Objective\ To investigate the effect and safety of LMWH on treatment of nephrotic syndrome(NS).Methods\ We randomized 43 patients with primary NS into 2 groups.Steroid and cyclophosphamide were given in control group.LMWH with the dosage of 3200～5000IU twice per day was added in the treated group.Results\ After 4 to 6 weeks of treatment,a significant increase in AT-Ⅲ,anti-Xa activity and serum albumin and decrease in fibrinogen and proteinuria were observed in LMWH.Conclusion\ LMWH should be recommended as a useful treatment of NS.

Objective:To explore the relationship between coronary heart disease (CHD)and silent brain infarction (SBI).Methods:A total of 430 patients who had received coronary angiography were enrolled,including 330 CHD patients and 100 non-CHD patients.According to complicated with SBI or not scanned by cranial MRI,CHD pa-tients were divided into CHD+SBI group (n=208)and CHD without SBI group (pure CHD group,n=122).Levels of high sensitive C reactive protein (hsCRP)and homocysteine (Hcy)were measured,and coronary artery score (CAS)and Gensini score (GS)were calculated in all patients.Results:Incidence rate of complicated SBI in CHD patients was significantly higher than that of non-CHD patients (63% vs.31%,P <0.01);compared with pure CHD group,there were significant rise in age [(60.79±9.65)years vs.(67.14±9.77)years],percentages of hy-pertension (41.0% vs.66.8%),hyperlipidemia (37.7% vs.55.8%)and levels of hsCRP [(3.92±2.17)g/L vs. (5.85±6.27)g/L],Hcy [(9.20±3.20)μmol/L vs.(10.54±4.25)μmol/L],CAS [(0.88±0.88)scores vs. (1.94±0.94)scores]and GS [(18.62±16.23)scores vs.(53.04±39.61)scores],and percentage of left anterior descending artery stenosis (25.4% vs.69.2%)in CHD+SBI group,P <0.01;Logistic regression analysis indicated that risk factors of SBI were age (OR=1.07,95%CI:1.032~1.108),hypertension history (OR=2.195,95%CI:1.104~4.366),Hcy (OR=1.088,95%CI:1.001~1.182),CAS (OR=1.776,95%CI:1.049~3.007)and GS (OR =1.039,95%CI:1.013~ 1.066),P <0.05 or <0.01. Conclusion:Incidence rate of SBI in CHD pa-tients is significantly higher than that of non-CHD patients;the more severe coronary artery disease is,the higher percentage of complicated SBI is.CAS and Gensini score abnormities suggest there may be SBI existence simultaneously.

Objective To observe Effect of baicalin on BV2 cell activation damage caused by rotenone.Methods Rotenone infected BV2 cell viability were detected by MTT assay, and OX42 expression by ICC method assay, the inner cell Ca2 + content by fluorescence spectrophotometry, intracellular iron content by ICP-AES when low concentrations iron of load without damage in cells and extracellular H2 O2 and intracellular content of MDA, NO, NOS with related kits.ResuIts Rotenone exposure BV2 cell reduced cell viability, the expression of cell marker protein OX42 and intracellular Ca2 +content and intracellular iron content were all significantly increased(P<0.05), resulting in oxidative damage to cells.Baicalin reduced OX42 expression of rotenone exposure BV2 cell, increased cells survival, reduced intracellular iron content and H2 O2 release and oxidative damage of BV2(P<0.05).ConcIusion Baicalin inhibits BV2 activation and damage by rotenone-induced, and it has neuroprotective effects.The protection mechanism may relate to reduce iron into cells .

Diabetes Mellitus, Type 1 ; diagnosis ; etiology ; Humans ; Klinefelter Syndrome ; complications ; diagnosis ; Male

