Objective:To study the differences of ultrasound on kidney in monitoring renal hemodynamics and renal perfusion of patients with septic shock-induced acute kidney injury(AKI),and the predictive value of ultrasound-related parameters on kidney for septic shock-induced AKI.Methods:This is a prospective study,a total of 100 patients with septic shock who were diagnosed and treated in our hospital between September 2022 and September 2023 were selected as the study subjects.They were divided into AKI group(35 cases)and non-AKI group(65 cases)according to the relative standards of＜Clinical Practice Guideline of Global Kidney Disease Prognosis for the Tissue of Acute Kidney Injury(2012)＞.The age,gender,body mass index(BMI),comorbidities,central venous pressure,serum creatinine,urea nitrogen,blood lactate,Acute Physiology And Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment(SOFA)score of all patients were collected after they admitted to hospital.Ultrasound on kidney was used to detect the renal resistive index(RRI)and power Doppler ultrasound(PDU)scores for patients,and indicators included peak intensity(PI),mean transit time(MTT),and area under curve(AUCTC)of the time-intensity were collected.Results:After septic shock,the PI,AUCTC,MTT parameter and RRI score of AKI group were lower than those of non-AKI group,while the PUD score was higher than that of non-AKI group,and the differences of them between two groups were significant(t=5.391,8.978,5.664,2.626,5.102,P＜0.05).There were no significant differences in gender,age,BMI,comorbidities(diabetes,hypertension,coronary heart disease),blood lactate,APACHE II score,and SOFA score between the two groups(P＞0.05).After multiple confounding factors were rectified,the results showed that PI,AUCTC and PRI scores were independent influencing factors for occurring AKI in sepsis patients(OR=0.51,0.86,0.77,P＜0.05).The PI,AUCTC and RRI were used as continuous variable,and receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of PI,AUCTC and RRI for septic shock-induced AKI.The results indicated that the AUC values of PI,AUCTC and RRI were respectively 0.83(95%CI:0.75～0.91),0.79(95%CI:0.70～0.88)and 0.72(95%CI:0.62～0.82).Conclusion:Renal ultrasound-related indicators can effectively monitor renal hemodynamics and perfusion in patients with septic shock,and can further predict the risk of occurring AKI.It is suggested to promote that in clinical application.

Objective:To study the differences of ultrasound on kidney in monitoring renal hemodynamics and renal perfusion of patients with septic shock-induced acute kidney injury(AKI),and the predictive value of ultrasound-related parameters on kidney for septic shock-induced AKI.Methods:This is a prospective study,a total of 100 patients with septic shock who were diagnosed and treated in our hospital between September 2022 and September 2023 were selected as the study subjects.They were divided into AKI group(35 cases)and non-AKI group(65 cases)according to the relative standards of＜Clinical Practice Guideline of Global Kidney Disease Prognosis for the Tissue of Acute Kidney Injury(2012)＞.The age,gender,body mass index(BMI),comorbidities,central venous pressure,serum creatinine,urea nitrogen,blood lactate,Acute Physiology And Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment(SOFA)score of all patients were collected after they admitted to hospital.Ultrasound on kidney was used to detect the renal resistive index(RRI)and power Doppler ultrasound(PDU)scores for patients,and indicators included peak intensity(PI),mean transit time(MTT),and area under curve(AUCTC)of the time-intensity were collected.Results:After septic shock,the PI,AUCTC,MTT parameter and RRI score of AKI group were lower than those of non-AKI group,while the PUD score was higher than that of non-AKI group,and the differences of them between two groups were significant(t=5.391,8.978,5.664,2.626,5.102,P＜0.05).There were no significant differences in gender,age,BMI,comorbidities(diabetes,hypertension,coronary heart disease),blood lactate,APACHE II score,and SOFA score between the two groups(P＞0.05).After multiple confounding factors were rectified,the results showed that PI,AUCTC and PRI scores were independent influencing factors for occurring AKI in sepsis patients(OR=0.51,0.86,0.77,P＜0.05).The PI,AUCTC and RRI were used as continuous variable,and receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of PI,AUCTC and RRI for septic shock-induced AKI.The results indicated that the AUC values of PI,AUCTC and RRI were respectively 0.83(95%CI:0.75～0.91),0.79(95%CI:0.70～0.88)and 0.72(95%CI:0.62～0.82).Conclusion:Renal ultrasound-related indicators can effectively monitor renal hemodynamics and perfusion in patients with septic shock,and can further predict the risk of occurring AKI.It is suggested to promote that in clinical application.

