Research progress of PCSK9 in the mechanism of atherosclerotic cardiovascular disease / 中国医师杂志

Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) inhibitor has become a new drug for the treatment of hypercholesterolemia and atherosclerotic cardiovascular disease. Recent studies have shown that the mechanism of PCSK9 in atherosclerotic cardiovascular disease is very complex, which is closely related to the increase of plasma low-density lipoprotein cholesterol level, apoptosis, autophagy, inflammation, foam cell formation and vascular smooth muscle cell calcification, which will help us better understand the " multiple effects" of PCSK9 inhibitors. This review aims to analyze the research status of PCSK9 in molecular structure, cell function and cardiovascular disease treatment, which will further consolidate the success of new treatment strategies for atherosclerosis.

Clinical efficacy of graded and staged treatment on keloid / 中华医学美学美容杂志

Objective:To explore the staged treatment of keloid scars and to optimise treatment options.Methods:From June 2005 to June 2019, 629 keloid patients, 253 males and 376 females, aged 9 to 78 years, with a mean age of 31.3±16.8 years, were admitted to the Department of Aesthetic Plastic Surgery of Weifang People＇s Hospital. Three-stage comprehensive treatment was administered according to the stage of the disease from low to high, and the treatment effect was observed regularly, and the recurrence rate was counted.Results:In stage Ⅰ, 251 patients had local recurrence in 14 cases (5.5%) and 4 cases (1.6%) at 2 years 6 months after treatment, all of whom were cured after re-injection; in stage Ⅱ, 302 patients had local recurrence in 56 cases (18.6%) at 6 months after treatment, 49 patients (87.5%) were cured after re-treatment and 35 patients (11.6%) at 2 years; in stage Ⅲ, at 6 months after treatment, 36 patients (47.3%) had recurrence and 19 patients (25%) had recurrence at 2 years after re-treatment.Conclusions:The results and recurrence rate of keloids after comprehensive treatment are related to their severity, and a more satisfactory outcome can be achieved by staging the treatment according to the stage of the disease.

Construction of a hypoglycemia prediction model for older adults with type 2 diabetes based on random forest algorithm / 中国实用护理杂志

Objective:To construct a hypoglycemia random forest prediction model for older adults with type 2 diabetes, and assess the model′s prognostication performance through internal and external verification.Methods:From August 2022 to January 2023, 300 older adults with type 2 diabetes in Beijing Hospital were selected. The demographic characteristics, medical history, laboratory tests, and other data of the patients were collected, and the data set was randomly divided into the training set and verification set in a ratio of 7∶3. The hypoglycemia prediction model for older adults with type 2 diabetes was constructed and optimized based on the random forest algorithm. The calibration curve was used to evaluate the model′s calibration, and the ROC was used to evaluate the model′s discrimination. The clinical applicability of the model was assessed by the decision curve analysis. The risk factors for hypoglycemia in the older adults were explored by prioritizing the contributions of variables in prediction. The Bootstrap method was used for internal validation, and the validation set was used for external validation.Results:Among the 300 older adults with type 2 diabetes, 128 cases (42.67%) experienced hypoglycemia within one week. The predictive contributions of risk factors in the model were ranked as follows: the number of episodes of hypoglycemia in one month, HDL-C, heart disease, diabetes knowledge and education, combination therapy, age, duration of diabetes, staple food restriction, glycosylated hemoglobin, and gender. The internal and external calibration curves of the hypoglycemia random forest model for the older adults with type 2 diabetes fluctuated around the diagonal, indicating that the calibration degree of the predictive model is good. The AUROC of internal verification was 0.823 (95% CI 0.752-0.894), the sensitivity and specificity were 0.867 and 0.698, respectively. The external verification was 0.859 (95% CI 0.817 - 0.902), and sensitivity and specificity were 0.789 and 0.804, respectively, showing that the overall discrimination of the prediction model was good. The DCA curves were far from the all-positive line and all-negative line, which indicated that the prediction model had good clinical applicability. Conclusions:The predictive effect of this model is good, and it is suitable for predicting the risk of hypoglycemia in older adults with type 2 diabetes, and it provides a reference for early hypoglycemia screening and predictive intervention for this kind of patients.

