Objectives To investigate the parmacokinetic characteristics of Meropenem used during the shock phase of severely burned patients. Methods The concentration of Meropenem in the plasma, blister and urine of 11 burn patients during the shock phase (S group) were determined by high performance liquid chromatography after the iv injection of Meropenem. Pharmacokinetic parameters were thus produced by 3P97 software. 6 healthy volunteers served as control group (C group). The t test was used to analyze difference between pharmacokinetic parameters of burned patients and healthy volunteers. Results Compared to those in control group, pharmacokinetic parameters of Meropenem in S group showed significant difference, such as prolonged elimination half-life (t1/2?):[(2 29?0 54)h vs (1 34?0 16)h] and decreased clearance(CLs): [(11 34?3 08)L? h-1 vs (18 76?4 60)L?h -1 ], and enlarged area under the serum concentration versus time curve(AUC):[(47 85?16 15)?g?h?ml -1 vs (27 54?10 76)?g?h?ml -1 ]. Conclusions Meropenem at the dose 500mg iv 3/d can show good activity (both in plasma and wound tissues)against most of pathogens which are common in burn clinic. The intervals should be prolonged when maximum dosage of Meropenem was administered in burn patients during the shock phases.

Autosomal dominant polycystic kidney disease (ADPKD) is a most common inherited renal disease, about 50% with a family history, although the exact etiology not yet clear. To date, ADPKD, a multisystem disorder without effective preventive and therapeutic means, has been shown to be detrimental to human health. Recent studies show that severe oligoasthenozoospermia, necrospermia, immotile sperm, azoospermia, epididymal cyst, seminal vesicle cyst, and ejaculatory duct cyst found in male ADPKD patients may lead to male infertility, though the specific mechanisms remain unknown. Structural anomaly of spermatozoa, defect of polycystin, mutation of PKD genes, and micro-deletion of the AZF gene could be the reasons for the higher incidence of abnormal semen quality in male ADPKD patients. Assisted reproductive techniques can increase the chances of pregnancy, whereas the health of the offspring should be taken into consideration. This article presents an overview of reproductive issues concerning infertile male ADPKD patients from the perspective of the morbidity, pathophysiological mechanism, diagnosis, and management of the disease.
Cysts ; pathology ; Ejaculatory Ducts ; pathology ; Female ; Humans ; Infertility, Male ; physiopathology ; Kidney ; pathology ; Male ; Mutation ; Polycystic Kidney, Autosomal Dominant ; physiopathology ; Pregnancy ; Reproductive Techniques, Assisted ; Semen Analysis ; Spermatozoa ; pathology

AIM: To characterize the gene expression of sortilin on adipogenic and osteogenic differentiation in mesenchymal stem cells (MSCs) in vitro and explore its significance.METHODS: MSCs derived from human bone marrow were isolated and cultured in vitro ,then were stimulated in osteogenic medium and adipogenic medium,respectively. Osteopontin and lipoprotein lipase were detected by RT-PCR. Sortilin expression was analyzed by semiquantitative RT-PCR. RESULTS: 1.MSCs displayed the potential of differentiation into osteoblast and adipocyte. 2.Sortilin was upregulated one day after osteogenic induction and remained upregulated for a week. The expression of sortilin was significant increased on day 3( P 0.05).CONCLUSION: Sortilin may be useful to modulate the osteogenic differentiation and may not be necessary for adipocyte commitment in MSCs. The regulation of sortilin expression may provide new protocal and strategy for the treatment of osteoporosis and osteopenic disease.

