Nephrotic syndrome(NS) is a common disease in children.Glucocorticoids(GC) is the firstline treatment for NS and can cause growth hormone(GH) secretion and synthesis disorder through various ways which reduces levels of GH.Consequently,the growth and development are affected.For another,kddney disease can intervene in the secretion and regulation of insulin-like growth factor (IGF) and insulin-like growth factor binding protein(IGFBP).GH-IGF axis's change plays a role in children's growth retardation.Other factors,such as bone metabolic disturbance and hypothyroidism aggravates the growth inhibition.This review focuses on the prevention and treatment of growth retardation in children with NS.

Objective To explore the clinical significance of monitoring the femoral artery hemodynamics of acute cerebral hemorrhage patients under general anesthesia by color doppler ultrasound .Methods Totally 30 patients who received emergency craniotomy for intracra-nial hematoma were performed the induction of general anesthesia and endotracheal intubation .The changes of femoral artery peak systolic ve-locity (Vs),early diastolic reverse peak velocity (Vd),systolic diameter (Ds),diastolic diameter (Dd),systolic blood pressure(SBP),dias-tolic blood pressure ( DBP) ,mean arterial pressure ( MAP) and heart rate ( HR) at each time point of before and after anesthesia induction , intubation,cutting the endocranium ,suturing the flaps were observed and recorded .Results Compared with those before anesthesia induc-tion,the MAP,VD and Vs were decreased (P<0.05),DS and DD increased (P<0.05) at each time point.Compared with those after anes-thesia induction,MAP and VD increased,VS reduced(P<0.05) at the intubation moment,the changes of DS and DD was not statistically significant,which compared with those after cutting the endocranium ,MAP,VS and VD decreased,but DS and DD increased (P<0.05).The changes of HR at each time point was not statistically significant (P>0.05).Conclusion Color doppler ultrasound could reflect the femoral artery hemodynamics of patients who subjected to craniotomy for intracranial hematoma under general anesthesia ,which provides some guid-ance for the general anesthesia strategies .

Objective To investigate the effect of Deanxit in treatment of Irritable bowel syndrome in patients in hematological index and intestinal sensitivity.Methods 82 cases with Irritable bowel syndrome were selected and divided into two groups, each had 41 cases.Control group was treated with conventional therapy, experiment group was treated on the base of the treatment with Deanxit.Hematology ndex and intestinal sensitivity index and clinical effect were compared after treatment.Results Compared with pre-treatment, plasma SS, SP and 5-HT decreased in two groups after treatment, NPY increased, levels of TNF-α, IL-6 and IL-8 decreased, levels of IL-10 increased, abdominal pain score, abdominal distension and diarrhea score score decreased, the differences were all significant(P<0.05).Compared with control group, plasma SS, SP and 5-HT in the experiment group were lower, NPY was higher, levels of TNF-α, IL-6 and IL-8 were lower, levels of IL-10 were higher, abdominal pain score, abdominal distension and diarrhea score score were lower than control group, the differences were all significant ( P <0.05 ) .Conclusion Deanxit in the treatment of Irritable bowel syndrome has curative effect.

Objective To explore the effect of serum uric acid ( UA ) level and its change in the incidence of nonalcoholic fatty liver disease( NAFLD) . Methods Subjects who participated in the adult health examination in a Top Three Hospital Medical Center of Guangzhou Province in 2012 and 2015, according to whether they have suffered from NAFLD after 3 years follow?up,were divide into NAFLD incidence group and negative control group. The data of anthropometry, laboratory examination and abdominal ultrasound were retrospective analyzed. Results There were 91 male in NAFLD incidence group and 317 males in negative control group. There were statistical significance in body weight ( Wt ) , BMI, UA, TG, HDL?C at baseline ( t=6. 10,4. 98,4. 21,1. 91,-4. 06;P<0. 05). According to UA<149 μmol/L,more than or equal to 149 to<416μmol/L,more than or equal to 416μmol/L as grouping standard,males detection of NAFLD in each group were 0 case,55 cases ( 19. 1%) , 36 cases ( 30. 3%) , and the difference was statistically significant compared with negative control group(χ2=6. 28,P=0. 012). According to UA<89 μmol/L,more than or equal to 89 to <357μmol/L,more than or equal to 357 μmol/L as grouping standard, females detection of NAFLD in each group were 0 case,91 cases( 20. 0%) ,39 cases( 37. 9%) ,and the difference was statistically significant compared with negative control group(χ2=14. 87,P=0. 001) . Age?adjusted partial correlation analyze showed that serum UA levels were positively correlated with Wt,BMI,SBP,DBP,BUN,SCr,ALT,TG and LDL?C levels,and negatively correlated with HDL?C levels( r=0. 349,0. 248,0. 152,0. 157,0. 201,0. 251,0. 132,0. 191,0. 148,-0. 228,P<0. 05) . There was no statistical significance between the NAFLD incidence group and the negative control group in the change of serum UA( z=0. 811,P=0. 417) . Binary Logistic regression analyze showed that the incidence of NAFLD was closely related to BMI,UA,ALT,TG and HDL?C at baseline,and the changes of Wt,ALT,TG, HDL?C during follow?up ( OR ( 95%CI ): 0. 767 ( 0. 709-0. 830 ) , 0. 996 ( 0. 994-0. 998 ) , 0. 964 ( 0. 937-0. 992),0. 702(0. 516-0. 955),4. 948(2. 414-10. 144),0. 890(0. 852-0. 930),0. 957(0. 937-0. 979), 0. 601(0. 441-0. 818),3. 111(1. 197-8. 080),P<0. 05). Conclusion Serum UA level is closely related to the incidence of NAFLD and its related risk factors, and serum UA level is an independent risk factor for NAFLD.

