Objective To investigate the approach to design dosage regi-mens of infection therapy in renal dysfunction patients according to dea-ling with clinic cases.Methods Clinical pharmacist took part in desig-ning optimal dosage regimens for two renal dysfunction patients , and therefore to investigate the key points for these patients .Clinical pharma-cists accumulate practical experiences through this process .Results and Conclusion Two patients returned to normal , to be discharged .Clinical physicians need clinical pharmacists to take part in designing optimal individua l regimens for renal dysfunction patients .Multiple disciplines cooperation is helpful to improve the efficacy and safety of medication treatment for patients.

Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease (ESRD).Early diagnosis is very important in preventing the development of DKD.Urinary albumin excretion rate (UAER) and glomerular filtration rate (GFR) are widely accepted as criteria for the diagnosis and clinical grading of DKD,and microaibuminuria has been recommended as the first clinical sign of DKD.The natural history of DKD has been divided into three stages:normoalbuminuria,microalbuminuria,and macroalbuminuria.However,this clinical paradigm has been questioned recently,as studies have shown that a portion of diabetes mellitus (DM) patients with normoalbuminuria have progressive renal insufficiency,referred to as normoalbuminuric diabetic kidney disease (NADKD) or nonalbuminuric diabetic nephropathy.Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common,and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted.Currently,the pathogenesis of NADKD remains unclear,but many clinical studies have identified some clinical and pathological features of NADKD.In addition,the long-term outcomes of NADKD patients remain controversial.In this article,we reviewed the latest studies addressing the pathogenesis,pathology,treatment and prevention of NADKD.

Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique, has been increasingly used to treat bipolar depression. Researchers recently noticed the risk of tDCS-emergent mania/hypomania in depressed patients and started to evaluate this risk by launching a meta-analysis. Here we present a female with bipolar II depression who rapidly developed hypomanic switching during bifrontal tDCS.
Bipolar Disorder* ; Depression ; Female ; Humans ; Transcranial Direct Current Stimulation*

This study was aimed to investigate the effects of peripheral blood Th17 cells and their secreting IL-17, IL-21 in the occurrence and development of multiple myeloma (MM). A total of 55 patients with MM were divided into non-remission group (group A , n = 30), remission group (group B, n = 25); healthy volunteers were used as control group (group C , n = 30). The concentration of IL-17, IL-21 and IL-6 in the peripheral blood mononuclear cell (PBMNC) culture supernatant were determined with ELISA. The ratio of Th7 cells in PBMNC was determined by flow cytometry. The results showed that IL-17, IL-21 levels and ratio of Th17 cells in group A were much higher than those in group B and C (P < 0.05), IL-17, IL-21 and the ratio of Th17 cells between group B and group C were not significantly different (P > 0.05); IL-17 level in non-remission MM group positively correlated with IL-6 level (r = 0.782, P < 0.05), IL-21 level in non-remission MM group positively correlated with IL-6 level (r = 0.778, P < 0.05). It is concluded that Th17 cells as a initiating factor may be involved in the immune pathogenesis of MM patients, promoting the progress of the disease.
Case-Control Studies ; Female ; Humans ; Interleukin-17 ; blood ; Interleukin-6 ; blood ; Interleukins ; blood ; Male ; Middle Aged ; Multiple Myeloma ; blood ; Th17 Cells ; metabolism

The purpose of this study was to investigate the effect of bisphosphonate combined with chemotherapy on bone mineral density (BMD) of patients with multiple myeloma (MM) and analyse its value of BMD detection in clinic of these patients. 53 MM cases were enrolled in this study, including 33 newly diagnosed, 10 refractory/relapsed and 10 stable cases. They were divided randomly into two groups, 33 MM cases were treated with bisphosphonates combined with chemotherapy and 20 MM cases were treated with chemotherapy alone. The chemotherapy schedules for all patients were same. BMD was tested using the dual energy X-ray absorptiometry at 2 time points, i.e. pretreatment (basal level) and 12 months after treatment with chemotherapy and bisphosphonates. Comparisons was performed with t tests using SPSS 11.0 software. The results indicated that there was minor difference between 2 groups for BMD scores of whole body and lumbar vertebra (L1-L4), but no difference for scores of the near-end of left femur. After treatment for 12 months, all BMD scores (whole body, lumbar vertebra and the near-end of left femur) increased significantly in the bisphosphonate combined with chemotherapy group (P < 0.05). In contrast, only minor changes were seen in chemotherapy alone group. It is concluded that the bisphosphonate combined with chemotherapy has displayed promotive effect on BMD of MM patients, the detection of BMD is sensitive and special method for monitoring therapeutic effect of bisphosphonate in MM patients, thus has useful value in clinic of these patients.
Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Bone Density ; drug effects ; Diphosphonates ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; metabolism ; pathology

