The pathogenesis of children's primary nephrotic syndrome has not been completely clear at present.In the past few years,The polymorphism of these genes,such as angiotensin-converting enzyme gene,apolipoprotein E gene,platelet-activating factor acetylhydrolase gene,human histocompatibility leukocyte antigen gene,glucocorticoid receptor gene and cytokine gene,ect have been discovered that were significantly correlated with susceptibility,pathological progress,steroid response,disease recurrence and prognosis of primary nephrotic syndrome.This article reviewed the research progress of PNS and gene polymorphism.

Pulmonary arterial hypertension is the result of a variety of heart,lung disease and finally leads to right heart failure and death.Pulmonary arterial hypertension is characterized by the progressive increasing of artery pressure and the gradually increasing of pulmonary vascular resistance,and its pathogenesis has not been fully elucidated.Recent studies have found that transforming growth factor beta/bone morphogenetic protein pathway plays an important role in pulmonary arterial hypertension.The research about transforming growth factor betal bone morphagenetic protein pathway provides a new theoretical basis for the prevention and treatment of pulmonary arterial hypertension.This review focuses on progress of transforming growth factor beta/bone morphogenetic protein pathway and genetic mechanisms of pulmonary arterial hypertension.

Objective To investigate the clinical risk factors of diabetic ketoacidosis (DKA ) combined with elevated serum amylase(AMS). Methods Totally 263 patients with DKA were enrolled in our study. They were divided into 2 groups according to the level of AMS:DKA with normal AMS (DKA,n=188);DKA with elevated AMS(HAMS,n = 75 ). HAMS patients then were divided into two subgroups according to the diagnosis with acute pancreatitis(AP)(HAMS+ AP,n = 25 )and without AP (HAMS,n = 50 ). TG,FPG and AMS were measured and analyzed with univariate analysis and multivariate analysis. Results HAMS group patients had a ratio of 28.5％ with elevated AMS and 9.5％ with AP.HAMS group had higher FPG,TG,HbA1 c,Na+ ,osmolality,BUN and Scr than DKA group(P <0.05).The levels of FPG,TG,osmolality,BUN and the time of CO2 CP recovery in HAMS+AP subgroup were all significantly higher than those in HAMS patients without AP (P < 0.05 ). Correlation analysis showed that HAMS was positively correlated with TG,FPG,Na+ ,Osmolality and BUN(P <0.05).Logistic regression analysis showed that hypertriglyceridemia was the independent risk factor of DKA combined with HAMS(OR 1.244,P <0.01),and was the independent risk factor of DKA combined with AP(OR 1.211,P <0.05). Conclusion Hypertriglyceridemia is the related risk factor of DKA combined with HAMS and AP. This study provides a theoretical basis to early screen patients with hyperamylasemia in DKA.

Allogeneic peripheral blood stem cells transplantation is the most effective method for maligant hematological disease. The author reviewed the indication of acceptance of HLA mismatch kinds and the prediction of the results by selecting the measures such as pretreatment,mobilization,stem cells disposal,immunity reconstruction,graft failure management in order to improve the engraft rate.

Ninty-four newly diagnosed young type 2 diabetic patients were treated by acarbose, metformin or glipizide for 36 weeks. The results showed that these drugs had similar effects in reducing blood glucose. Acabose decreased postprandial insulin secretion and had higher safety and better compliance. It was appropriate to use in newly diagnosed young type 2 diabetic patients.

Objective To investigate the relation of DNA content and SPF to the clinicopathological characteristic in lung cancer.Methods Fresh specimens taken from 56 patients with lung cancer and 36 patients with non-malignant pulmonary lesions were measured for DNA index(DI),S-phase fraction(SPF) by using FACSCalibur 4200 flow cytometry.Results ① DNA index(DI) of lung cancer was 1.18?0.33,0.99?0.07 in lung cancer and non-malignant groups,respectively.The percentage of heteroploid was 78.6% in lung cancer,(5.6%) in non-malignant.DI and the positive rate of heteroploid were significantly higher in lung cancer groups than that in non-malignant group(P0.05);③ It was demonstrated that SPF was significant higher in lung cancer groups than that in non-malignant group. The SPF of heteroploid tumors was higher than that of diploid tumors(P

