Clinical effect of tacrolimus combined with glucocorticoid in the treatment of IgA nephropathy in children / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect and safety of tacrolimus (TAC) combined with glucocorticoid (GC) versus mycophenolate mofetil (MMF) combined with GC in the treatment of primary IgA nephropathy (IgAN) in children.@*METHODS@#A retrospective analysis was performed for the clinical data of children with primary IgAN confirmed by renal pathology between January 2012 and December 2017. These children were divided into TAC group and MMF group according to the treatment regimen. Their clinical data before treatment and at 1, 3, and 6 months of treatment were collected, and the remission status of IgAN and adverse reactions were compared between the two groups.@*RESULTS@#A total of 43 children who met the inclusion criteria were enrolled, with 15 children in the TAC group and 28 children in the MMF group. At 1 month of treatment, there was no significant difference in the remission status between the two groups (P>0.05). At 3 and 6 months of treatment, the TAC group had a significantly better remission status than the MMF group (P0.05), but fungal infection was observed in one child from the TAC group.@*CONCLUSIONS@#TAC combined with GC can effectively reduce urinary protein in children with primary IgAN, and it has a better short-term clinical effect than MMF combined with GC, with good safety.

Arterial stiffness and its impact on prognosis in patients with stage 3-5 chronic kidney disease(pre-dialysis) / 中国实用内科杂志

OBJECTIVE: To assess the impact of arterial stiffness on prognosis in patients with chronic kidney disease(CKD)stages 3-5(pre-dialysis).METHODS: 141 patients suffered from chronic kidney disease(CKD)stages 3-5 pre-dialysis were enrolled in this study between April 2006 and November 2010.Automatic pulse wave velocity(PWV)measuring system was used to examine carotid-femoral pulse wave velocity(CFPWV).According to CFPWV level,we divided the patients into elevated CFPWV group(CFPWV ≥12 m/s)and the normal group(CFPWV<12 m/s).Patients were followed up for the occurrence of cardiovascular event,cardiovascular death and all-cause death.Kaplan-Meier methods were used for survival analysis and Cox's proportional hazard regression model were used to analyze risk factors.RESULTS: Two groups were followed-up(93.72±47.93)months.The incidences of cardiac-cerebral vascular event,cardiac-cerebral vascular death and all-cause death were higher in high CFPWV level groups(62.2%vs.21.6%,56.7%vs.15.7%,64.4%vs.19.6%,P<0.05).The level of CFPWV was higher in patients with cardiac-cerebral vascular event,cardiac-cerebral vascular death and all-cause death than those without those events[(15.31±3.41)m/s vs.(12.08±2.94)m/s,(15.66±3.40)m/s vs.(12.14±2.88)m/s,(15.38±3.38)m/s vs.(11.97±2.87)m/s,P<0.01].Kaplan-Meier curve for overall survivals and cardiac-cerebral vascular event free survivals showed a significant distinct between high and normal CFPWV level groups,suggesting that the incidence of cardiac-cerebral vascular events,cardiac-cerebral vascular mortality and all-cause mortality were significantly higher in high CFPWV level group than in normal CFPWV group(P=0.000).Multivariate Cox regression analysis revealed that increased CFPWV and commencing dialysis were the independent risk factors for cardiac-cerebral vascular event,increased CFPWV and CRP and decreased ALB and commencing dialysis were the independent risk factors for cardiac-cerebral vascular mortality and all-cause mortality(P<0.05).CONCLUSION: The levels of CFPWV in pre-dialysis chronic kidney disease(CKD)stage 3-5 patients increases significantly.The incidence of cardiac-cerebral vascular events,cardiac-cerebral vascular mortality and all-cause mortality are significantly higher in elevated CFPWV group than those of normal group in patients with CKD G3-5.The elevated CFPWV is one of independent risk factors of cardiac-cerebral vascular event,cardiac-cerebral vascular mortality and all-cause mortality in patients with pre-dialysis chronic kidney disease.

