Objective To explore the risk factors of primary nephritic syndrome complicated with thrombosis in children. Methods Clinical data of 238 children with primary nephritic syndrome were retrospectively analyzed. The children were divided into thrombosis group and non-thrombosis group according to whether complicated with thromboembolism. Univariate and logistic regression analysis were performed.Results Among 238 children, there were 32 cases of primary nephritic syndrome complicated with thrombosis and the rate was 13.44%. Univariate analysis showed that infections, the use of diuretic, degree of edema, white blood cell count, IgG, C3, total protein, albumin, urea nitrogen, plasma ifbrinogen, D-dimer, antithrombinⅢ, and 24-hour proteinuria were signiifcantly different between two groups (allP< 0.05). Multivariate analysis showed that D-dimer and 24-hour proteinuria were the independent risk factors for children with primary nephrotic syndrome complicated with thrombosis.Conclusion The elvated level of D-dimer and 24-hour proteinuria were the risk factors of children with primary nephrotic syndrome complicated with thrombosis.

Forensic dentistry is an interdiscipline of forensic m edicine and stom atology, w hich provides legal inform ation by collecting, testing and assessing the dental evidence scientifically. In this review , the present application of forensic dentistry has been described, such as the estim ation of age, sex, species, occupation and living habit, as w ell as the identification of individual, dom estic violence or abuse, w hich aim s to enrich and im prove forensic dentistry for m aking it be m ore useful in forensic m edicine even in juridical practice.

Objective To investigate the influencing factors and reference value of sympathetic skin response (SSR) in healthy adults. Methods SSR was studied in 40 normal subjects,with the waveform and onset latency analyzed. Five of them were treated with different intensities of electrical stimulus to observe the subsequent onset latency. Results ① SSR was present in all the hands and it was also true in all the feet except for one case. The waveforms were biphasic or triphasic in the hands and biphasic or triphasic or monophasic in the feet. ② No significant difference was seen between the left and right sides in amplitude and onset latency. ③ Age,height,weight and gender had no significant influences on onset latency of SSR. ④ The normal value on onset latency in the hands was within 1 664 ms and 2 234 ms in the feet,respectively. ⑤ The electrical stimulus intensity had no obvious effect on onset latency. Conclusion Onset latency is an important parameter in evaluating abnormality while amplitude is only a reference index.

Objective:To study the effect of sertraline plus cognitive behavior therapy in treatment of panic disorder Method:14 outpatients with panic disorder according to crteria of CCMD-2-R were collected as our sample All of them were given sertraline 50 mg/d for 6 months in addition to cognitive behavior therapy The clinical effect was assessed at the end of 1 month,3 months and 6 months Results:At the end of 1 month,3 patients were assessed as markedly improved,9 as improved At the time of 3 months,10 patients were assessed as markedly improved,2 as improved At the end of 6 months,12 markedly improved,2 improved There were 3 patients had mild side effects,which faded with time Conclusion:Sertraline plus cognitive behavior therapy has good effect in treatment of panic disorder with good compliance and little side effect

OBJECTIVE:To observe the efficacy and safety of cyclophosphamide,leflunomide sequentially combined with prednisone in the treatment of membranous nephropathy in stage Ⅱ. METHODS:72 patients with membranous nephropathy in stageⅡwere randomly divided into group A(24 cases),B(24 cases)and C(24 cases). All patients were given angiotensin convert-ing enzyme inhibitor (ACEI) Benazepril hydrochloride tablet,warfarin,dipyridamole,calcium and other conventional treatment. Based on it,group A was orally given 50 mg Compound cyclophosphamide tablet,twice a day,for continuous 3 months+1.0 mg/(kg·d)Prednisone tablet,it was reduced 5 mg every 2 weeks after 2 months,then it reduced 2.5 mg every 2 weeks when 30 mg/day,and then it maintained 4-6 months when 10 mg/day,it lasted for 12 months. Group B was given 50 mg Leflunomide tablet,it changed as 20 mg/day after 2 d,and for continuous 6 months+Prednisone tablet(the same dosage and usage as group A). Group C was given Compound cyclophosphamide tablet(the same dosage and usage as group A)was orally given in 1-3 months,and Leflu-nomide tablet(the same dosage and usage as group B)in 4-9 months Prednisone tablet(the same dosage and usage as group A). Clinical efficacy,24 h urinary protein,albumin,total cholesterol,serum creatinine,alanine aminotransferase before and after 3, 6,9 and 12 months and incidence of adverse reactions in all groups were observed. RESULTS:Before treatment,there were no significant differences in the 24 h urinary protein,albumin,total cholesterol,serum creatinine and alanine aminotransferase among all groups(P>0.05). After treatment,24 h urinary protein,total cholesterol,serum creatinine and alanine aminotransferase in all groups were significantly lower than before,and they gradually decreased by treatment time,24 h urinary protein in group C was lower than group A and B,albumin was significantly higher than before and gradually increased by treatment time,and group C was higher than group A and B,the differences were statistically significant(P<0.05 or P<0.01);but there was no significant dif-ference between group A and B(P>0.05). The total effective rate in group C was significantly higher than group A and B,the dif-ference was statistically significant (P<0.05),but there was no significant difference between group A and B (P>0.05). And there was no significant difference in the incidence of adverse reactions among 3 groups (P>0.05). CONCLUSIONS:Based on the conventional treatment,the efficacy of cyclophosphamide,leflunomide sequentially combined with glucocorticoid is superior to cyclophosphamide or leflunomide alone in the treatment of membranous nephropathy in stageⅡ,with similar safety.

