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The hypoxic microenvironment is commonly found in various solid tumors including pancreatic ductal adenocarcinoma (PDAC). Saururus chinensis is a medicinal Chinese herb widely used because of documented anti-inflammatory and anti-angiogenic properties. Sauchinone is special active lignin extracted from S. chinensis and its biological functions have been extensively explored. Recent studies have found that sauchinone could affect tumor initiation, metastasis and progression of some cancers. However, the specific role of sauchinone in PDAC remains to be elucidated. The main aim of this study was to elucidate the involvement of sauchinone in the progression of PDAC under the hypoxic condition. The human PDAC cell lines PANC-1 and BxPC-3 were exposed to hypoxia and various concentrations of sauchinone. The CCK-8 assay was performed to detect cytotoxic effects of sauchinone on PDAC cells. The levels of vascular endothelial growth factor, hypoxia-inducible factor-1α, E-cadherin, N-cadherin, Wnt3a and β-catenin were examined by the western blot analysis. Wound healing and transwell assays were used to assess cell migration and invasion. The results showed that the migratory and invasive abilities of PDAC cells were enhanced after exposure to hypoxia and the expression of epithelial-mesenchymal transition markers was also significantly regulated by hypoxia. All these effects induced under the hypoxic condition were terminated by sauchinone treatment. In addition, sauchinone suppressed hypoxia-induced activation of the Wnt/β-catenin signaling pathway. Our study provided important insight into understanding the mechanisms of the anti-cancer effect of sauchinone. Taken together, we suggested that sauchinone may be considered a new therapeutic agent for PDAC treatment.

Visceral obesity, assessed using the visceral adiposity index (VAI), is related to mortality, but studies of populations with chronic kidney disease (CKD) are scarce. The aim of this study was to evaluate the relationship between VAI and all-cause mortality among individuals with CKD.We retrospectively explored the relationship between VAI and risk for all-cause death by analyzing the data of 4145 patients with CKD who participated in the National Health and Nutrition Examination Survey (NHANES) 2001-2006. Patients were followed until December 31, 2015.After an average follow-up of 134.14 mo, 1034 (24.95%) deaths were recorded. Comparison of VAI quartiles with the reference showed an unstable association of VAI with all-cause mortality after adjusting for a wide range of potential confounders in Cox regression analysis. The correlation between VAI and mortality was J-shaped after applying the penalized spline method. Before the inflection point (VAI = 68.23), higher VAI had a protective effect against mortality (hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.28-0.77). However, the risk for all-cause mortality gradually increased with the VAI (HR, 1.13; 95% CI, 1.05-1.21).Visceral obesity may influence the rate of all-cause mortality in a nonlinear manner in populations with CKD. Risk for death was higher with visceral fat deficiency than with excessive visceral fat deposition.

Hydroxychloroquine (HCQ), the analog of chloroquine, augments the effect of chemotherapies and radiotherapy on various tumors identified in the current clinical trials. Meanwhile, the toxicity of HCQ retinopathy raises concern worldwide. Thus, the potent autophagy inhibitors are urgently needed. A systematic review was related to ‘hydroxychloroquine’ or ‘chloroquine’ with ‘clinical trials,’ ‘retinopathy’ and ‘new autophagy inhibitors.’ This led to many cross-references involving HCQ, and these data have been incorporated into the following study. Many preclinical studies indicate that the combination of HCQ with chemotherapies or radiotherapies may enhance the effect of anticancer, providing base for launching cancer clinical trials involving HCQ. The new and more sensitive diagnostic techniques report a prevalence of HCQ retinopathy up to 7.5%. Lys05, SAR405, verteporfin, VATG-027, mefloquine and spautin-1 may be potent autophagy inhibitors. Additional mechanistic studies of HCQ in preclinical models are still required in order to answer these questions whether HCQ actually inhibits autophagy in non-selective tumors and whether the extent of inhibition would be sufficient to alter chemotherapy or radiotherapy sensitivity.

