Objective To evaluate the efficacy and safety of methylprednisolone in the treatment of children with nephrotic syndrome ,and to observe its adverse reaction .Methods 62 cases with primary nephrotic syndrome were randomly divided into the two groups .32 cases in the treatment group were given methylprednisolone combined with prednisone ,30 cases in the control group were given prednisone therapy .Adreno-corticotropic hormone ( ACTH) and cortisol (Cr) in serum were detected by radioimmunoassay (RIA);plasma albumin,urine protein,creatinine,ala-nine aminotransferase ( ALT) ,blood uric acid were measured by conventional laboratory methods;bone mineral densi-ty was measured by bone mineral density machine .Results The curative effect of complete remission and partial remission between the two groups had no significant difference (χ2 =1.56,P>0.05).After treatment for 10 months, the concentrations of ACTH and Cr between the two groups had no significant differences (t=5.45,P>0.05).After treatment,the contents of plasma albumin in the two groups were (36.5 ±5.5)g/L,(36.7 ±5.9)g/L),the contents of urinary protein in the two groups were (1.5 ±1.1)g/24h,(1.6 ±1.5)g/24h.Before treatment,those in the two groups were albumin (25.7 ±3.3)g/L,(26.3 ±3.5)g/L,urinary protein (5.5 ±3.0)g/24h,(5.8 ±3.5)g/24h, the differences were significant (t=11.45,12.15,all P<0.05);The time of urinary protein changed to negative in the treatment group was 6 days,which was significantly shorter than 8 days in the control group ( Log Rank=10.56, P<0.05);The incidence rate of adverse reactions in the treatment group was 40%(13 cases),which was significantly higher than 26.6%(8 cases) in the control group (χ2 =23.11,P<0.05).Conclusion The combined treatment can shorten the time of urinary protein changed to negative ,but during the treatment ,it may increase adverse reactions in children with primary nephrotic syndrome .

Objective To compare the influence of hypothyroid function in neonatal with hyperbilirubinemia by two kinds blue-light treatment way.Methods 36 cases were divided into the Bilibed infant blue light the bed treatment in 18 cases(group A) and the traditional warm box with the both blue light treatment in 18 cases(group B).The influence of hypothyroid function in neonatal with hyperbilirubinemia were observed after treatment and before treatment.Results The contents of bilirubin in two group after treatment were obviously lower than that before treatment(P0.05).Conclusion The therapeutic of Bilibed method can get the better therapeutic effect than the traditional warm box with the both blue light treatment for the neonatal with hyperbilirubinemia.The change of thyroid function was no influence.

Aim To investigate glutamate-induced [ Ca2 + ] i changes in cultured rat neonatal cortical astrocytes after hypoxia/reoxygenation, H2O2 or high concentration of L-glutamate injury. In the meantime, the effects of Gingko biloba extract (GbE) were examined. Methods [ Ca2+ ]i changes in astrocytes were monitored by laser scanning confocal microscopy with the Ca2+ sensitive fluorescent probe [ Ca2 + ] i, but decrease by ( 3.3 ± 1.6) %, (81 ± 11 ) % and ( 81 ± 7 ) %, respectively. Pretreatment with H2O2 or high concentration of L-glutamate injury were ( 135 ± 98 ) %, ( 117 ± 93 ) % and ( 89 ± 36) %,different injury. Conclusion Hypoxia/reoxygenation, H2O2 and high concentration of L-glutamate impaired astrocytes' response to exogenous L-glutamate, and then bidirectional communication between astrocytes and neurons could not take place. GbE could improve the abnormal responses and maintain the normal function of astroglical network. These effects support that GbE has potential beneficial actions against brain injury.

OBJECTIVE To find out the relationship between mucoepidermoid carcinoma and Human papillomavirus (HPV) infection.METHODS Nested polymerase chain reaction (Nested PCR) was adapted to detect HPV DNA from 51 tissues of mucoepidermoid carcinoma using consensus primers, 9 tissues of chronic parotitis were as control.RESULTS HPV DNA was detected in 37 of total 51 mucoepidermoid carcinoma tissues, the detection rate was up to 72.5%, comparatively, it was 22.2% (2 of 9) in chronic parotitis tissues. The HPV DNA detection rate of mucoepidermoid carcinoma tissues was statistically higher than that of chronic parotitis tissues (χ2=8.517, P=0.004).CONCLUSION The results suggested that the HPV infection may cause mucoepidermoid carcinoma.

