Diet therapy is considered as the basic treatment of chronic kidney disease (CKD),and its primary goals are improving metabolic disorder,relieving symptoms and prevent complications,hence to retard renal function lost of CKD patients.However,there have been controversies about the results of clinical studies on nutritional treatment for CKD.This article reviews the effectiveness,safety and compliance of low-protein diet (LPD) for CKD patients,and related clinical management strategies.The article also recommends the feasible diet scheme to provide a reference of clinical LPD therapy for patients with CKD.

Objective To discuss the feature of the ultrasonic image and the clinical value of this test way.Methods six Cases of hypoplastie cartilage from 30 thousand fetus were detected.Results Shortened and widened long bone in four limbs,betl shape in chest,enlarged head and inflated abdomen are the main features of the ultrasonic image.Conclusion Ultrasound is superior to other methods in diagnosing fetus'hypoplastic cartilage.

Objective:To explore the effect of integrated treatment of Chinese and western medicine on muhiple organ dysfunction syndrome (MODS).Methods:129 cases of MODS were treated by syndrome differentiation of TCM with the“four syndrome and four methods”based on the routine western medicine treatment from 1997 to 2003,and their therapeutic effects were evaluated. Results:Of the 129 cases,75 were cured and 54 died,the mortality being 41.9%.After treatment of TCM,the state of illness of the patients were ameliorated,the level of blood endotoxin decreased and the clinical syndrome improved.Conclusion:Integrated with western medicine,the“four syndrome and four methods”has obvious therapeutic effect.

Objective To investigate the correlation between Bispectral index (BIS) value and the prognosis of patients with coma in ICU.Methods A total of 208 patients with coma in ICU were divided into 4 groups according to the BIS value.In group I,BIS value was 0 to 20; groupⅡ,BIS value 21 to 40; group Ⅲ,BIS value 41 to 60; and group Ⅳ,BIS value greater than 60.Comparison of the difference in BIS value with the differences in prognosis of patients with coma was carried out between four groups,and the prognosis of patients with coma was stratified into consciousness,coma,vegetative state,and brain death.Subsequently,the best cutoff score of BIS value calculated for determining the correlation between BIS and mental state was proposed.Results There are no significant differences in the age and APACHE Ⅱ scores between four groups (P ＞ 0.05).It was inverse correlation between BIS value and mental state (r =-0.749,P =0.00).According to the ROC curve,as BIS value was greater than 42.5,there were higher sensitivity and specificity in Conscious-Coma patients.Conclusions BIS value is correlated with the prognosis of patients with coma in ICU,and BIS value can be a useful marker for estimating the prognosis of comatose patients.

Objective To observe the influence of Xuebijing injection on apoptosis, apoptotic related gene mRNA levels and activity of caspase3 in activated T lymphocyte. Methods The T lymphocytes were obtained from the spleens of BALB/c mice and be induced to be activated and apoptotic by cultured with Con A + IL-2. Apoptosis was investigated by flow cytometry. RT-PCR was used to detect the expression of Fas, FasL, Bcl-2, Bax, IL-2 mRNA, and the activity of caspase3 in T lymphocyte was also detected by spectrophotometric method. In the mean time, the effect of Xuebijing injection on those parameters was observed. Results After the induction, T lymphocyte apoptosis raised at 18 h. At 6 h after the induction, there was no expression of FasL, Bax mRNA, and no change in the expression of Fas and Bcl-2 mRNA. At 18 h, the expressions of Fas, FasL, Bax mRNA rised and the expression of Bcl-2 mRNA lessened. The activity of caspase3 also ascended. Xuebijing injection can cut down the apoptosis induced by induction, make the expression of Fas, FasL, Bax mRNA decreased and Bcl-2 mRNA improved. The activity of caspase3 also fallen after the Xuebijing injection treated. It can promote the expressions of IL-2 mRNA at early phase of AICD (6 h) and depress the expressions at the late period (18 h). Conclusion The apoptosis of T lymphocyte induced by activation was regulated by the change of Fas, FasL, Bcl-2, Bax mRNA expression. Xuebijing injection can ameliorate the apoptosis through regulating the expression of IL-2 and apoptotic related gene mRNA, improve the proliferation activity of T lymphocyte.

SUMMARY Mercury intoxication is a rare cause of severe hypertension. A case of mercury intoxication presented with severe hypertension and erythromelalgia was reported. A 10-year-and-5-month-old girl presented with recurrent rash and painful hands for 2 months, with seizure attack and episodic loss of consciousness for one hand half months. The girl was found to have red painful hands, a blood pressure 170/120 mm Hg(1 mm Hg=0.133 kPa), tachycardia and hypokalemia (2.83-3.25 mmol/L, reference value 3.5-5.5 mmol/L). An extensive investigation ensued. Elevated renin-angiotensin and aldosterone were demonstrated in plasma. Cranial MRI T2 weighed images showed widespread white matter signal abnormalities, which particularly involved parietal, occipital and frontal lobes. With hypertension controlled, white matter signal abnormalities weakened. Other symptoms included insomnia, nausea and paroxysmal abdominal pain. The girl was found to have a raised concentration of mercury in urine (0.171 mg/L, reference value