Objective To investigate the effect of Dexamethasone (Dex) on the proliferation and apoptosis of osteoblasts in vitro and to explore its underlying mechanism.Methods Osteoblasts were acquired by primary culturing from new born SD rats.The inverted microscope was used to observe the cellular appearance.The cells were identified by alkaline phosphatase staining and alizarin red staining.The third generation osteoblasts were divided into four groups.Cells were incubated with different concentrations (0,10-8 mol/L,10-7 mol/L,10-6 mol/L) of dexamethasone for 12 hours,24 and 48 hours.Cell Counting Kit-8 was performed to evaluate the inhibitory effect on cell proliferation.The apoptosis rate was analyzed by flow cytometry with Annexin Ⅴ-FITC/PI double staining.The fluorescence microscopy was used to test the nuclear alteration and the expression of caspase-3.Western blot assay was applied to detect the expression of Bcl-2,Bad,caspase-3 and phosphorylated Akt.One-Way analysis of variance was used to determine the difference between groups.LSD-t was used to compare the difference between any two groups.Results Com-pared with the control group,dexamethasone at dose of 10-8 mol/L,10-7 mol/L and 10-6 mol/L inhibited the proliferation of osteoblasts,most evidently in 48 hours (0.980±0.028 vs 1.143±0.017,t=5.454,P＜0.05;0.798±0.057 vs 1.143±0.017,t=1 1.555,P＜0.05;0.728±0.031 vs 1.143±0.017,t=13.908,P＜0.05).Dexamethasone at dose of 10-7 mol/L and 10-6 mol/L induced apoptosis of osteoblasts at 48 hours,showing significant difference compared with control group [(9.8± 2.6)％ vs (4.1±0.8)％,t=3.508,P＜0.05;(12.4±2.6)％ vs (4.1±0.8)％,t=5.140,P＜0.05].However,10-8 mol/L of dexamethasone had no apparent effect in inducing apoptosis of osteoblasts [(4.9±1.2)％ vs (4.1±0.8)％,t=0.470,P ＞0.05].The immunofluorescene staining result showed that the expression of caspase-3 protein was significantly increased in 10-7 mol/L and 10-6 mol/L dex group (t=4.320,8.475,P＜0.05).The Western blotting results showed that dexamethasoneat the concentration of 10-7 mol/L,10-6 mol/L could significantly increase the expression of Bad and caspase-3 and down-regulate the expression of Bcl-2 and p-Akt.The expression of Bcl-2 was markedly reduced by 53.8％,78.4％ (t=4.019,5.988;P＜0.05),The expression of p-Akt decreased by 37％,49.6％ (t=2.067,3.491;P＜0.05),the expression of Bad protein increased by 276.9％ and 334.8％ respectively (t=7.342,8.872;P＜0.05),the expression of caspase-3 protein were increased by 138.0％ and 193.9％ (t=5.510,7.750;P＜0.05).Conclusion Dexamethasone is capable of inhibiting the proliferation of osteoblast,as well as augmenting the apoptosis.The mechanism of this process is probably related to reduction of the level of Bcl-2 expressionand up-regulation the expression of Bad,caspase-3 with the effects of inhibiting the PI3K/Akt signaling pathway.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.

BACKGROUND:Osteoblasts with high purity and activity are essential for bone metabolism research. OBJECTIVE:To explore a simple and effective culturing method of primary osteoblasts. METHODS:Osteoblasts were isolated from the parietal and frontal bones of newborn Sprague-Dawley rats using trypsin and collagenase digestion and tissue explant method. The morphology of osteoblasts was observed by inverted phase contrast microscope and transmission electron microscope;the cells was counted to draw the growth curve;the osteoblasts were identified by alkaline phosphatase BCIP/NBT staining and alizarin red staining. RESULTS AND CONCLUSION:The cells showed spindle, triangle or polygon shapes, having two or three protrusions. There were abundant mitochondria and endoplasmic reticulum under electron microscope, which presented the typical characteristics of osteoblasts. The cell growth was slow intially, accelerating at the 3rd day, and peaking at the 7th day. The cells were highly positive for alkaline phosphatase staining and were stained orangered through the alizarin red staining. To conclude, the cells isolated using enzymatic digestion combined with tissue explant method exhibit the typical characteristics and functions of osteoblasts, and this method is an ideal way to culture primary osteoblasts.

Objective Effects of intra articular injection of 153 Sm citrate HA on antigen induced arthritis were investigated to provide the theoretical fundation for its clinical application.Methods Rabbit arthritis was induced by subcutaneous injection of ovalbumin at weeks 2 and 4,and by intra articular injection of it at week 6.The dosage of 1 85?10 7 Bq or 3 7?10 7 Bq of 153 Sm citrate HA was injected separately into a side of knee joint.The severity of arthritis was determined by joint swelling,skin surface temperature,macroscopic and histologic changes in joints when the rabbits were killed at week 9 after establishment of model.Results Both dosages of 153 Sm have an initial pro inflammatory effects during one week after injection,and then resulted in reduction of joint diameter and skin surface temperature. 153 Sm (3 7?10 7 Bq) showed a more alleviation than 153 Sm (1 85?10 7 Bq) in respect of macroscopic and histologic changes.Conclusion Synovectomy with 153 Sm citrate HA is effective for treatment of chronic arthritis with dependence on the doses and deserves further study.

AIM: To develop a method to detemine pinostrobin in Weitengning Talets (Lindera reflexae Hemsl.) by HPLC. METHODS:A C_(18) column was used,methyl alcohol-water(80∶20) was used as a mobile phase and the wavelength of UV detector was set at 290 nm. RESULTS:The linearity of this method was good with the average recovery of 97.9%,RSD was 0.74%(n=5). CONCLUSION:The methed is simple,reliable,sensitivity,and with good reproducibility.It can be used in quality control of Weitengning Tablets.