Objective To discuss the significance of high frequency ultrasound for diagnosis of congenital anomoly of pediatric kidneys. Methods Totally 118 patients with congenital anomoly of pediatric kidneys were examined with high frequency ultrasound,the characteristics of the images were analysed.Results Congenital anomoly kidneys had great diversity of variety in number,size,position,axial direction,abnormal vein and renal pelvis. In the 118 cases,pelvi ureteric stenosis was in 72 cases,renal duplication in 23,renal hypoplasia in 10,kidney deficit in 7,rotatory anomaly in 1,fused kidney in 1,and double renal pelvis in 4. Conclusions High frequency ultrasound is beneficial for diagnosing and differential diagnosing congenital anomoly of pediatric kidneys.

Objective To explore the association between polymorphisms in non-muscle myosin heavy chain 9 gene (MYH9) and hypertension susceptibility in chronic kidney disease (CKD)patients.Methods Five hundred and ninety-five persons,including 301 patients with CKD and 294 healthy controls,were enrolled in the study.Two single nucleotide polymorphisms (SNPs) (rs3752462,rs4821480) were genotyped by TaqMan assay or a restriction fragment length polymorphism assay for a further case-control study.The discrepancies of the patients'quantitive traits (including age,sex,systolic and diastolic blood pressure,frequency of different primary diseases and using different kinds of antihypertensive drugs) among different genotypes of the two MYH9 SNPs were analyzed.Meanwhile,the association between polymorphisms in MYH9 and hypertension susceptibility in CKD patients were analyzed in the rs3752462 site.Results The systolic blood pressure of CT genotype patients [(147.94± 27.40) mm Hg] was significantly higher than that of C C genotype patients [(136.43 ± 19.09)mm Hg] by single factor analysis of variance (P ＜ 0.05).The frequency of using all kinds of antihypertensive drugs for CC genotype patients (7.4％) was lower than that of TT (43.9％) and CT (48.7％) genotype patients (P ＜ 0.05).After correcting the age factor,the result of Logistic regression analysis showed that CC genotype was a protective factor of systolic blood pressure increasing.The probability of high blood pressure for CT genotype patients with CKD was 0.175 times than that of CC genotype (95％ CI 0.071,0.431).Conclusions The CKD patients who carry the rs3752462 site CC genotype of MYH9 gene are not prone to high blood pressure.Polymorphism of MYH9 gene rs3752462 site is associated with systolic blood pressure in CKD patients.It may indicate that allele C mutation for T can lead to the increase in systolic blood pressure.

Objective To evaluate the effects of arterial pressure continuous output (APCO) derived from stroke volume variation (SVV)-guided fluid management in the patients undergoing supratentorial neoplasms surgery.Methods Sixty-three patients (29 males, 34 females, aged 18-65 years, ASA physical status Ⅰ or Ⅱ) undergoing elective supratentorial neoplasma surgery were randomly divided into control group (group C, CVP-guided fluid management, n=30) and GDT group (group S, SVV-guided fluid management, n=33).Before the induction of general anesthesia, the hydmxyethyl starch Voluven (130/0.4) bolus 3 ml/kg in the two groups was administered followed by infusion of crystalloid at the rate of physical requirement.Hydroxyethyl starch or vasoactive agents were administrated to achieve the goal of CVP≥8 mm Hg or MAP>80% of baseline in group C andto reach the value of SVV≤12% and MAP>70% of baselinein group S.Intraoperativecrystal, intraoperative colloids,total fluid volume, bleeding volume, volume of blood transfusion and urine volume were recorded.The radial artery and venous blood was sampled for blood gas analysis, measurement of lactate concentration and laboratory parameters at 30 min before anesthesia induction (T0), the dura mater cutted (T1), end of operation (T2) and postoperative 24 h (T3).Postoperative complications and the number of patients with complications in postoperative period, the length of ICU stay and postoperative days were assessed.Results Total infused fluid volume [(1 478±312) ml vs (1 183±294) ml] and intraoperative colloids [(775±236) ml vs (487±243) ml] were significantly higher in group S than those in group C (P<0.05).Compared with T0, the lactate concentration were decreased significantly in two groups at T1 and T2.The lactate concentration in group S was significantly lower than group C at T2 [(0.91±0.25) mmol/L vs (1.31±0.46) mmol/L](P<0.05).There was no significant difference of postoperative complications, the length of ICU stay and postoperative days between two groups.Conclusion Fluid management guided by SVV during supratentorial neoplasms surgery reduces lactate levels.

