Swallowing function and its related factors in elderly people in welfare homes of Wenzhou City / 上海预防医学

Objective:To understand the swallowing function of the elderly in welfare homes of Wenzhou City，Zhejiang Province and to analyze the related factors of swallowing dysfunction. Methods:A total of 507 elderly people aged 60 years and over were surveyed by questionnaires in three welfare homes of Wenzhou City from January 2018 to January 2020.Hinds time-limited water drinking test was used to screen dysphagia. Multivariate unconditional logistic regression analysis was used to analyze the related factors of swallowing dysfunction. Results:The incidence of swallowing dysfunction was 26.04% （132 out of 507）. Univariate analysis showed that there were significant differences in the incidence of swallowing dysfunction among the elderly in terms of age， spouse condition， self-care ability， health status， taking sleeping pills， cerebrovascular disease， nervous system disease and depression （P<0.05）. Multivariate logistic regression analysis showed that the following factors were related to swallowing dysfunction among the elderly： age ≥80 years old， taking sleeping pills， cerebrovascular diseases， nervous system diseases and depression. Conclusion:The incidence of swallowing dysfunction in elderly people in welfare homes of Wenzhou City is high， especially those aged ≥80 years who need more attention. In addition， taking sleeping pills， cerebrovascular diseases， nervous system diseases and depression all increase the risk of swallowing dysfunction. Corresponding preventive and intervention measures should be formulated.

Clinical study of curative effects of partial sigmoidectomy and pelvic floor repair for treatment of pelvic floor dysfunction with dolichasigmoid / 中国实用妇科与产科杂志

OBJECTIVE: To explore the curative effects of the combined therapy of laparoscopic partial sigmoidectomy and anterior and posterior vaginal wall repair for the treatment of severe pelvic floor dysfunction(PFD).METHODS: The clinical data of 14 severe PDF patients(uterine prolapse in stage Ⅲ-Ⅳ）with dolichasigmoid were studied retrospectively from May 2017 to August 2018 in Shanghai Traditional Chinese Medical University. The surgical way was laparoscopic partial sigmoidectomy and anterior and posterior vaginal wall repair. The objective effects were assessed by comparing the position of each indication points of the preoperative and postoperative pelvic organs' prolapse(in POP-Q scale).Subjective effects were also assessed by comparing Clevel score of constipation,pelvic floor distress inventory-short form 20(PFDI-20),pelvic floor impact questionnaire short form(PFIQ-7)between preoperation and 6 months and 1 year after operation.RESULTS: All 14 patients were successfully operated on without any intra-operative and post-operative complications. The comparion of positions of the POP-Q indication points(AA,Ba,C,D,AP,BP)between preoperation and 1 year after operation showed the difference was statistically significant(P<0.01). PFDI-20,PFIQ-7 and Clevel constipation scores were also significantly different respectively(P<0.01).CONCLUSION: Laparoscopic partial sigmoidectomy combined with pelvic floor repair is an optional method in the treatment for pelvic floor dysfunction, which could effectively improve the constipation caused by dolichasigmoid and pelvic floor defect. It is also with low postoperative morbidity.

Cangumycins A-F, six new angucyclinone analogues with immunosuppressive activity from Streptomyces / 中国天然药物

Cangumycins A-F (1-6), six new angucyclinone analogues, together with two known ones (7 and 8), were isolated from the fermentation broth of a soil-derived Streptomyces sp. KIB-M10. Structures of these compounds were elucidated via a joint use of spectroscopic analyses and single-crystal X-ray diffractions. Among them, cangumycins E (5) and F (6) share a C-ring cleaved backbone, and cangumycins B (2) and E (5) exhibit potent immunosuppressive activity (IC 8.1 and 2.7 μmol·L, respectively) against human T cell proliferation at a non-cytotoxic concentration.

Clinical Study on Acupuncture Treatment for Parkinson's Non-motor Symptoms / 上海针灸杂志

Parkinson disease (PD) is a neurodegenerative disorder resulting from alpha-synuclein lesions, which affects about eight million patients over the world. PD is manifested in progressive motor and non-motor symptoms. With understanding of PD gradually deepened, motor symptoms mainly manifested in resting tremor are not the only manifestations of PD. Clinically many non-motor symptoms such as autonomic nervous symptoms, mental symptoms and paresthesia are also the important manifestations of PD and can appear earlier than motor symptoms. The effect of the non-motor symptoms on the patients' life is often not less than that of the motor symptoms. Clinically the changeable non-motor symptoms are far more complex and more difficult to treat than the motor symptoms. Conventional anti-PD drugs such as levodopa have little effect on the non-motor symptoms. Present clinical studies have showed that acupuncture has a certain therapeutic effect on the non-motor symptoms of PD. This provides important help for expanding the way to treat PD.

