Chronic kidney disease ( CKD) has become a pandemic.Laboratory assay takes the important role in early diagnosis of CKD.We should develop these assays correctly on the basis of full understanding of CKD and guide clinical use for them in laboratory medicine.

Objective To investigate the prevalence of dyslipidemia,hyperglycemia,hypertension and metabolic syndrome(MS)and compare the prevalence rate of dysilipidemia obtained in this study with the previous study during 1984--1986.Methods A total of 16 344 adults in Beijing who attended for the medical examinations were recruited in the study.Subjects were asked to complete questionnaires regarding personal health,lifestyle and family health history.The physical examination emphasized measurement of height,weight and blood pressure.Blood samples were collected after an overnight fast and subjected to serum glucose,TC,HDL-C,LDL-C and TG measurements.MS was diagnosed according to Diabetes Society of Chinese Medical Association(CDS)criteria.Results Dyslipidemia occurred in 36.9%(6 034)of subjects.948 hyperglycaemia cases were found.The prevalence rate of high blood glucose was 5.8%. Hypertension occurred in 17.1% of subjects.Obesity/Overweight occurred in 5 252 subjects with the prevalence rate of 32.1%.On the basis of the diagnostic criteria for MS in China.MS occurred in 12.2% of subjects(14.2% for males and 10.0% for females).In both genders,the rate increased along with the increment of age.65.5% participants had at least one of the metabolic disorders.The prevalence of hypercholesterolemia,hypertriglyceridemia,and abnormally low HDL-C were higher than previous analysis during 1984-1986 in all age groups.Conclusions The prevalence of MS in this large occupational population in Beijing was quite high. The prevalence of hypeflipemia had increased considerably over the past 20 years.Balanced nutrition and reasonable consumption should be undertaken to modify these situations.

OBJECTIVE:To evaluate clinical efficacy through comparing the change of CT image in infrapatellar fat pad before and after Xiaoding ointment in the treatment of acute patellar bursitis of knee joint. METHODS:73 patients with acute patellar bur-sitis were randomly divided into observation group(39 cases)and control group(34 cases). Observation group was given Xiaoding ointment for local application,qd,7 d as a courses,3 courses in total;control group was given triamcinolone acetonide 30 mg af-ter the extraction of articular cavity effusion,once a week,totally for 3 times. All patients of two groups underwent knee CT exami-nation for observation of the infrapatellar fat pad and articular cavity effusion volume change before and after treatment. Clinical ef-ficacies were compared between 2 groups. RESULTS:CT image alterations of treatment group showed that infrapatellar fat pad den-sity were decreased,anteroposterior diameter,vertical diameter,internal to external diameter were significantly reduced. The total effective rate of treatment group was 92.31%,which was better than that of control group(88.24%),with statistical significance (P<0.05). CONCLUSIONS:Xiaoding ointment demonstrate markedly curative effects in the treatment of acute patellar bursitis, and CT image is an effective method for diagnosis of infrapatellar fat pad.

Objective To explore the role of process management in preventing peripheral central venous catheter (PICC)-related bloodstream infections (CRBSI). Methods A standard process management policy was established for the uniform management of PICC in our hospital. The incidences of CRBSI before and after the implementation of this policy were compared. Results The incidences of CRBSI was 6.0‰ (48/79 793 ) every 1000 catheter-days before process management and 2.9‰ (29/99643) after process management (P =0.000).Conclusion Standard process management can effectively prevent and control CRBSI caused by PICC.

Carcinosarcoma ; pathology ; Humans ; Stomach Neoplasms ; pathology

Objective To evaluate the effects of inhaled iloprost on pulmonary hypertension after cardiopulmonary bypass in patients with congenital heart disease undergoing surgical correction of anomaly. Methods Fifty-eight patients with congenital heart disease aged 14-60 yr undergoing surgical correction of anomaly under cardiopulmonary bypass (CPB) were enrolled in this study. Radial artery was cannulated before induction of anesthesia. A 6-lumen pulmonary catheter was placed via right internal jugular vein after tracheal intubation. Their mean pulmonary arterial pressure was still > 25 mm Hg after operation. ECG, HR, BP, CO, PAP and SpO_2 were continuously monitored. Aerosolized iloprost 10 fig was inhaled via nebulizer after CPB. Hemodynamics were measured before iloprost inhalation (baseline) and at 0, 5, 15, 30 and 60 min after the end of iloprost inhalation. Results There were 28 patients with pulmonary hypertension after CPB among the 58 patients with congenital heart disease. Inhalation of iloprost 10μg significantly decreased mPAP, pulmonary vascular resistance and intrapulmonary shunt as compared with the baseline. Iloprost inhalation could also improve significantly CO and the mixed venous oxygen saturation (SvO_2 ). Conclusion Iloprost inhaled after CPB can effectively reduce pulmonary arterial pressure and pulmonary vascular resistance in patients with congenital heart disease undergoing surgical correction of anomaly and help them wean from CPB.

Two hundred and thirty-five patients of both sexes (123 male,112 female) aged 18-54 yr,weighing 35-62 kg underwent repair of tetralogy of Fallot from January 1996 to July 2009 in Fuwai hospital.Direct BP, ECG,CVP,SpO2,naso-pharyngeal temperature and TEE were continuously monitored during operation.Anesthesia was induced with midazolam and/or etomidate, fentanyl and pipecuronium and maintained with isoflurane/sevoflurane inhalation and intermittent iv boluses of fentanyl and pipecuronium. The total amount of fentanyl administered ranged from 30-50 μg/kg. Cardiac function was supported and hemodynamic stability was maintained with vasoactive and inotropic drugs. Measures were taken to strengthen blood conservation and respiratory function support.Seven patients(2.9%) needed urgent CPB during operation because of serious cyanotic spells. Perfusion-induced lung injury occurred in 18 patients (7.6%). Circulation was assisted by ECMO in 2 patients (0.9%). Three patients (1.3%) died of serious low cardiac output and perfusion-induced lung injury.