Rare Variants of Monogenic Cerebral Small Vessel Diseases -Related Genes: A Study in a Cohort of Patients with Cerebral Small Vessel Diseases / 罕见病研究

  Objective  This study aimed at describing the frequency of rare variants of monogenic cerebral small vessel diseases (CSVD) in a cohort of patients with CSVD, and to explore its clinical relevance.  Methods  This study included CSVD patients visiting the Neurology Department of Peking Union Medical College Hospital(PUMCH) from March 2017 to January 2022, collecting their demographic and clinical information and DNA samples for whole-exome sequencing. Descriptive analysis and statistical analysis were conducted exploring the differences between monogenic CSVD-related gene mutation carriers and noncarriers.  Results  A total of 292 patients were included, 51.03% of whom carried one or more rare variants of monogenic CSVD-related genes. The most common rare low-frequency variants were located in the NOTCH3 gene (70 patients, 23.97%), followed by HTRA1 and COL4A1/COL4A2 (22 patients, 7.53%) respectively. Among the subgroup of patients without a family history of stroke (n=176), the frequency of rare variants was as high as 47.16%. Compared with non-carriers, the carriers were diagnosed at a younger age (58.76±13.71 vs. 63.46±13.21, P=0.003). No difference was found in phenotypes among single-SNP carriers, multiple-SNPs carriers, and noncarriers.  Conclusions  The frequency of rare mutation of monogenic CSVD-related genes were relatively high in Chinese CSVD cohort. The most common rare variant was within the NOTCH3, followed by HTRA1 and COL4A1/COL4A2 genes. For CSVD patients of unknown causes, genetic screening should not be neglected even if there is not a family history of the disease.

Clinical efficacy and mechanism of acupuncture for Parkinson's disease / 国际中医中药杂志

Acupuncture can improve the motor and non-motor symptoms of Parkinson's disease, and the effect of acupuncture combined with drug therapy is better than that of drug therapy alone. The possible mechanism includes inhibiting α-synuclein aggregation, oxidative stress, and neuroinflammation, inhibiting the apoptosis of dopaminergic neurons, and achieving a neuroprotective effect. The points mainly selected for Acupuncture treatment for this disease are Zusanli (ST 36), Yanglingquan (GB 34), Taichong (LR 3), Xuehai (SP 10), and other points. Early use of acupuncture and acupuncture combined with medical treatment strategy is worthy of clinical application.

Current status and considerations of sexuality education in primary and secondary school / 中国学校卫生

Abstract@#Comprehensive sexuality education is an important part of quality education, primary and secondary schools are the most suitable places for sex education. This paper sorts out the current status of sexuality education for primary and secondary school students in developed countries after presenting the overall significance of school based sexuality education, and further points out the problems and urgency of sexuality education for primary and secondary school students in China. It also put forward the way to new directions for advocacy, including the comphrehensive sexuality education curriculum system, training of sexuality education teachers, the positive and active role of families, as well as social and community support for sexuality education in schools.

Clinical Evidence of Oral Chinese Patent Medicine for Ischemic Stroke： A Scoping Review / 中国实验方剂学杂志

The method of scoping review was used to systematically search and sort out the clinical research of oral Chinese patent medicines for ischemic stroke，to understand the scope of relevant research and the distribution of evidence. Three medical catalogs were manually searched to obtain the oral Chinese patent medicines used for ischemic stroke，and 7 databases were retrieved to obtain the clinical research including these oral Chinese patent medicines. Then the clinical evidence results were visualized by description combined with chart analysis. A total of 68 oral Chinese patent medicines were retrieved，and 1 392 articles were included，with 367 published in core journals， involving 35 oral Chinese patent medicines. The research types included randomized controlled trials，cohort studies，case series，case reports，secondary studies，adverse drug reaction reports，pharmacoeconomic evaluations，drug interactions，consensus or guidelines，non-randomized intervention studies and cross-sectional studies，of which randomized controlled trials had the largest number （283， 77.1%），followed by secondary studies and case series （25， 6.7% for each）. Among the 283 randomized controlled trials，there were 159 clinical studies in the acute phase of ischemic stroke，65 in the non-acute phase，and 59 in the unclear phase. Ten intervention control types and 20 outcome index types were summarized. Among them， the composite outcome index and surrogate outcome index were used 217 times （76.7%） and 245 times （86.6%）， respectively，followed by the degree of neurological impairment （three scales）. Future clinical research of oral Chinese patent medicines for ischemic stroke should clarify the stage of the disease，and the research design should specify the advantages of oral Chinese patent medicines intervening in ischemic stroke. Furthermore， publicly-recognized positive controls should be employed，and important clinical outcome indexes should be selected.

