Six Cases of Philips Ingenuity CT Maintenance / 中国医疗器械杂志

The article describes the failure phenomenon, analysis and processing process of the high-voltage generator module, FRC unit, rack tilt circuit and slip ring system in the daily use of Philips Ingenuity CT, so as to sum up the experience, discuss with the medical staff, and further Deepen the understanding of Philips Ingenuity CT's structure and working principle, and jointly improve the maintenance skills of CT and other large equipments.

Role of M-type phospholipase A2 receptor and its antibody in hepatitis B virus-associated membranous nephropathy / 中南大学学报(医学版)

To examine levels of M-type phospholipase A2 receptor (PLA2R) and its antibody in the patients with hepatitis B virus-associated membranous nephropathy (HBV-MN), and to explore the correlation of PLA2R with laboratory parameters and pathological characteristics.
 Methods: A total of 49 adult patients with biopsy-proved HBV-MN were enrolled in this study. Levels of anti-PLA2R antibody in serum and PLA2R in renal tissue were detected. Patients were assigned into two groups: a positive PLA2R group and a negative PLA2R group. Differences in laboratory parameters and pathological characteristics were compared between the two groups.
 Results: Of 49 patients with HBV-MN, 17 had positive PLA2R expression in renal tissues. In the positive PLA2R group, 10 patients were positive for serum anti-PLA2R antibody. Patients with positive PLA2R expression in renal tissues showed higher levels of 24 hour urinary protein [(4.6±3.9) g/d], serum HbsAg (70.5%) and renal HbsAg expression (71%), while lower level of serum albumin [(24.1±7.5) g/L] than those of the negative group.
 Conclusion: PLA2R is expressed in the renal tissues and serum anti-PLA2R antibody can be detected in some HBV-MN patients. Positive PLA2R expression in renal tissue might be related to HbsAg deposition in serum and renal tissues. Patients with positive PLA2R expression in renal tissue have more severe glomerular sclerosis.

Influential factors for theraputic effect of steroid on adult primary nephrotic syndrome / 中南大学学报(医学版)

OBJECTIVE@#To determine the factors associated with the eff ect of steroid on adult primary nephrotic syndrome.@*METHODS@#The general information, laboratory examination and renal pathological type of 425 patients with primary nephrotic syndrome were retrospectively analyzed.@*RESULTS@#Th ere were significant differences in the response to steroid among the pathological types of minimal change disease, focal segmental glomerulosclerosis and IgA nephropathy. Th e patients in the age of 14-24 years old showed the strongest response to steroid (P0.05), while there was significant difference in urine protein in 24 hour quantitation in the non-steroid resistance group between pre- and post-treatment (P<0.05).@*CONCLUSION@#Pathological types and ages of the patients are related to the steroid curative effect. The decrease in IgA probably affects the effect of steroid on primary nephrotic syndrome.

Evaluation of dialysis in patients with end-stage renal disease by salivary urea, creatinine and uric acid / 中南大学学报(医学版)

Objective:To explore the changes of saliva urea, creatinine (Cr), and uric acid (UA) before and after hemodialysis in patients with end-stage renal disease (ESRD), and to evaluate the clearing effect of Urea, Cr, and UA. Methods:Saliva and serum (2 mL) were collected from the dialysis patients. The concentrations of Urea, Cr, and UA in both samples were measured by biochemical analyzer. The concentrations of Urea, Cr, and UA in the saliva and the serum, and their correlation were analyzed. Before and after the hemodialysis, the reduction ratio (RR) of Urea, Cr, and UA in the saliva and the serum was calculated. Results:In ESRD dialysis patients, the levels of Urea, Cr, and UA in the saliva and the serum were highly correlated (correlation coeffcients were 0.979, 0.973, and 0.948, respectively). The concentrations of Urea, Cr, and UA in the saliva and the serum before the dialysis were lower than those after the dialysis, with signiifcant difference (P0.05). Conclusion:The clearing effect of salivar Urea, Cr, and UA is similar to that of the serum. Saliva is expected to replace the serum to evaluate hemodialysis efficacy and monitor the renal disease in ESRD patients.

Clinical significance of saliva urea, creatinine, and uric acid levels in patients with chronic kidney disease / 中南大学学报(医学版)

