Objective To explore the efficacy and mechanism of combined hemodialysis-hemoperfusion in treating patients with end-stage renal failure associated cutaneous pruritus. Methods Eighty-one outpatients and inpatients with end-stage renal failure associated different degree of cutaneous pruritus were randomly divided into treatment group (combined hemoperfusion-hemodialysis, 50 cases) and control group (simple hemodialysis, 31 cases). At the pretreatment and 24 weeks posttreatment, all patients' serum creatinine, blood urea nitrogen, serum total calcium, serum phosphonium, serum intact parathyroid hormone and the intensity of cutaneous pruritus (visual analog scale,VAS) were determined detected. Results Compared with pretreatment, the intensity of cutaneous pruritus of patients in treatment group was obviously alleviated (P<0.01), but it was not alleviated in control group (P>0.05), there was significant difference between two groups (P<0.01). Compared with pretreatment, serum phosphonium and intact parathyroid hormone declined obviously in treatment group [(2.69±0.46) mmol/L vs (0.98±0.39) mmol/L and (632.78±76.89) ng/L vs(342.81±39.71) ng/L] ((P<0.01), but did not decline obviously in control group (P>0.05), there was significant difference between two groups (P<0.01). Conclusions Combined hemodialysis-hemoperfusion can obviously alleviate the intensity of cutaneous pruritus of patients with end-stage renal failure, but simple hemodialysis can not alleviate it,its mechanism may be that it can clean the internal irritant toxin which leads to cutaneous pruritus well.

Objective To understand the epidemiological characteristics of HIV infection in voluntary blood donors in Liuzhou city to provide the basis for the blood donation recruit launched by the blood collection and tranfusion service agencies and reduce the risk of transfusion transmitted HIV.Methods The epidemiological investigation on the voluntary unpaid blood donors infected with HIV during 2008-2012 was performed for analyzing the infection characteristics.Results HIV infection in blood donors in Liuzhou city had no statistical difference between different years (P >0.05);the differences in different sexes,age groups,married and unmarried persons had statistically significant differences (P <0.01 );the education background less than middle school ac-counted for 52.94%;56.21% of the infectors were the sexual transmission.Conclusion HIV infection in voluntary unpaid blood donors in Liuzhou city is dominated by young adult men and the persons with the education level less than junior high school,and the heterosexual transmission is predominant.The donor recruitment work should pertinently exclude the persons of high-risk be-havior and collect blood in low risk population as far as possible.

Objective To explore the correlation and significance between adult nut-cracker phenomenon (NCP) and varicocele. Methods The clinical characters of 226 adult patient (including inpatients and outpatients)with NCP diagnosed by color Doppler ultrasound examination were analyzed retrospectively, whose chief complaints were asymptomatic bematuria or/and orthostatic proteinuria (microalbuminuria). The ratio of left renal vein inner diameter before and after being compressed≥2 was regarded as the criteria of diagnosis of NCP. Among 226 cases, 184 male NCP patients were taken as study group, and the incidence of varicocele was tested. One hundred and fifty-six male adults who had physical examination in the same period and whose ages matched with study group were taken as control group, they were not NCP patients examined by color Doppler ultrasound. The incidence of varicocele was compared between two groups. The indexes associated NCP were examined in detail in study group. Logistic regression analysis was used to study the correlation between NCP and left varicocele. Results There were 184 male patients in study group, among which there were 22 patients with left sub-clinical varicocele (accounted for 11.96%), 47 patients with left varicocele (accounted for 25.54%).The total incidence of varicocole was 37.50%(69/184). There were 156 male adults in control group, among which there were 13 patients with sub-clinical varicocole(accounted for 8.33%), 8 patients with varicocele (accounted for 5.13%).The total incidence of varicocele was 13.46%(21/156). The total incidence of varicocele in study group was significantly higher than that in control group (P=0.000). In study group, there were 22 patients with left sub-clinical varicocele,with average age (24.73±1.03) years. The inner diameter of left renal vein(LRV) in front of spine was (3.65±0.11) mm(a),the inner diameter of LRV at left side of spine was (8.41±0.11)mm(b), and b/a ratio was 2.31± 0.06. The angle between superior mesenterie artery (SMA) and abdominal aorta(AA) was (15.95±0.59)°. There were 47 patients with left varicocele, with average age(26.62±1.74)years. The inner diameter of LRV in front of spine was (3.43±0.08)mm(a),the inner diameter of LRV at left side of spine was (8.72±0.14) mm (b), and b/a ratio was 2.54±0.08. The angle between SMA and AA was (14.54±0.53)°. In study group, Lagistic regression analysis proved that male patients with NCP were complicated with varicocele easier when the angle between SMA and AA became smaller, the inner diameter of LRV at the left side of spine (b)and age increased. Conclusions Male adult patients with NCP are complicated with left varicocele, which is significantly higher than that in non-NCP male adults at the same age. It shows that NCP is one important cause for varicocele and there is a close correlation between NCP and varicocele in male adults.

