The currently unfavorable physician - patient relationship has lead to a total loss of interests from multiple sides of hospitals,patients,medical staff,medical education and the society,which specifies in the wellbeing loss of patients and the whole population.The social stability has also been affected.The health care reform should aim to minimize the conflicts between doctors and patients,thus the above mentioned losses will be diminished and a harmonious physician - patient relationship will be built up and the win - win pattern of benefits between doctors and patients will also be realized.Multiple efforts from the government,society,hospitals,medical staff,and patients are all needed to achieve such a goal.

Objective To analyze the clinical and pathological characteristics of children with lupus nephritis(LN).Methods The data of 116 inpatients from Mar.2000 to Nov.2008 with LN were retrospectively analyzed.The clinical,immunochemical and pathological data were recorded.Renal tissue was observed by light microscopy and electron microscopy after HE,PAS,Masson and PASM staining according to WHO standards.Follow-up results showed complete remission,partial remission,disease activity,renal insufficiency and death.Results Of the 116 cases of LN,there were 27 male and 89 female with a ratio of male to female 1.03.3,and the mean age was(12.0?2.2) years.The incidence of nephrotic syndrome was 63.8 %(74 cases),and acute nephritis was 21.5%(25 cases).Class Ⅳ LN was the most frequent type(14 cases,50%) and classⅢ was next(25 cases,21.5%).In view of the outcome,rapidly progressive glomerulonephritis and class Ⅳ LN were the worst.LN was initially controlled in 96.5% of the patients.Relapses of LN were most caused by the intermittent treatment.Totally 32 cases showed different renal injury,and 6 cases progressed to death.Conclusions Renal biopsy is important to diagnosis,treatment and prognosis evaluation of LN.Long and regular treatment is important for children with LN.

ObjectiveTo explore the detection significance of insulin-like growth factor-I(IGF-I),IGF-binding protein-3(IGFBP-3) in children with acute lymphoblastic leukemia(ALL).MethodsSerum samples were obtained from 30 ALL children without any medication;serum control samples were obtained from 30 cases of healthy children.There were no significant differences of body weight,age and sex between 2 groups.All children had no case history of liver,kidney,malnutrition and endocrine system disease.IGF-Ⅰ was determined by radioimmunoassay kit.IGFBP-3 was determined by immunoradiometric kit.The data were analyzed with SPSS 11.0 software.ResultsThe level of IGF-Ⅰ in ALL group [(18.95?4.02)?106 g/L] was significantly lower than that in control group [(34.12?7.86)?106 g/L](t =9.412P

OBJECTIVETo assay the expression of KiSS-1 and GnRH in the male rat hypothalamus at different developmental stages, and to explore the significance of KiSS-1 in sex development onset and normal reproduction regulation.

METHODSExpression analyses of KiSS-1 and GnRH genes were conducted in the rat hypothalamus at different developmental stages with RT-PCR and real time-PCR. The testosterone level was assayed by chemoluminescence technique.

RESULTSKiSS-1 mRNA rose gradually during sex development in the rat hypothalamus, highest at puberty and lowered a little at adulthood. KiSS-1 mRNA of the prepubertal, early pubertal, pubertal and adult rats was 1.7, 2.1, 3.5 and 2.0 times higher than that of the infantile rats respectively. The expression of GnRH and KiSS-1 correlated positively (r = 0.905, P < 0.05). But the activation of GnRH neuron was later than KiSS-1. The expression of GnRH was the highest in the puberty rats. GnRH mRNA of the prepubertal, early pubertal, pubertal and adult rats was 1.1, 1.94, 2.42 and 1.92 times higher than that of the infantile rats respectively. The level of testosterone in the adult rats was significantly higher than that at the earlier stage and was the highest at the adult stage.

CONCLUSIONThe expression of KiSS-1 correlates positively with that of GnRH. KiSS-1 may participate in the regulation of GnRH and is relevant to puberty onset and the regulation of reproduction function.

Animals ; Gonadotropin-Releasing Hormone ; biosynthesis ; genetics ; Hypothalamus ; metabolism ; Kisspeptins ; Male ; Proteins ; metabolism ; RNA, Messenger ; biosynthesis ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction

