Renal replacement therapy is an effective treatment for end-stage diabetic nephropathy.This review summarized recent literatures on hemodialysis,peritoneal dialysis and renal transplantation for end-stage diabetic nephropathy.The purpose is to guide doctors for treating end-stage diabetic nephropathy more reasonably.

Objective To study the change tendency of air pollutants in Shenzhen, China in 2002-2005, further, to explore the relationship between disease spectrum and air pollution. Methods The daily mean concentration of SO2, NO2 and PM10 in 2002-2005 in eight environmental monitoring sites were determined according to Ambient Air Quality Standard. Results Air concentrations of SO2, NO2 and PM10 increased yearly in 2002-2004, from 0.018 3 mg/m3 to 0.023 4 mg/m3, 0.050 1 mg/m3 to 0.072 5 mg/m3, 0.061 0 mg/m3 to 0.075 7 mg/m3, respectively, however, the concentrations of the three indexes decreased in 2005. In the past four yeas, average levels of SO2 were under the limit of grade 2 of GB3095-1996, as for PM10, under the limit of grade 2, and most of the concentrations of NO2 were under the limit of grade 3, but in the other two monitoring sites, the concentrations of NO2 in 2004 exceeded the limit of grade 3. The year average concentrations of SO2, NO2 and PM10 in 2002-2005 in the outer region were higher compared with those in the inner region of the special economic zone, except the level of NO2 in 2002. As for the quarter average concentrations of SO2, NO2 and PM10, 1st and 4th were higher compared with 2nd and 3rd. Conclusion The air quality in Shenzhen is better in China, however, more attention should be paid to the pollution of nitrogen oxides and inhalable particle matters.

[Objective] To search a reasonable approach to the treatment of nasopharyngeal carcinoma (NC) with traditional Chinese medicine integrated with western medicine. [ Methods ] Seventy - six cases of NC were randomized into Group A and Group B. Group A ( n = 39) was treated with herbs for activating blood and removing blood - stasis, nourishing yin and clearing heat during radiotherapy and herbs for replenishing qi and nourishing yin, generating body fluid, moistening dryness and clearing heat after radiotherapy. Group B ( n = 37) was treated with radiotherapy alone. Short - term therapeutic effect, long - term survival rate, the relief of main symptoms, the reduction of cervical lymph node metastasis and side effect of radiotherapy in the two groups were observed. [ Results ] After treatment, the complete relief (CR) rate was 84.6% and 15.4% and partial relief (PR) rate was 73.0% and 27.0% in Group A and B respectively, the differences being significant ( P

Aim To evaluate the clinical application of propofol in critical patients with mechanical ventilation. Methods22 patients with mechanical ventilation after major operation were randomly divided into control group and propofol group patient in the propofol group were continually transfused with propofol by micro pump. Clinical manifestations, blood pressure, heart rate and the concentration of epinephrine (E)and norepinephrine (NE) in patients of both groups were observed. Results The patients in propofol group were all in sleeping state, while those in the control group had evidently higher blood pressure,heart rate and the concentration of epinephrine and norepinephrine after wearing of ventilator. There was a significant difference between the two groups ( P＜0.05) . Conclusion Propofol can make the critical patients quiet and inasleepingstate,inhilitthereleaseof epinephrine and norepinephrine, which rescdt in hemodynamic stability.

OBJECTIVE:To study pharmacokinetics of cyclosporine in healthy volunteers, and to investigate the relationship of drug exposure with blood sampling time after treatment. METHODS: The data of trial at the first 12 blood sampling time points after medication were collected from bioequivalence test in 24 healthy volunteers (trial preparation vs. reference preparation). Multiple linear regression analysis was used to study the blood concentrations of cyclosporine at different sampling time points and the area under the blood concentration-time curve (AUC). RESULTS: The concentrations at two points were adopted to estimate AUC. The correlation coefficient of different cyclosporines could reach 0.9 with estimation deviations less than 15%. The AUC of cyclosporine of trial preparation could be estimated by C8 and C12, and that of reference preparation by C2.5 and C12. CONCLUSION: The AUC estimated by concentrations at two points can meet clinical demand. There is great difference in estimate point among different preparations.