Expression of IMP3 in benign and malignant thyroid tumor / 临床与实验病理学杂志

Purpose To investigate the expression of insulin-like growth factor Ⅱ mRNA-binding protein 3 (IMP3) and its differential diagnostic significance in benign and malignant thyroid tumor. Methods The fluorescent quantitative PCR and immunohistochemical staining were used to detect the IMP3 expression in 71 cases of thyroid tissue of different pathological types. The differential diagnostic significance of IMP3 expression in benign and malignant thyroid tumor was analyzed. Results Compared with normal thyroid tissue, thyroid tumors including follicular variant of papillary thyroid carcinoma (FVPTC ), follicular thyroid carcinoma (FTC), papillary thyroid carcinoma(PTC), nodular goiter (NG), and follicular adenoma (FA) had significantly higher IMP3 mRNA expression levels with10.13, 8.81, 8.52, 2.46, and 1.49 holds, respectively. The positive expression rate of IMP3 protein in thyroid tumors were significantly higher, with the positive rate from high to low was FTC (100％ ), PTC (96.77％ ), FVPTC (90％ ), FA(20％ ), and NG (0). The expression level of IMP3 protein was positively correlated with the expression of mRNA (P＜0.01). The IMP3 expression level of malignant thyroid tumor(8.82 holds) was significantly higher than that of benign thyroid tumor (1.94 holds) (P＜0.01). The IMP3 expression level of malignant thyroid follicular lesions (9.36 holds) was higher than that of benign thyroid follicular lesions (1.49 holds) (P＜0.01). Conclusion IMP3 may be an effective and useful molecular maker for diagnosis of benign and malignant thyroid neoplasms, as well as the differential diagnosis between benign and malignant thyroid follicular lesions.

Effects of Couplet Medicines (Astragalus Membranaceus and Jiaozhen) on Intestinal Barrier in Postoperative Colorectal Cancer Patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of the couplet medicines (Astragalus Membranaceus and Jiaozhen) on intestinal barrier functions of postoperative colorectal cancer patients.</p><p><b>METHODS</b>Totally 90 inpatients with confirmed colorectal cancer by pathological diagnosis were recruited as subjects in this study. They were assigned to the Chinese medicine group (CM, treated with Astragalus Membranaceus and Jiaozhen), the Western medicine group (WM, treated with glutamine), and the blank control group (treated with normal saline) according to random digit table, 30 in each group. The treatment course consisted of eight days. Levels of blood D-lactic acid, diamine oxidase (DAO), urinary lactulose/mannitol ratio (L/M), ET, TNF-alpha, and postoperative recovery time of bowel sound were observed before surgery and after surgery. The effect of the couplet medicines (Astragalus Membranaceus and Jiaozhen) on intestinal barrier functions of postoperative colorectal cancer patients were comprehensively assessed by taking blood D-lactic acid levels, DAO levels, urinary L/M as main potency indices; ET and TNF-alpha, recovery time of bowel sound as the secondary potency indices.</p><p><b>RESULTS</b>CM showed similar effect with that of WM in improving blood D-lactic acid levels and DAO levels, and urinary L/M ratio, with no statistical difference between them (P > 0.05). But they showed better effect than that of the blank control group (P < 0.05). Levels of ET and TNF-alpha were decreased more in the CM group than in the WM group (P < 0.05). The recovery time of bowel sound was shorter in the CM group than in the WM group (P < 0.05, P < 0.01). Levels of ET and TNF-alpha were decreased more in the WM group than in the blank control group (P < 0.05). There was no statistical difference in the recovery time of bowel sound between the WM group and the blank control group (P > 0.05).</p><p><b>CONCLUSIONS</b>The couplet medicines (Astragalus Membranaceus and Jiaozhen) had obvious protection for intestinal barrier dysfunction of postoperative colorectal cancer patients, showing similar efficacy to that of WM. It was even superior to glutamine in restoring bowel functions, reducing toxin absorption, and lowering levels of pro-inflammatory factors.</p>

