For children suffering from primary nephrotic syndrome(PNS), podocyte is a crucial part of glomerular filtration barrier, whose injury usually causes proteinuria.The structural and functional integrity of podocyte cytoskeleton is the prerequisite of its normal physiological function.Recent studies demonstrated that under a certain pathological condition, B7-1, expressed in podocyte, can inhibit the activation of β1 integrin by competitively binding to the target site on the β1 integration, which may change the morphology and function of podocyte, consequently induced proteinuria.Other studies also have showed that abatacept, which selectively inhibit the cross-talk between B7-1 and β1-integrin,can reduce proteinuria in patients with B7-1-positive glomerular disease.These studies suggested that B7-1 may be a potential diagnostic biomarker and therapeutic target in proteinuria in PNS.This review summarizes the role of B7-1 expressed in podocyte in the pathogenesis of proteinuria and the possibility of clinical application in the future.

OBJECTIVE To study the occurrence of patients′ respiratory system infection in ICU and its incidence influenced by nursing interference. METHODS The incidence of respiratory system infection of patients who were in ICU longer than 48 hours. were analyzed the normal nursing group with 461 cases from Jan to Dec 2006 were compared with the normal nursing with interference group with 490 cases from Jan to Dec 2007. So the results of two groups were compared by statistical analysis. RESULTS Twelve from 461 cases (the incidence of 2.6%) in normal nursing group had respiration system infection,vs 6 from 490 cases incidence of 1.2% in normal nursing with interference group. With nursing interference the incidence of patients′ respiration infection decreased obviously. There was significant difference between two groups (P

Objective:To investigate the effects of hypoxia inducible factor-1?(HIF-1?)antisense oligonucleotides(ASODN)on the expression of vascular endothelial growth factor(VEGF)and retinal neovascularization in premature rat with retinopathy.Methods:A total of 80 postnatal day 7 wistar rats were randomly assigned into two group.The experimental group(n=40)were established as ROP mode group.The control group(n=40)was exposed to room air in the same experimental condition.HIF-1?ASODN was injected into rats'left cavum vitreum at 12、14、16 d in these two groups.Some of the experimental group were injected with saline at 14、16 d.So there were five groups of specimens including:normal eye(A),normal eye with HIF-1?ASODN(A1),ROP eye(B),ROP eye with HIF-1? ASODN(B1),ROP eye+saline(B2).The retinal vascular development and proliferation in five groups were evaluated by the retina stretch preparation of 15 newborn rats at 12、14、17 d respectively.Eyeball cross-section was staimed with hematoxylin and eosin(HE).The nuclei of proliferative retinal vessels of five groups were counted.The expression of VEGF and HIF-1?in retina by immunohisto-chemical stain were observed among all groups.Results:In ROP group(B)the central vessels became tortuous and constricted and the central avascular area increased at 12 d.At 14 d,neovascularization was seen,peaking at 17 d.ROP eye with HIF-1?ASODN(B1)presented the same as group A,but Neovascularization decreased obviously as compcured with group B.Retinal vessel shape of ROP eye+saline(B2)is same as group B.VEGF was mainly expressed in capillary endothelium endochylema and nucleus of ganglionic layer of retina and inner nuclear layer.The expressions of VEGF were weaker in group A, A1 than in group B,B2,with significant differences(P

Objective:To prepare a quantified animal model of retinopathy of prematurity by economic and easy method. Methods:A total of 44 postnatal day 7 wistar rats were randomly assigned into 2 groups according to different oxygen inhalation concentration(n=22).Experimental group was exposed to 75% oxygen for 5 days,and them deprived of oxygen supply suddenly and exposured in air for 5 days.The Control group was exposed to room air in same experiment condition.The retinal vascular development and proliferation were evaluated by stretched preparation (ADPase stained retina)and eyeball cross-section,The expression of vascular endothelial growth factor(VEGF) was detected by immunohisto-chemical stain.Results: The central vessels became tortuous and constricted and the central avascular area increased in high-concentration oxygen environ-ment.But hypoxia environment made great vessels of retina broaden and abnormal curvature become obvious,neova- scularization was seen in the Experimental group.The average numbers of neovascular nuclei which breakthrough limiting membrane of amphiblestrodes in the Experimental group and the Control group were 32.800 0?0.767 8 and 2.750 0?0.716 4 respectively.Stain of VEGF was weaker in the control group than in the treated group.Conclusion:The rat modle of retinopathy of prematurity has powerful repeatability,high constancy and can be used in quantitative study.It is a suitable mode to study the pathogenesis and therapy of retinopathy of prema-turity.