Objective To investigate the expression of serum B factor in the peripheral blood of patients with systemic lupus erythematosus (SLE),and explore its role in the pathogenesis.Methods Seventy eight patients with SLE in our hospital and 46 healthy persons were eligible to participate in this study.Rate nphelometyr was used to test serum B factor for 78 patients with SLE and 46 healthy controls.According to systemic lupus erythematosus disease activity index (SLEDAI),participants were divided into steady SLE group (SLEDAI ＜ 5) and active SLE group (SLEDAI ≥5),which was further divided into mild,moderate,and serious subgroups.The differences in serum B factor between SLE patients and healthy controls,including SLE patients with different severity,were all compared.Then we analyzed the differences in serum B factor and other laboratory and clinical indexes between active and steady SLE patients.The correction of serum B factor and other laboratory and clinical indexes were also analyzed.Results Compared to healthy controls,patients with SLE had significantly lower value of serum B factor [(27.13 ± 8.98) mg/dl vs (36.73 ± 5.47) mg/dl,t =7.4,P ＜ 0.01].Compared to steady SLE group,SLE active group had significantly lower level of serum factor B,C3 and C4,and also had significant higher level of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) (all P ＜ 0.05).Moreover,There were significant differences in the lower level of serum B factor between subgroups.Correlation analysis showed that the level of serum B factor was negatively associated with the levels of CRP and SLEDAI scores,whereas serum B factor was positively associated with the levels of C3 and C4 (all P ＜ 0.05).Conclusions Serum B factor is related to SLE.Serum B factor might be involved in the pathogenesis of SLE.Detection of serum B factor is helpful for diagnosis and evaluation of SLE disease activity.

Objective:To explore apoptosis changes of dilator muscles in the upper airway by detecting the expression of Bax, Bcl-2 in tensor veli palatini in patients with OSAHS.Method:The expression of Bax and Bcl-2 were detected in tensor veli palatini in 30 cases with OSAHS and 10 cases chronic tonsillitis without OSAHS by immunohistochemistry and image analytical system, and the results were analyzed.Result:①The expression levels of Bax in the OSAHS group increased significantly compared to control group(P<0.05), but there were no significant differences of Bcl-2 expression between two groups, the ratio of Bax/Bcl-2 increased significantly(P<0.05). ②There were positive correlations between AHI and the expression levels of Bax(r=0.697,P<0.01) respectively in the test group.Conclusion:The results indicate that apoptosis occurred in tensor veli palatini in patients with OSAHS, and the more severity of OSAHS , the more apoptosis.

The use-dependent characteristics of daurisoline on monophasic action potentials (MAP) of the left ventricle of the rabbit heart in situ were recorded with MAP recording technique. The results showed that daurisoline decreased monophasic action potential amplitude (MAPA) and prolonged monophasic action potential duration at the 50% and 90% (MAPD50, MAPD90), effective refractory period (ERP), ERP/MAPD90 at the steady-state cycle lengths of 240, 210, 180 ms. The percent of prolongation of MAPD50 was 12.8±2.9, 9.5±2.6, 9.0±1.6, that of MAPD90 was 10.9±2.6, 7.5±2.4, 6.5±2.7, that of ERP was 25.7±4.3, 18.5±4.1, 24.2±7.2, and that of ERP/MAPD90 was 13.7±4.5, 10.2±2.2, 16.1±5.1, respectively. Its effect showed no relation to frequency (n=6, P>0.05). The effects of sotalol on MAP were similar to that of daurisoline, but it prolonged MAPD90 and ERP in a reverse use-dependent manner (P<0.05). It is concluded that daurisoline has no use-dependent effects on MAP of rabbit hearts.

Objective To evaluate impacts of acute hypervolemic hemodilution (AHH) and intra-operative cell salvage (ICS) with 6％ volume fraction of hydroxyethyl starch (HES) on hemodynamics,blood saving efficiency and renal function of orthopedic surgery patients.Methods A total of 58 patients from orthopedic surgery were involved and randomly divided into AHH + ICS group (30 cases) and control group (28 cases).Changes of hemodynamic indices (HR,MAP and CVP) and renal function indices (BUN,BCr,UCr and ALB) in both groups were compared before operation (T0),immediately after operation (T1) and at postoperative 4 hours (T2),1 day (T3) and 2 days (T4).CCr was counted and intraoperative blood conservation was observed at each time point as well.Results HR,MAP and CVP of the two groups had no significant differences.Both groups showed some drop of HR (P ＜ 0.05),but an increase of MAP and CVP at T1-T4 (P ＜ 0.05),in contrast with levels at TO.BUN,BCr and ALB also showed insignificant differences between groups or within group at each time point.CCr in the control group showed no significant difference at each time point.On the contrary,CCr in the AHH + ICS group had a fall at T1-T4 and was declined to the lowest level at T2.CCr in the AHH + ICS group showed a recovery at T3-T4 and its level at T4 was still lower than that at TO,with no significant difference.CCr in the two groups showed insignificant difference at TO,but its level in the AHH + ICS group was lower than that in the control group at T1-T4,at T2 in particular (P ＜0.01).Moreover,CCr in the two groups was still significantly different at T4 (P ＜ 0.05).Renal function indices of the two groups were all within normal range at each time point.Intraoperative blood loss and unrine volume of the two groups had no significant differences,but intraoperative fluid requirement,allogenic blood transfusion volume and transfusion rate of AHH + ICS group were notably lower than those of control group (P ＜ 0.05 or P ＜0.01).Conclusions AHH plus ICS using HES are safe,effective and promising integrated blood conservation measures,which significantly reduces intraoperative allogenic blood transfusion volume and transfusion rate and has few impacts on fundamental vital signs and renal function.However,prolonged use of large dose of HES may do harm to renal function and therefore should be carefully considered in treatment of patients with severe renal dysfunction.