Prevention of osteopenia and dyslipidemia in rats after ovariectomy with combined aspirin and low-dose diethylstilbestrol / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study whether effect of aspirin plus low-dose diethylstilbestrol is more effective and safer than high diethylstilbestrol dose alone on prevention of ovariectomy-induced osteopenia and dyslipidemia.</p><p><b>METHODS</b>Thirty-eight 4-month-old female SD rats were divided into baseline (BAS) group (n=6), sham operation group (n=8) and ovariectomy (OVX) group (n=24). The OVX group was further divided into vehicle treatment group (n=8), diethylstilbestrol (30 μg/kg•d) treatment group (OVX+D30 group, n=8), and aspirin (9 mg/kg•d) plus diethylstilbestrol (10 μg/kg•d) treatment group (OVX+A-D10 group, n=8). Their left tibiae were collected for the bone histomorphometric analysis in undecalcified sections. Left femurs were collected for the bone mineral density measurement.</p><p><b>RESULTS</b>The body weight and serum cholesterol were increased, while uterine weight and cancellous bone mass were decreased in OVX rats compared with the SHAM group. Cancellous bone mass was significantly increased, while body weight and bone resorption parameters were decreased in both A-D10 and D30 treatment group compared with OVX group. The rats treated with A-D10 showed significantly increased in bone formation parameters and decreased in serum triglyceride compared with the D30-treated rats.</p><p><b>CONCLUSION</b>Aspirin plus low-dose diethylstilbestrol can effectively prevent osteopenia by reducing bone resorption, and is thus a better treatment modality for preventing dyslipidemia than high-dose diethylstilbestrol alone.</p>

Comparison of two low-dose adrenocorticotropic hormone stimulation tests for evaluating adrenal function in children with primary nephrotic syndrome / 中华实用儿科临床杂志

Objective To compare 2 kinds of low-dose in adrenocorticotropic hormone(ACTH) stimulation tests for evaluating adrenal function in children with primary nephrotic syndrome(PNS).Methods Seventeen patients (dose of prednisone ＜ 1 mg/kg) with PNS (PNS group) and 7 control subjects (control group) were enrolled.On the first day,all subjects were injected ACTH intravenously at 8 ∶ 00.Serum cortisol was measured just before the ACTH administration,after 20,30 minutes(the first method).On the second day,all subjects were injected ACTH intravenously at 14 ∶ 00.After the ACTH injection,blood was taken every 10 minutes for a period of 1 h to measure serum cortisol (the second method).Adrenal function was evaluated.Cortisol levels of 497 nmol/L or more were taken as normal adrenal response to low dose of ACTH stimulation.Results In the control group,all subjects showed normal adrenal function with the first method and the second method.Cortisol levels at 30 minutes were all ＞ 497 nmol/L.Cortisol levels at 0,20 and 30 min points with the first method did not differ from those with the second method(all P ＞ 0.05).In 17 PNS patients,3 cases (17.65％)and 7 cases (41.18％)showed subnormal responses with the first method and the second method,respectively.Detection rate of subnormal responses was significantly higher with the second method (P ＜0.05).In the first method,5 cases of the 17 patients showed subnormal responses at 20 minutes and 2 of above 5 cases turned to normal responses at 30 minutes.However,10 cases of the 17 patients showed subnormal responses at 20 minutes and none of above 10 cases achieved normal responses at 30 minutes with the second method.Comparison of function of adrenal cortex at 20 and 30 minutes showed that there were difference in the first and second method(P =0.025,0.008,respectively).Comparison of cortisol levels at 0,20 and 30 minutes in the first and the second method showed that there were difference at 0 minute and amplification of 20-30 minutes and there was no difference at any other points.Conclusions The low dose of ACTH test in the second method for evaluation of adrenocortical function in children with PNS is more accurate and sensitive.

Clinical analysis of acute kidney injury in children with renal diseases / 中华儿科杂志

<p><b>OBJECTIVE</b>Acute kidney injury (AKI) was recently proposed for early recognition of renal function impairment and prompt interventions. Previous study revealed that AKI was highly associated with the prognosis. However, there was rare report of AKI in renal diseases, especially in children cohorts. Therefore, we performed the prospective clinical research in children with renal diseases in our hospital, aiming to study the prevalence, the clinical characteristics and the short-term prognosis of AKI.</p><p><b>METHOD</b>The study was designed as a prospective, single-center observational study.</p><p><b>INCLUSION CRITERIA</b>(1) the primary diagnosis was primary nephrotic syndrome (NS), Henoch-Schoenlein purpura nephritis (HSPN) or lupus nephritis (LN), (2) the duration from the onset of the renal diseases to the admission was less than 3 months. The serum creatinine and urine output of the subjects would be prospectively monitored. AKI was defined by the adult criteria and stratified by Acute Kidney Injury Network (AKIN) criteria. The patients were followed up at 6 months and 12 months after enrollment.</p><p><b>RESULT</b>Between October 2007 and April 2009, a total of 95 children were included, including 65 cases with NS, 15 HSPN and 15 LN. Mean age was (8.9 ± 3.9) years (range 2 - 16 years). Thirty-three of the 95 patients (34.7%) fulfilled the AKI criteria, 13 patients (13.7%) were diagnosed as acute renal failure (ARF). All the AKI in children with LN and HSPN presented with serum creatinine elevation. However, 65.4% of AKI in NS presented with decreasing urine output, only 19.2% accompanied with increasing creatinine, with higher stages of urine output. Regarding the etiology, only 26.9% of AKI in NS had definite cause, most of which resulted from side-effect of cyclosporine, hypovolemia or tubule-interstitial damage, independent of glomerular diseases. In contrast, the AKI in LN and HSPN were exclusively caused by glomerular diseases. The length and costs of hospitalization of AKI group were significantly higher than non-AKI [length of hospitalization (d), 28(6 to 94) vs. 21(7 to 100), Z = -1.971, P = 0.049; cost of hospitalization (yuan), 12 035.7 (1561.7 to 94 783.1) vs. 8594.3 (1390.1 to 98 876.5), Z = -1.993, P = 0.046]. There was no significant difference in the serum creatinine at 6-month and 12-month follow-up between AKI group and non-AKI [6-month, (60.4 ± 91.8) µmol/L vs. (42.8 ± 12.2) µmol/L, t = 0.937, P = 0.358; 12-month, (48.7 ± 18.1) µmol/L vs. (47.7 ± 14.2) µmol/L, t = 0.197, P = 0.845].</p><p><b>CONCLUSION</b>The prevalence of AKI (34.7%) was higher than that of ARF (13.7%) in children with renal diseases. Most of the AKI in NS resulted from non-glomerular diseases. In contrast, most AKI in LN and HSPN were caused by underlying glomerular diseases. The length and costs of hospitalization were significantly higher in AKI group. However, there was no significant difference in serum creatinine between AKI and non-AKI group in the follow-up at 6 months and 12 months. Further investigations on criteria for the diagnosis of AKI in children with renal diseases are still needed.</p>