0.05). (2) There was a significant difference in the distribution frequency of ?_2-AR at locus +46 between mild, moderate and severe degrees of PIH (P

BACKGROUND: In vivo experiments have confirmed that fibroblast growth factor can effectively protect gentamicin-induced renal tubular epithelial cell injury, but the effect on the in vitro cultured cells is still rare. OBJECTIVE: To explore the mechanisms of basic fibroblast growth factor (bFGF) at different concentrations on preventing nephrotoxity mediated by genamicin on the primarily cultivated renal tubular epithelial cell models. METHODS: By use of enzyme and mesh screening, renal tubular epithelial cells were isolated from Kunming mice and purified, adjusting the cell concentration of 1×10~8/L, then cell suspension was moved to a 96-well culture plate and divided into different groups for culture: blank control group: normal culture; gentamicin group: 10, 30, 50 μL/hola (ie, 400, 1 200, 2 000 U/holes)arerecorded as G1, G2, G3; bFGF group: 20, 50, 80 μL/hole (ie, 90,225, 360 ng/hole) are recorded as B1, B2, B3; gentamicin plus bFGF intervention group: after adding bFGF 12 hours, then added gentamicin 12 hours, assigned into 9 dose subgroups, namely, G1B1, G1B2, G1B3, G2B1, G2B2, G2B3, G3B1, G3B2, G3B3, each subgroup contained four-hole complex. Cell morphology and quantity was observed. RESULTS AND CONCLUSION: Gentamicin showed a dose-dependent effect on the renal tubular epithelial cell injury, epithelial cells in the medium and high concentration groups exhibited shrinkage, rounded, swelling, poor adhesion, severely damaged cytoplasm and structural disorder. In the low concentration group, the number change of cells was not obvious, and fibroblasts began to appear; In the bFGF groups, cells were full, exhibited strong refraction, the cell number increased significantly, these manifestations were significant in 50 μL/hole concentration, and there was no significant difference compared with 80 μL/hore concentration; in case of gentamicin plus bFGF intervention, cells with low concentrations of gentamicin had no obvious damage to cells, which increased, the damaged cells collapse was reduced in the group of low concentration of gentamicin, cell shrinkage and poor adhesion were slightly relieved, high concentrations of bFGF intervention could yield to good cell morphology, but high concentrations of gentamicin caused cell swelling and necrosis of injury, which could not be improved by any concentrations of bFGF intervention. 50 μL/hole bFGF has antagonistic effect on the nephrotoxicity mediated by medium and low concentrations of gentamicin, but has no protection on high concentration of gentamicin-induced nephrotoxicity.

Purpose To explore the value of high frequency convex ultrasound probe in the diagnosis of ovarian tumor in infants and young children. Materials and Methods Sixty-nine infants and young children with ovarian tumor were examined with high frequency convex ultrasound probe, and the ultrasound findings were analyzed. Results Out of 69 cases, 45 had tumors on the right side of ovary and the rest 24 on the left side;27 cases of simple cyst, 24 cases of benign teratoma, 9 cases of borderline teratoma, 3 cases of serous cystadenoma, 3 cases of mucous cystadenoma, 3 cases of yolk sac tumor;24 accompanied with torsion or necrosis. The ultrasound of ovarian tumor presented the following features:polycystic structures were common;the strong echo posterior acoustic shadow was not obvious; no specific manifestation was shown to distinguish benign from malignant tumors. Doppler ultrasound of tissues around the tumor was significant in detecting ovarian tumor torsion and necrosis. Conclusion High frequency convex ultrasound probe can provide clear images and distinct dissection information, which is beneficial in diagnosis and differential diagnosis of ovarian tumor in infants and young children.

