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Objective:To investigate the influencing factors of recurrence after radical resection of middle and low rectal cancer, and to establish a prediction model based on magnetic resonance imaging (MRI) measurement of perirectal fat content and investigate its application value.Methods:The retrospective cohort study was constructed. The clinicopathological data of 254 patients with middle and low rectal cancer who were admitted to Tianjin Union Medical Center from December 2016 to December 2021 were collected. There were 188 males and 66 females, aged (61±9)years. All patients underwent radical resection of rectal cancer and routine pelvic MRI examina-tion. Observation indicators: (1) follow-up and quantitative measurement of perirectal fat content; (2) factors influencing tumor recurrence after radical resection of middle and low rectal cancer; (3) construction and evaluation of the nomogram prediction model of tumor recurrence after radical resection of middle and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(rang) and M( Q1, Q2). Count data were described as absolute numbers. Univariate and multivariate analyses were conducted using the COX regression model. The rms software package (4.1.3 version) was used to construct the nomogram and calibration curve. The survival software package (4.1.3 version) was used to calculate the C-index. The ggDCA software package (4.1.3 version) was used for decision curve analysis. Results:(1) Follow-up and quantitative measurement of perirectal fat content. All 254 patients were followed up for 41.0(range, 1.0?59.0)months after surgery. During the follow-up period, there were 81 patients undergoing tumor recurrence with the time to tumor recurrence as 15.0(range, 1.0?43.0)months, and there were 173 patients without tumor recurrence. The preoperative rectal mesangial fascia envelope volume, preoperative rectal mesangial fat area, preoperative rectal posterior mesangial thickness were 159.1(68.6,266.5)cm3, 17.0(5.1,34.4)cm2, 1.2(0.4,3.2)cm in the 81 patients with tumor recurrence, and 178.5(100.1,310.1)cm3, 19.8(5.3,40.2)cm2 and 1.6(0.3,3.7)cm in the 173 patients without tumor recurrence. (2) Factors influencing tumor recurrence after radical resection of middle and low rectal cancer. Results of multivariate analysis showed that poorly differentiated tumor, tumor pathological N staging as N1?N2 stage, rectal posterior mesangial thickness ≤1.43 cm, magnetic resonance extra mural vascular invasion, tumor invasion surrounding structures were independent risk factors of tumor recurrence after radical resection of middle and low rectal cancer ( hazard ratio=1.64, 2.20, 3.19, 1.69, 4.20, 95% confidence interval as 1.03?2.61, 1.29?3.74, 1.78?5.71, 1.02?2.81, 2.05?8.63, P<0.05). (3) Construction and evaluation of the nomogram prediction model of tumor recurrence after radical resection of middle and low rectal cancer. Based on the results of multivariate analysis, the tumor differentiation, tumor pathological N staging, rectal posterior mesangial thickness, magnetic resonance extra mural vascular invasion, tumor invasion surrounding structures were included to construct the nomogram predic-tion model of tumor recurrence after radical resection of middle and low rectal cancer. The total score of these index in the nomogram prediction model corresponded to the probability of post-operative tumor recurrence. The C-index of the nomogram was 0.80, indicating that the prediction model with good prediction accuracy. Results of calibration curve showed that the nomogram prediction model with good prediction ability. Results of decision curve showed that the prediction probability threshold range was wide when the nomogram prediction model had obvious net benefit rate, and the model had good clinical practicability. Conclusions:Poorly differentiated tumor, tumor pathological N staging as N1?N2 stage, rectal posterior mesangial thickness ≤1.43 cm, magnetic resonance extra mural vascular invasion, tumor invasion surrounding structures are independent risk factors of tumor recurrence after radical resection of middle and low rectal cancer. Nomogram prediction model based on MRI measurement of perirectal fat content can effectively predict the probability of postoperative tumor recurrence.
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OBJECTIVE@#To detect genetic variant in a sib-pair with Finnish type congenital nephrotic syndrome (CNF).@*METHODS@#Clinical data of the sib-pair was reviewed. Coding regions of the NPHS1 gene was analyzed for the sib-pair and both parents.@*RESULTS@#The sister and brother respectively developed severe proteinuria 1 month and 28 days after birth, in addition with low serum albumin, hypercholesterolemia and severe edema, which were suggestive of CNF. Genetic testing identified that the sib-pair has both carried two heterozygous variants of NPHS1 gene, namely c.2605G>C (p.P869>A) and c.-61G>A, for which their father and mother were heterozygous carriers.@*CONCLUSION@#The c.2605G>C (p.869P>A) and c.-61G>A variants of the NHPS1 gene probably underlay the CNF in both sibs. The c.2605G>C(p.869P>A) was unreported previously.
