0.05).

Objective To study the protection of Kangnaoling capsule to free radical injury and influence on the expression of caspase-3 and Bcl-2 in neuron of VD rat. Methods VD rat model was duplicated. Using spectrophotometry to detect contents of SOD, MDA and NO, spectro-fluorimeter to detect the expression of caspase-3, spectrophotometric method to detect the expression of Bcl-2 after traditional Chinese medicine interference. Results Kangnaoling capsule can markedly reduce the contents of MDA, raise contents of SOD and NO, degrade the expression of caspase-3, enhance the expression of Bcl-2. Conclusions Kangnaoling capsule can markedly protect VD rat from free radical injury, which probably correlated with increasing expression of Bcl-2, decreasing expression of caspase-3.

Objective To investigate the significance of non - concentrated proteinuria electrophroresis in early diagnosis of type 1 diabetic nephropathy(DN). Methods A total of 47 selected patients with type 1 diabetes and 30 healthy controls were recruited in the study. Fourty seven patients were divided into diabetes mellitus(DM) group and DN group based on the rate of urinary excretion of albumin. Sodium dodcyl sulfate - agarose gel electrophoresis(SDS - AGE) was used to analyze the proteinuria in patients and controls group. Results The positive ratio of urinary albumin SDS - AGE was significantly higher in DN group than in DM group and normal control(group P

Objective To explore the feature and the optimal treatment of kidney stones in children associ-ated with infant formula which had been aduherated with melamine.Method Total of 47 cases of urinary stone and 31 cases of acute renal failure caused by urinary multiple obstruction in children associated with infant formula which had been adulterated with mlelamine in Beijing Children's Hospital University of Medical Science,form Jan-uary to November,2008 were retrospectively analyzed.Results Infant formula which had been adultemted with melamine may lead to kindey stones in 15 days.The mean age was 11-month and the ratio of male to female was 2.6:1.The kindey stones were usually multiple and mostly located either in the ureteropelvic junction or all through the ureter.In the view of the renal function resuming duration,there was no statistic difference among the acute renal failure group,operation group and the conservative group(P=0.683～0.846).In children with uri-nary obstruction and acute renal failure,hemedialysis or peritoneal dialysis was performed.83.9%were relieved by posting catheter through panedoseope and blood purification.100% of the patients resumed normal renal func-tion.81.3% of the patients without acute renal failure had recovered after conservative therapies such as infusion.Conclusions The patients associated with infant formula which had been adulterated with melamine were Usually little infants.Male were more vulnerable than female.Most of them had recovered smoothly and the renal function resumed normal after effcient therapies.

Plasma exchange is a commonly used blood purification method, h includes plasma exchange,double filtration plasmapheresis and immunoadsorption.Many nervous system diseases have the antibody. Guillian-Barre syndrome is caused by antibodies of the nervous system demyelinafing disease; Myasthenia grads is caused by the acetylcholinc receptor antibodies. CIDP also has autoimmune-mediated mechanism. Plasma exchange can be apphed effectively to remove antibodies, and to quickly improve the patient' s clinical symptoms and shorten the course of disease.

Objective To assess the indications,effect and complications of plasma exchange(PE) application in children.Methods A total of 93 patients treated with PE were enrolled,and the clinical mani-festations before and after treatment were analyzed retrospectively.Results Ninety-three cases of children received PE treatment 2 to 1 1 times,an average of 5.5 times,53 cases with combination blood purification treatment.In 93 patients,there were 36 cases with hemolytic uremic syndrome,among them,22 cases (61.1 %)were healed,14 cases(38.9%)remained hematuria,and proteinuria and 5 of them(13.9%)with injured renal function.There were 9 cases with Guillain-Barre'syndrome and 8 of them got improved.Six in 8 cases with anti-N-methyl-D-aspartate receptorencephalitis got better after treatment.All of the 3 cases with myasthenia gravis got recovery.There were 4 cases with acute disseminated encephalomyelitis and 4 cases with chronic inflammatory demyelinating polyneuropathy respectively.The treatment effect rate was all 3 /4. Four in 9 patients with poisonous mushroom poisoning also got improved.The adverse reactions were ob-served in 12 cases(12.9%),including allergic in 9 cases and hypotension in 3 patients.No serious adverse reactions were found during treatment.Conclusion PE is an safe and effective blood purification method, with less adverse reaction,for treatment of the atypical hemolytic uremic syndrome and some serious nervous system diseases,such as myasthenia gravis,Guillain-Barre syndrome,etc.

