Tomato (Solarium lycopersicum) is one of the most popular vegetables worldwide and is a classic model plant for studying fruit development and ripening due to its short growth cycle, clear genetic background and ease of molecular manipulation. This paper used virus-induced gene silencing (VIGS) to construct SlWRKY53b gene-silenced tomato fruits and analyzed the effect of SIWRKY531) gene silencing in the tomato fruit ripening process. We found that transient silencing of SIWRKY531) resulted indelayed in-broken color, higher chlorophyll contents (P<0.05) and reduced carotenoid contents (P<0.05) in tomato fruits, and color difference results indicated that the differences in L *, a * and b * values were consistent with fruit color changes. Further studies showed that genes significantly down-regulated (P<0.01) in SIWRKY531) gene-silenced tomato fruits include the chlorophyll degradation-related genes (AFCl, PAO, PPH, SGR1), carotenoid synthesis-related genes (PSYl, PDS, ZDS), ethylene synthesis pathway-related genes (ACOl, ACS2, NOR, AC03, EA, RIN), and cell wall degradation-related genes (PG, EXP, CELT.). Correlation analysis showed that the expression of SlWRKY53b was negatively correlated with chlorophyll contents and positively correlated with carotenoid contents and the expression of maturation-related genes. These results suggest that inhibition of SIWRKY531) expression at the transcrip-tional level can achieve the effect of delaying tomato fruit ripening, indicating that S1WRKY531) plays arole as a facilitator in the tomato fruit ripening process.

Objective:To investigate the occurrence of drug-induced acute kidney injury (AKI) in adult hospitalized patients in Xuanwu Hospital, Capital Medical University.Methods:All medical records of adult inpatients who were discharged from January 1, 2014 to December 31, 2014 and whose diagnosis were in accordance with AKI during their hospitalization in Xuanwu Hospital, Capital Medical University were collected. The patients were divided into drug-induced AKI group and non-drug-induced AKI group according to whether AKI was caused by drugs. Basic information, comorbidity, change in serum creatinine (Scr), disease outcome, nephrotoxic medication exposure, and evaluation of the relationship between drugs and AKI of the patients were collected and retrospectively analyzed.Results:A total of 592 patients enrolled in the study, including 138 (23.31%) in the drug-induced AKI group and 454 (76.69%) in the non-drug-induced AKI group. The differences in gender, age, days in hospital, comorbidity, Scr level on admission, time for Scr level to peak after admission, and outcome between the patients in the 2 groups were not statistically significant, respectively ( P>0.05 for all). Peak value of Scr during hospitalization and at discharge in patients in the drug-induced AKI group (178 μmol/L, 116 μmol/L) were obviously higher than those in the non-drug-induced AKI group (129 μmol/L, 103 μmol/L), and the differences were statistically significant ( P<0.001, P=0.001). A total of 231 times of suspected drugs were involved in the 138 patients in the drug-induced AKI group. The top 6 types of drugs in turn were anti-infectious agents (35.06%, 81/231), diuretics (17.32%, 40/231), contrast agents (13.42%, 31/231), plasma substitutes (9.96%, 23/231), angiotensin converting enzyme inhibitors/angiotensinⅡreceptor blocker (8.23%, 19/231), and non-steroidal anti-inflammatory drugs (NSAIDs) (6.93%, 16/231). Contrast agents and plasma substitutes had the shortest (range: 1-3 days) but anti-infectious agents had the longest time (range: 1-12 days) from medication to AKI occurrence. Peak values of Scr in AKI inpatients caused by NSAIDs and contrast agents were lower [median value: 118 (103, 300) μmol/L, 133 (90, 243) μmol/L], but in those caused by anti-infectious agents was the highest [median value: 223 (138, 396) μmol/L]. Multivariate logistic regression analysis showed that hypoproteinemia ( OR=8.369, 95 %CI: 3.379-20.724, P<0.001) and advanced age ( OR=1.689, 95 %CI: 1.206-2.365, P=0.002 for every 10 years of aging) were independent risk factors related to the death of patients with drug-induced AKI. Conclusions:The patients with AKI induced by drugs accounts for 23.31% of all AKI adult inpatients in Xuanwu Hospital, Capital Medical University. Anti-infectious agents, diuretics, and contrast agents are the most common suspected pathogenic drugs. Hypoproteinemia and advanced age are independent risk factors for hospital deaths in drug-induced AKI patients.