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Adult , Female , Humans , Infant, Newborn , Male , Membrane Proteins/genetics , Mutation , Nephrotic Syndrome/genetics , SiblingsABSTRACT
Objective@#To investigate the drug resistance and risk factors of community-acquired urinary tract infection(UTI) caused by extended-spectrum β-lactamase(ESBLs)-producing Escherichia coli in children.@*Methods@#The clinical data of 125 children with community-acquired urinary tract infection caused by Escherichia coli were analyzed, who were hospitalized at Department of Pediatric Nephrology of Tianjin Children′s Hospital from June 2017 to June 2018.The ESBLs-producing group and the non ESBLs-producing group were named depending on the production of the ESBLs.WHONET 5.6 bacterial resistance monitoring software was used to calculate the drug resistance rate of bacteria.The drug resistance rate and clinical data were analyzed by adopting χ2 test and Fisher′s exact probability method, then, factors with statistical significance identified by single factor analysis were further analyzed by multivariate Logistic regression analysis.@*Results@#Among 125 strains of Escherichia coli, 68 strains(54.4%) were ESBLs-producing Escherichia coli and 57 strains(45.6%) were non ESBLs-producing.The drug resistance rates of ESBLs-producing Escherichia coli to penicillins, cephalosporins, quinolones and monocyclic beta-lactams were higher than those of non ESBLs-producing strains, and the drug resistance rates to Ampicillin, Piperacillin, Cefazolin, Cefuroxime, Ceftriaxone and Cefotaxime were nearly 100%.The resistance rates of ESBLs-producing strains to Imipenem, Meropenem, Amikacin, Furantoin, Cefotetan and Piperacillin/Tazobactam were lower (< 5%). Univariate analysis showed that there were significant differences in recurrent UTI (χ2=12.043, P<0.01) and use of third-generation cephalosporins in the past 3 months(χ2=28.545, P<0.01) between ESBLs-producing group and non ESBLs-producing group.Multivariate Logistic regression analysis showed that use of third-generation cephalosporins in the past 3 months was an independent risk factor of community-acquired UTI caused by ESBLs-producing Escherichia coli(OR=11.285, 95%CI: 3.140-39.134, Wald=13.972, P<0.01).@*Conclusions@#The isolation rate of ESBLs-producing Escherichia coli in children with community-acquired UTI is high, and the drug resistance rate is high, so children who used third-generation cephalosporins in the past 3 months were more likely to develop community-acquired UTI caused by ESBLs-producing Escherichia coli.
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Objective@#To investigate the clinical significance of detection of urine renal injury biomarkers in children with primary nephrotic syndrome (PNS).@*Methods@#Seventy-nine children with PNS at the Department of Nephrology, Tianjin Children′s Hospital were enrolled from January to December 2016, who were given sufficient glucocorticoid for 4 weeks.According to the response to glucocorticoid, they were divided into steroid-sensitive nephrotic syndrome (SSNS) group (63 cases) and steroid-resistant nephrotic syndrome (SRNS) group (16 cases), then they were divided into simple type and nephritic type according to diagnostic criteria.Urinary levels of microalbuminuria (MAlb), transferrin (TfR), retinal binding protein (RBP), N-acetyl-β-D-glucosaminidase (NAG), α1-microglobulin (α1-MG) and β2-microglobulin (β2-MG) were measured in the children before and after treatment, and the data were analyzed by the statistical method.