Acute kidney injury(AKI) is defined as functional and structural disorder or signs of renal damage including any defect from blood and urine test,or tissue imaging that is less than 3 months.The current treatment for AKI includes therapeutic agents and renal replacement therapy (RRT).The goal of RRT is to remove endogenous and exogenous toxins,inflammatory mediator,pathogenic factor,and to maintain fluid,electrolyte,and acid-base balance until renal function returns.The principal methods of RRT include intermittent hemodialysis,continuous renal replacement therapy,peritoneal dialysis,plasmaphresis exchange and hemoperfusion.In this article,we discussed the timing,choice of therapeutic mode,indication and common technical issues of RRT in pediatric AKI.

Myasthenia gravis is an autoimmune disorder resulting from the production of antibodies against acetylcholine receptors leading to the destruction of the postsynaptic membrane at the neuromuscular junction.Myasthenic crisis is defined as any myasthenia gravis exacerbation necessitating mechanical ventila-tion or post-operation extubation delayed beyond 24 hours because of respiratory weakness.Most patients presenting with myasthenic crisis have an identifiable risk factor.The diagnosis of myasthenic crisis should be suspected in all patients with respiratory failure,particularly those with unclear etiology.Acute management of myasthenic crisis includes ventilatory therapy,removal of the offending trigger and immunomodulatory treat-ments.The latter includes plasma exchange or intravenous immunoglobulin,and high dose corticosteroids therapy.

The investigation was conducted among eight untrained male and six well-trained male cyclists with the purpose of finding out the relationship between muscle fiber composition and lactate threshold. Muscle biopsy samples were taken of vastus lateralis to determine the composition of fiber type (Ⅰ, Ⅱ). Maximal oxygen uptake was measured in a progressive cycle ergometer test, while blood lactate threshold was determined on the basis of a systematic increase in BLa above baseline warm-up values. Analyses show that the percentage of type Ⅰ is closely correlated with lactate threshold in both groups of subjects and that muscle fiber composition plays (?) important role in determining lactate threshold. Therefore, an assessment of muscle fiber composition is useful for spotting athletes with high potential for endurance performance.

OBJECTIVE:To investigate the utilization situation and tendency of antihypertensive drugs in our hospital during the period 2004～ 2005.METHODS:The consumption sum,DDDs and the defined daily cost of antihypertensives during 2004～ 2005 were analyzed statistically.RESULTS:The consumption sum of antihypertensive drugs increased year on year,dominating the first 4 places were calcium antagonists,ACEI,angiotensin receptor antagonists and ? adrenoceptor antagonists.Dominating the first 10 places in terms of consumption sum were chiefly newly marketed,expensive but safe and effective varieties.Leading the top 15 places in terms of DDDs were those drugs that proved to be of confirmed efficacy and lower prices.CONCLUSION:The utilization of antihypertensive drugs in our hospital is basically in line with the general utilization condition home and abroad,and it is up to the current medication principle of antihypertensive drugs

Objective To observe the function of kidney compromised and histopathological changes of renal tissue in heatstroke rats under the dry-heat atmosphere of desert in order to find the mechanism for provide a rationale of clinical treatment.Methods Forty-eight anaesthetized rats were divided into six groups (n =8 in each group):mild heatstroke group with its control group,moderate heatstroke group with its control group,and severe heatstroke group with its control group.The rats of three heatstroke groups were placed in a dry-heat environment prolonged with 41 ℃ and 10％ humidity,and the three control groups were placed in a room temperature prolonged with 25 ℃ and 35％ humidity.At heatstroke status of each group,arterial blood samples were collected from each group for testing creatine kinase (CK),creatinine (CREAT),uric acid (UA) and urea,kidney tissues and muscle tissues were taken for pathological examinations.Results Pathological examination showed dilatation and congestion of vessels,thrombosis,bleeding,protein casts and endothelium injury were found in the heatstroke rats.In mild heatstroke,the pathological changes mainly manifested as dilatation and congestion of vessels ; in moderate one,the changes mainly manifested as thrombosis; and in severe one,changes mainly manifested as bleeding and protein casts.Muscle tissues presented rhabdomyolysis,especially in severe one.The differences in biomarkers between three different degrees of heatstroke showed statistical significance (CK:F =136.204,P =0.000;CREAT:F =172.865,P=0.000; UA:F=546.454,P=0.000; urea:F=73.823,P=0.000).There was no significant difference in UA between mild heatstroke group and its control group (t =1.943 ;P =0.072),and the differences in rest biomarkers showed statistical significance between each heatstroke group and its control group (P =0.000).Conclusions The kidney injury developed during heatstroke in dry-heat environment of desert suggests that we should be alert to disseminated intravascular coagulation (DIC),myolysis and acute kidney failure,and should monitor the blood biochemical changes closely and treat it energetically,rescuing a heatstroke patient in dry-heat environment of desert.