Tension-free hernioplasty under local anesthetic infiltration is a reasonable choice for end-stage renal disease patients with hernia.The purpose of the study was to investigate the feasibility of cryotherapy after hernioplasty surgery to relieve pain and scrotal edema.This was a prospective, randomized, and controlled trial held in a large integrated health care facility in South China. One hundred sixty-nine male patients on hemodialysis and scheduled for hernioplasty were enrolled between March 2013 and February 2017. The participants were divided into an intervention group and a control group. In the intervention group, ice packs were applied after surgery. Demographic information, vital signs, pain score, opioid consumption, wound inflammation, scrotal edema, and patient satisfaction were compared between the two groups. The primary outcome was pain score.Cryotherapy-treated patients required less opioid consumption (5.95 vs. 15.29 mg; P 0.05), reported lower pain scores from 30 minutes to 48 hours after operation (P 0.05), less wound inflammation (11.90 vs. 32.94%; P 0.05), lower incidence of scrotal edema in the first and second days (P 0.05), and higher patient satisfaction (8.95 vs. 6.50 cm; P 0.05), with stable vital signs throughout the monitoring period (P 0.05).Owing to its favorable cost, convenience, and low frequency of adverse effects, cryotherapy is useful for end-stage renal disease populations after hernioplasty to relieve pain and scrotal edema.

Arteriovenous grafting offers an alternative for patients whose vessels are unsuitable for arteriovenous fistula. However, as a result of subcutaneous tunnel dissection, postoperative pain and edema of the operated limb present early after surgery. As a traditional therapeutic approach, cryotherapy has the ability to suppress postoperative pain and edema.The purpose of the study was to investigate the feasibility of cryotherapy after arteriovenous graft surgery to decrease perioperative medication usage.This study was a randomized controlled trial.A large integrated health care facility in South China.A total of 85 hemodialysis patients who received arteriovenous graft surgery from March 2011 to February 2017 were enrolled.The participants were divided into an intervention group and a control group according to the postoperative management. Ice packs were applied covering the operative forearm for 120 minutes after wound closure in the intervention group. General information, pain score, analgesic consumption, wound inflammation, forearm edema, and participant satisfaction were compared between the two groups.Cryotherapy-treated patients required less analgesia (26.19% vs. 48.84%, p .05), reported lower pain score from 30 minutes to 48 hours postoperative (p .05), less wound inflammation (11.90% vs. 25.58%, p .05), and higher participant satisfaction (8.92 ± 0.57 vs. 6.52 ± 0.63, p .05), whereas the incidence of forearm edema was equivalent (p .05). No adverse events were reported in either group.Cryotherapy is a preferable intervention for patients after arteriovenous graft implantation as a result of its favorable cost, convenience, and fewer side effects.

BACKGROUND B-cell-activating factor belonging to the tumor necrosis factor family (BAFF) has been found to have the function of activating B cells and participating in the class switching of B cells; however, its clinical application needs further study. In the present study, the serum BAFF levels of patients with IgA nephropathy (IgAN) with different histopathological phenotypes were measured. METHODS Levels of serum BAFF in 153 patients with IgAN, 55 healthy controls and 20 disease controls were recorded using commercially available ELISA kits. Their correlations with clinical and histopathological features of patients with IgAN were further evaluated. RESULTS Levels of serum BAFF in patients with IgAN were significantly higher than in controls. Serum BAFF levels were significantly higher in patients with mesangial hypercellularity and segmental glomerulosclerosis than in those without. Serum BAFF levels were associated with the severity of tubular atrophy/interstitial fibrosis. Serum BAFF levels were significantly positively correlated with estimated glomerular filtration rate and serum creatinine. Patients with elevated serum BAFF levels showed significantly greater severity in clinical and histopathological stages. CONCLUSION Levels of serum BAFF were elevated in patients with IgAN and were associated with clinical and pathological features of the disease. Serum BAFF levels could be a noninvasive biomarker for monitoring disease severity of IgAN.

The aim of this nested case-control study was to assess the combined use of urinary kidney injury molecule (KIM)-1 and interleukin (IL)-18 for acute kidney injury (AKI) after cardiopulmonary bypass surgery (CPB). From a cohort of 122 subjects who underwent CPB, serial urinary KIM-1 and IL-18 concentrations were determined in 30 AKI and 92 non-AKI patients. An increased level of urinary KIM-1 was associated with the occurrence of AKI, whereas an increased level of IL-18 was related to progressive AKI. The combination of these two biomarkers facilitates the early diagnosis and assessment of the likely progression of AKI after CPB.