@*Results@#Before treatment, the levels of RBP, NAG, α1-MG and β2-MG in the SSNS group [0.91(1.80) mg/L, 28.00(31.5) U/L, 8.40(14.2) mg/L, 0.45(0.35) mg/L]were lower than those in SRNS group[3.94(4.82) mg/L, 37.10(18.20) U/L, 11.10(21.42) mg/L, 0.66(1.41) mg/L], and the differences were statistically significant (all P<0.05); After treatment, the MAlb, TfR, RBP, NAG, α1-MG, β2-MG in the SSNS group [14.10(5.60) mg/L, 0.40(1.60) mg/L, 0.26(0.38) mg/L, 7.90(9.10) U/L, 2.00(4.40) mg/L, 0.27(0.35) mg/L] were lower than those before treatment[MAlb: 1 704.00(1 995.60) mg/L, TfR: 142.10(81.90) mg/L] and those after treatment in the SRNS group[557.90(1 857.17) mg/L, 117.40(102.10) mg/L, 4.19(5.15) mg/L, 38.80(32.43) U/L, 10.85(16.60) mg/L, 0.63(0.91) mg/L], and the differences were statistically significant (all P<0.05). However, before and after treatment, except for MAlb[before treatment: 2 258.75(2 028.43) mg/L], the indicators in the SRNS group were not significantly improved.Before treatment, the RBP in the SRNS group was significantly higher than that in the SSNS group in children with simple type PNS, and the RBP, NAG, α1-MG and β2-MG in the SRNS group were significantly higher than those in the SSNS group in children with nephritic type PNS (all P<0.05). According to receiver operating characteristic curve, there were obvious differences in the urinary levels of RBP, NAG and β2-MG, and area under curve(AUC) was 0.858, 0.837 and 0.679, respectively, all of which were <0.9, so the value of diagnosis was not high.Logistic regression analysis was used to identify RBP and NAG as influencing factors and to establish a model.Through the combined detection of these two indicators, the diagnostic value was higher (AUC was 0.956), and when the diagnostic sensitivity was 93.8%, the specificity could reach 82.5%.@*Conclusions@#Urinary RBP, NAG, α1-MG and β2-MG can early reflect tubular interstitial impairment in children with PNS, especially SRNS.Combined detection of RBP and NAG has certain value in predicting the efficacy of glucocorticoid.
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Objective To investigate the distribution and antibiotic resistance to pathogens isolated from children with acute pyelonephritis(APN) and explore the risk factors for it.Methods A retrospective analysis was performed on the distribution and antibiotic resistance to 173 pathogens isolated from 264 children with APN who hospitalized at Tianjin Children's Hospital from March 2012 to March 2017.The antibiotic resistance to pathogens was determined by using antimicrobial susceptibility.The clinical indicators of children were compared with APN and 200 children with lower urinary tract infection,including sex,age,index of blood and urine.The risk factors for APN were analyzed.Results Gram-negative bacilli were the main pathogen (61.3％),and involved Escherichia coil (E.coil) of 34.1％.Gram-positive cocci accounted for 38.7％,and involved enterococcus faecium of 24.3％.The resistance rate of E.coli to Ampicillin was the highest(89.8％),but the rate significantly decreased by adding Amoxicillin/Clavulanic acid(47.5％).Compared with Ampicillin,the difference was statistically significant(P ＜ 0.05).The resistance rate of E.coli to Tocefoperazone/Sulbactam was significantly lower than to other cephalosporins(P ＜ 0.01).E.coli had lowest resistance rate to Imipenem (0.03 ％).The resistance rate of enterococcus faecium was low to Linezolid and Vancomycin(＜ 5％).Single and multiple regression analysis revealed that younger than 1 year old,children with urinary tract malformation,increasing procalcitonin (PCT) of blood and β2-microglobulin (β2-MG) and neutrophil gelatinase-associated lipocalin (NGAL) of urine were all the risk factors of APN (all P ＜ 0.05).Conclusions E.coil is the major pathogen in children with APN and the enterococci-caused APN has been increasing.These pathogens have a high antibiotic resistance rate.Antimicrobial therapy should be based on the findings of urine culture and antimicrobial susceptibility test.In the children,less than 1 year old,with urinary tract malformation,the increasing PCT of blood,β2-MG and NGAL of urine are the risk factors for APN.