Effects of Cullin1 on the Biological Characteristics of Lung Adenocarcinoma A549 and H1395 Cells / 中国肺癌杂志

BACKGROUND@#Cullin1 is a representative member of the Cullin family, and it plays an important role in the ubiquitination of cell cycle, transcription and signal transduction related proteins. Cullin1 is closely related to the occurrence and development of a variety of malignant tumors. The aim of this study is to investigate the effects of Cullin1 on biological function of lung adenocarcinoma A549 and H1395 Cells.@*METHODS@#The expression of Cullin1 mRNA was detected by quantitative Real-time polymerase chain reaction in lung adenocarcinoma cells (A549, H358, H1395, H1650) and human normal lung epithelial cells BEAS-2B, siRNA technology was used to interfere with lung adenocarcinoma cells with relatively high expression of Cullin1 mRNA; cell proliferation, cell cycle distribution, early cell apoptosis, invasion and migration ability were detected by methyl thiazolyl tetrazolium assay (MTT), flow cytometry and Transwell experiment; Western blot was used to detect the expression levels of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), Cyclin D1, Cyclin E2, p21 and p27.@*RESULTS@#Compared with the BEAS-2B cell, Cullin1 mRNA was highly expressed in lung adenocarcinoma cells, especially in lung adenocarcinoma A549 and H1395 cells (P<0.05). The proliferation ability of lung adenocarcinoma cells was inhibited after interference with Cullin1, and the number of cells in G1 phase increased, the number of cells in S phase decreased, and the early apoptosis rate of lung adenocarcinoma cells is significantly increased (P<0.05); The invasion and migration ability of lung adenocarcinoma cells decreased (P<0.05). After interference with Cullin1, the protein expression of MMP-9, MMP-2, CyclinD1 and CyclinE2 decreased (P<0.05), while the expression of TIMP-1, p21 and p27 protein increased (P<0.05).@*CONCLUSIONS@#Interference with Cullin1 inhibits the proliferation, invasion and migration of lung adenocarcinoma A549 and H1395 cells, Cullin1 plays a role in promoting cancer in lung adenocarcinoma.

Relationship between interleukin gene polymorphism and susceptibility to brucellosis / 中华地方病学杂志

Brucellosis is a kind of animal epidemic disease that can be transmitted to human beings through skin, mucous membrane, digestive tract, respiratory tract and other ways. In recent years, the incidence of brucellosis has increased. Its pathogenesis is relatively complicated. In addition to bacteria, toxins and other factors, genetic susceptibility has gradually attracted the attention of scholars. In this paper, we summarized the previous reports and reviewed the relationship between interleukin gene polymorphism and susceptibility to brucellosis.

Perlman syndrome research progress / 中华医学遗传学杂志

Perlman syndrome is a rare autosomal recessive congenital overgrowth syndrome caused by pathogenic variants of the DIS3L2 gene at 2q37 region. Clinically this syndrome is characterized by polyhydramnios, macrosomia, distinctive facial appearance, and renal dysplasia. Prognosis of the disease is poor, and survivors usually have mental delay and a high risk of developing Wilms tumor. At present, the pathogenesis of this disease is still poorly understood. This article intends to provide a review for this disease.