Hepcidin can regulate cell irons' efflux transport. The expression of hepcidin can be influenced by the body signals (such as serum ferritin and erythropoietin levels) as well as inflammation, hypoxia and other disease states. These stimulus activate the signaling pathway of BMP-the SMAD, the JAK-STAT and HIF1 through the liver parenchymal cell surface type I transmembrane glycoprotein of HFE, transferrin receptor 1, 2, hepcidin regulatory proteins, thereby changing the hepcidin gene transcription, regulating the expression levels of hepcidin. However, the molecular mechanism that regulate hepcidin expression is unclear. From the signal factors that affect hepcidin expression and signaling pathways involved in its expression, the latest research progress on regulatory mechanism of hepcidin are summarized.
Animals ; Antimicrobial Cationic Peptides ; metabolism ; Hepcidins ; Humans ; Membrane Proteins ; metabolism ; Signal Transduction

OBJECTIVETo explore the clinical value of urine N-telopeptides of type I collagen (uNTX) and serum bone specific alkaline phosphatase (sBAP) in myeloma bone disease, and to understand the role of bisphosphonates therapy for multiple myeloma(MM) osteolytic bone lesion.

METHODSThirty-three MM cases were treated with bisphosphonates combined with chemotherapy (considered as treatment group), and 20 untreated MM cases with chemotherapy alone considered as control group. uNTX was detected by ELISA, and sBAP by chemiluminescence analysis.

RESULTS(1) There was no significant differences in uNTX between treatment \[(173.74 ± 14.55) µg/L\] and control groups \[(129.79 ± 12.13) µg/L\] before bisphosphonates treatment (P > 0.05). After six-month treatment, there was significant differences between two groups \[(85.71 ± 8.23) µg/L and (121.59 ± 12.43) µg/L, respectively\] (P < 0.05); Meanwhile, there were significant differences in uNTX between before and after three-month treatment (P = 0.045) and between before and after six-month treatment (P < 0.01) in treatment group. (2) There was no significant differences in sBAP concentration between treatment and control groups \[(4.78 ± 0.55) µg/L and (8.42 ± 1.32) µg/L, respectively\] before treatment (P > 0.05). After six-month treatment, there were significant differences between them \[(16.01 ± 0.52) µg/L and (9.62 ± 1.29) µg/L, respectively\] (P < 0.01). Meanwhile, in treatment group, there was no significant differences between before and after three-month treatment (P > 0.05), but being significant difference between before and after six-month treatment (P < 0.01).

CONCLUSIONuNTX, sBAP are important early sensitive index to measure the osteolytic bone lesion in MM patients. Bisphosphonates can significantly improve the osteopathy in MM cases.

Adult ; Aged ; Alkaline Phosphatase ; blood ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Density ; Bone and Bones ; metabolism ; Collagen Type I ; urine ; Diphosphonates ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; metabolism