10.3969/j.issn.1007-3969.2013.04.011

Objective To investigate the association of red cell distribution width (RDW) with prognosis in patients with sepsis. Methods Patients with sepsis admitted to intensive care unit (ICU) of the First Hospital of Soochow University from January 2011 to December 2016 were enrolled. All clinical data were collected for participants, which mainly included basic data, main underlying disease, site of infection, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, blood routine test, biochemical test, blood gas analysis, coagulation index, procalcitonin (PCT), hospitalization days, and 28-day and 90-day mortality. Patients were divided into two groups according to whether the RDW levels were higher than the time of admission or not. Kaplan-Meier survival curve was performed to analyze 28-day and 90-day cumulative survival rates in two groups. Multivariate Cox regression analysis was done to find the independent risk factors of death in patients with sepsis. Results 196 septic patients were eligible to participate into this study. 150 patients (53.57%) had higher RDW levels than those at the time of admission. Compared to negative or static change of RDW group, positive change of RDW group had higher APACHE Ⅱ score (20.42±6.29 vs. 16.17±6.37), more percentage of chronic kidney insufficiency (35.24% vs. 19.78%), bloodstream infection (32.38% vs. 15.38%), continuous renal replacement therapy (CRRT: 32.38% vs. 16.48%), higher level of C-reactive protein [CRP (mg/L): 14.71±3.52 vs. 11.15±7.94], and higher serum creatinine [SCr (μmol/L): 128.0 (74.0, 263.5) vs. 90.0 (57.0, 145.5)], PCT [μg/L: 3.45 (2.39, 6.64) vs. 2.35 (0.56, 3.54)], and lactic acid [Lac (mmol/L): 3.40±1.72 vs. 2.70±1.61]; and had lower levels of hematocrit (Hct: 0.357±0.128 vs. 0.437±0.143), hemoglobin [Hb (g/L):103.60±22.63 vs. 115.67±28.49], platelets [PLT (×109/L): 133.37±87.29 vs. 191.43±87.65], albumin [Alb (g/L):28.15±5.72 vs. 35.51±5.91], total cholesterol [TC (mmol/L): 2.43±1.12 vs. 3.05±1.55], estimated glomerular filtration rate [eGFR (mL·min-1·1.73 m-2): 82.02±63.90 vs. 125.46±83.47], and oxygenation index [PaO2/FiO2 (mmHg, 1 mmHg = 0.133 kPa): 229.69±60.61 vs. 264.21±74.78]; and longer time of hospitalization [days: 17.0 (12.0, 21.7) vs. 11.0 (7.0, 18.0)], higher 28-day and 90-day mortality (57.14% vs. 36.26%, 62.86% vs. 47.25%) with statistically significant differences (all P < 0.05). It was shown by Kaplan-Meier survival curve that the 28-day and 90-day cumulative survival rate in positive change of RDW group was significantly lower than that of negative or static change of RDW group (χ 12 = 8.462, χ22 = 6.411, both P < 0.05). It was shown by multivariate Cox regression that high APACHE Ⅱ score [odds ratio (OR) = 1.049, 95% confidence interval (95%CI) = 1.010-1.090, P = 0.013] and positive change of RDW (OR = 0.517, 95%CI = 0.280-0.953, P = 0.034) were the risk factors of death in patients with sepsis. Conclusions The change of RDW values during hospitalization was related to the poor outcomes in patients with sepsis. The increase of RDW predicts the progress of sepsis and bad prognosis. Serial surveillance of RDW values could provide useful information for long-term prognosis in sepsis.