ObjectiveTo review the clinical features,management and prognosis of renal Ewing's sarcoma (ES) of a single case report.MethodsA single case of renal ES was reported.A 33-year-old male presented with a mass in the left kidney found during a three day medical examination.B-ultrasound examination showed a lesion with rich blood flow signals and well defined margins in the inferior portion of the left kidney.The CT scan revealed a solid mass of 5.1 cm × 4.7 cm in the inferior portion of the kidney with un-even enhancement by contrast.A possible diagnosis of renal carcinoma was given prior to surgery.No metastasis was proven.A literature review of ES was then conducted.ResultsA left retroperitoneoscopic radical nephrectomy was successfully performed.Gross pathologic examination showed a solid tumor with necrosis,localized at the inferior pole of the left kidney.The histopathological examination revealed the tumor consisted of small round tumor cells,which were positive for CD99,vimentin and PAS,but negative for WT-1.A diagnosis of ES of the kidney was then determined.The patient received alternating short cycle ( CTX + VCR + THP) and long cycle ( IFO + VP-16) adjuvant chemotherapy for 6 cycles after the operation.There has been no evidence of recurrence at the 14-month follow up.ConclusionsES of the kidney is a rare disease with no specific clinical feature in most cases.Diagnosis of renal ES must be confirmed with histological features.Surgery combined with radiotherapy and chemotherapy is the main method of therapy for renal ES.The prognosis of renal ES is poor.

Objective:To probe the effect of intermittent aerobic exercise on adrenomedullin secretion of kidney in hypertensive nephropathy rat (HNR),and investigate the renal mechanism for exercise in the prevention and treatment of hypertension.Method:Thirty-two HNRs were divided into two groups:intermittent exercise group (Group IAE) and control group (Group C).The IAE group performed intermittent treadmill exercise for 8 weeks and their blood pressure was measured before and after exercise by tail pressure of HNR,and serum ADM was detected by enzyme linked immunosorbent assay.Adrenomedullin (ADM) was expressed in kidney by immunohistochemistry.Quantification of specific receptor RAMP2 and CRLR in kidney ADM was detected by immunoblotting.Result:The blood pressure in the Group IAE was significantly lower than that in the Group C(P＜ 0.05).The expression of ADM of kidney and serum in the Group IAE was obviously higher than that in the Group C.The quantity of RAMP2 and CRLR in kidney was obviously increased(P ＜ 0.05).Conclusion:Intermittent aerobic exercise increases serum ADM of HNR with the up-regulated expression of ADM in kidney and their specific receptor CRLR and RAMP2.The increase of serum ADM induced by intermittent aerobic exercise may be related to the change of ADM and the regulation of its specific receptor which may be one of the mechanisms for intermittent aerobic exercise in the prevention and treatment of hypertension.

A facial allotransplanted patient presented hyperglycemia with blood glucose ranged 14. 3 -33. 3 mmol/L after receiving immunosuppressive drugs and glucocorticoids. To control the blood glucose level, the patient was treated with two subcutaneous doses of 10 U human neutral protamine hagedorn (NPH) insulin, and the fasting glucose level came down to 3. 6 - 9. 4 mmol/L. Then the continuous subcutaneous infusion of insulin aspart ( Novo Industri) was administrated (from 96 to 21 U/d) , and the fasting blood glucose levels were 3. 9 -4. 6 mmol/L. With oral administration of Metformin and Repaglinide, the fasting blood glucose was maintained to 4. 3 -5.9 mmol/L. With these medications, the blood glucose level of the patient was under good control and the acute and chronic complications of hyperglycemia were effectively prevented.

