Primary nephrotic syndrome (PNS) is one of the most common forms of glomerular disorder in chil dren.It is reported that over 90％ of patients are due to minimal change disease and most respond to glucocorticoid (GC) therapy.However,76％-93％ cases have relapses and 40％-50％ frequently relapses nephritic syndrome or steroid dependent nephritic syndrome when steroid is tapered.Long-term courses of GC and immunosuppressant will place them at increased risk for severe side effects.Not all patients do respond to therapy.Although most reports on rituximab use in pediatric patients have not recognized significant side effects,the long-term adverse events of rituximab are not known.Thus,controlled long-term studies are required to be done to assess the risk-benefit profile of rituximab in childhood nephrotic syndrome.

The new educational system integrating both medical undergraduate and professional degrees,by integrating the curriculum system rationally,strengthening the clinical practice,innovating the assessment and management mode,establishes and enforces normative resident physician training system to cultivate high-starting point general practitioners led by medical colleges and provide qualified general practitioners,for the purpose of supporting the health reform successfully.

Objective To investigate the levels of aluminum in serum of people who long-term consumed the foods contained aluminum. Methods 1 500 people who like to enjoy the Chinese traditional foods in which aluminum often contained were investigated and the serum were collected for determination of aluminum, the other 1 500 people whose dietary habits were not the same as that of the former were chosen as the control. Results In the people who like to enjoy the Chinese traditional foods, the number of people who burdened a high level of aluminum in serum(572) was much larger than that of the control(40), and the time-effect relationship was found. Conclusion The aluminum contained foods should be controlled and restricted in China to prevent and reduce aluminum intake.

0.05). However,compared with others segments, significantly high per centage of TA-SLN was absorbed in colon(P0.05). With the decrease of Na+ or existence of deoxycholate, T ween 80,SLS or DNP in the perfusion solution, the absorption rate increased rem arkably(P

Objective To construct high expression system for obtaining human ?-defensin 2 (h?D2) in human lung cancer cell line A549. Methods A recombinant retrovirus expression vector pLNCX2-CEA (signal peptide)-h?D2 (mature peptide) was constructed, and then the retrovirus vector was transfected into PT67 cells by DOTAP. After screening and amplification of single clones by G418, the virus was used to infect A549 cells. A549 cells were also screened by G418, and the cell clones resistant to G418 were obtained. Expression of h?D2 was detected by Western blot analysis. Results A recombinant retrovirus expression vector pLNCX2-CEA-h?D2 was constructed successfully. h?D2 with high level of expression was obtained in A549 cells transfected with the expression vector. Conclusion Human lung cancer cell line A549 can be used for high expression of h?D2 with gene engineering technology.

Objective:To better understand the clinical characteristics of children with pneumocystis pneumonia(PCP).Methods:Seven cases of non-human immunodeficiency virus infected children with PCP admitted to pediatric intensive care unit(PICU) at Xi′an Children′s Hospital from January 1, 2019 to December 31, 2019 were enrolled.Clinical findings, laboratory examination results, diagnosis, treatment, and outcome data were retrospectively reviewed.Results:There were seven children enrolled in this study including six boys and one girl.The average age was(6.09±3.80)years.Six patients received a long-term steroid or immunosuppressive therapy, and the average duration of medication was(80±30)days.One patient was eventually diagnosed with immunodeficiency disease despite no history of steroid and immunosuppressive therapy.Fever, cough and progressive dyspnea were the main manifestations.The pulmonary signs were not obvious, however, the chest radiographs showed serious ground glass changes.Laboratory examination showed that white blood cell counts were normal, lymphocyte counts were decreased to varying degrees, while C-reactive protein, calcitonin and lipopolysaccharide increased slightly or normal.Lactate dehydrogenase significantly increased and PaO 2/FiO 2 decreased, respectively.All children combined with different degrees of heart, liver and digestive tract damage.Pneumocystis jirovecii infection was diagnosed by metagenomics next-generation sequencing(mNGS), of which one case was detected by bronchoalveolar lavage fluid, and the remaining six cases were detected by peripheral blood.After entering PICU, mechanical ventilation, intravenous injection of human immunoglobulin, and continuous renal replacement therapy were performed.None of the children used TMP-SMZ for prophylaxis outside the hospital.Among them, one case was diagnosed with PCP before entering PICU and was given TMP-SMZ for 20 days, while the remaining six patients started to receive TMP-SMZ after entering PICU.Finally, one patient was cured, three died and another three cases died after giving up treatment.The average hospitalization days were(11.28±8.78)days, and the average hospitalization costs were (78, 000±24, 000) RMB. Conclusion:Children with non-human immunodeficiency virus infected PCP usually have underlying diseases or immunodeficiency diseases.Due to non-specific manifestations, rapid progression and high mortality, clinicians should pay more attention to it.It is necessary to dynamically observe the respiratory symptoms, perform mNGS as soon as possible, and give TMP-SMZ treatment in time.TMP-SMZ prophylaxis can be given to patients who are highly suspected of PCP but unable to perform pathogenic examinations.

