Primary central nervous system T-cell lymphoma in children and adolescents: a clinicopathological analysis of five cases / 中华病理学杂志

Objective: To study the clinicopathological characteristics, and further understand primary central nervous system T-cell lymphoma (PCNSTCL) in children and adolescents. Methods: Five cases of PCNSTCL in children and adolescents were collected from December 2016 to December 2021 at the First Affiliated Hospital of Zhengzhou University. The clinicopathological characteristics, immunophenotypic, and molecular pathologic features were analyzed, and relevant literatures reviewed. Results: There were two male and three female patients with a median age of 14 years (range 11 to 18 years). There were two peripheral T-cell lymphomas, not otherwise specified, two anaplastic large cell lymphoma, ALK-positive and one NK/T cell lymphoma. Pathologically, the tumor cells showed a variable histomorphologic spectrum, including small, medium and large cells with diffuse growth pattern and perivascular accentuation. Immunohistochemistry and in situ hybridization showed CD3 expression in four cases, and CD3 was lost in one case. CD5 expression was lost in four cases and retained in one case. ALK and CD30 were expressed in two cases. One tumor expressed CD56 and Epstein-Barr virus-encoded RNA. All cases showed a cytotoxic phenotype with expression of TIA1 and granzyme B. Three cases had a high Ki-67 index (>50%). T-cell receptor (TCR) gene rearrangement was clonal in two cases. Conclusions: PCNSTCL is rare, especially in children and adolescents. The morphology of PCNSTCL is diverse. Immunohistochemistry and TCR gene rearrangement play important roles in the diagnosis.

Effect of Suanzaoren Decoction on expression of ionotropic glutamate receptors and synaptic plasticity in hippocampus of anxiety rats / 中国中药杂志

This study investigated the effect of Suanzaoren Decoction on the expression of N-methyl-D-aspartate receptors(NMDAR) and α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptors(AMPAR) in the hippocampus and synaptic plasticity in rats with conditioned fear-induced anxiety. The effect of Suanzaoren Decoction on rat behaviors were evaluated through open field experiment, elevated plus maze experiment, and light/dark box experiment. Enzyme-linked immunosorbent assay(ELISA) was used to measure the levels of glutamate(Glu) and γ-aminobutyric acid(GABA) in the rat hippocampus. Real-time fluorescence quantitative PCR(qRT-PCR) and Western blot were employed to assess the gene and protein expression of ionotropic glutamate receptors in the hippocampal region. Transmission electron microscopy was utilized to observe the changes in the ultrastructure of synaptic neurons in the hippocampal region. Long-term potentiation(LTP) detection technique was employed to record the changes in population spike(PS) amplitude in the hippocampal region of mice in each group. The behavioral results showed that compared with the model group, the Suanzaoren Decoction group effectively increased the number of entries into open arms, time spent in open arms, percentage of time spent in open arms out of total movement time, number of entries into open arms out of total entries into both arms(P<0.01), and significantly increased the time spent in the light box and the number of shuttle crossings(P<0.01). There was an increasing trend in the number of grid crossings, entries into the center grid, and time spent in the center grid, indicating a significant anxiolytic effect. ELISA results showed that compared with the model group, the Suanzaoren Decoction group exhibited significantly reduced levels of Glu, Glu/GABA ratio(P<0.01), and significantly increased levels of GABA(P<0.01) in the rat hippocampus. Furthermore, Suanzaoren Decoction significantly decreased the gene and protein expression of NMDAR(GluN2B and GluN2A) and AMPAR(GluA1 and GluA2) compared with the model group. Transmission electron microscopy results demonstrated improvements in synapses, neuronal cells, and organelles in the hippocampal region of the Suanzaoren Decoction group compared with the model group. LTP detection results showed a significant increase in the PS amplitude changes in the hippocampal region of Suanzaoren Decoction group from 5 to 35 min compared with the model group(P<0.05, P<0.01). In conclusion, Suanzaoren Decoction exhibits significant anxiolytic effects, which may be attributed to the reduction in NMDAR and AMPAR expression levels and the improvement of synaptic plasticity.

