Steroid-resistant nephrotic syndrome (SRNS) is a relatively difficult clinical type of treatment.The major therapy measures in present include steroid and immunosuppressant.Commonly used immunosuppressant include tacrolimus,cyclosporin,cyclophosphamide,mycophenolate mofetil,ect.Tacrolimus-induced clinical remission rate is superior to other immunosuppressive agents,has been the first-line agent of SRNS.Because of the individual difference in metabolism,the drug concentration of tacrolimus should be determined periodically.In order to obtain optimal efficacy of tacrolimus and reduce renal toxicity,the treatment protocols of small doses with long courses for children with SRNS were recommended.

BACKGROUND: Nitric oxide in the central nervous system is involved in controlling the sympathetic outflow. The authors' recent data show that the reduction of nitric oxide in the rostral ventrolateral medulla (RVLM)enhanced the cardiac sympathetic afferent reflex (CSAR) evoked by stimulating the cardiac sympathetic afferent nerves in rats with chronic heart failure (CHF).OBJECTIVE: To further investigate the effect of nitric oxide in the RVLM on modulating the CSAR evoked by epicardial chemical stimulation in rats with CHF.DESIGN: Randomized controlled experiment.SETTING: Department of Physiology, Nanjing Medical University, and Department of Cellular and Integrative Physiology, University of Nebraska College of Medicine.MATERIALS: This study was carried out in the Department of Physiology, Nanjing Medical University from July 2003 to May 2004. A total of 52male Sprague-Dawley rats weighing 360-420 g were used, and were randomly divided into chronic heart failure group and control group with 23 in each group.METHODS: The rats were carried out either sham surgery or the left coronary artery ligation. Six to eight weeks later, all rats were anesthetized with α-chloralose and urethane and baroreceptor denervated and vagotomized. The CSAR was evoked by epicardial application of bradykinin (BK, 0.04 μg and 0.4 μg in 2.0 μL) to mimic the effect of chemical stimulation on the heart in the CHF state. The renal sympathetic nerve activity (RSNA), mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline and during elicitation of the CSAR. Cannulae were inserted into the RVLM for microinjections.croinjection of MeTC, a nitric oxide synthase inhibitor, into the RVLM on Effects of epicardial pretreatment with lidocaine on the CSAR in CHF rats.infarction of (30.6±2.0) % of the left ventricular (LV) surface. The systolic arterial pressure, pulse pressure, left ventricle peak systolic pressure and maximum of the first differentiation of left ventricular pressure were decreased and the left ventricular end-diastolic pressure was significantly ininto the RVLM had no significant effects on the CSAR in rats with CHF,of SNAP (50 nmol) into the RVLM inhibited the CSAR in both sham rats ventricle abolished the CSAR evoked by epicardial application ofBK on the same area.CONCLUSION: Nitric oxide in the RVLM inhibits the CSAR evoked by epicardial application of BK in normal rats and CHF rats, and the reduction of nitric oxide in the RVLM led to the augmentation of the CSAR in CHF rats.

This paper was aimed to discuss the feasibility and attentions of application of instrumental variable (IV) methods in traditional Chinese medicine (TCM) outcome research. First, the application of IV was introduced, which included the basic principles and hypothesis, statistical model, estimator of IV and weak IV. Then, an example was given to illustrate the evaluation criteria and attentions of IV. The resultsshowed that IV method was proposed as a potential approach to the problems of confounding in statistics. But using IV methods should be based on a series of statistical hypotheses. It was concluded that the IV analysis was a method controlling confounding bias, but generally it was not chosen as the preferred analytical method. The issue of searching for valid and plausible IV seemed to be the biggest obstacle in the outcome of TCM researches.

