When the patients with chronic renal failure need drug therapy,we must select the appropriate drugs and adjust the drug delivery methods and dosage according to the renal function of these patients,at the same time we have to consider the factors such as age,sex,weight,combined medication,damage of other organs and so on,the therapeutic drug concentration monitoring should be paid attention to.For patients with blood purification,if the drug mainly removed by the kidneys,adjustments of drug administration must be based on the molecular weight of drug,volume of distribution,protein binding rate,mode of dialysis and hemodialyzer.We must ensure the drug efficacy and reduce the adverse reactions of drugs at the same time in the patients of renal insufficiency.

To explore the relationship between clinical findings and pathological changes of IgA nephropathy (IgAN), 37 children with IgAN were undertaken clinical classification and renal-pathological comparison including glomerulus change, renal tubule-interstitial change and immunopathology. The results showed that there were 18 (49%) cases with hematuria, 14 (38%) cases with nephrotic syndrome, 3(8%) cases with both of hematuria and proteineuria, and 2 (5%) cases with nephritic syndrome in the clinical classification. 54% of cases with glomerulus changes was as class III. No significant relationship was found between clinical classification and glomerulus changes. There were 24 cases with renal-tubule interstitial changes and 7 cases with hematuria. 43% of them were classified as class I and 57% as class II.All cases with nephrotic syn-drome developed renal tubule-interstitial change. 78% (11 cases) of them were as class II and 22% (3 cases) as class III. Besides, 2 of 3 cases with both of hematuria and proteineuria and 1 of 2 cases with nephritic syndrome also manifested renal tubule-interstitial change. There were four phenotypes were observed in immunopathology including 16 cases of them as IgA, 6 cases as IgAG, 10 cases as IgAM and 5 cases as IgAGM, respectively. 66% of cases with hematuria was found as IgA and 50% of cases with nephrotic syndrome as IgAM. It is concluded that hematuria can be a main clinical finding in both of IgAN and nephrotic syndrome. Glomerulus changes is usually not correlated with clinical classification. There is a significant renal tubule-interstitial change in cases with nephrotic syndrome. Hematuria is usually as IgA and nephrotic syndrome as IgAM in immunopathology.

Systemic Inflammatory Response Syndrome ; virology ; Virus Diseases

Asian Continental Ancestry Group ; China ; Humans ; Sepsis ; Terminology as Topic ; Translations

Anti-Bacterial Agents ; therapeutic use ; Child ; Humans ; Practice Guidelines as Topic ; Sepsis ; classification ; complications ; diagnosis ; drug therapy ; physiopathology

Enterovirus A, Human ; Enterovirus Infections ; pathology ; Female ; Hemorrhage ; etiology ; virology ; Humans ; Infant ; Male ; Pulmonary Edema ; etiology ; virology

Infectious diseases have emerged as one of the leading causes of morbidity and mortality in systemic lupus erythematosus(SLE)patients,so early diagnosis of infectious complication in SLE patients is absolutely beneficial for patients' prognosis.C-reactive protein(CRP)and Procalcitonin(PCT)can help to differentiate infections with active SLE in SLE patients.Serum KL-6 can help to distinguish pulmonary involvement of SLE from infections in SLE patient.The most common pathogens for infection in SLE patients are bacteria,but more attention should be paid to viral and fungal infections,which have been on a rise recently.

Non-myeloablative allogeneic hematopoietic stem cell transplantation has been extensively applied in patients with hematologic malignancies who are ineligible for conventional hematopoietic stem cell transplantation because of age or medical comorbidities. Non-myeloablative regimens lead to an initial state of mixed hematopoietic chimerism which can produce a marked effect of graft versus tumor to treat the diseases. Compared with the conventional hematopoietic stem cell transplantation, non-myeloablative allogeneic hematopoietic stem cell transplantation has a lower transplant-related mortality and incidence rate of graft-versus-host disease. The improvement of non-myeloablative regimens and the prophylaxis of diseases associated with transplantation can improve the therapeutic efficacy. Though many therapies have been introduced and proved to be successful in animal models, we still need to investigate the research trend and the problem on human body.

Objective To observe the efficacy of irbesartan combined with metoprolol in the treatment of chronic congestive heart failure.Methods From April 2015 to April 2016,60 patients with chronic congestive heart failure in Central Hospital of Zhuji were randomly divided into the observation group and the control group,30 cases in each group.The two groups were given conventional treatment,the control group was treated with metoprolol,and the observation group was treated with irbesartan combined with metoprolol.The changes of left ventricular ejection fraction (LVEF),left ventricular end systolic diameter (LVESD),left ventricular end diastolic diameter (LVEDD),heart rate,systolic pressure and diastolic pressure before and after treatment in two groups were observed.And the clinical efficacy of the two groups was compared.Results After treatment,compared with the control group,the heart function index of the observation group changed obviously,LVEF increased (t=5.88,P＜0.01),LVESD and LVEDD significantly decreased (t=7.19,4.11,all P＜0.01).The heart rate of the observation group was significantly slowed down (t=2.72,P＜0.01),systolic blood pressure and diastolic blood pressure were also significantly reduced (t=2.93,3.98,all P＜0.01).The total effective rate of the observation group was 93.3％,which of the control group was 73.3％,the difference was statistically significant (χ2=4.32,P＜0.05).ConclusionIrbesartan combined with metoprolol in the treatment of chronic congestive heart failure has significant clinical efficacy,is conducive to ease the clinical symptoms and improve heart function effectively.