The hypolipidemic and hypoglycemic effects of two dietary dosages (0.1% and 0.5%) of water and 80% ethanol extracts from hot-air dried Orostachys japonicus A. Berger were evaluated in the serum and organ tissues of streptozotocin-induced diabetic rats. The STZ-induced diabetic groups supplemented with the O. japonicus extracts showed significantly higher body weight compared to a diabetic control group at the end of experiment. The extracts exhibited substantial hypoglycemic effects by significant reductions of fasting blood glucose levels at all time points tested compared to the initial stage before treatment of the extracts. Declines of serum and hepatic triglyceride levels were greater than declines of total cholesterol in the groups treated with the 0.5% O. japonicus extract (DBW2 and DBE2) when compared to the DBC group. Hepatic glycogen content was higher in the groups treated with O. japonicus extract, while lipid peroxide content was decreased in these treated groups compared to the DBC group. Hepatic antioxidant activity was significantly increased in the groups supplemented with the O. japonicus ethanol extract. The hypolipidemic and hypoglycemic effects of the O. japonicus ethanol extract were significantly greater than the effects of the water extract. Based on this study, it seems that O. japonicus ethanol extract, due to its higher phenolic and flavonoid components than the water extract, may control blood glucose and alleviate hyperlipidemia in diabetes.
Animals ; Blood Glucose ; Body Weight ; Cholesterol ; Ethanol ; Fasting ; Hyperlipidemias ; Hypoglycemic Agents ; Liver Glycogen ; Phenol ; Rats ; Rats, Sprague-Dawley ; Water

OBJECTIVEThis paper presents the experience in using the reverse buccinator musculomucosal flap for repairing the defect following excising inverted papilloma of the nose.

METHODSAfter the inverted papilloma of the nose was excised through an endonasal approach, the reverse buccinator musculomucosal flap supplied by the retrograde blood flow of the anterior buccal artery was harvested and sutured to the defect through the ora-nasal tunnel. The procedure was performed on three patients.

RESULTSThe postoperative course was uneventful. All the flaps survived completely.

CONCLUSIONSThe technique provides the solution to prevent nasal stricture from cicatricial contracture after excising inverted papilloma. In the operation, excising the inverted papilloma and repairing the defect was performed simultaneously, saving another operation for the secondary deformity. The technique is also applicable to the treatment of existing cicatricial stricture of the nose.

Humans ; Male ; Middle Aged ; Mouth Mucosa ; transplantation ; Nose Neoplasms ; pathology ; surgery ; Papilloma, Inverted ; pathology ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

BACKGROUNDIn 2008, infants in some areas of China suffered from stones of the urinary system which were caused by melamine-contaminated milk formula. Most of the infants were asymptomatic, and a few suffered from acute renal failure induced by urinary obstruction by stones. This study aimed to assess the significance of blood purification therapy in treatment of infants with acute obstructive oligo-anuric renal failure. Corrective perception, timely diagnosis, and active treatment of this complex disease are critical factors that guarantee a quick recovery of renal function of infants and help them to prevent multiple organ system failure.

METHODSThirteen infants with acute renal failure induced by urinary multiple obstruction caused by melamine-containing stones who had been admitted to Beijing Children's Hospital Affiliated to Capital Medical University in 2008 were investigated for the epidemiological characteristics, image features and indications of dialysis. All these infants were treated with dialysis. The efficacy of dialysis was compared with that of two control groups treated with cystoscopic retrograde catheterization into the ureter and medical treatment for the recovery of renal function.

RESULTSThe 13 infants with life-threatening complications treated with dialysis showed a blood urea nitrogen (BUN) level of (30.9+/-7.9) mmol/L and a creatinine (Cr) level of (572+/-173) micromol/L. Of these infants, 8 were treated with peritoneal dialysis (PD), and 5 with hemodialysis (HD). Ten infants recovered to urinate 24-72 hours after dialysis and 3 infants with persistent ureteral obstruction were further treated with cystoscopic retrograde catheterization into the ureter for drainage, and urination resumed soon after the operation. The average time of PD and HD were (2.1+/-0.8) days and (1.2+/-0.4) days, respectively. The total average time of PD and HD dialysis was (1.77+/-0.83) days. The recovery time of renal function of infants after dialysis was (3.08+/-1.20) days, comparable to that of the two control groups treated with catheterization with a cystoscope or by medication. There was no significant difference in the recovery time of renal function among the three groups (P>0.05).

CONCLUSIONSMelamine-contaminated milk formula may cause urinary stones and obstructive acute renal failure in infants. Dialysis is suggested to treat life-threatening complications such as hyperkalemia, oliguria or anuria if surgical intervention fails. If possible, hemodialysis or peritoneal dialysis can be performed early. Blood purification is feasible to help the infants overcome the critical stage of acute renal failure. Surgical measures can be taken to remove the obstruction if necessary.

Acute Kidney Injury ; chemically induced ; surgery ; therapy ; Child, Preschool ; China ; Cystoscopy ; methods ; Female ; Humans ; Infant ; Kidney Function Tests ; Male ; Peritoneal Dialysis ; methods ; Renal Dialysis ; methods ; Treatment Outcome ; Triazines ; poisoning

OBJECTIVETo evaluate the value of transbronchial needle aspiration (TBNA) combined with transesophageal endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of mediastinal and pulmonary hilar lesions as well as in the lymph node staging (N staging) of lung cancer.

METHODS129 patients with mediastinal and pulmonary hilar lesions underwent either TBNA or EUS-FNA with cytological needle aspiration. The samples obtained from TBNA or EUS-FNA were examined by both cytologiy and histopathology.

