Objective To evaluate the acute effects of different calcium concentration dialysate (1.25 mmol/L, 1.5 mmol/L, 1.75 mmol/L) on calcium balance and intact parathyroid hormone(iPTH) in maintenance hemodialysis(MHD) patients with normal serum tCa, and to provide scientific basis for individualized calcium concentration dialysate formula. Methods Dialysate with different calcium concentration (DCa1.25, DCa1.5, DCa1.75) was used in twelve stable MHD patients. Serum tCa, iCa(normalized to pH 7.4) and iPTH were assessed before and after each dialysis session with different calcium concentration dialysate. The iCa from fresh dialysate, spent dialysate at every 30 minutes interval and final total mixed spent dialysate were examined respectively. Phosphorus removal was also determined. Arterial blood pressure(BP) was measured every 30 minutes during hemodialysis session. Results With the DCa1.25, mean calcium loss was 5.03 mmol, but no significant changes of serum iCa and tCa between pre dialysis and post dialysis were found. Serum iPTH increased from (127.17?89.22)pg/ml to (281.92?244.84)pg/ml significantly (P

Medical professionalism is an important part of competencies which physicians are acquired to own.Team of physician's competency model construction and education revolution project concluded the current situation and theoretical cognition of physician's professionalism of experts from medical education and administration organizations in China according to the results of the first round of Delphi.Meanwhile,suggestions for the further improvement of physician's professionalism were pro

Objective To study the diagnostic value of coronary disease with 16-slice spiral CT.Methods 35 patients with coronary heart disease(CHD) were divided into two groups according to the risk rate of CHD:group 1 with acute coronary artery syndrome(ACS)(including acute myocardial infarction,AMI;unstable angina,UA);group 2 with stable angina(SA).They were studied by 16-slice spiral CT(retrospectively ECG-gating,0.5 s ratation),the images were reconstructed by survey methods to display the coronary artery atherosclerosis plaques,then to evaluate the nature of plaques by detecting CT value of plaque(using the standard of the CT value of the coronary artery atherosclerosis plaque of Schroeder)and to analyze the degree of the stenosis of coronary artery caused by the different type of plaque.Results There were 19 soft plaqes,11 middle plaques and 7 calcification plaques in ACS group;3 soft plaqes,3 middle plaques and 11 calcification plaques in SA group.There was a positive relation between soft plaqes and middle plaques with the risk rate of CHD,especially soft plaque(P

Objective To evaluate the prognostic accuracy of the score of toxic epidermal necrolysis (SCORTEN) scoring system in patients with toxic epidermal necrolysis (TEN) or Stevens-Johnson syndrome (SJS).Methods Clinical data were collected from 39 patients with SJS/TEN hospitalized in Peking Union Medical College Hospital during April 1992 and March 2014,and retrospectively analyzed.Among the 39 patients,13 had died,and the other 26 patients,who were matched to the dead patients in a ratio of 2:1 for age,all had a definite diagnosis and were discharged with improved conditions.The SCORTEN scoring system was used to evaluate the 39 patients with SJS/TEN and calculate expected mortality.The expected mortality and actual mortality were compared between different groups stratified by age in the 39 patients.The receiver operating characteristic (ROC) curve was drawn to assess the prognostic accuracy of the SCORTEN scoring system.Results According to the SCORTEN scoring system,15 out of the 39 patients scored 1 point,14 scored 2 points,6 scored 3 points,and 4 scored 4 points.The total number of expected deaths was 6.808,while that of actual deaths was 13.There was no significant difference between the expected mortality and actual mortality in every SCORTEN score-based group.The area under curve (AUC) was 0.832 8,indicating a good predictive ability of the SCORTEN scoring system.Conclusion The SCORTEN scoring system can predict mortality in TEN/SJS patients at early stage.

Objective To explore the effects of diabetes mellitus on the left ventricular geometry in essential hypertension(EH). Methods Patients with hypertension admitted between 2000 to 2007 were retrospectively analysed.Those meeting the study criteria were divided into EH group(n=1660) and EH with diabetes mellitus group(n=953).The general data,biochemical parameters and echocardiographic findings were analysed. Results Compared with EH group,the age,course of hypertension,body mass index,systolic blood pressure,fasting blood glucose and triglyceride were increased(P

BACKGROUND:Extracorporeal shock wave has been shown to influence the physiological function of endothelial cel s via the activation of mechanoreceptors and specific signal transduction system, and gene expression regulation.
OBJECTIVE:To explore the impact of different energy flow densities and numbers of shots of extracorporeal shock waves on the new vessel formation ability, migration capability and apoptosis of bone microvascular endothelial cel s.
METHODS:Bone microvascular endothelial cel s isolated from the femoral head of patients undergoing arthroplasty were subcultured in vitro, and then were immunofluorescently evaluated with endothelial cel marker antibodies to CD31 and von Wil ebrand factor (vWF), and grouped according to different energy flow densities (low, 0.03 mJ/mm2;high, 0.11 mJ/mm2) and numbers of shots (400 and 800). Capil ary-like tube formation, migration capability and apoptosis of bone microvascular endothelial cel s were determined by 3-D culture in vitro, scratch test, and flow cytometry, respectively.
RESULTS AND CONCLUSION:vWF and CD31 were positively expressed in approximately 100%of bone microvascular endothelial cel s, which indicates the cultured cel s had characterization of microvascular endothelial cel s. Extracorporeal shock wave enhanced angiogenesis and migration capability of bone microvascular endothelial cel s derived from the femoral head, and especial y low-energy flow density of extracorporeal shock wave exerted more superior effects. Angiogenesis of bone microvascular endothelial cel s was decreased with the increased shot number in the low-energy flow density group. In addition, extracorporeal shock wave inhibited bone microvascular endothelial cel apoptosis induced by steroids. Our results suggest that energy flow density and number of shots of extracorporeal shock waves impact the physiological function of bone microvascular endothelial cel s derived from the femoral head.