Objectives To investigate the incidence of deep vein thrombosis (DVT) of lower limbs and pulmonary embolism (PE) caused by hypercoagubility in patients with nephrotic syndrome and to estimate the indication and clinical effect of anticoagulation therapy. Methods 54 patients with nephrotis syndrome(thirty-one males and twenty-three females with mean age: 44 13?15 88, 24 hours proteinuria:8 43?5 64g, albuminemia: 20 48?5 41g/L) were enrolled in this study.DVT of lower limbs and PE were confirmed by radionuclide imaging (RNV) with 99mTc-MAA and the clinical effect of subcutaneous injection of low molecular weight heparin (LMWH) and oral antiplatelet coagulation therapy were evaluated as well. Results 41 out of 54 cases (76%) had DVT of lower limbs, 14 8% of which had clinical manifestations. 32 out of 54 cases (59 25%) had PE, 7 4% of which had symptoms. 70 7% of PE were caused by DVT of lower limbs. No patient died of PE after the LMWH treatment.Conclusions DVT is one of the most important complications of NS. RNV can be used to make early diagnosis of DVT of lower limbs and PE. Early anticoagulation therapy might ameliorate the prognosis of NS and lower the mortality of PE.

Objective To evaluate the applicability of the simplified equation of MDRD to predict glomerular filtration rate(GFR)from serum creatinine in Chinese patients with chronic kidney disease(CKD),and refit the MDRD equation parameter estimates with Chinese patients data.Methods A total of 760 hospitalized CKD patients were investigated from 2002 to 2005.Patients'sex,age,height and body weight were recorded;plasma creatinine and ~ 99m Tc-GFR(standardized by body surface area)were measured in all patients;GFR was estimated with simplified equation of MDRD and Cockcroft-Gault;the accurancy of estimated GFR with MDRD and CG were compared with~ 99m Tc-GFR in different stage of CKD.Totally 670 patients were randomly selected as the training sample,the remaining 90 patients constituted the validation sample.We used stepwise multiple regression to refit the equation of MDRD and the regression models were developed by using the training sample.The refitting equation was then tested and compared with the other equation in the validation sample.Results (1)Both the MDRD and CG-GFR prediction equations seemd to systematically underestimate GFR,but the accurancy of MDRD equation was better than CG-GFR in stage Ⅰ~Ⅲ of CKD.(2)The bias of estimated GFR(MDRD or CG-GFR equation)with ~ 99m Tc-GFR was lower in stage Ⅰ~Ⅲ than in stage Ⅳ~Ⅴ of CKD.(3)Refitting of the MDRD equation parameter estimates to Chinese patients data set resulted in the following prediction equations:GFR=234.96?(Scr)~ -0.926 ?(Age)~ -0.280 ?0.828(Female).(4)Comparing with~ 99m Tc-GFR,the bias of estimated GFR calculated by the refitting MDRD equation was lower than that of estimated with MDRD or CG especially in the stage Ⅳ~Ⅴ of CKD in Chinese patients.Conclusion the simplified equation of MDRD can estimate GRF accurately,but the equation must be refitted in Chinese patients.

Objective:To amplify and sequence of the variable region genes of anti CD3 McAb.Methods:The V H?V L genes were amplified by RT PCR from total RNA that were extracted from WuT3 hybridoma.Recombinant cloning vector was constructed and sequenced after the enzyme digestion.Results:It showed that V H gene consisted of 363 bp encoding amine acid residues,belongs to mouse heavy chain subgroup IIB;V L gene consisted of 330 bp encoding amine acid residues,belongs to mouse ? light chain subgroup III.Comparing with Kabat database,the V H?V L genes were in agreement with the characterization of DNA sequences present in the mouse Ig V H?V L regions respectively.Conclusion:The success of cloning of the V H?V L genes of WuT3 McAb lay a good foundation for the construction and expression of chimeric antibody.

Objective To evaluate the clinical outcomes of cemented bipolar femoral head arthroplasty in treatment of intertrochanteric fractures in elderly patients combined with heart,lung,brain and other diseases.Methods The study comprised 23 cases,aged 75-86 years old,treated with cemented bipolar artificial femoral head arthroplasty between January 2005 and October 2013 (replacement group).Evans' classification of the fracture was type Ⅰ in 3 cases,type Ⅱ in 9,type Ⅲ a in 5,type Ⅲ b in 2,type Ⅳ in 3 and reverse intertrochanteric fracture in 1.Additionally,23 cases with the similar physical condition treated with anatomical locking plates were chosen as controls.For comparisons between groups,operation time,amount of bleeding,drainage volume,mean time to extract drainage tub,antibiotics dosage,perioperative complications,complications of lying in bed,fracture complications and Harris score were measured.Results There were no significant differences between replacement and control groups with respect to operation time (52.7 minutes vs 52.0 minutes),amount of bleeding (160.9 ml vs 156.5 ml),drainage volume (162.2 ml vs 158.3 ml),Harris score (73.7 points vs 74.2 points),time to extract drainage tub (69.9 hours vs 68.9 hours) (P ＞ 0.05).Both groups had 5 days of preventive antibiotic usage.Better results were observed in replacement group than in control group concerning mean time of ambulation (8.1 days vs 109.3 days),rate of perioperative complications (19％ vs 59％),rate of bed rest complications (0 vs 36％) and rate of internal fixation complications (0 vs 18％) (P ＜ 0.05).Conclusion Cemented bipolar femoral head arthroplasty is effective to prevent the complications of internal fixation,bed rest as well as perioperation and improve the quality of life during the treatment of intertrochanteric fracture in elder patients with heart,lung,brain and other diseases.

