Refractory nephrotic syndrome(RNS) is one of the main causes of end-stage renal disease (ESRD) in children,which is also a difficult issue in clinic.Several therapies,including immunosuppressive agents,have been shown to be effective and safe for RNS.It is proved,however,that a substantial number of children are still refractory to treatment despite these therapies.Recently,rituximab as a new immunosuppressant has achieved good results for RNS,and a number of case reports and clinical trials have suggested that rituximab may be effective for children with RNS.This review will analyse the scientific basis for the efficacy and safety of using rituximab in children with RNS.

Acute kidney injury (AKI)was a common problem in children in clinic.pRIFLE Criteria, AKIN Criteria, KDIGO Criteria are the main classification criteria of AKI.Though serum creatinine is still used as the most common biomarkers for diagnosis of AKI, the sensitivity and specificity is unsatisfactory.In recent years, many potential biomarkers of AKI have been studied in a variety of experimental and clinical settings.This review describes the novel biomarkers of AKI, including cystatin C, neutrophil gelatinase associated lipocalin, interleukin-18 ,kidney injury molecule-1 and liver-type fatty acid binding protein,, which have now made a progress in clinic.

Objective To study the treatment influences on immunity and tumor recurrence of oral canc -er patients with the combination therapy of hyperbaric oxygen treatment and postoperative adjuvant chemotherapy . Methods In the period from March 2011 to March 2014 ,84 patients were clearly diagnosed with oral cancer and randomly divided into hyperbaric oxygen treatment combined postoperative adjuvant chemotherapy group ( group A,n=42)and postoperative adjuvant chemotherapy group (group B,n=42).From day 1 prior to the last day of chemotherapy ,patients in group A were treated with hyperbaric oxygen ,and patients in group B were just accepted chemotherapy.After chemotherapy,we tested the levels of CD3 +,CD4 +,CD8 +and NK cells by flow cytometry, and the expression of IL -2,IL-4,IL-10 and INF-γby ELISA essay.All patients had been followed for two years.Results The levels of CD4 +and NK cells in group A were higher than group B (P<0.05),but the levels of CD3 +and CD8 +between the two groups were obviously different (P>0.05).Compared with group B,the ratio of CD4 +and CD8 +was increased in group A(P<0.05).The levels of cytokines involved IL -2,IL-4,IL-10 and INF-γin group A were higher than the levels of group B ( P<0 .05 ) .Follow-up results showed that pa-tients treated with hyperbaric oxygen combined postoperative adjuvant chemotherapy had less recurrence in 2 years(P<0.05).Conclusion Hyperbaric oxygen combined postoperative adjuvant chemotherapy can improve the patients′immune function ,and to be effective in preventing two years′recurrence .

Objective The study was designed to investigate the effect of atomization inhalation of Qingjin-Huatandecoction on prevention of elderly patients’ postoperative pulmonary complications after thoracotomy.MethodsA total of 60 elderly patients with thoracotomy were randomized into 2 groups. Both groups of patients were treated with oxygen uptake, anti-infection, antispasmodic, analgesic, and nutritional support. Based on the conventional treatment, the control group was added with atomization inhalation of mucosolvan and dexamethasone, while the treatment group with atomization inhalation ofQingjin-Huatan decoction. The volume of phlegm, serum CRP, TNF-α level and absolute neutrophil count (ANC), arterial blood gasanalysis, and records of the pulmonary complications were meausred.Results The pH value at Day 3 (7.39 ± 0.06vs. 7.36 ± 0.05,t=2.120), the PaO2at Day 3 (86.51 ± 3.96 mmHgvs. 84.07 ± 3.51 mmHg,t=2.520) and Day 5 (92.27 ± 2.94 mmHgvs. 90.40 ± 3.08 mmHg,t=2.400) of treatment group were significantly higher than those of the control group; the PaCO2at Day 3 (44.57 ± 2.53 mmHgvs. 46.39 ± 3.35 mmHg,t=2.390) and  Day 5 (40.77 ± 2.48 mmHgvs. 42.42 ± 3.33 mmHg,t=2.130) of treatment group were significantly lower than those of the control group. The serum CRP at Day 3(8.26 ± 2.38 mg/Lvs. 9.76 ± 2.37 mg/L,t=2.440) and Day 5 (6.94 ± 1.76 mg/Lvs. 8.15 ± 2.38 mg/L,t=2.250), the ANC at Day 3 (8.54 ± 1.85)×109/Lvs. (9.58 ± 1.94)×109/L, t=2.140) and Day 5 (6.54 ± 1.85)×109/Lvs. (7.58 ± 1.95)×109/L,t=2.160), the serum TNF-a at Day 5 (7.54 ± 1.38 mg/Lvs. 8.43 ± 1.36 mg/L,t=2.540) of treatment group were significantly lower than those of the control group. The sputum volume at Day 3 (50.74 ± 18.46 ml/dvs. 59.92 ± 15.25 ml/d,t=2.099) and Day 5 (39.64 ± 18.21 ml/dvs. 48.99 ± 13.55 ml/d,t=2.256) of treatment group was lower than that of the control group. At Day 5, the pneumonia (3.33%vs. 20.00%,t=4.043) and the atelectasis (6.67%vs. 26.77%,t=4.320) of treatment group were significantly lower than those of the control group(P<0.05).ConclusionAtomization inhalation ofQingjin-Huatandecoction can improve pulmonary function of postoperative pulmonary complications of elderly patients after thoracotomy, take control of inflammation and the occurrence of postoperative pulmonary complications.

