Clinical application of tacrolimus with low-dose prednisone in 21 children with steroid-resistant nephrotic syndrome / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze and evaluate the efficacy and safety of tacrolimus and low-dose steroids in the treatment of steroid-resistant nephrotic syndrome in children.</p><p><b>METHOD</b>Twenty-one children with steroid-resistant nephrotic syndrome enrolled from October 2008 to July 2010 into this retrospective longitudinal study received oral tacrolimus treatment, 0.1 to 0.15 mg/kg per day and once every 12 hours, and prednisone 0.2 to 0.75 mg/kg per day simultaneously. During the treatment, the plasma concentration of tacrolimus, urine volume, urine, serum creatinine and liver function were regularly monitored.</p><p><b>RESULT</b>After 1 to 3 months treatment, 14 cases showed complete remission and 7 cases had partial remission. Sixteen patients received renal biopsy, of whom 6 revealed minimal change nephropathy with complete remission in 3 cases, 3 cases had partial remission;4 cases revealed focal segmental glomerulosclerosis with 2 complete remission and 2 partial remission; other 5 children with IgM nephropathy and 1 mesangial proliferative glomerulonephritis achieved complete remission. Within treatment period, 6 patients presented transient adverse reactions, without altering the principle treatment strategy, but only taking the symptomatic treatment. During follow-up, 1 case was lost to follow-up and the remaining 20 cases were followed up from 2 months to 21 months. In 4 patients the disease relapsed within 1st-year follow-up, while at 2nd-year follow-up, 4 cases had (6 times) recurrence.</p><p><b>CONCLUSION</b>Tacrolimus showed a reliable effect in children with steroid-resistant nephrotic syndrome. Less adverse reactions were seen, and most of them could be tolerated. Nevertheless, the patients had a higher relapse rate after 1 to 2 years treatment. Therefore, the long-term effects of tacrolimus for steroid-resistant nephrotic syndrome remains to be further evaluated.</p>

Establishment of a canine model of intracranial artery stent implantation / 中华神经医学杂志

Objective To establish a canine model ofbasilar artery (BA) stent implantation. Methods After angiography, 2.0 mmx8.0 mm metal stents were implanted in the BA of 12 dogs by passing the stents through the vertebral artery V1 segment, anterior radiculomedullary artery, anterior spinal artery S1 segment, anterior spinal artery S2 segment, and vertebral artery V5 segment till reaching the BA using catheter guidewire exchange technique. The dogs surviving the procedure were observed for 4 weeks, and a repeat angiography was performed to detect the presence of vascular stenosis. Results Eleven stents were successfully implanted in the BA of the dogs. On follow-up angiography, BA occlusion was observed in one dog, and the other 10 dogs showed no obvious vascular stenosis or neurological deficits. Conclusion We have establish a safe and efficient stent implantation technique according to the segmentation of the vertebral artery, anterior spinal artery, and BA, which provides the basis for further study of vascular response after intracranial stent implantation.