAD-like T regimen (vincristine, doxorubicin/doxorubicin derivatives, dexamethasone combined with thalidomide) in the treatment of patients with newly diagnosed multiple myeloma (MM). Methods The efficacy of 54 patients with MM who received VAD like-T regimen and 72 patients with MM who were treated with PAD regimen, including complete remission (CR) rate, very good partial remission (VGPR) rate, overall response rate (ORR), overall survival (OS), progression-free survival (PFS) and adverse events, were retrospectively analyzed. Results The CR rate of PAD group was higher than that of VAD-like T group [31.5 % (23/72) vs. 9.3 % (5/54), χ2=0.30, P=0.002]. The VGPR rate and ORR of PAD group were not statistically higher than those of VAD-like T group [16.7 % (12/72) vs. 16.6 % (9/54), P=0.180; 82.2 %(65/72) vs. 81.5 % (44/54), P=0.190, respectively]. Median PFS of PAD group was significant longer than that of VAD-like T group [(38.2±2.2) months vs. (28.0±7.6) months, P=0.017]. The 3- and 5-year OS rates of PAD group were higher than those of VAD-like T group, but there were no significant differences between two groups (P>0.05). In terms of the adverse events, the incidence of peripheral neuropathy in PAD group was significantly higher than that of VAD-like T group [31.5 % (23/72) vs. 14.5 % (8/54), P=0.03]. Conclusions Compared with PAD protocol, the CR and median PFS of VAD-like T regimen are poor, however, VGPR,ORR, PFS and 5-year OS are similar between the two groups, and VAD-like T regimen is safer with low incidence of peripheral neuropathy. VAD-like T regimen as the first-line treatment is effective and well-tolerated, especially for newly diagnosed MM patients not suitable for transplantation and bortezomib.

Objective: To assess the clinical efficacy of Xuebijing injection in the prevention of postoperative systemic inflammatory response syndrome (SIRS) in the patients with ureteral stones and urinary tract infection during the perioperative period of ureteroscopy.Methods: Totally 64 cases with ureteral stones complicated with urinary tract infection treated with ureteroscopy were selected as the subjects and divided into two groups according to the digital method.The 32 cases in the control group were given the conventional antibiotics during the perioperative period for preventing the incidence of SIRS, and the observation group was given 500ml Xuebijing added to 100ml normal saline for intravenous drip additionally.The incidence of SIRS and the laboratory indicators after the operation were observed and compared between the groups.Results: The incidence of postoperative SIRS of the observation group was 9.38% , which was lower than that of the control group (34.38% , P <0.05);the incidence of sepsis of the observation group was 0%, while there was no statisticcally difference bettween the two groups(P＞0.05).The C-reactive protein (CRP), procalcitonin (PCT), leucocyte count and endotoxin in the observation group on the 2nd, 4th and 6th day after the operation were better than those in the control group, and the difference was statistically significant (P＜0.05).Conclusion: Xuebijing injection combined with antibiotics has significant clinical effect on the incidence of SIRS after ureteroscopy in the patients with ureteral stones and urinary tract infection, which can effectively improve the clinical indicators and reduce the incidence of sepsis, and is worthy of clinical promoted application.

