0.05).Two cases were lost to follow up,19 out of 21 cases were followed up.The follow-up duration was from 4 to 51 months[mean follow-up duration was(22.84?12.13) months].At last follow-up,10 cases(53%) had complete remission,4 cases(21%) had significant remission,4 cases(21%) had partial remission and 1 case(5%) had no remission.Tubulointerstitial lesions were related with prognosis(P1).Conclusions 1.The predominant clinical manifestation of primary FSGS is nephrotic syndrome in children.The not otherwise specified variant is the commonest pathological variant in primary FSGS.There is no relationship between patholo-gical types and clinical manifestations of FSGS.2.Most of the children with primary FSGS have a good short-term prognosis,but their long-term prognosis must be followed up.3.Tubulointerstitial lesions are risk factors for prognosis.

In light of the scientific procedure of policy making and based on the logical deduction of direct and indirect factors related to the chaotic drug market, the authors found the root of the chaos, viz. The mechanism of reimbursement ofr medical institutions that formed a vicious circle. Inview of the root, a policy model was developed and verified, viz. The optimal utilization of medical resources. The prerequisite condition to the implementation and success of the policy is the exertion of concerted efforts by various departments concerned underthe centralized leadership of the government. And it has been proven by experience that to tackle the chaos of the drug market it is necessary to start with medical institutions and the logical order of the steps to be taken to carry out the policy is as follows: control of the total drug expenses, gradual control of the gross profit from drugs, extrication of medical institutions from their dependence on drugs, improvement of the management of the frug market,perfection of the "rules of game" of the market, and development of key techniques for each procedure. Evaluation of the results of the implementation of the policy indicates that the policy is scientific, rational and easy to operate and the steps are feasible.

ObjectiveTo investigate the association of angiotensin converting enzyme(ACE) gene polymorphism and its serum levels with cerebral infarction, and further to explore its possible mechanism. MethodsEighty-four patients with cerebral infarction(cerebral infarction group) and 74 healthy controls(healthy control group) underwent the determination of ACE gene insertion/deletion polymorphism by polymerase chain reaction(PCR) and agarose gel electrophoresis(AGE). The serum levels of ACE were measured simultaneously. The difference in distribution of ACE gene polymorphism was compared between cerebral infarction group and ealthy control group. ResultsThe frequency of DD genotype in cerebral infarction group was significantly higher than that of healthy control group(50% vs 28% ,P<0.01); so was the frequency of D allele(64% vs 46% ,P<0.05). ACE gene polymorphism was associated with the serum level of ACE. A significant difference in serum ACE level was observed among three ACE genotypes. The highest serum ACE level or activity was in deletion homozygote(genotype DD), followed by heterzygote(genotype ID) and insertion homozygote(genotype Ⅱ)(P<0.01). ConclusionThe polyrnorphism of ACE gene and serum level of ACE are associated with cerebral infarction. The DD gene type of ACE and D allele may be the risk factor for cerebral infarction.

BACKGROUND:Calcineurin inhibitors reduce acute rejection rates and improve short-term graft survival in renal transplantation, but its nephrotoxicity associated with long-term use of calcineurin inhibitors remains an important issue. To both avoid exposure to calcineurin inhibitors and maintain effective immunosuppression, immunosuppressive agents such as sirolimus have emerged.
OBJECTIVE:To summarize the research progress of the two main protocols of sirolimus in kidney transplantation (de novo sirolimus-based therapy without calcineurin inhibitors and protocol conversion from a calcineurin inhibitor based therapy to sirolimus).
METHODS:With the key words of“kidney transplantation, sirolimus”in Chinese and in English, respectively, a computer-based search of articles was performed in CNKI (January 2000 to September 2013) and PubMed (January 1996 to September 2013) databases. Articles with the de novo sirolimus-based therapy without calcineurin inhibitors and protocol conversion from a calcineurin inhibitor based therapy to sirolimus were included.
RESULTS AND CONCLUSION:Sirolimus may obtain the advantages of no renal toxicity, anti-tumor and lower incidence of cytomegalovirus infections when compared with calcineurin inhibitors. But not al patients are suitable for sirolimus, and to screen patients strictly is the key of satisfactory clinical results. An appropriate treatment plan, drug monitoring of sirolimus, prevention and treatment of complications are essential features of the use of sirolimus.

