Objective To observe the effect of leflunomide and cyclophosphamide combined with prednisone in the treatment of idiopathic membranous nephropathy .Methods 30 patients with idiopathic membranous nephropa-thy were randomly divided into two groups ,15 cases in each group .A group was treated by leflunomide combined with prednisone , B group was treated by cyclophosphamide combined with prednisone , 6 months a course .The clinical effect,24h urine protein quantity,serum albumin levels,blood fat,renal functions and adverse reactions were com-pared.Results 3,6 months after treatment ,the remission rates in A group were 60.00%,73.33%,those in B group were 53.33%,66.67%(χ2 =0.965,0.896,all P>0.05).After treatment,24h urine protein quantity,serum albu-min levels in the two groups [A group:(1.33 ±1.25)g/24h,(38.24 ±4.84)g/L;B group:(1.42 ±1.37)g/24h, (37.12 ±5.43)g/L] were significantly lower than those before treatment [A group:(7.34 ±2.75)g/24h,(20.31 ± 7.33)g/L;B group:(7.22 ±2.84)g/24h,(20.46 ±7.73)g/L] (A group:t=6.232,5.734,all P<0.05;B group:t=5.934,5.267,all P<0.05).After treatment,total cholesterol,triglyceride in the two groups [A group:(6.74 ± 1.45)mmol/L,(2.43 ±0.75)mmol/L;B group:(6.63 ±1.45)mmol/L,(2.14 ±0.63)mmol/L] were significantly lower than those before treatment [A group:(11.94 ±2.98) mmol/L,(3.56 ±1.35) mmol/L;B group:(11.53 ± 2.84)mmol/L,(3.24 ±1.46)mmol/L] (A group:t=6.246,5.234,all P<0.05;B group:t=5.256,5.672,all P<0.05).There were no significant differences in urea nitrogen ,serum creatinine between before and after treatment in the two groups(all P>0.05).There were no significant differences in above indicators between A group and B group after treatment (all P>0.05).The incidence rate of adverse reactions in A group (13.33%) was significantly lower than that in B group(40.00%)(χ2 =4.246,P<0.05).Conclusion The clinical efficacy of leflunomide is similar to cyclophosphamide in treating idiopathic membranous nephropathy with fewer adverse reactions .

According to the structure-activity relationships (SARs) of modafinil, a therapeutic drug of hypnolepsy, we designed and synthesized two series of compounds 2-[(diphenylmethane)sulfinyl] acetamides and 2-[(diphenylmethyl)thio] acetamides, and measured their biological activities. The target compounds (6a-6o) were synthesized beginning with diphenyl carbinol by substitution, oxidation, acylation and so on. Their structures were confirmed by ESI-MS, 1H NMR and elemental analysis. The central stimulatory effects of the target compounds were determined by the independent activity assay on mice. Compounds 6c, 6f and 6n have considerable activities, while the central stimulative effect of 6h is slightly better than the positive control modafinil.

Objective To observe and compare the antiemetic effectiveness and adverse effects of magnetotherapy plus the 5 -hydroxytryptamine (5-HT3 ) receptor inhibitor granisetron hydrochloride with that of granisetron hydrochloride alone with chemotherapy patients. Methods Sixty-four patients were randomized to receive either granisetron hydrochloride alone ( control group: granisetron hydrochloride 3 mg intravenous infusion before chemotherapy, from the 1st day of chemotherapy until the day after the chemotherapy course was completed) or magnetotherapy plus granisetron hydrochloride ( treatment group: the same granisetron hydrochloride regimen plus rotatory magnetotherapy of 1 h/time every day after chemotherapy). The baseline characteristics of the two groups were similar. The patients' emesia was evaluated according to the WHO's criteria. The density of 5-HT, in serum was detected by enzyme-linked immunosorbent assay ( ELISA). Results In terms of acute vomiting, there was no significant difference between the two groups, but in terms of tardive vomiting, the effectiveness in the treatment group was significantly better than in the control group. The densities of S-HT, in serum in the treatment and the control group were (225.32±57.29 ) ng/ml vs (213.00±53.29 ) ng/ml before chemotherapy and (273.88±5.42) ng/ml vs ( 313.17±76.36 ) ng/ml after chemotherapy, a significant difference. The rates of adverse events were 36.36% and 48.39% respectively in the treatment group and control group, a difference which was not significant. Conclusions Magnetotherapy plus granisetron hydrochloride is more effective than granisetron hydrochloride alone, and the two therapies have a synergistic effect. Adverse events didn't rise in the treatment group.