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Objective To study the application of Internet of Things, wireless health monitor all-in-one machine, health management platform, energy consumption monitoring in employee health management. Methods Enrollment criteria were set based on employees' health examination data, 126 employees were enrolled in this study voluntarily, 97 were male, and 29 were female. The age was from 26 to 59 years, the average age was 43.7 ± 6.1 years. Using motion energy consumption monitor, wireless health monitor all-in-one machine and health management platform, employee's exercise, body weight, body mass index, fat and muscle mass, systolic blood pressure, diastolic blood pressure, cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), uric acid, fasting blood glucose etc. were monitored. Data were collected for before and after 3 months intensive intervention. Results After 3 month of intensive intervention, body weight ( (74.90 ± 9.95) kg, (71.77 ± 9.57) kg), body mass index ((25.94 ± 2.65) kg/m2, (24.96 ± 2.55) kg/m2), fat mass ((21.30 ± 4.31) kg, (18.89 ± 4.23) kg), muscle mass ((49.78 ± 7.12) kg, (49.07 ± 6.97) kg), systolic pressure ((129.72 ± 11.16) mmHg(1 mmHg=0.133 kPa), (118.32 ± 10.50) mmHg), diastolic blood pressure ((89.10 ± 8.28) mmHg, (76.94 ± 7.57) mmHg), cholesterol ((5.16±0.85) mmol/L, (4.96±0.90) mmol/L), triglyceride ((1.72±0.92) mmol/L, (1.43±0.64) mmol/L), uric acid ((353.00 ± 85.33) μmol/L, (345.00 ± 73.01) μmol/L) were decreased with statistical significance (t=10.92, 11.03, 6.75, 5.56, 4.23, 3.99, 4.26, 3.46, 1.98, P0.05). Conclusion Health Internet of Things can help employees to develop scientific exercise habits , to correct unhealthy diet habits, and improve health. It will provide a new option for enterprise employee health management and can be recommended for health management programs by large enterprises with domestic and abroad projects.
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Objective To explore the correlations of soluble thrombomodulin (sTM) and high sensitive C reactive protein(hs-CRP) levels with the hypercoagulable state and indicators of predicting thrombosis in children with primary nephrotic syndrome(PNS).Methods Sixty-four PNS patients who had primary clinical diagnosis or recurrence after hormone withdrawal for 6 months or more hospitalized in Department of Urology,the Second Children's Hospital of Tianjin from January 2010 to January 2014 were selected as PNS group.Thirty patients with inguinal hernia undergoing elective surgery hospitalized in Department of Surgery,the Second Children's Hospital of Tianjin from January 2010 to January 2014 were selected as control group.All the selected patients were extracted for venous blood samples,and the double-antibody sandwich enzyme-linked immunosorbent assay was used to detect plasma sTM levels,while immunoturbidimetric assay was used to detect plasma hs-CRP levels;the indicators of predicting thrombosis as blood lipid and fibrinogen(Fb) etc.were simultaneously detected.Inspection results were compared and the correlation was analyzed by using statistical methods.Results The level of plasma sTM in children with PNS was significantly higher than that in the control group[(1.63 ±0.68) μg/L vs.(0.30 ±0.24) μg/L],and the difference was statistically significant between the 2 groups (t =12.545,P ＜ 0.05).The level of plasma sTM in PNS group with urine protein negative was significantly lower than that before hormone treatment[(1.05 ± 0.56) μg/L vs.(1.63 ± 0.68) μg/L],and there was a statistically significant difference(t =6.298,P ＜ 0.05).The level of plasma sTM in children with PNS had positive correlation with 24 h urinary protein,low density lipoprotein,apolipoprotein B,lipoprotein a and Fb (r =0.379,0.203,0.184,0.177,0.224,all P ＜ 0.05).The level of plasma hs-CRP in children with PNS was significantly higher than that in the control group [(1.9 ± 1.7) mg/L vs.(0.7 ± 0.6) mg/L],and the difference was statistically significant between the 2 groups (t =3.487,P ＜ 0.05).In PNS group,the level of plasma hs-CRP with urine protein negative was significandy lower than that before hormone treatment[(0.4 ±0.3) mg/L vs.(1.9 ± 1.7) mg/L],and there was a statistically significant difference (t =5.473,P ＜ 0.05).The level of plasma hs-CRP in children with PNS was negatively correlated with plasma albumin (r =-0.194,P ＜ 0.05),but positively correlated with Fb (r =0.257,P ＜ 0.01).Plasma sTM and hs-CRP levels in children with PNS were positively correlated (r =0.395,P ＜ 0.05).Conclusions sTM involves in the formation process of PNS hypercoagulable state possibly through dual influencing by blood coagulation process and blood lipids.sTM may be used as one of the reference indicators for PNS activity and prediction of thrombosis.Plasma hs-CRP reflects the micro-inflammatory state in children with PNS,and involves in the formation of hypercoagulability by effecting blood coagulation process,and should be used as indicators for monitoring the hypercoagulability of active PNS.