Objective:To establish the model of rats with UC by 2,4,6 trinitrobenzene sulfonic acid ( TNBS)/ethanol to understand the changes of IL-17,IL-23,TGF-β1,IFN-γin pathogenesis of ulcerative colitis (UC) and the impacts of mesalazine,mont-morillonite powder and clostridium on that.Methods:85 rats were divided randomly into 6 groups including the model ,mesalazine, montmorillonite,clostridium,mesalazine combined with montmorillonite powder group (15 rats per group ) and an additional control group of 10 normal rats.TNBS/ethanol was used to establish the model of rats with UC.The dosage of model, mesalazine, montmorillonite powder ,clostridium and mesalazine combined with montmorillonite powder were converted by surface area of rat and given to the rats by gastric-tube daily.All rats were executed at the 12th day of the molding and treatment ,and the blood and colon samples were collected.The content of IL-17,IL-23,TGF-β1,IFN-γwas measured in the blood by the ELISA method.The different changes of the four cytokines were compared separately.Results: ( 1 ) TNBS/ethanol was used to establish the model of rats with UC.The obvious inflammation can be observed on distal colon of rats by pathologic sections of HE stained .(2) The levels of plasma IL-17,IL-23 and IFN-γin the model,mesalazine,montmorillonite,clostridium and mesalazine combined with montmorillonite powder group were higher than ones in the control gruop (P<0.05),meanwhile,the levels of plasma TGF-β1 are lower (P<0.05).3.Comparing with the model group,the levels of plasma IL-17,IL-23 and IFN-γin the mesalazine,montmorillonite,clostridium and mesalazine combined with montmorillonite powder group were lower , and the levels of TGF-β1 were higer.The differences have statistic significative ( P<0.05).(4)Comparing the efficacy of treatment among mesalazine ,montmorillonite powder,clostridium and mesalazine combined with montmorillonite powder ,mesalazine and mesalazine combined with montmorillonite powder gets the best results ( P<0.05 ).The efficacy between montmorillonite powder and clostridium is similar.Conclusion:(1) TNBS/ethanol can be used to establish the model of rats with UC and can be successfully approved by the measurement of symptoms and pathologic investigation .(2)The IL-17,IL-23 and IFN-γare very active higher in the blood of rats with experimental ulcerative colitis induced by TNBS /ethanol, and have a positive correlation with inflammation.The TGF-β1 is in decrease in the blood of rats with colitis , and has a Negative Correlation with inflammation.(3)Mesalazine,montmorillonite powder,clostridium and mesalazine combined with montmorillonite powder may renovate the damage of inflammatory tissues of rats with experimental ulcerative colitis , and relieve the symptom of inflammation by reducing exudation of proinflammatory cytokines IL-17, IL-23 and immune regulatory cytokines IFN-γby producing the exudation of proinflammatory cytokines TGF-β1 to be good for recovery of UC.

Objective To provide valid data and useful genetic counseling in the clinical application of non‐invasive prenatal test (NIPT) ,fetal chromosomal disorder were screened by massive parallel sequencing and made a follow‐up study .Methods Preg‐nant women with Down screening in high‐risk were screened by NIPT ;NIPT verified high‐risk individuals were suggested for kary‐otyping ;and we follow up on whoever showed low risk by NIPT before and after their deliveries .Results (1)Totally 1 676 cases of pregnant women were tested by NIPT ,25 cases prompted to be abnormal ,with an abnormal rate of 1 .49% ,karyotype analysis re‐sults in 12 cases of abnormalit ,the accuracies of NIPT for T21 ,T18 ,XO ,XXY ,and XYY were 99 .93% ,100 .00% ,99 .66% , 100 .00% ,100 .00% respectively ;the accuracy of NIPT for women with advanced paternal age and twins were both 100 .00% ;kary‐otyping positive individuals underwent abortion ,which gives a prenatal intervention rate of 100 .00% .(2)Out of 1 651 cases of NIPT low risk testers ,1 468 cases were successfully followed up ,with a 88 .91% success rate .We found chromosome abnormality with one case of inversion of chromosome 9 (maternal) .(3)Ultrasound‐detection possessed 98 .17% accuracy and 7 .69% in detec‐tion rate;in high‐risk pregnant woman ,Down screening had an accuracy of 0 .88% and false positive rate of 99 .12% ;98 .71%women were avoided prenatal diagnosis via NIPT .Conclusion Compare to ultrasound and maternal plasma screening ,NIPT is a far more accurate prenatal screening approach .To build effective follow‐up and service systems of NIPT is necessary to reduce birth de‐fects in medical institutions .

Objective To implement comprehensive nutrition management based on the advanced concept of health quotient in elderly patients with femoral neck fracture,and explore the effect in improving nutriture of patients after operation.Methods The concept of health quotient was introduced to comprehensive nutrition management,and a systematic assessment and screening system of three-level nutrition was built.Besides,we carried out hierarchical and thinning nutritional intervention based on health quotient score and health education system with continual improvement.The index of health quotient and relevant index of nutrition were evaluated among 71 patients after being hospitalized and 14 days after operation.Results There were statistically significant differences in the score of health quotient and McDonald nutrition index among 71 elderly patients with femoral neck fracture after being hospitalized and 14 days after operation (P ＜ 0.05).Conclusions Nutrition management based on health quotient can solve the problem related to nutrition and health after operation among elderly patients with femoral neck fracture,improve the nutritional support and nutrition-related indicators,it is conducive to the recovery.

Objective To explore the effect of finger exercises and cognitive training on cognitive function, ability of daily living and quality of life of elderly patients with mild cognitive impairment. Methods About 90 elderly patients with mild cognitive impairment were randomly divided into experimental group and control group. In the experimental group finger exercises and cognitive training were implemented, and the control group was given routine care and health education. 3 months and 6 months after the intervention, the two groups were compared in respect of the cognitive function, ability of daily living and quality of life. Results The difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between the two groups 3 month and 6 month after the intervention (P<0.05). Pairwise comparison done at three time points (before intervention, 3 months and 6 months after intervention) in the experimental group showed that the difference of cognitive function, daily living ability and quality of life in the elderly were statistically significant between before intervention and 3 months after intervention, before intervention and 6 months after intervention. Conclusion The finger exercises and cognitive training in elderly patients with mild cognitive impairment can effectively strengthen the cognitive function and ability of daily living, and improve the quality of life.

