Objective To explore and provide guidelines for the clinical diagnosis and treatment of primary nephrotic syndrome complicated with acute pancreatitis. Methods The clinical data of 14 children with primary nephrotic syndrome complicated with acute pancreatitis during September 2013 to September 2016 were retrospectively analyzed. Results In 14 children (6 males and 8 females) aged 3 to 15 years. all children presented massive proteinuria, hypoalbuminemia, varying degrees of edema, hyperlipidemia and pain in upper abdomen or left hypochondrium. Seven children had nausea and vomiting, and their amylase in serum and urine fluctuated at 392–802 U/L and 561–3180 U/L, and the lipase level was 339.1±2.52 U/L. After supportive treatment, 13 children were cured from pancreatitis except one who gave up the treatment. Conclusion Due to infection, coagulation disorder, hyperlipidemia and drug application in primary nephrotic syndrome, acute pancreatitis may be induced. Clinician should be alerted to it and early diagnosis and treatment were needed for acute pancreatitis.

Objective To explore the effects of parent-adolescent conflict and cohesion on relational aggression among junior students.Methods Parent-adolescent Conflict Questionnaires,Parent-adolescent Cohesion Questionnaires,and the Relational Aggression Questionnaires were used in investigating 392 junior students.Results The level of relational aggression of junior students was low (22.52±5.15).There was no differences between relational aggression of male students (22.93± 5.43) and female students (22.00± 4.73) (P＞ 0.05),and of grade 1 students(22.72±5.14)and grade 2 students(22.64±5.67),grade 3 students(21.93±4.22) (P＞0.05).The students' relational aggression showed a significantly positive correlation with frequency and intensity of parent-adolescent conflict(r=0.269,r=0.307,r=0.268,r=0.271,P＜0.01),and negative correlation with father-adolescent cohesion(r=-0.171,P＜0.01).Parent-adolescent cohesion was negative predictor of relational aggression(β=-0.123,P＜0.05),and the intensity of parent-adolescent conflict was positive predictor(β=0.301,P＜0.01).Conclusion Parent-adolescent conflict and cohesion have significant effect on relational aggression among junior students.

Objective To investigate the changes of Treg cells,Th17 cells and related cytokines in pe?ripheral blood of patients with severe hand?foot?mouth disease( HFMD) in the initial stage of infection caused by Enterovirus 71 virus. Methods Thirty?five cases of severe HFMD children in the Fifth Hospital of Shijiazhuang from May 2013 to December 2013 were selected as the research subjects,including 27 cases of severe formed group and 8 cases of danger severe formed group. The frequencies of Th17 cells ( CD3+CD8?IL?17+) and Treg cells( CD4+CD25+Foxp3+) in peripheral blood were detected by flow cytometry in patients with severe HFMD and 31 healthy children(control group). Moreover the serum levels of interleukin 6(IL?6),interleukin 17(IL?17) ,interleukin 10( IL?10) ,interleukin 23( IL?23) ,and human transforming growth factorβ1 ( TGF?β1) were measured by ELISA. Results As compared with those in control group,the frequencies of Treg cells,ratio of Treg/Th17,serum levels of TGF?β1, IL?10 in severe HFMD groups were significantly decreased ( F=23. 23, 30. 88,10. 766,11. 680 respectively;P<0. 05) . However the frequency of Th17 cells,serum levels of IL?6,IL?17,IL?23 in severe HFMD groups were significantly increased( F=646. 81,5. 904,10. 557,3. 490 respectively;P<0. 05) . Conclusion The changes of Treg and Thl7 cells and related cytokines appear in peripheral blood of patients with HFMD in the initial stage of infection caused by Enterovirus 71 virus. The frequency of Treg cell is decreased,however,the frequency of Thl7 cells frequency is increased,as a result,which may spread inflammato?ry reaction and cause complication.

Objective To explore the breakthrough point of pharmaceutical care for a patient with bronchiectasis ,diabe-tes and gout .Methods The clinical pharmacist recommended appropriate antibiotics and gout medications .The dosage and therapy regimen were optimized based on the patient′s renal function ,allergy and disease history .Results The physician ac-cepted the suggestions from clinical pharmacists .The patient recovered well with no adverse drug reactions .Conclusion With the knowledge of clinical pharmacist ,clinical treatment plan was optimized .The patient received better pharmaceutical care .