In light of the scientific procedure of policy making and based on the logical deduction of direct and indirect factors related to the chaotic drug market, the authors found the root of the chaos, viz. The mechanism of reimbursement for medical institutions that formed a vicious circle. In view of the root, a policy model was developed and verified, viz. The optimal utilization of medical resources. The prerequisite condition to the implementation and success of the policy is the exertion of concerted efforts by various departments concerned under the centralized leadership of the government. And it has been proven by experience that to tackle the chaos of the drug market it is necessary to start with medical institutions and the logical order of the steps to be taken to carry out the policy is as follows: control of the total drug expenses, gradual control of the gross profit from drugs, extrication of medical institutions from their dependence on drugs, improvement of the management of the drug market, perfection of the “rules of game” of the market, and development of key techniques for each procedure. Evaluation of the results of the implementation of the policy indicates that the policy is scientific, rational and easy to operate and the steps are feasible.

Kidney is the most important organ to maintain the balance of hyperkalemia.Due to reduced glomerular filtration rate or renal tubule potassium excretion dysfunction, all kinds of acute and chronic kidney diseases can result in increased hyperkalemia.Therefore, hyperkalemia becomes a common electrolyte disorder in children with kidney disease.Hence, the diagnosis and differential diagnosis of renal hyperkalemia are particularly important for clinicians.

OBJECTIVETo investigate the action mechanisms of the FZD5 gene in prostate cancer bone metastasis and search for some new treatments for this disease.

METHODSWe determined the expression level of the FZD5 gene in prostate cancer PC3 cells and, after transfection of siRNA into the PC3 cells and silence of the FZD5 gene, observed the changes in the migration and proliferation of the cells. We established the model of prostate cancer bone metastasis by tibial injection of prostate cancer cells in the nude mice. Then we injected control siRNA and FZD5-silenced siRNA into the tibia of the mice followed by evaluation of tumor-induced bone destruction by X-ray imaging at 0, 1, and 3 weeks and by HE staining at 3 weeks after injection.

RESULTSAfter transfection of FZD5-silenced siRNA into the prostate cancer PC3 cells, the expression of the FZD5 gene was decreased about 70%. The rate of cell proliferation was significantly lower in the gene silencing group than in the control (P < 0.05), and that of cell migration dropped by 30% in the former as compared with the latter group at 48 hours after FZD5 silencing (P < 0.05). At 3 weeks after injection of control siRNA or FZD5-silenced siRNA into the tibia of the mice, osteolytic damage was observed in both groups, though less in the FZD5 silencing group, with only a few remaining bone trabeculae visible.

CONCLUSIONSilencing the FZD5 gene can reduce the migration and proliferation of prostate cancer cells, help to suppress bone metastasis and destruction, and thereby improve the survival rate and quality of life of the patients.

Animals ; Bone Neoplasms ; genetics ; prevention & control ; secondary ; Cell Line, Tumor ; Cell Movement ; genetics ; Cell Proliferation ; genetics ; Frizzled Receptors ; genetics ; physiology ; Gene Expression ; Gene Silencing ; Male ; Mice ; Mice, Nude ; Osteolysis ; Prostatic Neoplasms ; genetics ; metabolism ; pathology ; Quality of Life ; RNA, Small Interfering ; administration & dosage ; genetics ; Transfection

Purpose:To study the clinical and pathologica l features of rectal carcinoid and factors influencing the prognosis.Metho ds:Data of 43 rectal carcinoid patients were analyzed retrospectively.4 2 patients were followed up postoperatively. Primary tumors were classified by s ize and muscularis invasion respectively.Results:The 5-year su rvival rate was 100% for the patients with tumor 2cm. the 5-year survival rate was 100% for the patients without muscularis invasion, and 50% for those with muscularis invasion.Conclusions:Tumor size and muscularis invasion are important pr ognostic factors for rectal carcinold.