Renal interstitial fibrosis involves several pathological mechanisms, including excessive activation of fibroblasts, epithelial-to-mesenchymal transition, and so on. Chinese herbal medicine can resist or lighten renal interstitial fibrosis by intervening one way or more.

Objective To investigate the features of renal lesion in patients with rheumatoid arthritis (RA). Methods The clinical pathology changes of 20 patients with renal lesion by RA were analyzed. Results The clinical features of patients showed chronic glomerulonephritis in 8 cases,nephritic syndrome 4 cases, chronic interstitial nephritis in 3 cases, chronic renal failure in 4 cases, and acute renal failure in 1 case. The patients with glomerulonephritis accompanied with the increase of immunoglobulin, erythrocyte sedimentation rate, C-reactive protein or rheumatoid factor. Kidney biopsy of 7 patients found membranous nephro-pathy in, IgA nephropathy in 3 and vasculitis in 1. Conclusion The common renal lesion in RA is glomerulonephritis, with mesangial proliferative glomerulonephritis or membranous nephropathy. One of the basic pathoh,gi,.al changes is vasculitis,which could result in necrotizing vasculitis.The disorder of immunologic function couht play important role in renal damage in patients with RA.

Objective To study the benchmark dose (BMD) of fluoride concentration in saliva,and to evaluate the significance of saliva fluoride on control and prevention of endemic fluorosis.Methods In September 2014,middle school students in endemic fluorosis areas and non-endemic fluorosis areas in North China Petoleum were selected as objects.The contents of fluoride in water,urine and saliva were determined.The correlation of fluoride content in water,urine fluoride and fluoride concentration in saliva was analyzed.According to the levels of the saliva fluoride concentration,the children were divided into 11 groups,＜ 1.00,1.00-,2.00-,3.00-,4.00-,5.00-,6.00-,7.00-,8.00-,9.00-and ≥ 10.00 mg/L.The prevalence of dental fluorosis and defected dental fluorosis were investigated and the saliva fluoride concentration was calculated by Banch-Mark Dose Software.Results Compared with non endemic areas,the fluoride contents in water,urine and saliva [(2.13 ± 0.13),(1.29 ±0.73),(4.01 ± 3.61) mg/L] were higher than that in endemic areas [(0.67 ± 0.13),(0.38 ± 0.08),(0.75 ± 0.12) mg/L,t =158.730,24.780,18.114,all P ＜ 0.01].The fluoride concentration in saliva was positively correlated with the fluoride content in water and urine in endemic areas (r =0.626,0.945,all P ＜ 0.01).The (BMDs and benchmark dose lower bound (BMDLs) were 0.91,0.54,3.72,3.32 mg/L respectively,calculated by Banch-Mark Dose Software.With the increase of fluoride concentration in saliva,the prevalence of dental fluorosis and defect dental fluorosis had increased too,especially when the fluoride content in saliva was more than 4 mg/L.There were significant doseresponse relationships between the urine fluoride and the prevalence of dental fluorosis and defected dental fluorosis.Conclusion The fluoride concentration in saliva could be used as one of the evaluation indexes of fluorosis,and the BMD of saliva fluoride concentration in endemic fluorosis areas is suggested as 0.91 mg/L.

Objective The purpose of this study was to study the correlation between dental fluorosis, saliva and plaque fluoride levels and urinary fluoride values in adolescents dental fluorosis. Methods A middle school was chosen as a survey point in the study. Two hundred adolescents were examined the degree of dental fluorosis by Dean's method. These adolescents were divided into four groups according to the severity of fluorosis (n = 52, 40, 28 and 80). Fluoride ion specific electrode was used to measure the fluoride levels in dental plaque, saliva, urinary and drinking water. The differences were analyzed b y ANOVA. Correlation of the fluoride levels between dental plaque, saliva, urine and the degree of dental fluorosis were analyzed by the method of multiple linear regression. Results The average fluoride content of drinking water was (2.20 ± 0.40) mg/L. Compared with controls, the fluoride concentrations in dental plaque, saliva and urine were higher in light, medium and severe dental fluorosis groups [(1.55 ± 0.88), (1.94 ± 0.77), (2.74 ± 0.83) than (0.32 ± 0.20) mg/L; (4.44 ± 1.62), (8.09 ± 0.93), (10.72 ± 0.99) than (0.02 ± 0.01) mg/L;(31.77 ± 6.09), (57.98 ± 1.83), (65.98 ± 2.78) than (13.06 ± 2.11) μg/g, all P<0.05]. Urinary fluoride was correlated with fluoride in saliva and dental plaque (r=0.245, 0.440, all P<0.05). Saliva fluoride was correlated with fluoride in dental plaque (r=0.849, P<0.01). The degree of dental fluorosis was correlated with fluoride in urine and saliva (r = 0.497, 0.896, 0.924, all P< 0.01). The multiple linear regression equation between fluoride in urine and the degree of dent al fluorosis, fluoride in dental plaque and saliva was as follow: y = 1.357 + 1.618x1 + 0.001x2 - 0.331x3 ± 0.69. Conclusions The metabolism of fluoride in body is related with oral fluoride repository in adolescents dental fluorosis. Fluoride in urine is influenced by plaque fluoride level, saliva fluoride concentration and the degree of dental fluorosis.