Objective To explore the effect and injury mechanism of reactive oxygen species (ROS) after spinal cord injury (SCI) through detecting the dynamic changes of malonyldialdehyed (MDA)content in spinal cord and observing neurocyte apoptosis and correlation apoptosis factor expression after SCI. Methods Totally 132 adult SD male rats were randomly divided into three groups: sham group, SCI group, methylprednisolone (MPSS) group. The SCI of SD rats was performed by Allen's weight dropping way to impact on the posteriors of spinal cord T_(10). The contents of MDA were determined by chromatometry, the expression of Caspase-3 and Bcl-2 family in the injured spinal cord was detected by immunohistochemical staining;Apoptotic cells were detected by using fluorometric terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (fluorometric TUNEL) staining. Results The content of MDA in the injured cord increased significantly after SCI;R3eached the peak at 6 hours and 3 days post-injury, then dropped down gradually, then was back to the normal level after 7 days. The number of TUNEL labeling positive cells of SCI group increased at 6 hours post-injury;R3eached the peak at 3 days, then dropped down gradually;Bcl-2, Bax protein began to increase at 6 hours post-injury;R3eached the peak at 5 days after injury, then dropped down gradually. Caspase-3 protein began to increase at 6 hours post-injury;R3eached the peak at 3 days after injury, then dropped down gradually. The content of MDA, the number of TUNEL labeling positive cells, the expression of Caspase-3 and Bax of MPSS group decreased significantly than that of SCI group at the same time;R3espectively, while Bcl-2 protein was up-regulated after administration of MPSS.Conclusion ROS could promote the expression of Caspase-3 and degrade the ratio of Bcl-2/Bax to induce apoptosis of neurocyte, which might play significantly role in the process of secondary SCI. In addition, MPSS exerts neuroprotective effects against ROS toxicity, which might be of importance and might contribute to their clinical efficacy for the treatment of SCI.

Objective To observe the effects of intensive insulin treatment on islet β cell apoptosis associated protein bcl-2 and bax in type 2 diabetic rats.Methods 36 Wistar rats were randomly divided into two groups : normal control group and high fat diet group.Rats in normal control group fed by basical feedstuff.Rats in high fat diet group fed by high fat and basical feedstuff.After 10 days,rats in high fat group were injected with STZ.After 3 days,rats in high fat group were randomly divided into two groups:diabetes control group and insulin treatment group.The course of treatment was 4 weeks.After 10 days by fat milk intragastfic administration, after 3 days of STZ injection and after 4 weeks treatment, each index was measured.After experiment, pancreatic tissue bel-2 and bax were detected through immunohistocbemical method.Results After 4 weeks intensive insulin treatment,the bcl-2 was significantly increased at(6.20 ± 2.05 )% in insulin treatment group than diabetes control group.The bax was significantly decreased at ( 2.68 ± 1.04 ) % in insulin treatment group than diabetes control group ( P < 0.05 ).Conclusion The method of insulin intensive treatment could increase islet βcell bcl-2 and decrease bax in type2 diabetic rots, Insulin intensive treatment could decrease islet β cell apoptosis.

ObjectiveTo investigate the effectiveness and safety of insulin glargine in the treatment of patients with type 2 diabetes mellitus (T2DM),and verify the new remedy called one central and three steps for T2DM.MethodsUsed multicenter,random,open and self-control study.Two hundred and three cases with T2DM treated with insulin glargine were divided into four groups according to different therapy:30 cases with one needle method,106 cases with one needle and one pill method,48 cases with one long-acting and several short-acting method,and 19 cases with one long-acting,one pill and several short-acting method.The changes of blood glucose,glycosylated hemoglobin (HbA1c),weight and so on before and after treatment were observed.ResultsThe levels of fasting plasma glucose(FPG),2 h postprandial plasma glucose (2hPPG) and HbA1c decreased significantly after treatment than those before treatment[(5.78 ±0.76)mmol/L,(8.37 ±:1.37) mmol/L,(6.81 ±0.38)％ vs. (11.73 ±4.49) mmol/L,(16.73 ±4.96) mmol/L,(9.43 ± 2.31 )％,P ＜ 0.01 ].The weight and body mass index had no obvious changes before and after treatment( P ＞ 0.05 ).There was significant difference in the level of FPG,2hPPG and HbA1c before and after treatment in four groups respectively(P＜0.01 ).There was only 1 case who occurred hypoglycemia during the treatment.ConclusionThe therapy,one central and three steps,is not only effective and safe,but also convenient and cheap for T2DM.

Objective:To construct suitable vectors for the secretory expression of hirudin in Pichia pastoris.Methods:The α-facor-hirudin gene was amplified from pPIC9-hirudin by PCR and sub-cloned into PA0815.The multi-copy recombinant plasmid pA0815-(α-Hirudin)n was constructed.The recombinant was transformed into P.pastoris strain GS115 for induction expression and then the activity of secreted products was identified.Results:A new multi-copy vector pA0815-(αHirudin)n was successfully constructed and was capable of secreting recombinant hirudin efficiently,which was confirmed respectively by PCR and SDS-PAGE.The products possessed the activity of thrombin inhibitor.Conclusion:This result offers efficient P.pastoris stains for mass production of biological active hirudin.