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Objective: To summarize the clinical features of invasive pulmonary fungal infection (IPFI) secondary to malignant blood diseases (MBD)., Methods: We retrospectively analyzed the clinical data of 52 patients with IPFI secondary to MBD admitted to Peking Union Medical College Hospital from January 1995 to December 2008., Results: The incidences of IPFI secondary to acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), non-Hodgkin's lymphoma (NHL), and aplastic anemia (AA) were 4.6%, 3.2%, 2.8%, and 2.5%, respectively. In patients with IPFI secondary to AML, 88.5% (23/26) of the patients suffered from the infections during the non-remission (NR) period (including relapse), and 11.5% (3/26) in the complete-remission (CR) period. In all the patients with IPFI secondary to malignant blood diseases, 86.5% (45/52) of MBD were neutropenic or agranulocytic, and 67.3% (35/52) had been treated with broad-spectrum antibiotics for more than 96 hours before anti-fungal therapy. The total mortality after anti-fungal therapy was 13.7% (7/51). More than half of patients with fluconazole or itraconazole as the first-line therapy had to switch to other medicines because of poor infection control., Conclusions: IPFI secondary to MBD is most common in AML patients. Patients with NR of AML, neutropenia or agranulocytosis, and long-term broad-spectrum antibiotics usage are susceptible to IPFI. Fluconazole and itraconazole have low efficacy, and other more potent anti-fungal medicines should be considered.

Objective: To explore the ideal anticoagulation dose of argatroban during high volume hemofiltration., Methods: Crossover study was designed and 10 patients were treated with high volume hemofiltration for 3 times. Three argatroban anticoagulation regimens were instituted accordingly. The dose of argatroban was 0.02 mg kg (-1) h(-1) in regimen A, 0.04 mg kg(-1) h(-1) in regimen B, and 0.06 mg kg(-1) h(-1) in regimen C. Coagulation parameters of patients on 1, 4 and 8 hours after the beginning of treatment were detected. Coagulation degree of the filter at the end of treatment and bleeding event during 12 hours after the end of treatment were observed., Results: The value of activated partial thromboplastin time (APTT), thrombin time (TT) and international normalized ratio (INR) after treatment were significantly higher than those before treatment (all P<0.05). APTT during treatment showed no difference among three regimens. TT and INR of 1 hour after beginning of treatment in patients of regimen C and B were longer than those in regimen A (all P<0.05), there was no bleeding event in three regimens. Filter coagulation in regimen C at the end of treatment was more serious than other two regimens., Conclusion: Argatroban dose in the range of 0.02-0.06 mg kg(-1) h(-1) is safe for anti-coagulation in high volume hemofiltration.

Objective: To investigate the anticoagulant methods and characters of hemodialysis patients in hospitals of Grade III Level A., Methods: A questionnaire survey was conducted in 7 hemodialysis centers of class 3 first level general hospital in Beijing, Shenyang, Harbin, and Dalian, on the hemodialysis status, primary diseases, anticoagulation methods, and complications., Results: 808 of the 842 patients (95.9%) underwent hemodialysis, and 34 patients (4.1%) were subjected to hemodialysis filtration. 606 hemodialysis patients (74.9%) used heparin as the anticoagulant, and the doses and using method were different among different centers. 223 patients (26.5%) used low molecular weight heparin (LMWH) with different kinds, doses and using methods. The underlying diseases included diabetes (15.1%), hypertension (9.4%), and other diseases (75.5%). There was no significant difference in the dosage of heparin among different diseases, while the dosage of LMWH was lower for the diabetes and hypertension patients. 171 patients (20.3%) had hemorrhagic tendency, and 67 patients (20.3%) suffered from thrombus. The dosage of heparin was lower in the patients with hemorrhagic tendency while no difference was found in the dosages of LMWH among the patients with different diseases. Antiplatelet agents were co-administrated in 172 hemodialysis patients (20.4%). The percentages of co-administration of antiplatelet for patients with thrombus and hemorrhagic tendency were 14% and 12.8% respectively. The dosages of heparin and LMWH were higher in the patients with co-administration than those without co-administration. Coagulation marker examination was conducted in only 385 patients (45.7%), and no difference in the frequency of coagulation marker examination was found among the patients with hemorrhagic tendency, thrombus, and other diseases., Conclusion: Heparin is the main anticoagulant in hemodialysis. The anticoagulant methodology in hemodialysis is still empirical without clotting monitor and standard for usage of anticoagulants.