Objective:To study the effects of dental fluorosis on the tooth movement following extraction of adjacent tooth in adoles-cents for orthodontic treatment.Methods:50 adolescents were divided into mild(n =1 3),moderat(n =1 0),severe(n =7)and healthy control(n =20)groups according to the fluorosis severity using Dean's index.4 4 were extracted and appliance was applied. X-ray image was taken 1 week and 1 ,2 and 3 months after appliace activation.Tooth movement was measured cephalometrically by Auto CAD.Results:Tooth moving distance was more(P <0.01 )and the alveolar bone resorption area was smaller in fluorosis group than those in healthy control group(P <0.01 )1 ,2 and 3 months after appliance activation.The moving distance was negativelly relat-ed with bone remodling area(P <0.05).Conclusion:Adolescent dental flurosis play an important role in bone remdodeling in extra-tion sites and tooth movement during orthodontic treatment.

To investigate the incidence and treatment of benign prostatic hyperplasia (BPH) with prostatitis. Methods:2 152 cases of patients withBPH were investigated about their illness history, and the rou tine examination of prostatic fluid, the ultrasonography of prostate, the prostatic special antigen in serum and the urine routine had been done. Results:Among them , 385 patients suffered prostatitis, 87 patients have the obvious symptom of prostatitis, of which only 35 patients were treated discontinuously as prostatitis. Conclusions: The di agnosis and treatment of BPH with prostatitis should be paid special attention to

Purpose:To present the experiences and lessons of emergency management for the obstructive renal failure induced by urinary calculi.Methods:Clinical data of 81 cases of patients with obstructive renal failure from January 1988 to May 2000 was reviewed retrospectively.Results:14 cases were treated by emergent open operation (one died of bleeding ceaselessly), 36 cases by dwelling ureteral stent retrogradely(28 cases succeeded and no severe complications observed, the other 8 cases received nephrostomy of TUL),38 cases treated with percutaneous nephrostomy drainage(3 cases had to undergo nephrectomy, and the other 2 patients died after the primary treatment because of bleeding continually). The serum creatinine level decreased significantly after treatments(P＜0.01).Conclusions:It is noteworthy that the surgical interventions were affected severely by the bleeding tendency caused by uremia, and the complicated surgical intervention could not be carried out before the bleeding tendency be corrected. The indwelling ureteral stent retrogradely is recommended as the first choice of emergent treatment for patients with obstructive renal failure.

