In recent years,it is a tendency to substitute acute kidney injury (AKI) foracute renal failure (ARF)in the aspect of international nephrology and emergency medicine.Compared with the past,the causes for AKI in children at present has been transferred from primary kidney disease to multi-factors,moreover,the morbidity and mortality of AKI is staying at a high level.From the perspective of epidemiology this paper briefly analyses the common cause,mortality and morbidity of AKI in children.

Cerebral amyloid angiopathy is closely associated with intracerebral hemorrhage. In recent years, a further understanding of etiology, pathogenesis, diagnosis and treatment on cerebral amyloid angiopathy-related intracerebral hemorrhage has been achieved.

Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) includes granulomatosis with polyangiitis,microscopic polyangiitis,eosinophilic granulomatosis with polyangiitis,which are known for this name because the common involvement of ANCA in the serum.New revise have been made in the Chapel Hill consensus conference 2012 about the nomenclature and definition of vasculitides,including the AAV.AAV can be misdiagnosed and delay diagnosed very easily for the variety and lack of specificity of clinical manifestations,and a early diagnosis and timely treatment is the key for a better prognosis.

The immunopathogenesis of IgA vasculitis and IgA nephropathy both demonstrate IgA deposition,and abnormal glycosylation of IgAl molecule is their major pathogenesis.Therefore,it is clinically controversial that they are actually one disease.The present text will delineate their similarities and differences from aspects of epidemiology,clinic,pathology,mechanism and prognosis.

Forty-five patients with peritonsillar abscesses(PA) were treated by needle aspiration. Pus was drawn in 89%(40/45) of the cases at the first aspiration and repeated aspiration was necessary in 33%(15/45) of the patients. All of the patients were cured by needle aspiration without further invasive therapy and no serious complication was observed. 32 out of 45 patients were available for follow-up. Among them, three had another recurrent PA in situ and the other ten(31%) had recurrent tonsillitis. However, analysis showed that the patients under 35 years of age had higher recurreuce rate of PA of recurrent tonsillitis than those over 35 years old(P

Aim: To search for novel α_1-adrenoceptor(α_1-AR) antagonists. Methods: On the basis of hybridization principle with silodosin as the lead compound, twelve 5-[2-[4-[ ( substituted phenoxy) alkyl] piperazin-1-yl] propyl] indoline compounds were designed and synthesized by maintaining indoline while incorporating the 1-[(substituted phenoxy) alkyl] piperazine group. Results: The structures of synthesized target compounds were confirmed by the elemental analysis, IR, ESI-MS and ~1H NMR. Preliminary pharmacological test showed that pA_2 values of six target compounds were greater than 7. 50, which suggested that the compounds possessed considerable α_1-AR antagonic activity. Conclusion: 5-[2-[4-[ ( substituted phenoxy) alkyl] piperazin-1-yl] propyl] indoline compounds is potentially a new candidate for α_1-AR antagonist.

ObjectiveTo observe the effect of continuous elastic outside distraction on female minipig nipples and their supporting tissues,and to investigate its mechanism to correct inverted nipples.MethodsThree female 3-month-old minipigs with 12 nipples were employed.4 nipples of each minipig were remained without distraction as control group,and the other 8 nipples were continuously distracted with inverted nipple correction instruments.Corresponding nipples were excised at 2,4,8 and 12 weeks after traction.Before excision,the diameters and heights of nipples were measured with a vernier caliper.Then the excised nipple specimens were employed for HE staining to observe the change of their tissue structure and the number counting of capillaries.ResultsThe volumes of nipples all obviously increased after traction,as compared with control group,and diameters and heights of nipples were significantly different (P＜0.01).In addition,there was a trend that nipple height increased with traction time.Under light microscope,the traction group showed that epidermis thickened,basal cells,fibroblasts and capillary significantly proliferated.Capillary counts compared with the control group were significantly different (P＜0.01).ConclusionsContinuous elastic outside distraction can promote the proliferation of female minipig nipple and areola papillaris.

Objective To observe the effect of continuous elastic outside distraction on the expression of basic fibroblast growth factor (bFGF) and transforming growth factor-beta 1 (TGF-β1) in the female porcine nipples,and to further investigate the mechanism of continuous elastic outside distraction stimulation on the proliferation of supporting tissue in nipples.Methods Three female minipigs were employed,each of them had 12 nipples.Four nipples of each minipig were used as control group,while the other eight nipples were continuously distracted with prefabricated instruments.One nipple without distraction and two distracted nipples of each minipig were excised at 2,4,8,and 12 weeks after operation under general anesthesia respectively.The excised nipples were prepared for immunohistochemical staining to observe the expression of bFGF and TGF-β1.Image analysis software was employed for quantitative analysis.Results bFGF and TGF-β1 expression of control groups was weaker than those of the distracted groups at any time (P＜0.01).The expression of bFGF increased gradually after tracted and reached the peak at 4 weeks.There was significant difference (P＜0.05) in the expression of bFGF between 4 weeks and 12 weeks groups.The expression of TGF-β1 was increased to the peak after 2 weeks.The expression of TGF-β1 between 8 weeks and 12 weeks groups and 2 weeks group had statistical significance (P＜0.05).The expression of bFGF and TGF-β1 had a positive correlation during the traction.Conclusions Continuous elastic outside distraction can promote female minipig nipple to synthesis and secretion of b-FGF and TGF-β1.

