Characteristics of kidney diseases in children aged 0-3 years old / 中华肾脏病杂志

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.

Analysis on unqualified items of infant formula food by supervision and sampling inspection in China / 上海预防医学

Objective:To describe the unqualified situation of infant formula food by supervision and sampling inspection in China， and then recommend appropriate countermeasures. Methods:The results of supervision and sampling inspection of infant formula food were summarized from 2015 through 2020 in China， and the unqualified items were classified and analyzed. Results:From 2015 through 2020， a total of 30 252 batches of infant formula food were sampled and examined in China， in which 187 batches were determined to be unqualified with an overall unqualified rate of 0.62% （187/30 252）. Content of items in 82 batches of samples did not meet the national standards for food safety， accounting for 43.85% （82/187） of the total number of unqualified batches. Labels in 105 batches were unqualified， accounting for 56.15% （105/187）. Generally， the unqualified rate of infant formula food showed an overall downward trend over years， with a 1.8% of decrease between 2020 （0.03%） and 2015 （1.83%）. The main problems in the unqualified infant formula food in China were minerals， vitamins， optional ingredients， microorganisms and conventional nutrients， which accounted for 39.50% （94/238）， 15.97% （38/238）， 14.29% （34/238）， 10.50% （25/238） and 10.08% （24/238） of the total unqualified items， respectively. Conclusion:Food manufacturers should strictly implement the principal responsibility of food safety， and government regulatory sectors should continue to strengthen the supervision to ensure the quality and safety of infant formula food.

Significance of serum resistin level in the diagnosis of juvenile idiopathic arthritis / 中华实用儿科临床杂志

Objective:To investigate the clinical significance of serum resistin in juvenile idiopathic arthritis(JIA) patients.Methods:A prospective observational study was performed and 32 cases of patients with systemic onset JIA(SOJIA)(SOJIA group) in children admitted to the nephrorheumatology and outpatient were enrolled at Children′s Hospital of Shanghai between October 2013 and September 2015, 52 cases of other types(N-SOJIA group), and 33 cases of other rheumatic diseases(other rheumatic diseases group), 30 cases of children undergoing health checkups in the child health outpatient clinic(healthy control group)were involved as well.Serum resistin levels were measured by enzyme-linked immunosorbent assay(ELISA), and comprehensive analysis was carried out with clinical data and related laboratory findings.The basic data of gender, age and body mass index(BMI) of each group were collected, and the duration of disease in children in JIA group, rheumatoid factor, antinuclear antibody, white blood cell, hemoglobin, platelet, C reacting protein(CRP), erythrocyte sedimentation rate(ESR), clinical manifestations and current drug use were collected.Using the receiver operating characteristic(ROC)curve analysis of sensitivity and specificity resistin levels in diagnostic systemic juvenile idiopathic arthritis.Results:There was no statistically significant difference in the age, gender and BMI of children in SOJIA group, N-SOJIA group, other rheumatism group and healthy control group.Children in the SOJIA group and the N-SOJIA group had arthritis in clinical manifestations.Fever and rash were more common in the SOJIA group, and the difference was statistically significant ( P<0.01). Laboratory results showed that the sedimentation rates of white blood cells, CRP, and red blood cells were in the SOJIA group was significantly elevated.The antinuclear antibody was mainly found in the N-SOJIA group with a higher positive rate ( P<0.05). The mean serum resistin in the SOJIA group [(17.98±13.78) mg/L] was higher compared to the healthy control group [(1.84±1.66) mg/L], other rheumatic diseases group [(8.00±6.28) mg/L]and the N-SOJIA group [(9.86±6.11) mg/L], the differences were statistically significant ( F=21.625, P<0.01). Resistin was positively correlated with white blood cells and CRP( r=0.532, 0.351, all P<0.05), and had no correlation with BMI, hemoglobin, platelets, and ESR( r=0.059, -0.176, 0.152, 0.203, all P>0.05). Based on serum resistin≥5.55 mg/L as the positive threshold value, the area under ROC curve was 0.802, and the sensitivity and specificity in diagnosis of SOJIA was 96.9% and 49.6%, respectively. Conclusions:Serum resistin is increased in patients with JIA, especially in SOJIA increased significantly; Serum resistin can be used for the diagnosis of SOJIA, and ≥5.55 mg/L can be a suitable cut-off level.