Diagnosis and treatment of posttransplant lymphoproliferative diseases in liver transplant recipients: a single-center experience / 器官移植

Objective To summarize the incidence, diagnosis and treatment experience of posttransplant lymphoproliferative diseases (PTLD) in the liver transplant recipients. Methods Clinical data of 734 liver transplant recipients were retrospectively analyzed. The incidence, clinical symptoms, laboratory and imaging data of PTLD in liver transplant recipients were collected. The pathological results and treatment methods of PTLD recipients were analyzed. The prognosis of PTLD recipients was evaluated. Results The incidence of PTLD in liver transplant recipients was 2.2% (16/734). The median time of onset after operation was 8(3, 46) months. The main clinical manifestations of PTLD were fever and lymph nodes enlargement. Some patients developed anemia, hepatosplenomegaly, abnormal liver function and digestive system symptoms, etc. Among 16 PTLD recipients, 1 case showed abnormal increase in blood concentration of tacrolimus, 6 cases of elevated transaminase levels, 14 cases of increased Epstein-Barr virus (EBV) DNA load and 5 cases of increased cytomegalovirus (CMV) DNA load. Positron emission tomography and computed tomography (PET/CT) showed hypermetabolism of 18F-flurodeoxyglucose in the enlarged lymph nodes of 13 recipients. CT scan of the neck and abdomen indicated multiple lymph node enlargement in the corresponding area of 2 recipients. Lymph nodes enlargement of 1 recipient showed on ultrasound only. All 16 PTLD recipients received pathological examination. In situ hybridization showed that EBV-encoded small RNA (EBER) was positive in 13 recipients. Reducing the immunosuppressant level was the basal treatment plan for PTLD recipients, and it can be combined with rituximab-targeted therapy and chemotherapy according to different pathological types of PTLD. Surgery and radiotherapy were used for enlarged lymph nodes. One recipient died of transplant liver failure due to PTLD treatment. Conclusions Administration of immunosuppressants after liver transplantation can increase the risk of PTLD. The incidence of PTLD is higher in pediatric liver transplant recipients than in adults. Early diagnosis and reasonable treatment can significantly improve the prognosis of PTLD recipients.

Diagnosis and treatment of posttransplant lymphoproliferative disorder after pediatric liver transplantation / 中华器官移植杂志

Objective To retrospectively explore the clinical symptoms ,diagnosis ,treatment and prognosis of posttransplant lymphoproliferative disorder (PTLD) after pediatric liver transplantation .Methods The diagnosis and treatment of PTLD were reviewed for 3 children recipient with living donor liver transplantation .Their primary diseases were biliary atresia ,glycogen storage disease type III and ornithine-transcarbamylase deficiency . All of them received FK506 for immunosuppression therapy . They were diagnosed as PTLD at 7 ,8 ,6 months post-operation respectively .Their major clinical manifestations were non-specific ,including fever ,diarrhea and anemia .Positron emission tomography/computed tomography (PET/CT) and ultrasound revealed enlarged mesenteric lymph nodes with neck lymphoadenopathy (n=2) . Pathological examinations of resected enlarged lymph nodes indicated post-transplantation lymphoproliferative disorder .One case was diffuse large B cell lymphoma and two of them belonged to preliminary EBER + . Results After a definite diagnosis ,there was one cycle of R-CHOP regimen (rituximab ,cyclophosphamide , pirarubicin ,vincristine ,dexamethasone) or 2 cycles of rituximab along with a .reduction of anti-rejection drug and they stayed in remission .Three were followed up for 37 ,39 and 20 months respectively from May 31 , 2019 . Currently transplanted liver function was stable and EBV viral load remained negative persistently .Conclusions This case highlights the complexity of clinical presentations and co-morbidities of PTLD . Reducing immunosuppressive agents and using rituximab plus chemotherapy can achieve a satisfactory efficacy for Epstein-Barr virus-related PTLD patients after pediatric liver transplantation .

Function of four pairs of genes in toxin-antitoxin system of Mycobacterium tuberculosis / 中国人兽共患病学报