Objective To evaluate the efficacy of cyclosporine A plus prednisone in the treatment of refractory nephrotic syndrome in children.Methods The 26 refractory nephrotic syndrome children were treated with CsA plus prednisone,3 ～6 mg/(kg d),Po.The duration of treatment was 3 to 27 months (12.69 ± 6.44) mos.The 24 h quantitative urinary proteins,serum cholesterol,urea nitrogen,plasma creatinine,N-acetyl beta amino glycosidase enzymes cystatin C were detected before and after treatment,and the adverse drug reactions were accessed.Results Among 26 cases,12 cases of steroid-resistant NS,6 cases of steroid-dependent NS,and 8 cases of frequent relapse NS were included.16 patients (61.54％) were complete remission,8 patients (30.77％) partial remission,2 cases (7.69％) were non-remission,The total remission rate was 92.31％.The 24 hours urine protein was 3.01 g and 0.63 g before treatment and after treatment,respectively,with a statistically significant difference (P ＜0.01); serum cholesterol was (7.72 ± 3.86) mmol/L and (7.15 ± 3.23) mmol/L; nitrogen urea was (3.93 ± 1.44) mmol/L and (4.04 ± 1.27) mmol/L,creatinine (33.38 ± 13.16) μmol/L and (35.64 ± 3.53) μmol/L serum N-acetyl beta amino glycosidase enzymes was (18.96 ±4.86) u/L and (20.45 ±5.85)u/L before treatment and after treatment,respectively,without a statistically significant difference (P ＞ 0.05).The response to CsA was no significant difference in SRNS,SDNS and FRNS.Children complete remission,follow-up to 6 months,9 months,12 months and 18 months of the recurrence rate was 37.5％,31.25％,18.75％ and 12.5％.Eight cases ended treatment 3 ～ 6 months,all cases were not recurrence.The main adverse effects of CsA included hirsutism,tremble,gastrointestinal reaction and so on,and liver kidney toxicity was not obvious during the therapy course.Conclusions The treatment of CsA in combination with prednisone to children refractory nephrotic syndrome had a significant curative effect,which could obviously minimize the dosage of glucocorticoids and reduce the recurrence after at least one year of maintenance treatment of CsA.

Objective: To use vertical and humidity correcting method to calibrate aerosol optical depth (AOD), and to explore the feasibility of calibrated-AOD as exposure index to measure the level of air pollutants from the ground and to establish the exposure-response relationship between calibrated-AOD and people's health outcomes.Methods: First of all, we interpolated AOD, PM2.5, relative humidity and planetary boundary layer height using Kriging method to obtain data at different locations and matched different data with respiratory death in Beijing by geographical coordinates.Then, the planetary boundary layer height and aerosol hygroscopic growth factor calculated based on relative humidity was used to calbrate the AOD.To compare the effects of calibrated-AOD and PM2.5, we used standardization method to get non dimensionless calibrated-AOD and PM2.5.At last, we used the generalized additive mixed model (GAMM) to estimate the acute effects of calibrated-AOD and PM2.5 on respiratory death and chronic obstructive pulmonary disease (COPD) death, after controlling the time trend, temperature and humidity effects, days of the week effect and holiday effects.Results: The correlation coefficient between calibrated-AOD and PM2.5 was 0.72.The effects of calibrated-AOD on respiratory death and COPD death was the strongest at lag 0-3, one unit of calibrated-AOD increases was associated with 3.64% (95%CI: 0.58%-6.78%) increase of respiratory death and 4.92% (95%CI: 1.81%-8.14%) increase of COPD death.As for PM2.5, the strongest effects appeared at lag 0-1, one unit of PM2.5 (about 155 μg/m3) increases was associated with excess risks of 3.96% (95%CI: 0.82%-7.19%) and 6.12% (95%CI: 1.44%-11.02%) for respiratory death and COPD death respectively.Compared with PM2.5, the effects of calibrated-AOD on respiratory death and COPD death had narrower confidence intervals.The calibrated-AOD was sensitive to capture the lag effects, and the cumulative lag effects of calibrated-AOD were all significant on multiple lag days which indicated that the calibrated-AOD was sensitive to capture cumulative lag effects of air pollutants on respiratory death and COPD death as well.Conclusion: We believe that calibrated-AOD can be used as an index to reflect the effects of air pollutants on respiratory death in Beijing.In the absence of ground monitoring, calibrated-AOD can be used to mea-sure the relationship between air pollutants and some health outcomes.