Objective To explore the best percentage of adaptive statistical iterative reconstruction Veo (ASiR-V)in detection of pulmonary nodule by chest ultralow dose CT (ULDCT).Methods 81 patients with pulmonary nodule detected by chest low dose CT (LDCT)underwent a local ULDCT scan at the center of the nodule with a range of 3 cm scan length.LDCT was performed with the mode of the Assist kV (120/100 kV)/Smart mA with noise indices of 14.1 HU and reconstructed with ASiR-V 50% algorithm.ULDCT was acquired at a tube potential of 120 kV and tube current-time product of 2.8 mAs and reconstructed with ASiR-V 50%,70% and 90%algorithms.Subjective and obj ective image qualities,sensitivities of detection and diameter of nodule among all ULDCT images were compared.Results Compared with the radiation dose of LDCT [(0.9 9±0.3 6)mSv],a 90.2% decrease was seen with the ULDCT, for which the calculated mean effective radiation dose was (0.097±0.007)mSv.The noise values of fat and paravertebral muscle for ULDCT reconstructed with ASiR-V 90% were 12.33±1.86 and 14.82±2.6,which were significantly lower than those in the group of ASiR-V 50% (1 9.73±1.98, 21.19±2.46)and the group of ASiR-V 70% (15.79±1.82,17.71±2.50)(P＜0.05).The subjective scores of images reconstructed with ASiR-V 70% (4.13±0.47)were the highest,which were slightly higher than those in 90%groups (4.03±0.38)(P＜0.05).No significant differences for overall sensitivity of nodule detection were observed among the ULDCT reconstructed with ASiR-V 50%(86.42%),ASiR-V 70%(87.04%)and ASiR-V 90% (88.89%)(P＞0.05).The mean nodule diameter measurements were (6.4±2.0)mm,(5.9±2.2)mm,(6.0±2.2)mm and (6.1 ±2.2)mm for LDCT and ULDCT (ASiR-V 50%,70% and 90%),respectively with P＞0.05.Conclusion At extremely low exposure levels,ASiR-V can obviously improve the image qualities of ULDCT,and 90% is the best percentage for lung algorithm reconstruction with a high sensitivity of pulmonary nodule detection.

Objective: To explore the clinical characteristics of glucocorticoid induced eye damage in children with primary nephrotic syndrome. Methods: The clinical data of steroid-induced high intraocular pressure or cataract in 49 children who were from Zhengzhou Children′s Hospital with primary nephrotic syndrome admitted from September 2016 to April 2018 were analyzed retrospectively in order to observe the relationship between relevant eye damage and clinical medication. Results: There were 37 boys and 12 girls in the 49 cases, of which the average age of onset was (7.6±3.0) years old, and among them there were 22 cases with glucocorticoid high intraocular pressure, 19 cases with glucocorticoid cataract, 8 cases with glucocorticoid high intraocular pressure combined with cataract, but no glaucoma in 49 cases.The shortest time of using glucocorticoid was 15-3 240 days[(863.33±871.46) days]; the cumulative dose of glucocorticoid was (7 865±3 691.66) mg/m², the left eye pressure was (26.68±5.95) mmHg(1 mmHg=0.133 kPa) and the right eye pressure was (27.71±5.82) mmHg.There was no significant correlation between glucocorticoid using time, cumulative dose and high intraocular pressure(r=-0.158, -0.264, -0.237, -0.361, all P>0.05). All the 19 patients with glucocorticoid cataract and 8 patients with glucocorticoid high intraocular pressure combined with cataract presented posterior capsular opacity, including 23 males and 4 females, and their time of using glucocorticoid was(1 296.67±903.35)days, who were followed up continuously. Conclusions Glucocorticoid-induced high intraocular pressure and cataract should be paid attention to by clinicians.Once high intraocular pressure or cataract occurs, the dosage of glucocorticoid should be gradually reduced or stopped, at the same time, ophthalmologic treatment should be actively performed to avoid serious eye diseases.