Study of masking ability of laminate veneers for discolored teeth / 北京大学学报(医学版)

OBJECTIVE@#To select the most effective method among different masking treatments, such as different thickness and transparence, tissue surface's opaque coating, and opaque resin cement to restore discolored teeth esthetically by porcelain veneer.@*METHODS@#Four extracted intact maxillary central incisors were prepared for porcelain veneer restoration and each three heat pressed porcelain veneers from three thicknesses (0.8 mm, 1.0 mm, 1.2 mm) and two transparency(high transparence, HT and low transparence, LT))in Vita shade A2 were fabricated for each tooth, in total of 72 pieces. The surfaces of three prepared teeth were then painted to mimic situations of severe dental fluorosis, severe tetracycline teeth, and necrotic teeth. Each of the veneers was temporarily cemented to the corresponding tooth surface using try-in cements with three different colors (transparent, opaque, and yellow), then used the shade guide (3D master) and electronic colorimeter (easy shade) to record the shade of each porcelain veneer through hue, lightness, and chroma reading. After that, high-transparence porcelain veneers in thickness of 0.8 mm was fused with a layer of opaque porcelain in tissue surface, and were shade matched again after cementation. Statistic treatments were performed to analyze the difference in each masking method.@*RESULTS@#For each 0.2 mm increase in the veneer thickness of porcelain, the average lightness was reduced by 1 unit, while the chroma was not changed which was independent of the type of the resin cements. When the thickness of the porcelain veneer was decreased to 0.8 mm, the opacity effect was not remarkable even if a low-transparence porcelain veneer was used. Transparent and yellow resin cements had poor opaque performance, while opaque resin cement could reduce the lightness by 2 units and the chroma was also reduced. The opaque layer of the tissue surface could be applied uniformly, and the lightness and chroma could be reduced to Vita 2M1 to 2M1.5 levels regardless of the color of resin cements, which suggested a stable opacity effect for different discolored teeth in this study.@*CONCLUSION@#For porcelain veneer restoration of discolored teeth, thickened veneers are the most effective means to display a natural transmittance and color. Tissue surface's opacity coatings and opaque resin cements can also be used to reduce grayscale and increase lightness.

Finite element analysis of InterTan for the treatment of femoral intertrochanteric fractures / 中国骨伤

OBJECTIVE@#To study the biomechanical characteristics of InterTan for the treatment of femoral intertrochanteric fracture of Evans-Jensen IV.@*METHODS@#Scanning the femur and internal plant of volunteers with spiral CT to obtain DICOM format data. Three-dimensional models of left femur and InterTan were reconstructed by Mimics software. On this basis, a three-dimensional finite element model of internal fixation for Evans-Jensen IV intertrochanteric fracture of femur was established. The stress and microstrain distribution of Von Mses in different models were studied. The biomechanical stability after internal fixation of the Evans Jensen IV femoral intertrochanteric fracture was analyzed.@*RESULTS@#The stress pattern of the femur of InterTan model was the same as that of the normal femur, which was mainly located on the medial side of the proximal femur and the lower third of the femur. However, the stress of femur in InterTan model was lower than that in the same part of normal femur. The peak stress of the femur in the model was 13.92 MPa, located at the end of the inner plant in contact with the femur. The stress peak of the plant in the model was 146.5 MPa at the lower contact point between the tension nail and the main nail.@*CONCLUSIONS@#InterTan fixation has obvious biomechanical advantages and is not easy to cause stress fractures in the middle femur in patients with osteopenic Evans-Jensen IV intertrochanteric fractures. In particular, for patients with greater activity in the intertrochanteric fracture of the Evans-Jensen IV femur, InterTan fixation has better stability and provides a theoretical basis for the choice of internal fixation.

