Association between hypersensitive C reactive protein and the incidence of acute kidney injury insubarachnoid hemorrhagic patients-a research on the clinical perspective / 中华检验医学杂志

Objective To evaluate the association between hypersensitive C reactive protein (hs-CRP) and the incidence of acute kidney injury in subarachnoid hemorrhage(SAH) patients.Methods It retrospectively recruited 213 cases of computerized tomography validated SAH patients from the neurology ICU from Beijing Tiantan Hospital between January 2012 and January 2015.The average age was (56.29±11.95) years old,and the patients were divided into AKI and non-AKI groups according to Kidney Disease: Improving Global Outcomes (KDIGO) diagnosis standards, Clinical features of AKI and Non-AKI patients including serum levels of hs-CRP were compared and multi-logistic regression was applied to find the risk factors concerning with the incidence of AKI.Receiver operating characteristics (ROC) curve was also plotted to evaluate the diagnostic value of hs-CRP towards the incidence of AKI.Results A total of 25 (11.74%) patients developed AKI.Average age of the SAH patients in both AKI and non-AKI groups were (63.60±12.21) years old vs.(55.31±11.60) years old(t=-3.33, P<0.05).The ratios of diabetics were were 28.00% vs.11.17% (χ2=5.47,P<0.05) and the ratio of proteinuria were 80.00% vs.34.57%, respectively (χ2=3.83, P<0.05).The median of serum creatinie were 63.72(51.45, 79.72)μmol/L vs.53.21(45.27, 65.62)μmol/L (P<0.05), and serum hs-CRP were (14.12±5.03)mg/L vs.(10.23±6.76)mg/L (P<0.05), and the ratios of antibiotics application were 84.00% vs.43.08% (P<0.05 for all).Multi-logistic regression analysis showed that serum hs-CRP was an independent risk factors for AKI after age, serum creatinine at admission were adjusted.[OR (95% CI) was 3.33(1.13, 9.85),P<0.05 for all].The area under curve of ROC was 0.69 (P<0.05), and the cut-off point of serum hs-CRP under the maximum Youden index was 13.85 mg/L.Conclusion Serum hs-CRP is an independent risk factor of theincidence of AKI in SAH patients, the significantly increase of serum hs-CRP might be an important predictor of the incidence of AKI in SAH patients.

Effects of atorvastatin on release of endothelial microparticles and myo-cardial apoptosis in rats with acute myocardial infarction / 中国病理生理杂志

AIM: To investigate the effect of atorvastatin ( AT) on the release of endothelial microparticles (EMP) and myocardial apoptosis in the rats with myocardial infarction .METHODS: SD male rats (n=24) were ran-domly divided into 3 groups:sham operation ( sham) group , myocardial infarction ( MI) group and MI+AT group.The rat model of acute myocardial infarction was prepared by coronary artery ligation .At 2 h and 24 h after modeling , the pe-ripheral blood was collected to detect creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT).The circulating levels of EMP were measured by flow cytometry .The myocardial apoptosis was detected by terminal deoxynucleotidyl transferase -mediated dUTP nick end labeling (TUNEL) assay.RESULTS: At 2 h after modeling, the level of CK-MB was signifi-cantly increased in MI group compared with sham group , and the level of EMP and the myocardial apoptotic rate were sig-nificantly increased in MI group and MI +AT group compared with sham group .At 24 h after modeling , the level of EMP was significantly increased in MI group compared with sham group .The levels of CK-MB, cTnT, EMP and the myocardial apoptotic rate were significantly decreased in MI +AT group compared with MI group .Moreover , the level of CK-MB in MI group was significantly increased at 24 h compared with that at 2 h after modeling .The levels of CK-MB, cTnT and EMP were significantly decreased in MI +AT group at 24 h compared with those at 2 h after modeling .CONCLUSION: Ator-vastatin may reduce the level of EMP and the myocardial apoptotic rate in the rats with acute myocardial infarction , indica-ting that atorvastatin plays a role in protecting endothelium .

Cases of hepatitis C virus infection with 2i/2a recombination genotype in the Lanzhou area and effects of related genetic variations on interferon alpha response / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate Lanzhou area cases of hepatitis C virus (H-CV) infection with a 5'-non coding region (NCR) 2i genotype and core (C), envelope protein (E) and non-structural protein (NS5) 2a genotype and the relationship with therapeutic response to interferon-alpha (IFNa).</p><p><b>METHODS</b>Nine patients who received IFNa-based treatment for HCV between 2007 and 2009 at the Second People's Hospital of Gansu Province were selected for analysis.Restriction enzyme analysis was carried out for the 5'-NCR and sequencing was carried out for the other gene areas.The relationship between genetic variants and IFNaresponse was examined.</p><p><b>RESULTS</b>Of the total nine HCV cases treated with IFNa-based therapies, five of the patients achieved sustained virological response (SVR), which included two cases with type 2 genotype and three cases with no MboI restriction enzyme point of tangency (i.e.type 1b). The remaining four patients that did not achieve SVR included one case of type 2a, with a 1b and 2a mixed state, and one case with 5'-NCR 2i genotype and C area, NS5 area 2a genotype; the other two cases had 5'-NCR and C area type 1b. Of the five cases with 5'-NCR 2i genotype, all had C 2a genotype and two had C/E 2a and NS5 2a genotypes.The seven patients that showed no response to ordinary IFNa were converted to long-term IFNa plus ribavirin combination antiviral treatment; five (71.4%) of the cases showed response in HCV RNA level and the patients treated with the pegylated form showed greater response.</p><p><b>CONCLUSION</b>HCV genotyping can only provide information on the particular region of gene sequence examined, and it is important to sequence all gene regions where mutations related to antiviral drug response are located. Peg-IFNa-2a combined with ribavirin may achieve better therapeutic effect in patients infected with 2i/2a recombinant forms of HCV.</p>

The clinical effect of the combination of lamivudine and adefovir dipivoxil in the treatment of decompensated hepatitis B cirrhosis / 中国基层医药

Objective To evaluate the effect of the combination of lamivudine and adefovir dipivoxil on the treatment of decompensated hepatitis B cirrhosis patients. Methods One hundred thirty-six patients with decompensated hepatitis B cirrhosis were randomly administered the combination of lamivudine and adefovir dipivoxil (combination group), only lamivudine( LAM group)and only adefovir dipivoxil (ADV group). The liver founction tests, ChildPugh scores and the rate of negative conversion for the serum HBV-DNA were measured at baseline,six months after therapy and 12 months after therapy. Results The rate of negative conversion for the serum HBV-DNA ( ＜ 1 ×103cop/ml)of combination group were 78.3% and 85.2% respectively at six and twelve months after therapy. The rates of negative conversion for the serum HBV-DNA of LAM group were 62. 1% and 57.8% respectively at six and twelve months after therapy. The rates of negative conversion for the serum HBV-DNA of ADV group were 41.3% and 53.6% respectively at six and twelve months after therapy. Compared with the LAM and ADV group, The rates of negative conversion for the serum HBV-DNA of combination group were higher. In addition, the rates of better conversion of liver function tests and Child-Pugh scores were higher in combination group than LAM and ADV groups.Conclusion The combination of lamivudine and adefovir dipivoxil could more effectively improve liver founction tests, Child-Pugh scores and the rates of negative conversion for the serum HBV-DNA in patients with decompensated hepatitis B cirrhosis than only lamivudine and only adefovir dipivoxil.