Clinicopathological feature and treatment of idiopathic membranous nephropathy in children / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological feature and treatment of idiopathic membranous nephropathy (IMN) in children.</p><p><b>METHOD</b>A retrospective analysis of 25 cases of biopsy-proven IMN seen between January 2004 and December 2009.</p><p><b>RESULT</b>The incidence of IMN was 3.81% in all the children patients who underwent renal biopsy. Of 25 patients with IMN, nine were boys and sixteen were girls. The mean age at onset was (9.4 ± 3.4) years with a range of 2 - 14 years. Renal biopsies were performed at a median 2.5 months (range 0.4 - 11 months) after onset. The clinical manifestations included nephrotic syndrome (NS) nephritic type in 21 cases (84%) and glomerulonephritis in 4 cases. All patients presented with hematuria, and 7 had macroscopic hematuria. Hypertension was noted in 4 patients. Two patients were complicated with thrombosis. One patient was in a chronic renal insufficiency(CRI)state. According to the MN staging criteria, 21 cases were in stage II IMN (84%). Six patients showed moderate or severe tubulointerstitial lesion. Focal segmental glomerulosclerosis (FSGS) was found in two patients. Of the 22 patients with NS and nephrotic proteinuria, 21 cases were treated with prednisone initially and in 20 of them the efficacy of corticosteroid therapy was evaluated:one of them was steroid sensitive (became steroid-resistant after relapse) and all the others were steroid-resistant (95%). The subsequent treatment: eight of them were treated with prednisone followed by a taper to alternate-day therapy. Five of them had complete remission and three partial remission. Twelve cases were treated with combined therapy of prednisone and immunosuppressive agents. Of these 12 cases together with one case who received initially combined treatment with prednisone and immunosuppressive agent and one case treated with prednisone initially for five weeks then with combined therapy contained another immunosuppressive agent, totally 14 cases, 5 had complete remission, 2 partial remission, 3 did not achieve remission, and 3 had unknown response.</p><p><b>CONCLUSION</b>Of the patient cohort, the predominant presenting feature was nephrotic syndrome, and with different degree hematuria. Almost all of them were steroid resistant, but followed by a taper to alternate-day therapy, some could achieve remission. The effect of a combination of prednisone and immunosuppressive agent is needed to be further proven in children.</p>

Changes of leptin resistance, blood lipids and inflammatory response before and after the exercise therapy in children with obesity / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Some research has shown that C-reactive protein (CRP), leptin, soluble leptin receptor (sLR) and blood lipids are involved in the development of obesity. This study aimed to investigate the changes of leptin resistance, blood lipids and inflammatory response before and after the exercise therapy in children with obesity.</p><p><b>METHODS</b>Fifty-one obese children at ages of 12 years received an exercise therapy for 2 months. The levels of serum leptin, sLR, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (hs-CRP) were measured before and after the exercise therapy. Forty normal children served as the control group.</p><p><b>RESULTS</b>Compared with the control group, serum levels of leptin, TG, TC, LDL-C and hs-CRP and the body mass index (BMI) in the obese group increased (p<0.01), while the serum level of sLR decreased significantly (p<0.05). The levels of hs-CRP, leptin, TC, TG, LDL-C and BMI in the obese group were significantly reduced after the exercise therapy (p<0.05). In the obese group, the serum leptin level was positively correlated with the levels of blood lipids and hs-CRP (p<0.05); serum levels of leptin and hs-CRP were negatively correlated with the sLR level (p<0.05); the hs-CRP level was positively correlated with the levels of blood lipids (p<0.01).</p><p><b>CONCLUSIONS</b>Leptin resistance and the changes of blood lipids and inflammatory response are found in children with obesity. Exercise therapy can partially improve these changes.</p>