We discussed the function of four pairs of genes in the toxin-antitoxin system of Mycobacterium tuberculosis,providing theoretical foundation and scientific basis for studying the transmission mechanism of Mycobacterium tuberculosis.Four pairs of genes which belong to VapBC family,including four VapC genes (Rv1720c,Rv2103c,Rv2494,Rv3408) and four VapB genes (Rv1721c,Rv2104c,Rv2493,Rv3407) were chosen.We constructed a serial of arabinose-induced hybrid plasmid system in Escherichia coli and a serial of acetamide-induced hybrid plasmid system in Mycobacterium smegmatis respectively,in order to observe the potential inhibition effect of VapC and the release inhibition of homologous VapB.Results showed that only one toxin gene(Rv2103c) showed the function of bacteriostasis in both E.coli and M.smegmatis and the homologous antitoxin gene(Rv2104c) could release the inhibition of growth.We built the inducible systems of VapBC family in both E.coli and M.smegmatis respectively and found only a pair of toxin and antitoxin genes(Rv2103c,Rv2104c) had the function of inhibition and release for the growth of bacteria.And two pairs of toxin genes(Rv1720c,Rv2494) did not have the function of inhibition for the growth of both E.coli and M.smegmatis.Whereas,another toxin gene VapC47(Rv3408) also did not have the bacteriostastic activity,only this result was not consistent with the existing literature.We speculated that the reason for this kind of difference may be the different inducible systems we used.Cause the other three results were consistent with all existing literature and the doubtful result also appeared in other reports,so our protocol could be confirmed as reliable,and we would use it to build inducible systems and make further functional identification of certain toxin and antitoxin genes that we are interested in.

Effects of Uygur Medicine Branchlets roses extracts on blood glucose and glucose tolerance in diabetes mice induced by alloxan / 药物评价研究

Objective To observe the effect of extract from Branchlets roses on blood glucose and glucose tolerance in diabetes mice induced by alloxan.Methods Diabetes animal model was established by alloxan.Dividing the model mice into eight groups:model group,water extract high,middle,and low dose (3.70,1.85,and 0.93 g/kg) group,and ethanol extract high,middle,and low dose (2.75,1.37,and 0.70 g/kg) group,and metformin (positive drug,200 mg/kg) group,and normal mice were taken as control group.Drug was ig administered to mice 3 d after molding once daily.Blood glucose test paper was used to determine fasting blood glucose 0,10,20,and 28 d after modeling,and the glucose tolerance test was performed 30 d after modeling.Results The extract of Branchlets roses from all the groups could decrease the blood glucose and improve the glucose tolerance,and showed a certain dose-effect relationship.In all the extracts,the alcohol extract had the best effect,but the effect was not as good as the positive control drug metformin hydrochloride group.Conclusion The extract of Branchlets roses can reduce the blood sugar content of diabetic mice,and improve the glucose tolerance.

Rapid determination of six flavonoids from seabuckthorn leaves by RP-HPLC-DAD / 中国药科大学学报

To establish a rapid determination method of six flavonoids:catechin,rutin,myricetin,quercetin,kaempferol and isorhamnetin,from seabuckthorn leaves by RP-HPLC-DAD.The seabuckthorn leaves were first degreased by petroleum ether,extracted by ethanol,and determined by RP-HPLC-DAD.The six flavonoids were separated and eluted by a Shimadzu C18(150 mm ×2.1 mm,5 μm) column with methanol-water (0.1％ phos phoric acid) (60∶ 40) at a flow rate of 1.0 mL/min.The detection wavelength were as follow:catechin 208 nm,rutin 257 nm,myricetin 373 nm,quercetin 371 nm,kaempferol 367 nm,and isorhamnetin 371 nm,respectively.The injection volume was 20 μL.The contents of the six flavonoids were in the range of 0.47 to 30.00 μ,g/mL with good linearity.The validation of the method,including precision,stability and recovery rate,was acceptable.The established method can be used for fast determination of the content of six flavonoids in seabuckthorn leaves.

Clinical Efficacy and Safety of Tocilizumab on Rheumatoid Arthritis in 35 Cases / 医药导报