Objective The occurrence and progression of renal cell carcinoma ( RCC) is complicated process associated with DNA abnormal methylation , histone modification , and Wnt signaling pathway .This study aimed to investigate the expression of histone methylase SET8 in RCC, its relationship with the Wnt signaling pathway , its action mechanism in RCC , and its clinical significance . Methods We selected 50 cases of RCC treated by radical nephrectomy , detected the expression of SET 8 in the RCC and adjacent noncancerous kidney tissues by immunohistochemical EliVision two-step staining with β-catenin.We compared the expression levels of SET8 and β-catenin in the two types of tissue and analyzed their relationship with the patients′clinical information and the pathologic stage and grade of tumor as well as the correlation between the SET 8 andβ-catenin expressions . Results SET8 was mainly express in the cytoplasm of the RCC and noncancerous kidney tissues , partially in the cell membrane and nucleus , while theβ-catenin protein chiefly in the cell membrane of renal tubular epithelial cells in the normal kidney tissue .The expression levels of SET 8 and β-catenin in the RCC tissue were closely related to the TNM stage and tumor grade (P<0.05).The positive expression of SET8 in the RCC tissue (76%[38/50]) showed no significant difference from that in the ad-jacent noncancerous kidney tissue (66% [33/50]) (P>0.05), but that of β-catenin was remarkably higher in the former (68%[34/50]) than in the latter (4%[2/50]) (P<0.01).There was a positive correlation between the positive expression of SET 8 and the abnormal expression of β-catenin (r=0.219, P<0.05). Conclusion SET8-activated H4K20me-1 controls the activation and abnormal activities of the Wnt signaling pathway , affects the gene transcription and cell activity , and participates in the occurrence , progression, and distant metastasis of RCC .

Objective To evaluate the efficacy and safety of ureteroscopic endo-incision and drainage in the treatment of renal cysts.Methods Thirty cases(19 females and 11 males)of renal cysts(1 1 parapelvie cysts,15 simple cysts.and 4 multiple cysts)were treated with ureteroscopic endo-incision and drainage.The renal cysts were located in renal pelvis,and opened and decompressed by electrotme with ureteroscope.Double J stent was placed afterwards.Urinary and blood biochemistry were tested post-operatively.Results All the operations were successfully completed with no severe complication.The cyst managing time ranged from 15 tO 45 min.Urinary biochemistry(urinary protein and glucose)turned normal 1 2 days after the surgery.Patients were followed up for 3 to 9 months.Renal cysts disappeared in 24 cases,diminished in 4 cases,and recurred in 2 cases.Conclusion Application of ureteroscopic technique in the treatment of renal cyst is safe,effective and minimally invasive.

Objective To investigate the risk factors for reduced renal function in patients with ischemic stroke.Methods The medical records of patients with ischemic stroke were analyzed retrospectively.They were divided into normal renal function group and reduced renalfunction group.Reduced renal function was defined as estimated glomerular filtration rate (eGFR) ＜60 ml/(min·1.73 m2).Multivariate logistic regression analysis was used to identify the risk factors for reduced renal function in patients with ischemic stroke.Results A total of 805 patients with ischemic stroke were enrolled in the study.8.8％ of patients had a reduced renal function.There was no significant differences in the proportion of patients with mild and moderate neurological deficit between the reduced renal function group and the normal renal function group (all P ＞ 0.05),however,the proportion of patients with severe neurological deficit was significantly higher than that in the normal renal function group (8.4％vs.2.6％,x2 =5.573,P =0.017).The proportion of small artery occlusion in the reduced renal function group was sigaificantly higher than that in the normal renal function group (66.2％ vs.46.5％,x2 =9.962,P =0.002),and the proportion of large artery atherosclerosis was significantly lower than that in the normal renal function group (19.7％ vs.43.5％,x2 =15.045,P =0.000).Multivariate logistic regression analysis indicated that old age (odds ratio [ OR] 3.301,95％ confidence interval [ CI],1.575 to 6.918; P=0.002) was the most important independent risk factor for reduced renal function,then was female (OR,2.291,95％ CI 1.355to 3.872; P=0.002) and hyperlipidemia (OR,2.527,95％ CI 1.095 to 5.831; P=0.030).Conclusions Reduced renal function in patients with ischemic stroke is strongly associated with old age,female,and hyperlipidemia.