Reversible ceftriaxone-associated biliary pseudolithiasis in three children with renal diseases / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics of ceftriaxone-associated biliary pseudolithiasis in children with renal diseases.</p><p><b>METHOD</b>Three children with renal diseases developed biliary pseudolithiasis when they were treated with ceftriaxone. Their clinical and laboratory data were retrospectively analyzed.</p><p><b>RESULTS</b>Case one was an 11-year-old boy. The initial diagnosis was primary nephrotic syndrome. Ceftriaxone was administered intravenously at a dose of 2 g/d [50 mg/(kg * d)] for gastroenteritis. After that the boy complained of nausea and loss of appetite. Abdominal sonogram obtained on day 3 of ceftriaxone therapy revealed gallbladder sludge. After cessation of ceftriaxone treatment, symptoms and ultrasound abnormalities gradually disappeared, with complete sonographic resolution after 16 days. Case two was a 10-year-old boy. The primary diagnosis was post-streptococcal glomerulonephritis with acute renal failure. The child was treated with 1.5 g/d [30 mg/(kg * d)] intravenous ceftriaxone for gastroenteritis. After that, the boy complained of nausea and abdominal pain with positive Murphy's sign. Gallstone was detected by ultrasonographic examination on day 6 of ceftriaxone therapy. After cessation of ceftriaxone treatment, symptoms and sonographic abnormalities gradually disappeared, with complete sonographic resolution after 18 days. Case three was a 12-year-old boy. The primary diagnosis was nephrotic syndrome. He was treated with 2 g/d [40 mg/(kg.d)] ceftriaxone for gastroenteritis. Gallbladder lithiasis was detected 17 days after the initiation of ceftriaxone therapy (3 days after cessation of ceftriaxone treatment). Gallbladder sonogram was found to be normal two months after the discontinuation of the therapy.</p><p><b>CONCLUSIONS</b>Biliary pseudolithiasis occurred in 3 cases with renal diseases receiving low doses of ceftriaxone. The risk of developing ceftriaxone-associated biliary pseudolithiasis might increase in patients with renal diseases who are treated with ceftriaxone.</p>

Clinical and genetic analysis of Dent' s disease in 6 Chinese children with low molecular weight proteinuria / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features and gene mutations of 6 Chinese children with Dent's disease.</p><p><b>METHOD</b>The clinical and laboratory data of 6 children with Dent's disease were summarized. CLCN5 gene was analyzed using PCR amplification and DNA sequencing.</p><p><b>RESULT</b>All the six patients presented with low molecular weight proteinuria and hypercalciuria, including 3/6 hematuria, 4/6 nephrocalcinosis, 3/6 hypophosphatemia, 1/6 rickets. Six mutations of the CLCN5 gene were revealed, including L594fsX595, R637X, R467X, IVS4-2A > G, S244L and V505G. The mutation L594fsX595, IVS4-2A > G and V505G was never reported before.</p><p><b>CONCLUSION</b>Low molecular weight proteinuria and hypercalciuria were the main clinical features of the six Chinese boys with Dent's disease. Dent's disease could be associated with a Bartter-like syndrome, which make the gene diagnosis more important.</p>

Evaluation of the applicability of three prediction equations for estimating glomerular filtration rate in children with chronic kidney disease / 中华儿科杂志