Objective To explore the risk factors influencing the prognosis of patients with acute poisoning by analysis of clinical data of 356 patients in order to provide the scientific evidence for planning therapeutic strategies in ICU.Methods The clinical data of 356 patients with acute poisoning were collected during the period from January 1,2005 through December 30,2009,and the clinical findings from close observation were filled into the tables of specially designed “ Clinical observation of acute poisoning patients”.Some risk factors of 356 cases with complete clinical data were studied by single-factor analysis and Logistic multiple regression,such as gender,age,mode and cause of poisoning,kind of poison agents,time elapsed from poisoning to admission into the hospital,time elapsed from poisoning to admission into ICU,length of hospital stay,cardiopulmonary resuscitation,mechanical ventilation,APACHE Ⅱ score.Results Three hundred fifty-six patients with complete data were divided into survival group (n =260) and death group (n =96).Univariate analysis showed the length of hospital stay (5.72 ± 4.37) d,APACHE Ⅱ score (10.27 ±7.77),time elapsed from poisoning to admission into ICU (17.16 ± 31.22)h in the survival group,and the length of hospital stay (3.53 ± 5.79) d,APACHE Ⅱ score (18.78 ±8.66),time elapsed from poisoning to admission into the ICU (37.21 ±67.35) h in the death group (P ＜0.05 or P ＜ 0.01).The differences in rates of CPR,mechanical ventilation and kind of poison agents between the two groups were statistically significant (P ＜ 0.05).Multivariate Logistic regression analysis revealed that the length of hospital stay,APACHE Ⅱ score,rates of cardiopulmonary resuscitation,mechanical ventilation and kind of poison agents were positively correlated with prognosis of patients with acute poisoning (P ＜ 0.05).Model to predict mortality was established:Y =-0.817-0.137X1 +0.140X3 + 2.133X4 + 1.039X5-0.291X6.Conclusions Hospital stay,APACHE Ⅱ score,cardiopulmonary resuscitation,mechanical ventilation and kind of poison agents were independent risk factors for predicting prognosis.APACHE Ⅱ score system and Logistic regression analysis can be used to evaluate the severity and prognosis of patients with acute poisoning.

Objective To identify the gene mutations of an inherited coagulation factor Ⅶ deficiency pedigree.Methods PCR and DNA sequencing were used to identify the FⅦ gene mutations in the proband.The identified mutations were validated by PCR followed by restriction fragment length polymorphism technique or DNA sequencing.100 healthy volunteers were chosen randomly as controls. Results R1S2Q and IVS6+1G→T double heterozygous mutations were discovered in the Droband.The pedigree analysis showed that R152Q missense mutation inherited from his father,and IVS6+1G→Twas from his mother. The R1S2Q missense mutation in exon 6 was not found in 100 healthy volunteers. Conclusion The congenital deficiency of F Ⅶ in the proband might be caused by the coinheritance of the R152Q missense mutation in exon 6 and the splicing donor site mutation ( ⅣS6+1G→T)in intron 6.

