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Minimally degenerative nephropathy is one of the common types of primary nephrotic syndrome, and it is currently believed that B lymphocytes are closely related to its pathogenesis. Patients with refractory small degenerative kidney disease require treatment with glucocorticoids combined with immunosuppressant. Rituximab is a monoclonal antibody that consumes B cells. Its use in the treatment of patients with refractory microdegenerative kidney disease can reduce recurrence rate, prolong remission period, and reduce hormone exposure. However, there is no consensus on the treatment plan and adverse reaction response measures, and multicenter, prospective, and large-scale research answers are still needed. This article summarizes the latest progress of rituximab in the treatment of refractory minimal degenerative kidney disease, hoping to provide assistance for the development of clinical treatment strategies.
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Objective To investigate the present situation of nursing professional environments in our hospital and provide theoretical basis for mapping out relevant countermeasures. Method A questionnaire survey was conducted among 338 nurses in our hospital by using the general information questionnaire and practice environment scale (PES). Result The dimensions of PES by their average scores in descending sequence included leadership and ability of nurse administers, doctor-nurse cooperation, foundation for high quality care nurses′participation in hospital affairs, and sufficient manpower and resources. Conclusion In order to provide good and healthy work environment for nurses, nursing administrators should provide enough nursing manpower resoures and apply excitation mechanism in their hospital.
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Objective To compare the preservation quality of intestinal grafts from donors of donation after cardiac death (DCD)and cadaveric donors.Methods Quality of intestinal grafts from 7 cadaveric donors (group N)and 7 DCD donors (group DCD)in Beijing from 201 3 to 201 4 was evaluated.The grafts were preserved after perfusion and resection,and then intestinal tissue was collected 30 min and 6 h later.Meanwhile,histopathological examination and intestinal graft injury score (Chiu's integral method)were performed.The content of malondialdehyde (MDA)in intestinal tissue was detected by thiobarbituric acid assay,and the apoptosis of intestinal mucosa cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL)method.Results Intestinal graft injury scores for group N and DCD were (1 .46 ±0.81 )and (1 .76 ±0.21 )respectively at 30 min after preservation,and (3.86 ± 0.42)and(4.1 7 ±0.71 ),respectively at 6 h after preservation(both in P >0.05).Compared with the preservation of 30 min,intestinal graft injury scores increased significantly in both groups at 6 h after preservation (both in P <0.05).The contents of MDA in intestinal tissue of the small intestinal graft in group N and DCD were (1 00 ±1 0)pmol/mg and (1 1 0 ±1 3)pmol/mg,respectively at 30 min after preservation (P >0.05),and (1 70 ±1 8)pmol/mg and (31 0 ±29) pmol /mg,respectively at 6 h after preservation,of which the difference was statistically significant between the two groups at the same time (P <0.05).Compared with the preservation of 30 min,the contents of MDA increased significantly in both groups at 6 h after preservation (both in P <0.05 ).The number of apoptotic intestinal mucosal cells in small intestinal grafts for group N and DCD was (9.78 ±2.56)and (1 5.78 ±2.84),respectively at 30 min after preservation (P >0.05),and (31 .32 ±1 .38)and (53.42 ±1 .95),respectively at 6 h after preservation,of which the difference was statistically significant between the two groups (P <0.05).Compared with the preservation of 30 min,the number of apoptotic intestinal mucosal cells in small intestinal grafts increased significantly in both groups at 6 h after preservation (P <0.05).Conclusions Preservation quality of small intestinal grafts in DCD donors is roughly equivalent to that in traditional cadaveric donors,which suggests that small intestinal grafts in DCD donors may be used in clinical intestinal transplantation.
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Objective To study the histone acetylation level of CD4+ T cells in peripheral blood of lupus nephritis ,to explore the role of histone acetylation in pathogenesis of lupus nephritis .Methods According to Feng X ,Bernstein ,Wagner S J and other scholars′s classification criteria for LN ,those who met the following conditions considered for the activity of LN :proteinuria >0 .5 g/d ,change or activity of urinary sediment (hematuria > 5 red blood cell /Hp ,or pyuria > 5 Hp white blood cells ,or 1 cell type/Hp) ,serum creatinine increased >1 .2 mg/L ,and the exclusion of infection ,kidney stones and other causes .Lupus nephritis pa‐tients were divided into inactive group (group I) 8 people ,active group (group A) 10 people .18 patients with LN and 8 normal con‐trols were collected peripheral blood 50 mL ,density gradient centrifugation method (Ficoll method) for separation of mononuclear cells in peripheral blood;CD4+ T cell was analyzed by immunomagnetic beads ,extracted histone acetylation level and detected H3/H4 protein by the acetylation of histone H3/H4 kits and the relationship of histone H3/H4 acetylation with diseases was analyzed . Results First ,compared with group N ,the histone H3 and H4 of CD4+ T cells in peripheral blood both in A and I of group LN pa‐tients showed low acetylation status (P0 .05) .Third ,it was nega‐tively related to the acetylation level of histone H4 and 24 h urinary protein excretion(r= -0 .661 ,P<0 .05) .Conclusion Histone H3 and histone H4 of the CD4+ T cells showed low acetylation may be involved in the pathogenesis of lupus nephritis .The acetyla‐tion level of histone H4 in CD4+ T cells may be related to the activity of the LN .
