Chronic kidney disease (CKD) is a global public health problem with a high mortality and case fatality, and multiplies the risk for complications of cardiovascular disease and huge medical costs. Integrated traditional Chinese and Western medicine is effective in preventing and treating CKD with less adverse, however there are a lot of questions that we don't know well. Strategies and approaches of the integrated traditional Chinese and Western medicine in preventing and treating CKD are: (1) enhance the study of optimized scheme for single entity; (2) accelerate the step of new drug exploitation; (3) augment the study of action mechanism of traditional Chinese medicine in treating CKD; (4) strengthen the study of the mechanism of Chinese crude drug which is poisonous to kidney and its prevention and cure; (5) utilize the systems biology to study the essence of kidney; (6) establish a guideline for integrated traditional Chinese and Western medicine in prevention and treatment of CKD; (7) preach up the general knowledge of CKD, pay attention to mass screening and early prevention of CKD. It is expected to improve diagnosis and treatment of CKD with integrated traditional Chinese and Western medicine by carrying out these strategies and methods mentioned above.

Objective To investigate the performance of Injury Severity Score (ISS), New Injury Severity Score (NISS), Revised Trauma Score (RTS), CRAMS (circulation, respiration, abdomen, motor, speech)score and combined score on the trauma response of trauma patients. Methods Data of acute trauma patients from March 2014 to February 2015 were chosen as the research object. The clinical information at admission was recorded, and the ISS, NISS, RTS, CRAMS and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) were calculated. The optimal cut-off values were looked for the comparability between the four scores and APACHE Ⅱ score were figured out by ROC curve. The joint diagnosis combined physiological score with anatomical score in overlap mode was used for comparing sensitivity and specificity. Results There was a total of 1 020 patients included in the study. APACHEⅡscore ≥20 was found 711 cases, and APACHEⅡ<20 was 309 patients, and there were significant statistic differences in ISS score (U=11.347, P<0.05),NISS score (U=11.969, P<0.05),CRAMS score (U=8.194, P < 0.05) and RTS score (U=8.357, P < 0.05) between two groups. It was showed by ROC curve analysis that the area under the ROC curve (AUC) of ISS, NISS, CRAMS and RTS was 0.907, 0.941, 0.768 and 0.803 (all P<0.05). Compared with the trauma score, combined scores could increase the sensitivity of the prompt assessment of trauma severity in trauma patients, but the combined scores may also reduce the specificity. Conclusions Of these four scoring systems, NISS has the best correlation with APACHEⅡ. Compared with the trauma score, combined scores can increase the sensitivity of the prompt assessment of trauma severity in trauma patients, but the combined scores may also reduce the specificity.

Objective To study the risk factors for failure of INSURE strategy in very and extremely low birth weight preterm (V/ELBW) infants.Method From January 2005 to December 2014,clinical data of 149 preterm infants (gestational age less than 32 weeks) admitted to neonatal department of Tongji Hospital who received intubation-surfactant-extubation (INSURE) strategy were collected.These infants were assigned into two groups:INSURE failure group and INSURE success group,according to whether a second dose of surfactant or mechanical ventilation was needed within 72 hours after first pulmonary surfactant treatment.The clinical characteristics and outcomes between the two groups were compared.Chi square and t tests were used to define the differences between groups.Logistic regression analysis was used to identify the independent risk factors for INSURE failure.Result Among the 1 149 patients,148 received INSURE treatment,and 113 cases (76.4％) were successfully treated with the INSURE strategy.The infants in the failure group were statistically lower in birth weight,gestation age,antenatal steroids utilization rate,PaO2 and PaO2/FiO2 than those in the success group,while the age of mother,male/female ratio and PaCO2 were higher in the failure group.Logistic regression analysis showed that male (OR =7.440,95％ CI 1.846 ～29.984),BW ＜ 1 000 g (OR =9.180,95％ CI 1.716 ～49.105),PaCO2 ＞48 mmHg (OR =5.996,95％ CI 2.088 ～ 17.213),PaO2/FiO2 ＜205 (OR =3.010,95％ CI 1.033 ～8.774) were independent risk factors for INSURE failure.Conclusion INSURE strategy failure was associated with gender,birth weight,gestation age,antenatal steroids utilization,PaO2,PaCO2 and PaO2/FiO2 of the first blood gas after birth.BW ＜ 1 000 g,PaCO2 ＞ 48 mmHg and PaO2/FiO2 ＜ 205 of the first blood gas after birth were independent risk factors for INSURE strategy failure.