To investigate the prevalence of metabolic syndrome (MS) among Xinjiang Uigur population aged 30 - 80 and to compare the differences of the three diagnostic criteria used for MS. The three diagnostic criteria were developed by the National Cholesterol Education Program (ATP III), International Diabetes Federation (IDF) and Chinese Medical Association Diabetes Branch (CDS).A cross-sectional study was conducted on 2053 Xinjiang Uigur people aged 30 - 80. The prevalence of MS and the degree of agreement were both calculated according to the three definitions. The results of MS components were also analyzed.(1) According to the three definitions (ATP III, IDF and CDS), the prevalence and adjusted prevalence rates of MS were 35.80% (29.64%), 39.41% (35.88%) and 23.72% (19.17%). (2) According to the three definitions (the ATP III, IDF and CDS), the prevalence rates of subjects who had at least 3 risk factors were 98.64%, 97.90% and 92.81%. (3) Among all the subjects with MS, the MS diagnostic criteria of ATP III and IDF were in good accordance with the Kappa index (0.7801), Youden index (0.7928) and the concordance rate (0.9026). CDS was in relatively weak agreement when comparing with other definitions (ATP III and IDF).Our findings revealed big differences regarding the prevalence rates, the degree of agreement and the aggregation of risk components on MS among Xinjiang Uigur population. The detection rate of IDF criteria on MS and the highest while detection rate of ATP III criteria on subjects presented at least 3 risk factors were the highest. The concordance of ATP III criteria and IDF seemed to be a better one.

To determine the influencing factors and life quality of patients undergoing maintaining hemodialysis (MHD).One hundred and two MHD patients in hemodialysis center were enrolled, and a questionnaire investigation using KDQOL-SF(TM) 1.3 was employed. This questionnaire was disease-specific for chronic kidney disease. The object was to evaluate the quality of life, in relation with the patients' kidney disease and dialysis (KDTA) and the patients' general health (SF-36), and to analyze the influencing factors.Among the influencing factors revealed in questionnaire investigation, the items such as encouragement from medical staff, social support, symptoms, cognitive function, quality of social relationship and satisfaction degree of patients won higher scores, while the items such as sex function, difficulties in daily activity due to kidney disease, expectation of general health and self-evaluation of health won lower scores. Among the influencing factors, the scores of physical functions and body pain were much lower in female than male patients (63.52±17.96 vs. 71.65±18.66, 64.33±21.23 vs. 76.58±19.20, both P0.05). Patients of age60 won higher scores than patients of age≤40 and 40-60 in respect to work condition and sex function (61.98±13.63 vs. 52.27±7.54 and 55.23±19.97, 68.33±4.04 vs. 5.45±9.34 and 15.81±26.92, all P0.05); patients of 60 years old or older won higher scores in respect of satisfaction degree of patients but lower scores in respect of physical functions. Among primary diseases, only patients with diabetes won much encouragement from medical staff (93.57±11.29). Patients whose serum albumin was lower than 3.5 g/L won much lower scores than those with serum albumin higher than 3.5 g/L in respect of scoring of KDTA, influence to daily life due to kidney disease, cognitive function, physical functions, expectation of general health, and scores obtained previously (53.62±8.87 vs. 61.26±9.42, 44.58±12.52 vs. 57.47±17.15, 65.56±20.60 vs. 78.18±15.73, 54.38±19.73 vs. 68.87±17.57, 31.11±10.23 vs. 41.19±66.27, 44.44±27.06 vs. 68.57±26.94, all P0.05). Patients who had undergone hemodialysis for longer than 6 years won higher scores in respect to symptoms, body pain, vigour and expectation of general health (86.92±6.67, 85.08±57.34, 78.40±13.04, 53.33±24.22, respectively), while patients who had hemodialysis for as long as 3 to 6 years won highest scores in respect to social support (94.23±10.96, all P0.05). The level of hemoglobin and urea clearance index showed no obvious influence to MHD patients' daily life.MHD patients have poor self-confidence and they usually lose self-confidence. Nutritional status greatly influences patients' daily life. So it is important to improve the quality of daily life in MHD patients, especially in respect of nutritional support, and this aspect should form our focus of medical support.