The application of the Daytona ultra-widefield retinal imaging device in preoperative fundus examination before refractive surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the effectiveness of the Daytona ultra-widefield retinal imaging device in preoperative fundus examination before refractive surgery.<p>METHODS: A consecutive series of 624 eyes in 312 patients intended to performing refractive surgery with myopia were examined fundus by the Daytona ultra-widefield retinal imaging device before dilating pupil. After dilating pupil, the non-contact slit lamp lenses and three-mirror contact lens were used to examine fundus again.<p>RESULTS: Average examination time of the Daytona and non-contact slit lamp lenses was 5.38±1.25min and 7.25±3.23min respectively, there was no statistical significant difference(<i>P</i><0.001). The Daytona detected peripheral retinal pathology in 107 eyes(17.1%)and the non-contact slit lamp lenses detected peripheral retinal pathology in 108 eyes(17.3%), 126 lesions were detected and there was no statistical significant difference between the two methods(<i>P</i>=1.000).<p>CONCLUSION: The Daytona has non-contact, shorter time and ultra-widefield view of the retina which is a reliable method in examining the retinal pathology without mydriasis.

Effects of SMILE and Trans-PRK on corneal higher order aberrations after myopic correction / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To observe the effects of small incision lenticule extraction (SMILE) and trans-epithelial photorefractive keratectomy (Trans-PRK) on corneal horizontal coma, vertical coma, and spherical aberration and total higher order aberrations after refractive correction for myopia. ·METHODS: This was a prospective non-randomized cohort study. The cohort included 40 patients (80 eyes) with myopia, who received refraction correction surgery from December 2016 to February 2017 in Leshan Ophthalmic Center. Twenty patients (40 eyes) received SMILE surgery and the other 20 patients (40 eyes) received Trans-PRK surgery. Corneal aberrations were determined by a high-resolution Pentacam Scheimpflug camera before the surgery and at 1 and 3mo after the operation. Statistical analyses were performed using analysis of variance of repeated measures. · RESULTS: At 1 and 3mo post - operation, the uncorrected visual acuity in both groups was better than or equal to the preoperative best corrected visual acuity. The preoperative corneal aberrations showed no significant difference between the two groups (P>0.05). Significantly higher aberration was found after the surgery in both groups (P < 0. 05), however, no significant difference in higher aberration was found between 1 and 3mo post - operation (P > 0. 05). Post - operation, horizontal and vertical coma had no significant difference between the two groups (P>0.05), while SMILE group showed lower spherical aberration and lower total higher order aberration than Trans-PRK group (P<0.05). ·CONCLUSION: Both SMILE and Trans-PRK increase corneal aberration and their effects on horizontal and vertical coma are similar. However, SMILE has a minor influence on spherical aberration and total high order aberration than Trans-PRK.

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 / 临床儿科杂志

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.

Retrospective analysis of cuffed-tunneled catheters in pediatric patients receiving maintenance hemodialysis / 中华儿科杂志

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.

Significance of acute kidney injury biomarkers in the treatment of refractory nephrotic syndrome with calcineurin inhibitors / 中华实用儿科临床杂志

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.

Oral absorption of asiatic acid nanoparticles modified with PEG / 中国中药杂志

A solvent diffusion method was used to prepare pegylated asiatic acid (AA) loaded nanostructured lipid carriers (p-AA-NLC), and the ligated intestinal circulation model was established to observe the absorption and distribution in small intestine. The concentration of AA in bile after oral administration of p-AA-NLC was detected by HPLC in healthy SD rats to indirectly evaluate the oral absorption promoting effect of PEG-modified namoparticles. The results showed that the penetration of p-AA-NLC was enhanced significantly and the transport capacity was increased greatly in small intestinal after PEG modification. As compared with the normal nanoparticles (AA-NLC), the Cmax of the drug excretion was increased by 76%, the time to reach the peak (tmax ) was decreased and the elimination half-life t1/2 was doubled in the rats after oral administration of p-AA-NLC, and the AUC0→t was 1.5 times of the AA-NLC group, indicating that the oral bioavailability of AA-NLC was significantly improved by hydrophilic modification of PEG.

