Primary nephrotic syndrome (PNS) is one of the most common forms of glomerular disorder in chil dren.It is reported that over 90％ of patients are due to minimal change disease and most respond to glucocorticoid (GC) therapy.However,76％-93％ cases have relapses and 40％-50％ frequently relapses nephritic syndrome or steroid dependent nephritic syndrome when steroid is tapered.Long-term courses of GC and immunosuppressant will place them at increased risk for severe side effects.Not all patients do respond to therapy.Although most reports on rituximab use in pediatric patients have not recognized significant side effects,the long-term adverse events of rituximab are not known.Thus,controlled long-term studies are required to be done to assess the risk-benefit profile of rituximab in childhood nephrotic syndrome.

The new educational system integrating both medical undergraduate and professional degrees,by integrating the curriculum system rationally,strengthening the clinical practice,innovating the assessment and management mode,establishes and enforces normative resident physician training system to cultivate high-starting point general practitioners led by medical colleges and provide qualified general practitioners,for the purpose of supporting the health reform successfully.

Objective To investigate the levels of aluminum in serum of people who long-term consumed the foods contained aluminum. Methods 1 500 people who like to enjoy the Chinese traditional foods in which aluminum often contained were investigated and the serum were collected for determination of aluminum, the other 1 500 people whose dietary habits were not the same as that of the former were chosen as the control. Results In the people who like to enjoy the Chinese traditional foods, the number of people who burdened a high level of aluminum in serum(572) was much larger than that of the control(40), and the time-effect relationship was found. Conclusion The aluminum contained foods should be controlled and restricted in China to prevent and reduce aluminum intake.

0.05). However,compared with others segments, significantly high per centage of TA-SLN was absorbed in colon(P0.05). With the decrease of Na+ or existence of deoxycholate, T ween 80,SLS or DNP in the perfusion solution, the absorption rate increased rem arkably(P

Objective To construct high expression system for obtaining human ?-defensin 2 (h?D2) in human lung cancer cell line A549. Methods A recombinant retrovirus expression vector pLNCX2-CEA (signal peptide)-h?D2 (mature peptide) was constructed, and then the retrovirus vector was transfected into PT67 cells by DOTAP. After screening and amplification of single clones by G418, the virus was used to infect A549 cells. A549 cells were also screened by G418, and the cell clones resistant to G418 were obtained. Expression of h?D2 was detected by Western blot analysis. Results A recombinant retrovirus expression vector pLNCX2-CEA-h?D2 was constructed successfully. h?D2 with high level of expression was obtained in A549 cells transfected with the expression vector. Conclusion Human lung cancer cell line A549 can be used for high expression of h?D2 with gene engineering technology.

Objective:To better understand the clinical characteristics of children with pneumocystis pneumonia(PCP).Methods:Seven cases of non-human immunodeficiency virus infected children with PCP admitted to pediatric intensive care unit(PICU) at Xi′an Children′s Hospital from January 1, 2019 to December 31, 2019 were enrolled.Clinical findings, laboratory examination results, diagnosis, treatment, and outcome data were retrospectively reviewed.Results:There were seven children enrolled in this study including six boys and one girl.The average age was(6.09±3.80)years.Six patients received a long-term steroid or immunosuppressive therapy, and the average duration of medication was(80±30)days.One patient was eventually diagnosed with immunodeficiency disease despite no history of steroid and immunosuppressive therapy.Fever, cough and progressive dyspnea were the main manifestations.The pulmonary signs were not obvious, however, the chest radiographs showed serious ground glass changes.Laboratory examination showed that white blood cell counts were normal, lymphocyte counts were decreased to varying degrees, while C-reactive protein, calcitonin and lipopolysaccharide increased slightly or normal.Lactate dehydrogenase significantly increased and PaO 2/FiO 2 decreased, respectively.All children combined with different degrees of heart, liver and digestive tract damage.Pneumocystis jirovecii infection was diagnosed by metagenomics next-generation sequencing(mNGS), of which one case was detected by bronchoalveolar lavage fluid, and the remaining six cases were detected by peripheral blood.After entering PICU, mechanical ventilation, intravenous injection of human immunoglobulin, and continuous renal replacement therapy were performed.None of the children used TMP-SMZ for prophylaxis outside the hospital.Among them, one case was diagnosed with PCP before entering PICU and was given TMP-SMZ for 20 days, while the remaining six patients started to receive TMP-SMZ after entering PICU.Finally, one patient was cured, three died and another three cases died after giving up treatment.The average hospitalization days were(11.28±8.78)days, and the average hospitalization costs were (78, 000±24, 000) RMB. Conclusion:Children with non-human immunodeficiency virus infected PCP usually have underlying diseases or immunodeficiency diseases.Due to non-specific manifestations, rapid progression and high mortality, clinicians should pay more attention to it.It is necessary to dynamically observe the respiratory symptoms, perform mNGS as soon as possible, and give TMP-SMZ treatment in time.TMP-SMZ prophylaxis can be given to patients who are highly suspected of PCP but unable to perform pathogenic examinations.

