ABSTRACT
Objective:To investigate the characteristics of renal disease spectrum in children aged 0-3 years old, and to evaluate the clinical value of renal biopsy in children aged 0-3 years old with renal diseases.Methods:It was a retrospective analysis study. The children aged 0-3 years old with kidney diseases receiving renal biopsy and having complete clinical data in Shanghai Children's Hospital from January 1, 2009 to December 31, 2020 were enrolled. The clinical and pathological data of the children were collected. The spectrum of renal diseases, clinical phenotype, renal pathology, and the relationship between renal pathology/genotype and clinical phenotype were analyzed.Results:A total of 117 children aged 0-3 years old with kidney diseases were enrolled in the study, accounting for 6.5% (117/1 790) of all children (0-18 years old) with renal biopsies during the same period. There were 77 males and 40 females. The age was (2.20±0.51) years old (5-35 months). All cases of renal biopsies in children aged 0-3 years old were successful without serious complications. Nephrotic syndrome was the common clinical phenotype of kidney diseases in children aged 0-3 years old (59.0%, 69/117), followed by hematuria and proteinuria (29.1%, 34/117). Primary glomerular disease (69.2%, 81/117) was the major clinical type of renal diseases, followed by hereditary kidney diseases (29.1%, 34/117), in which Alport syndrome was the main hereditary kidney disease (79.4%, 27/34). Renal pathological types of children aged 0-3 years old were mainly distributed in minimal change disease (30.8%, 36/117), followed by glomerular minor lesion (26.5%, 31/117), mesangial proliferative glomerulonephritis (15.4%, 18/117), and focal segmental glomerulosclerosis (10.3%, 12/117). Among 40 children aged 0-3 years old with hematuria with/without proteinuria, 25 cases were diagnosed as Alport syndrome by abnormal immunofluorescence of type IV collagen in renal tissues. Among the 28 children with kidney diseases who underwent genetic testing, 23 cases had gene mutations, mainly in COL4A5 gene (60.9%, 14/23), among which 4 children had gene mutations in 8 children with refractory nephrotic syndrome. Among the children aged 0-3 years old with clinical manifestations of hematuria, the proportion of gross hematuria in children diagnosed with Alport syndrome (59.3%, 16/27) was significantly higher than that in children without Alport syndrome (20.0%, 3/15, χ2=5.999, P=0.014). Conclusions:Primary glomerular disease is the principal type of kidney diseases in children aged 0-3 years old, followed by hereditary kidney disease. Attention should be paid to children aged 0-3 years old with gross hematuria. Renal biopsy in children aged 0-3 years old is safe and reliable, and it is an essential means for the diagnosis of renal diseases. Renal biopsy combined with gene testing can better understand the etiology of kidney diseases and guide treatment in children aged 0-3 years old.
ABSTRACT
Objective To discuss thk curk kffkct and sidk kffkcts of donor anti-CD19 chimkric antigkn rkckp-tor T lemphocetks(CD19 CLA-T)for trkating rkcurrknt acutk B-ckll lkuckmia aftkr allogknkic hkmatopoiktic stkm-ckll transplantation(Lllo-HSCT),and to analezk thk influkncing factors for this thkrape. Methods Thk clinical data of 5 acutk B-ckll lkuckmia patiknts wkrk analezkd rktrospkctivkle who rklapskd aftkr Lllo-HSCT and rkckivkd donor CD19 CLA-T thkrape at Bkijing Childrkn＇s Hospital from Jule 2015 to Octobkr 2017. Diskask status bkfork infusion, conditioning rkgimkn,rkinfusion ckll dosk,and sidk-kffkct of CLA-T infusion,changks in thk rklatkd immunological indicators,and follow-up trkatmknt rksults wkrk invkstigatkd. ResuIts Onk patiknt had no kffkct,othkr patiknts got rk-mission or minimal rksidual diskask(MAD)nkgativk within 4 wkkcs aftkr CLA-T infusion,and thk middlk timk was 14 daes. Pkriphkral CLA-T pkac happknkd 2 wkkcs aftkr CLA-T infusion. Be thk last follow,2 patiknts dikd of lkuckmia, 3 patiknts wkrk alivk,and 1 cask of thkm livkd with tumor aftkr CD19 nkgativk rklapsk,othkrs livkd with diskask-frkk condition. Cetocink rklkask sendromk(CAS)was thk most common sidk kffkct,happkning in 1 to 2 wkkcs aftkr infusion, 1 patiknt had nkurologic toxicitiks,and 2 patiknts had suspicious graft -vkrsus -host diskask. ConcIusions Donor CD19 CLA-T thkrape has a good short-tkrm kffkct for rklapskd B -ckll lkuckmia patiknts aftkr Lllo -HSCT,but long-tkrm kffkct rkquirks furthkr obskrvation;CAS is thk most common sidk-kffkct. Off-targkt and ckll kxhaustion ark thk main rkasons for dkfkat.