Objective To discuss influence factors on prognosis of the patients with capillary leak syndrome (CLS) in ICU.Methods The clinical data of 191 patients with CLS in ICU were reviewed,and the patients were divided into three groups according to prognosis:death group ( n =37),cured group ( n =132) and non-healed group (n =22).The clinical data of death group were compared with those of cured group at admission,during the course of CLS and before discharging from hospital.Results Compared with the cured group,the central venous pressure and serum albumin decreased ( P ＜ 0.01 ) ; anion gap,triglycerides,pressure adjusted heart rate (PAHR) and oxygenation index were lower ( P ＜ 0.01 or P ＜ 0.05) ; serum glucose and SIRS score increased ( P ＜ 0.01 ) in death group.There was higher rate of poor renal function at admission in death group than that in other groups ( P ＜ 0.01 ).There were more many patients treated with intravenous administration of hydroxyethyl starch,ulinastatin and continuous blood filtration therapy in cured group than those in other groups ( P ＜ 0.05).Conclusions The factors influencing the outcomes of the patients with CLS were hypovolemia,severe hypoproteinemia,interior milieu disorder,malnutrition,hypoxemia,renal injury and severe systemic inflammatory response.The outcomes of patients with CLS in ICU could be improved by using hydroxyethyl starch,ulinastatin and continuous blood filtration therapy.

Objective To study the effects of pulse high volume hemofiltration (PHVHF) on the changes of Th17 cells (T helper 17 cells) and CD4 + CD25 + reguratory T cells (Treg cells) in peripheral blood of patients with sepsis and to evaluate the clinical value of this intervention. Methods The patients were included in this prospective study as per the criteria of sepsis set by America Chest Physicians College/America Society for Critic Care Medicine in 1992. The patients were excluded: ① immune system disorder, ② acute stroke, ③ myocardial infarction, ④ virus hepatitis,⑤ human immunodeficiency virus infection, ⑥ under immunosuppressive therapy. Forty patients (24 males, 16 females, aged from 25 to 75years) with sepsis in ICU were enrolled from January. 2008 to November. 2010. According to the severity of disease, the patients were divided into three groups; moderate sepsis group (n = 14, 8 males, 6 females) , severe sepsis group (n = 15, 9 males, 6 females) , and septic shock group (n = 11, 7 males, 4 females). The initially clinical data of three groups were comparable. Twenty healthy individuals served as controls. According to the mode of treatment, forty patients were also divided into two groups: conventional treatment group (group A, n= 15) in which patients were treated without PHVHF within 5 days after admission and trial group (group B, n=25) in which patients were treated with pulsed high volume hemofiltration (PHVHF) within 5 days after admission. In group B, high volume hemofiltration (70 mL · kg-1 · h-1) was given to patients for 6 ～ 8 hours, and then conventional continuous vein - vein hemofiltration (35 mL · kg-1 · h-1) for 16 ~ 18 hours. The total length of period for continuum blood scavenging was 24 hours as one cycle. The interval between two cycles of blood scavenging was 24 hours. The changes of Th17 cells and CD4+ CD25 + Treg cells of 40 patients were detected with flow cytometry on the 1st day and the 5th day after admission. The data were analyzed by using SPSS version 13. 0 software. Measurement data were analyzed with Paired-samples t-test, independent-samples t-test or one way ANOVA . Ratio of small samples was compared with fisher's exact test, and the correlation was analyzed by using Pearson correlation analysis. Results The rates of Th17 cells were( 0.91 ±0.38)%, (2.09 ±0. 53)% , (3.90 ±0. 80)% , and ( 1. 85 ±0.35)% in control, moderate sepsis, severe sepsis, and septic shock groups, respectively, while the rates of CD4+ CD25+ Treg cells were (0.39 ±0.23)%, (1. 72 ±0. 59)% , (2.72 ±0. 22)% , and (3. 55 ±0. 51)% , respectively. The rate of Thl7 cells on the 1st day was higher in severe sepsis group than that in other two groups ( P < 0. 05 ) without significant difference between septic shock and moderate sepsis groups ( P > 0. 05). Moreover , the rate of CD4+ CD25 + Treg cells was up - regulated on the 1st day in the following order from high to low: septic shock group > severe sepsis group > sepsis group (P < 0.05). The rates of Th17 cells and CD4 + CD25 + Treg cells in patients of group B decreased in greater degree than that did in patients of group A (P < 0.05 ). Conclusions The changes of Th17 cells and CD4 + CD25 + Treg cells may play an important role in pathogenesis of sepsis, and the pulsed high volume hemofiltration may be one of the effective treatments for the patients with sepsis by regulating the rates of Thl7 cells and CD4 + CD25 + Treg cells.