Objective To investigate the effectiveness of oxytoein antagonist atosiban in the alternative rescue therapy of preterm labor.MethodsAlternative toeolysis atosiban was given as rescue therapy to 35 women,who had received ritodrine or magnesium sulphate but failed,due to either progression of labour or intolerable adverse events.Atosiban was administered for up to 48 hours.Efficacy and tolerability were assessed based on the proportion of women who did not deliver and did not need alternative toeolytie therapy at 48 hours and 7 days after therapy initiation.The numbers of maternal adverse events and neonatal morbidity were also assessed.ResultsEfficacy and tolerability at 48 hours and 7 days after atosiban nitiation were 77％(27/35)and 60％(21/35).One woman presented drug-related side effects with mild nausea and omiting.Thirty-four women have delivered and one bigemina(28 weeks)is being followed-up.In 34 women,11 delivered before 28 gestational weeks,17 delivered after 28 gestational weeks,3 delivered after 34 weeks and 3 had term delivery.Pregnancies were rolonged by 4 hours to 14+2 weeks.There were nine neonatal deaths,with gestational ages less than 28 weeks at delivery.Conclusion xytocin antagonist atosiban could be given as alternative rescue therapy if therapy with ritodrine or magnesium sulphate fails in the treatment of preterm labor,and it is safe and effective.

Objective To explore the effect and safety of rituximab (RTX) in children with frequently relapsed nephrotic syndrome.Methods Twelve children (8 male and 4 female) with frequently relapse nephrotic syndrome were treated with RTX.They all showed resistance to various immunosuppressive agents and relapsed when steroid was reduced at 1.5-2.0 mg/kg.All immunosuppressive agents were stopped.Steroid was prescribed at doses of 2 mg/(kg · d),followed by alternate-day dosing (2 mg/kg) after proteinuria was negative for 5 days,and then tapered by 5 mg every 2 weeks until to low dose (＜ 0.5 mg/kg on alternate day) or discontinued.RTX was administered at a dose of 375 mg/m2 once every week for 3 weeks.Results The patients were followed up for 4-19 months [median (7.79 ± 3.00) months].Proteinuria turned negative on 1-14 d after first RTX treatment.Mean steroid dosages were significantly reduced than before treatment [alternate-day dosing (1.83 ± 1.02) mg/kg vs alternate-day dosing (0.34 ± 0.16) mg/kg,t =3.78,P =0.002].Gingival hyperplasia and Cushing appearance were significantly improved and steroid-induced glaucoma disappeared.The height was significantly increased compared with before treatment [(2.21 ± 1.40) cm/year vs (8.27 ±2.10) cm/year].Six cases had no relapse during follow-up.Another 6 cases relapsed in 5.5-19.0 months.All patients showed CD19 + B lymphocytes depletion after RTX treatment.However,CD19 + recovery could be seen in 5.5-12.0 months.Serum immunoglobulin did not significantly change.None of the patients was found with adverse events.Conclusions RTX can significantly reduce the dosage of steroid or even stop medication in children free of immunosuppressive agents,maintain remission for (7.79 ± 3.00) months,significantly improve the adverse reaction induced by steroid and immune-suppression.Thus,for children with frequently relapsed nephritic syndrome/steroid-dependent nephrotic syndrome who show resistance to immunosuppressive therapies,RTX treatment may be considered.

Objective To analyze the monitoring data of iodine deficiency disorders in Jiangxi Province and to provide a basis for adjusting iodized salt concentration.Methods Thirty primary schools were selected in 30 counties and 40 pupils' goiters were examined with B ultrasound in every school.At the same time,salt iodine level was tested at their home.Twelve pupils urinary iodine in selected schools,15 pregnant urinary samples,15 lactating women urinary samples in 3 towns around the schools and water samples in the counties with the schools were collected.Results The goiter rate of children aged 8 to 10 was 1.25％ (15/1 200); the median salt iodine was 30.80 mg/kg and the consumption rate of qualified iodized salt was 96.92％ ; the median urinary iodine level of children,pregnant and lactating women was 308.73,206.95 and 206.75 μg/L,respectively.The proportion of urinary iodine level of children above 300 μg/L was 52.25％(186/356),while the proportion of urinary iodine level of pregnant women below 150 μg/L was 34.81％(157/451).The water iodine median was 4.62 μg/L and the per capita daily salt intake was 13.20 g in Jiangxi Province.Conclusions The status of iodine deficiency in Jiangxi has been significantly improved.According to the monitoring results,it's necessary to adjust salt iodization standards appropriately.