Objective In order to make clear the clinical characteristics of gallbladder carcinoma.Method 37 cases of gallbladder carcinoma treated in Xinhua hospital have been analyed in recent 5 years.Result The higher incidence was in the elderly and the ratio between femal and male is 2 1 to 1.Clinical symptoms include right upper abdominal pain,nausea,fever,jaundice and abdominal mass.With gallstones is about 81 1%.Conclusion BUS and CT are common diagnostic methods.BUS is more reliable in early case,but CT in late case.The type of operation and the result of treatment are dependent on the pathologic stage and grade.

Objective:To investigate the curative effect of Chinese medicine foot bath combined with foot massage on diabetic peripheral neuropathy (DPN).Methods:Seventy-six patients with DPN who received treatment in Lishui Hospital of Traditional Chinese Medicine from July 2018 to December 2019 were included in this study. They were randomly assigned to undergo either Chinese medicine foot bath combined with foot massage (combined treatment group, n = 38) or Chinese medicine foot bath alone (single treatment group, n = 38) for 4 successive weeks in addition to diet and exercise management, medication for lowing blood glucose level, microcirculation improvement, and neurotrophic treatment. Before and after treatment, Toronto Clinical Neuropathy Score, Michigan Diabetic Neuropathy Score, and combined foot score were compared between the combined treatment and single treatment groups. The curative effect was also compared between the two groups. Results:After 4 weeks of treatment, Toronto Clinical Neuropathy Score [(5.82 ± 0.57) points, (7.62 ± 0.89) points], Michigan Diabetic Neuropathy Score [(14.92 ± 2.16) points, (18.01 ± 2.87) points], combined foot score [(3.17 ± 0.49) points, (4.41 ± 0.52) points] in the combined treatment and single treatment groups were significantly lower than those before treatment [(9.84 ± 1.27) points, (9.65 ± 1.21) points, (23.09 ± 4.03) points, (22.81 ± 3.92) points, (5.62 ± 0.85) points, (5.76 ± 0.73) points, t = 3.137, 2.361, 2.952, 2.392, 3.341, 2.427, all P < 0.05]. The declines in the combined treatment group were significantly greater than those in the single treatment group (all P < 0.05). Total effective rate in the combined treatment group was significantly higher than that in the single treatment group (94.74% vs. 78.95%, χ2 = 4.150, P < 0.05). Conclusion:Chinese medicine foot bath combined with foot massage is effective for DPN, which can significantly improve the clinical symptoms and promote the recovery of neurological function.

Objective To observe the therapeutic effects and toxicities of bone marrow-sparing intensity-modulated radiation therapy (BMS-IMRT) for postoperative cervical cancer.Methods From January 2011 to June 2012,totally 70 postoperative patients with cervical cancer were divided into BMS-IMRT group with 34 cases and IMRT group with 36 cases randomly.External whole pelvic intensitymodulated irradiation combined with chemotherapy was carried out for all patients.The planning target volume received a dose of 45 Gy/25 fractions in all patients.Delineation of the pelvis and limitation dose were carried out in BMS-IMRT group:the pelvis V30 ≤ 50％.All cases received chemotherapy with cisplatin (40 mg/m2) once a week concurrently with radiotherapy.Results Treatment was completed in 67 patients,as the other 3 patients stopped chemotherapy because of myelosuppression.There was no statistically significant differences between two groups for the 2-year local control survival(LCS)and overall survival(OS),alimentary tract toxicity and urinary toxicity.IMRT group had more serious hematologic toxicity than BMS-IMRT group,with statistically significant difference (x2 =14.355,P ＜ 0.05).Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo concurrent chemoradiotherapy,IMRT group has more serious hematologic toxicity than BMS-IMRT group.The short-term effect and other toxicities reaction are similar between two groups.

