Objective To evaluate the different methods of blood purification for acute septic renal injury (AKI) in respect of outcome by using RIFLE(risk,injury,failure,loss and end-stage renal disease)criteria and A-PACHE Ⅱ score. MethodData of 96 patients with ASRI admired to ICU of Tianhe Hospital, Tianjin, from March 2004 to September 2006 were analyzed. Including criteria: 2001 International Sepsis Definitions Conference and 2004 RIFLE criteria of AKI. The methods of blood purification used continuous renal replacement therapy (CRRT, n=54) and imermittent hemodialysis (IHD, n=42).The patients of CRRT group could be classified into stages Ⅰ, Ⅱ and Ⅲ referred to RIFLE criteria. Excel was evaluated to set up clinical data base from documented material. Data were analyzed with SPSS version 11. 5 software. Physical signs, laboratory findings, variation of APACHE Ⅱ score and outcomes of patients were documented evaluated. Data of two groups compared using indepent samples T test, before and after the treatment compared using paired-samples T test, rate compared using chi-square test. Results①There were no statistical differences in APACHE Ⅱ score and creatinine (Cr) between CRRT group and IHD group before treatment (P>0.05). The mortalities of CRRT group and IHD group were 51.9％ and 52.4％, respectively (P>0.05), but the recovery rates of renal function in CRRT group and IHD group were 92.3％ and 65.0％ ,respectively (P< 0.05).②Mean arterial pressure (MAP),oxygen saturation (SpO2) of CRRT group were lower than those of IHD group (P<0.05) and they increased to some extent after treatment (P< 0.05). ③In the patients of stag Ⅰ ,the survival rate was 78.6％, APACHE Ⅱ score was 25.4± 2.5 before treatment, renal function recovery rate was 90.9％ ,and APACHE Ⅱ changed - 13.6 ± 4.3, while those relevant markers in the patients of stage Ⅲ were 38.1％, 36.1 ± 5.7,62.5 ％ and - 7.1 ± 4.2, respectively (P<0.05). ConclusionsThe RIFLE criteria has guiding significance for the early diagnosis and prognosis of ASRI,and the RIFLE and APACHE Ⅲ score may help to choose the optimum opportunity of treatment and the early CRRT as soon as possible after diagnosis can improve the outcome of patients with acute septic renal injury.

Poly(diallyldimethylammonium chloride)(PDDA) was chosen to disperse multi-walled carbon nanotubes(MWCNTs) to prepare the stable PDDA-MWCNTs aqueous dispersion. Then, the positively charged PDDA-MWCNTs composite and negatively charged choline oxidase(ChOx) were employed to fabricate multilayer films on platinum(Pt) electrodes by layer-by-layer self-assembly technique, the anti-interferential film of Nafion was dropped at the end of the last multilayer films. The results showed that MWCNTs were evenly dispersed within the PDDA films and the multilayer films of (PDDA-MWCNTs)_n could improve the catalytic current response to choline significantly with the increased number of the multilayer films. The optimum assembly number was 6. The choline biosensor fabricated showed good linear correlation from 5×10~(-6)-2.5×10~(-4) mol/L with a detection limit of 2×10~(-6) mol/L(S/N=3), and the sensitivity was 21.97 mA/mol with a response time of 6.6 s, the RSD was less than 5%(n=3). Moreover, the biosensor exhibited an excellent anti-interferential property and a good stability.

Objective To study the effect of magnesium/selenium on the expression of matrix metalloproteinases-20(MMP-20) and kallikrein 4(KLK4) during fluorosis in mice and to explore the formation mechanism of dental fluorosis.Methods Eighty SPF male ICR mice were randomly divided into 8 groups according to body weight:control group,magnesium group,selenium group,magnesium-selenium group,fluoride group,magnesium-fluorine group,selenium-fluorine group and magnesium-selenium-fluorine group.Mice in control,magnesium,selenium and magnesium-selenium groups were fed double steamed water,and mice in the other four groups were feddouble steamed water with 50 mg/L F.Mice in control and fluoride groups were fed conventionally.Mice in magnesium and magnesium-fluorine groups were fed conventionally by adding MgSO4·7H2O 162.5 mg/kg.Mice in selenium and selenium-fluorine groups were fed conventionally by adding Na2SeO3·5H2O 2 mg/kg.Mice in magnesium-selenium and magnesium-selenium-fluorine groups were fed conventionally by adding MgSO4· 7 H2O 162.5 mg/kg + Na2SeO3·5H2O 2 mg/kg.Incisor specimens were obtained after the mice were put into death when they were 42 days.The expressions of MMP-20 and KLK4 were observed by using immunohisto-chemicalstain.Results The meangray value of MMP-20 of fluoride group(133.1±10.3) was significantly higher than that of control group(116.8±10.0),magnesium group (113.6 ± 9.6),magnesium-selenium group(108.2 ± 15.2),magnesium-fluorine group(Ill.1 ± 8.1) and magnesium-selenium-fluorine group(108.2 ± 11.0),respectively(F=3.864,P＜0.05).The mean gray value of MMP-20 of magnesium-selenium-fluorine group(108.2 ± 11.0) was significantly lower than that of selenium group(125.4 ± 7.9),fluoride group (133.1 ± 10.3) and selenium-fluorine group(126.2 ± 2.8),respectively(F=3.864,P＜0.05).The mean gray value of KLK4 of magnesium-selenium group(117.2± 11.7) was significantly lower than others(137.3±7.9 of control group,144.2±7.7 of magnesium group,138.9±13.3 of selenium group,149.7± 12.4 of fluoride group,148.9±7.5 of magnesium-fluorine group,140.6± 17.0 of selenium-fluorine group and 140.7 ± 7.3 of magnesium-selenium-fluorine group,F=3.668,P＜0.05).In factorial analysis of fluorosis mice,magnesium had effect on the expression of MMP-20(F=42.613,P＜0.05),selenium had effect on the expression of KLK4(F=6.649,P＜0.05).Conclusions The excessive fluoride could inhibit the expressions of MMP-20.The excessive fluoride hadno significant influence on the expression of KLK4.Magnesium and selenium had antagonistic effect on the dental fluorosis.