<p><b>OBJECTIVE</b>Accurate and reliable assessment of renal function is important in the management of children with chronic kidney disease (CKD). Glomerular filtration rate (GFR) is the best index of assessing kidney function. For assessment of GFR, both gold standard tests and prediction equations have been used. The well-known 24-hour endogenous creatinine clearance (Ccr), the Schwartz formula and the Filler formula are increasingly used in daily clinical practice. However, there are few studies on the applicability of these prediction equations for estimating GFR in Chinese children with CKD. The aim of this study was to compare these prediction equations estimating GFR with an isotope clearance method [isotope glomerular filtration rate (rGFR)] in such patients.</p><p><b>METHOD</b>Children aged 1-16 years who underwent isotope (99m)Tc-diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) GFR testing (Gates' method) between the year of 2002 and 2005 were studied retrospectively. GFR was estimated using: (1) 24-hour Ccr, which was calculated using the standard formula: [urine creatinine (milligrammes per millilitre) × 24-hour urine volume/serum creatinine (milligrammes per millilitre) × 1440] × [1.73 (m(2))/body surface area (m(2))]; (2) the Schwartz formula, which is: eGFR (ml/min per 1.73 m(2)) = k × height (centimetres)/serum creatinine (micromoles per litre), where k is 62 in males at 13 years of age and older, 40 in infants, and 49 in all other children; and (3) the Filler formula, which is: logGFR = 1.962 + [1.123 × log(1/Cys C)], where cystatin C is measured in milligrammes per litre. Serum and urinary creatinine levels were detected by alkaline kinetic method. Serum cystatin C was analysed by particle-enhanced immunoturbidimetric assay. Bias and precision were evaluated.</p><p><b>RESULT</b>Thirty subjects (18 males and 12 females; mean age 9.4 years) fulfilling both inclusion criteria and exclusion criteria were included in this study. The mean (SD) rGFR was 81.57 (36.92) ml/min per 1.73 m(2); 18 subjects were in CKD stage I, 8 in CKD stage II, 8 in CKD stage III, and 1 in CKD stage IV. Only the mean 24 h Ccr-eGFR was slightly higher than rGFR (0.4 ml/min per 1.73 m(2) higher). Within 95% limits of agreement, the maximum absolute value of bias was about 50 ml/min per 1.73 m(2). Accuracy (estimated GFR values within ± 30% of rGFR) for all formulae was poor, ranging from 23.3% to 43.3%. All formulae overestimate or underestimate rGFR in different CKD stages.</p><p><b>CONCLUSION</b>In Chinese children with CKD, there was a significant difference between measured GFR and estimated GFR using 24h Ccr, Schwartz formula and Filler formula. More suitable GFR predictive equations to assess glomerular function of such patients should be developed.</p>

Clinicopathological study of 212 children with primary focal segmental glomerular sclerosis / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the correlation between clinico-pathological features and outcome of children with primary focal segmental glomerular sclerosis (FSGS).</p><p><b>METHOD</b>A total of 212 pediatric patients with D'Agati (2004) primary FSGS were included in this study between 1997 and 2008. According to FSGS histologic classification criteria, 5 pathologic variants were recognized: collapsing (COLL), cellular (CELL), glomerular tip lesion (GTL), perihilar, and not otherwise specified (NOS). Retrospective analysis of the therapeutic response, the relationship between the clinical efficacy and pathology and the outcome of the patients was made.</p><p><b>RESULTS</b>Of the 212 patients, 178 (83.9%) had nephritic syndrome (NS), 97 (45.8%) had simple NS, 81 (38.2%) had nephritis-type NS, GTL variants were mostly appeared to be nephritic syndrome (n = 28) and COLL variants were the fewest (n = 11). The difference between the two variants had statistical significance (P < 0.05). Fourteen cases (6.6%) had nephrotic proteinuria, 20 cases (9.4%) had proteinuria with micro-hematuria. According to histologic classification, NOS (n = 86, 40.6%) was the most common type; perihilar type was seen in 25 cases (11.8%); CELL was seen in 58 cases (27.4%), COLL in 12 cases (5.6%), GTL in 31 cases (14.6%). Chronic tubular injury was present in most cases. CEL variants were mostly found in the early infancy. GTL and NOS variants initially appeared to be responsive to steroids, but subsequently became resistant or frequently recurrent; CELL and COLL appeared to be primarily steroid resistant, GTL and COLL variants had statistically significant differences (P < 0.05). The patients were followed-up for 5 months to 10 years. A response to therapy was observed in 50%, COLL FSGS had the highest rate of ESRD; 2 years renal survival rates were 67%, 3 years were 41%.</p><p><b>CONCLUSIONS</b>FSGS is defined as a clinicopathologic syndrome manifesting proteinuria and focal and segmental glomerular sclerosis with foot process effacement. The location of the sclerosis within the glomeruli proved to have prognostic significance. Collapsing glomerulopathy is the most aggressive variant of FSGS. Compared with other variants, GTL variant may be the best type. Different histologic variants of FSGS have substantial differences in clinical features at the time of biopsy diagnosis and substantial differences in renal outcomes. Prolonged treatment of FSGS-NS with corticosteroids and immune suppressive agents may have some effects in achieving sustained remission and improve prognosis in children.</p>

Clinical and pathological characteristics of children with dense deposit disease / 中华儿科杂志