Objective To establish a mini-column centrifugation-HPLC method to determine the entrapment efficiency of levodopa-loaded PEGylated-solid lipid nanoparticles.Methods A dextran gel(Sephadex G-50) mini-column centrifugation was employed to separate the free drug from solid lipid nanoparticles.The content of levodopa was qualified by HPLC.Results Under the applied chromatographic condition,the excipients had no influence on the determination of levodopa.A calibrated linear of levodopa concentration was within 10.54-527.00 μg·mL-1.The recoveries of high,medium and low concentrations of levodopa were 99.13%,99.51% and 99.04%(RSD were 1.25%,1.91% and 1.71%), respectively.The free levodopa was well separated from solid lipid nanoparticles by using mini-column centrifugation.The addition of blank solid lipid nanoparticles recovery was 98.84% with RSD of 0.80%(n=3).The average adsorption rates of the three concentrations of free levodopa were 100.00%,98.75% and 98.56%(RSD were 0.00%,0.19% and 0.18%,n=3),respectively.The adsorption rate of the physical mixtures of three different concentrations of drugs and empty PEGylated solid lipid nanoparticles were 99.68%,98.46% and 99.21%(RSD were 1.52%,0.23% and 0.21%),respectively.Conclusion The method was simple,accurate and reproducible,which can be used for determination of the entrapment efficiency of levodopa-loaded PEGylated-solid lipid nanoparticles.

Objective To analyze the distribution and antimicrobial resistance of pathogenic bacteria in urinary tract infection (UTI)so as to provide evidence for appropriate selection of antimicrobial agents in clinical practice. Methods From January 2001 to December 2008 in Shanghai Ruijin Hospital,4683 strains of pathogenic bacteria isolated from urine samples were detected by ATB system;drug susceptibility test was performed with disk diffusion method and pathogenic bacteria distribution and drug resistance was analyzed with WHO NET 5.3 software. Results Among 4683 strains of pathogenic bacteria,most was gramnegative bacilli,accounting for about 77.8%,of which predominant strain was Escherichia coli (68.7%,3217/4683).The predominant strain of gram-positive bacteria was Enterococcus faecalis,accounting for 10.0%(468/4683).Escherichia coli showed hish resistance rotes to ampicillin,piperacillin and compound snlfamethoxazole(SMZ-TMP),which were 76.6%,61.7%and 57.4%respectively,while a low resistance to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,Enterococcus faecalis showed high resistance rates to erythromycin,gentamicin and levofloxacin,which were 65.8%,43.2%and 31.1%respectively,and were most susceptive to vancomycin and teicoplanin, both with resistance rates of 0. The susceptibility rate of Enterobacteriaceae to imipenem was 100%. From 2006 to 2008, the detection rate of extend-spectrum β-lactamases ESBLs -producing Escherichia coil in outpatient increased year by year, from 28.7% to 43.3% (P＜0.05), whereas no significant change was found in inpatients. The detection rate of (ESBLs)-producing Escherichia coil in inpatients was significantly higher than that in outpatients (P＜0.05).The detection rate of ESBLs-producing Escherichia coil was 23.6%. The antimicrobial resistance rate in elderly patients was significantly higher than that in overall antimicrobial resistance rote (P＜0.05). Conclusions The predominant bacteria of UTI are still gram-negative bacteria, main of which is Escherichia col. Bacteria are resistant to a variety of antibiotics. Approximate selection of antibiotics in clinical practice should be made on the basis of susceptibility test results.