The mechanism of Tongmai Oral Liquid (TOL) for chronic nephritis rat model with Qi-deficiency and blood-stasis syndrome was studied.The model was established by adding Qi-deficiency and blood-stasis syndrome to the chronic nephritis rats. The experimental rats were randomly allocated to 5 groups: Group A (treated with high dosage of TOL), Group B (treated with low dosage of TOL), Group C (treated with Jinshuibao), Group D (model control group) and Group E (normal control group). After 4 weeks of treatment, general health state, biochemical indexes including T lymphocyte subgroup and blood rheology, and pathological damage of kidney tissue were much improved in Group A than Group B and Group C. It is indicated that TOL can improve the renal function and delay the occurrence of glomerular arteriosclerosis in rats by reinforcing Qi, activating blood flow, regulating immune function, lessening the hypercoagulative state and reducing renal damage.

Objective To investigate the clinical features,early diagnosis and individualized treatment of renal hypophosphatemia and osteomalacia induced by adefovir dipivoxil (ADV) in patients with chronic hepatitis B (CHB).Methods Thirty-nine CHB or hepatitis B virus (HBV)-related cirrhosis patients of renal hypophosphatemia and osteomalacia induced by ADV were consecutively collected.The clinical features were analyzed and treatment outcome was followed up.Results The mean age of the 39 patients was 54 (27-71) years old.There were 26 male and 13 female patients,and 19 patients with cirrhosis.The mean ADV treatment duration was 69 (range 18-116) months,and 31 patients were treated for 36-96 months.The mean serum phosphate was 0.68 (0.42-0.79) mmol/L.Twenty-six cases developed renal hypophosphatemic osteomaolacia,of which 14 had bone pain and 19 had abnormally elevated alkaline phosphatase (ALP).Three patients had increased serum creatinine and 24 patients had decreased estimated glomerular filtration rate (eGFR).After individualized treatment,patients gained normal serum phosphate in mean of 2.0 (range 0.5-6.0) months,and had bone pain remission in the mean of 0.8 (range 0.2-1.0) month and bone pain disappeared in the mean of 1.5 (range 0.5-5.0) months.Function indices of liver and kidney were improved gradually,and the bone mineral density examination improved slowly.Conclusions CHB and HBV-related cirrhosis patients treated with longterm ADV could develop renal hypophosphatemia and hypophosphatemic osteomalacia,which is partially reversible.Monitoring serum phosphate,creatinine and cystatin C is necessary during long-term ADV therapy.After confirmed diagnosis,withdrawal or dosage reduction of ADV,and switch to telbivudine or entecavir should be considered.Meanwhile,serum phosphate and HBV DNA level should be monitored.

Objective Toinvestigatethechangesofiron,fatandwatercontentinspleentissuesforacutepancreatitis(AP).Methods Atotal of44patientswithAP(experimentalgroup)and21healthysubjects(controlgroup)wererecruitedinthisstudy.RoutineupperabdominalMR scansandIDEAL-IQsequencescanwereperformed.TheR2?,Water,FatandFFvaluesofspleenwererespectivelymeasuredinthe experimentalgroupandcontrolgroup,andthedataofthetwogroupswereanalyzedstatistically.Results TheR2?value(P=0.011),Water value(P=0.003)andFatvalue(P=0.022)ofspleenintheexperimentalgroupandthecontrolgrouphadsignificantdifferences, whiletheFFvalue(P=0.861)didn’t.TherewerenosignificantdifferencesinR2?,WaterandFatvaluesinthemild,moderateand severeAP (P>0.05).aswellasintheyounggroup (14-44yearsold),themiddle-agedgroup (45-59yearsold)andtheelderly group (≥60yearsold)inAP (P>0.05).Conclusion APcanleadtothechangesofirondeposition,fatandwatercontentinspleen tissue,andIDEAL-IQtechnologycanquantitativelyevaluatethechangeofthem.

Objective To summarize our experience with surgical management of renal neoplasm involving inferoir veno cava.Methods We review the data of 115 patients,including 74 male patients and 41 female patients,with renal neoplasm involving venous system between March 1993 and December 2015.The mean age was 52 years old,ranging 22 to 77 years old.The tumor was found in right side in 77 cases and left side in 38 cases.There were 15 patients (13.0％) with renal vein thrombus,38 (33.1％) with infrahepatic thrombus,29 (25.2％) with low retrohepatic thrombus,20 (17.4％) with high retrohepatic thrombus,and 13 (11.3％) with supradiaphragmatic thrombus.The mean age was 52 years old,ranging 22 to 77 years old.The tumor was found in right side in 77 cases and left side in 38 cases.All patients accepted the radical nephrectomy.Primary outcomes were overall survival (OS),and cancer special survival (CSS) in patients with renal cell carcinoma (RCC) estimated by Kaplan-Meier method.Secondary outcome included operative and oncological features,past-operative complications and hospital mortality.Cox proportional hazard model was used to univariate and multivariate analysis for risk factor impacting on OS of RCC patients.Results Complete resections of renal neoplasm with tumor thrombus were achieved in 113 patients (98.3％),2 patients died intraoperatively due to the dropping of thrombus.Postoperative complication rate was 16.8％.Hospital mortality was 2.6％.Mean follow-up interval was 48 months.OS rates at 5-,and 10-year in RCC patients were 66.5％,and 61.8％,respectively.Metastasis was an independent risk factor affecting on OS (P =0.000).However,the level of thrombus was not an risk factor affecting the prognosis.Conclusions Radical resection of renal tumor and caval thrombus is an effective treatment for prolonging survival in patients with RCC extending into venous system.Retrohepatic caval tumor thrombus below or above the main hepatic vein should be dichotomized and managed respectively with diverse techniques.Metastatic rather than the level of thrombus was a risk factor impacting on RCC patient survival.