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Objective To observe the effects and safety of adrenocorticotropic hormone (ACTH) combined with Huaiqihuang on frequent relapse nephrotic syndrome (FRNS) in children. Methods Fifty-five child patients with FRNS were divided into control group, which was given glucocorticoid (GC) to maintain the treatment (group A, n=10), Huaiqihuang group (group B, n=17), ACTH group (group C, n=14) and ACTH combined with Huaiqihuang group (combined treatment group, group D, n=14). Continuous treatment was for 12 months. The GC treatment doses, the levels of basal secretion of adrenal cortex and adrenal cortex reserve were recorded at 6-month and 12-month respectively. And the recurrence rate and adverse reactions were observed in four groups. Results After 6-month treatment, the doses of GC were significantly lower in group C and group D than those in group A and group B (P0.05). After treatment for 6 months and 12 months, the recurrence rates of nephrotic syndrome were significantly lower in group C and group D than those of group A and group B (P<0.05). Conclusion The simple application of ACTH and the combination of Huaiqihuang can relieve the inhibition of long-term using GC on hypothalamic pituitary adrenal axis in FRNS patients.
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Objective To quantitatively assess renal hemodynamic changes in hypertensive acute kidney injury in rabbits induced by L-NAME using 64-slice spiral CT functional imaging techniques,and to explore the application of these techniques in evaluation of early kidney functional changes.Methods Fourteen female New Zealand white rabbits were randomly divided into normal control group (n=6)and L-NAME group (n=8).The control group was injected NaCl solution and the L-NAME group was injected the same amount of L-NAME solution to make hypertensive acute kidney injury model.64-slice spiral CT and SPECT were scanned af-ter injection.Blood samples were collected before and after injecting NaCl and L-NAME solution to detect serum creatinine (Cr).Cr level and CT perfusion parameters of the two groups were analyzed and compared with the pathology results.GFRCT detected by con-trast-enhanced CT and GFRSPECT detected by SPECT were analyzed by the rank correlation test.Results Renal blood volume,blood flow,permeability surface,time to peak,and peak value had statistically significant differences between the control and L-NAME group (P <0.05).GFRCT and GFRSPECT had obvious correlation.GFRCT of L-NAME group was obviously lower than that of the con-trol group.The kidneys of L-NAME group showed obviously injured under both light microscope and microscope.Conclusion 64-slice spiral CT functional imaging techniques can dynamically observe and quantitatively assess early hypertensive kidney dysfunc-tion,especially unilateral renal blood flow abnormalities.It is an effective examination in quantitatively assessing kidney function.
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Objective To investigate the effects of adrenocorticotropic hormone (ACTH)combined with Huaiqihuang on hypothalamic pituitary adrenal (HPA) in rats. Methods Fifty rats were randomly divided into five groups according to the random number table method:normal control group (group A), prednisone group (group B), Huaiqihuang group (group C), ACTH group (group D) and combined treatment group (group E) with 10 rats in each group. Rats in group B, C, D and E were gavaged by acetic acid prednisone water solution 12.5 mg/(kg · d) for 4 weeks to establish HPA axis suppression model. Group A was given distilled water 10 mL/(kg·d) as control. Rats in group C and E were gavaged with Huaiqihuang 5 g/(kg·d) 30 minutes after intragastric administration of prednisone acetate. At the third week of the experiment, group D and E were subcutaneous injected with ACTH 200 μg/(kg·d). The serum cortisol levels were measured respectively at the start of the ex?periment, 2 weeks and 4 weeks of experiment. Animals were sacrificed at the end of the experiment, and then weights of the pituitary, adrenal glands and the viscera index were calculated. The pathological changes of the pituitary and adrenal glands were observed by HE stainning. Results After 2 weeks, the serum cortisol levels were significantly lower in group B, C, D and E than those of group A (Pgroup D>group C (P<0.05). At the same time, the weights of pituitary and adrenal gland and the viscera in?dex were higher in the three groups than those of B group (P<0.05). The HE staining showed that there were no significant changes in the distal part of the pituitary gland in five groups. The adrenal cortex zona was thinning and the structure was dis?ordered in group B. There were different degrees of hyperplasia in group C, group D, and group E, which was the most obvi?ous in group E. Conclusion ACTH combined with Huaiqihuang can promote adrenal cortex zona hyperplasia and cortisol secretion, which reduces the glucocorticoid induced inhibition of HPA axis in rats.