Objective To explore the levels and the significance of IL-11 and sgp130 in the treatment of newly-diagnosed acute leukemia(AL)during the treatment of the induced remission,and to evaluate the curate effect of rhIL-11 on AL.Methods The levels of IL-11 and sgp130 in patients with AL were determined by ELISA respectively before treatment and after completing remission(CR).1.5 mg of rhIL-11 was injected subcutaneously,once a day,continuously for 14 days as one course,of treatment time 1～2 courses as total.Results Plasm IL-11 level in AL patients was significantly lower than normal(P

Objective To investigate the expression of CDX2 and its clinical significance in gastric intestinal epithelial tissue,and investigate the relationship between expression of CDX2 and infection of Helicobacter pylori.Methods The expression of CDX2 was studied by immunohistochemical technique in 93 cases of gastric mucosa (including 7 cases of normal gastric mucosa,21 cases of superficial gastritis,22cases of atrophic gastritis,43 cases of atrophic gastritis with intestinal metaplasia).14C urea breath test was used to detect the Helicobacter pylori infection.Results Helicobacter pylori was negative in 7 cases of normal gastric mucosa,the positive rate of Helicobacter pylori infection in atrophic gastritis and atrophic gastritis with intestinal metaplasia was 77.27％ (17/22),65.12％ (28/43),significantly higher than that of superficial gastritis [ 19.05％(4/21 )] (P ＜0.01 ).No expression of CDX2 was observed in normal gastric mucosa and superficial gastritis.The positive rate of CDX2 in atrophic gastritis with intestinal metaplasia was 83.72％(36/43 ),which was higher than that in atrophic gastritis [40.91％(9/22)](P＜ 0.01 ).Conclusions The infection of Helicobacter pylori and the expression of CDX2 are significantly associated with intestinal metaplasia.The abnormal expression of CDX2 might be the origin of intestinal metaplasia.The detection of gastric mucosa of CDX2 expression can be used to identify the intestinal metaplasia of gastric mucosa,predict the progress of gastric precancerous lesions,and provide a basis for the selection of treatment program.

Adenovirus,respiratory syncytial virus,influenza virus type A and B,cytomegalovirus and EB virus are the mainly etiology of severe pneumonia in children.New type of virus,such as influenza-H1N1 virus,avian influenza virus(H5N1 or H7N9) can also be epidemic in pediatric population.Ribavirin is effective drugs in the treatment of respiratory syncytial virus and adenovirus pneumonia.Acyclovir or ganciclovir is used for EB virus or immune deficiency and irnmunosuppressive patients with CMV pneumonia.Current opinin strongly recommend treatment with oral oseltamivir as soon as possible in influenza and seasonal influenza.Oseltamivir reduces the severity,duration of the symptoms of influenza,and reduces the frequency of secondary illnesses and exacerbation of underlying conditions.Zanamivir and peramivir may be effective in patients infected with influenza virus,including oseltamivir-resistant virus.Some Chinese medicine such as maxingshigan-yinqiaosan can obtain similar effect of oseltamivir in treatment of influenza virus infection.

Early goal-directed therapy ( EGDT ) emerged as a novel approach for reducing septic shock mortality and the EGDT protocol requires invasive patient monitoring to guide resuscitation with intra-venous fluids.EGDT was incorporated into guidelines published by the international Surviving Sepsis Cam-paign,but remains controversial.Recently,large randomized trials showed that EGDT did not significantly de-crease mortality in patients with septic shock compared with usual care.Fliud resuscitation and monitoring is the most important in septic shock.Therefore the EGDT is still valuable in present stage.Further,development practical methods for accurately assessing optimal fluid administration is needed.

Objective To learn the cognitive appraisal of the necessary conditions for the medical services delivery synergy by doctors at county and township levels,and to provide evidence for the health policy in question.Methods One county-level public hospital and one township hospital were randomly sampled from five sampled counties of Yancheng city in Jiangsu province for a field survey.The questionnaire was designed to cover such dimensions as institutional,information,service,interpersonal and management,in an effort to learn the cognitive appraisal of such doctors on such aspects as the two-way referral between county-township medical institutions,medical information sharing,good personnel relationships of medical workers,service collaboration,and necessity of inter-agency physician teams. Results These doctors in general presented different appraisal for two-way referral between county-township medical institutions,medical information sharing,service collaboration,good inter-personnel relationships and necessity of inter-agency physician teams.Those of lower academic titles considered it necessary to set up inter-agency physician teams(χ2=6.723,P<0.05);while county public hospitals′physicians considered that two-way referral between county-township medical institutions and inter-county agency information sharing as necessary to achieve the synergy of medical services delivery (P<0.05);most township physicians considered that good personnel relationships and service collaboration as necessary to achieve the synergy (P<0.05 ).Conclusions The characteristics of county and township physicians′appraisal of the necessary conditions for synergy of medical services delivery deserve attention,for improvement of their appraisal of two-way referral and information sharing among institutions.

The improvement of oxygenation basis on prone positioning in acute respiratory distress syndrome (ARDS) includes increased end-expiratory lung volume,improved ventilation-perfusion (V/Q) matching,and drainage of secretions.Randomized controlled trials report that prone position ventilation in patients with ARDS tends to reduce mortality rates,especially when used in conjunction with lung protective strategies and greater prone positioning durations.At present,the available data suggest that early prone positioning may provide benefit to ARDS with severe hypoxemia.keeping in mind that a risk of positioning-related complications will have to be taken into account when weighing the risk to benefit for patient with ARDS.There is still limited information available of prone position ventilation application in pediatric ARDS.