ABSTRACT
Objective To investigate the effect of community diabetic prevented and treated by integrated traditional Chinese and western medicine based on TCM constitution identification. Methods There were 700 patients with diabetes aged 45 to 65 by cluster sampling in community, divided into two groups:experimental group and observation group. The observation group was treated with standardized management and treatment of diabetes. The experimental group was in addition to treated with standardized management and treatment of diabetes, but also given targeted Chinese medicine health guidance and intervention based on TCM Constitution identification. The research last for one year. To observe the fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin and diabetic symptoms scale of the two groups before and after intervention. Results The fasting blood glucose and 2-hour postprandial blood glucose had significant difference before and after the intervention (P<0.01), between the experimental and observation group (P=0.001, 0.014). It had significant differences between the two groups in postprandial 2 h blood glucose by analysed of interaction comparison (P=0.002). The scores of diabetic symptoms had significant difference before and after the intervention in different groups (P<0.01). And it also had significant differences in analysis of interaction comparison (P<0.01). Before and after the intervention of diabetes symptoms curative effect index difference was statistically significant (mann whitney U=-2.302, P=0.021). Conclusions Community diabetic prevented and treated by integrated traditional Chinese and western medicine based on TCM constitution identification plays a certain role in the control of blood sugar. It can effectively improve the patient's disease symptoms. While the mechanism still need further study.
ABSTRACT
Objective To analyze the clinical characteristics,treatment and prognosis of allogeneic hematopoietic stem cell transplantation (allo-HSCT)-associated thrombotic microangiopathy (TA-TMA) in children.Methods The clinical information,treatment and prognosis of 9 cases with TA-TMA hospitalized following alloHSCT from January 2008 to November 2017 in Hematology Oncology Center,Beijing Children's Hospital,Capital Medical University were retrospectively analyzed.Results Of all the 283 allo-HSCT recipients,9 patients (3.2％) were diagnosed as TA-TMA.Among them,there were 5 male and 4 female,with a median age of 94 months (39-129 months).The median time to of diagnosis was 63 days (6-342 days) after HSCT.Additionally,the median platelet counts,hemoglobin and lactate dehydrogenase(LDH) levels were 44 × 109/L [(7-75) × 109/L],76 g/L (40-105 g/L) and 594 U/L(445-1 386 U/L).Neurological symptoms were found in 5 of the patients,4 had kidney involvement,and 6 had gastrointestinal involvement.The major treatment of TA-TMA was plasma exchange,Rituximab and defibrotide instead of the use of calcineurin inhibitors.Finally,4 patients achieved response after treatment,5 children died of ineffective treatment.Conclusion TA-TMA is a fatal complication after allo-HSCT.It can lead to multiorgan and multi-systems dysfunction.If there are more than 2 systems involved in TA-TMA,it suggests poor prognosis.The combined therapy is better than monotherapy,and the selective individual treatment of TA-TMA is essential.