Objective To analyze the distribution and antimicrobial resistance profile of clinical bacterial strains isolated from blood culture in China.Methods Clinical bacterial strains isolated from blood culture from participating hospitals of Blood Bacterial Resistance Investigation Collaborative System (BRICS) during January 2014 to December 2015 were collected.Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods as recommended by US Clinical and Laboratory Standards Institute(CLSI)2018.The data were analyzed with Whonet 5.6 software.Results During the study period,4 801 clinical bacterial isolates were collected from 26 hospitals,of which 1 798 (37.5％) were Gram-positive bacteria and 3 003 (62.5％) were gram-negative bacteria.The top 10 isolates were Escherichia coli (33.8％),coagulase-negative Staphylococcus (19.0％),Klebsiella pneumoniae (11.9％),Staphylococcus aureus (10.1％),Acinetobacter baumannii (4.0％),Pseudomonas aeruginosa (3.8％),Streptococcus (3.0％),Enterobacter sulcus (2.9％),Enterococcus faecium (2.8％) and Enterococcus faecalis (1.8％).Methicillin-resistant Staphylococcus aureus (MRSA) and methicillinresistant coagulase-negative Staphylococcus (MRCNS) accounted for 33.9％ (165/487) and 56.9％ (520/913) of Staphylococcus aureus and coagulase-negative Staphylococcus respectively.No vancomycinresistant Staphylococcus was detected.The resistance rate of Enterococcus faecium to vancomycin was 0.7％ (1/135),and no vancomycin-resistant Enterococcus faecaliss was detected.The positive rates of extendedspectrum β-1actamases(ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus were 56.9％ (923/1 621),30.1％ (172/572) and 29.2％ (7/24),respectively.The positive rates of carbapenemresistant Escherichia coli,Klebsiella pneumoniae,Enterobacter,Salmonella and Citrobacter were 1.2％ (20/1 621),7.2％ (41/572),4.3％ (6/141),1.5％ (1/67) and 2.9％ (1/34),respectively.The resistance rates of Acinetobacter baumannii to polymyxin and tegacycline were 2.6％ (5/190) and 8.9％ (17/190)respectively,and that of Pseudomonas aeruginosa to polymyxin and fosfomycin were 1.1％ (2/183)and 0.6％ (1/183),respectively.Conclusions The surveillance results from 2014 to 2015 show that the main pathogens of blood stream infection in China are Gram-negative bacteria,while Escherichia coli is the most common pathogen,the detection rate of MRSA is lower than other surveillance data in the same period in China;carbapenem-resistant Klebsiella pneumoniae and Escherichia coli are at a low level as shown in this surveillance.

OBJECTIVETo investigate the clinical and hematological features and prognostic factors of primary myelofibrosis (PMF) patients in Shanghai and surrounding area of Shanghai, China.

METHODSThe clinical manifestations, laboratory parameters and survival were retrospectively analyzed in 75 PMF patients diagnosed from Jan, 1996 to Dec, 2013 in our hospital and were compared with those of Chinese subjects from Tianjin and foreign Caucasian patients, respectively. Comparison of categorical variables was performed by χ² test. Survival was estimated using the Kaplan- Meier method. Log- rank test was used to compare survival date. A Cox model was used for multivariate analyses.

RESULTSThe median age of the 75 patients was 56(19-81) years old. There were 51(68%) patients with HGB less than 100 g/L. The median value of HGB was 83 g/L. Similar with those from Tianjin, the patients in our study were significantly younger with higher proportion of severe anemia and lower platelet counts when compared with foreign Caucasian patients. Using IPSS and dynamic international prognostic scoring system (DIPSS) model, the survival curves of intermediate- 1, intermediate- 2 and high risk groups were significantly different. In univariate analyses, variables significantly correlated with poor prognosis were systemic symptoms, HGB<100 g/L, HGB<80 g/L, PLT ≤ 100 × 10⁹/L, WBC<10 × 10⁹/L and blood blasts ≥ 0.01. Multivariate analysis identified IPSS and HGB < 80 g/L as independent risk factors for survival.

CONCLUSIONChinese PMF patients may have characteristics of younger age at onset with more severe anemia. However, IPSS and DIPSS model are still suitable for Chinese patients to predict survival. To increase the weight of anemia severity may provide a better prognostic stratification for Chinese patients with PMF.

Adult ; Aged ; Aged, 80 and over ; China ; Humans ; Middle Aged ; Primary Myelofibrosis ; diagnosis ; Prognosis ; Retrospective Studies ; Risk Factors ; Young Adult