As society develops,it has become one of the important goals of higher medical personnel training to cultivate medical students' information literacy.After explaining the definition of information literacy,this paper discussed the importance of information analysis and evaluation in information literacy education.

Endoscopy ; Foreign Bodies ; surgery ; Humans ; Maxillary Sinus ; surgery ; Orbit ; surgery

Objective To investigate the significance of neutrophil gelatinase associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in the patients of primary nephmpathy syndrome (PNS) complicated with acute kidney injury (AKI) by detecting urinary level of NGAL and KIM-1.Methods Senventy-two patients of PNS were selected as our subjects including 34 case with minimal change disease (MCD),23 cases with membranous nephropathy(MN),15 cases with mesangial proliferative glomerulonephritis (MsPGN).Fifteen cases of healthy physical examination were selected as control group.Meanwhile subjects were also divided into PNS with ATN group (15 cases) and PNS without ATN group (57 cases) according to their pathology check.ELISA was applied to detect the urinary level of NGAL and KIM-1,whose correlation with pathological type and clinical index were analyzed.Results The urinary level of NGAL and KIM-1 in patients with PNS were (42.37 ± 28.24) μg/L,(2.76 ± 1.11) μg/L respectively,higher than that of control group (P ＜0.01).The urinary level of NGAL in the MCD group,MN group,MsPGN group were higher than that of control group (46.81 ± 15.75) μg/L,(22.09 ± 7.69) μg/L,(15.31 ± 3.74) μg/L,(8.03 ± 0.35) μg/L respectively,P ＜ 0.05).The urinary level of NGAL in MCD group was significantly highest than that in the other groups (P ＜ 0.05).The urinary level of KIM-1 in the MCD group,MN group,MsPGN group were higher than that of control group(2.41 ±0.58) μg/L,(2.54 ±0.67) μg/L,(2.87 ±0.50) μg/L,(0.73 ±0.35) μg/L respectively,P ＜0.05).But there was no significant difference among MCD,MN,MsPGN groups(P ＞ 0.05).The urinary level of NGAL and KIM-1 in patients PNS were (42.37 ± 28.34) μg/L and (2.76 ± 1.11) μg/L,significantly higher than that of control group (t =4.668,12.665,P ＜ 0.05).The urinary level of NGAL and KIM-1 in patients PNS with ATN were significantly higher than patient without ATN (NGAL:(74.98 ±9.52) μg/L vs.(31.31 ±2.34) μg/L;KIM-1:(3.60 ±0.92) μg/L vs.(2.54 ±0.81) μg/L,P ＜0.05).The correlation analysis showed that the urinary level of NGAL and KIM-1 was positively correlated with serum β2-MG,serum creatinine,serum blood urea nitrogen and 24-hour urine protein.(r =0.432,0.299,0.234,0.254,0.434,0.650,0.276,0.301 respectively,P ＜ 0.05).Conclusion The urinary level of NGAL and KIM-1 could be considered as the early,non-invasive biologic factors to reflect in patients of PNS with ATN.