It is inevitable for colleges and universities to reform their information literacy education course with the coming of education informationization time.The construction elements of MOOC-based flipped classroom for information literacy education course in colleges and universities were studied in aspects of teaching design, classroom activities, hardware, teachers literacy based on the analysis of its necessity and feasibility, and strategies were put forward for colleges and universities to construct their multi-mainstay plus multi-element flipped classroom for information literacy education course.

Primary hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide.MicroRNAs (miRNAs) are a kind of endogenous non coding singlestranded RNAs,which can function as a tumor promoter or suppressor in the development and progression of human malignant tumors.Studies have shown that miRNAs play an important role in the occurrence and development of HCC.Numerous studies have found that the expression of miR-34a in various tumors is reduced and it participates in the carcinogenesis.Currently,the role of miR-34a in the tumorigenesis and development of HCC has attracted widespread attentions.Studies have confirmed that miR-34a can regulate the expression of its target genes and thus affect some key biological processes such as cell proliferation,apoptosis,invasion and metastasis of HCC.In this paper,we mainly reviewed the recent research progress on the role of miR34a in HCC.

Pancreatic encephalopathy(PE)is one of the severe complications in acute pancreati-tis,which is characterized by a group of neurological signs and symptoms. Itˊs very difficult to have an early diagnosis,while the morality of PE is very high and the prognosis is very poor. Eliminating causes of pan-creatic encephalopathy,early diagnosis and combined therapy are the keys to achieve good curative effects. This paper reviewed the recent progress in the main mechanisms,clinical manifestations,diagnosis and therapy of PE.

Objective To investigate the clinical effect of Gonadotropin-releasing hormone agonist (GnRHa) combined with addback therapy after laparoscopic surgery on 153 cases with severe endometriosis patients. Methods 153 cases with severe endometriosis patients who underwent laparoscopic surgery from 2011 to 2013 were retrospectively analyzed in the Second Affiliated Hospital of Zhengzhou University. According to GnRHa or addback therapy three groups were divided:GnRHa group,GnRHa and addback therapy group, control group. The curative effects of different treatment group, adverse reactions, recurrence rates, and fertility were analyzed. The follow-up time was 6-24 months with an average time of 17.15 months. Results 51 patients suffered from obvious menopausal symptoms and received addback therapy (Progynova,0.5~1 mg/d). The VAS score and Kupperman score in GnRHa group,GnRHa and addback therapy group were significantly superior to the control group (P <0.05). And no statistical significance was found in the interval to relapse, recurrence and postoperative pregnancy rate (P>0.05). The VAS scores in the GnRHa group and addback therapy group were 2.14±2.02 and 1.73±2.17 , respectively (P > 0.05). The main side effect of GnRHa group is hot flashes, diaphores, insomnia, sexual dysfunction, etc. The incidences were higher in the GnRHa group than that in the addback therapy group. But the addback therapy can significantly relieve the symptoms of low estrogen introduced by the application of GnRHa (P<0.05). Conclusions Laparoscopic combined with GnRHa treatment can significantly improve clinical curative effect of endometriosis. Addback therapy could abate the side reaction of GnRHa and do not affect the clinical curative effect. The clinical curative effect in the GnRHa and addbacktherapy group were superior to the GnRHa group.