A case of cutaneous Rosai-Dorfman disease with increased IgG4-positive plasma cells / 中华皮肤科杂志

A 28-year-old female patient presented with indurated erythema and nodules on the right lower limb for 2 years,with mild itching and pain.Skin examination showed a well-circumscribed irregular dark red patch measuring about 10 cm × 5 cm in size on the extensor aspect of the right thigh.On the patch,there were scattered or densely distributed mung bean-to soybean-sized quasi-circular violaceous nodules with a smooth surface,which were hard on palpation.Subcutaneous nodules with medium hardness were found on palpation,and hyperpigmentation was observed on the surface of some nodules.Local skin temperature was increased,with tenderness on palpation.Histopathologically,mononuclear cells showed nodular or sheet-like distribution in the middle and upper dermis,some of which had pale-staining cytoplasm.Moreover,plenty of plasma cells were observed.Immunohistochemistry revealed that histiocytes were stained strongly positive for S100.The number of IgG4-positive plasma cells increased obviously,and was more than 50 per high-power field (× 200).The proportion of IgG4-positive plasma cells in IgG-positive plasma cells was 45％.Finally,the patient was diagnosed with cutaneous Rosai-Dorfman disease with increased IgG4-positive plasma cells.

Lumbar Scoliosis Induction in Juvenile Dogs by Three-dimensional Modulation of Spinal Growth Using Nickel-Titanium Coil Springs / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Current treatments for scoliosis have some defects and complications. To study spinal deformities and test novel scoliosis treatments, many animal models of scoliosis have been developed. These models applied a single load to the spine and could not precisely modulate the spinal growth in different dimensions. In this study, we applied posterior tethering in various directions with the application of nickel-titanium (NT) coil springs in dog's spine to modulate spinal growth in the coronal, sagittal, and transverse planes and create a scoliosis model possess curves that mimic adolescent idiopathic scoliosis (AIS) three dimensionally.</p><p><b>METHODS</b>Scoliosis was surgically induced in eight 8-week-old female dogs (weight: 1.95-2.30 kg) using bone screws and NT coil springs. The deformity was induced through the placement of posterior NT coil springs that tethered the spine by bone screw fixation. All dogs were monitored with serial radiographs to document changes in deformities.</p><p><b>RESULTS</b>All experimental animals developed scoliotic curves convex to the left in the lumbar segment. The mean coronal Cobb angle was 18.0° immediately postoperatively and 54.5° at 22 weeks. The mean lordosis increased from 6.2° postoperatively to 35.0° at final follow-up. Apical axial rotation increased from 4.5° postoperatively to 31.2° at 22 weeks.</p><p><b>CONCLUSIONS</b>With the application of NT springs in dogs that allowed posterior tethering in various directions, lumbar spinal deformity was achieved in three planes: coronal, sagittal, and transverse planes. Notably, the lumbar spine in surgically treated dogs developed lordoscoliosis with obvious rotation and the curves mimic AIS three dimensionally well. This method allows lumbar scoliosis to develop without deep dissection of muscle and maintains the essential anatomical elements along the spinal curve. Moreover, the spinal growth modulation technique could yield information that would provide a basis for developing novel early-stage treatments for children with scoliosis.</p>

Acetylsalicylic acid treatment enhanced immunomodulatory function of mesenchymal stem cells derived from gingiva / 北京大学学报(医学版)

Objective:To analyze the role of acetylsalicylic acid (ASA) in immunomodulation of mesenchymal stem cells derived from gingiva (GMSCs),and to explore the role of ASA in enhancing the immumomodulation of GMSCs and the capacity of GMSCs to treat immune disorders and the underlying mechanism.Methods:Flow cytometry analysis were used to analyze the role of ASA in the expression of stem cells surface markers CD146,CD105,CD90,CD34 and CD45 in GMSCs,and the GMSCs proliferation was analyzed by 5-bromo-2-deoxyuridine (BrdU) staining and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.The GMSCs and T cells co-culture system was established to analyze the role of ASA in immunomodulation of GMSCs by measuring T cell apoptosis using flow cytometry analysis and inflammatory cytokines using enzyme linked immunosorbent assay (ELISA).Further more,the dextran sulfate sodium (DSS) induced colitis mouse model was established and the mouse body weight,disease activity score,histological index and pathological change of colons were analyzed after GMSC infusion.Results:The proliferation of GMSCs and the expressions of CD105,CD146 in GMSCs were increased after ASA treatment.In the GMSCs and T cells co-culture system,GMSCs induced T cells apoptosis and inhibited interferon γ (IFN-γ) and tumor necrosis factor α (TNF-α) secretion by T cells,which were enhanced by ASA treatment.In vivo,GMSCs infusion could ameliorate DSS-induced colitis,including inhibited DSS-induced mouse body weight loss,decreased disease activity score and histological index,and decreased inflammation cells infiltration in colons,as shown by hematoxylin-eosin (HE) staining.Moreover,the therapeutic effects of GMSC infusion on DSS-induced colitis could be enhanced by ASA treatment.Mechanically,ASA treatment increased FasL expression of Fas/ FasL death pathway in GMSCs to induce T cells apoptosis.Conclusion:ASA enhanced immunomodulation of GMSCs and increased the capacity of GMSCs to ameliorate DSS-induced colitis in mice.