Objective:To investigate the expressions of matrix metalloproteinase 9 (MMP-9), matrix metalloproteinase 2 (MMP-2), migration-inducing protein 7 (MIG-7) and filamin A (FLNa) in colon cancer tissues and their effects on prognosis.Methods:The tumor specimens and corresponding adjacent normal tissues of 899 colon cancer patients undergoing surgical resection in the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University from January 2013 to December 2015 were collected. The expression levels of MMP-9, MMP-2, MIG-7 and FLNa in colon cancer tissues and adjacent normal tissues were measured by using enzyme-linked immunosorbent assay (ELISA), and the relationship between their expression levels and clinicopathological characteristics as well as prognosis of colon cancer was analyzed.Results:The expression levels of MMP-2, MMP-9 and MIG-7 in colon cancer tissues were (481±69) ng/ml, (262±85) ng/ml,(156±23) ng/ml, respectively, which were higher than those in adjacent normal tissues [(136±33) ng/ml, (191±21) ng/ml, (98±18) ng/ml], and the differences were statistically significant ( t was 41.591, 120.224, 59.896, all P < 0.01); the expression level of FLNa in colon cancer tissues was (19.5±3.2) ng/ml, which was lower than that in adjacent normal tissues [(65.4±8.3) ng/ml], and the difference was statistically significant ( t = 154.902, P < 0.05). The expression levels of MMP-9, MMP-2, MIG-7 and FLNa in colon cancer tissues were correlated with tumor diameter, Dukes stage, lymph node metastasis and degree of differentiation (all P < 0.05). Cox multivariate analysis showed that the high expressions of MMP-9, MMP-2, and MIG-7 and the low expression of FLNa were independent factors affecting the prognosis of patients (all P < 0.05). Kaplan-Meier analysis showed that the median overall survival time of patients with low expression of MMP-9, MMP-2 and MIG-7 was 55 months (95% CI 25-78 months), 56 months (95% CI 26-79 months) and 54 months (95% CI 25-78 months), respectively, which were longer than those with high expression, while the median overall survival time of patients with high expression of FLNa was 58 months (95% CI 27-80 months), which was longer than those with low expression, and the difference was statistically significant ( P < 0.05). Conclusions:MMP-9, MMP-2, MIG-7 and FLNa are closely related to the occurrence and progression of colon cancer. The high expression levels of MMP-9, MMP-2 and MIG-7 and the low expression level of FLNa have influences on the prognosis of colon cancer patients, and it can be used as important indicators for clinical prognosis judgement.

To investigate the effects and characteristics of Fuzheng Huayu recipe, a compound Chinese herbal medicine, and its decomposed therapies against hepatocyte apoptosis in mice with hepatic injury.

Objective To investigate the effect of implanted cortical electrical stimulation (CES) on the expression of Nissl bodies and growth-associated protein 43 (GAP-43) in the brain after ischemic injury,and its mechanism.Methods Models of middle cerebral artery occlusion (MCAO) were established in 23 male Sprague-Dawley rats.They were randomly divided into a CES group (CES,n=13) and a no stimulation group (NS,n=10) and electrical stimulators were implanted in both groups.CES was applied for 14 d in the CES group but not in the NS group.The expression of Nissl bodies and GAP-43 around the infarct were quantified using version 6.0 of the ImagePro Plus system.Results In the CES group the Nissl bodies had a deep color,and their percentage of area was higher than that in the NS group.The GAP-43 positive expression area also had a relatively deep color,and the average percentage of positive expression area was also higher than that in the NS group.Conclusions CES can enhance the expression of Nissl bodies and GAP-43 after cerebral infarction.This suggests that CES can promote axon growth and the formation of new neural circuits.

Objective To analyze the failure ratio and the causes of the inoculation failure of hepatitis B virus(HBV)-vaccine in children and relevant the remedial measures. Methods One thousand three hundred and sixty cases treated in Suzhou Wuzhong people′s hospital during Jan.2007 to Jul.2008 were chosen,of whom 286 children from 1-5 years old to be anti-HBs negative or anti-HBs titre to be 0-10 IU/L were screened,and specific failure reasons for the vaccination were analyzed,also the timely treatment measures were taken.Then 286 children were divided into 5 groups randomly.Apart from one group was set up as blank control,the other 4 groups were arranged to accept different immunization methods with 0,1,2 month schedule,group A simply got revaccinated with HB vaccine(10 ?g) 3 times;group B revaccinated with double dosage of HB vaccine(20 ?g) 3 times;group C besides being revaccinated 3 times,the immune regulatory agent was jointly used;group D revaccinated 3 times with genetically engineered CHO hepatitis B vaccine. Results The ratio of failure of HBV-vaccine was 21.03%,what caused failure of hepatitis B vaccine included immunologic inadequacy 218(76.22%),repeated respiratory infection 192 cases(67.13%),abuse hormone 140 cases(48.95%),zinc deficiency 129 cases(45.10%),anaemia 108 cases(37.76%),passive smoking 80 cases(27.97%),the mother being chronic parenchymatous nephritis or HBV carrier 63 cases(22.03%),premature 54 cases(18.88%),adiposity 38 cases(13.29%),dystrophy 29 cases(10.14%).There were 4 methods of revaccination,the positive rate for group A,B,C,D were 90.00%,96.47%,99.08%,95.83%,respectively.Group C had the highest positive rate,compared with the other 3 groups,which were statistically significant(P a

Behcet Syndrome ; complications ; Hemorrhage ; etiology ; Humans ; Pharynx