Aim To evaluate the effects of aspirin on the expression of inflammatory proteins induced by oxidized low-density lipoprotein(ox-LDL) in human vascular endothelial cells (HUVECs). Methods HUVECs were stimulated with different concentrations of ox-LDL. The expression of inflammatory proteins was detected by Western blot.Intracellular ROS generation was measured by flow cytometry using perexide-sensitive flurscent probe 2′, 7′-dichrofluorescein diacetate(DCFH-DA).Results ① Aspirin inhibited COX-2 expression induced by ox-LDL. Cells were preincubated with 2.5 mmol?L-1, 5 mmol?L-1 of aspirin or without any treatment for 30 min and then stimulated by 0.3 g?L-1 ox-LDL for 16 h, COX-2 expression was reduced by treating of aspirin.COX-2 expression was enhanced after the stimulation with ox-LDL, and aspirin inhibited the increasing.② Aspirin suppressed ICAM-1 expression induced by ox-LDL in HUVECs. ICAM-1 expression was increased by ox-LDL stimulation for 16 h, and aspirin significantly down-regulated the expression. Similar results were obtained by immunofluorescence.③ Aspirin partially reduced ROS production induced by ox-LDL in HUVECs. After stimulation with 0.3 g?L-1 ox-LDL for 16 h, the intracellular level of ROS was increased, however, aspirin failed to fully inhibit the phenomenon.Conclusion Nonsteroidal anti-inflammatory drugs (NSAID) aspirin significantly down-regulated the expression of COX-2 and ICAM-1 induced by ox-LDL.The results suggested that aspirin could reduce the inflammation responses mediated by ox-LDL on HUVECs in atherosclerosis.

Objective To study the chemical constituents of Evodia lepta.Methods The chemical constituents were isolated by chromatographic methods and their structures were elucidated by physicochemical characteristics and spectral data.Results Two compounds were isolated and their structures were identified as erythro-3-(1',2',3'-trihydroxy) isopentyl-7-hydroxycoumarin(Ⅰ) and?-daucosterol (Ⅱ).Conclusion CompoundⅠis a new one named evodosin A while compoundⅡis isolated from E. lepta for the first time.

Objective To study the constituents in Melicope pteleifolia. Methods Plant material was isolated with 80% EtOH. Compounds were separated with chromatographic methods and their structures were elucidated on the basis of spectral analysis (EI-MS, 1H-NMR, and 13C-NMR) and chemical evidence. Results Five compounds were isolated from petrol ether or ethyl acetate soluble fraction. Their structures were identified as 3,5,3'-trihydroxy-4'-methoxy-7-(3-methylbut-2-enyloxy) flavone (pteleifolosin C, 1), 3,7-dimethoxyl kaempferol (kamatakenin, 2), vanillic acid (3), tricosanoic acid tetradecyl ester (4), and p-sitosterol (5), respectively. Conclusion Compound 1 is a new structure named pteleifolosin C. Compounds 2-4 are isolated from this plant for the first time.

BACKGROUND:In oral warm and moisture circumstance, al oy which contains Be is easily to be eroded to release Be2+. But there is stil no research focusing on beryl ium influence on genotype of Porphyromonas gingivalis fimbriae gene cluster. OBJECTIVE:To investigate Be 2+effect on genotype of Porphyromonas gingivalis fimbriae gene cluster. METHODS:The revived Porphyromonas gingivalis was resuscitated for 48 hours in the anaerobic culture medium with different concentration of Be 2+(10×10-6, 5×10-6, 1.25×10-6). Through PCR amplification and sequencing, we investigated the effects of Be2+RESULTS AND CONCLUSION:(1) When Be on genotypes of Porphyromonas gingivalis fimbriae gene cluster. 2+concentration was 5×10-6, we found the peak of 217 and 257 sites on DNA sequence expressing G/A overlap peak, different from G single peak of the other groups, suggesting the suspicious bases changes, part of the single base G mutated into A. (2) On al concentrations, we found a base group composed of seven A bases was inserted into the 101 site of DNA sequence. Up to now, there is no direct contacts of the mutations occurring to Be2+concentration. Changes of gene may lead to the shifting of the reading frame, the abnormal synthesis of proteins, the change of Porphyromonas gingivalis fimA gene toxicity, and lastly the unbalance of the micro-ecological environment.