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Objective To evaluate the value of multi-slice spiral computed tomography (MSCT) in diagnosing postoperative intestinal obstruction of rectal cancer.Methods The CT imaging results and clinical manifestation of 50 patients with postoperative intestinal obstruction of rectal cancer confirmed by pathology were reviewed retrospectively.These cases including Miles (24 cases),Dixon (18 cases),Hartmann(8 cases) procedure were collected from Tianjin People's Hospital from 2011 to 2013.Conservative management was done in 10 cases and the remaining 40 patient underwent surgical intervention.Statistical difference between the three kinds of surgical causes of intestinal obstruction was analysed by x2 test.Results Most common cause after Miles and Hartmann postoperative intestinal obstruction was of adhesion,while anastomotic stenosis was the most common reason of intestinal obstruction after Dixon procedure.The difference of incidence of intestinal obstruction caused by hernia and anastomotic stenosis between the three kinds of operation method was statistically significant (x2 =5.382、20.486,P ＜ 0.05).Conclusions MSCT could identify the etiology and site of postoperative intestinal obstruction of rectal cancer,providing favorable imaging evidence for clinical treatment.
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Objective To assess the value of contrast-enhanced ultrasound (CEUS) on quantitative analysis of re?nal cortex perfusion in hypertensive rabbits model. Methods Hypertensive rabbit modal (n=10) were established by inject?ing N-nitro-L-arginin methylester (L-NAME). CEUS and Cystatin C (CysC) serum level analysis were performed at differ?ent time points:before and the 2nd, 4th, 6th and 8th week after injecting L-NAME. Time-intensity curve and area under curve (AUC) were analyzed quantatively while correlation of AUC and CysC were also analyzed. Results Serum level of Cys C in?creased significantly at the 6th week after L-NAME administration which is earlier than the increase of serum levels of Scr and BUN. AUC decreased at first then increased after L-NAME administration. Upon addition of L-NAME, rise time (RT) and peak intensity (PI) decreased while mean transit time (MTT), time from peak to one half (HPT) and time to peak (TTP) in?creased. Our study confirmed a positive correlation between AUC and Cys C (r=0.950, P<0.001). Conclusion Setting up rabbits model by L-NAME is convenient and reproducible, which is an useful tool in experimental study of preclinical and clinical phase of hypertensive renal injury. CEUS combining with CysC serum level analysis is considered as an effective technology for evaluating renal function in hypertensive patients.
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Objective To explore changes of urine transferrin (TFR),micro albumin (mALb),β2 microspheres protein (MG),α1MG and N-acetylβ-D amino group (NAG) in children with kidney injury induced by cytomegalovirus (CMV) infec?tion, and the outcome after treatment. Methods Fifty children with CMV infection were used as case group, and 35 chil?dren of convalescence stage of upper respiratory tract infection were used as control group. The serum levels of creatinine (Scr), blood urea nitrogen (BUN),β2MG, liver function, CMV-IgM, CMV-PCR and brainstem auditory (BAEP), head CT and urine routine test, urine TFR, mALb,β2MG,α2MG and NAG were detected. The sputum CMV-PCR was detected if childrencombined with CMV pneumonia. Ganciclovir (5mg/kg) was given to two groups, 1/12 h i.v. for 14 d. The urine TFR,mALb,β2MG, α2MG and NAG were detected again after treatment. Results There were no significant differences in the urine mALb and TFR between the two groups. The urine levels ofα1MG, NAG andβ2MG were higher in case group than those of control group. The urine levels ofα1MG, NAG andβ2MG were decreased after 2-week treatment in case group. There were no significant differences in urine mALb and TFR before and after treatment. Conclusion The combined detection ofβ2MG,α1MG and NAG can predict CMV kidney damage in children at a early stage.