<p><b>OBJECTIVE</b>To analysis the clinical and pathological characteristics of children with dense deposit disease (DDD).</p><p><b>METHODS</b>12 Children diagnosed as DDD by electron microscope were enrolled in this study. The clinical and pathological data were analyzed.</p><p><b>RESULTS</b>Of the 12 cases, 7 were males and 5 females, mean age 9.1 +/- 3.9 (5-13) years at onset, the duration from onset to renal biopsy was 1 month to 5 years and the follow-up period was 1-9 years. All cases had heavy proteinuria >50 mg/(kg x d), and persistent microscopic hematuria with recurrent gross hematuria during the course. Seven cases had hypertension (> or = 140/100 mm Hg, 1 mm Hg =0. 133 kPa), 5 cases had transient or recurrent abnormal renal function, and mild to severe anemia were observed in 8 cases respectively. All the cases had lower serum C3 (0.15-0.55 g/L). Clinically, 10 cases were diagnosed as nephritic syndrome (one case had partial lipodystrophy at the same time), and 2 cases were diagnosed as acute nephritic syndrome. Immunofluorescence study showed intense deposition of C3 along GBM, TBM and the wall of Bowman's capsule in a ribbon-like pattern and in the mesangial regions as coarse granules in all the cases. Under light microscopy, 9 cases showed the feature of membrane proliferative glomerulonephritis (MPGN), 1 case with focal segmental glomerulosclerosis (FSGS), 1 case with endocapillary proliferative glomerulonephritis (EnPGN) and 1 case with proliferative sclerosis (PSGN). Crescents were seen in 3 cases. Under electron microscopy, ribbon-like or linear electron-dense intramembranous deposits were identified in the lamina dense of GBM, and often along TBM and the wall of Bowman's capsule. All patients showed steroid resistance. After methylprednisone treatment, some patients showed transient remission. During the follow- up stage of 1-9 years, 3 cases showed normal urinalysis, 5 cases showed partial remission, 2 cases progressed to end stage renal disease (ESRD) and 2 cases were lost.</p><p><b>CONCLUSION</b>DDD is an in dependently rare disease with pathological-clinical varieties. Children with DDD presented with persistently lower C3, heavy proteinuria, recurrent gross hematuria and anemia. The characteristic immunopathologic finding is intense deposition of C3 along the GBM. Under electron microscopy, ribbon-like or linear electron-dense deposits in the lamina dense of the GBM, TBM and the wall of Bowman's capsule. Electron microscopic examination to demonstrate the intramembranous dense deposits is definitive diagnosis, regardless of the finding of light microscopy. All of them showed steroid resistant. Patients with steroid and CTX treatment showed some clinical improvement of their urinalysis.</p>

Molecular typing of isolates from two dysentery outbreaks in Chengdu, through pulsed field gel electrophoresis technology / 中华流行病学杂志

<p><b>OBJECTIVE</b>Using pulsed field gel electrophoresis (PFGE) and polymerase chain reaction (PCR) typing to analyze strains isolated from two outbreaks caused by Shigella sonnei and to trace the source of infection.</p><p><b>METHODS</b>Virulence genes ipaH and ial were detected by PCR and PFGE was used to subtype the isolates. Patterns were compared, using the software BioNumerics.</p><p><b>RESULTS</b>Within the 54 isolates, all were ipaH positive with 48 as ial positive. Strains from the Chongzhou outbreak were clustered into 4 PFGE patterns, with the predominant pattern accounted for 72% of the analyzed strains. The pattern of strains isolated from the cold pork with sauce was identical to the predominant pattern. The strains from Dayi outbreak were clustered into 8 PFGE patterns and the predominant pattern accounted for 56% of the test strains.</p><p><b>CONCLUSION</b>Strains from the two outbreaks were quite different and the 'cold pork with sauce' seemed to be the major source of infection, causing the outbreak of diarrhea in Chongzhou. The sources of infection of the Dayi outbreak might be complicated whereas PFGE showed a discriminatory and reproducible laboratory tool in the epidemiologic investigation on outbreaks of diarrhea.</p>