OBJECTIVE To study the antibacterial activity of pazufloxacin in vitro against bacteria isolated from(patients) with respiratory and urinary tract infection,compared with levofloxacin,ciprofloxacin,cefuroxime and(cefotaxime) to provide guideline for clinical application.METHODS The infected bacteria were identified by the(fully) automatic VITEK system.The susceptibility test was determined by MIC method and K-B disk diffusion method respectively.RESULTS The sensitivity of most Gram-negative bacteria to pazufloxacin was basically the same to levofloxacin,cefotaxime, etc.However,the sensitivity of Pseudomonas and Acinetobacter to(pazufloxacin) was higher than to other four antibiotics;the sensitivity of Gram-positive cocci,particularly(Streptococcus) to(pazufloxacin) was obviously lower than cephalosporins and no better than other quinolones.(CONCLUSIONS) The antibacterial activity of pazufloxacin in vitro against the bacteria isolated from patients with(respiratory) and urinary tract infection is comparatively strong,especially in the urinary system.Pazufloxacin has an excellent broad-(spectrum) and strong antibacterial activity.However,the antibacterial activity against Gram-positive cocci is(expected) to promote.

Objective To study the clinical significance of platelet, coagulation ,and fibrinolysis alteration in perioperative period in patients with different Child classifications of cirrhosis. Methods Alterations on the platelet count and the indices of coagulation and fibrinolysis in 17 cases of Child B class who underwent portal-systemic shunt, and 6 cases of Child C class who underwent portal-azygus vein disconnection were detected. Results Before operation,except the decrease in platelet count, there as no significant difference in the indices of other platelet function, coagulation and fibrinolysis in patients with Child B class compared with control group. While in patients with Child C class, the platelet count decreased, and GMP-140, FPA and D-dimer increased greatly. After operation, GMP-140 increased in patients with Child B class, while decreased in patients with child C class. The platelet count and factorⅧ:C in patients with Child C class decreased significantly compared with those with Child B class. Conclusions Operation may induce DIC in patients with Child C class, so it is necessary to determine the fibrinogen and factorⅧ:C during the operation.

Anti-neutrophil cytoplasm antibody-associated vasculitis (ANCA) is an autoimmune disease with multi organ involvement characterized by vascular wall inflammation and fibrinoid necrosis, including microscopic polyangitis (MPA), granuloma polyangitis (GPA), and eosinophilic granuloma polyangitis (EGPA). Because its clinical manifestations are complicated and non-speciifc, it is dififcult to make early diagnose. In recent years, some new progress has been made in diagnosis and treatment of this disease. The article will review the related information.

AIM　To study the structures of the epimerides of cycloclausenamide. METHODS　The structures of compound I, extracted from Clausena lansium (Lour.) Skeels, and synthesized compound III were determined by single crystal X-ray diffraction analysis. The stereo-structures of compound II and IV were also built up through Tripos force field based on crystal structures of compound I and III. RESULTS　The molecular formula and molecular weight were found to be C18H17O2N and 279.34 respectively. Compound I crystallized in monoclinic system, space group P21 with a=0.5928(1), b=1.5014(1), c=1.6190(1) nm, V=1.4410(3) nm3, Z=4, Dx=1.288 g*cm-3, Rf=0.075, Rw=0.073(w=1/σ2｜F｜), S=3.983; compound III crystallized in triclinic system, space group P1 with a=0.5667(1), b=1.2934(1), c=2.1119(1) nm, α=102.17(1), β=90.25(1), γ=102.65(2)°, V=1.4770(5) nm3, Z=4, Dx=1.224 g*cm-3, Rf=0.047, Rw=0.051(w=1/σ2｜F｜), S=0.467. CONCLUSION　These results showed that compound I and III both are cycloclausenamide except that the directions of the phenyl group on C6 are different. Cycloclausenamide can form 4 pairs of epimerides but the directions of the phenyl group does not affect their energy in free state.