Platelet-activating factor (PAF), an endogenous bioactive lipid generated by phospholipase A2 and other pathways, displays a variety of biological activities in the nervous system. It has been suggested that PAF plays important roles in neuronal physiological functions including acting as a retrograde messenger to enhance synapse plasticity and memory formation, via activation of its specific membrane receptors.Therefore,the drugs that mimic the action of PAF or modulate the production and inactivation of PAF maybe promising in memory-enhancing. However, under certain pathological conditions, such as Alzheimer's disease, HIV-associated dementia or post-ischemic neuronal death, acting as a potent inflammatory mediator and neurotoxin, PAF has been implicated in the pathophysiology of brain injury. So, modulating the metabolism and effects of PAF (e.g., blocking the PAF receptor) may become important strategies of intervention of Alzheimer's disease, HIV-associated dementia or post-ischemic neuronal death.

Objective Quantitative evaluation was conducted to assess the development level and trend,as well as discipline distribution of basic medical research in China,based on SCI publications.Methods Descriptive analysis and trend analysis by 5-year moving time window were applied to analyze the quantity,quality,discipline distribution and current status and trend of development of medical research papers published by Chinese scientists during 2004 and 2013;Results Among a total of 280,200 medical research papers published from 2004 to 2013 period,China ranked # 5 in the world in terms of the quantity of papers.However,the average citation of 8.34 for Chinese paper was far below the global average of 14.11.Among all papers published by Chinese scientists,the percentages of papers in the field of psychiatry/psychology,neuroscience/behavior,immunology and clinical medicine were 2.20％,7.59％,3.93％ and 40.67％,respectively,lower than those of global average (6.71％,9.41％,4.62％ and 47.45％).The percentages of papers in other disciplines were higher for China than for global average.Regarding to the development trend,the annual increase in the number of publications of 5 years was 22.24 ％,while the 5-year citation per paper was only 2.03 ％.Conclusions The quantity of basic medical research in China is large and growing rapidly,while the quality of these researches remains in relatively lower level,and need to be improved substantially.With the discipline distribution different from the global average,psychiatry/psychology,neuroscience/behavior,immunology and clinical medicine should be strengthened in the future.

Objective To explore the influencing factors of hypotension in hemodialysis patients with end stage of diabetic nephropathy.Methods 106 patients of advanced diabetic nephropathy who received maintenance hemodialysis were selected in the present study.According to the patients'condition needs, chose different dialysis modes,dialyzers, dialysis blood flow and ultrafiltration rate, compared the frequency of occurrence of hypotension during treatment.Results By multivariate regression analysis,gender,dialysis mode,dialysis and blood flow had no correlation with hypotension during dialysis.The age, hemoglobin, serum albumin, cardiac function and individual ultrafiltration rate were correlated with the incidence of hypotension in patients with diabetic nephropathy.Individual-ized ultrafiltration rate was less than or equal to 10 mL · kg-1 · min-1 and individual ultrafiltration rate was up to 10 mL· kg-1 · min-1 ,the incidence rates of hypotension were 18.9% and 25.9%,the difference was statistically significant (χ2 =7.102,P<0.05).Conclusion Diabetic nephropathy patients during dialysis,ultrafiltration rate control individuals can effectively reduce the frequency of occurrence of hypotension during dialysis, hemodialysis patients may improve tolerability.

Objective To investigate the incidence of postoperation constipation in patients who experienced thoracolumbar fractures screw fixation surgery.Methods A prospective cohort study was performed by investigating 99 cases who experienced thoracolumbar fractures screw fixation surgery.The patients were followed up for 1 month.The postoperative constipation relief situation was observed.Kaplan-Meier method was used to draw a plot of survival,Cox proportional hazards regression model analysis was adopted for single factor and multiple factors analysis and the prediction model of constipation relief after surgery was established.Results The trend of postoperative constipation relief of patients showed a trend of first increased and then decreased,the number of cases reached high peak on the second week,the constipation relief median time was (14.00±0.76) days.Cox multiple factors regression analysis showed that prediction function model of postoperative constipation relief was h(t)=[h0(t)]e(-0.826X1+0.353X2+0.381X3-1.404X4).Conclusions There was a high incidence of constipation in patients with thora-columbar fractures after surgery and it is difficult to relieve,clinical nurses should pay more attention to the influencing factors of postoperative constipation relief and help patients reestablish normal bowel movement as soon as possible.