Therapeutic effect of 3D curvature traction on neck-type cervical spondylosis / 医疗卫生装备

Objective To investigate the therapeutic effect of 3D curvature traction on neck-type cervical spondylosis.Methods Totally 100 neck-type cervical spondylosis patients were divided randomly and equally into an observation group and a control group.The observation group underwent the treatment by 3D curvature traction combined with intermediate frequency therapy,and the control group went through the treatment by cupping and intermediate frequency therapy.Evaluation was carried out on neck pain,tenderness and cervical mobility before and after the treatment.Results The recovery rate was 88％ in the observation group,which was significantly higher than that (40％) in the control group (P=0.007).The total effective rate was 100％ in the observation group,which was obviously higher than that (88％) in the control group (P=0.029).The score differences for pain and cervical mobility before and after the treatment were 4.96±0.36 and 1.67±0.73 respectively in the observation group,which were statistically different from the score differences for pain (3.38±0.80) and cervical mobility (0.88±0.76) in the control group (P＜0.05).Conclusion 3D curvature traction gains high clinical effect when used to treat neck-type cervical spondylosis.

Therapeutic effect of 3D curvature traction on neck-type cervical spondylosis / 医疗卫生装备

Objective To investigate the therapeutic effect of 3D curvature traction on neck-type cervical spondylosis.Methods Totally 100 neck-type cervical spondylosis patients were divided randomly and equally into an observation group and a control group.The observation group underwent the treatment by 3D curvature traction combined with intermediate frequency therapy,and the control group went through the treatment by cupping and intermediate frequency therapy.Evaluation was carried out on neck pain,tenderness and cervical mobility before and after the treatment.Results The recovery rate was 88％ in the observation group,which was significantly higher than that (40％) in the control group (P=0.007).The total effective rate was 100％ in the observation group,which was obviously higher than that (88％) in the control group (P=0.029).The score differences for pain and cervical mobility before and after the treatment were 4.96±0.36 and 1.67±0.73 respectively in the observation group,which were statistically different from the score differences for pain (3.38±0.80) and cervical mobility (0.88±0.76) in the control group (P＜0.05).Conclusion 3D curvature traction gains high clinical effect when used to treat neck-type cervical spondylosis.

Complications of treatment of acromioclavicular joint dislocation and unstable distal clavicular fracture with clavicular hook plate / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the causes and prevention of the complications about treatment of acromioclavicular joint dislocation (Tossy III) and unstable distal clavicular fracture (Neer II) with clavicular hook plate.</p><p><b>METHODS</b>From January 2001 to December 2011, 246 patients with acromioclavicular joint dislocation (Tossy III) and 222 patients with unstable distal clavicular fracture (Neer II) were treated with acromioclvicular hook plate fixation,including 348 males and 120 females with an average age of 45.4 years old ranging from 21 to 80 years old. The mean time from injury to operation was 30.8 hours (ranged from 1 h to 15 d). All patients had normal shoulder function before injury. According to Karlsson evaluation standard, the cases with excellent and good function of the shoulder joint were regarded as the normal group, and the cases with poor function of shoulder joint as the abnormal group. The comparison of the range of forward flexion,backward stretch, adduction, abduction and elevation of shoulder joints between two groups was performed. The data of impingement, subacromial osteolysis, acromioclavicular arthritis, clavicular stress fracture, downward acromioclavicular joint subluxation, hook cut-out and hook break were summarized.</p><p><b>RESULTS</b>All patients were followed up from 8 to 48 months with an average of 12.5 months. The results were excellent in 308 cases,good in 76,and poor in 84 according to Karlsson evaluation. The excellent and good rate was 82.1%. The difference of the range of forward flexion, backward stretch, adduction, abduction and elevation of shoulder joints between two groups had a statistically significant difference (P < 0.01). Among 84 poor cases, there were 41 (8.76%) in acromial impingement or inadequate place of plate hook, 12 (2.56%) with subacromial osteolysis or/and bursitis, 10 (2.14%) with acromioclavicular arthritis or painful shoulder caused by delayed dirigation,7 (1.50%) with clavicular stress fracture or interal plate upward, 6 (1.28%) with downward acromioclavicular joint subluxation, 5 (1.07%) with hook cut -out and 3 (0.64%) in hook break.</p><p><b>CONCLUSION</b>The clavicular hook plate is useful for the treatment of acromioclavicular joint dislocation (Tossy III) and unstable distal clavicular fracture (Neer II). The correct place and suitable preflex of plate hook,the restoration of fiber structure around the acromioclavicular joint and the advisable dirigation contribute to the modified rate of complications.</p>