Objective To identify the changes of DNA methylation profile in the process of malignant transformation of BEP2D cell induced by α particles.Methods The genomic DNAs were isolated from the malignant transformation BERP35T4 cells and immortalized human bronchial epithelial cell line BEP2D.Genomic DNAs were digested by MseI and ligated of PCR linkers.Methylated DNAs were digested by BstUI and amplified by PCR.The methylated DNA probes were prepared by labeling with Cy3 and Cy5 fluorescence dyes individually and hybridized to the methylation CpG-Island microarray.The hybridization results were scanned and analyzed.Intensity values were quality controlled and normalized.The normalized data were used to identify the differentially expressed genes based on a 1.5 fold difference of the expression level.Results There were 16 genes which showed changes of methylation level in malignant transformation BERP35T4 cells, 9 of them were hypermethylation and 7 were hypomethylation.These genes were including the SKIP gene, PPP3CC gene, MAP2K6 gene, KIR2DL1 gene, KIR2DL4 gene, KIR3DP1 gene, ZNF493 gene, ZNF100 gene, NKX2-5 gene, TFAP2D gene, DR1 gene, KCNJ16 gene, CCDC18 gene, FNBP1L gene, IRX4 gene, EPB41L3 gene, TCP10 gene and so on.Conclusions The DNA methylation might have effects on ionizing radiation drived tumorigenesis.

AIM: To investigate the role of Forkhead box M 1 ( FoxM1 ) and B-cell leukemia/lymphoma-2 (Bcl-2) in the pathogenesis of acute myeloid leukemia (AML).METHODS:RT-qPCR and immunofluorescence analysis were used to determine the expression of FoxM 1 at mRNA and protein levels in AML-de novo patients, AML-complete re-mission (CR) patients, AML-refractoriness and relapse (RR) patients and healthy controls.HL60 cells and K562 cells were transfected with FoxM1 siRNA.The cell proliferation was detected by cell proliferation assay and colony formation as-say on soft agar, and the cell apoptosis was determined by flow cytometry .The expression of FoxM1 and Bcl-2 at mRNA and protein levels was detected by RT-qPCR and Western blotting .The activity of bcl-2 promoter was examined by lucifer-ase reporter assay with FoxM1 targetting.RESULTS:FoxM1 expression level in the AML-de novo patients was significant-ly higher than that in the healthy controls .As compared with the AML-de novo patients, FoxM1 expression in the AML-CR patients was reduced , and the FoxM1 expression level was the highest in the AML-RR patients .FoxM1 expression was in-hibited in the HL60 cells and K562 cells transfected with FoxM1 siRNA.Transfection with FoxM1 siRNA in the HL60 cells and K562 cells inhibited the proliferation as compared with NC siRNA transfection , and impaired the colony formation abili-ty.On the contrary , transfection with FoxM1 siRNA promoted the cell apoptosis .FoxM1 regulated bcl-2 expression posi-tively.CONCLUSION:FoxM1 promotes the development of AML by regulating bcl-2 expression.Silencing of FoxM1 ex-pression suppresses cell proliferation and promotes cell apoptosis .FoxM1 is a potential target for AML treatment .

Objective To analyze the therapeutic effect of percutaneous transhepatic cholangial drainage (PTCD) in the treatment of bile duct obstruction in patients with malignant hilar bile duct carcinoma,and to discuss the clinical application and practical value of PTCD.Methods A total of 55 patients with malignant biliary obstruction were divided into the PTCD group (30 cases who recieved percutaneous transhepatic cholangial drainage) and the control group (25 cases who recieved endoscopic stent implantation).Observed the preoperative and postoperative biochemical indexes of PTCD group,including serum total bilirubin (TB),serum direct bilirubin (DB),serum alanine aminotransferase (ALT) and serum glutamic acid amino turn shift of aspartate aminotransferase(AST) and serum alkaline phosphatase(AKP).Compared the effect rate and postoperative survival time of the two groups through postoperative follow-up.Results The TB,DB,ALT,AST and APK of PTCD group one week after operation changed obviously compared with the relative index before opreation with statistically significant differences (P<0.05), which indicated a significant improvement of biochemical indicators.The treatment efficiency of the PTCD group and the control group were 83.3% and 64.0% respectively, and survival time of the two groups were(7.5±2.6)months and(4.8±2.8)months respectively.Results of the PTCD group was significantly better than that of the control group,and the differences were statistically significant(P<0.05).Conclusion All the patients with PTCD get better biochemical indicators and longer postoperative survival time,and the interventional therapy PTCD can be used as an effective clinical treatment method for bile duct obstruction with malignant hilar bile duct carcinoma.