Objective To investigate the clinical features of rheumatoid arthritis (RA) associated with thyroid function abnormalities.Methods Serum thyroid function,anti-thyroglobulin antibodies (TGAb) and anti-thyroid peroxidase antibodies (TPOAb) were detected in 186 RA patients.Clinical data were then analyzed.Comparison of continuous data between groups was made by t test,while comparison of categorical data was made by x2 test.The non-normal distribution of the data was analyzed by Mann-Whitney U rank sum test.Results Fifty-six RA cases (30％) had abnormal thyroid function,including 25 low T3 syndrome cases,16 subclinical hypothyroidism cases,10 hypothyroidism cases and 5 Graves' disease cases.Among them 23 cases were diagnosed as Hashimoto's thyroiditis.The positive rate in the hypothyroidism group with chills (45 cases,80.3％,x2=99.94),lazy words (14 cases,25.0％;x2=7.896),lethargy (24 cases,42.9％;x2=7.433) and abdominal distension (21 cases,37.5％;x2=7.15) was higher than that in the group with normal thyroid function (all P＜0.05).Level of serum high density lipoprotein was decreased in hypothyroid group [(1.0±0.5) mmol/L vs (1.4±0.6) mmol/L,t=4.087,P＜0.05].Patients with abnormal thyroid function had higher positive rate of ANA [(10 cases,7.7％) vs (25 cases,44.5％),x2=34.98],anti-SSA [(3 cases,2.3％) vs (23 cases,41.1％),x2=48.91],anti-SSB [(2 cases,1.5％) vs (12 cases,21.4％),x2=22.25],TGAb [(20 cases,15.4％) vs (43 cases,76.7％),x2=65.88] and TPOAb [(13 cases,10.0％) vs (27 cases,48.2％),x2=35.90] than those with normal thyroid function (all P＜O.05).Conclusion Rheumatoid arthritis is often accompanied by thyroid disease.The positive rate of auto-antibodies in RA with abnormal thyroid function is higher than those with normal thyroid function and has no relationship with the disease activity.

Objective · To investigate the smoking hypertensive elderly, find out the status of smoking in this population, and explore effective system intervention. Methods · The smoking hypertensive elderly in Waigang Town of Shanghai who received free antihypertensive drugs were recruited to investigate and descriptively analyze the smoking status of them with questionnaires. Results · There were 77.6% of the smoking hypertensive elderly who began to smoke in the age of 13 to 25, and nearly 70% smoking for more than 40 years. There were 59.5% of these people smoking 11 to 29 cigarettes daily in recent 3 years, and 41.6% spending 200-299 yuan on smoking monthly. Conclusion · Currently almost 70% of the smoking hypertensive elderly, who receives free antihypertensive drugs, have been smoking for more than 40 years, and the average number of cigarettes smoked daily is big. It is clear that the health education attached to the policy of providing free antihypertensive drugs has not changed the behavior. Therefore, medical personnel still needs to contact the illness and smoking hazards to help the elderly reduce smoking. Besides, it proves that tobacco control should be implemented in the young population to control epidemic at the early stage.

Objective · To investigate the prevalence of passive smoking among pregnant women in Shanghai and to analyze its influencing factors and to provide the basis and suggestion for making related intervention measures to reduce the harm of secondhand smoke on the health of pregnant women. Methods · From July to October 2014, pregnant women and their spouses were recruited for a questionnaire investigation at the antenatal care clinics of 3 maternity hospitals and 3 community hospitals in Shanghai. The questionnaire included demographic information, family basic situation and cognitive status of passive smoking. Results · The passive smoking rate before pregnancy in the 2831 pregnant women, who were involved in the investigation, was 17.1%. The passive rate during pregnancy was 7.8%. The difference between these two rates was statistically significant (P<0.05). 71.0% of the pregnant women have passive smoking for 15~59 min each day. Relative to home and work place, the passive smoking rate of pregnant women in public place was the highest (P<0.05). The passive smoking rate of pregnant women was significantly associated with the educational level of smoking spouses and the attitude of pregnant women when they faced the smokers. Conclusion · The passive smoking rate of pregnant women is influenced by the educational level of their spouses and the pregnant women's feedback to the smokers face to face. Public places are the most important exposure places to secondhand smoke for pregnant women. In order to reduce the harm from passive smoking to pregnant women and their fetuses, the related measures of smoking control at home education and smoking ban in public place should be made.

