Objective To evaluate the soothing effects of hemodiafiltration on patients with refractoriness nephrotic edema and its influence on prognosis of nephrotic syndrome.Methods All the 15 cases involved had undergone hemodiafiltration periodically during acme edema and administered with the same standard loading dose of prednisone for 8 weeks.Meanwhile,clinical and lab indexes (urine volume,Cr,Bun,urinary protein,albumin) were measured.Results All patients improved in urine volume and renal function gradually after the treatment of hemodiafiltration for 1 to 3 times.By the 8th week of post-hemodiafiltration,urinary protein 24 h declines obviously[(6.42?2.31)g/d to (0.87?1.24)g/d].Conclusion Hemodiafiltration is an effective treatment in relieving retention of water,increasing the remission rate of protein urine,recovering patients' renal function and improving their prognosis to nephritic syndrome patients with severe refractory edema.

Objective To evaluate the influence factor of 'SF-FDG and 18F-FLT PET/CT for diagnosing pulmonary nodules.Methods 55 patients with pulmonary nodules were chosen as study target,include 33 male cases and 22 female cases,the age range from 17 to 82 years old.In all cases,28 cases had one pulmonary nodule,others had 2 or 3 pulmonary nodules,and the nodule size was 0.6-11.0 cm.18F-FDG and 18F-FLT PET/CT were performed on 55 patients.The relationship of SUV of 18F-FDG and 18F-FLT with sex,age,size and pathology of all pulmonary nodule patients were analyzed.Results The SUV of 18F-FDG and 18F-FLT had no statistics difference on sex,age and size(P>0.05),the SUV of 18F-FDG had no statistics difference on pathology of pulmonary nodule(P>0.05).Otherwise,the SUV of 18F-FLT had statistics difference on pathology of pulmonary nodule(P<0.05).Conclusion The pathology of pulmonary nodule was an important influence factor for SUV of 18F-FLT,and the ~SF-FLT PET/CT has the high diagnostic effectiveness for pulmonary nodules and this method will has great influence on the clinical management of pulmonary nodule patients.

ObjectiveTo investigate the effect of neoadjuvant chemotherapy in locally advanced cervical cancer on cell cycle,proliferation,and evaluate the feasibility of proportion of cell in different phase 　and proliferating cell nuclear antigen(PCNA) as sensitive indices to assess chemotherapeutical sensitivity and therapeutical effect.MethodsForty-nine cases of locally advanced cervical cancer were divided into response group and no-response group according to the clinical efficacy of neoadjuvant chemotherapy.Compared the proportion of cell in different phase and proliferation index of PCNA between two groups.The clinical therapeutic effect was evaluated after 4 weeks in the second neoadjuvant chemotherapy regimen.Results In 49 patients with locally advanced cervical cancer,clinical effective of 39 cases (response group),no effective of 10 cases(no-response group).The S-phase proportion of cell in the pre-neoadjuvant chemotherapy and post-neoadjuvant chemotherapy of response group[ (21.47 ± 5.21 )％ and(18.32 ±5.07)％] were higher than those of no-response group [ (9.63 ± 2.58)％ and ( 10.14 ± 2.32)％ ] (P ＜ 0.05 ).The proliferation index of PCNA of cervical cancer in the pre-neoadjuvant chemotherapy of response group [ ( 81.67 ± 7.14)％ ] was higher than that of no-response group [ (66.99 ± 2.29 )％ ] (P ＜ 0.05 ).Conclusion The S-phase proportion of cell and proliferation index of PCNA in the pre-neoadjuvant chemotherapy are important indexes to assess chemotherapeutical sensitivity and therapeutical effect.

Objective To explore special nursing measures for patients with pulmonary edema related to uremia. Methods Treatment and nursing were performed on 101 patients with pulmonary edema related to uremia. Results Of the 101 patients, 84 cases were rescued successfully, 13 cases were dead and 3 cases were discharged automatically. Conclusion When nursing for patients with pulmonary edema related to uremia, besides general nursing measures, the following aspects should be included: ① specially observing the blood pressure, arterial blood oxygen saturation and urine volume of patients; ② controlling the blood pressure of patients effectively; ③ dialysing or ultrafiltrating in proper manner and at proper time, meanwhile nursing carefully during dialysis; ④ ameliorating the general nutritional status of patients to prevent infection of the lungs; ⑤ keeping firmly in mind the care program: postur sucking oxygen drugs of vasodilatation hemodialysis; ⑥ controlling water drinking.

ObjectiveTo investigate the treatment and safety of interferon ? plus Ribovirin for chronic hepatitis C after kidney transplantation. MethodsFive patients with chronic hepatitis C after kidney transplantation were administered with interferon ? (50 ?g) subcutaneously once a week, plus Ribovirin (600 mg) orally once daily. The levels of HCV-RNA, ALT and serum creatinine in patients’ serum were monitored monthly. ResultsFour in 5 patients presented normal ALT and negative HCV-RNA in serum 12 weeks after treatment, and obtained sustained viral response 24 weeks after interferon ? plus Ribovirin therapy. During treatment, renal graft rejection did not occur. The most frequent side-effects were the decrease of leukocyte and hemoglobin, myalgia and fever, but did not influence the course of treatment. ConclusionCombination of interferon ? with Ribovirin can be a valid therapeutic option in renal transplant recipients with hepatitis C, and shows no influence on the renal function.