BACKGROUND: Whether horizontal and vertical impacts cause craniocerebral injury of the same degree, and whether serum myelin basic protein (MBP) changes is associated with the direction of impact have been scarcely addressed in previous studies.OBJECTIVE: To observe the change in the serum MBP levels and morphological changes of the brain tissue rabbits with craniocerebral injury resulting from impacts from different directions.DESIGN: A randomized controlled experiment.SETTING: Department of Neurosurgery of a hospital affiliated to a medical university.MATERIALS: This study was conducted in the Central Laboratory of Shenyang Medical College between October 2003 and January 2004. Totally 30 healthy rabbits of either sex were randomly divided into two equal groups to receive vertical and horizontal impact on the head.METHODS: All the rabbits were anesthetized and fixed in prone position onto a table equipped with a device for inducing impact on the head from different directions. Venous blood of 1 mL was taken from the edge of the ear of each rabbit for detecting MBP before injury. The rabbits in vertical impact group received the impact of a hammer falling directly on the parietal bone of the skull. In the horizontal group, the rabbits were subjected to horizontal impact on the lateral side of the skull. Forty-eight hours after the injury, venous blood were again taken for MBP measurement. The rabbits were then killed for pathological examination of the brain.MAIN OUTCOME MEASURES: Changes in serum MBP and pathomorphology of the brain tissues in the two groups after the impact.RESULTS: ① According to intention to treat analysis, all the 30 animals were involved in the experiment. There was no significant difference in serum MBP levels between the two groups before the impact, nor 48 hours after the impact( P ＞ 0.05). In the vertical impact group, serum MBP levels before the impact was( 1.68 ± 0. 86) μg/L, which was significantly lower than that after the impact[ (5.25 ± 1.96) μg/L, t = 3. 226, P ＜ 0. 05]. ② In the horizontal strike group, serum MBP also significantly increased from the level of( 1.70 ± 0.91 ) μg/L before impact to(5.73 ± 2.07) μg/L after that( t = 3. 080, P ＜ 0.05) . ③ After the impact, vasodilation and congestion in the cortex near the midline of the bilateral parietal region and edema in the deep layer of the white matter were observed in the vertical impact group, along with significant enlargement of the extravascular and extracellular space. In the horizontal group, similar changes except those near the midline of the bilateral parietal region took place after the impact; the same pathological changes were also observed in the basal plane, with nearly identical pathological changes in the deep layer of the white matter.CONCLUSION: Vertical and horizontal impacts can both result in almost identical brain injuries demonstrated by similar changes in serum MBP and the pathomorphology of the brain tissues after the impacts.

Objective To investigate the level of human cytomegalovirus(HCMV)specific CD8+ T lymphoeytes in peripheral blood and the immune reaponae of HCMV reactivation after kidney transplantation.Methods Thirty-eight HCMV seropesitive HLA-A*0201 kidney transplant recipients(9 with HCMV infection and 29 without HCMV infection)and 54 healthy individuals were enrolled.The levels of total HCMV specific CD8+ T cells were measured using HLA-A2 pentamer folded with HCMV-peptide NLVPMVATV.The levels of IFN-γ secreting CD8+ T cells were measured by intracelluhr IEN-γ staining pulsed with the same peptide.Results The median levels of pentamer stained CD8+ T cells were 1.19%(0-19.42%),1.20%(0-18.40%)and 3.2%(0.51%-18.90%)in healthy group,negative HCMV group and positive HCMV group(H=5.34,P＞0.05),respectively.The median levels of IFN-γ secreting CD8+ T cells were 0.72%(0-0.70%),0.47%(0-5.61%)and 0.67%(0.07%-4.00%),respectively(H=0.58,P＞0.05).However,the mean proportions of IFN-γ secreting pentamer stained T cells relative to total HCMV specifc CIL were(60.18±19.16)%,(39.19±17.22)% and(20.02±13.26)%,respectively.There were significant differences among the groups(P＜0.01).Condusiorm There was no significant difference of levels of HCMV specific CD8+ T lymphocytes in peripheral blood between the kidney transplant recipients and healthy individuals.However,the proportion of HCMV-specific IFN-γ producing CD8+ T cells in pentamer stained cells was reduced in the kidney transplant recipients especially in those with active HCMV infection,which may contribute to the inability to control HCMV reactivation.

Objective To investigate the preventive effect of oral ulcer using two methods in radio-therapeutic patients after tongue squamous cell carcinoma operation. Methods Thirty-six radiotherapeutic patients after tongue squamous cell carcinoma operation were collected from May 2012 to May 2014 and divided into control group and treatment group according to the random number table method. Regular oral nursing was administered to control group, treatment group were received regular therapy plus orally vitamin B and cetylpyridinium chloride gargle for gargling, and then evaluated the efficacy according related standards. Results Less oral ulcer (1/18 vs.7/18,χ2=-2.372,P<0.05), better oral lustration (Z=-2.093,P<0.05) and overall oral nursing effect (Z=-2.166,P<0.05) were observed in treatment group compared to control group after 7 days of therapy, however, treatment group presented no significantly better comfort level at the same time (Z=-1.708,P>0.05). Conclusions Regular therapy plus orally vitamin B and cetylpyridinium chloride gargle for gargling are effective for the prevention of oral ulcer in radiotherapeutic patients after tongue squamous cell carcinoma operation.