Objective:To produce monoclonal antibodies(McAb) against aspergillus fumigatus and to establish rapid assay for the measurement of aspergillus fumigatus antigen.Methods:Recombinant galactomannoprotein of aspergillus fumigatus(AFMP1) was used to immune BALB/c mice.Monoclonal antibodies against AFMP1 were produced from hybridoma.Results:Three hybridomas producing antibodies against AFMP1 were obtained.IgG isotypes of three McAb were IgG1,IgG2a and IgG2b.The affinity constants(K) were 1.2?10 10 ,4.56?10 9 and 1.81?10 10 mol/L.The antibodies were proved to be specific for aspergillus fumigatus by Western blot and recognized different epitopes on AFMP1 by the additivity assay.An sandwich enzyme-linked immunosorbent assay(ELISA) to detect AFMP1 was established to produce standard curve which showed linearity between 0.1～60.0 ng/ml with a sensitivity of 0.1 ng/ml.Conclusion:These results show three hybridomas producing high specificity and affinity monoclonal antibodies against AFMP1 and can provide for rapid assay for the measurement of aspergillus fumigatus antigen.

Objective To investigate the features of clinical and EEG changes during follow up in patients with BECCT. Correlative analysis between the disease duration and some factors were also performed.Methods The clinical and EEG data of 87 recovered patients with BECCT were retrospectively analyzed.Results The EEG and clinical manifestations are mostly characteristic. Clinical seizures disappeared early before the rolandic spikes of EEG in most patients,showing a longest duration of 6 years. There was only the onset age being correlative with the duration of disease in both seizures and abnormal EEG. Medication was withdrawn after there appeared seizures free for more than two years and a recovery of EEG. However medication can also be stopped even at patient′s EEG still remaining abnormal.Conclusion BECCT is an age dependent, idiopathic epilepsy syndrome in childhood, comprehensively recognizing the clinical and EEG features should be helpful in clinical practice.

Objective To assess the value of ictal video-electroencephalography monitoring (IVEEG) in presurgical evaluation for medically intractable nonlesional temporal lobe epilepsy(TLE). Methods The data of presurgical evaluation and postsurgical follow-up from 15 patients with intractable TLE were retrospectively analyzed.Results In this selected patients group, all 15 patients manifested clinically seizures during long term VEEG monitoring, with initial rhythmic activity from one side of temporal lobe in 13 cases. Of these 13 patients, the side of initial ictal focal pattern was concordant with the side of anterior temporal lobectomy or selective amygdalohippocampectomy in all cases and excellent postsurgical outcome were attained in 11 patients.Conclusion IVEEG monitoring may not only help to confirm the diagnosis and seizure type(s),but also more important to correctly localize the side of epileptogenic region in most patients with intractable TLE.

BACKGROUND:Sunshine time in northem region is short in winter,the infants and young children are vulnerable to lack of vitamin D. Up-to-date textbooks and the guidelines formulated by Chinese Medical Association account that glass block ultraviolet and indoor exposure to human is meaningless. Early studies have shown that sunlight exposure through glass had meaning in rats,but it was difficult to accurately quantify,while outdoor exposure in rats is difficult to continue. This expedment uses B-band ultraviolet rays,which has the impact on vitamin D metabolism in some wavelengths,to facilitate further study.OBJECTIVE:To study the effect of ultraviolet B exposure in laboratory on 25-hydroxy vitamin D(25-OHD)level and bone metabolism in the serum of growing rats.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed in June 2007 in the ExperimantalAnimal Center of Chinese PLA General Hospital.MATERIALS:Forty male 21-day-old Wistar rats were employed in this study. Ultraviolet waves were sourced from an artificial UV light instrument(wavelength 280-350 μm,irradiation intensity 5.5μW/cm~2).METHODS:Forty Wistar rats were divided into four groups by random sampling table,exposed to different doses of ultraviolet Bwave. Direct exposure group:direct exposure for 20 minutes at an irradiation dose of 4.2 mJ/(cm~2·d);Indirect exposure 60 and 120 min groups:exposure through a single pane of glass for 60 and 120 minutes at an irradiation dose of 0.36 and 0.72 mJ/(cm~2·d).Control group:no exposure was given. For the direct exposure group,the lamp was placed above the cage. A 3-mm-thick pane of glass(common window glass) was placed underneath the lamp in the indirect exposure groups. Exposure groups were given irradiation for successive 20 days.MAIN OUTCOME MEASURES:Serum 25-OHD,bone alkaline phosphatase (BALP),and bone mineral density (BMD) were measured on day 21.RESULTS:25-OHD was significantly higher in all exposure groups compared with the control group (P＜0.001),but there was no difference between the direct exposure group and two indirect exposure groups. BALP was significantly lower in the exposure groups than control group (P＜0.001),it was also significantly lower in the 120-min indirect group than in the 60-min indirect group (P=0.022). There was a positive correlation between exposure dose and 25-OHD (r=0.555,P=0.002) and a negative correlation between exposure dose and BALP (r=0.595,P=0.001),also a negative correlation between 25-OHD and BALP (r=0.569,P=0.002),but there were no differences between groups for BMD. Exposure dose exhibited a threshold,serum 25-OHD and BALP no longer increased or decreased when it was 0.36 mJ/(cm~2·d).CONCLUSION:Midwave ultraviolet rays might affect serum 25-OHD and BALP levels in the growing rats through glass exposure,with no significant difference compared to direct exposure. The B-band ultraviolet exposure dose may play an important role in serum 25-OHD synthesis,but there is a threshold dose for the synthesis. Low-dose and prolonged exposure time also achieve threshold exposure.