Subclinical hypothyroidism is common in children,but its clinical significance is widely debated.The pathogenesis is not very clear and etiology appears to be multifactorial,such as autoimmune thyroiditis,obesity,antiepileptic drugs and so on.Currently there is no broad consensus on the management of children with subclinical hypothyroidism.In this review,the available evidences regarding to investigation,risk factors,trreatments and outcomes for this disease are summarized.

Hereditary renal diseases (inherited kidney diseases) include glomerular diseases,tubular diseases and cystic diseases.The incidence of inherited kidney diseases is relatively low, but the variety of clinical insufficient understanding of the disease, the means test about inherited kidney diseases is also not standardized, easily lead to missed diagnosis and misdiagnosis.As the common clinical manifestation of hereditary renal disease and congenital/hereditary renal disease are mainly low blood potassium, kidney stones, polyuria, growth retardation, and may develop renal failure without treatment.Therefore, clinicians should pay special attention to the diagnosis of congenital/hereditary renal disease, and early interventions are recommended.

AIM: To optimize the process of extracting effective constituents from Radix Polygalae by central composite design/response surface methodology. METHODS: Independent variables were ethanol concentration,reflux time and solvent fold,dependent variable was extraction rate of senegenin in Radix Polygalae.Linear or nolinear mathematic models were used to estimate the relationship between independent and dependent variables.Response surface methodology was used to optimize the process of extraction.Prediction was carried out through comparing the observed and predicted values. RESULTS: Regression coefficients of binomial fitting complex model was as high as 0.979 0, the optimum conditions of extraction process were 60% ethanol,2.5 hours for reflux,10-fold solvent and 2 times for extraction.Bias between observed and predicted values was-5.93%. CONCLUSION: It shows that the optimum model is highly predictive.

Henoch Schonlein purpura nephritis is a systemic inflammatory response of systemic vasculitis in anaphylactoid purpura,it is often occurred in childhood with systemic vasculitis reaction.Some patients will develop nephritic syndrome or nephrotic syndrome,even kidney failure,either of which is harmful to the health of children.However,a unified standard for the diagnosis and treatment of purpura nephritis is still lack.Combined with the latest research results,this research intends to review the pathogenesis,clinical diagnosis and treatment of purpura nephritis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Anti-Anxiety Agents ; therapeutic use ; Anxiety Disorders ; drug therapy ; etiology ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications

Objective To evaluate the effect of probucol on endothelium-dependent vasodilatation(i,e.flow- mediated dilation,FMD) function of the old patients with isolated systolic hypertension.Methods In this single- blind study,a total of 64 old pariems with isolated systolic hypertension were randomized to receive conventional an- tihypertensive therapy and probucol (0.5g twice daily,group A,n=33) or receive conventional antihyperrensive therapy(group B,n=31) for 12 weeks.The levels of blood lipid were measured and vascular endothelial function was assessed in the brachial artery by high-resolution ultrasound technique in form of endothelium-dependent vasodi- latation before and after treatment.Results After 12-week treatment,the levels of TC,LDL-C and HDL-C in group A were significantly reduced compared with those before treatment(all P0.05).Flow-mediated dilatation parameters in both groups were obviously improved compared with those before treatment( P