Bacillus cereus growth model established in cooked rice / 上海预防医学

Objective Establishment of growth model of Bacillus cereus in cooked rice.Methods To study the effects of temperature (10,15,20,25,30,34,37 and 43℃) on the growth of Bacillus cereus in rice.And then the SGompertz and SLogistic models were selected as the primary growth models to fit the growth curve of Bacillus cereus in cooked rice at variable storage temperatures.Using the fitness (R2),accuracy factor (Af) and deviation factor (Bf) as evaluation index,quadratic polynomial model and square root model were selected further to fit and to establish the secondary growth models of Bacillus cereus in cooked rice.Results The SGompertz model could be better fitting the growth of Bacillus cereus at different temperatures,and therefore was chosen as the primary growth model of Bacillus cereus in rice.For the developed square root model,Af was 1.12 and 1.24,Bf was 0.99 and 1.03,R2 values were 0.9537 and 0.8503;respectively.For the developed quadratic polynomial model,Af was 1.24 and 1.11,Bf was 0.92 and 0.92,R2 values were 0.9550 and 0.9462;respectively.Conclusion The quadratic polynomial model can well predict the growth of Bacillus cereus in cooked rice,which proves to be reliable.

Perchlorate contamination exposure assessment on commercial foods in Shanghai / 上海预防医学

Objective To ascertain the perchlorate contamination level in commercial foods and health risks so as to provide reference for perchlorate standard formulation and risk management.Methods Perchlorate risk survey was done on commercial foods in Shanghai;in combination with the survey results of residents'' food consumption,the exposure assessment on the presence of perchlorate in commercial food was performed by probability assessment approach.Results A total of 80 food samples from 8 food categories were analyzed,including grain,vegetables,fruits,dairy products,meat,eggs,aquatic products and teaand perchlorate detection rate was 78.8% with a mean value as 13.0±26.4 μg/kg.The highest mean value of perchlorates was 59.0±51.9 μg/kg in tea,and the lowest mean value was 3.4±2.3 μg/kg in fruits.With protection of human life and health as the maximum principle (there were supposed to be no losses of perchlorate during food processing),it was found that the estimated average dietary intake of perchlorate from the 8 food categories was 0.25 μg/kgbw.However,the 95 percentile exposure estimates reached up to 0.44 μg/kgbw,which exceeded the tolerable daily intake value of 0.3μg/kgbw established by European Food Safety Authority for healthy adults.Therefore,potential health risk may exist to certain groups of people.Conclusion Due to its high water-solubility,degradation of perchlorate in food processing probably occurs to certain extent.Therefore,there is need to carry out further actual exposure study.

Significance of acute kidney injury biomarkers in the treatment of refractory nephrotic syndrome with calcineurin inhibitors / 中华实用儿科临床杂志

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.

Expression of TRPC 6 in renal tissue and its significance in children with primary nephrotic syndrome / 临床儿科杂志

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.

Response surface method for optimization of asiatic acid nanoparticles modified with PEG and its enhancing effects on intestinal absorption / 中国中药杂志

A solvent diffusion method was used to prepare pegylated asiatic acid (AA) loaded nanostructured lipid carriers (p-AA-NLC). Then central composite design-response surface method was used to obtain optimum condition for preparation technology of p-AA-NLC, where PEG/lipid ratio was 8.0% and AA/lipid ratio was 22.0%. Under the optimum condition, the system had particle size of (111.2±2.9) nm, Zeta potential of (-37.1±0.9) mV, drug loading of (15.4±0.2)% and entrapment efficiency greater than 90%. The deviations between observed values and predicated values were all below 5%, indicating that the established model had a good predictability. Meanwhile, a low-speed single pass perfusion model of rat in situ was set up to estimate the absorption kinetics of p-AA-NLC in small intestine, where the effective permeability (Peff), absorption rate constant (Ka) and other parameters were used to evaluate the drug absorption. It turned out that Peff and Ka in p-AA-NLC group were significantly higher than those in unmodified group (P<0.05), indicating that asiatic acid loaded nanostructured lipid carriers (AA-NLC) could enhance the effects on intestinal absorption after being modified with hydrophilic PEG.