Objective To expore the effects of international resident assessment instruments (InterRAI) comprehensive evaluation and intervention on nutritional status of aged inpatients.Methods Totally 235 aged inpatients of a tertiary hospital from February to December 2015 were selected,and 126 cases of them had nutritional risk after the test of NRS 2002. Patients with nutritional risk were randomly divided into the intervention group and the control group,with 63 cases in each group. Patients in two groups were all given dietary estimation,nutritional education,and enteral or parenteral nutrition;besides,patients in the intervention group also received InterRAI comprehensive evaluation and intervention. At the first day and three months after intervention,Inbody 720 body composition analyzer was used to test the protein,body fat, skeletal muscle and BMI,and the second nutritional evaluation was conducted through blood nutrition indicators (plasma total protein concentration,serum albumin,prealbumin and transferrin). SPSS 17.0 software was used to analyze the data,and measurement data adopted two independent samples to design thet test.Results At the first day after admission,there were no differences in body composition index and blood nutrition indicators between two groups (P>0.05). Reexamination after three months showed that,the protein (8.5±0.7) kg,body fat (16.5± 4.8) kg,skeletal muscle (24.2±4.0) kg and BMI (17.2±5.6) kg/m2 in the intervention group,were all higher than the protein (6.6±0.9) kg,body fat (20.2±5.6) kg,skeletal muscle (18.5±3.1) kg and BMI (16.5±6.1) kg/m2 in the control group (t=9.595,8.055,11.331,2.015;P<0.05). and blood nutrition indicators in the intervention group, were better than that in the control group (P<0.05). The plasma total protein concentration (67.1±6.9) g/L, serum albumin (44.3±7.4) g/L, prealbumin (245.1±15.4) mg/L and transferrin (2 530.3±190.5) mg/L in the intervention group,were all higher than the plasma total protein concentration (55.6±7.2) g/L,serum albumin (32.5±6.3)g/L, prealbumin (210.1±16.8) mg/L and transferrin (2 001.1±169.8) mg/L in the control group (t=12.805,7.890, 9.421,14.427;P<0.05).Conclusions The InterRAI comprehensive evaluation and intervention can effectively improve the nutritional status and the quality of life in the elderly,and reduce the nutritional risk.

Objective:To evaluate the diagnostic value of refined transthoracic lung ultrasound(TLUS) scoring method in interstitial lung diseases(ILD).Methods:The TLUS was performed in 39 ILD patients in respiratory department and immunology department of the Second Affiliated Hospital of Fujian Medical University from March 2019 to February 2020. The ultrasonic recordings were evaluated by Buda ultrasound scoring method and refined ultrasound scoring method. The diagnostic efficacies of the refined ultrasound scoring method, Buda ultrasound scoring method and high resolution computed tomography(HRCT) scoring method for ILD were analyzed. The correlations between refined ultrasound score and Buda ultrasound score/HRCT score were evaluated. The difference of diagnostic efficacy between refined ultrasound scoring method and Buda ultrasound scoring method were analyzed in different severity of ILD. Then, the HRCT Warrick scoring method was used as the criterion to judge the severity of ILD, and the receiver operator characteristic (ROC) curve was plotted to predict the cutoff values of the fefined ultrasound score for different degrees of ILD.Results:①The sensitivity of the refined ultrasound scoring method in diagnosing ILD was 92.3%, specificity was 92.3%, area under ROC curve(AUC)=0.978, 95% CI=0.941-1.000. The sensitivity of Buda ultrasound scoring method in diagnosing ILD was 87.2%, specificity was 87.2%, AUC=0.950, 95% CI=0.892-1.000. The sensitivity of HRCT scoring method in diagnosing ILD was 97.4%, specificity was 97.4%, AUC=0.999, 95% CI=0.994-1.000. ②The correlations between the refined ultrasound score, the HRCT Warrick score and the Buda ultrasound score were high ( r=0.929, 0.920, 0.862 respectively, P<0.001). ③The values of refined ultrasound scoring method and Buda ultrasound scoring method consistently and significantly increased with the increasing severity of ILD. With regards to the former one, there were significant differences among mild group, moderate group and severe group ( P<0.05). ④The ROC curve confirmed that refined ultrasound score cut-off points for predicting mild and severe interstitial lung diseases, were 34 [sensitivity of 100%, specificity of 87.5% respectively, AUC=0.891, 95% CI=0.686-1.000] and 64.5 [sensitivity of 91.3%, specificity of 87.5% respectively, AUC=0.954, 95% CI=0.877-1.000]. Conclusions:The severity of the interstitial lung diseases could be evaluated by the refined ultrasound scoring method, which is useful in the semi-quantitative evaluation of ILD.