To prospectively study the value of cystatin C in diagnosis of acute kidney injury (AKI) in patients after cardiac surgery.A total of 132 patients undergoing cardiopulmonary bypass were enrolled in this prospectively study. From each patient, blood samples were collected everyday before and after operation to detect the serum creatinine (Scr) and cystatin C levels by enzymatic method and particle-enhanced turbidimetric immunoassay (PETIA), respectively, and the glomerular filtration rate (eGFR) was estimated using MDRD equation. AKI diagnosis was made according to the RIFLE criteria of the Acute Dialysis Quality Initiative (ADQI) (R: Scr increased byor =50%; I: Scr increased byor =100%; F: Scr increased byor =200%; L: Loss of kidney function; E: End-stage renal disease). Another AKI diagnostic criterion was also adopted according to the levels of cystatin C increment, namely an increase byor =50%,or =100%, andor =200%.Twenty-nine patients (21.9%) developed AKI of varied severities, including 10 meeting the R-criteria, 12 the I-criteria, 7 the F-criteria, with the other 103 patients without AKI serving as the control group. Cystatin C of the 29 AKI patients was drastically increased in comparison with that of the control group (P0.001). Significant linear correlation was found between cystatin C and Scr (r=0.732, P0.001) and between [cystatin C]-1 and estimated GFR (R=0.803, P0.001). By the two diagnostic criteria based on cystatin C and Scr levels, respectively, the median diagnostic time of AKI was 2 days (range 1-4 days) and 3 days (range 2-5 days) for R criteria (10 patients, P=0.014), 3.5 days (range 1-6 days) and 5 days (range 2-8 days) for I criteria (12 patients, P=0.008), and 5 days (range 3-7 days) and 6.5 days (range 4-9 days) for F criteria (7 patients, P=0.02), respectively. ROC analysis confirmed excellent accuracy of cystatin C in AKI diagnosis (AUC=0.992). With the cut-off value of cystatin C increment byor =50%, the diagnostic sensitivity and specificity of AKI was 92% and 95%, respectively.Cystatin C can serve as a good indicator for AKI diagnosis to allow earlier detection of AKI than Scr-based diagnosis in patients after cardiac surgery.

To investigate the role of serum-and-glucocorticoid-inducible-kinase-1 (SGK1) in colitis and its potential pathological mechanisms.SGK1 expression in mucosal biopsies from patients with active Crohn's disease (CD) and normal controls was detected by immunohistochemistry. We established an acute colitis model in mice induced by 2,4,6-trinitrobenzene sulfonicacid, and demonstrated the presence of colitis using the disease activity index, the histologic activity index and hematoxylin and eosin staining. The cellular events and potential mechanisms were implemented with small interference RNA and an inhibitor of signaling molecule (i.e., U0126) in intestinal epithelial cells (IECs). The interaction between SGK1 and the signaling molecule was assessed by co-immunoprecipitation.SGK1 expression was significantly increased in the inflamed epithelia of patients with active CD and TNBS-induced colitis model (0.58 ± 0.055 vs 0.85 ± 0.06, P0.01). At the cellular level, silencing of SGK1 by small interference RNA (siSGK1) significantly inhibited the phosphorylation of mitogen-activated protein kinase kinase 1 (MEK1) and the downstream molecule extracellular signal regulated protein kinase (ERK) 1/2, which induced the upregulation of p53 and Bcl-2-associated X protein, mediating the subsequent cellular apoptosis and proliferation in IECs. Cells treated with MEK1 inhibitor (i.e., U0126) before siSGK1 transfection showed a reversal of the siSGK1-induced cellular apoptosis.Our data suggested that SGK1 may protect IECs in colitis from tumor necrosis factor-α-induced apoptosis partly by triggering MEK/ERK activation.

To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12–30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P