Objective To study the factors which influence the dose distribution of brachytherapy in cervical cancer. Methods Ninety-five patients with cervical cancer Ⅱ - Ⅲ b received fundamental radiation therapy including brachytherapy in our department from Aug. 2004 to Nov. 2005. The deviation of isodose curve of brachytherapy was based on A-B reference system, and the deviation of dose was defined by measuring in a practical standard body model. Results The factors influencing isodose offset significantly were parametrial infiltrating degree, and anatomy factor of cervical cancer and operating skill. The degree of isodose offset could not be lowered with the increased frequency of brachytherapy. Conclusion Making simulation in cervical brachythecapy is necessary not only for the identification of the deviation of isodose curve but also for adjusting the dose distribution and revising the plan of radiotherapy.

OBJECTIVETo understand the changing trend on the way of delivery since 1970s and its related factors that influencing the attitude of choice on Cesarean section (C-section) in women at child-bearing age.

METHODSA face-to-face interview was conducted anonymously in pregnant and lying-in women visited at the out-patient department of Gynecology and Obstetrics, Tiantan Hospital of Beijing. Totally, 415 women at child-bearing age, with a history of previous birth were interviewed on date, place and way of delivery of last birth, as well as on information that could have had impact on the choice of C-section.

RESULTSThe average rate of C-section in Tiantan Hospital had been 29% since the year of 2000, much higher than that during 1970s, 1980s and 1990s (chi(2) = 22.81, P = 0.001) which showed an increasing trend. Rate of C-section among lying-in women with native Beijing origin was 25.0%, significantly higher than 9.6% (chi(2) = 21.96, P = 0.000 002) that in the migrants. Lying-in women with education level of high school or above had higher chance to choose C-section than those with lower level of education (chi(2) = 43.64, P < 0.000 01). Workers, managerial staff or clerks had more chance to choose C-section than those with other occupations (chi(2) = 20.07, P = 0.01). As reported by the interviewees, 93% (70/75) of C-section in the hospital were performed and recommended by obstetricians.

CONCLUSIONRate of C-section in the hospital showed an increasing trend which suggested that intervention with health education be carried out for both pregnant women and obstetricians.

Adult ; Cesarean Section ; statistics & numerical data ; China ; epidemiology ; Delivery, Obstetric ; statistics & numerical data ; Female ; Humans ; Pregnancy ; Surveys and Questionnaires

OBJECTIVEThis study aims to evaluate the quality of life (QOL) of patients who underwent resection of oral cancer and reconstruction by free anierolateral thigh perforator flaps (ALTF).

METHODSA total of 32 patients with oral and maxillofacial malignancies who had undergone the resection of oral cancer and reconstruction by ALTF were retrospectively analyzed. At 12 months postoperatively, the QOL of these patients was assessed by using the 14-item oral health impact profile (OHIP-14) and the medical outcome study short form-36 (SF-36) questionnaires.

RESULTSA total of 32 questionnaires were collected. In SF-36, the highest scoring domains were bodily pain (78.58 ± 14.82), physical functioning (72.08 ± 27.86), and the role of physical (60.00 ± 42.63), whereas the lowest scoring domains were role-emotional (41.67 ± 39.62), followed by mental health (50.75 ± 13.07) and health transition (54.17 ± 21.75). In OHIP-14, the lowest scoring domains were social disability (34.50 ± 11.32) and handicap (36.04 ± 12.05), indicating the functional recovery was better; and the highest scoring domains were physical pain (73.50 ± 18.96) and psychological discomfort (60.17 ± 20.66), indicating the functional recovery was worse.

CONCLUSIONThe ALTF is an ideal selection for the reconstruction of oral defects after cancer resection. In using this flap, the basic social need of patients after surgery can be satisfied. Moreover, the appearance and the functions of chewing, deglutition, and speech can be restored in varying degrees. Thus, ALTF can improve the patients' QOL.

Emotions ; Free Tissue Flaps ; Humans ; Mastication ; Mouth Neoplasms ; physiopathology ; psychology ; surgery ; Pain ; Perforator Flap ; Postoperative Period ; Quality of Life ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surveys and Questionnaires ; Thigh