Improved neurite outgrowth on central nervous system myelin substrate by siRNA-mediated knockdown of Nogo receptor / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To investigate the in vitro effect of short interfering RNAs (siRNAs) against Nogo receptor (NgR) on neurite outgrowth under an inhibitory substrate of central nervous system (CNS) myelin.</p><p><b>METHODS</b>Three siRNA sequences against NgR were designed and transfected into cerebellar granule cells (CGCs) to screen for the most effcient sequence of NgR siRNA by using reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescence staining. NgR siRNA sequence 1 was found the most efficient which was then transfected into the CGCs grown on CNS myelin substrate to observe its disinhibition for neurite outgrowth.</p><p><b>RESULTS</b>Compared with the scrambled control sequence of siRNA, the NgR siRNA sequence 1 significantly decreased NgR mRNA level at 24 h and 48 h (p <0.05), which was recovered by 96 h after transfection. NgR immunoreactivity was also markedly reduced at 24 and 48 h after the transfection of siRNA sequence 1 compared with that before transfection (p<0.05). The NgR immunoreactivity was recovered after 72 h post-transfection. Moreover, the neurite outgrowth on the myelin substrate was greatly improved within 72 h after the transfection with siRNA sequence 1 compared with the scrambled sequence-transfected group or non-transfected group (p<0.05).</p><p><b>CONCLUSION</b>siRNA-mediated knockdown of NgR expression contributes to neurite outgrowth in vitro.</p>

Features of clinical phenotype and genotype in Alport syndrome: a monocentric study / 中华儿科杂志

<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>

Epidemiological investigation and analysis of children with strabismus and amblyopia in No. 1 primary school of Jiajiang County, Leshan, Sichuan Province / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To understand the epidemiology and related factors of strabismic amblyopia of students of primary school, and to provide guidances for the prevention and control strategy. METHODS: A total of 600 cases of primary school students of Leshan City, Jiajiang County were given vision, oblique incidence and ocular and other screening. The prevalence rate of poor eyesight of strabismus, amblyopia prevalence rate of different sexes, ages were compared, and the degree of amblyopia and strabismus of children with different types of amblyopia and whether or not had stereoscopic vision were counted. RESULTS: The prevalence rate of amblyopia and strabismus prevalence rate were respectively 4. 0% and 2.5%;With the growth of all age, low vision of students was significantly decreased, the difference of comparison of low vision rate of each age had statistical significance (P0. 05 );Ametropic amblyopia was the main type, accounting for 55. 6%, and the degree of amblyopia mainly was light, moderate; ametropic amblyopia, most of ametropic amblyopia and strabismus had stereo vision, but there were no stereopsis of most of the strabismic amblyopia and all esotropia. CONCLUSION:Ametropic is mainly type of amblyopia, the prevalence of relationship between the incidence of strabismic amblyopia of primary school students and sexes is not obvious, but the oblique amblyopia treatment effect, such as the establishment of stereoscopic vision and the age, eye position has a close relationship, should be early discovered, early treatment.

Transumbilical single-site single-port versus single-site double-port laparoscopic varicocelectomy for varicocele in adolescents / 中华男科学杂志

<p><b>OBJECTIVE</b>To compare the effect of transumbilical single-site single-port with that of transumbilical single-site double-port laparoscopic varicocelectomy in the treatment of varicocele in adolescents.</p><p><b>METHODS</b>We randomly assigned 80 varicocele patients aged 10 - 16 years to two groups of equal number to receive transumbilical single-site single-port and single-site double-port laparoscopic varicocelectomy, respectively. We compared the operation time, postoperative hospital stay, incisional pain, complications and satisfaction with the abdominal cosmetic outcomes between the two groups.</p><p><b>RESULTS</b>All the operations were successfully performed. The double-port group showed a significantly higher score on the Visual Analogue Scale than the single-port group (4.8 +/- 1.4 vs 3.6 +/- 1.1, t = -4.986, P < 0.01), but there were no significant differences between the two groups in the operation time ([29.8 +/- 4.2] vs [31.2 +/- 4.6] min, t = 1.383, P = 0.171), postoperative hospital stay ([1.95 +/- 0.7] vs [1.82 +/- 0.8] d, t = -0.784, P = 0.436), complications (0 vs 0) and scores on the satisfaction with abdominal cosmetic outcomes (4.6 +/- 0.6 vs 4.8 +/- 0.5, t = 1.253, P = 0.214). No recurrence, umbilical hernia, hydrocele and orchiatrophy were found in the two groups of patients at 6 months after operation, and no visible scar was observed on the abdominal surface.</p><p><b>CONCLUSION</b>With strict surgical indications, single-site single-port and single-site double-port laparoscopic varicocelectomies have similar clinical effects in the treatment of varicocele, which leave no scar on the abdominal surface. Single-site double-port laparoscopy needs no special instruments and therefore is worthier of wide clinical application.</p>