Recently,zebrafish,as a new model species,has been used widely in the study of developmental mechanism of the embryo,a model of human disease and the drug screening.Zebrafish has been applied widely in the study of the drug for tumor antiangiogenesis with the development of the advanced technology of the mutagenesis and the confocal microscopy using for observation.Zebrafish applied in the screening of tumor antiangiogenesis drug and the mechanism of tumor angiogenesis are summered.

Objective To investigate the nursing care in ultra-high pressure balloon dilatation for treating in patients with hemodialysis patients.Methods The patients with arteriovenous fistula were treated with ultra-high pressure balloon dilatation.Under fluoroscopy guidance the ultra high pressure balloon was used to dilate the stenosis.Preoperative preparation included psychological and routine care.Results Blood flow in all the 14 patients with hemodialysis was ≥ 250 ml/min,mean (270.00±27.33) ml / min.All patients were successfully completed the treatment,there were no angiorrhexis,bleeding,infection and embolism.Conclusion Careful nursing can promote the rehabilitation of patients,improve the effect of postoperative treatment.

Objective To investigate clinical feature,diagnosis and prognosis of eosinophilic gastroenteritis(EG),and to analyze the causes of misdiagnosis.Methods Eleven children diagnosed as EG were studied.Their history,clinical manifestations,laboratory tests and endoscopies and treatment,follow-up data were analyzed.The data were analyzed by SPSS 10.0 software.Results 1.The children with EG usually had abdominal pain(5 cases),diarrhea(7 cases),hemafecia(5 cases) and sometimes with fever(2 cases).2.EG and allergy in children was closely related with disease(54.55%).3.Peripheral blood eosinophil(EOS) count increased significantly,and declined when symptoms eased(18.18%).4.Endoscopic manifestations were not specific,the mucosa could see sheet erosion,shallow ulcers,congestive spots or bleeding spots,mainly in antrum,duodenum,terminal ileum,ileocecal junction.The biopsy showed that a large number of EOS infiltration.5.Imaging were not specific,CT or gastrointestinal barium meal examination did not show special often(90.91%).When muscular wall was affected(9.09%),imaging presentations of EG could be partly obstructive.6.Glucocorticoid therapy could relieve symptoms and EOS.Symptoms probably recured by good prognosis.7.EG was a self-limiting allergic diseases,although the attack may be repeated.After long-term follow-up,most had good prognosis and without malignant.Conclusions Clinical and endoscopic presentations of EG are not specific,therefore the presence of EOS in gastrointestinal mucosa strongly indicate the diagnosis.It was easy to misdiagnosis.Biopsy pathology and cli-nical characteristics are the key to diagnosis.

Objective To evaluate the effect of peer educatio n program by the application of the peer education on human immunodeficiency vir us/aeguired immune deficiency syndrome(HIV/AIDS) prevention and the analysis of the change on knowledge, attitude and behavior about HIV/AIDS among technical sc hool students in Shanghai. Methods Three technical schools in Shanghai were selected randomly. Two classes of each school were selected randomly as education group and the students added up to 284.Two hundred and sixty-one students of another 2 classes in each school were selected as the interior control group. Some freshmen came from medical un iversity were carefully trained as peer educators to conduct the education inclu ding 6 models. The same questionnaires were carried before and after the educati on in both groups. Results After peer education the score of average knowledge abo ut reproductive health, HIV/AIDS, STD was significantly higher than before (P 0.05). Conclusions The conduction of the peer education on HIV/AIDS pr evention among technical school students is effective in promoting the knowledge level,but the change of attitude and behavior is a long term. So we highly adv ocate that not only the health education for HIV/AIDS especially safe sex shall be given and strengthened among technical school students in order to promote t he notion of self-protection but also the conception of care others especially t he HIV/AIDS. J Appl Clin Pediatr,2005,20(2):167-169