AIM: To investigate the pathogenic factors and prevention and cure of drug-induced renal damageMETHODS:According to the clinical manifestations,110 cases of drug-induced renal damage were divided into two types∶one type had acute renal failure(ARF),another had hematuria and proteinuria but no ARFOf 110 cases,65(32 ARF)were treated with glutathione,45(31 ARF) as controlRESULTS:Of 110 cases,49(472%)had received more than two kinds of nephrotoxic agents,72(655%) had had fever and had received antibiotics or dehydrantsThe effective rates for ARF in above-mentioned two groups were 906% and 645% respectivelyThe effective rates for hematuria and proteinuria were 848% and 572% respectively with significant difference(P

Objective To observe the therapeutic efficacy of different schemas in partients with contagious atypical pneumonia outbreaking in GuangZhou area.Methods Patient who were hospitalized in our ward from Feb,2003 to May,2003 were allocated to different groups according to the therapentic schema.To compare and analyse the efficacy.Results resnlts indicate that the effects of antivirus drugs of all groups have no difference.The use of glucocorticoid decreased the opportunity of mechanical ventilation and intubation.Conclusion Patients who have severe condition or present with adult respiratory dyspnea syndrome will relieve in pulmonary inflammatory bleeding at some degree if they get proper glucocorticoid and positive pressure nonivasive ventilation,the possibility of intubation and fatality will decrease

Objective To evaluate the significance of p53,Cdk_4 and Survivin in gastric epithelial dysplasia with colonic and small intestinal metaplasia.Methods Immunohistochemical SP method was used to detect p53,Cdk_4,and Survivin in 44 cases of colonic intestinal metaplasia(27 low grade epithelial dysplasia,17 high grade epithelial dysplasia) and 51 cases of small intestinal metaplasia(42 low grade epithelial dysplasia,9 high grade epithelial dysplasia) by endoscope.Results The positive expression rates of p53 and Survivin had significant difference in two types of intestinal metaplasia and the difference was significant between low-grade and high-grade epithelial dysplasia.The expression of CDK_4 had significant difference in two types of intestinal metaplasia and had not difference between low-grade and high-grade epithelial dysplasia.Conclusion The expressions of p53,CdK_4 and Survivin are closely associated not only with the types of intestinal metaplasia but also with the different grades of epithelial dysplasia.The expression of p53,Cdk_4,and Survivin may be valuable markers in assessing the biological behavior of gastric epithelial dysplasia with intestinal metaplasia.

Objective To explore and compare the effect of sevoflurane and disoprofol to inflammatory factors in patients received abdominal surgeries.Methods Patients with sevoflurane and disoprofol respectively were anaesthetized and detected IL-6,IL-8,IL-10 and TNF-α in their serum at T1 (when anesthesia induction),T2 (after anesthesia induction),T3 (30min after beginning of operations) and T4 (after operations).Results Compared with T1,the serum level of IL-6,IL-8,IL-10 and TNF-α increased significantly in all patients(all P ＜ 0.05) ; Compared with disoprofol group,the serum level of IL-6,IL-8 and TNF-α increased significantly (all P ＜ 0.05) ; Compared with sevoflurane group,the serum level of IL-10 increased significantly(all P ＜ 0.05).Conclusion Intravenous anesthesia with disoprofol in patients receiving abdominal operations is proper for maintenance of inflammatory balance.

Objective To investigate the risk factors of anastomotic leakage after laparoscopic anterior resection of rectal cancer.Methods Literatures on the risk factors of laparoscopic anterior resection of rectal cancer were retrieved from August 2003 to August 2013,and then a Meta analysis was carried out based on the data.Data were expressed by odds ratio (OR) and 95％ confidence interval (95％ CI).The heterogeneity of the data was analyzed using the chi-square test or I2 test.Data were pooled using the fixed or random model.Results Eight literatures including 3 289 patients with rectal cancer were retrieved.The incidence of anastomotic leakage was 6.050％ (199/3 289).The incidence of anastomotic leakage after laparoscopic anterior resection of rectal cancer in males was significantly higher than females (OR =2.17,95％ CI:1.54-3.06,P ＜0.05).Neo-adjuvant chemotherapy might increase the risk of postoperative anastomotic leakage (OR =1.53,95％ CI:1.00-2.32,P ＜ 0.05).Interoperative blood transfusion might increase the risk of postoperative anastomotic leakage (OR =4.80,95％CI:2.98-7.73,P ＜0.05).Patients with low rectal cancer had greater risk of anastomotic leakage than those with high rectal cancer (OR =1.60,95％ CI:1.14-2.23,P ＜ 0.05).Number of linear stapler firings greater than 3 increased the risk of postoperative anastomotic leakage (OR =0.46,95％ CI:0.27-0.78,P ＜ 0.05).The ASA classification of anethesia risk,depth of tumor infiltration,lymph node metastasis,preventive colostomy were not correlated with the incidence of postoperative anastomotic leakage (OR =0.66,0.91,1.25,0.78,95％CI:0.36-1.20,0.55-1.51,0.75-2.09,0.50-1.23,P＞0.05).Conclusion Male,neo-adjuvant chemotherapy,interoperative blood transfusion,low rectal cancer,number of linear stapler firings greater than 3 are the main risk factors for anastomotic leakage after laparoscopic anterior resection of rectal cancer.