The effect of rosiglitazone on the activity of STAT1 in rats with severe acute pancreatitis / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the effect of rosiglitazone on the activity of signal transducer and activator of transcription 1 in rats with severe acute pancreatitis.</p><p><b>METHODS</b>Fifty-four male Wistar rats were randomly allocated into three groups (n = 18). SO group: sham-operated animals served as control, operation was executed and sodium chloride but not sodium taurocholate was injected. SAP group: SAP was induced by the retrograde injection of 5% sodium taurocholate into the biliopancreatic duct. ROSI group: same as SAP group, but rosiglitazone (6 mg/kg) was administered intravenously 30 min before operation. Rats in each group were sacrificed at 3,6 and 12 h after operation. The levels of serum amylase and histologic scores of pancreatic tissue were measured. The expression of TNF-alpha mRNA in pancreatic tissue were determined by reverse transcription-polymerase chain reaction (RT-PCR). The expression of phosphorylated STAT1 in pancreatic tissue was assayed by immunohistochemistry.</p><p><b>RESULTS</b>Compared to SO group, the levels of serum amylase and phosphorylated STAT1, TNF-alpha mRNA and histologic scores of pancreatic tissue were significantly elevated at the same time points after SAP (P < 0.01). The levels of these detection in ROSI group were lower than those of the SAP group at the same time points (P < 0.05), but higher than SO group (P < 0.05).</p><p><b>CONCLUSIONS</b>STAT1 was activated in severe acute pancreatitis. Rosiglitazone has a protective effects in rats with severe acute pancreatitis. The mechanism of its protective effects maybe that it inhibits the activation of JAK/STAT pathway, which can down-regulate the expression of TNF-alpha mRNA and block the the inflammatory cascade partially.</p>

Effects of rosiglitazone on severe acute pancreatitis in rats / 中华急诊医学杂志

Objective To investigate the effect of administration intravenously of rosiglitazone (ROSI) on severe acute pancreatitis (SAP) in rats and its mechanisms. Method Fifty-four male Wistar rats were randomly divided into sham operation group (SO group), severe acute panereatitis model group (SAP group) and rosiglita-zone pretreatment group (ROSI group),18 rats in each group.SAP model was induced by retrograde inufsion of 5% sodium taurecholate into the biliopancreatic duct. The rats in SO group and SAP group were injected with 10% DMSO (0.2 ml/100 g) by femoral vein 30 minutes piror to the operation. In ROSI group,rosiglitazone partes ae-quales(6 mg/kg) was injected instead of 10% DMSO. Rats were killed at 3, 6 and 12 h after operation. Serum amylase level and myelopemxidase activity were detected. Pancreatic tissue samples were stained with hematoxylin and eosin for histopathological evaluation. Reverse transcription-polymerase chain reaction was used for detecting the levels ofTNF-α mRNA and ICAM-1 mRNA in pancreatic tissue. Results Amylase level, myeloperexidase ac-tivity, pathologic score and the expression of TNF-α and ICAM-1 mRNA were increased significantly in SAP group at each time point than those in SO group (P<0.05). Compared with SAP group, pretreatment with rosiglitazone reduced serum amylase level and pathologic score at time point of 6 h and 12 h (P<0.05), decreased myeloper-oxidase activity at 12 h (P<0.05), downregulatied the expression of TNF-α mRNA at all time pointy, (P<0.05),ICAM-1 mRNA at 6 h and 12h(P<0.05). Conclusions Rosightazone has the effect on pancreatitis in SAP through downregulating the expression of TNF-α mRNA and ICAM-1 mRNA.