OBJECTIVE To observe the influence of XueBiJing on apoptosis,apoptosis-associated proteins and activity of caspase 3 in spleen of sepsis rats.METHODS The sepsis models were produced by cecal ligation and puncture(CLP).Ninety-six Wistar rats were randomly divided into four groups:control group(n=8),sham operation group(n=8),model group(n=40),and XueBiJing treatment group(n=40).TUNEL method was used to assess the apoptosis,the activity of caspase 3 and the percent of CD3+ lymphocyte in spleen were tested,and the expressions of FasL and Bcl-2 in spleen were detected by immunohistochemistry methods.RESULTS The integrated optic density(IOD) of FasL expression in spleen for sham operation group was 4.54?1.41,but in model group was much higher(757.96?188.10 at 48 h) and the IOD of Bcl-2 in sham operation group was 594.05?183.32,but in model group was only 22.71?9.22 at 48 h.There were a few apoptosis appeared in sham operation group(0.87?0.51),the activity of caspase 3 was low(4.34?1.34),and the percent of CD3+ lymphocyte in spleen was 63.49%.At 4 h after the CLP operation,there were more apoptosis appeared in model group(8.88?3.68),the activity of caspase 3 reached to 12.22?3.15,and the percent of CD3+ lymphocyte in spleen decreased to 52.09%.After the intervention of XueBiJing,the expression of FasL reduced and Bax raised.The intervention also lightened the activity of caspase 3 and the apoptosis,and made the percent of CD3+ lymphocyte returned to normal level.CONCLUSIONS The activation of apoptosis pathway makes the apoptosis over-appeared,also induces the immune system out-of-balance.The intervention of XueBiJing can ameliorate the immune paralysis of sepsis by regulating the expression of apoptosis-associated proteins and lighten the apoptosis of lymphocyte.

Objective:To investigate the expression of MHC class Ⅰ chain-related gene A(MICA) on different human tumor cells(K562,MCF-7,HR-8348,CNE-2,HeLa) and their sensitivity to NK cytotoxicity.Methods:Cytotoxicity of NK cells(isolated from 3 healthy persons) were detected by LDH releasing assay at different effect-to-target cell ratios(E∶T). The expression of MICA was measured by FACS.Results:Different level of MICA was detected on surface of tumor cell lines, anti-MICAmAb could partially inhibit the cytotoxicity of NK cells.Conclusion:NKG2D-MICA interaction can trigger the cytotoxicity of NK cells against tumor,NK cells can be a kind of effector cell for the treatment of some certain tumors.

Objective To study the quality and effect of root cause analysis (RCA) on long-range video EEG monitoring on epilepsy patients.Methods The process of RCA long-range video EEG monitoring on patients with epilepsy was investigated to find out the root causes for quality of epilepsy capturing from pseudo differential of EEG and video effects.Then the measures were taken to improve the quality of monitoring.Result After the intervention,except canmera not clear enough,the incidences were significantly decreased compared with pre-intervention (all P ＜ 0.001).Conclusions Root cause analysis is effective in improving the quality of long-range video EEG monitoring on epilepsy patients.It is worth clinically promoting.

OBJECTIVE:To develop a method for simultaneous determination of chlorogenic acid,geniposide,gentiopicro-side,ferulic acid,baicalin and ammonium glycyrrhizinate in Yindan pinggan capsule. METHODS:HPLC method was adopted. The separation was performed on Wonda SilTM-C18 column with mobile phase consisting of acetonitrile-0.4% phosphoric acid solu-tion(gradient elution)at the flow rate of 0.8 mL/min. The detection wavelength were set at 325 nm(chlorogenic acid,ferulic ac-id),250 nm (geniposide,ammonium glycyrrhizinate) and 275 nm (gentiopicroside,baicalin). The column temperature was 30 ℃. RESULTS:The linear ranges were 0.087-3.480 μg for chlorogenic acid(r=0.9998),0.201-8.040 μg for geniposide(r=0.9997),0.200-8.000 μg for gentiopicroside(r=0.9995),0.016-0.640 μg for ferulic acid(r=0.9999),0.105-4.200 μg for ba-icalin (r=0.9999) and 0.028-1.120 μg for ammonium glycyrrhizinate (r=0.9995),respectively. The limits of quantitation were 1.31,0.75,1.14,1.25,0.94,0.98 ng,and the limits of detection were 0.87,0.67,0.96,0.93,0.60,0.88 ng,respectively. RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 99.9%-101.9%(RSD=0.7%,n=6), 98.7%-100.9%(RSD=0.9%,n=6),98.1%-101.5%(RSD=1.4%,n=6),98.5%-101.3%(RSD=1.3%,n=6),98.5%-101.7%(RSD=1.2%,n=6),98.2%-101.4%(RSD=1.2%,n=6),respectively. CONCLUSIONS:The method is simple and accurate , can be used for simultaneous determination of chlorogenic acid,geniposide,gentiopicroside,ferulic acid,baicalin and ammonium glycyrrhizinate in Yindan pinggan capsule.