Objective To observe the influence of trunk control training on motor function and the ability of cerebral palsy (CP) patients in the activities of daily living (ADL).Methods Forty patients with CP were randomly divided into a treatment group (n =20) and a control group (n =20).Both groups were treated with routine rehabilitation,while the treatment group also received trunk control training.All patients were assessed with function ambulation category (FAC) classification,time to walk 10 m,the Berg balance scale (BBS),and the modified Barthel index (MBI) at the beginning and eight weeks later.Results Before the intervention there was no significant difference between the two groups in terms of any of the assessments.Eight weeks later,all the assessment scores were significantly better in the treatment group than in the control group.Conclusion Trunk control training can significantly improve motor function and the ADL ability of patients with CP.

Objective To observe the hemodynamic change and stress reaction of target-con-trolled infusion (TCI)of propofol guided by Narcotrend for anesthetic induction in renal transplanta-tion patients.Methods Forty patients (25 males,1 5 females,aged 21-38 years,ASA grade Ⅲ orⅣ)undergoing related living donor kidney transplantation were randomly divided into two groups:group A and group B (n =20).Group A was induced using TCI system with propofol under the moni-toring of Narcotrend.Group B was induced with propofol manually.HR,MAP,Narcotrend index (NTI),blood glucose (Glu)and plasma cortisol (Cor)were measured before induction (T0 ),before tracheal intubation (T1 ),and 1 (T2 ),3 (T3 ),and 5 (T4 )minutes afterwards.Results HR and MAP at T1 were lower than those at T0 (P < 0.05 )in two groups,they were significantly lower in group B than in group A at corresponding points(P <0.05).HR and MAP in group B increased sig-nificantly (P <0.05)and were significantly higher than those in group A (P <0.05)at T2 and T3 . There was no obvious difference in Glu and Cor between T0 and T2-T4 in group A.Glu and Cor at T2-T4 were obviously higher than those at T0 (P <0.05)in group B and those at corresponding points in group A (P <0.05).Conclusion TCI of propofol guided by Narcotrend in renal transplantation pa-tients can better control the depth of anesthesia,attenuate the stress reaction caused by tracheal intu-bation,and keep hemodynamic smooth during anesthesia induction.

To search for fluoroquinolones(FQs)with antitumor activity;the C-3 carboxylic acid group of peflox-acin (1)was replaced by fused heterocyclic core;and twelve novel thiazolo[3;2-b][1;2;4]triazole heterocycles(6a-6l)were designed and synthesized.The structures of target compounds were characterized by elemental anal-ysis and spectral data.The results of the in vitro antiproliferative effect on SMMC-7721;L1210 and HL60 cell lines showed that the title compounds exhibited more significant antitumor activity than both of the pefloxacin and the corresponding opening-ring intermediates(5 a-5 l).Among them;the target compounds which possess a ben-zene ring bearing a hydroxyl group (6e)or a fluorine atom (6j)exhibited more potent antiproliferative effect on SMMC-7721 cells than other compounds.Therefore;the antitumor fluoroquinolones can be designed by replacing the C-3 carboxylic acid group of fluoroquinolones with the thiazolo[3;2-b][1;2;4]triazole moiety.

To discover novel antitumor rhodanine unsaturated ketones, a series of fluoroquinolone (rhodanine α, β-unsaturated ketone) amine derivatives (5a-5r) were designed and synthesized with fluoroquinolone amide scaffold as a carrier. The structures of eighteen title compounds were characterized by elemental analysis, 1H NMR and MS. The in vitro anti-proliferative activity against Hep-3B, Capan-1 and HL60 cells was evaluated by MTT assay. The results showed that the title compounds not only had more significant anti-proliferative activity against three tested cancer cell lines than that of the parent ciprofloxacin 1, but also exhibited the highest activity against Capan-1 cells. The SAR revealed that some compounds carrying aromatic heterocyclic rings or phenyl attached to an electron-withdrawing carboxyl or sulfonamide substituent were comparable to or better than comparison doxorubicin against Capan-1 cells. As such, it suggests that fluoroquinolone (rhodanine α, β-unsaturated ketone) amines are promising leads for the development of novel antitumor fluoroquinolones or rhodanine analogues.