Objective To investigate the characteristics of Wegener granulomatosis in children and to improve its recognition. Methods Ten pediatric patients with Wegener granulomatosis were studied retrospectively by clinical manifestations, serum examination, pathological data, treatment, etc. Results All children had clinical evidence of upper respiratory tract and lungs involvement; kidney lesion occurred in 6 cases(6/10); joints, skin, eyes and nervous system were also involved with different degree, cANCA (PR3) showed positive in 8 cases; Pathological examination (1 kidney sample, 2 nasal mucosa samples, 2 skin samples) showed granulomatous vasculitis and crescents were found in renal biopsy; 7 cases were treated with corticosteroid plus cyclophosphamide, 1 case was treated with corticosteroid plus methotrexate, and improvement were seen in all of them. Conclusions Wegener granulomatosis in children have diverse clinical manifestations and clinical diagnosis is difficult. The upper and lower respiratory tract and kidney are most commonly involved organs. ANCA inspection is characteristic. Treatment with corticosteroid and immunosuppressive can achieve good outcome.

To enhance the level of experimental teaching,the exploring teaching method was studied. Compared to the traditional teaching method,this new method was approved by its obviously advantages. The results show that the students who were taught by exploring teaching method are more excellent in experimental operation,problem resolving capability,and report writ-ing. Also,this result induce a possibility of new method application in experimental teaching.

Objective To investigate the treatment of atypical hemolytic uremic syndrome (aHUS) in their acute phase and relate the prognostic factors.Methods Twenty-eight patients with aHUS treated in Department of Nephrology,Beijing Children's Hospital Affiliated to Capital Medical University from January 2011 to March 2015 were collected,the outcomes of the treatment were summarized.Results All the patients were given plasma exchange (PE)treatment,21 patients with hemodialysis (HD) treatment;13 patients with H factor (FH) antibody were further treated with corticosteroid therapy,and 1 patient was treated with the combination of mycophenolate mofetil.Evaluation of patients' indices were conducted at month 3.Out of the 28 patients,there were 13 patients with complete remission;of the 14 patients showed improvement,6 patients were complicated with hypertension and 4 patients with renal dysfunction.One patient,with ongoing hemodialysis,did not show restoration of renal function.There was no death in children.Statistical analysis showed that the acute phase serum creatinine levels were (430.0 ± 124.7) μmol/L and (265.6 ± 90.8)μmol/L for the group with remaining kidney injury and the group with complete remission,respectively,the difference was statistically significant(P ＜0.01).The levels of FH for the 2 groups were (206.5 ± 134.9) mg/L and(415.4-±214.1) mg/L,and the difference was statistically significant (P ＜ 0.01) as well.Statistical analysis showed that differences were no statistically significant between the 2 groups of patients on their age,platelets,complement C3,complement C4,hemoglobin and lactate dehydrogenase (all P ＞ 0.05).For the group with positive antibody,its average serum creatinine was (346.4 ± 112.5) μmol/L.For the group with negative antibody,its average serum creatinine was (297.0 ± 89.3) μmol/L.The FH for group with positive antibody and group with negative antibody were (307.4 ±187.3) mg/L and (379.8 ± 203.5) mg/L,respectively.The differences were not statistically significant (all P ＞0.05).Conclusions PE is an effective treatment for aHUS at acute phase,and corticosteroid and immunosuppressive therapy are effective for patients with positive anti-FH antibody.For patients with severe kidney injury at acute phase,the possibility of long-term kidney damage is high.Low concentration of serum FH indicates a poor prognosis.

Objective To analyze the clinical features of pediatric sepsis with initial symptoms of autoimmune hemolytic anemia(AIHA) and acute renal failure.Methods Ten cases of pediatric sepsis with initial symptoms of AIHA and acute renal failure were selected from January 2000 to January 2014 in Department of Nephrology,Beijing Children's Hospital Affiliated to Capital University of Medical Science.The clinical data were retrospectively analyzed and long-time follow-up was taken.Results There were 8 boys and 2 girls of the 10 cases.The ages ranged from 8 months to 12.8 years.There were 8 children less than 6 years old having a prevalence of 80％.There were sudden dark urine and progressive anemia in all the cases,jaundice in 9 cases,abdominal pain and vomiting in 6 cases.Urine volume decreased in 7 cases and anuria in 3 cases.Four cases showed disorder of consciousness and 2 developed shock.Respiratory failure and disseminated intravascular coagulation happened in 1 case respectively.In terms of pathogens,2 cases were infected by mycoplasma and 1 case was infected by hemolytic streptococcus.The rest of the pathogen was unknown.The Coomb's test was 3 +-4 + positive.Serum urea nitrogen and creatinine gradually increased.High level total serum bilirubin and unconjugated bilirubin were shown in 8 cases and low level complement in 7 cases.Bone marrow films showed hyperplasia in all the cases.Renal biopsy was taken in 3 cases and no microthrombus was found.Corticosteroid was used in all 10 cases for 6 months.Blood purification was taken in 8 cases.Respiratory support was used in 4 cases.Nine recovered and 1 case gave up treatment.Further follow-up was taken for 2.2-8.1 years.Eight cases had normal urine and blood routine test and renal function.Relapse happened in 1 girl 1 year later.One case lost follow-up.Conclusions Once sudden hemoglobinuria,anemia and progressively decreased urine output occur in sepsis cases,the clinicians should consider AIHA and acute renal failure.Based on active infection control,the early use of steroids and blood purification treatment can improve the prognosis.