Objective To observe the application of allopurinol in the treatment of gouty nephropathy, and evaluate its clinical effect on the level of serum creatinine and urea nitrogen. Methods Patients with gouty nephropathy from April 2015 to May 2017 in Xining first people's hospital 126 patients as the research object, divided into observation group and control group of 63 cases with double blind random method, given the reference group of patients basic treatment, the observation group treated with allopurinol in the reference group on the basis, effects were compared between the two groups the clinical therapeutic effect and serum creatinine and blood urea nitrogen, blood pressure level. Results After 12 months of therapy, compared two groups of patients before treatment, serum uric acid, creatinine, blood urea nitrogen, blood pressure (systolic blood pressure, diastolic blood pressure) were improved, and the observation group was obviously better than that of control group (P<0.05); the observation group total efficiency of treatment group was 88.89％ (56/63), the reference group was 74.60％ (47/63), with significant difference between two groups (P<0.05). Conclusion Allopurinol can be used in the treatment of gouty nephropathy. It can help to improve the clinical effect and improve the clinical symptoms of the patients. It is of practical value.

Objective:To analyze the incidence of postoperative pulmonary complications and related factors in elderly patients after major abdominal surgery.Methods:Clinical data of elderly patients undergone major abdominal surgeries at Beijing Hospital were retrospectively analyzed.The incidence of postoperative pulmonary complications was studied, and related factors were analyzed using Logistic regression analysis.Results:A total of 96 cases were included.The incidence of postoperative pulmonary complications was 53.1%(51/96)in elderly patients after major abdominal surgery.Logistic regression analysis showed laparoscopy was a protective factor for postoperative pulmonary complications( OR=0.293, 95% CI: 0.100-0.865, P=0.026), while driving pressure > 18 cmH 2O(1 cmH 2O=0.098 kPa)( OR=3.300, 95% CI: 1.148-9.434, P=0.027)and intraoperative bleeding volume > 500 ml( OR=4.444, 95% CI: 1.091-18.180, P=0.037)were risk factors for postoperative pulmonary complications. Conclusions:Attention should be paid to the incidence of postoperative pulmonary complications in elderly patients after major abdominal surgery.Laparoscopy is a protective factor for postoperative pulmonary complications, while driving pressure more than 18 cmH 2O and intraoperative bleeding volume more than 500 ml can increase the risk of postoperative pulmonary complications.

Data of patients underwent thoracic surgeries were retrospectively collected in our center from November 2016 to January 2019.The last recorded tidal volume and driving pressure before two-lung ventilation were selected.Patents were classified into driving pressure increase group (>15 cmH 2O) and normal group.The baseline characteristics, parameters of pulmonary function, left one-lung ventilation and protective ventilation strategies were recorded.Logistic regression analysis was used to identify the risk factors for driving pressure increase, correlation analyses between predicted body weight and total lung capacity and between forced vital capacity and total lung capacity were performed.The Receiver Operating Characteristic (ROC) curve was used to analyze the accuracy of the ratio of tidal volume to corrected forced vital capacity in predicting driving pressure increase.Sixty-two patients were included in this study.Body mass index, left one-lung ventilation and the ratio of tidal volume to corrected forced vital capacity ratio were the risk factors for driving pressure increase ( P<0.05 or 0.01). Predicted body weight (correlation coefficient was 0.66, P<0.01) and forced vital capacity (correlation coefficient was 0.75, P<0.01)were both positively correlated with total lung capacity, but the two coefficients were statistically significant difference ( P<0.05). The area under the ROC curve of the ratio of tidal volume to corrected forced vital capacity in predicting driving pressure increase was 0.846 (95% CI 0.749-0.943) ( P<0.01), the diagnostic threshold was 0.312, the sensitivity and specificity of this threshold were 0.800 and 0.781 respectively, so the boundary of tidal volume during one-lung ventilation should be either forced vital capacity×0.149 for left one-long ventilation or forced vital capacity×0.163 for right one-lung ventilation.In conclusion, the ratio of tidal volume to corrected forced vital capacity has a higher predictive value for driving pressure increase during one-lung ventilation, and forced vital capacity can be used as a reference while calculating tidal volume.

Objective: To establish comprehensive laboratory reference intervals for Chinese children. Methods: This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex. Results: In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old. Conclusion This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.

Objective: To study the chemical constituents from traditional Chinese (Mongolian) medicine, Lomatogonium carinthiacum and Halenia corniculate. Methods: The chemical constituents were isolated and purified by silicagel column, Sephadex LH-20, ODS and high performance liquid chromategramphy. The structures were identified by NMR and MS analysis technics. Results: Twelve compounds were isolated and identified as isovitexin (1), Luteolin-5-O-β-D-glucoside (2), Isosaponarin (3), Luteolin-7-O-β-D-glucoside (4,7), 1,4,8-Trimethoxy-xanthone-6-O-β-D-glucoronyl-(1 → 6)O-β-Dglucoside (5), friginosideD (6), 1-hydroxy-2,3,5-trimethoxyxanthone (8), 1-hydroxy-2,3,4,5-tetramethoxyxanthone (9), 1-hydroxy-2,3,4,7-tetramethoxyxanthone(10), 1-hydroxy-2,3,4,5,7-pentamethoxyxanthone (11) and usnic acid (12). Conclusion: Compounds 6 and 12 are obtained from L. carinthiacum and H. corniculate for the first time.