Objective To explore the predictive value of dynamic serum phosphorus levels in the evaluation of prognosis in patients with sepsis. Methods A retrospective study was conducted. The septic patients admitted to intensive care unit (ICU) of the Second People's Hospital of Changzhou from January 2016 to June 2017 were enrolled, who were ≥18 years old and whose length of ICU stay > 72 hours. These patients were divided into survival group and death group according to 28-day outcome. The general information, the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score within 24 hours of ICU admission, the serum phosphorus at 1, 3, 5, 7 days after admission were collected. Receiver operating characteristic curve (ROC) was plotted according to the dynamic serum phosphorus levels and APACHE Ⅱ score for evaluating the predictive value of 28-day prognosis. Kaplan-Meier survival curve was used to analyze the 28-day cumulative survival rate between two groups of patients, who were divided according to the corresponding time of the serum phosphorus cut-off value. Results ① Eighty-five patients with sepsis were enrolled, among whom 25 cases were in the death group and the mortality was 29.4%. APACHE Ⅱ score in the death group was significantly higher than that in the survival group (22.28±3.98 vs. 16.05±5.44, P < 0.01), the rate of using vasoactive drugs was significantly higher than that in the survival group [64.0% (16/25) vs. 31.7% (19/60), P < 0.01], but there was no significant difference in the length of invasive mechanical ventilation and ICU stay between two groups.② The level of serum phosphorus was increased in survival group along with time of the treatment, and the death group showed a downward trend. The levels of serum phosphorus at 3, 5, 7 days after admission to ICU in death group were significantly lower than those in survival group (mmol/L: 0.90±0.24 vs. 1.05±0.19 at 3 days, 0.96±0.16 vs. 1.11±0.17 at 5 days, 0.83±0.19 vs. 1.21±0.14 at 7 days, all P < 0.01).③ROC curve analysis showed that APACHE Ⅱ score and serum phosphorus level on the 7th day could significantly predict 28-day mortality in patients with sepsis, and the areas under ROC curve (AUC) of them were 0.813 and 0.945 respectively (both P < 0.01). The AUC of serum phosphorus level on the 3rd day and 5th day were 0.692 and 0.745 respectively (both P < 0.01). Based on serum phosphorus cut-off value 1.01 mmol/L on the 7th day to evaluate the predictive value of 28-day mortality, the sensitivity was 91.7%, the specificity was 84.0%, the positive and negative likelihood ratios were 5.73 and 0.10 respectively. ④ Kaplan-Meier survival analysis showed that the 28-day survival rate was significantly higher and the length of survival was significantly longer if the serum phosphorus were higher than the cut-off value at different time points of ICU admission. The 28-day survival rate was significantly higher and the length of survival was significantly longer in the patients with serum phosphorus > 1.01 mmol/L than those serum phosphorus ≤ 1.01 mmol/L on the 7th day [28-day survival rate: 93.2% (55/59) vs. 22.7% (5/22), χ2= 49.697, P = 0.000; survival period (days): 27.1±3.6 vs. 19.8±7.8, t = 4.768, P =0.000]. Conclusion The continuous decline of serum phosphorus indicates poor prognosis, and the serum phosphorus level on the 7th day is one of the most important indicator to evaluate the prognosis of patients with sepsis.

Objective: To determine the correlation of IgM deposition with clinic-pathological features and outcomes of IgA nephropathy patients. Methods: A total of 1060 patients, who were diagnosed as IgA nephropathy by renal biopsies between 2001 and 2007 in Guangxing Hospital were enrolled. According to immunofluorescent test, patients were divided into patients with mesangial IgM deposition and patients without IgM deposition. Renal survival curves were assessed by Kaplan-Meier method. The effect of IgM deposition on outcomes of IgA nephropathy patients was examined by univariate and multivariable Cox proportional-hazards regression. Results: Among 1060 IgA nephropathy patients, there were 750 patients with IgM deposition and 310 patients without IgM deposition. (1) Urinary protein and uric acid in patients with IgM deposition were significantly higher than those in patients without IgM deposition (all P<0.05). Other clinical indicators shown no statistical difference (all P>0.05). Moreover, IgM deposition patients had higher serum IgA, serum IgG and serum IgM (all P<0.05). (2) In pathological indicators, IgM deposition patients had more segmented sclerosis or adhesions (S1 of Oxford classification), activity lesions as inflammatory cell infiltration and mesangial proliferation, and chronic pathological changes as tubular atrophy, segmented glomerular damage than patients without IgM deposition (all P<0.05). (3) All patients were followed-up for a median of 89.7(61.8, 113.4) months, Kaplan-Meier analysis revealed that kidney survival rate was significantly lower in IgM deposition patients compared with patients without IgM deposition (Log-rank χ²=4.95, P=0.026). In a univariate Cox hazards regression mode, IgM deposition was a risk factor for poor prognosis of IgA nephropathy patients (HR=1.597, 95% CI 1.053-2.422, P=0.027). However, in a multivariable Cox analysis, IgM deposition shown no influence on outcomes of IgA nephropathy patients (HR=1.409, 95% CI 0.921-2.156, P=0.114). Conclusions IgA nephropathy patients with IgM deposition have higher urinary protein, and more serious pathological damage and immune fluorescence deposition. IgM deposition affects renal survival of IgA nephropathy, while IgM deposition is not an independent risk factor for prognosis of IgA nephropathy.

The clinical manifestations of Japanese encephalitis virus infection are often acute encephalitis, and etiological diagnosis is a common diagnostic method. It is difficult to detect and isolate viruses clinically, and the types of pathogens detected are relatively limited. Metagenomics second-generation sequencing (mNGS) is a rapid and accurate molecular diagnostic method, which can improve the detection rate and types of pathogenic microorganisms. Pathogens uncommon in central nervous system infections can be detected. This paper reports a 27-year-old male patient with nausea and vomiting, high fever, disturbance of consciousness, and multiple organ failure as the main clinical manifestations. Japanese encephalitis virus was considered clinically, but etiological evidence was lacking. Japanese encephalitis virus was detected by cerebrospinal fluid mNGS, which greatly improved the accuracy of diagnosis of Japanese encephalitis virus infection.