The pattern of incidence and clin ic al presentation of primary hyperparathyroidism (PHPT) collected during the past 45 years were analysed. It showed that most of PHPT patients were young or mid- aged, and female patients were somewhat more than male patients. The duration of illness was longer and symptoms were more severe. The number of post-menopausa l female patients was increased in recent ten years.

Objective To study the clinical significance of platelet, coagulation ,and fibrinolysis alteration in perioperative period in patients with different Child classifications of cirrhosis. Methods Alterations on the platelet count and the indices of coagulation and fibrinolysis in 17 cases of Child B class who underwent portal-systemic shunt, and 6 cases of Child C class who underwent portal-azygus vein disconnection were detected. Results Before operation,except the decrease in platelet count, there as no significant difference in the indices of other platelet function, coagulation and fibrinolysis in patients with Child B class compared with control group. While in patients with Child C class, the platelet count decreased, and GMP-140, FPA and D-dimer increased greatly. After operation, GMP-140 increased in patients with Child B class, while decreased in patients with child C class. The platelet count and factorⅧ:C in patients with Child C class decreased significantly compared with those with Child B class. Conclusions Operation may induce DIC in patients with Child C class, so it is necessary to determine the fibrinogen and factorⅧ:C during the operation.

2.65 mmol/L with co-elevated PTH. For locating the adenoma, the specificity of B-Us was 95% and the sensitivity of MIBI was 100%. Our standard surgical procedure were bilateral exploration. We found much more tumors in inferior glands than that in superior glands. The success rate in a single exploration in benign cases was 99%. Conclusions PHPT could be diagnosed by co-elevated calcemia and PTH. B-US with 99m Tc-MIBI was the first choice for localization. Bilateral exploration is safe and effective.

Objective To design a new combination transplantation method for management of Gustilo type Ⅲ distal tibial fractures.Methods The study involved 46 patients with Gustilo type Ⅲ distal tibial fractures ( 16 patients with Gustilo type Ⅲa fractures and 30 with Gustilo type Ⅲ b fractures)treated with retrograde soleal muscle with periosteum-cortex bone flap grafting from October 1998 to November 2008.There were 29 males and 17 females at an average age of 36 years (range,23-77 years).After the complement of fracture fixation,the attachment point of the medial half of the soleal muscle to the upper tibia was exposed.The periosteum together with thin cortex bone flap on the surface of tibia was incised.The soleal muscle with pefiosteum-cortex bone flap was turned downwards to cover the bone and the soft tissue defects.Results All patients were followed up for average 26 months ( range,30-46 months).Nine patients were treated with autologous iliac grafts and the other 37 patients underwent periosteum-cortex bone flap grafting.The mean time of bone union was 22 weeks ( range,18-37 weeks).One patient had infection of external fixation pin tract.The ankle joint movement of 38 patients was recovered to a normal or nearly normal,but the other eight patients had limitation in the activity.All patients were able to walk normally after operation,but five patients felt powerless when running.Conclusions Retrograde soleal muscle with periosteum-cortex bone flap grafting is characterized by simple operation,simultaneous reconstruction of bone and soft tissue defects and promotion of fracture healing,and hence is a feasible and effective method to repair bone and soft tissue defects in Gustilo type Ⅲ distal tibial fractures.

Objective To detect the change of hepatitis C virus (HCV)RNA in the peripheral blood mononuclear cells (PBMC)and serum of patients with chronic hepatitis C (CHC)during treatment with peg-interferon α-2a (Peg IFNα-2a)plus ribavirin (RBV),and to analyze the clinical significance of HCV RNA detection in PBMC.Methods The peripheral blood samples of 20 CHC patients who visited Department of Infectious Diseases in Guangzhou No.8 People′s Hospital from June 2013 to December 2014,were collected during treatment with Peg IFNα-2a+RBV at different time points (week 0,2,4, 12,24,36 and 48).Serum and PBMC were separated.Accurate fluorescence quantification assay (Cobas TaqMan real time polymerase chain reaction[PCR])was used to detect HCV RNA level in serum,while real-time PCR and nest-PCR were applied to detect HCV RNA in PBMC.Categorical data were analyzed byχ2 test.Results Accurate fluorescence quantification of serum HCV RNA showed that HCV RNA level decline rapidly after treatment (F = 148.06,P < 0.01 ),and 18 patients achieved HCV RNA undetectable at week 12 of treatment.The positive rate of nest-PCR was higher than real-time PCR (all P <0.01).Comparison of HCV RNA levels in serum and PBMC from 20 cases found that,the clearance rate of HCV RNA in PBMC was postponed.Two patients whose HCV RNA in PBMC kept detectable relapsed at week 24 after end of treatment.Conclusions HCV RNA can be detected in PBMC of CHC patients and the positive rate of nest-PCR is higher than real-time PCR.Antiviral therapy is effective on HCV both inside and outside PBMC,but the clearance rate of HCV RNA in PBMC is postponed compared with that in serum.Slow clearance of HCV in PBMC may be a risk factor for relapse after end of treatment.