ABSTRACT
Objectives To explore the distribution of CTX-M drug resistance genotypes in Escherichia coli isolated from urethra in children and the influence of pH changes on its drug resistance. Methods A total of 113 strains of Escherichia coli isolated from clean midstream urine in children with urinary tract infection were cultured from October 2013 to May 2014. The drug sensitivity of ESBL-producing Escherichia coli was detected and counted. The distribution of CTX-M drug resistance genotypes were analyzed by PCR and gene sequencing. Different pH environment was established in vitro to evaluate the effect of pH on drug resistance of CTX-M resistant Escherichia coli. Results In 113 Escherichia coli strains, there were 68 ESBL-producing strains (60.18％), in which rate of drug resistance to meropenem and imipenem were 1.47％ and 2.94％ respectively. There were 41 strains carried CTX-M drug resistance genotype, which mainly were type CTX-M-14 and type CTX-M-15, 18 strains each. Compared with neutral environment of the pH value at 6 or 6.5, the rate of Escherichia coli resistant to cefuroxime, cefotaxime, ceftazidime and ceftriaxone had no difference (P>0.05), while the resistance to cefepime was significantly increased when pH was 6.0 (P<0.01). With the pH value at 8 or 8.5, the rate of Escherichia coli resistance to ceftazidime and cefepime was significantly decreased, and with the pH value at 8.5 the rate of Escherichia coli resistance to cefotaxime also significantly decreased (P<0.01). Conclusions The rate of ESBL-producing Escherichia coli resistance to carbapenem antibiotic is low. The rate of Escherichia coli carrying CTX-M drug resistance genotype is high with CTX-M-14 and CTX-M-15 being the most prevalent genotypes. Properly alkalization of urine may contribute to the treatment of CTX-M resistant Escherichia coli in children with urinary tract infection.
ABSTRACT
Objective@#To establish comprehensive laboratory reference intervals for Chinese children.@*Methods@#This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex.@*Results@#In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old.@*Conclusion@#This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.
ABSTRACT
Objective@#To summarize the characteristics of cuffed-tunneled catheters insertion and investigate the values of cuffed-tunneled catheters in pediatric patients.@*Methods@#Between March 2015 and July 2017, all the pediatric patients who received maintenance hemodialysis at least 3 consecutive months in our center were included. Sixteen cuffed-tunneled hemodialysis catheters were inserted in patients for long-term hemodialysis access. The clinical manifestations and complications were retrospectively reviewed.@*Results@#Fifteen pediatric patients with end stage ranal disease (ESRD) were included in this study and they received 16 cuffed-tunneled catheters for long-term vascular access, including 10 males and 5 females; median age at start of catheter insertion was 11.5 (4.2-14.5) years. Body weight was (27.8±8.0)kg (16.0-39.4 kg) . The size and the length of the catheters were based on the height of patients as follows: 28 cm for (115.6±10.6) cm (102.0-130.0 cm) ,36 cm for (148.6±9.9)cm (140.0-167.0 cm) . Cuffed-tunneled catheters outcome: 10 cuffed-tunneled catheters were still functional at the end of the study; 5 catheters were removed after successful kidney transplantation. Catheter failure occurred in 1 out of 16 cuffed-tunneled catheters due to catheter-related infections. The median catheter survival time was 11.9 months (range 3.5-21.3 months). Complications of cuffed-tunneled catheters: Catheter placements operation was successful in 15 cases using ultrasound guidance. No serious complications were observed in any patients receiving catheter inserting operation. The overall rate of catheter-related infections and thrombosis/malposition was 6.3% and 18.7%, respectively.@*Conclusions@#Ultrasound guidance is suggested in pediatric patients during the catheters insertion. The size and the length of the catheters should be based on the height of patients. Cuffed-tunneled hemodialysis catheters could be effectively used for maintenance of hemodialysis vascular access for pediatric patients with ESRD.