Objective: To quantitatively assess the progress of cardiovascular aging in the healthy people in North China by non-invasive ways, and to analyze the law of cardiovascular aging., Methods: 855 healthy people randomly sampled from 3 cities in northern China: Shenyang, Dalian, and Beijing, divided into 4 age groups: < or = 44, 45 - 59, 60 - 74, and > or = 75, underwent interview of the life style and dietary structure, measurement of blood pressure, heart and carotid ultrasonography, blood biochemistry, blood routine, urine routine, and detection of micro-inflammation indexes such as C-reactive protein, fibrinogen (FIB), thrombomodulin, and interleukin-6. Totally 70 items were surveyed. Then the cardiovascular aging assessment equation was constructed and cardiovascular biological aging score (CBAS) was calculated to analyze the law of cardiovascular aging., Results: Seven items including pulse pressure, carotid artery intimal-medial thickness, carotid artery end-diastolic velocity, mitral valve anulus anterior wall A, mitral valve anulus lateral wall E, FIB, total cholesterol were correlated with chronological age significantly (r = 0.63, 0.54, -0.41, 0.45, -0.42, 0.43, and 0.46, all P < 0.01). The CBAS was positively correlated with chronological age (r = 0.85, P < 0.05) with the most rapid change rate in the group aged 45 - 59., Conclusion: CAS can be used as an objective index to quantitatively assess the cardiovascular aging. With an acceleration of cardiovascular aging rate after the age 45, the speed of cardiovascular aging in healthy people may be inconstant. The age 45 - 59 may be the key threshold for cardiovascular aging.

To investigate the effect of EPO on hepcidin mRNA expression in normal mice, acute inflammatory mice and ACD mice, the acute phase model and ACD model of mouse was produced by subcutaneous injection of turpentine oil. Hepatic hepcidin mRNA expression levels of normal mice, acute inflammatory mice and ACD mice were detected by semi-quantitative retro-transcriptase polymerase chain reaction (RT-PCR) after intra-peritoneal injection of EPO. The results showed that prolonged chronic inflammation did not significantly increase mouse hepatic hepcidin mRNA expression, but a single injection of turpentine oil increased mouse hepatic hepcidin mRNA expression transiently. Intra-peritoneal injection of EPO down-regulated hepatic hepcidin mRNA expression in normal mice, ACD mice and acute inflammatory mice. Hb levels had a negative correlation with hepatic hepcidin mRNA expression levels in ACD mice treated with EPO. It is concluded that the ACD model can be produced by repeated subcutaneous injection of turpentine oil. Hepatic hepcidin mRNA expression increased during the early period of ACD process and then fall to normal level. EPO down-regulate hepcidin mRNA expression under the normal, acute inflammation and chronic inflammation conditions.

Objective: To explore the expression and role of integrin-linking kinase (ILK) in aging rats subjected to unilateral ureteral obstruction (UUO)., Methods: The UUO model and sham-operated rats (SHAM) were established with 3-month-old rats and 26-month-old rats and the rats were sacrificed before UUO and after UUO at 3, 7 and 14 days. Immunofluorescent staining, Western blot, RT-PCR, etc were applied to detect the expressions of ILK and fibronectin (FN) in the renal of UUO rat at each time point., Results: With the time of UUO, the relative interstitial areas and tubulointerstitial fibrotic areas in 26-month-old rats were significantly higher than those in 3-month-old ones at each time point (P < 0.01) and the mRNA and protein levels of ILK and FN are increasing with the time of UUO in both groups (P < 0.01). ILK mRNA semi-quantitative values of 26-month and 3-month rats were 0.98 +/- 0.06 vs 0.72 +/- 0.06, 3 days after UUO (P < 0.01), 1.49 +/- 0.05 vs 1.03 +/- 0.04, 14 days after UUO (P < 0.01), respectively. ILK proteinsemi-quantitative values of 26-month and 3-month rats were 0.57 +/- 0.04 vs 0.52 +/- 0.03, 3 days after UUO (P < 0.01), 0.76 +/- 0.04 vs 0.63 +/- 0.03, 14 days after UUO (P < 0.01), respectively. The expressions of ILK mRNA and protein level were positively correlated with the relatively renal interstitial areas (r = 0.71, P < 0.05 and r = 0.80, P < 0.05, respectively). And the whole levels of ILK and FN in 26-month-old rats are higher than those of 3-month-old rats., Conclusion: With aging, the expressions of ILK and FN increase progressively in UUO rat, and the over-expression of ILK probably promotes renal tubulointerstitial fibrosis and aging.