BACKGROUND:Kawasaki disease (KD) is a common cause of acquired heart disease in children. Recent studies have focused on the biochemical markers of the myocardium, their high sensitivity and specificity and significance in the diagnosis of KD. This study aimed to determine the serum level of brain natriuretic peptide (BNP) and its relation with the heart function of children with KD and to explore its clinical value in diagnosis of KD. METHODS:Forty-three KD children, aged from 5 months to 8 years (mean 2.3±0.6 years ), were admitted to Qingdao Children's Hospital from February 2007 to April 2009. Among them 27 were male, and 16 female. The 43 patients served as a KD group. Patients with myocarditis, cardiomyopathy, congenital heart disease and other primary heart diseases were excluded. Thirty healthy children, aged from 3 months to 15 years (mean 2.5±0.8 years) or 17 males and 13 females served as a control group. There were no significant differences in age and gender between the two groups (P>0.05). In the KD group, ELISA was used to measure the levels of serum BNP in acute and convalescent stages;and in the control group, the levels of serum BNP were measured once randomly. Left ventricular ejection fraction (LVEF), left ventricular shorten fraction (LVSF), cardiac index (CI) and left ventricular inflow velocity through the mitral annulus (including E-velocity and A-velocity) were measured by two-dimensional echocardiography in the acute and convalescent stages in the KD group. All data were expressed as mean±SD. The methods of analysis included Student's t test and the linear regression analysis test. P<0.05 was considered statistically significant. RESULTS:The level of serum BNP in the acute stage (517.26±213.40) ng/ml was significantly higher than that in the convalescent stage (91.56±47.97) ng/ml in the control group (37.55±7.56) ng/ml (P<0.01). The levels of LVEF, LVSF and CI in the acute stage were significantly lower than those in the convalescent stage (P<0.05), but the E/A level was not significantly different between the acute and convalescent stages (P>0.05). Linear regression analysis showed that the BNP level was negatively correlated with the levels of LVEF, LVSF and CI(r=-0.63, -0.52, -0.53, P<0.05) , but not significantly correlated with the E/A level (r=-0.18, P>0.05). CONCLUSION:The levels of serum BNP are significantly increased in KD patients, and are negatively correlated with the levels of LVEF, LVSF, and CI. The detection of serum BNP level is of clinical significance in the diagnosis of KD.

Objective　In a RCT study, the safety and efficacy of sabot (a slow-release salbuteral) and volmax (controlled-release salbuterol) were compared in bronchial asthma. Methods　40 patients with moderate to severe asthma were randomly divided into two groups and treated by sabot or volmax for 2 weeks. The FEV1%, peak expiratory flow (PEF), symptom score and use of rescue ventolin were measured to evaluate the effect of treatment. Results　After treatment FEV1%, PEF and symptom score improved and the need for inhaling short-acting beta 2-agonis in both groups reduced significantly. There was no difference of these improvement between two groups. Conclusion　The safety and efficacy of sabot for treatment of asthma was similar to volmax.

OBJECTIVETo investigate the therapeutic effects of oral zinc supplement in infants and young children with rotavirus enteritis, and its preventive effects against diarrhea recurrence within 3 months after treatment.

METHODSA total of 103 infants and young children with rotavirus enteritis were randomly divided into zinc supplement group (n=51) and conventional treatment group (n=52). Both groups were equally treated with a comprehensive therapy, besides which the zinc supplement group received zinc gluconate granules for 10 days. The treatment outcomes were examined at 72 hours after treatment, and the time required for the disappearance of positive symptoms and the recovery of injured extra-intestinal organs were determined. In addition, these patients were followed up for 3 months to determine the incidence of diarrhea recurrence after treatment.

RESULTSThe overall response rate in the zinc supplement group was significantly higher than that in the conventional treatment group (90% vs 75%; P<0.05). The durations of diarrhea, high fever, and vomiting in the zinc supplement group were significantly shorter than that in the conventional treatment group (P<0.05). In addition, the recurrence rate of diarrhea and the incidence of severe diarrhea within 3 months after treatment in the zinc supplement group were significantly lower than in the conventional treatment group (P<0.05).

CONCLUSIONSOral zinc supplement as adjunctive therapy is effective in treating infants and young children with rotavirus enteritis, and reducing the incidence and severity of diarrhea recurrence in the subsequent 3 months.

Child, Preschool ; Dietary Supplements ; Enteritis ; drug therapy ; Female ; Humans ; Infant ; Male ; Recurrence ; Rotavirus Infections ; drug therapy ; Zinc ; administration & dosage