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Objective To analyze the clinical characteristics of Candida parapsilosis septicemia of prematurity and provide a reference for both diagnosis and treatment.Methods The clinical data of 9 premature suffering with candida parapsilosis septicemia were retrospectively analyzed.Results All 9 cases (0.73 percent in the corresponding period) were premature infants with gestational age less than 37 weeks.The average weight of the patients was (1 621.00 ±372.22) g,among which 5 cases were of very low birth weight and 4 cases were of low birth weight.The average time of the fungi infection was (22.00 ± 7.58) d.Of the 9 cases,7 cases had been treated with broad spectrum antibiotics previously,9 cases were given nutrition intravenously,7 cases were treated with mechanical ventilation,7 cases adopted peripherally inserted central catheter(PICC) and 1 case received surgery.The symptoms included poor response,unstable serum oxygen saturation,jaundice,poor perfusion,abdominal distention,fever and no bodyweight increase.Laboratory tests results presented platelet decrease(6 cases),C-reaction protein increase (6 cases),high plasma (1-3)-β-D glucan level(9 cases) and white blood cells in the normal range(6 cases).All 9 infants recovered after receiving fluconazole and supporting treatment.Two cases failed to complete the hospital treatment but after discharge from hospital continued treatment by administering prescribed medicine,and through regular follow-up was done,the prognosis of all cases turned out to be good,and no case died.Conclusions Gestational age,birth weight,application of broad spectrum antibiotics,mechanical ventilation and peripherally inserted central catheter are common high risk factors of Candida parapsilosis septicemia in premature infants.The disease was featured with normal white blood cell,low platelet,high serum levels of C-reaction protein and (1-3)-β-D glucan.Anti-fungi therapy with fluconazole may be a good choice for it.
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Objective To assess whether treatment with compound danshen tablets plus alendronate would be safe and effective in women with postmenopausal osteoporosis. Methods 180 women with postmenopausal osteoporosis were randomized to receive combination therapy and independent therapy with compound danshen tablets and alendronate for 6 months. Scores of VRS were assessed,mean serum alkaline phosphatase, serum osteocalcin, urinary creatinine, urinary hydroxyproline, urinary calcium were detected. Bone mineral density of lumbar vertebra 1 ~5 was determined by dual X - ray absorptiometry. Results Mean serum alkaline phosphatase, serum osteocalcin, and urinary creatinine, urinary hydroxyproline, urinary calcium were statistically different between the combination therapy group and the independent therapy group, and bone mineral densities increased in all therapy groups while there was higher elevated level in the combination therapy group. Conclusions The combination therapy of compound danshen tablets with alendronate has a favorable influence on women with postmenopausal osteoporosis.
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Objective To evaluate the clinical value of CT perfusion (CTP) imaging for providing quantitative information about angiogenesis in patients with lung carcinoma and investigate the correlation of CTP enhancement parameters and histological microvessel density (MVD) with lymphatic involvement in peripheral lung carcinoma. MethodsFifty-three patients with pathology-proved peripheral lung carcinoma underwent CT perfusion scan before operation. The enhancement parameters of CTP were calculated based on the time-density curves (TDC) of fist pass phase. All cases were classified into two groups according to pathologic results: tumor with and without lymph node involvement. Two-sample t test was used for the statistics. The ROC curve was used to assess the efficiency of the enhancement parameters of CT perfusion and MVD for predicting lymphatic involvement.Results Tumors with lymph node involvement had significantly higher value of MVD than those without lymph node involvement (64.69±16.34 and 42.67± 16.78, respectively,t=4.84,P<0.01). Tumors with lymph node involvement had significantly higher value of CTP enhancement parameters (PH, M/A, PV) than those without lymph node involvement [PH= (41.79±15.50) and (29.99±10.91) HU,M/A =0.24±0.09 and 0.15±0.06, PV=(2.14±1.09) and (1.27±0.53) ml·min~(-1)·ml~(-1), t=3.21,3.95, 3.66, P<0.01, respectively]. The CTP enhancement parameters (PH, M/A, PV) of lung cancer correlated positively with the MVD, the highest correlation coefficient was between the PV and MVD (r=0.716, P<0.01). MVD and PV had higher values for predicting lymph node involvement in ROC curve analysis.The sensitivity, specificity and accuracy for predicting lymph node involvement were 80.8%, 81.5% and 81.1% or 84.6% ,85.2% and 84.9% respectively if MVD>52/0.74 mm~2 or PV>1.52 ml·min~(-1)·ml~(-1). ConclusionThe CT perfusion PV and histological MVD have good correlation with lymph node involvement in peripheral lung carcinoma and are important predicting parameters before operation.
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OBJECTIVE To evaluate the efficacy and safety of teicoplanin treatment on complicated Gram-positive urinary tract infection.METHODS The patients′ clinical manifestation,laboratory results,bacterial culture changes after intravascular administration of teicoplanin were observed.Each patient was administered teicoplanin(200 mg once a day for 10-14 days,but 400 mg in the first day).RESULTS The effective rate and the bacterial eradication rate were 90.0% and 86.7%,respectively.All patients experienced relief from clinical infective symptoms and systemic reactions.There were no abnormal laboratory findings and adverse reactions.CONCLUSIONS Teicoplanin is an effective and safe antibiotic for the treatment of patients with complicated urinary tract infection.
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Objective To investigate the effect of meridian point cosmetic therapy of traditional Chinese medicine(TCM)on acne.Methods 80 cases of acne patients were selected and divided into the treatment group(50 cases)and the control group(30 cases).The treatment group was given medication by differentiation of symptoms and signs and designed a complete treatment scheme by the demonstration of health analysis curve through test by balanced cosmetic equipment and meridian point of TCM.The control group only received extravenous medication.The effect of the two groups was observed after 2 months' treatment.Results The total effeetive rate in the treatment group was 94.0%,which was superior to that of the control group(73.3%),x2=11.08,P＜0.05. Conclusion Application of meridian point cosmetic therapy of TCM could facilitated the diagnosis and treatment by differentiation of symptoms and signs and thus improve the curing rate.