OBJECTIVE@#To explore the changes and clinical significance of saliva urea, creatinine (Cr), uric acid (UA) in both healthy people and chronic kidney disease (CKD) patients, and to provide a noninvasive, quick, accurate and reliable test to diagnose kindey disease.@*METHODS@#Urea, Cr and UA in the saliva and serum collected from both healthy people and the CKD patients were measured by biochemical analyzer. We calculated the correlation coefficient of Urea, Cr and UA between the saliva and serum, compared the levels of saliva Urea, Cr and UA among CKD patients in different periods, drew the receiver operation characteristic (ROC) curve and analyzed the sensitivity and specificity of saliva Urea, Cr and UA to predict CKD patients in various periods.@*RESULTS@#The concentrations of Urea, Cr and UA in both the saliva and the serum were positively correlated in healthy individuals and CKD patients (r = 0.918, 0.932, 0.840 and 0.984, 0.971, 0.920). The levels of saliva Urea, Cr and UA in the CKD patients were significantly higher than those of healthy people (P<0.05). Saliva Urea, Cr and UA concentrations of middle and late stage CKD patients were obviously higher than those of healthy people and early stage CKD patients (P<0.05). Areas under the curve (AUC) of the ROC of Urea, Cr and UA to diagnose diverse periods of CKD were 0.898, 0.897 and 0.848. The sensitivity was 0.806, 0.776 and 0.704; and the specificity was 0.968, 0.989 and 0.871.@*CONCLUSION@#The levels of Urea, Cr and UA between the saliva and the serum are closely related. The concentration of saliva Urea, Cr and UA can reflect the renal damage, monitor kidney function of the CKD patients, and help diagnose middle to late stage CKD patients. It is a simple, nonivasive and quick method.

Correlation studies between urinary retinol binding protein and renal tubular damage / 中南大学学报(医学版)

OBJECTIVE@#To study correlation between urinary retinol binding protein (RBP) content and renal tubular damage.@*METHODS@#A total of 1 353 healthy people and 186 patients with renal tubular damage diagnosed by renal biopsy were enrolled. The indicators such as endogenous creatinine clearance rate (Ccr), creatinine(Cr), urinary retinol binding protein(RBP), urinary β(2)-microglobulin(β(2)-MG), urinary N-acety1-beta-D-glucosaminidase (NAG), urine specific gravity(SG), urine osmolality of the 2 groups were examined and compared. Score of tubulointerstitial impairing and all indicators were analyzed by Spearman rank correlation analysis, and the sensitivity and specificity of indicators were calculated.@*RESULTS@#Renal tubular damage was positively correlated with urinary RBP, β2-MG, NAG (r=0.863, P<0.001; r=0.777, P<0.001; r=0.374, P=0.002, respectively), while negatively correlated with urine osmolaling, SG (r=-0.519, P<0.001; r=-0.624, P<0.001, respectively). The specificity and sensitivity for renal tubular damage of RBP were 91.03% and 72.06%.@*CONCLUSION@#RBP is an idea marker for renal tubular damage, and is useful to diagnose renal tubular damage and assess the extent of the damage.

Correlation of urinary podocyte number and glomerular podocalyxin expression with clinicopathology in IgA nephropathy patients / 中华肾脏病杂志

Objective To examine the correlation of urinary podocyte number and giomerular podocalyxin expression with clinicopathology in IgA nephropathy(IgAN)patients. Methods Morning urinary specimens(100 ml)3 days before renal biopsy from 50 patients with IgAN diagnosed by renal biopsy and from 20 healthy volunteers as control were collected. After centrifugation, 300 μI sediment was used for smear. Immunohistochemical staining with monoclonal anti-podocalyxin antibody was performed to detect urinary podocytes and the number of podocyte was counted under optical microscope. Computer image analysis system was used to examine glomerular PCX expression. Renal pathology and classification were investigated based on Lee's grading and Katafuchi semi-quantitative integration method. Relevance analysis was carried out on urinary podocyte number, glomerular PCX expression with pathological score and clinical data. Results The amount of urinary podocytes in IgAN was obviously higher than that in healthy controls(P<0.01). Significant differences were found in multiple comparison of the median of urinary podocytes among Lee's grade groups. I - II group was lower as compared to Ⅲ , Ⅳ, Ⅴ groups(all P<0.05). Ⅲ group was lower as compared to V group(P<0.05). The positive rate of urinary podocyte was the highest in Ⅳ and V groups(100%), while the lowest in Ⅰ - Ⅱ group(55%). Glomerular PCX expression in IgAN decreased with the aggravation of renal pathology. Significant differences were found in multiple comparison of the glomerular PCX expression with the pathological score. Lee's Ⅰ - Ⅱ group was higher as compared to Ⅲ, Ⅳ, Ⅴ groups(all P<0.05). Ⅳ and Ⅳ groups were higher as compared to V group(P<0.05). In IgAN, urinary podocyte excretion was negatively correlated with glomerular PCX expression(r=-0.702, P<0.01), positively correlated with 24-hour urinary protein(r=0.465, P<0.01)and positively correlated with glomerular and tubular scores(r=0.233, 0.307, P<0.05). Glomerular PCX expression was negatively correlated with 24-hour urinary protein(r=-0.367,P<0.05)and negatively correlated with glomerular and tubular scores(r =-0.560, -0.377, P <0.05). Conclusions Injury and desquamation of glomerular podocytes may involve in the development of IgAN. The number of urinary podocyte can reflect the loss of podocytes in renal tissue, which may be used as a marker of disease progression of IgAN.

