Glucocorticoid is the first choice for the treatment of nephrotic syndrome in children. But due to various reasons, nephrotic syndrome becomes hormone dependent or resistant, and progresses into refractory nephrotic syndrome in some children, which forces the clinician to constantly look for new immunosuppressants in order to alleviate the condition.,Rituximab injection (RTX) as a monoclonal antibody against CD20 has been widely used in the treatment of a variety of immune diseases in recent years. The use of RTX in refractory nephrotic syndrome in children, its main adverse effects and possible mechanisms was reviewed in this article.

Objective To discuss the possibility of prognosing the hydatidiform mole deterioration and metastasis by detecting the expression of matrix metalloproteinase 9(MMP-9)in different type of trophoblastic disease,and analyze the correlative factors of the hydatidiform mole deterioration,so as to improve the criterion of hydatidiform mole prognosis.Methods The expression of MMP-9 in 30 cases of normal human(Iess than 12 weeks)cytotrophoblast cells,32 cases of partial hydatidiform mole,93 cases of complete hydatidiform mole,30 cages of invasive mole and 5 cases of choriocarcinoma were detected by immunohistochemical streptavidin-pemxidase.The factors as the age of onset,uterine size,luteinizing cyst,β-human chorionic gonadotropin hCG of 7 cases of the hydatidiform mole deterioration were analyzed.Results The expression of MMP-9 was detected in all types of trophoblastic cells,with the development of the malignant transformation the stainning Was markedly increased in the invasion of the normal human cytotrophoblast cells(X2=23.49,P＜0.05).Conclusion The difference of MMP-9 expressin gestational trophoblasts is helpful to predict the hydatidiform mole deterioration and metastagis,the hydatidiform mole deterioration correlates with the age of onset,β-hCG,uterine size,luteinizing cyst.

Child ; Cough ; etiology ; therapy ; Female ; Humans ; Mental Disorders ; complications ; Psychotherapy

Background Herpetic stromal keratitis (HSK) is an immunopathologic eye disorder mediated by CD4+ T lymphocytes.Interleukin-9 (IL-9) is a cytokine linked to the process of many immune inflammatory diseases,but whether IL-9 is involved in the immunopathology of HSK remains unclear.Objective This study was to investigate the expression of IL-9 in murine cornea during the development of HSK and its relationship with the degree of HSK.Methods One hundred and eighty clean BALB/c mice were divided into the normal control group (20 mice) and experimental group (160 mice).HSK models were established by scratching on the surface of the cornea followed by inoculation of 1 × 106 plague forming unit(PFU) herpes simplex virus type 1 (HSV-1) KOS strain.Change of ocular surface was examined under the slit lamp biomicroscopy before and I day,3,5,7,8,10,14,21 days after inoculation of HSV-1.The corneas of mice were collected on the time points mentioned above.The relative expression level of IL-9 mRNA in the cornea of mice was detected by real-time PCR.Immunocytochemical localization of IL-9 protein in murine cornea was viewed by a confocal microscope after preparation of the corneal cryostat sections.All experimental manipulations were undertaken in accordance with the institutional guidelines for the care and use of laboratory animals.Results Punctiform,dendriform or geographic defect in corneal epithelium were seen 3 days and healing 6 days after inoculation of HSV-1.However,edema and opacity of the corneal stroma appeared 7 days and peaked 14 days following the inoculation.Real-time PCR assay showed that very little of IL-9 mRNA (A260/A280) was expressed in the cornea in the mice of the control group.But in 1 day,3,5,7,8,10 and 14 days,the relative level of IL-9 mRNA was 6.37±0.45,5.66±0.53,3.93±0.35,3.62±0.34,3.23±0.18,2.57±0.14,2.19±0.20,with a significant difference among the various time points (F=92.764,P=0.000),and IL-9 mRNA in 1 day,3,5,7,8,10 and 14 days after inoculation was significantly higher than before inoculation (P＜0.05);while no markedly difference was found in IL-9 mRNA expression between the 21-day group after inoculation and the normal control group (P =0.340).IL-9 protein was expressed in the epithelial layer,stromal layer and endothelial cell layer of the corneas,with a stronger green fluorescence in the HSK mice,but no expression of IL-9 protein was seen in the control mice.Conclusions HSK model can be successfully created by corneal scratching and inoculation of HSV-1 KOS strain in BALB/c mouse.IL-9 is involved in the pathogenesis and development of HSK mediated by immunoresponse.