An experimental study on fracture resistance of metal-ceramic crowned incisors with different post-core systems / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate fracture resistance of metal-ceramic crown restored incisors with different post-and-core systems.</p><p><b>METHODS</b>Selected 40 intact maxillary central incisors were endodontically treated and then randomly assigned to four groups of 10 teeth each. Teeth in Group A were prepared to root canal with 10 mm in length, 1.6 mm in diameter and restored with fiber-reinforced posts and composite cores. Same final preparation but root canal with 1.5 mm in diameter was achieved for teeth in the other three groups. Teeth in Group B were restored with prefabricated titanium alloy posts and composite cores and teeth in Group C were restored with cast nickel-chromium post-cores. The posts were luted with a composite resin luting system, and metal-ceramic crowns were restored and cemented with the same luting system for all of the teeth in Group A, B and C. The other 10 teeth were restored with cast nickel-chromium post-cores and metal-ceramic crowns as a control, which were cemented with glass-ionomer cement. All restored teeth were thermo-cycled for 5000 cycles (5 degrees C/55 degrees C) as a fatigue test. The tooth was loaded in a universal testing machine at an angle of 135 degrees to the long-axis at the incisal edge with a cross-head speed of 1.5 mm/min until fracture. Fracture loads (N) and modes (repairable or catastrophic) were recorded. One-way ANOVA and SNK test were used to determine the significance of the failure loads between groups. Chi-square test was conducted for evaluation of the fracture mode.</p><p><b>RESULTS</b>The fracture loads from Group A, B, C and control group were (534.4 +/- 145.7) N, (499.8 +/- 168.9) N, (412.6 +/- 99.3) N, (337.4 +/- 121.2) N, respectively. A significant difference was existed among four groups (P < 0.05). The fracture loads of Group A and Group B were significantly higher than control group (P < 0.05). The repairable mode of fracture observed from Group A to control group was 80%, 40%, 20% and 30%, Group A had a significantly higher number of repairable fractures than those of the other groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Within the limitations of this study, fiber-reinforced post has an excellent fracture resistance, and can be recommended as an alternative to cast post-cores, especially for incisor esthetic restoration.</p>

Peritoneal equilibration test and results analysis in children undergoing chronic peritoneal dialysis / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the characteristics of peritoneal transport in children undergoing chronic peritoneal dialysis (PD).</p><p><b>METHODS</b>Peritoneal equilibration test (PET) was carried out 10 times in 6 children (aged from 2 to 14 years) who were maintained by continuous ambulatory peritoneal dialysis (CAPD), and the peritoneal solution transport rate was evaluated by the standards of Twardowski's and Pediatric Peritoneal Dialysis Study Consortium (PPDSC)'s criteria.</p><p><b>RESULTS</b>In this study, the initial PET was performed at (38.7 +/- 15.6) days following initiation of PD, the 4-hours of peritoneal creatinine clearance (4 h-D/P) and glucose absorption (4 h-D/D(0)) was (0.85 +/- 0.24) and (0.34 +/- 0.19), respectively. According to the standards of Twardowski's and PPDSC criteria, the peritoneal transport categories were divided into high transport (H) (6/10), high average transport (HA) (1/10), low average (LA) (3/10) for peritoneal solution transport, and H (3/10), HA (4/10), LA (1/10), low transport (2/10) for glucose absorption. No low transport type of solution was used in the patients. The coincidence rate of peritoneal creatinine and glucose transport types were 100% and 90% between the Twardowski's and PPDSC criteria, respectively. The different changes of peritoneal transport type were found in two patients with continuous PET. The value of 4 h-D/P increased after peritonitis episodes.</p><p><b>CONCLUSION</b>The results showed that the PET in 70% of CAPD children fell into high and high average transport categories elevated by PPDSC's and adult standards, no-sinusoid distribution. The peritoneal solute clearance was adequate in the children, but net water ultrafiltration was lower. Standard pediatric PET and its criteria are consistent with the adult criteria. The capability of peritoneal solute transport increased after peritonitis episodes.</p>

Incidence rates of human immunodeficiency virus and syphilis as well as the rate of retention in a 6-month follow-up study of female sex workers in areas with heavy drug use in Xichang of Sichuan province, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the human immunodeficiency virus (HIV) and syphilis incidence rates as well as the retention rate in a cohort with 6-month follow-up study among female sex workers (FSWs).</p><p><b>METHODS</b>From December, 2004, to January, 2005, a community-based baseline survey was conducted to recruit 343 FSWs for a prospective cohort study in Xichang county of Sichuan province, China. Follow-up visits were conducted at 6 months to analyze risk factors associated with cohort retention for subjects' baseline sociodemographic and sexual behavioral characteristics. Blood specimens were also collected to test antibodies against HIV and syphilis.</p><p><b>RESULTS</b>During the 6-month follow-up period, HIV and syphilis incidence appeared to be 1.00 per 100 person-years and 6.23 per 100 person-years, respectively. The rate of retention in the cohort was 53.6% (184/343). Results from multivariate logistic regression model showed that factors were significantly associated with cohort retention including people with minority ethnic background (OR = 0.36; 95% CI: 0.18-0.74), people having participated in AIDS prevention program (OR = 1.83; 95% CI: 1.17-2.86) or being clients in the last 6 months > or = 50 (OR = 1.75; 95% CI: 1.11-2.77) and having changed living/working place (OR = 0.56; 95% CI: 0.33-0.94).</p><p><b>CONCLUSION</b>The results of this study showed that the syphilis incidence and unprotected sex behavior were high among local FSWs. People belonged to Han nationality, having participated in AIDS prevention program and having a steady living/working place were associated with cohort retention at 6-month follow-up study among FSWs, respectively.</p>