ObjectiveTo explore the clinical and pathological characteristics in diagnosing the renal diseases with diffuse glomerular nodular changes. MethodsThe clinical and pathological data of 127 patients whose renal pathological feature was mainly diffuse glomerular nodular changes were retrospectively analyzed. ResultsThe most common diagnosis was diabetic nephropathy and renal amyloidosis, and sometimes light chain deposit diseases and Mix cryoglobulinemia. ConclusionDiffuse glomerular nodular changes occurred in many diseases. We should make differential diagnosis based on the clinical symptoms, the results of laboratory examinations and the renal pathological characteristics.

Objective To observe the impact of transplant nephrectomy on panel reactive antibodies and a secondary renal transplantation.Methods Panel reactive antibodies in 15 patients with a failed renal transplant admitted in our hospital between 2004 to 2007 were measured before transplantation,before and 1 month,6 months,12 months after transplant nephrectomy,and the pathological changes were observed after transplant nephrectomy.Results Panel reactive antibodies was increasing after renal transplantation,and reached the highest level one month after transplant nephrectomy,then grandually got down.New HLA allosensitization sites were discovered after transplant nephrectomy.Large amount of C4d was stained in failed transplant.Conclusion Serum PRA increased after transplant nephrectomy.New HLA allosensitization sites were found,which may be useful in HLA matching.

Objective To investigate the expression and clinical significance of mineral dust-induced gene(MDIG) in malignant pleural effusions (MPE) and tuberculosis pleural effusions (TBPE).Methods Fifty-four patients with MPE (MPE group) and 50 patients with TBPE (TBPE group) were collected.The MDIG protein was detected by enzyme-linked immunosorbent assay and the relative quantification of MDIG mRNA was measured by real-time quantitation polymerase chain reaction.The cutoff value,sensitivity and specificity of the MDIG protein and MDIG mRNA to diagnose the MPE were evaluated by receiver operating characteristic (ROC) curve analysis.By Spearman correlation analysis,the correlation of MDIG protein and MDIG mRNA was evaluated.Results The MDIG protein in MPE group was significantly higher than that in TBPE group [(304.38 ± 228.47) ng/L vs.(44.43 ± 40.57) ng/L],and there was statistical difference (P ＜ 0.01).The MDIG mRNA in MPE group was significantly higher than that in TBPE group (6.27 ± 3.54 vs.1.82 ± 0.64),and there was statistical difference (P ＜ 0.01).With a cutoff point of 114.23 ng/L,MDIG protein had a sensitivity of 77.8％ and a specificity of 94.0％ for differential diagnosis.With a cutoff point of 2.75,MDIG mRNA had a sensitivity of 88.9％ and a specificity of 92.0％ for differential diagnosis.There was a positive correction between MDIG protein and MDIG mRNA (r =0.915,P ＜ 0.01).Conclusions The MDIG protein and MDIG mRNA are highly expressed in MPE with a good sensitivity and specificity.MDIG protein and MDIG mRNA maybe a good clinical indicator in the diagnosis of malignant pleural effusions.

OBJECTIVE:To promote the clinical application and improve the curative effect of serum concentration.METHODS:In a retrospective review,the serum drug concentrations of 487 outpatients and inpatients of our hospital treated with 3 kinds of anti-epileptics included valproic acid,phenytoin and carbamazepine were analyzed.RESULTS:Among 487 samples,there were 248 cases(50.92%) whose serum concentration were in normal range,177 cases (36.34%) in low range and 51 cases(10.47%) in high range.Also,there were 11 cases(2.26%) whose serum concentration could not be monitored.The percentage of patients treated with valproic acid,carbamazepine and phenytoin whose serum concentrations in normal range were 48.18%,74.29% and 10.87%.CONCLUSION:The serum concentration monitoring of Anti-epileptic is the important measure which provide the basis for adopting individualized administration and ensures the clinical effect and safety in the medical care.

Objective To investigate the therapeutic effect of endothelial progenitor cells(EPCs) in ameliorating rat progressive focal segmental glomerular sclerosis(FSGS) model induced by adriamycin.Methods Bone marrow mononuclear cells from male SD rats,after cultured by adherence method,were identified as EPCs.Female SD rats were divided into normal control group,adriamycin induced renal disease(ADR) group,EPCs transplantation group.ADR group and EPCs group underwent unilateral nephrectomy and received 5,3 mg/kg of adriamycin via tail vein 1 week and 2 weeks after operation,while the control group underwent sham operation and received 0.9% sodium chloride solution of equal volume.The whole body irradiation by 5 Gy X ray was done 1 week after the 2nd injection of adriamycin,then immediately 1?106 EPCs were transplanted via tail vein.The rats in control group and ADR group were only injected with 0.9% sodium chloride solution after whole body irradiation.The body weight and urine protein were measured before operation(0 week) and 4(1 week after EPCs transplantation),8,12 and 16 weeks after nephrectomy.Y chromatosome incorporation was detected with in situ hybridization at the 4th and 16th week.The histological and ultrastructural changes of kidney were evaluated at the 16th week.Results At the 4th and 16th weeks,Y chromatosome positive cells could be found incorporation in the area of glomerular and tubular epithelial cells.Since the 4th week,the weight of rats in both ADR group and EPC group became significantly less than that in control group and since the 8th week that in ADR group became less than that in EPC group(P