Surgical approaches to the correction of congenital penile curvature / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate some currently used surgical approaches to the correction of congenital penile curvature.</p><p><b>METHODS</b>Seventy-six patients with congenital penile curvature underwent surgical correction, of whom 67 were accompanied with hypospadias, 5 with epispadias and 4 with normal urethral meatus. The methods for straightening the phallus included 5-week preoperative hCG treatment, complete degloving of penile skin, release of periurethral fibrous bands extending proximally to the meatus, plication of dorsal or ventral tunica albuginea, and embedding of dermis and tunica vaginalis grafts.</p><p><b>RESULTS</b>All the cases were followed up for 2 months to 2 years, and the mean follow-up time was 9.3 months. Satisfactory phallus straightening was achieved in 67 cases (88%), mild residual chordee remained in 6 (8%), which needed no reoperation for the time being unless warranted by follow-up, and relapse occurred in 3 (4%), which needed further operation.</p><p><b>CONCLUSION</b>Most cases of congenital penile curvature can be corrected sufficiently with the above methods.</p>

Clinical and Autopsy Analysis of Systemic Fungal Diseases:A Report of 31 Cases / 中华皮肤科杂志

Objective To investigate the prevalence of systemic fungal infection in patients at auto-psy and its association with clinical data.Methods The materials from unselected adult patients were exa-mined at necropsy in our hospital from1971to2000,and the fungal species were identified by their mor-phologies in pathology.The clinical and pathological data were compared.Results The rate of fungal infec-tion was7.8%(31/396)among396cases.Seventeen(54.8%)of the31cases were infected with as-pergillus.The frequencies of organs involved with fungal infection were83.87%in lungs,48.39%in kid-neys,35.48%in brain and29.03%in heart,respectively.The fungal infection attributed directly to death in21cases.Conclusion Systemic fungal infection is one of the most common fatal causes among the critically ill patients,and aspergillosis becomes a major pathogenic fungus for patients with systemic fungal infection at autopsy.

Cultivation of medical students' clinical thinking ability in dermartology probation practice / 中华医学教育探索杂志

To train medical students' clinical thinking ability is an important aspect of clinical probation practice and also the common goal of dermartology probation training. This article analyzes the problems around the cultivation of clinical thinking ability during probation practice in our department,and proposes the corresponded measures to improve it.

Study on point mutations in mitochondrial DNA control region for replication DLP(6) of cultured dermal fibroblast with 8-MOP/UVA treatment / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationships between skin photoaging and point mutations in mitochondrial DNA (mtDNA) control region for replication of dermal fibroblast.</p><p><b>METHODS</b>Cultured dermal fibroblasts were treated by 8-methoxypsora len /ultraviolet A (8-MOP/UVA). mtDNA was extracted by one-step-method and th e PCR products of D-loop and adjacent transcription promoter (DLP(6)) fragment of mtDNA control region for replication were detected by polymerase chain reaction-single strain conformation polymorphism and direct sequencing.</p><p><b>RESULTS</b>After treated by 8-MOP/UVA, point mutations of 414 T-->G of DLP(6) fragment of mtDNA control region for replication largely accumulated.</p><p><b>CONCLUSION</b>Accumulation of point mutations of DLP(6) fragment of mtDNA control region for replication may be closely associated with skin photoaging.</p>

Overlapping coverage with bilateral shaft based vascularized dartos pedicle in Snodgrass hypospadias repair / 中华泌尿外科杂志