Objective To investigate the efficacy and safety of regional citrate anticoagulation (RCA) for continuous veno-venous hemofiltration (CVVH) in patients with severe trauma.Methods Sixty-four patients with severe trauma who needed to apply continuous renal replacement therapy (CRRT) and were admitted into the department of critical care medicine in Tianjin Hospital from June 2013 to August 2015 were enrolled in the study.According to the patient's actual condition,they were divided into two groups:no anticoagulant group (29 cases) and RCA group (35 cases).The filter lifetime,after treatment the activated partial thromboplastin time (APTT),acid-base balance,free calcium ([Ca2+]i) and serum sodium (Na+) concentrations,bleeding episodes were compared between the two groups.Results The average filter lifetime in RCA group was longer than that in no anticoagulant group (hours:50.7 ± 11.3 vs.4.9 ± 1.2,P ＜ 0.01).After the end of treatment,the levels of APTT (s:30.7 ± 8.8 vs.32.1 ± 7.3),pH value (7.41 ± 0.09 vs.7.40 ± 0.07),[Ca2+]i (mmol/L:2.13 ± 0.20 vs.2.21 ± 0.17),and Na+ (mmol/L:139 ± 8 vs.141 ± 6) were ofno significant differences between the RCA group and the no anticoagulant group (all P ＞ 0.05).The incidence of clinicalbleeding in RCA group was lower than that in no anticoagulant group [2.9％ (1/35) vs.13.8％ (4/29)],but the differencewas not statistically significant (P ＞ 0.05).Conclusions RCA-CVVH is a safe and effective therapeutic method inpatients with severe trauma who need for CRRT,the stability of internal environment is not affected and no incidence ofclinical bleeding event is increased.

Objective:To comprehensively understand the operational status and existing problems of the neurosurgery professional training bases for standardized residency training in Guangdong Province.Methods:According to the scoring rules of "Standardized Residency Training Evaluation Indicators—Surgery (Neurosurgery) Professional Base" formulated by the Post-Graduation Medical Education Neurosurgery Professional Committee of the Chinese Medical Doctor Association, 28 training bases were supervised and evaluated. The scoring results of the supervision of 28 neurosurgery training bases were collected, and the training bases were divided into two categories according to the traditional teaching history, 6 affiliated hospitals of traditional medical schools and 22 non-traditional affiliated/teaching hospitals. GraphPad 5.0 software was used for statistical analysis of the 14 core indicators, and t-test, variance analysis and Chi-square test were used for analysis. Results:The results showed that there was a statistically significant difference in the compliance rate of 14 core indicators between traditional teaching hospitals and non-traditional teaching hospitals ( P = 0.003), skill operation and type and number of surgeries ( P = 0.041) and student rotation plan ( P = 0.012). The differences were also statistically significant. Conclusion:This study reveals that the comprehensive management ability of training bases in traditional teaching hospitals is significantly better than that in non-traditional teaching hospitals. Additionally, it's suggested to strengthen the construction of professional bases, enhance the institutionalized management of bases, and thus realize the homogenization training of neurosurgery residents.

OBJECTIVETo examine the expression profile and immunofluorescence localization of the major egg antigen p40 of Schistosoma japonicum (Sjp40) during granuloma formation in the liver of infected New Zealand white rabbits.