Effect of glucose peritoneal dialysates on the transmesothelial electrical resistance and cellular migration of monolayer human peritoneal mesothelial cell / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of different concentrations of glucose peritoneal dialysates (PDS) on monolayer transmesothelial electrical resistance (TER) and migration ability of cultured human peritoneal mesothelial cells (HPMCs) to clarify the cause of peritoneal hyperpermeability state and ultrafiltration failure during prolonged peritoneal dialysis.@*METHODS@#HPMCs were cultured in a 1:1 mixture of DMEM and PDS containing 1.5%, 2.5%, and 4.25% glucose. Methyl thiazolyl tetrazolium (MTT) assay and TER were measured to determine the effect of glucose PDS on the proliferation and permeability of human peritoneal mesothelial monolayers, respectively. Wound-healing assay was used to confirm whether glucose could do harm to the migration of cells.@*RESULTS@#Proliferation of HPMCs was significantly suppressed by different glucose concentrations at 24 hours. TER decreased in a time- and concentration-dependent manner after culture with different concentrations of glucose PDS. Cells lost migration in the presence of high glucose after 24 hours, and most cells lost their normal morphology and became detached from plates after 48 hours of wounding.@*CONCLUSION@#High glucose in PDS can cause peritoneal damage by suppressing cell proliferation, inducing increase in paracellular permeability of HPMCs and inhibiting cell migration after damage, which may be responsible for peritoneal hyperpermeability and the development of ultrafiltration failure.

Expression of plasma thrombospondin-1 in renal interstitial fibrosis / 中南大学学报(医学版)

OBJECTIVE@#To observe the expression of plasma thrombospondin-1(TSP-1) at different time in protein-overload rats and to analyze the relationship between plasma TSP-1 expression and renal interstitial fibrosis.@*METHODS@#Forty-five male Sprague-Dawley rats were randomly divided into a bovine serum albumin (BSA) group and a control group after uninephrectomization. Rats with protein overload nephropathy induced by intraperitoneally injected BSA were used as a model (control group received saline). At the 1st, 5th, and 9th weekend, the level of 24 h proteinuria and renal function was assessed. Pathological changes were observed by electron and fluorescent microscopy. The expression of plasma TSP-1 was detected by Western blot. The relationship between plasma TSP-1 and tubulointerstitial lesions (TIL) score was analyzed.@*RESULTS@#Twenty-four hour proteinuria and blood urea nitrogen (BUN) significantly increased in protein-overload rats compared with those in the control group. While protein-overload rats developed more severe fibrosis in the tubular and interstitium. Glomerulosclerosis index and TIL score were upregulated compared with those in the control group. The expression of TSP-1 increased significantly at the 5th and 9th weekend. The expression of TSP-1 was positively correlated with TIL score (r=0.836, P<0.01).@*CONCLUSION@#Plasma TSP-1 expression is positively correlated with renal interstitial fibrosis in protein-overload rats. Plasma TSP-1 may be used for an important biomarker of renal interstitial fibrosis.

Risk factors for acute kidney injury following 5100 cardiac surgeries with extracorporeal circulation / 中南大学学报(医学版)

OBJECTIVE@#To determine the incidence and risk factors associated with acute kidney injury (AKI) in patients after cardiac surgery with extracorporeal circulation.@*METHODS@#A retrospective case control study was done in patients who underwent cardiac surgery from 2003 to 2007 in Second Xiangya Hospital, with 340 patients in an AKI group and the other 4 760 patients without AKI as a control group. All variables were analyzed by univariate analysis, Mann-Whitney U test and logistic regression.@*RESULTS@#AKI occurred in the 340 patients (6.7% incidence). Univariate analysis revealed that age, preoperative serum creatinine, preoperative ejection fraction (EF), preoperative beta2-microglobulin, preoperative blood albumin, preoperative blood uric acid, intraoperative cardiopulmonary bypass time, intraoperative aortic cross-clamp time, and dosage of mannitol were significantly related to AKI following cardiac surgery with extracorporeal circulation. Logistic multivariate regression analysis showed that preoperative serum creatinine (P<0.001), preoperative ejection fraction (EF) (P<0.001), preoperative beta2-microglobulin (P=0.002), preoperative blood uric acid (P=0.015), intraoperative cardiopulmonary bypass time (P<0.001), and intraoperative aortic cross-clamp time (P<0.001) were independent risk factors for AKI.@*CONCLUSION@#The incidence of AKI after cardiac surgery with extracorporeal circulation is closely related with a variety of perioperative risk factors. Our data suggest that patients planning to accept cardiac surgery with extracorporeal circulation should be more comprehensively assessed and monitored, thereby preventing the occurrence of AKI.