Actins ; metabolism ; Adult ; Breast Diseases ; metabolism ; pathology ; surgery ; Breast Neoplasms ; pathology ; Calcium-Binding Proteins ; metabolism ; Carcinoma ; pathology ; Diagnosis, Differential ; Fasciitis ; metabolism ; pathology ; surgery ; Female ; Fibroma ; pathology ; Fibrosarcoma ; pathology ; Follow-Up Studies ; Humans ; Microfilament Proteins ; metabolism ; Vimentin ; metabolism ; Young Adult

Objective To investigate the glucocorticoid treatment of nephrotic syndrome curative effect and the effect of psychological intervention on the patients. Methods From June 2015 to May 2016 in our hospital treated 110 cases of patients with nephrotic syndrome, patients were randomly divided into two groups, control group patients with routine treatment and nursing measures, observation group of patients on the basis of conventional treatment nursing glucocorticoid treatment and nursing intervention measures for nursing, completion of treatment, compared two groups of patients with therapeutic effect and recurrence. Results In terms of treatment, observation group of patients treatment effectiveness 94.55％, control group patients treatment effective rate was 81.82％, the observation group of patients treatment effectiveness is significantly higher than patients with the control group (P<0.05); In terms of relapse, observation group after treatment in patients with recurrence rate was 3.64％, the control group after treatment in patients with recurrence rate 9.09％, observation group of patients with recurrence rate was significantly lower than patients with the control group (P<0.05). Conclusion By glucocorticoid treatment of nephrotic syndrome curative effect and psychological intervention on the patients, can significantly improve the effect of treatment of nephrotic syndrome patients, reduce the occurrence of patients relapse, help patients recover better, worthy of popularization and application in clinic.

As a non-pungency inhaled agent with less respiratory irritation,sevoflurane has been widely used in various surgeries for induction and maintenance of general anesthesia.However,the incidence of pediatric emergence delirium has been significantly increased with sevoflurane general anesthesia which severely disturbs the surgical effect and increases the requirement of medical staff in post anesthesia care unit.This article systematically reviews the research advance in emergence delirium in children with sevoflurane general anesthesia and introduces the reasonable intervention for the improvement of anesthesia quality.

Objective To investigate the effect of lipopolysaccharide (LPS) on the activation of mouse lung fibroblasts. Methods Primary cultured mouse lung fibroblasts were incubated in 96 well plates and randomly divided into 2 groups: control group ( group C, n = 6) and LPS group ( n = 24). The fibroblasts were cultured for 72 h in group C. LPS 1 μg/ml was added and then the fibroblasts were incubated for 72 h in group LPS. The expression of type Ⅰ procollagen mRNA, α-smooth muscle actin (α-SMA) mRNA, Toll-like receptor 4 (TLR4)mRNA and integrin β1 mRNA was determined using real-time PCR at 3, 6, 24 and 72 h of incubation (6 wells at each time point). Results Compared with group C, there was no significant change in the expression of type Ⅰ procollagen mRNA, α-SMA mRNA, TLR4 mRNA and integrin β1 mRNA at 3, 6 and 24 h of incubation ( P ＞0.05), but the parameters mentioned above were significantly up-regulated at 72 h of incubation in group LPS ( P ＜ 0.05). Conclusion In the early acute lung injury, LPS leads to pulmonary fibrosis through activating lung fibroblasts directly, and also accelerates the activation of lung fibroblasts and promotes the process of pulmonary fibrosis through up-regulating the expression of TLR4 and integrin β1 in mice.

Objective To evaluate the changes in three-dimensional computer tomography (3DCT) images of upper airway in patients with difficult tracheal intubation and provide theoretical evidence for predicting the difficult tracheal intubation. Methods Seventeen ASA Ⅰ or Ⅱ male patients, 25-60 yr old, height 165-185 era, weight 55-110 kg, body mass index 19-33 kg/m2, scheduled for elective surgery under general anesthesia, were studied. The airway condition was evaluated with Mallampati classification and Willsan score system in all patients before the operation. The patients underwent 3DCT scanning under 2 different statuses: with or without tongue protruding while opening his mouth maximally. The volume of the oropharyngeal cavity (Va1, Va2) andtongue body (Vt1, Vt2), and area of the oropharyngeal cavity (Aa1, Aa2) and tongue body (At1, At2) in the coronal position were measured before and during tongue protruding. The midline sagittal images of the upper airway were made on computer to measure the direct laryngoscope angle and vertical distance between the mandible and hyoid (MHD). Awake blind tracheal intubation was performed in all patients. The exposure of the glottis was performed after anesthesia induction and evaluated with Cormack-Lehane classification. The patients were divided into non-difficult intubation group (group NDI, Cormack-Lehane grade Ⅰ or Ⅱ) and difficult intubation group (group DI, Cormack-Lehane grade Ⅲ or Ⅳ) according to Cormack-Lehane classification. Results There were 8 patients in group NDI, and 9 patients in group DI. There was no significant difference in the indices before tongue protruding between group DI and NDI (P>0.05). Va2, Va1 - Va1, Aa2, Aa1 - Aa2, and At1- At2 weresignificanfly smaller, MHD was significantly longer and Va1,/Vt1- Va2/Vt2was significantly larger in group DI than in group NDI (P < 0.05 or 0.01). Va2 and Aa2 were significantly smaller than Va1 and Aa1 in group DI respectively (P < 0.05). Conclusion The changes in 3DCT images of the upper airway in patients with difficult tracheal intubation are mainly presented as smaller volume and area of the oropharyngeal cavity, larger difference value of the ratio of cavity volume to tongue volume and prolonged MHD.