METHODSNew Zealand white rabbits were infected with S. japonicum cercariae, and the livers were harvested at 29 and 45 days post-infection (dpi). The total RNA of the liver tissues was extracted for expression profiling of Sjp40 by quantitative reverse transcription-PCR (qRT-PCR) with GAPDH of S. japonicum as the endogenous reference gene. The expression of Sjp40 in the liver were detected by Western blotting using anti-Sjp40 monoclonal antibody (mAb) 9G7 or anti-Toxoplasma gondii tSAG1 mAb Y3A8 (control) as the primary antibody. Paraffin sections of the liver were prepared for observing egg granuloma formation using HE staining and for indirect immunofluorescence assay of Sjp40 location in the trapped eggs and egg granulomas.

RESULTSThe level of Sjp40 mRNA in the eggs trapped in rabbit livers was significantly higher at 45 dpi than that at 29 dpi (P<0.05), and Western blotting confirmed the presence of Sjp40 protein in the rabbit livers at both 29 and 45 dpi. Immunofluorescence assay demonstrated localized expression of Sjp40 in the immature eggs in the rabbit liver at 29 dpi, but at 45 dpi fluorescence was detected in clusters of mature eggs containing miracidium and in the surrounding egg granulomas.

CONCLUSIONSThe transcriptional levels of Sjp40 significantly increased with the maturation of eggs trapped in the rabbit livers. Sjp40 protein spread from the eggs to the surrounding egg granuloma at 45 dpi when acute liver granulomatous lesions occur, suggesting that Sjp40 plays a key role in egg granulomas formation in the livers of infected New Zealand white rabbits.

Animals ; Antibodies, Monoclonal ; Antigens, Helminth ; metabolism ; Fluorescent Antibody Technique ; Gene Expression Profiling ; Granuloma ; parasitology ; Helminth Proteins ; metabolism ; Liver ; parasitology ; RNA, Messenger ; Rabbits ; Schistosoma japonicum ; Schistosomiasis japonica

With wide applications of radiation therapy in the treatment of cancer and other diseases and amid the in-creasing concerns about global nuclear safety,the research and development of drugs against radiation damage has become a hot spot.Thanks to its high energy properties,ionizing radiation can not only directly damage cell DNA through targeted effects,but also indirectly affect the cell environment through non-targeted effects,leading to cell dysfunction and even death.In this paper,the mechanism of ionizing radiation damage was analyzed,and the mechanisms of action and clinical applications of four types of anti-radiation drugs,namely,antioxidant,apoptosis inhibitor,cytokine and natural radiation protection agent were discussed.These drugs have huge implications for alleviating the targeted and non-targeted effects caused by ionizing radiation.

Objective:To analyze clinical significance of peripheral blood neutrophil CD64(nCD64)index in patients with anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV).Methods:The clinical data of 98 AAV patients admitted to the First Medical Center of Chinese People's Liberation Army General Hospital from February 1,2023 to February 29,2024 were retrospectively selected,and they were divided into the high-value group(nCD64 index＞1.82,28 patients)and the normal-value group(nCD64 index≤1.82,70 patients)based on the nCD64 index.Ethylenediaminetetraacetic acid(EDTA)-anticoagulated venous blood specimens were collected from patients in both groups,and the mean fluorescence intensity of CD64 expression on the surfaces of polymorphonuclear leukocytes(PMN),lymphocytes(Lym)and monocytes(Mo)was detected by flow cytometry.Clinical manifestations,relevant examination data of hospital,and survival situation of patients with regular follow-up were compared between the two groups.Results:Spearman correlation analysis showed that peripheral blood nCD64 index was positively correlated with Birmingham vasculitis activity score(BVAS)in AAV patients(r=0.216,P＜0.05).There were no statistically significant differences in white blood cells(109/L),blood creatinine(μmol/L),CD8+lymphocytes(amount/μl),CD3-CD16+CD56+lymphocytes(amount/μl),blood sedimentation and interleukin 6 between the two groups.The mean values of BVAS,neutrophils(109/L),CD8+CD28-lymphocytes(％)were respectively(14.96±8.62),(7.51±4.56),(22.16±13.28)in high-value group,which were significantly higher than those[(11.88±7.39),(6.32±3.60)and(17.32±11.27)]in normal-value group,and the mean values of lymphocytes(109/L),platelets(109/L),hemoglobin(g/L),CD3+lymphocytes(amount/Al),CD4+lymphocytes(amount/μl),CD8+CD28+lymphocytes(％)were respectively(1.52±1.01),(216.84±92.32),(106.26±21.99),(1401.15±658.22),(618.43±420.50)and(12.43±5.98)in high-value group,which were significantly lower than those[(1.98±0.95),(248.20±97.21),(114.30±24.71),(1815.43±657.29),(969.15±385.72)and(15.77±7.66)]in normal-value group,and the differences of them between two groups were statistically significant(t=-2.68,-2.04,-2.54,3.25,2.26,2.34,2.02,2.84,3.02,P＜0.05),respectively.Neutrophil/lymphocyte ratio and C-reactive protein of high-value group were higher than those of normal-value group,and eosinophils of high-value group were lower than that of normal-value group,and the differences of them between two groups were statistically significant(Z=-3.370,-2.396,-4.462,P＜0.05),respectively.Conclusions:Peripheral blood nCD64 index is positively correlated with BVAS in AAV patients,which involve in multiple immune cells and inflammatory factors.It has clinically application value in monitoring the disease progression and assessing the prognosis.

