It mainly discusses the therapy of kidney edema on“Shanghan Lun”,which is caused by nephritis,nephrotic syndrome and renal failure.In addition to the manifestation and therapeutic principle of edema,the implication of some herbs combination is also described in detail.Meanwhile,some viewpionts are strengthened with concepts of modern medicine.In conclusion,Zhang Zhongjing puts importance on the etiology,pathogenesis of disease when treating edema.Therefore,ascending and discending Qi is highlightened as the general principle during the treatment of kidney edema.

One hundred and fifty cases of gouty arthritis were divided into two groups.Treatment group(85 cases) were treated with Tong Feng lotion and control group(65 cases)with external application of Voltaren. Results indicated that Tong Feng lotion could improve clinical symptoms and function of joints, and decrease blood sedimentation,reaction protien C,blood uric acid and blood viscosity; the total effective rate was 89.42% in the treatment group and 75.38% in the control group, with significant difference between the two groups(P<0.05); there was no obvious relation between therapeutic effects and TCM syndrome types.

Cytotoxic T lymphocytes (CTLs) are critical effectors which play important roles both in anti-tumor and anti-virus immune responses.Through T cell receptors(TCRs),CTLs can specifically recognize MHC- Ⅰ -peptides complexes presented on the surface of target cells,and then release biological substances such as perforin and granzymes into the target cells and dissolve them.Since the significant potential value of CTLs,more and more people are focusing on its basic and appliedstudies.Most researches are about the transformation of the TCR gene.With the development of molecular biology,cloning and transduction of TCR gene have been more mature.Researchers are finding ways to ensure that TCR gene expresses efficiently and assemble correctly.

Nursing experiences on 4 children with organic acidemia were summarized. The nursing care focused on correct collection of samples for early diagnosis,prompt opening of an effective intravenous route to manage water,electrolyte,acid-base and metabolic imbalances,special medication nursing,strict diet control to prevent relapse,health education to keep normal growth and development. Three children were followed up for 1 month,7 months and 1 year respectively with disease controlled and a child was withdrawn treatment from.

[Objective] To evaluate the clinical efficiency of refratory edema based on daytime prelonged Online-HDF.[Methods] Six patients include four females and two males whose age ranging from 28 to 74 years old and average 55 years old.Online-HDF treatment for 3-9 times,vascular access was percutaneous femoral or internal jugular catheterization.One patient's temporary access was changed to permanent access because who needed continous hemodialysis.The machine version was Ganbro AK-100S.To filter by u2000 and replace fluid online for 6-10 hous,blood flow was 200-250ml/min,uf 1200-8600,the total fluid used for replacement was 20-42 liter,during the process,regular heparin or low molecular was used for anticoagulation.[Results]Three patients' clinical symptoms resulted from edema resolved,one patient accepted continous hemodialysis treatment for inpaired kidney function,one patient left hospital for expensive medical cost,one patient accepted ventilation treatment for respiratory failure in ICU.[Conclusion]Daytime prelonged Online-HDF is effective on the trentment of refratory edema,especially effective on dyspnea,tachypnea,chest distress that resulted from edema.

Objectives:To investigate the efficacy and toxicity of the full coverage radiation to primary and all metastatic lesions in patients with oligometastatic castration-resistant prostate cancer (CRPC).Methods:Forty-four patients with oligometastatic CRPC was retrospective analyzed from Oct. 2011 to Jun. 2017 at Peking University 1 st Hospital. Before radiotherapy, average age was 72(57-86), the median value of initial PSA was 38.545 (6.640-1 066.000)ng/ml, the median value of PSA nadir after initial androgen deprivation therapy(ADT) was 0.259(0.011-18.762)ng/ml, the time interval between initial ADT to diagnosis of metastatic castration resistant prostate cancer(mCRPC) was 12(4-96) months, and the median PSA value pre-radiotherapy was 3.765(2.040-187.000) ng/ml. There were 23(52.3%)patients with Gleason score 9-10 and 15(34.0%) patients with Gleason score 8. At the time of initial diagnosis, there was 41(93.2%) cases with stage T 3-T 4, 23(52.3%)cases with lymph node metastasis, and 29 (63.9%) case with distant metastasis. The number of metastatic foci before radiotherapy was 1 in 22(50.0%)cases, 2 in 12(27.3%)cases, 3 in 6(13.6%)cases and 4 in 4(9.1%)cases. There were 3 cases of pelvic lymph node metastasis (6.8%), 9 cases of retroperitoneal lymph node metastasis(20.5%), 21 cases of bone metastasis(47.7%), 11 cases of bone metastasis+ lymph node metastasis(25.0%), and no visceral metastasis. Image-guided volumetric modulated arc therapy(IGRT-VMAT) was used to fully cover primary and metastatic foci. The prostate and seminal vesicle were routinely underwent 76Gy/38 fractions, and the bioequivalent dose(BED 3) was 126.67 Gy. For those with pelvic lymph node metastasis, the drainage area of pelvic lymph node was 46Gy/23 fractions. According to the tolerance of different normal tissues around the lesions, the median BED 3 of local radiotherapy dose in the metastatic foci was 112.26(91.14-140.77)Gy. The efficacy and side effects of all these patients were recorded. Kaplan-meier method was used to analyze the overall survival and the new metastasis-free survival. Results:Only 1 patient had grade 3 urinary tract obstruction and underwent indwelling catheter. All the other patients had grade 1-2 toxic and side effects. After a median follow-up of 34.5(9-96) months, the PSA-nadir after radiotherapy was 0.088(0.003-132.000)ng/ml. Forty(90.9%) patients showed a decrease in PSA after radiotherapy, and 34(77.3%) cases. showed a decrease of >80%. The 1, 3, and 5-year overall survival rates were 90.9%, 54.5%, 36.8%, the 1, 3, and 5-year new metastasis free survival rates were 47.7%, 25.0%, 12.9%, respectively.Conclusion:The full coverage radiotherapy to primary and metastatic lesions showed high PSA response rate, the satisfactory survival and tolerable toxicity in oligometastatic CRPC patients.