Objective To evaluate contrast-enhanced ultrasound(CEUS) in the diagnosis of vascular complications of transplanted kidneys.Methods Twelve patients with vascular abnormalities after renal transplantation were observed and analyzed using CEUS, and the diagnosis of all cases was confirmed by means of operation,pathology or angiography.Results Five patients with renal artery stenosis,2 patients with renal artery thrombosis,3 patients with pseudoaneurysm, 1 patient with pseudophlebangioma, and 1 patient with intrarenal extensive microthrombus were found.The coincidence of CEUS was 100%.Conclusions CEUS is a new method with the characteristics of non-nephrotoxic damage to kidney and comparable with angiography in terms of dynamic imaging.

Objective To study the protective effects of curcumin on LPS-induced acute renal injury to offer the clinical evidence of treatment in mice. Methods Fifty-two mice were randomly divided into 3 groups, the control group (n=12), the LPC group (n=20) and the treated group (LPS + curcumin group, n=20). LPS (5 mg/kg) was injected intraperitoneally into the mice of the LPS group. Curcumin (20 mg/kg) was injected intraperitoneally after an intraperitoneal injection of LPS (5 mg/kg) to the mice of the treated group. The TNF-? level of the renal tissue, the serum level of urea nitrogen (BUN) and serum creatinine (Cr) were determined in 3, 6, 12 and 24 h after injection. The expression of TLR2 mRNA was detected with semi-quantitative RT-PCR and the histopathological changes of the kidneys were studied. Results The TNF-? level of renal tissue and the serum levels of BUN and Cr were significantly increased in 3 h after injection in the LPS group and reached the peak at 6 h. The significant increase of the parameters lasted for 24 h. The changes of the expression of TLR2 mRNA were similar to those of TNF-?, BUN and Cr. The histopathological changes of the kidneys included renal tubular necrosis and detachment, formation of casts, glomerular ischemia and shrinkage and infiltration of large amount of PMN in LPS group. In the theated group, the tissue level of TNF-?, the serum levels of BUN and Cr and the expression of TLR2 mRNA were significantly decreased in 3, 6 and 12 h after injection and the histopathological changes were obviously alleviated. Conclusion Curcumin can alleviate LPS-induced acute renal injury and exerts good protection on the functions of the kidneys.

AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.METHODS: Retrospective self-controlled study was designed.A total of 15 patients (20 eyes) with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People`s Hospital from January 2015 to June 2016.The changes of central macular thickness (CMT) and best corrected visual acuity (BCVA) were observed at baseline and 2, 4, 8wk after treatment.We also focused on the incidence of complications and relapse.RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively.The differences among them were statistically significant (F=15.467, P<0.05).The BCVA (log MAR) were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them (F=5.208, P<0.05).When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications;and when it came to 2800mg, 5 patients (33%) had methazolamide-related complication.After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients (20%), 5 patients (33%) and 8 patients (53%) relapsed, respectively.CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk.When the cumulative dose is more than 1400mg, we need pay attention to the complications.After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo.So the patients should be followed closely in 3mo after withdrawal of methazolamide.

Objective To evaluate the value of three-dimensional (3D) ultrasonic imaging of vascular volume in assessing postoperative acute rejection(AR) of renal transplant patients. Methods Color Doppler flow imaging(CDFI) and 3D vascular volumetric parameters were collected and analyzed in 30 cases with stable renal function (control group) and 13 cases with AR of kidney transplantation (AR group). The diagnostic performances of each ultrasonic parameter were compared by receiver operating characteristic (ROC) curve. Results The parameters of resistance index(RI) and pulsatility index(PI) in AR group were significantly higher than those in control group( P <0.005 and P <0. 05, respectively). Analysis of the areas under ROC curve showed that the area under VFI curve was the largest;no significant difference( P > 0. 05) was found compared the area under VFI curve to those areas under VI,FI and MG curves;Comparing the area under VFI curve to those under RI, V and PI,there were significant differences( P <0. 05). Taking VFI≤18. 78% as the critical value, the sensitivity and specificity for the diagnosis of AR of transplanted kidneys were 70. 0% and 93. 3% ,and the positive and negative predictive values were 60. 8% and 93. 4%, respectively. Conclusions The sensitivity and specifity of 3D vascular volumetric imaging parameter VFI in the diagnosis of transplanted kidneys with AR were higher than those of blood flow parameters RI and PL VFI with the optimal critical value of ≤18. 78% might be a useful index for the early diagnosis of transplanted kidneys with AR.

Adolescent ; Adult ; Aged ; Female ; Humans ; Janus Kinase 2 ; genetics ; Karyotyping ; Male ; Middle Aged ; Mutation ; Myelodysplastic Syndromes ; genetics ; Nuclear Proteins ; genetics ; Proto-Oncogene Proteins c-kit ; genetics ; Young Adult ; fms-Like Tyrosine Kinase 3 ; genetics