ABSTRACT
Objective To investigate the significance of acute kidney injury biomarkers with calcineurin inhibitors (CNI) related nephrotoxicity in the treatment of refractory nephritic syndrome.Methods Ninety-two patients were included with 59 males and 33 females with average age of (5.67 ± 3.65) years old,who were diagnosed with nephrotic syndrome at Shanghai Children's Hospital from March 2014 to December 2015.66 patients including 44 males and 22 females with mean age of (4.97 ± 3.52) were treated by steroid as the control group and 26 patients including 15 males and 11 females with mean age of (6.59 ± 3.95) were treated by steroid combined with CsA and FK506 as the observation group.The blood,urine samples were collected before drug treatment (0 d) and very early stage of treatment (3 d),early stage (1 month),middle and late stage (3 months and 6 months) as the different observation time points.The change level of neutrophil gelatinase associated lipocalin(NGAL),kidney injury molecular-1 (KIM-1),fibronectin(FN) and tumor necrosis factor-alpha(TNF-α) in serum and urine were detected at different time points to compare with biomarkers such as retinol-binding protein(RBP),N-acetyl-β-D-glucosamccharase(NAG) in urine.Results The serum NGAL(sNAGL) level was more obvious after 6 months of CNI treatment in the observation group than in the control group[(138.00 ±32.49) μg/L vs.(46.54± 11.41) μg/L,t =2.115,P ＜0.05];the level of urine TNF-oα(uTNF-α) was higher obviously after 6 months of CNI treatment in the observation group than in the control group with significant differences [(2.35 ± 0.78) pg/μmol vs.(0.75 ± 0.36) pg/μmol,t =1.840,P ＜ 0.05];the level of urine KIM-1 (uKIM-1) was lower in the observation group than the control group after 3 months treatment of the CNI [(0.15 ± 0.03) ng/μmol vs.(0.33 ± 0.07) ng/μmol,t =-2.077,P ＜ 0.05);the level of urine NGAL (uNGAL) was lower in the observation group than the control group after 3 months treatment of the CNI [(0.09 ±0.03) ng/μmol vs.(0.23 ± 0.04) ng/μmol,t =-2.959,P ＜ 0.05].But the serum TNF-α (sTNF-α),urine FN (uFN),urine RBP(uRBP) and urine NAG (uNAG)did not show any significant change before and after the C NI treatment.Conclusions Compared with other acute kidney injury biomarkers (uNGAL,KIM-1,FN,RBP,and NAG),sNAGL and uTNF-α may be more sensitive to the early evaluation of CNI related nephrotoxicity.The occurrence of CNI related kidney injury shall be watched out at the beginning of 6-month of CNI treatment.
ABSTRACT
Objective To investigate the significance of acute kidney injury biomarkers with calcineurin inhibitors (CNI) related nephrotoxicity in the treatment of refractory nephritic syndrome.Methods Ninety-two patients were included with 59 males and 33 females with average age of (5.67 ± 3.65) years old,who were diagnosed with nephrotic syndrome at Shanghai Children's Hospital from March 2014 to December 2015.66 patients including 44 males and 22 females with mean age of (4.97 ± 3.52) were treated by steroid as the control group and 26 patients including 15 males and 11 females with mean age of (6.59 ± 3.95) were treated by steroid combined with CsA and FK506 as the observation group.The blood,urine samples were collected before drug treatment (0 d) and very early stage of treatment (3 d),early stage (1 month),middle and late stage (3 months and 6 months) as the different observation time points.The change level of neutrophil gelatinase associated lipocalin(NGAL),kidney injury molecular-1 (KIM-1),fibronectin(FN) and tumor necrosis factor-alpha(TNF-α) in serum and urine were detected at different time points to compare with biomarkers such as retinol-binding protein(RBP),N-acetyl-β-D-glucosamccharase(NAG) in urine.Results The serum NGAL(sNAGL) level was more obvious after 6 months of CNI treatment in the observation group than in the control group[(138.00 ±32.49) μg/L vs.(46.54± 11.41) μg/L,t =2.115,P ＜0.05];the level of urine TNF-oα(uTNF-α) was higher obviously after 6 months of CNI treatment in the observation group than in the control group with significant differences [(2.35 ± 0.78) pg/μmol vs.(0.75 ± 0.36) pg/μmol,t =1.840,P ＜ 0.05];the level of urine KIM-1 (uKIM-1) was lower in the observation group than the control group after 3 months treatment of the CNI [(0.15 ± 0.03) ng/μmol vs.(0.33 ± 0.07) ng/μmol,t =-2.077,P ＜ 0.05);the level of urine NGAL (uNGAL) was lower in the observation group than the control group after 3 months treatment of the CNI [(0.09 ±0.03) ng/μmol vs.(0.23 ± 0.04) ng/μmol,t =-2.959,P ＜ 0.05].But the serum TNF-α (sTNF-α),urine FN (uFN),urine RBP(uRBP) and urine NAG (uNAG)did not show any significant change before and after the C NI treatment.Conclusions Compared with other acute kidney injury biomarkers (uNGAL,KIM-1,FN,RBP,and NAG),sNAGL and uTNF-α may be more sensitive to the early evaluation of CNI related nephrotoxicity.The occurrence of CNI related kidney injury shall be watched out at the beginning of 6-month of CNI treatment.
