Objective:To explore and compare the clinical efficacy of lyophilized recombinant human brain natriuretic peptide (Lrh-BNP) and dobutamine (Dob) in the treatment of patients with acute heart failure (AHF) and impacts on the plasma galectin (Gal)-3,Cystatin C (CysC) and endothelin (ET-)-1 levels.Methods:114 cases of patients with AHF in our hospital from February 2015 to February 2017 were selected as the research objectives and randomly divided into two groups.Dob group was treated by Dob,while Lrh-BNP group was treated by Lrh-BNP.The cardiac function parameters,plasma Gal-3,CysC,ET-1 levels before and after treatment,clinical comprehensive efficacy and incidence of adverse reactions were compared between two groups.Results:The FS,LVEF levels of both groups at 72 hours after treatment were significantly higher than those before treatment (P＜0.01),but the LVEDD,plasma Gal-3,CysC,ET-1 levels were obviously decreased (P＜0.01),the index mentioned above of Lrh-BNP group improved more significantly than those of the Dob group(P＜0.01).The overall effective rate of Lrh-BNP group was 89.5 ％,which was significantly higher than that of the Dob group (73.7％,P＜0.05).No significant difference was found in the incidence of adverse reaction between two groups(P＞0.05).Conclusion:Lyophilized recombinant human brain natriuretic peptide was more effective in the treatment of AHF than Dobutamine with equal safety,which might be related to the decrease of plasma Gal-3,CysC,ET-1 levels.

Objective: To investigate the correlation between CXC chemokine receptor 6 (CXCR6) and prognosis of renal clear cell carcinoma. Methods: A total of 100 patients with renal clear cell carcinoma who underwent surgery in the First People's Hospital of Ziyang from January 2013 to October 2014 were selected. Immunohistochemistry was used to detect the expression of CXCR6 in 100 cases of renal clear cell carcinoma and adjacent normal tissues. The patients were followed up to observe the positive rate of CXCR6 expression and the factors affecting overall survival (OS) and progression-free survival (PFS) of renal clear cell carcinoma and adjacent normal tissues. Results: The positive rate of CXCR6 expression in renal clear cell carcinoma tissues was higher than that in adjacent tissues, and the difference was statistically significant [46.0% (46/100) vs. 20.0% (20/100), χ² = 15.287, P < 0.01]. The positive expression rate of CXCR6 in patients with clinical stage Ⅲ-Ⅳ, lymph node metastasis and pathological grade Ⅲ-Ⅳ was higher than that in patients with clinical stage Ⅰ- Ⅱ, pathological grade Ⅰ- Ⅱ and without lymph node metastasis, and the difference was statistically significant (all P < 0.05). A total of 92 patients were followed up and 40 died. The follow-up time reached to (35-60) months and the median follow-up time was 48.9 months. Kaplan-Meier and log-rank test showed that patients with positive CXCR6 expression had lower 3-year OS and PFS rate compared with patients with negative CXCR6 expression, and the difference was statistically significant (3-year OS rate: 52.1% vs. 78.6%, χ² = 10.027, P = 0.001; 3-year PFS rate: 48.3% vs. 67.8%, χ² = 4.344, P = 0.037). Cox regression multivariate analysis showed pathological grade (OS: OR = 2.154, 95% CI 1.547-9.517, P = 0.023; PFS: OR = 1.235, 95% CI 1.109-5.917, P = 0.042), lymph node metastasis (OS: OR = 1.412, 95% CI 1.109-5.917, P = 0.041; PFS: OR = 1.841, 95% CI 1.354-8.994, P = 0.010), CXCR6 expression (OS: OR = 1.864, 95% CI 1.358-6.813, P = 0.031; PFS: OR = 1.457, 95% CI 1.127-6.884,P = 0.025) were independent risk factors of OS and PFS for renal clear cell carcinoma patients treated by the surgery. Conclusions The positive expression of CXCR6 is an independent risk factor for OS and PFS of renal clear cell carcinoma. The prognosis of patients with positive CXCR6 expression is poor.

Hemophilia is a recessive inherited disorder linked to the X chromosome. On July 28, 2020, a case of hemophilia A with severe left kidney hydronephroses and acute left kidney hemorrhage was admitted to the Affiliated Hospital of Qinghai University. The patient had a family history of hemophilia A and activated partial thromboplastin before surgery. The APTT was 95.0s (reference value 22.7-31.8s), factor Ⅷ activity (FⅧ∶C) was 3.2% (reference value 70%-150%), and B-ultrasonic examination revealed severe hydronephroses in the left kidney, and the nephrogram indicated that the left kidney was absent of perfusion. On the 9th day of admission, the pain in the left lower back was aggravated than before. The CT scan of the whole abdomen revealed irregular patches with slightly higher density in the left kidney. Considering bleeding, through multidisciplinary consultation and perioperative infusion of human coagulation factor Ⅷ, the patient was underwent retroperitoneal laparoscopic left nephrectomy. There was no bleeding during and after operation. After 20 months of follow-up, the renal function and coagulation function were normal, and there were no symptoms of hematuria and low back pain.