Objective To analyze the influence of atrial fibrillation(AF) on N‐terminal pro‐brain natriuretic peptide(NT‐proB‐NP) for the assist diagnosis of acute heart failure(AHF) .Methods Totally 457 inpatients with suspected AHF due to acute dysp‐nea and conducting blood NT‐proBNP detection and electrocardiogram(ECG) within 24 h of admission were collected and devided into groups according to whether AHF was diagnosed and complicated with AF identified by ECG on admission ,that was AHF +AF group ,AHF + non AF group ,non AHF + AF group ,non AHF + non AF group .The receiver operating characteristic (ROC) curve was adopted to evaluate the value of NT‐proBNP for diagnosing AHF .Results Among 457 cases ,194 cases (42 .5% ) were diagnosed as AHF and 140 cases (42 .5% ) as AF .The NT‐proBNP level in the AF group was significantly higher than that in the non AF group (4 482 .0 pg/mL vs .1 302 .0 pg/mL ,P < 0 .01) .The NT‐proBNP level had no statistical difference between the AHF + AF group and the AHF + non AF group AF(6 580 .0 pg/mL vs .6 769 .0 pg/mL ,P> 0 .05) .The NT‐proBNP level in the non AHF + AF group was significantly increased compared with the non AHF + non AF group (403 .3 pg/mL vs .2 892 .0 pg/mL ,P< 0 .01) .The area under the curve(AUC) of NT‐proBNP for diagnosing AHF in the AF group and the non AF group was 0 .759(95% CI :0 .677 - 0 .841 ,P < 0 .01) and 0 .931(95% CI :0 .903 - 0 .985 ,P < 0 .01) .Conclusion The NT‐proBNP level in AF patients without AHF is significantly increased ,which might affect the value of NT‐proBNP in the diagnosis of AHF .In the clinical applica‐tion ,whether the patient has AF cardiac rhythm should be paid attention to for better interpretating the detection result of NT‐proBNP .

Objective To study the efficacy of endoscopic retrograde cholangio-pancreatography (ERCP) and endoscopic nasobiliary drainage (ENBD) in the diagnosis and treatment of bile leakage after laparoscopic cholecystectomy (LC).Methods The clinical data of 9 patients with bile leakage after LC were analyzed retrospectively.Results The procedure of ERCP was successful in all 9 patients.Bile leakage was treated successfully by ENBD in 8 patients with no further complication,and 1 patient was treated surgically because of biliary ductal injury.Conclusions ERCP is recommended as a safe and efficacious option to detect and treat bile leakage after LC.ENBD combined with percutaneous drainage of abdominal collections can cure bile leakage after LC.

Objective: To explore the effects of Qichu Fujin Recipe (QCFJR), a compound traditional Chinese medicine, in repairing sciatic nerve injury in rats. Methods: A total of 60 male Sprague-Dawley (SD) rats were randomly divided into four groups: normal control group, untreated group, mecobalamin group and QCFJR group. Except the normal control group, sciatic nerve injury was induced by crushing of left sciatic nerve. Rats in the mecobalamin group were intragastrically administered with mecobalamin solutions 150 mug/(kg.d), and rats in the QCFJR group were intragastrically administered with QCFJR 35.2 g/(kg.d), while rats in the untreated group were intragastrically administered with normal saline (0.5 mL/d), once a day for 4 weeks respectively. Sciatic function index (SFI) was determined by walking tract analysis 1 week and 2 and 4 weeks after crushing. Five rats in each group were sacrificed for histological observation at the different time points. The remnant rate of gastrocnemius wet weight and the diameter of gastrocnemius cells were calculated. Expression of S-100 protein in the distal stump of injured nerve was observed by using immunohistochemical method. Distal injured sciatic nerves were determined with toluidine blue staining and observed under a light microscope 1 week and 2 and 4 weeks after operation. Diameter of axon and depth of myelin sheath were calculated by an image analysis system. Ultrastructure of nerve fibers was determined with uranyl acetate and lead citrate staining and observed under an electron microscope. Results: Compared with the normal control group, SFI, remnant rate of gastrocnemius wet weight, diameter of gastrocnemius cells, expression of S-100, diameter of axon and depth of myelin sheath in the mecobalamin group and the QCFJR group were significantly decreased at different time points (P<0.05), superior to those of the untreated group (P<0.05, P<0.01). Except the remnant rate of gastrocnemius wet weight and the diameter of gastrocnemius cells, there were no significant differences in other indexes between the mecobalamin group and the QCFJR group 1 week and 2 and 4 weeks after crushing (P>0.05). Conclusion: QCFJR can stimulate the regeneration and repair of nerve fiber and delay the skeletal muscle atrophy after sciatic nerve injury in rats.