Objective To purify asprosin protein expressed in Escherichia coli expression system and to study its effect on cardiac function.Methods Coding sequence of asprosin was obtained from GenBank.Codon optimization was performed according to the codon preference of E.coli.After gene synthesized, recombinant plasmid was made.Asprosin was then induced and purified by Ni-affinity purification.The mouse model of impaired cardiac function was established by ligating and relaxing the left anterior descending coronary artery.30 mice were randomly divided into 3 groups: sham operation group (sham), cardiac dysfunction group (MI/R) and cardiac dysfunction plus injection of recombinant asposin protein group (MI/R+rAsp).The left ventricular function was detected by echocardiography to determine the improving effect of recombinant asprosin protein on cardiac function.Results After prokaryotic expression and purification, the purity of the target protein was higher than 95%, and the endotoxin content was less than <0.1 EU/μg protein, which was suitable for cell and animal studies.After the recombinant asprosin protein was given, the left ventricular function of the mice was improved significantly (P<0.05).Conclusions Asprosin acts as a myocardial protective molecule to improve cardiac function.

Objective To investigate the efficacy and safety of aminophylline,caffeine citrate and aminophylline combined with naloxone in prevention of apnea of prematurity(AOP).Methods Ninety-four infants with a birth weight ＜ 1 500 g and gestational age ＜ 34 weeks admitted to Department of Pediatrics,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology between Jan.2010 and Jan.2012 were randomly divided into 3 groups.(1) Aminophylline group (n =30):30 infants received a loading dose of 4-5 mg/kg of aminophylline and then maintained by a dose of 2 mg/kg,with intravenous drip q12 h.(2) Caffeine citrate group(n =32):a loading dose of 20 mg/kg of caffeine citrate was followed by a daily maintained dose of 5 mg/kg,with intravenous drip per day.(3) Aminophylline combined naloxone group (observation group,n =32):32 infants were treated with Aminophylline combined with naloxone.After 6 hours of the first dose of aminophylline,a dose of 0.1 mg/kg naloxone was injected,q12 h.Then the two drugs were used alternately.The mortality and incidence of AOP,bronchopulmonary dysplasia(BPD),retinopathy of prematurity (ROP) and brain injury were evaluated,and drug-related side effects were recorded.Results 1.There was no significant difference in gender,gestational age,birth weight,maternal antenatal glucocorticoid application,pregnancy (including multiple pregnancy) and delivery,5 min Apgar score,oxygen therapy,and the application of positive airway pressure as well as pulmonary surfactant among the 3 groups(all P ＞0.05).2.Compared with aminophylline group,the incidence of apnea of caffeine group and observation group were significantly lower (F =6.704,P ＜ 0.05),but there was no significant difference between caffeine group and observation group (P ＞0.05).3.There was no statistically significant difference in mortality,duration of oxygen therapy,the incidence of ROP,brain injury and hearing loss,postmenstrual age,body weight at discharge,the duration and cost of hospitalization among the 3 groups(all P ＞0.05).4.The BPD incidence in caffeine group[9.4％ (3/32 cases)] and observation group [12.5％ (4/32 cases)] were lower than that in Aminophylline group [20.0％ (6/30 cases)],but there was no statistical significance among the 3 groups(P ＞ 0.05).5.No drug-related side effects were recorded in the 3 groups.Conclusions It is safe and effective to use aminophylline combined with naloxone in prevention of AOP,and its efficiency is similar to caffeine citrate.

Objective To study the efficacy and clinical value of pulmonary surfactant on premature infant's hyaline menbrace disease.Methods Nineteen high risk premature infant's were received tratment of PS hy injected into trachea in 5 minutes of life at dose of 100mg/kg and were compared with twenty-one cases of same condition,contrasted group received treated without pulmonary surfactant injected.Results The clinical symptoms and results of blood gas analysis in prevented group were improved.The time of inhaled oxygen and mechanical ventilation,and the time of inpatient in prevented group were significantly shorter than the contrasted group(P