ABSTRACT
Objective To explore the relationship between the expression of transient receptor potential cation channel subfamily C member 6 (TRPC6) and podocyte injury in children with primary nephrotic syndrome (PNS) and its clinical significance. Methods The renal tissue of 18 children with PNS was obtained. The pathological changes of kidney were observed by routine section staining and light microscopy. The structural changes of podocyte were observed by electron microscope. The mRNA and protein expressions of TRPC6 in tissues were determined by qPCR and immunohistochemistry, respectively. Further the correlation of TRPC6 mRNA with serum levels of albumin (Alb), creatinine (Cr), triacylglycerol (TG), cholesterol (Tch), complement C3 and 24 h urinary protein quantitation and estimated glomerular filtration rate (eGFR) were analyzed respectively. Results The expression of TRPC6 protein in renal tissue of children with PNS was higher than that in the control group, and the difference was statistically different (P0.05). Conclusion The pathological types of PNS were mainly podocyte lesions, and the expression of TRPC6 protein was increased in podocytes. TRPC6 detection may be helpful in the diagnosis of podocyte lesions.
ABSTRACT
Objective To explore the relationship between quality life and TCM constitutions of elderly patients with hypertension in a community in Shanghai; To provide the basis for the suitable and feasible community elderly hypertension management method. Methods Through multistage stratified sampling method, 808 elderly patients with hypertension in the community were investigated for their life quality and TCM constitutions on the basis of inform consent and voluntary participation. The life quality and TCM constitution characteristics as well as the relationship were analyzed by applying the statistic analysis software. Results Among the investigated elderly patients with hypertension in the community, 97.28% cases’ overall life quality was above the middle level and 91.46% cases’ self-evaluated health and quality of life scores were above the middle level. 54.70% cases were gentleness type, and the biased constitution was dominated by qi deficiency, yang asthenia, yin asthenia and phlegmatic hygrosis. The relationship between life quality and TCM constitutions may be existent. If TCM constitutions tended to be gentleness type, the physical score and the psychological score would be higher, which leaded to better quality of life. Conclusion TCM constitution characteristics are associated with quality life of elderly hypertension patients in the community. Intervention targeted on the results of TCM constitution identification would be better to prevent and control hypertension and improve health level and quality of life.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinical features and gene mutation of Chinese children with Alport syndrome(AS).</p><p><b>METHOD</b>From May 2011 to May 2014, clinical and pathological information gathered from 25 patients was retrospectively analyzed. COL4A5, COL4A4 and COL4A3 genes were analyzed using next-generation sequencing in these patients, and gene mutations of related family members were identified by Sanger method.</p><p><b>RESULT</b>Of these 25 cases, 19(76%) had X-linked Alport syndromes (XL-AS), 6 had autosomal recessive Alport syndromes (AR-AS). Twenty five patients had an onset of hematuria and proteinuria and in 8 cases the disease was induced by upper respiratory tract infections. Hearing loss was present in 2 of 25 (8%) cases and ocular lesions in 1 of 25 (4%). Renal pathology showed that 16 of them had minimal change disease (MCD), 8 mesangial proliferative glomerulonephritis (MsPNG), 1 focal segmental glomerulo-sclerosis (FSGS). Extensive lamination and split of glomerular basement membrane (GBM) dense layers were found in 2 (8%) of 25 patients. Twenty one of 25 patients (84%) showed abnormal renal α-chain distribution. COL4A5, COL4A4 and COL4A3 genes of 25 patients (23 families) were analyzed and 24 pathogenic mutations were identified: 18 in COL4A5, 1 in COL4A3 and 5 in COL4A4. It was observed that 13 patients inherited the mutation from the mother, 3 patients inherited from the father, 2 patients inherited 1 mutation from the mother and another mutation from the father, and 7 patients carried the novel mutations.</p><p><b>CONCLUSION</b>XL is the main inherited type in AS. Most of patients showed MCD and MsPNG in renal biopsy. This research examined 24 mutations and 16 mutations were not reported previously.</p>