Objective:To investigate the occurrence of drug-induced acute kidney injury (AKI) in adult hospitalized patients in Xuanwu Hospital, Capital Medical University.Methods:All medical records of adult inpatients who were discharged from January 1, 2014 to December 31, 2014 and whose diagnosis were in accordance with AKI during their hospitalization in Xuanwu Hospital, Capital Medical University were collected. The patients were divided into drug-induced AKI group and non-drug-induced AKI group according to whether AKI was caused by drugs. Basic information, comorbidity, change in serum creatinine (Scr), disease outcome, nephrotoxic medication exposure, and evaluation of the relationship between drugs and AKI of the patients were collected and retrospectively analyzed.Results:A total of 592 patients enrolled in the study, including 138 (23.31%) in the drug-induced AKI group and 454 (76.69%) in the non-drug-induced AKI group. The differences in gender, age, days in hospital, comorbidity, Scr level on admission, time for Scr level to peak after admission, and outcome between the patients in the 2 groups were not statistically significant, respectively ( P>0.05 for all). Peak value of Scr during hospitalization and at discharge in patients in the drug-induced AKI group (178 μmol/L, 116 μmol/L) were obviously higher than those in the non-drug-induced AKI group (129 μmol/L, 103 μmol/L), and the differences were statistically significant ( P<0.001, P=0.001). A total of 231 times of suspected drugs were involved in the 138 patients in the drug-induced AKI group. The top 6 types of drugs in turn were anti-infectious agents (35.06%, 81/231), diuretics (17.32%, 40/231), contrast agents (13.42%, 31/231), plasma substitutes (9.96%, 23/231), angiotensin converting enzyme inhibitors/angiotensinⅡreceptor blocker (8.23%, 19/231), and non-steroidal anti-inflammatory drugs (NSAIDs) (6.93%, 16/231). Contrast agents and plasma substitutes had the shortest (range: 1-3 days) but anti-infectious agents had the longest time (range: 1-12 days) from medication to AKI occurrence. Peak values of Scr in AKI inpatients caused by NSAIDs and contrast agents were lower [median value: 118 (103, 300) μmol/L, 133 (90, 243) μmol/L], but in those caused by anti-infectious agents was the highest [median value: 223 (138, 396) μmol/L]. Multivariate logistic regression analysis showed that hypoproteinemia ( OR=8.369, 95 %CI: 3.379-20.724, P<0.001) and advanced age ( OR=1.689, 95 %CI: 1.206-2.365, P=0.002 for every 10 years of aging) were independent risk factors related to the death of patients with drug-induced AKI. Conclusions:The patients with AKI induced by drugs accounts for 23.31% of all AKI adult inpatients in Xuanwu Hospital, Capital Medical University. Anti-infectious agents, diuretics, and contrast agents are the most common suspected pathogenic drugs. Hypoproteinemia and advanced age are independent risk factors for hospital deaths in drug-induced AKI patients.

Pharmacokinetic parameters can be significantly altered for acute kidney injury (AKI), extracorporeal membrane oxygenation (ECMO) and continuous veno-venous hemofiltration therapy (CVVH). Here we reported a case of individualized vancomycin dosing for a patient diagnosed as severe acute pancreatitis treated with concurrent ECMO and CVVH. A 65 kg 32-year-old woman was admitted to hospital presented with severe acute pancreatitis (SAP), respiratory failure, metabotropic acidosis and hyperkalemia. She was admitted to intensive care unit (ICU) on hospital day 1 and was initiated on CVVH. She progressed to multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) on ICU day 2, and veno-venous ECMO was instituted. Several catheters were inserted into the body to support ECMO, CVVH and pulse indicator continuous cardiac output (PiCCO), so vancomycin was prescribed empirically on ICU day 3 for prevention of catheter-related infection. Given the residual renal function and continuous hemofiltration intensity on day 3, vancomycin bolus of 1 000 mg was prescribed, followed by a maintenance dose of 500 mg every 8 hours. On ICU day 4, a vancomycin trough serum concentration of 14.1 mg/L was obtained before the fourth dose, which was within the target range of 10-20 mg/L. By ICU day 7, vancomycin dosage was elevated to 1.0 g every 12 hours because of aggravated infection and improved kidney function. On ICU day 14, a vancomycin trough serum concentration of 17 mg/L was obtained. Her white blood cell (WBC) and neutrophil percentage (Neut%) dropped to the normal level by ICU day 19. This vancomycin regimen was successful in providing a target attainment of trough serum concentration ranging from 10-20 mg/L quickly and in controlling infection-related symptoms and signs properly. With the help of this case report we want to call attention to the clinically significant alteration in vancomycin pharmacokinetics among critically ill patients. Individualized vancomycin dosing regimens and therapeutic drug monitoring are necessary for critically ill patients receiving CVVH and ECMO to ensure that the target serum vancomycin levels are reached to adequately treat the infection and avoid nephrotoxicity.
Adult ; Anti-Bacterial Agents/administration & dosage* ; Critical Illness ; Extracorporeal Membrane Oxygenation ; Female ; Hemofiltration ; Humans ; Pancreatitis/drug therapy* ; Vancomycin/administration & dosage*

Objective To investigate the relationship between carotid intima media thickness (IMT) and pulse pressure index (PPI) in elderly hypertensive patients.PPI was defined as 24 h mean pulse pressure(PP)/24 h mean SBP.Methods One hundred and three elderly hypertensive patients were categorized by PPI level:group A (PPI

OBJECTIVETo explore the therapeutic effect of Pushen capsule (PSC) in treating primary hyperlipidemia.

METHODSTwo hundred and forty patients with primary hyperlipidemia were randomly divided into two groups, the 120 patients in the treated group treated with PSC (4 capsules, tid) and the 120 patients in the control group treated with Zhibituo tablet (3 tablets, tid), and they were administered at the same time with Zhibituo placebo. The therapeutic course for both groups was 4 weeks. The therapeutic effect and the effects on blood lipids and viscosity were observed.

RESULTSThe effective rate in the treated group was 76.3%, which was significantly higher than that in the control group (48.7%, P < 0.01). PSC showed a significant lowering effect on TC, TG and LDL-C and raising effect on HDL-C, and the effect in lowering TG was significantly better than that of Zhibituo (P < 0.01). PSC also showed a certain effect in decreasing whole blood viscosity of both high-sheared and low-sheared viscosity.

CONCLUSIONPushen capsule has promising blood lipid regulating effect in patients with hyperlipidemia, and some effects in lowering the blood viscosity.

Adult ; Aged ; Blood Viscosity ; Capsules ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperlipidemias ; drug therapy ; Hypolipidemic Agents ; therapeutic use ; Male ; Middle Aged ; Phytotherapy ; Prospective Studies ; Triglycerides ; blood