Objective To investigate the clinical outcomes in the treatment of complex acetabular fractures through a single supra-ilioinguinal approach after the application of preoperative 3D printing and rapid prototyping simulating the operative procedure.Methods From January 2013 to January 2016,24 cases of complex pelvic and acetabular fractures in our hospital were retrospectively analyzed.Among them 18 cases were male and 6 were female.The average age was 39.2+±13.8 years (range,24-68 years).According to Letoumel-Judet's classification,there were 6 cases of transverse,4 cases of T shaped,4 cases of combined anterior column and posterior hemi-transverse (ACPHT) and 10 cases of 2-column fractures.The time from injured to operation averaged 9 days (range,4-18 days).Before operation,pelvic AP view,three-dimensional CT as well as CTA of iliac blood vessels was taken routinely in all cases.The CT and CTA scan data were then imported into Mimics software for 3D reconstruction.Surgical simulation and optimal placement of internal fixations were performed on computer.After that,the individual simulated model of the pelvis was printed by the use of 3D printing and rapid prototyping technique.The order of reduction,selection and optimal position of the implants were determined.The plates were bent before operation and the length and direction of the screws were recorded.A uniform supra-ilioinguinal approach was used in all cases.Results The length of incision averaged 9 cm (range,8-13 cm).The operative time average 130 min (range,90-220 min).The blood loss averaged 600 ml (range,300-1 500 ml).Once a satisfactory reduction was obtained,single placement of the plates was achieved.In accordance with the preoperative plan,the plates were perfectly fitted to the bone surface.The 24 patients were followed for an average time of 18.3 months (range,15-30 months).The fractures healed in all cases.The average healing time was 4.2 months (range,3-6 months).According to Matta criteria,there were 16 cases of excellent,6 cases of good,2 cases of poor and the excellent rate was 91.7％ (22/24).The average modified Merle d'Aubigne score was 16.5 (range,13-18).The functional outcome was excellent in 13 cases,good in 6 cases and poor in 5 cases.The excellent rate of hip functions was 79.2％ (19/24).There were 2 cases of femoral lateral cutaneous nerve injury (recovered one month later) and another 1 case of fat liquefaction of the incision happened three days postoperatively (the wound healed completely after several dressing changes).No inguinal hernia or abdominal wall hemias was found.No other postoperative complications was found.Conclusion The application of 3D printing and rapid prototyping technique allows preoperatively simulating reduction in vitro,determining the optimal position of the implants,bending the plates and measuring the length of the screws in advance,which could largely reduce the operative time,intraoperative blood loss and occurrence of postoperative complications.Adopting supra-ilioinguinal approach for the treatment of complex acetabular fractures with a small incision and less trauma,a full exposure could be obtained,so the reduction and fixation of the anterior,posterior and middle column (also named pubo-ischiatic column) could be completed in a direct visualization,resulting in a satisfactory clinical outcomes.

Objective To investigate the effects of sevoflurane post-conditioning on oxidative stress and inflammatory reaction during rat cerebral ischemia-reperfusion, and to explore its cerebral protective mechanism.Methods Thirty-six health male Sprague-Dawley rats (aged 12-14 weeks, weighing 220-260 g) were randomly divided into 3 groups (n=12 each): sham control group (group Sham), cerebral ischemia-reperfusion group (group IR), sevoflurane post-conditioning group (group SPC).Cerebral ischemia-reperfusion model was established, ischemia for 30 min followed by reperfusion 24 h.Rat middle cerebral artery was not occluded in group Sham.Cerebral ischemia-reperfusion model was established in group IR.Group SPC was subjected to 2.6% sevoflurane for 15 min in the beginning of reperfusion.At the end of reperfusion, rats were cut off the head to take out the brain tissue.The expression level of Iba-1 and HO-1 proteins was measured by western blot.The levels of reactive oxygen species (ROS), malondialdehyde (MDA), TNF-α, IL-1β and the activity of superoxide dismutase (SOD) were evaluated.Results Compared with group Sham, the expression of cerebral cortex Iba-1 protein was higher than that in groups IR and SPC (P＜0.05), the expression of Iba-1 protein in group SPC was lower than that in group IR (P＜0.05).Compared with group Sham, the contents of ROS, MDA, TNF-α and IL-1β were increased in groups IR and SPC (P＜0.05), but the activity of SOD and expression of HO-1 protein were decreased (P＜0.05).And the contents of ROS, MDA, TNF-α and IL-1β in group SPC were less than those in group IR, the activity of SOD and expression of HO-1 protein in group SPC were higher than those in group IR.Conclusion Sevoflurane post-conditioning can mitigate the microglia activation, reduce cerebral oxidative stress and inflammation, thus protect rat cerebral against ischemia reperfusion injury.