Objective To introduce a new technique for urethral coverage in Snodgrass hypospadias repair,and to evaluate its effectiveness and complications.Methods From April 2003 to February 2006, this new procedure was performed in 289 children with hypospadias aged 3 months to 12 years (mean age,2. 4 years).The native meatus of urethra was identified subcoronal in 78 cases,penile/shaft in 136,penoscrotal in 36 and scrotal in 16;and 23 cases had undergoneⅡstage operation and re-operation.The overlapping coverage with bilateral shaft based vascularized dartos pedicle was done in the new urethra by Snodgrass hy- pospadias repair in these children.Results All the cases were followed for 3 months to 2 years.Postoper- atively,urinary fistulas developed in 32 cases (11%).Of them,11 were cured spontaneously within 4 weeks. The incidence of actual urinary fistula was 7% (21/289).Of the 21 fistulas which were not cured,11 (5%) occurred in 214 cases of distal hypospadias;and 10 (13%) in 75 cases of proximal hypospadias,Ⅱstage and re-operation.No dehiscence and diverticulum was found.Combined with mucosal collar technique,the ventral skin of the penis was sewn on the midline.During the follow-up,excellent cosmetic results with normal-ap- pearing circumcised penis were achieved in most patients.Conclusions Bilateral shaft based vascularized dartos pedicle urethral coverage procedure is a reliable and effective method for preventing urethral cutaneous fistulas and dehiscence.This method can reconstruct a satisfactory cosmetic appearance of the penis.

Expression and Gene Polymorphism of Cytotoxic T Lymphocyte-Associated Molecule4on Peripheral Blood Mononuclear Cells from Patients with Psoriasis / 中华皮肤科杂志

Objective To investigate the status of expression and gene polymorphism of cytotoxic T lymphocyte-associated molecule4(CTLA4)on peripheral blood mononuclear cells(PBMCs)from patients with psoriasis.Methods Expression of CTLA4mRNA/antigen and polymorphism of CTLA4gene were analyzed in33and133patients with psoriasis confirmed clinically and/or pathologically,respectively.Expression of CT-LA4mRNA and antigen was detected by in situ hybridization and immmunohistochemistry.CTLA4exon1and3'untranslated region were amplified by polymerase chain reaction(PCR)and the amplified products were identified by single-stand conformation polymorphism(SSCP),restriction fragment length polymorphism(RFLP)or sequencing.Results Expression of both mRNA and antigen of CTLA4was significantly weaker on PBMCs induced by staphytococcal enterotoxin B(SEB)in patients with psoriasis than that in normal con-trols,without a regular pattern.The guanine49on exon1in association with fragment106bp of3'untranslat-ed region was shown to be linked to the susceptibility of psoriasis.Conclusion Defective translation and ex-pression of CTLA4take place in patients with psoriasis,which is possibly related to the polymorphism of CT-LA4.Our results suggest that CTLA4may be one of the candidate genes which cause autoimmunity in psoria-sis.

In Vitro Study on Th1/Th2 Shift Modulated by CTLA4Ig in Psoriasis / 中华皮肤科杂志

Objective To investigate Th1/Th2 pattern of response in psoriasis and to study the effects of CTLA4Ig on Th1/Th2 shift in psoriasis. Methods The levels of IL-2, IFN-?and IL-4 were assessed by ELISA in the supernatant of cultured peripheral blood mononuclear cells (PBMCs) from 33 patients with psoriasis vulgaris and 20 healthy blood donors. Cytokine synthesis was induced by activation with phytohemagglutinin (PHA) and staphylococcal enterotoxin B (SEB) with or without CTLA4Ig. Results Levels of IL-2, IFN-?and IL-4 were markedly increased by PBMCs from psoriatic patients incubated with SEB (P

Study on preventing nephrotoxic injury of amikacin / 实用儿科临床杂志

Objective To search for the methods preventing nephrotoxic injury of amikacin,Methods Case-control research was used in this study. There were 50 normal children in control group The urine routine, the ?2-microglobulin (?2 -M), mosmol and THP in urine and blood, the AIb, rGT and NAG in urine, the renal function and serum concentration of amikacin were determined respectively.The 43 patients with serious illness childten in study group, were divided into 2 groups (Group 1 and group 2 ). Group 1 (23 cases) was treated only with amikacin for 7 days, and group 2 (20 cases) was treated with vitaminC, vitamin E and amikacin for 7 days. Before treatment, the 3rd and 7th day during the treatment, all the items mentioncd above were examined in gtoup 1 and 2.Results The incidences of nephrotoxic injury of amikacin are 87 per cent (20/23)and 55 per cent (11/20) respectively in group 1 and 2. There is significant difference (P