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Objective Discussing the role of Yunnan baiyao in the newborn umbilical cord.Methods 120 cases newborns were selected and randomly divided into the control group of 60cases and the observation group of 60 cases according to birth order.The two kinds of newborns were both used single valve care,and were disinfected with 75%alcohol twice a day,Newborns of the observation group were dipped in Yunnan baiyao cream which was taken 75%alcohol to apply the root of umbilical and around after each nursing time.Observed the umbilical cord healing of two groups of newborns and take notes.Results In the observation group newborns,umbilical cord on the drying time [(3.1 ±1.1)d]and off time[(6.6 ±1.8)d]were better than the control group[(3.1 ±1.1)d,(8.0 ±3.2)d](t =7.8,2.95,all P <0.05);6 cases occurred redness and swelling around the belly button,2 cases occurred hemor-rhage,17 cases occurred secretions.which were better than that in control group(18 cases,6 cases,35 cases).The statistical analysis showed significant difference in the data of the two groups.Conclusion Yunnan baiyao can promote healing of umbilical cord,it should be popularize in clinical use.
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Objective To explore the effect of leukotriene receptor antagonist (LTRAs,montelukast) on serum indicators,urine indicators,renal pathology,intercellular adhesion molecule-1 (ICAM-1),nephrin and podocalyxin on renal tissue in adriamycin(ADR)-induced nephropathy(ADN) rats.Methods ADN was induced through a tail intravenons injection of ADR.The 40 healthy male Wistar rats were randomly divided into 5 groups:group A (control group),group B(ADN group),group C(prednisone-treated group),group D(montelukast-treated group) and group E (prednisone and montelukast-treated group).Twenty-four-hour urinary protein (24 h-up) and serum index were measured serially in the 4th,8th week and the values of creatinine clearance rate(Ccr) were calculated.At the end of the 8th week,all rats were sacrificed to collect kidney tissues for microscopy observation of renal pathological changes.The expression of nephrin,podocalyxin and ICAM-1 in renal tissues were detected through immunohistochemistry method.Results Compared with group A,in the 4th week,24 h-up and albumin reached the level of ADR nephropathy model.Compared with group B,in the 8th week,24 h-up,cholesterol,serum creatinine and renal pathology changes in the 3 treated groups were significantly reduced (P ＜ 0.05),but serum total protein,albumin and Ccr significantly increased (P ＜ 0.05),while extracellular matrix/glomerulararea and renal pathology score significantly reduced (P ＜ 0.01),and ICAM-1 significantly decreased(P ＜0.01).Compared with group C and group D,expressions of nephrin and podocalyxin in group E were the highest.Besides,the curative effect of integrated treatment was better than other treatments.Conclusions Maybe through inhibition of ICAM-1,LTRAs had a protective effect on renal tissue.The integrated treatment of LTRAs with prednisone has a synergistic effect and drug effect is superior to any drug alone in ADN.
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Suspension array technology,a bead-based multiplex assay,allows a fast and automatic detection of multi-analytes and batch samples in limited sample volume,and it is great potential clinical application in the determination of autoimmune antibodies,muhitumor markers,the phenotype of Human Leukocyte Antigen and the genes of infectious pathogens.However,currently,there are various limitations which hinder the clinical application of this technology broadly.The globally accepted panel of multi analytes,performance criteria,and quality control programs should be established before we get benefit from this high throughput,sensitivity and repeatability platform,which will help to provide scientific and accurate laboratory data for the clinical diagnosis,treatment and prevention.
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Objective To explore the diagnosis and of immune neutopenia.Methods Clinical data of 150 patients with immune neutropenia were collected and analyzed.Results Of 150 patients with immune neutropenia,35 cases went male(23.3％),115 cases were female(76.7％),and male to female ratio was 1 ∶ 3.3.Based on the difference produced way of granulocytes associated antibody,all patients could be divided into alloimmune neonatal neutropenia 9 cases (6.0％),drug-induced immune neutropenia 28 cases (18.7 ％),primary autoimmune neutropenia 22 cases(14.6％),and secondary autoimmune neutropenia 91 cases (60.7％).Secondary autoimmune neutropenia included 39 cases of systemic lupus erythematous,21 cases of rheumatoid arthritis,2 cases of immune hemolytic anemia accompany with neutropenia,6 cases of immune thrombocytopenia accompany with neutropenia,3 cases of autoimmune hepatitis,16 cases of autoimmune thyroiditis,and 4 cases of Sjogren's syndrome.Conclusion The majority of primary immune neutropenia are female,which is usually secondary to autoimmune diseases.The diagnosis of primary immune neutropenia is very complicated,which requires a long period of clinical observation and follow-up.The majority of granulocytes associated antibody is IgG in the autoimmune neutropenia patients.Yet sometimes two or three kinds of antibodies were increased as well.