Subject(s)
Child , Humans , Deafness , Genes, Recessive , Genotype , Hematuria , Kidney , Mutation , Nephritis, Hereditary , Genetics , Pathology , Pedigree , PhenotypeABSTRACT
Objective To observe the incidence,clinical types,and prognosis of pulmonary involvement in children with systemic lupus erythematosus(SLE),and to probe the relationship between the relative factors.Methods The clinical data of 61 children with SLE,who treated in Children's Hospital of Shanghai from Jan.2006 to Dec.2011 were analyzed retrospectively.The lung manifestations of the patients were classified according to their clinical symptoms and signs,and lung imaging examination (chest X-ray and CT).Other data of the SLE patients with lung injury or without lung injury were collected,including the course of the disease,activity index [SLE disease activity index (SLEDAI) scoring 0-4 was divided into no activity,5-9 was divided into low activity,10-14 was divided into moderate activity,and more than 15 as severe activity],blood sedimentation,the values of serum complement and the positive rate of dsDNA in autoantibody,and a comparison was made and statistical analysis was performed.Results Pulmonary injury occurred in 17 cases with an incidence rate of 27.9％ (17/61 cases),and the average course of the disease was (8.76 ± 6.96) months.The clinical manifestations of 17 cases included fever,cough,dyspnea,hypoxemia,chest pain,lower breath sound,and lung rale,which were not non-specificity.According to imageological examination,in 17 cases there were 2 cases with pulmonary hypertension (the incidence rate was 11.8％),4 cases with acute lupus pneumonitis (the incidence rate was 23.5％),6 cases with interstitial pneumonia (the incidence rate was 35.3％),7 cases with lesion of pleura (the incidence rate was 41.2％),10 cases with pulmonary infection (the incidence rate was 58.8％).There were no statistical differences between patients with and without lung injury(infectious and non-infectious)in the course,the values of serumn complement,the positive rate of dsDNA and activity index.Lung lesions of the 17 patients recovered quickly after early diagnosis and active treatment.Conclusions Pulmonary manifestation in children with SLE is not uncommon,and it can happen at any stage of the disease,not just on the stage of lupus activity,but it usually indicates disease was not controlled.Pulmonary manifestation of SLE in children involve many parts of lung,including pulmonary parenchyma,interstitial,blood vessels,pleura,etc.Early diagnosis and active treatment can improve the short-term prognosis of lung injury with lupus,and long-term outcome remains to be observed.
ABSTRACT
ObjectiveTo investigate the effect and outcome of critically illness with acute kidney injury (AKI) treated with continuous veno-venous hemodiafiltration (CVVHDF) in children.Methods Twenty-four cases of critically illness with AKI were treated with CVVHDF in our pediatric intensive care unit from Jan 2008 to Dec 2010.The levels of creatinine (Cr),blood urea nitrogen (BUN),K +,Na + and HCO3- were observed before CVVHDF and 6,12,24,48,72 h after CVVHDF.ResultsCatheter was successfully established for CVVHDF in 24 cases of AKI.The average duration of CVVHDF was 46 h ( 16 ～142 h).The blood levels of Cr and BUN were significantly decreased at 6 h after CVVHDF [ ( 196.3 ±112.4) μmol/L,( 13.3 ± 8.5 ) mmol/L] and 12 h after CVVHDF [ ( 106.1 ± 84.2) μ mol/L,( 10.2 ± 9.7 )mmol/L] as compared to those before treatment [ (340.6 ±298.2) μmol/L,(31.6 ± 11.3) mmol/L] (P ＜0.05,P ＜ 0.01 ).After 48 h of CVVHDF,the Cr,BUN returned to normal range.The imbalance of blood K +,Na +,and HCO3- improved at 6 h after CVVHDF and returned to nomal levels at 24 h.Total 28 d fatality rate was 29.2％ (7/24),and all death cases were complicated with multiple organ dysfunction syndrome.ConclusionCVVHDF therapy for AKI can quickly clear Cr,BUN and excess water,correct electrolyte disorders,improve kidney function in children.