Per-and polyfluoroalkylated substances (PFASs) are a group of persistent organic pollutants that are widespread in the environment and organisms. Given their unique hydrophobicity, oil-repellence, and chemical stability, PFASs are widely used in various industrial and commercial products. PFASs can accumulate and be biomagnified through the food chain, and its toxic effects have posed a certain threat to human health. The response of the immune system to PFASs exposure is one of the most sensitive human health effects, and has attracted remarkable attention from related scientists and organizations. We summarized international and domestic epidemiological studies on the associations between exposure to PFASs and immune system, including immunosuppression and immunoenhancement. We also reviewed experimental evidence of PFASs on immune system from perspectives of immune organs, immune cells, and cytokines. Furthermore, the possible mechanisms of peroxisome proliferator-activated receptor-α (PPAR-α)-dependent, nuclear factor-κB (NF-κB)-activated, and mitochondrial apoptosis pathways were summarized. While the relationships between PFASs and immune-related diseases in human are not yet conclusive, accumulative epidemiological studies provide evidence for associations between PFASs and reduced immune response to vaccination in children. In addition, previous studies mainly focus on the immunotoxicity of traditional PFASs, and our understanding of the molecular mechanism of the effects of PFASs on immune system is still in its infancy. Therefore, it is necessary to further explore the immunotoxicity of new PFASs and associated mechanism.

Background Exercise during pregnancy is closely related to maternal and infant health. Previous studies in developed countries have linked maternal exercise during pregnancy with newborn body weight as well as subcutaneous fat thickness. However, the relevant studies in China are limited, and the conclusions remain inconsistent. Objective To investigate the effects of maternal exercise during pregnancy on neonatal weight and subcutaneous fat thickness. Methods Based on the Shanghai Birth Cohort, 959 maternal-infant pairs were included in this study. The International Physical Activity Questionnaire was used to collect average weekly frequency and daily minutes of walking in the first and second trimesters, and entropy weight method was used to calculate the cumulative exercise index in the two trimesters. Birth weight was measured using a calibrated weigh scale. Subcutaneous fat thickness was measured at abdomen, scapula, and triceps with a Harpenden skinfold caliper for all newborns and the sum of the thickness for the three sites was then calculated. A multiple linear regression model was employed to estimate the relationships of cumulative exercise index during pregnancy with neonatal body weight and subcutaneous fat thickness. Subgroup analyses stratified by pre-pregnancy body mass index (BMI) and sex of newborns were also performed. Results The mean age of pregnant women was (28.5±3.8) years, and the pre-pregnancy BMI was (21.4±3.0) kg·m⁻². Newborn boys were slightly more than newborn girls (54.3% vs 45.7%), and the neonatal weight was (3374.0±427.5) g. The means of newborns' abdominal, scapular, and triceps subcutaneous fat thickness were (4.4±1.3), (5.4±1.4), and (6.0±1.5) mm, respectively, and the sum of subcutaneous fat thickness was (15.8±3.9) mm. In the first and second trimesters, 77.3% and 88.7% of pregnant women walked 4 d per week and more, respectively; the daily minutes of walking was (36.9±27.2) min and (43.3±26.3) min, respectively; the cumulative exercise index was 25.6±17.7 and 35.9±21.1, respectively. The results of multiple linear regression analysis showed that the cumulative exercise index in the second trimester was negatively associated with newborns' abdominal (b=−0.006, 95%CI: −0.010-−0.003), scapular (b=−0.005, 95%CI: −0.009-−0.002), triceps (b=−0.006, 95%CI: −0.010-−0.002), and their sum of (b=−0.018, 95%CI: −0.028-−0.007) subcutaneous fat thickness (P<0.05); in the first and second trimesters, however, the relationship between maternal cumulative exercise and newborns' body weight was not significant. The results of stratified analyses showed that the negative associations between maternal cumulative exercise index and newborns' subcutaneous fat thickness for the second trimester remained significant in the subgroups of boys and neonates whose mothers had normal pre-pregnancy BMI (P<0.05). Conclusion Cumulative exercise index in the second trimester is negatively correlated with the neonatal thickness of subcutaneous fat, and the association may be altered by neonatal sexes and maternal pre-pregnancy BMI levels.