Objective To compare the effect,relapse rate and outcomes between mycophenolate mofetil(MMF)and pulse intravenous cyclophosphamide(CTX)in the induction therapy of pauci-immune crescentic glomerulonephritis(PICGN)in Chinese.Methods A total of 44 patients who had PICGN[16 male,28 female,age(46.8?13.7)y],of whom 25 patients were ANCA positive,were enrolled in this study.All patients had renal involvement with ≥50% crescent formation prior to the study and received either MMF treatment(MMF group,n=22)or intermittent CTX pulse therapy(CTX group,n=22).The patients in both groups also received methylprednisolone(MP)pulse therapy followed by oral prednisone.General conditions,clinicopathological findings,remission rate,relapse rate,and outcomes were compared.All the patients were followed up until June 2005,with an average follow-up of 8～60(Med 27)months in the MMF group,and 6～72(Med 29)months in the CTX group.Results No significant difference was found between MMF group and CTX group in general conditions,base parameters of clinical and pathological findings.The remission rate at the 12th month in MMF and CTX group was 90.9% and 72.7% respectively.The complete remission rate in MMF group(59.1%)was significantly higher than that of the CTX group(27.3%)(P

Objective To find out the general features ,drug type ,route of administration DID clinical mani-festation,outcome and so on in DID patients .Methods The statements of drug-induced diseases caused by traditional Chinese medicine and its preparation were collected ( the data provided by Adverse Drug Reaction Monitoring Center of Dongying City ) from 2004 to 2012 in Dongying area ,which would be reviewed and analyzed .Results 3 446 drug-induced disease cases of traditional Chinese medicine preparations were screened out .From 3 446 DID reports in which 603 kinds were involved ,599 kinds of traditional Chinese medicine and 4 kinds of Chinese herbal medicine .The rates of the new and serious DID were high .Conclusion The defense system of the drug-induced diseases caused by traditional Chinese medicine need to be established urgently which is used for collecting ,monitoring and analyzing the data of Chinese medicine drugs to the clinicians ,providing the information of rational use and advisory services by ef-fective ways and management measures ,and providing the basis to modify the specification for pharmaceutical manage-ment and administrative departments .As a result,it can minimize the incidence of drug-induced diseases and maintain the safety of the public takeing medicine .

Objective To investigate the long-term effect and radiation side reaction of different boost methods in patients with local remnants of locally advanced nasopharyngeal carcinoma after curative radiotherapy Methods Based on the retrospective analysis , 102 patients with local remnants of locally advanced nasopharyngeal carcinoma, after curative radiotherapy, were enrolled from February 2009 to May 2011. Forty-nine patients received gamma knife boost and 53 patients received 3-dimensional conformal radiotherapy (3D-CRT). The long-term effect and radiation side reaction were compared between the two groups. Results The 1-year, 3-year, and 5-year relapse-free survival rate (RFS) in the gamma knife boost group and the 3D-CRT group was 97.8%, 90.0%, 80.8%, and 94.3%,76.1%,72.9%, respectively (P < 0.05). No significant differences of the overall survival and metastasis-free survival rate wer found in two groups , as well as the long-term radioactive reaction. Conclusion The gamma knife boost is better than 3D-CRT with respect to local control rate , but the long-term radiation side reactions were similar between the methods.