Glaucoma is the first leading cause of irreversible blindness globally. China is one of the major developing countries and has the biggest burden of primary angle closure glaucoma (PACG) in the world. As the aged population grows in China, the amount of patients of PACG and"oecludable angle"will be increased consequently. China is facing a number of barriers in the prevention of glaucomatous blindness such as unbalanced alloeation of heahhcare resources, laek of evidence-based guidelines of glaucoma in accor- dance with Chinese situation, and sequential severe over-treatment. In this article, we reviewed the current mode of the prevention of glaucomatous blindness in China from the point of view of evidenee-based medicine and health economics, and provided several sugges- tions in further researehes and clinical works.

To investigate the pathogenic mechanism of interleukin 6(IL-6) in the tubulointerstitial lesions of patients with active lupus nephritis(LN). Methods Uninary IL-6 from 42 active LN cases and the renal tissues sections from 15 of them were examined by performing ELISA and in situ hybridization with IL-6 cDNA probe labelled by digoxingenin respectively. Results In 36/42 (85.7%) of active LN patients, uninary IL-6 content was higher than or equal to 5 pg/mg ,cr, while no one case did in normal controls. Uninary IL-6 content was highly correlated with the uninary ft-m and NAG excretion respectively. In normal tubules and interstitium, IL-6 mRNA was undetectable. For all sections from 15 active cases, IL-6 mRNA was found in tubular and interstitial cells, and the distribution correlated with the extent of tubulointerstitial lesions. Conclusion IL-6 is probably involved in tubulointerstitial lesions of patients with active lupus nephritis.

Objective: To determine the optimal preparation conditions for Huangmai granules. Methods: Using single factor screening method and orthogonal design method, the extraction process and granulation process were optimized. Results:The optimal preparation process was as follows:the medicinal materials in the prescription were extracted 3 times with 8-fold amount of water with 2h for each time. The water extract was combined followed by vacuum concentration, and then dried to obtain dry extract. The powder of dry extract was evenly mixed with dextrin at appropriate amount, and the wet granules were prepared with the 40% ethanol followed by drying and size stabilization to obtain the products. Conclusion:The selected preparation process is scientific, reasonable and sta-ble, and suitable for the industrial production.

Objective:To prepare the placebos of Sicao Tongmai capsules to provide the reference for the placebo preparation in clinical trials of traditional Chinese medicines. Methods: Taking the placebo preparation of Sicao Tongmai capsules as the example, the appearance, color and smell of the placebo were assessed by the scoring method and an electronic nose. Results:The appearance, color and taste of the placebo were in line with those of the drug powder, while there was difference in smell. The simulated clinical ex-periments showed that the placebo was difficult to be unblinded. Conclusion:The placebo can be used in TCM clinical trials, howev-er, the production technology should be further improved and modified.

Objective To explore an assessment questionnaire for assessing caregiving knowledge of primary caregivers in children with nephrotic syndrome. Methods Delphi method was used to review the literature. Ten primary caregivers of children with nephrotic syndrome were interviewed and five medical, nursing experts were pre-surveyed to form an expert consultation questionnaire. Sixteen experts from some provinces were selected to carry out two rounds expert consultation. To screen the dimensions, factors, entries of the questionnaire and to analyze the reliability and validity of the questionnaire. Results The positive coefficient was 100%, the expert authority coefficient was 0.95 and the expert co-ordination coefficient W test was P<0.05 of the two rounds expert consultation. The questionnaire data included 6 dimensions, 26 factors, 106 items. The basic knowledge of disease, diet knowledge, medication knowledge, personal hygiene and infection prevention, activity and rest, home care constitute the dimensions. The Cronbach α coefficient was 0.872, the test-retest reliability was 0.823, the split-half reliability was 0.855, and the average overall validity index of the questionnaire was 0.948. Six common factors were extracted for exploratory factor analysis and the cumulative variance contribution> 65.633%. Conclusions The questionnaire of caregiving knowledge of primary caregivers of children with nephrotic syndrome developed by Delphi method has high reliability. The questionnaire is of practical significance for evaluating the care of primary caregivers of children with nephrotic syndrome.