Objective To investigate the relatio nship between the DNA methylation status of gluco-corticoid receptor (GR) gene promoter and mRNA expression level of GRα gene of peripheral blood mononuclear cells (PBMCs) in patients with systemic lupus erythematosus (SLE). Methods Fifteen new onset SLE patients and fifteen healthy controls were enrolled in this study. The DNA methylation status of GR gene promoter 1 of PBMCs was detected through bisulfite sequencing polymerase chain reaction (PCR). The mRNA expression of GRα, DNA methyltransferases, growth arrest and DNA damage-induced 45α (GADD45α) of PBMCs was detected using the quantitative real-time polymerase chain reaction method. T-test and χ2-test were used to detect the differences between the two groups, Pearson's correlation coefficient was used to analyze the linear correlation between two variables. Results Compared with healthy controls, the mRNA expression of GRα was signi-ficantly declined in SLE patients (10±5, 17±7, t=2.69, P<0.05), and the mRNA expression of DNMT1 and GADD45α was significantly elevated in SLE patients (t=3.11, P<0.05 and t=2.98, P<0.05). The overall mean methylation status of the 142 CpG islands of the four promoters was significantly elevated in SLE patients [(16±8)%vs (11±6)%, t=2.75, P<0.05]. The global methylation status of PBMCs in SLE patients was obviously lower than healthy controls (t=4.39, P<0.05). Conclusion Hypermethylation of GRα promoter may result in GRαgene low expression in PBMCs of patients with SLE.

One hundred and fifty cases of gouty arthritis were divided into two groups.Treatment group(85 cases) were treated with Tong Feng lotion and control group(65 cases) with external application of Voltaren. Results indicated that Tong Feng lotion could improve clinical symptoms and function of joints, and decrease blood sedimentation,reaction protien C,blood uric acid and blood viscosity; the total effective rate was 89.42% in the treatment group and 75.38% in the control group, with significant difference between the two groups(P<0.05); there was no obvious relation between therapeutic effects and TCM syndrome types.

Objective: To develop the mental health knowledge questionnaire in order to know about the awareness of mental health knowledge in non-psychiatric clinicians. Methods: A sample of the 641 non-psychiatric clinicians from 2 tertiary general hospitals, 2 second-class general hospitals, and 1 community hospital were used for item analysis and internal consistency test; 38 cases were selected for the re-test interval of 2 weeks to test the test-retest reliability. And totally 99 psychiatrists finished the survey as controls. The awareness rates between the non-psychiatric and psychliatric clinicians were compared. Results: The questionnaire included 46 items and consis-ted of 6 subscales, involving anxiety, schizophrenia, depression, dyssomnia and psychological counseling, or-ganic brain disorder, and recognition for mental health service situation in general hospital The results of confirma-tory factor analysis showed that the ratio of chi-square and degree of freedom was below 3. The fitting indexes except GFI and AGFI were more than 0.90. The Cronbach's alpha coefficients ranged from 0.73 to 0.89, and test-retest Pearson correlation coefficient of reliabifity ranged from 0.59 to 0.78. Awareness rate was 47.6% in general hospital and 90.9% in psychiatric hospitals. Conclusion: The mental health knowledge questionnaire has good psychometric properties and may be applied in clinical studies.

Objective:To explore the amplitude of normal kidney motion in the 3D direction and its influencing factors under free-breathing condition.Methods:Clinical data of 28 patients with a KPS score≥80 who received 4D CT scan from March 2018 to March 2019 were collected. All patients were diagnosed with liver, pancreatic or lung tumors. The kidney was outlined and the geometric center and 3D coordinate values were recorded. The motion of bilateral kidneys in each direction and the 3D direction was calculated. The volume of kidney and surrounding organs, age, sex, height and body mass index (BMI) were recorded. Clinical data were statistically compared by t-test or nonparametric test. Results:The motion of the left and right kidneys in the the sup-inf (SI) direction were the largest up to (8.39±3.18) mm and (7.71±3.55) mm. The motion amplitudes of bilateral kidneys in male patients were significantly larger than those of the female counterparts in the left-right (LR), SI and 3D directions (all P<0.05). The motion amplitudes of bilateral kidneys in patients taller than 165 cm were significantly larger than those of their counterparts with a height of ≤165 cm (all P<0.05). Patients with a BMI≥25 kg/m 2 had significantly larger motion amplitudes of the left kidney in the LR and ant-post (AP) directions compared with those of normal weight counterparts (all P<0.05). The motion amplitude of the left kidney in the AP direction in patients with the left kidney volume of >180 cm 3 was significantly larger than that of patients with smaller left kidney volume ( P=0.014). Age was not significantly associated with kidney motion in each direction ( P>0.05). Conclusions:Kidney motion mainly occurs in the SI direction. The kidney motion amplitudes in male and taller patients are larger. Special attention should be paid to the use of breath motion control device to decrease the normal tissue damage.