RESULTSOf the 129 patients, 59 underwent TBNA and 70 EUS-FNA. The diagnostic rate were 84.7% (50/59) by TBNA and 94.3% (66/70) by EUS-FNA, resepectively. The diagnosis of 116 (89.9%) patients were confirmed by either TBNA or EUS-FNA. The pathological and cytological diagnostic rates were 92.2% (107/116) and 88.0% (102/116), resepectively. The diagnostic rate was elevated by 8.4% (9/107) through pathological examination. The histological classification rates by cytological and pathological examination were 73.8% (76/116) and 89.3% (92/103), respectively. The diagnostic rate of histological classification was elevated by 35.5% (27/76) through pathological examination.

CONCLUSIONThe combination of TBNA and EUS-FNA can improve the diagnostic rate for wider mediastinal and pulmlonary hilar lesions. Pathological examination of the samples obtained from the TBNA and EUS-FNA can elevate not only the rate of diagnosis but also the rate of histological classification.

Adenocarcinoma ; diagnostic imaging ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; methods ; Biopsy, Needle ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; Endosonography ; methods ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; Male ; Mediastinal Neoplasms ; diagnostic imaging ; pathology ; secondary ; Mediastinum ; Middle Aged ; Neoplasm Staging ; Small Cell Lung Carcinoma ; diagnostic imaging ; pathology ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of endoscopic mucous resection with transparent cap (EMR-Cap) and endoscopic multi-band mucosectomy (MBM) in the treatment of early esophageal cancer and precancerous lesion.

METHODSA retrospective study was performed to review 30 EMR-Cap cases from December 2008 to December 2009 and 32 MBM cases from January 2010 to January 2011 of early esophageal cancer and precancerous lesions. The differences between these two techniques in efficacy, safety, and cost were compared.

RESULTSIn EMR-Cap group, the median resection time was 26(10-56) min and median procedure time was 43(22-81) min, significantly longer than those in MBM group [10(7-18) min and 32(28-45) min, P=0.036 and 0.038, respectively]. There were no significant differences between the two groups in total thickness and depth of resected lesions (P>0.05). In EMR-Cap group, the median cost was significantly higher than that of MBM group [(5466±354) vs. (4014±368) RMB, P=0.008)].

CONCLUSIONSEMR-Cap and MBM are minimally invasive, safe and effective methods in the treatment of early esophageal cancer and precancerous lesions. Compared to the EMR-Cap, MBM is simple with shorter treatment time and lower cost.

Aged ; Endoscopy ; methods ; Esophageal Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Precancerous Conditions ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo assess the depressive status and its influence on Chinese HIV-1(+) population, and how it was influenced by highly active antiretroviral therapy (HAART) and the CD4(+) T cell count.

METHODSAnti-HIV-1(+) patients (age between 18 and 65 years old) who had met the criteria to commence the anti-HIV treatment but had not yet started, were selected from the Beijing Ditan Hospital between March 2011 and June 2012. BDI-II (Beck Depression Inventory) and a self-designed questionnaire were used to evaluate the baseline and the status of 48 weeks post the HAART treatment. Statistically, t test and the Wilcoxon rank sum test were used to compare the BDI scores under different conditions and before/after the HAART.

RESULTS(1) Of 100 subjects: male to female ratio was 99:1; the average age was 31.37 ± 5.58 years; the average education background was of 13.13 ± 3.51 years; the unemployed percentage was 4%; time before being identified as anti-HIV-1(+) was 5.0 (1.0 - 21.0) months; the percentage being infected through homosexual contact was 83%. The baseline BDI score was 6.0 (3 - 10.25). (2) There was no significant difference (P > 0.05) in BDI score between those subjects having had education less or more than 12 years; the BDI score of patients whose anti-HIV-1(+) was significantly higher (P < 0.05) among those discovered within the past 6 months than those more than 6 months. The BDI score of patients whose baseline CD4(+) T cell count below 200 cells/µl was significantly higher (P < 0.05) than those with baseline CD4(+) T cell count greater than 200 cells/µl. The CD4(+) T cell count was significantly high (P < 0.001) after 48 weeks of anti-viral treatment, but the BDI score was not significantly different (P > 0.05). There was no significant change (P > 0.05) in the proportion of patients with different degrees of BDI score before and after 48 weeks of antiviral treatment.

CONCLUSIONDepression in HIV patients was most overt in the first six months when they were aware of the infection. The degree of depression was more severe in patients with baseline CD4(+) T cell count less than 200 cells/µl with improvement of immunity after the HAART did not alleviate the level of depression.

Acquired Immunodeficiency Syndrome ; drug therapy ; psychology ; Adolescent ; Adult ; Aged ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Depression ; Emotions ; Female ; HIV-1 ; Humans ; Male ; Middle Aged