Objective To explore and compare the clinical curative effect of tocilizumab and leflunomide in the treatment of rheumatoid arthritis and to evaluate the safety. Methods From March 2015 to March 2016,70 cases of rheumatoid arthritis treated in the department of rheumatism in this hospital were divided into treatment group and control group by using a random number table method,35 cases in each group.The patients in the observation group were intravenously treated with tocilizumab,at dosage of 8 mg·kg-1,once every four weeks.The control group was treated by oral administration of leflunomide tablets,at 50 mg·d-1from the 1st to 3rd day,and at 20 mg·d-1from the fourth day to the end of the treatment.The treatment period was 24 weeks in the two groups.Joint swelling,joint pain,morning stiffness,ESR,CRP,IL-6 and IL-8 were recorded and compared before and during the treatment.Total effective rate of treatment was compared between the two groups.Adverse drug reaction was recorded and the incidence of adverse drug reactions was compared. Results After the treatment,joint swelling, joint pain,morning stiffness,ESR,CRP,IL-6 and IL-8 were significantly lower in the treatment group than those in the control group (P<0.05).After the treatment,the total effective rate of the treatment was significantly higher than that of the control group (P<0.05).After the treatment,incidence of adverse reaction was significantly lower in the treatment group than that in the control group(P<0.05). Conclusion Tocilizumab and leflunomide has certain curative effect in the treatment of rheumatoid arthritis, but tocilizumab is more effective,with low incidence of adverse reaction and a high clinical value.

Effect of lipopolysaccharide on the stromal cell-derived factor-1 expression in human stem cells from apical papilla / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the expression of stromal cell-derived factor-1 (SDF-1) in human stem cells from apical papilla (SCAP), and to evaluate the effect of lipopolysaccharide (LPS) on SDF-1 expression by SCAP.</p><p><b>METHODS</b>SCAP were isolated from dental papilla of human immature third molars. The expression of SDF-1 was evaluated by reverse transcription-PCR (RT-PCR). After SCAP being exposed to different concentrations (0.1, 1.0, 10 mg/L) of LPS for 24 and 48 h, the effect of LPS on cell proliferation and gene expression of SDF-1 was investigated by cell counting kit-8 and real-time PCR respectively, while cells without LPS stimulation were considered as negative control.</p><p><b>RESULTS</b>LPS had no significant effect on SCAP proliferation until day 7. RT-PCR assays demonstrated that SCAP expressed SDF-1 mRNA. Different concentrations of LPS significantly promoted the SDF-1 expression in SCAP after 24 h (F = 12.102, P = 0.002) and 48 h (F = 39.054, P < 0.001) exposure, with relative gene expression ratio (experimental/control) increased to 1.4 ± 0.1, 2.2 ± 0.4, 2.3 ± 0.5 in 24 h group and 2.1 ± 0.4, 3.4 ± 0.3, 3.8 ± 0.5 in 48 h group.</p><p><b>CONCLUSIONS</b>Isolated SCAP in cultures have the expression of SDF-1 mRNA. LPS can significantly promote the expression of SDF-1 in SCAP.</p>

Mineral and bone disorder in patients with chronic kidney disease: a cross-sectional single center study / 中华肾脏病杂志

Objective To investigate and analyze the mineral and bone disorder (MBD) in the patients with chronic kidney disease (CKD),reveal the change of related indexes of CKD-MBD.Methods A cross-sectional study was carried out in the First Affiliated Hospital of Harbin Medical University.From October 2011 to May 2014,1318 inpatients and hemodialysis outpatients were enrolled.Parameters related to MBD,including serum phosphorus (P),total calcium (t-Ca),intact parathyroid hormone (iPTH) and alkaline phosphatase (AKP) were analyzed.Last,it was analyzed with multiple regression analysis to related factors of the secondary hyperparathyroidism (SHPT) in patients with CKD.Results Serum calcium,phosphorus and iPTH had no obvious abnormalities at the early stages of CKD [GFR ＞ 60 ml· min-1· (1.73 m2)-1],and relatively stable before GFR ＞ 30 ml· min-1· (1.73m2)-1.After entering the CKD4 stage,serum phosphorus,iPTH increased sharply and serum calcium decreased obviously along with the decreased glomerular filtration rate (GFR).Serum P,t-Ca and iPTH levels were statistically significant in CKD 1 to 5D patients,respectively,serum P:(1.13±0.20) mmol/L,(1.14±0.22) mmol/L,(1.26±0.23) mmol/L,(1.48±0.34) mmol/L,(2.05±0.61) mmol/L and (2.08±0.58)mmol/L;serum t-Ca (mmol/L) (2.35±0.13) mmol/L,(2.35±0.12) mmol/L,(2.35±0.15) mmol/L,(2.26± 0.18) mmol/L,(2.07±0.29) mmol/L and (2.31±0.26) mmol/L;iPTH:57.8(45.6,91.8) ng/L,54.1(37.8,74.6) ng/L,71.6(45.8,102.2) ng/L,131.1(81.7,205.1) ng/L,277.5(173.6,395.3) ng/L and 354.9 (194.4,720.3) ng/L;The stepwise logistic regression analysis showed:hypocalcemia (OR=3.32,P ＜ 0.01) and decreased GFR (OR=5.28,P ＜ 0.01) were independent risk factors of iPTH elevation at stage CKD3～ 5.Conclusions From the beginning of the CKD3 stage,serum t-Ca,P,iPTH level began to be relatively abnormal as renal function declined.Hyperphosphatemia,SHPT has not been improved significantly in CKD5D stage patients even with hemodialysis.The regulation of hemodialysis on serum calcium showed overcorrecting phenomenon.