Expression of Pref-1 and Related Chemokines during theDevelopment of Rat Mesenteric Lymph Nodes / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The aim of this study was to investigate the ability of Pref-1+ adipocyte progenitor cells to mobilize into mesenteric lymph nodes (MLNs) and the dynamic expression of related chemokines during the development of rat MLNs.</p><p><b>METHODS</b>Immunohistochemical analyses were used to detect the expression of Pref-1 and related chemokines. Transmission electron microscopy (TEM) was used to observe the changes in ultrastructure of MLNs.</p><p><b>RESULTS</b>Cells containing lipid droplets were found in all rat MLNs at embryonic day (E) 18.5, 2 and 6 weeks (w) after birth, and they were similar to fibroblastic reticular cells (FRCs) or follicular dendritic cells (FDCs) under TEM. Pref-1+ adipocyte progenitor cells were found in all MLNs. The expression level of Pref-1 was significantly increased at 2 w after birth and decreased at 6 w after birth. The tendency of Cxcl12 expression was consistent with that of Pref-1 and was positively correlated with the expression of Pref-1 (P < 0.01; r = 0.897). At E18.5, Cxcl13, and Ccr7 were significantly expressed in the MLN anlage, but the expression level of Ccl21 was low. The expression level of Cxcl13, Ccr7, and Ccl21 in MLN were significantly increased at 2 w after birth (P < 0.05), while the expression of Ccr7 and Ccl21 were significantly decreased at 6 w after birth (P < 0.05).</p><p><b>CONCLUSION</b>Adipocyte progenitor cells are involved in the rat MLNs development through differentiation into FRC and FDC. The expression of the relevant chemokines during the development of MLNs is dynamic and may be related to the maintenance of lymph nodes self-balance state.</p>

Influence of pulmonary function after combined thoracoscopic and laparoscopic esophagectomy for the treatment of esophageal carcinoma / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the influence of combined thoracoscopic and laparoscopic esophagectomy for early postoperative pulmonary function, and to study the relative factors for postoperative pulmonary complications.</p><p><b>METHODS</b>From September 2009 to December 2010, 61 patients with esophageal cancer had undergone esophagectomy surgery, of which 32 patients had undergone combined thoracoscopic and laparoscopic esophagectomy (CTLE group), and 29 patients had undergone open three-field esophagectomy (open group). Pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)) were measured on the 1(th) preoperative day, 5(th) and 10(th) postoperative day, and arterial blood gas analyses were performed during the same period. Meanwhile, pain scores and other potentially relevant factors were recorded as well.</p><p><b>RESULTS</b>Preoperative pulmonary function and arterial blood gas analysis, including FEV(1)%, FVC%, PaO2 in two groups had no significant difference (t = -1.608 to 0.709, P = 0.113 to 0.481). On the 10(th) postoperative day, FEV(1)%, FVC%, PaO2, and SaO2 of two groups were significantly different (FEV(1)%: 77% ± 17% vs. 53% ± 13%, t = 6.241, P = 0.000; FVC%: 78% ± 13% vs. 57% ± 16%, t = 5.549, P = 0.000; PaO2: (87 ± 9) mmHg vs. (79 ± 14) mmHg, t = 2.477, P = 0.017; SaO2: 96% ± 3% vs. 94% ± 2%, t = 2.313, P = 0.024; 1 mmHg = 0.133 kPa). Pain score of CTLE group was lower than open group, and the scores of two groups had significant difference before the 5(th) day after surgery (t = -4.398 to -1.815, P = 0.000 to 0.049). Postoperative pulmonary complications of CTLE group was lower than open group (6/32 vs. 12/29, χ(2) = 3.745, P = 0.049).</p><p><b>CONCLUSIONS</b>Combined thoracoscopic and laparoscopic esophagectomy has advantages on early postoperative pulmonary function. It can relatively reduce the incidence of pulmonary complications after surgery.</p>

Development and clinical application of the tractor for the fracture reduction / 中国医疗器械杂志

This paper expounds how the tractor for the fracture reduction works. The clinical results show that the traction apparatus is a labour-saving and time-saving orthopedic device with simple operation and few suffering to patients.