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Objective To explore the influencing factors of frequent relapse primary nephritic syndrome (PNS) in children according to the statistical analysis of their clinical data and laboratory examinations. Method We collected in-hospital and out-patient medical records of children who were diagnosed PNS from Jan. 2007 to Feb. 2010 and whole clinical data were analyzed. Results In 245 cases of children with steroid sensitine nephrotic syndrome, non-frequent replapse (NFR) accounted for 82.4% and frequent relapse (FR) accounted for 17.6%. In univariate analysis, period of first relapse between initial treatment remission within 3 months , level of serum total protein and cholesterol and IgE at onset had statistical significance in FR children and NFR children, which were significant predictors of FR. The logistic regression analysis revealed that the first relapse after initial treatment remission within 3 months and increasing of serum IgE level (more than 358 IU/ml)were risk factors of FR. Among frequent relapses factors, infection, especially upper respiratory tract infection was the first (65. 1%). The relapse with motivation mainly in January to March, accounted for 30. 4%. Conclusion FR had a proportion of 17. 6% in children with PNS under regular glucocorticoid treatment. It showed seasonality feature that relapse. peak in winter and spring. Level of the serum total protein less than 40g/L and cholesterol more than 10mmol/L at onset can be predictive index of FR. Infections are the main motivation of relapse, but the relapse by irregular treatment and specific constitutions should be pay more attentions too.
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Objective To investigate the effects of azithromycin on serum indicators, urine indicators, renal pathology, intercellular adhesion molecule-1 (ICAM-1), nephrin and podocalyxin in adriamycin(ADR)-induced nephropathy(ADN) rats. Methods ADR nephropathy was induced by a tail intravenous injection of ADR. The rats were randomly divided into azithromycin-treated group, prednisone -treated group, integrated treatment group, model group and control group. Serum index and 24 h urine protein were measured serially at 0, 4th, 8th weeks. The values of creatinine clearance (Ccr) were calculated. Kidney tissues were collected for microscopy observation. The expressions of nephrin, podocalyxin and ICAM-1 in renal tissue were detected by immunohistochemistry SP. Results Compared with normal control group, at the 4th week, 24 hours urine protein and albumin reached the level of ADR nephropathy model. Compared with model group, at the 8th week, 24 h urine protein, cholesterol, serum creatinine, renal pathology changes in the three treated group rats were significantly reduced (P<0.05), serum total protein, albumin and Ccr (except C group) significantly raised (P<0.05), ECM/GA and renal pathology score significantly reduced (P<0.01), ICAM-1 significantly decreased (P<0.01), nephrin and podocalyxin significantly increased. Besides, the curative effect of integrated treatment was better than other treatment group. Conclusions Azithromycin induces similar responses in ADR nephropathy as prednisone, but its early protective effect of renal function is worse than prednisone.The integrated treatment of azithromycin and prednisone has a synergistic effect, and the efficacy is superior to each drug alone.
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Objective To investigate the distribution of TH17 cells in peripheral blood of patients with rheumatoid arthritis(RA). Methods Intracelluar flow cytometirc detection of TH17 cells in peripheral blood was establised using PHA or PMA + Ion as stimulators in vitro. Thirty-five active and 30 stable RA pa-tients and sex and age paired healthy controls were enrolled in this study. Results The stimulating effect of PMA + Ion was better than that of PHA alone. Under PMA + Ion stimulation, the percentage of TH17 cells in peripheral blood from RA patients and healthy controls was increased significantly(P<0.05). With or with-out PMA + Ion stimulation, such percentage in active group was higher than that of stable group and both of them were higher than that of heathy controls(P<0.05). The distribution profile of TH1 cells was similar to that of TH17 cells. Conclusion There is a distribution abnormality of TH17 cells in peripheral blood of RA patients, which could be used as a new marker for the assessment of immunological condition in RA.