Fungal and virus infection following kidney transplantation / 中国组织工程研究

BACKGROUND: Infection following kidney transplantation has become one of the main reasons for graft failure and death of allograft recipients. However, there is not a standard therapeutic scheme for infection following kidney transplantation. OBJECTIVE: To investigate the clinical features and treatment measures of infection, additionally, to increase the cure rate of infection following kidney transplantation.DESIGN, TIME AND SETTING: A retrospectively analysis was performed at the Organ Transplantation Center, the First Affiliated Hospital of Kunming Medical College from February 2006 to February 2008.PARTClPANTS: Eighteen cases of infections in 84 kidney allograft recipients.METHODS: All cases were checked by chest X-ray. Patients who had no significant lung infection symptoms or obvious signs received lung CT scan. Pathogen detection was performed, including hemoculture, urine culture, sputum culture, nose swabs culture, throat swab culture, checking clinically important cytomegalovirus (CMV), EB-DNA and mycoplasma in blood, acid-fast bacilli and eumycete culture in sputum. All cases of pulmonary infection underwent a comprehensive treatment-antiviral drugs, antibiotics and antifungal. Depending on the individual condition and absolute values of lymphocytes and CD4+T cells, the immunosuppressant was adjusted individually. The occurrence time, clinical symptom, auxiliary examination and treatment strategies were analyzed.MAIN OUTCOME MEASURES: The occurrence time of infection and clinical symptoms; imaging manifestation and results of pathogenic detection; selection of antibiotics and immunosuppressant adjustment.RESULTS: Among 18 cases, 11 cases (61.2%) were deceased-donor kidney transplant recipients. Inflection following kidney transplantation occurred in 12 cases (66.7%) within 3 months, and increased to 15 cases (83.3%) within 3-6 months. Of the 18 infection cases, 14 cases (77.8%) had a main symptom of fever. There were 15 cases (83.3%) of respiratory tract infection, including 13 cases (72.2%) of pulmonary infection. Fungal cultivation, especially Monilia, was positive in 6 cases. Three out of the 18 cases (16.7%) died, two of whom had CMV infection. Mixed infection occurred in all cases.CONCLUSION: Infected patients following kidney transplantation present with diversity pathogens, which are dominated by bacteria, fungus and virus. Severe pneumonia combined with CMV infection demonstrates that poor prognosis, fungal and virus infection following kidney transplantation should be given more attention. Combined de-escalation therapy is the main method, and timely adjustment and even discontinuance of immunosupprassive agents is one of the key points in the treatment of infection following kidney transplantation

Immuno-regulatory effects of S-TF and its HPLC analysis / 中国免疫学杂志

2.S-TF contained the activity responsible foraugmenting T and B lymphocytes proliferation of mitogen-induced responses innormal and gamma-ray irradiated mice. The HPLC analysis indicated that all TFs contained whole components ofnucleosides and bases.The total amounts of these components per unit of H-TF,P-TF and S-TF were 67.2?g,52.1?g,94.1?g respectively.here were much more in-osine(IR).cytosine(CR)and deoxycytidine(CdR)in S-TF than in H-TF and P-TF.which may play a significant role in DNA repair synthesis of radiation injuri-ed cells.The TFs may act as important mediators in modulating immune regulation.