Objective To investigate the effectiveness of oxytoein antagonist atosiban in the alternative rescue therapy of preterm labor.MethodsAlternative toeolysis atosiban was given as rescue therapy to 35 women,who had received ritodrine or magnesium sulphate but failed,due to either progression of labour or intolerable adverse events.Atosiban was administered for up to 48 hours.Efficacy and tolerability were assessed based on the proportion of women who did not deliver and did not need alternative toeolytie therapy at 48 hours and 7 days after therapy initiation.The numbers of maternal adverse events and neonatal morbidity were also assessed.ResultsEfficacy and tolerability at 48 hours and 7 days after atosiban nitiation were 77％(27/35)and 60％(21/35).One woman presented drug-related side effects with mild nausea and omiting.Thirty-four women have delivered and one bigemina(28 weeks)is being followed-up.In 34 women,11 delivered before 28 gestational weeks,17 delivered after 28 gestational weeks,3 delivered after 34 weeks and 3 had term delivery.Pregnancies were rolonged by 4 hours to 14+2 weeks.There were nine neonatal deaths,with gestational ages less than 28 weeks at delivery.Conclusion xytocin antagonist atosiban could be given as alternative rescue therapy if therapy with ritodrine or magnesium sulphate fails in the treatment of preterm labor,and it is safe and effective.

Objective To explore the relationship between MR enhancement signs with MVD and VEGF expression in early breast carcer or benign lesion,improve the correct diagnosis rate of breast mass.Methods The MR enhancement signs(early enhmcement rate,eurve type of enhancement)of 31 patients with breast cancer and 19 benign lesions were analyzed retrospectively.Results Mean early enhancement rate of 31 neoplasm(20 invasive duet csncer,6 invasive lobule cancer,2 mucous cancer,3 situ lobule caner)were(68.4±14.7)%,enhancement curve type of which manifested as 18 type Ⅰ curve,11 typeⅡcurve and 2 type Ⅲ curve.Mean early enhancement rate of 19 benign mass(11 fibre adenoma,6 cystic hyperplasia,1 angioma,lobular tumor,1 infecmd cyst)were(47.6 ±15.2)%,of which 2 were typeⅠcurve,10 type Ⅱ cnrve and 7 type Ⅲ curve.In early cancer focus,mean MVD and VEGF expression index were 48.2±5.6 and 1.8 ±0.3,while in benign mass they were 30.8 ±6.1,0.9 ±0.3 respectivdy.Condusion Early enhancement rate,MVD and VEGF expression index in malignant focus were higher than those in benign mass,type Ⅰ curves were predominate in malignant lesions,by which early breast cancer could be diagnosed in time.

Objective To investigate the value of protective transverse colostomy in decreasing postoperative anastomotic leakage and stricture after laparoscopic resection for rectal cancer.Methods The clinical data of 128 patients with rectal cancer who were admitted to the Jinhua Hospital of Zhejiang University from March 2008 to February 2012 were retrospectively analyzed.All the patients received laparoscopic anterior resection of rectal cancer after neoadjuvant chemoradiotherapy.Sixty-one patients received protective transverse colostomy (colostomy group) and 67 patients did not receive protective transverse colostomy (non-colostomy group).The incidences of postoperative anastomotic leakage and stricture,condition of the patients and the prognosis of the patients in the 2 groups were compared.Patients were followed up via out-patient examination,in-patient chemotherapy or phone call till May 2013.All data were analyzed using the t test,chi-square test or Fisher exact probability.Results The overall incidence of postoperative anastomotic leakage was 7.03％ (9/128).The incidences of postoperative anastomotic leakage in the colostomy group and non-colostomy group were 6.56％ (4/61) and 7.46％ (5/67),with no significant difference between the 2 groups (x2 =0.000,P ＞ 0.05).The systemic condition of 4 patients who were complicated with anastomotic leakage in the colostomy group was comparatively better,and all of them were cured by conservative treatment.The condition of 5 patients who were complicated with anastomotic leakage in the non-colostomy group was severe,and 4 of them received reoperation,with the reoperation rate of 4/5 ; the other patient received conservative treatment.There was significant difference in the reoperation rate between the 2 groups (P ＜0.05).The overall incidence of postoperative anastomotic stricture was 13.28％ (17/128).The incidences of postoperative anastomotic stricture in the colostomy group and the non-colostomy group were 19.67％ (12/61) and 7.46％ (5/67),with significant difference between the 2 groups (x2=4.133,P ＜ 0.05).The incidences of severe anastomotic stricture of the colostomy group and the non-colostomy group were 8.20 (5/61) and 0,respectively.Conclusion Protective transverse colostomy could not reduce the incidence of postoperative anastomotic leakage,but could mitigate the symptoms followed anastomotic leakage and reduce the reoperation rate.Protective transverse colostomy may improve the incidence of anastomotic stricture,therefore it should be applied cautiously.