ABSTRACT
Objective To observe the action of Rhodiola Crenulate(RC) oral liquid reproduction function for the male rats. Methods 100 SD rats were randomly divided into 5 groups with equal gender number respectively. The male rats were given RC oral liquid (0, 2.48 g/kg, 7.48 g/kg, 24.80 g/kg) and Nanbao (2.00 g/kg)by oral twice a day for 48 d, respectively. Then the male rat was put into the same box in which the female rat whit two-side ovarys were excised for 15 d, respectively. The intercoursing ability,testosterone levels, and the weight of immune organs of the male rats were examined. 40 four-week-old rats were divided into 5 groups. Except for blank control, all rats's testis were excised. The castrated rats were treated with RC oral liquid (2.48 g/kg, 24.8 g/kg)and Methyltestosterone (2.00 mg/kg). The blank control group and model control group were given the same dose NS by oral twice a day for 28 d, respectively. The weight of accessory sex organs in castrated rats was observed. Results The level of testosterone and the organ coefficients of thymus and spleen in RC oral liquid groups were higher than blank control (P<0.05 or P<0.01).The weight of accessory sex organs of castrated rats in RC oral liquid groups were heavier than model control (P<0.05). Conclusion RC oral liquid can improve the reproduction function in male rats.
ABSTRACT
As patients with type 1 diabetes,both the function and number of their beta cells decreased.Despite treating with insulin in early stage,it can't avoid the occurrence of serious complications or death.However,Immunotherapy,different from the previous replacement therapy,emphasizes re-balance between affected T cells and immune regulative effect,suppresses autoimmune reaction,and strengthens the tolerance of beta cells of islet to it.At present,a variety of immune medicines have already been approved for the treatment of type 1 diabetes,such as anti-CD3 monoclonal antibody,GAD-alum,etc.
ABSTRACT
We arranged for experienced doctors to carry out the programme of short-term strengthening training in obstetrics,gynecology and pediatrics to trainees before the end of their clinical practice,aiming at assisting trainees to systematize and categorize skill and knowledge that they had gained confusedly and disorderly during obstetrics,gynecology and pediatrics practice.It demonstrated that such programme was beneficial to their comprehensive examination of graduation and future clinical practice.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the effect of fluoroacetamide on cardiomyocytes of rat and the antidotal effect of acetamide.</p><p><b>METHODS</b>4 groups of SD rats were treated with various dosages of fluoroacetamid(p.o.) and 2 groups of them were treated with acetamide(i.p.). The changes of cardiomyocytes and serum AST, LDH, CK, CK-MB and HBDH were measured at different intervals after poisoning.</p><p><b>RESULTS</b>In the group treated with fluoroacetamid 8 mg/kg. bw, serum AST[(589.58 +/- 821.72) U/L], CK[(916.78 +/- 343.55) U/L], HBDH[(504.47 +/- 148.88) U/L] raised obviously compared with control[(187.70 +/- 46.87), (755.65 +/- 498.90), (347.25 +/- 228.40) U/L respectively] (P < 0.01), and the pathological findings such as degeneration, liquefactive necrosis and filtration of inflammatory cells in cardiac muscles were observed 24 hours later, while all the male dead within 3 days. In the group treated with fluoroacetamid 4 mg/kg. bw, serum LDH and HBDH rose significantly compared with control(P < 0.01) 5 day later. On the day of 10, myocardial enzymes restored in all experiment groups with some interstitial fibroblastic proliferation. The pathological changes were reduced in the group treated with acetamide synchronously (100 mg/kg. bw).</p><p><b>CONCLUSION</b>Acute intoxication of fluoroacetamide could damage cardiomyocytes while acetamide could reduce the injury of them, but the injury was reversible. The levels of serum myocardial enzymes could be a usable index for early diagnosis.</p>